Browse publications by year: 2015

  1. Tan HM, Low WY, Tong SF, Hanif J, Appannah G, Lee VKM, et al.
    MyJurnal
    The Aging Male Symptoms Scale (AMS) measures health-related quality of life in aging men. The objective of this paper is to describe the translation and validation of the AMS into Bahasa Melayu (BM). The original English version of the AMS was translated into BM by 2 translators to produce BM1 and BM2, and subsequently harmonized to produce BM3. Two other independent translators, blinded to the English version, back-translated BM3 to yield E2 and E3. All versions (BM1, BM2, BM3, E2, E3) were compared with the English version. The BM pre-final version was produced, and pre-tested in 8 participants. Proportion Agreement, Weighted Kappa, Spearman Rank Correlation Coefficient, and verbatim responses were used. The English and the BM versions showed excellent equivalence (weighted Kappa and Spearman Rank Coefficients, ranged from 0.72 to 1.00, and Proportion Agreement values ranged from 75.0% to 100%). In conclusion, the BM version of the AMS was successfully translated and adapted.
    MeSH terms: Aging; Humans; Language; Malaysia; Male; Quality of Life; Translating; Translations; Statistics, Nonparametric
  2. Taha Almahbashi, Syed Aljunid, Aniza Ismail
    MyJurnal
    Student's feedback is one of the most important considerations in health profession quality management. One of the most popular approaches for receiving feedback from students within individual institutions is the Student Satisfaction Approach. The aim of this study was to measure the satisfaction with educational services among health profession students and the determinants of satisfaction. Cross-sectional study was conducted in the main campus of the High Institute of Health Sciences in Yemen, including its eight branches. A self-directed questionnaire was distributed to 327 students who were randomly selected. The participation rate was very high: 94% (309/327); 57.9% were male and 42.1% were female. Overall, 59% of students were totally satisfied, 35% were partially satisfied; however only 6% of them were not satisfied. Results showed that personal development was the highest component of satisfaction among students, while the research subjects showed less–satisfaction with the learning resources. The findings provide valuable insights and offer recommendations for improvement in terms of quality management in health profession education.
    MeSH terms: Cross-Sectional Studies; Feedback; Female; Health Occupations; Male; Personal Satisfaction; Surveys and Questionnaires; Students, Health Occupations; Yemen; Research Subjects
  3. Hanizah M.Y., Nor Hassim I
    MyJurnal
    Most people with musculoskeletal problem suffer pain at multiple body sites. The most frequent form of multisite pain studied is chronic widespread pain (CWP). Focusing solely on CWP may exclude the commoner form of multisite pain which is less wide spread. Therefore, studies on multisite pain which do not consider the spatial distribution of pain can be beneficial to tackle the overall problem of musculoskeletal pain. Nevertheless, multisite pain has been defined differently in the studies among workers. The absence of uniformed definition will jeopardize the understanding of this musculoskeletal problem. A review was thus carried out to identify how multisite pain were defined, how they influenced the reported occurrence of multisite pain and whether the definition determined the physical work exposures assessed in previous studies among worker. A systematic review was initiated by the search of electronic databases for multisite pain. Articles were included and excluded based on the selection criteria. A final of nine full text articles were reviewed. It was found that the difference in the definitions lies mainly in the body sites considered and the pain characteristics. The characteristics of pain influenced the multisite pain prevalence more than the sites.It wasdifficult to conclude whether the definition used determined the physical work exposures since only five studies were involved and three of them had similar research team which may explained the usage of similar exposures. The findings from this review, however, could not be inferred due to the small number of studies involved.
    MeSH terms: Physical Examination; Research; Prevalence; Patient Selection; Chronic Pain; Musculoskeletal Pain
  4. Azmawati M.N., Aisah M., Norfazilah A.
    MyJurnal
    Children less than 6 years old are the most vulnerable group to get harm from Environmental Tobacco Smoke (ETS) exposure, especially their respiratory system. To determine the prevalence of ETS exposure and its association with asthma like symptoms among children less than 6 years old. A cross sectional study was conducted in between January till April 2014 among parents with children less than 6 years old in Selangor, Malaysia. A total of 142 parents were selected by simple random sampling and data were collected using guided questionnaire on ETS exposure and asthma like symptoms (cough and wheeze) among their children. A total of 52.8% of children found to be exposed to ETS, and 43.7% were exposed from their father. ETS exposure significantly associated with cough without cold (adjusted OR=5.46, 95% CI 2.37, 12.61), dry cough at night (adjusted OR=3.74, 95%CI 1.41, 9.95) and cough upon physical activity (adjusted OR=3.08, 95% 1.07, 8.89) among these children. Children less than 6 years old are vulnerable to respiratory problem due to ETS exposure especially on cough symptoms. More strategies should be developing to reduce the exposure to ETS.
    MeSH terms: Asthma; Child; Cough; Cross-Sectional Studies; Fathers; Humans; Malaysia; Motor Activity; Parents; Surveys and Questionnaires; Respiratory Sounds; Respiratory System; Smoke; Tobacco; Prevalence
  5. Shahruz Idzwan Azmi, Sharifa Ezat Wan Puteh, Noor Hassim Ismail
    MyJurnal
    Occupational Related Chronic Low Back Pain (OCLBP) is a globally recognized illness that causes reduction in productivity and substantial economic burden to the countries. It requires a multidisclipinary approach involving employer, healthcare provider, compensatory and enforcement agencies. However there is no specific guideline or pathway that has integrated the roles of each responsible agency. The objective of this article is to highlight the need and to propose a coordinated approach through the concept of Integrated Care Pathway (ICP). Therefore, we reviewed international and local guidelines as well as published articles on chronic low back pain and care pathway. We believed that development of a pathway will be able to organize the role of management at every level, reducing the variations in the management, addressing issues of communicating the findings between the responsible stakeholders, fulfilling the requirements as the laws, allows effective and feasible approaches to take place in terms of cost and practicality, and increase the awareness on occupational diseases. Expected challenges such as limitation of resources, unawareness and lack of understanding on OCLBP from every level are issue that we agreed can be bridged through ICP.
    MeSH terms: Awareness; Health Personnel; Health Resources; Occupational Diseases; Low Back Pain; Disease Management
  6. Al-Zurfi, Balsam Mahdi Nasir, Fuad, Maher D., Abdelqader, Mohammed A., Baobaid, Mohammed Faez, Elnajeh, Maged, Hasanain Faisal Ghazi, et al.
    MyJurnal
    Dengue Fever is a major public health issue in Malaysia. This study aimed to assess knowledge, attitude and practice regarding dengue fever and effectiveness of health education programme among 204 students of Alam Shah Science School, Cheras/Kuala Lumpur. Study design was a cross sectional study followed by an interventional (pre-post) Study. The self-administered questionnaire included questions on sociodemographic factors, knowledge, attitude and practice regarding dengue fever. Majority of respondents were Malays (96.6%), monthly family income more than RM 3000 (64.6%) and lives in urban area (64.6%). There was no significant association between knowledge status and socio-demographic factors (p-value>0.05). Most of the respondents had good knowledge (63.2%) good attitudes (79.9%) regarding dengue fever. However, practices to prevent dengue was poor (74.0%). Only about one-fifth of the respondents (18.2%) believed that dengue fever is a flu-like illness. Knowledge score was significantly increased after health education programme (p value
    MeSH terms: Attitude; Cross-Sectional Studies; Demography; Dengue; Health Education; Malaysia; Public Health; Surveys and Questionnaires; Schools; Students
  7. Vikneswaran A/L Sabramani, Idayu Badila Idris, Rosnah Sutan, Zaleha Md. Isa, Saidatul Norbaya Buang, Hasanain Faisal Ghazi
    MyJurnal
    The evolution in lifestyle and dietary habits of the Malaysian people that have taken place over the last few decades can be largely attributed to both family and social environment. These factors are known to affect the nutritional status of the community, in both children and adults. Reduced physical activity and changes in their diet have been one of the contributing factors to the rising prevalence of overweight and obesity. However, in Malaysia, in which nutrition transition has been a norm, it is worrying when the trends of overweight and obesity have been rising steadily over the years especially among children. Although numerous strategies to control obesity in Malaysia have been taking place, many had shown little effect. Analysing strategies implemented at national level is thus crucial in order to ascertain reasons for the shortfalls of these strategies especially among children. Obesity most commonly begins as early as the ages of 5 and 6 years, or during adolescence. Obesity is indeed a major public health concern due to its huge negative impact on the society at large which is well supported by evidence-based literatures. Managing this issue is complex and holistic approach is thus crucial in reducing its incidence and prevalence.
    MeSH terms: Adolescent; Adult; Child; Diet; Food Habits; Humans; Life Style; Malaysia; Motor Activity; Nutritional Status; Obesity; Public Health; Social Environment; Incidence; Prevalence; Overweight
  8. Md Mizanur Rahman, Mohd Taha Arif, Mohd Fadzillah Abd Razak, Mohd Raili bin Suhaili, Zainab Tambi, Akoi, Cliffton, et al.
    MyJurnal
    Menthol brand cigarette has been found to be linked with early initiation of smoking and addiction of nicotine. This study was designed to find out the factors associated with smoking menthol brand cigarettes among adult population in Sarawak. This was a cross-sectional study conducted among the adult population in Sarawak. Data were collected from ten villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Non-probability purposive sampling method was adopted to select the villages. All the households of the villages were visited, and an adult member was selected randomly from each household irrespective of sex. After missing value imputation, 1000 data sets were analysed using statistical software SPSS 19.0 version. Analysis showed that 28.8% of the respondents were current smokers, and 7.8% were past smokers. Among the smokers, 56.3% were habituated with menthol brand cigarette. Logistic regression analysis revealed that age at initiation of smoking before 15 years of age (OR=11. 68, 95% CI: 4.25, 32.10), smoking within five minutes of wake up from sleep (OR=3. 20, 95% CI: 1.35, 7.54), nature of job as business (OR=4. 81, 95% CI: 2.13, 10.86) and service holders (OR= 3.85, 95% CI: 2.07, 7.16) and family size 5 and above (OR=2. 22, 95% CI: 1.25, 3.94) appeared to be important determinants of smoking any menthol brand cigarette (p< 0.05). Menthol is a prominent design feature to attract and retain younger smokers. It does not necessarily make the transition from experimenting with cigarettes, but to encourage early smokers to become a confirmed smoker. So, anti-tobacco public health programme should focus on age-specific community approach.
    MeSH terms: Adult; Cross-Sectional Studies; Family Characteristics; Humans; Malaysia; Menthol; Nicotine; Public Health; Surveys and Questionnaires; Smoking; Software; Tobacco; Tobacco Use Disorder; Logistic Models; Behavior, Addictive; Tobacco Products
  9. Maimaiti, Namaitijiang, Lotfizadeh, Masoud, Zafar Ahmed, Azam Rahimi, Jadoo, Saad Ali, Aljunid, Syed
    MyJurnal
    Streptococcus pneumoniae (pneumococcus) is the most common cause of community-acquired pneumonia, meningitis, and bacteremia in children and adults, including the elderly, and is responsible for high rates of morbidity and mortality worldwide. Aim of this paper to review published articles on incidence of pneumococcal meningitis in children less than 5 years of age in Malaysia, Singapore and Thailand, and compare the incidence of pneumococcal meningitis among the children in the three courtiers. Literature searches were conducted using google scholar, PubMed, the World Health Organization (WHO) website of the Weekly Epidemiological Record, and the countries’ Ministry of Health (MOH) website, and were limited to articles written in English. All relevant publications/abstracts published/presented during the period December 2000 through March 2014. Searches were conducted from April 1, 2014, till July 11, 2014 using various combinations of the following search terms “ Pneumococcal diseases” OR “meningococcal” OR “pneumococcal meningitis” OR “meningococcus”. A total of five articles and abstracts described the incidence of pneumococcal meningitis among children 5 years old. These five documents include two conference abstracts from Malaysia, one published paper from Singapore and two published papers from Thailand. The Malaysian, Singaporean and Thai pneumococcal meningitis incidence rate was 3.8-8.6, 2.3 and 0.10-1.8 per 100,000 children respectively. Our review confirmed that the incidence rate of pneumococcal meningitis was vary among the countries. The highest incidence rate of pneumococcal meningitis was found in Malaysia followed by Singapore and Thailand.
    MeSH terms: Adult; Aged; Child; Humans; Malaysia; Meningitis, Pneumococcal; Morbidity; Neisseria meningitidis; Pneumonia; Singapore; Streptococcus pneumoniae; Thailand; Incidence; Bacteremia; Pneumococcal Vaccines; Meningococcal Vaccines; PubMed
  10. Zin, Thant, SabaiAung, Tin, Sahipudin Saupin, Myint, Than, KhinSN, Daw, Aung, Meiji Soe, et al.
    MyJurnal
    The lower percentage of water, sanitation and hygiene are the root causes of diarrhoea and cholera. Cholera is a sudden onset of acute watery diarrhoea which can progress to severe dehydration and death if untreated. The current pandemic, Vibrio Cholera O1 started in 1961. This study explores water, sanitation, hygiene and cholera and diarrhoea in three affected villages of Beluran District, Sabah Malaysia to support effective and timely public health intervention. This cross sectional study uses purposive sampling. All (114) households were interviewed and household water samples collected. The study reported lower coverage improved sanitation facilities (35.3% to 52.3%), no latrine at home (37% to 63%), improved water supply (52% to 60%), and prevalence of hand washing after toilet (57% - 74%). For water quality, Ecoli was present in household water (32% to 37%) but Vibrio cholerae was not isolated in any of the water samples tested. Statistically significant associations were found for; 1) occupation−nonagriculture and unimproved sanitation facility and 2) house ownership and correct knowledge of ORS preparation. Predictors for household water quality were: latrine at home, and improved household toilet. Aggressive strategies to improve water supply, sanitation and hygiene−hand washing after toilet−were recommended for future prevention of cholera and diarrhoea in the affected area.
    MeSH terms: Cholera; Cross-Sectional Studies; Dehydration; Diarrhea; Family Characteristics; Hand Disinfection; Hygiene; Malaysia; Occupations; Ownership; Public Health; Sanitation; Toilet Facilities; Vibrio cholerae; Water; Water Supply; Prevalence; Pandemics; Water Quality
  11. Aniza, I., Hayati, K., Juhaida, M.N., Ahmad Taufik, J., Idayu Badilla, I., Khalib, L.
    MyJurnal
    Obesity is a major health concern and the growing rate raises important issues specific to concurrent rise of the related diseases especially hypertension. This study aimed to determine the relationship between hypertension and obesity based on body mass index and waist circumference besides relevant sociodemographic factors according to gender specific analysis. The analysis is important to determine in depth insight of two genders. This cross-sectional study was conducted among community in Tanjung Karang, Selangor, Malaysia in 2009 and included a total of 439 male and 668 female respondents aged 18-59 years old. Data was collected by interview-guided questionnaire and anthropometric measurements. SPSS version 21.0 was used for analysis of the relationship between socio demographic factors, smoking, body mass index and waist circumference with hypertension. Finally logistic regression analysis was used to assess the predictors of hypertension according to gender. The prevalence of hypertension was 25.5% in males and 23.1% in females, giving a total of 24%. Significantly higher prevalence of hypertension was found in overweight and obese categories (42.2% and 60.5% in males; 39.5% and 48.9% in females). Those with abdominal obesity also had significantly greater risk in having hypertension (41.6% in males and 33.2% in females). The logistic regression analysis indicated that age, high BMI and abdominal obesity were significantly associated with hypertension in women, and on the other hand age and BMI only for men. Both obesity and abdominal obesity are significantly important predictors of hypertension in females but BMI obesity only in males. Effective weight management strategies targeting obese people and abdominally obese women should be implemented in order to prevent hypertension and related cardiovascular diseases.
    MeSH terms: Cross-Sectional Studies; Female; Humans; Hypertension; Malaysia; Male; Obesity; Surveys and Questionnaires; Residence Characteristics; Smoking; Body Mass Index; Prevalence; Logistic Models; Overweight; Waist Circumference; Obesity, Abdominal
  12. Norfazilah, A., Azmawati, M.N, Madihah, M
    MyJurnal
    This study aimed at measuring the quality of life (QOL) among young adults in rural area of Selangor, and determined the factors that affect the QOL scores. A cross-sectional study was conducted among young adults aged 18 to 39 years in rural area of Hulu Langat district, Selangor with a total sample of 308 selected through simple random sampling. Validated Malay version of WHOQOL-BREF questionnaire was used to measure the QOL, which generated overall QOL score and four domains’ scores of physical health, psychological health, social relationship and environmental QOL. The results showed that the highest mean score was social relationship domain 67.07 (18.87), followed by overall QOL 65.10 (17.92), environmental QOL domain 64.88 (12.83), psychological health domain 60.67 (11.88) and physical health domain 58.23 (11.00). Variables such as unemployment, having chronic diseases and mental distress were found to lower the QOL score.
    MeSH terms: Adult; Mental Disorders; Chronic Disease; Cross-Sectional Studies; Environment; Humans; Mental Health; Quality of Life; Surveys and Questionnaires; Unemployment; Young Adult
  13. Kuan, Gary Low Kim, Papapreponis, Panayiotis, Hin, Yong Mun
    MyJurnal
    Breast cancer is the commonest cancer in women worldwide. This study examined the use of spatial analysis and mapping to visualise the disease distribution. The geographic units used were the states of Malaysia. Breast cancer data was obtained from the National Cancer Registry Report 2007 and the female population data was obtained from the Malaysian Census 2010. A spatial analysis was used to analyse the data by indirect standardisation of the underlying female population of each state. Sarawak has a high standardised incidence ratio (SIR) of 16.81 compared to all other states of the country where the highest SIR was only up to 2.15. However, the age-standardised rate (ASR) does not reflect so. SIR could provide a comprehensive evaluation of the disease for further research and public health intervention.
    MeSH terms: Breast Neoplasms; Female; Humans; Malaysia; Public Health; Registries; Research; Incidence; Censuses; Spatial Analysis
  14. Saperi Sulong, Haris Cendera Khazaani Osman, Aniza Ismail
    MyJurnal
    The rapid development in the health sector has spurred many healthcare organizations to improve their productivity and quality, particularly in terms of service. Clinical Pathways was introduced with the objective of improving the quality of care and services in health; while at the same time eyeing the possibility of reducing the medical expenses. It can be defined as a document based tool that links the best available evidence and clinical practice and provides recommendations, the process and time frame for the clinical management of healthcare. A cross sectional study was carried out at University Kebangsaan Malaysia Medical Centre (UKMMC) Malaysia with the aim to evaluate the level of knowledge about Clinical Pathways (CP) and to ascertain its level of practice in the implementation of CP among healthcare workers at UKMMC; and to establish correlated determinant factors. The study involved a total of 127 respondents; majority of whom were female (77.2%), aged between 32 and 45 years (51.2%), working as nurses (71.7%), and having working experience of six years or longer (52.0%) at UKMMC. The findings reveal that 52.8% of respondents agreed that there is a proper implementation of the Clinical Pathways (CP) programme at UKMMC; and that 52.0% of the respondents have a higher level of knowledge about CP and 70.1% of them practiced it well. The findings also unravel two factors (position and working experience) as the predictors of respondents’ level of knowledge about CP, and position as a predictor representing the practice of it at UKMMC. It can be safely surmised that most of the respondents have a higher level of knowledge about Clinical Pathways and that they practice it well in their daily task as healthcare workers.
    MeSH terms: Cross-Sectional Studies; Delivery of Health Care; Female; Health Personnel; Humans; Malaysia; Nurses; Surveys and Questionnaires; Universities; Work; Critical Pathways
  15. Abuduli, Maihebureti, Zaleha Md Isa, Syed Mohamed Aljunid
    MyJurnal
    Although the Ministry of Health Malaysia has been encouraging the practice of Traditional and Complementary Medicine (T&CM)1, 2 , 3, 4 but patients/clients has not been able to apply it for their need of medical treatments and sometimes it leads to negative outcomes due to lack of knowledge on T&CM and its safe applications5,6’ 7,8 Most of the western-trained physicians are ignorant of risk and benefits of T&CM9,10,11 . This study was aimed to determine the gap between knowledge regarding T&CM and perception on education in T&CM among the medical staffs in five selected hospitals in Malaysia. A cross-sectional survey was done at five public hospitals among medical staff in Malaysia by using quantitative methods. A total of 477 medical staffs were involved in this study. The study showed that the overall knowledge of T&CM among the medical staffs were poor (61.2%). Having good knowledge regarding T&CM were significantly higher in Hospital Duchess of Kent (52%, p=0.001), among the non-Malays (44%, p=0.047) and pharmacists (47.2%, p=0.030). Positive perception on health education in T&CM among medical staffs were high (85.3%) especially among females (88.1%, p=0.002) and pharmacists (93.7%, p< 0.001). The use of T&CM among the general population is relatively high in Malaysia and many patients increasingly seek the information on T&CM therapies from medical staffs. Knowledge regarding T&CM was poor in this study because most of the medical staffs have not been exposed to T&CM education. This interesting scenario between poor knowledge and high positive perception on health education in T&CM shows the demand of urgent intervention in educating the medical staffs. We recommend that medical staffs must have some basic education and knowledge about T&CM before they could offer advice to their patients. Doctors are of the utmost important in this regard because they play a very important role in patient care. Providing T&CM education to medical staff may help to integrate T&CM into the mainstream medicine.
    MeSH terms: Complementary Therapies; Cross-Sectional Studies; Female; Patient Care; Health Education; Hospitals, Public; Humans; Malaysia; Medical Staff; Pharmacists; Physicians; Surveys and Questionnaires
  16. Phua, K.L.
    MyJurnal
    The Orang Asli of Malaysia continue to experience poor health. There appears to be stagnation of certain aspect of their health status. Underweight (low weight-for-age) and stunting (low height-for-age) are significant amongst Orang Asli children. Worm infestation such as Ascaris, Trichuris and hookworm continue to afflict Orang Asli communities in Malaysia. Orang Asli communities can also be afflicted by other kinds of parasites, e.g. malaria parasites, microsporida parasites and Cryptosporidium parasites. Thus, primary care doctors who treat Orang Asli patients should be on the lookout for malnutrition and its effects (including anaemia, iodine deficiency, Vitamin A deficiency) as well as worm and parasite infestations. Such patients may need to undergo de-worming at regular intervals because of the tendency to get re-infected. Primary care doctors also need to be aware of possible interactions between infestations and nutritional deficiencies.
    MeSH terms: Ancylostomatoidea; Anemia; Animals; Ascaris; Child; Cryptosporidium; Growth Disorders; Health Status; Hookworm Infections; Humans; Iodine; Malaria; Malaysia; Parasites; Parasitic Diseases; Primary Health Care; Residence Characteristics; Thinness; Trichuris; Vitamin A Deficiency; Microsporida
  17. Mohd Hasni Jaafar
    MyJurnal
    Dioxins are a most toxic compound ever studied by human until today. Their significant health effects involved all ranges of age, including infants due to exposure to contaminated breast milk. The objective of the study was to appraise the status of dioxin contamination in breast milk among postnatal mothers live in urban and suburban areas in Klang Valley. It was conducted as a cross sectional study involving 101 postnatal mothers who came for their infant second hepatitis B vaccination. The samples were analysed using High Resolution Gas Chromatography (HRGC) following the USEPA Method 8290. About 70.3% of the samples were found detected with dioxin congeners. More suburban mothers have positive breast milk dioxins compared to urban mothers, 100.0% and 67.0% respectively. Significant associated factors include high fat daily intake (p=0.013), high milk daily intake (p= 0.044), high meat daily intake (p=0.001), body mass index more than 30 kg/m2 (p=0.005), and body fat % of more than 26% (p=0.046). In conclusion, amount daily intake of fat diet, meat, milk, body mass index and body fat are significant associated factors for the present of dioxins in breast milk among postnatal mothers in Klang Valley. More suburban mothers contain dioxins in their breast milk, which poses higher risk of health problems among their infants. A comprehensive study need to be conducted and regular followup need to be established in monitoring the future severity of maternal breast milk contamination to ensure the health of the next generations.
    MeSH terms: Adipose Tissue; Animals; Cephapirin; Chromatography, Gas; Cross-Sectional Studies; Diet; Dioxins; Female; Hepatitis B; Humans; Infant; Meat; Milk, Human; Mothers; Tetrachlorodibenzodioxin; United States; United States Environmental Protection Agency; Vaccination; Body Mass Index
  18. Hafiza Alauddin, Suziana Mohamad Nasir, Madzlifah Ahadon, Raja Zahratul Azma Raja Sabudin, Azlin Ithnin, Noor Hamidah Hussin, et al.
    Malaysian Journal of Pathology, 2015;37(3):287-292.
    MyJurnal
    Haemoglobin (Hb) Lepore is a variant Hb consisting of two α-globin and two δβ-globin chains. In a heterozygote, it is associated with clinical findings of thalassaemia minor, but interactions with other haemoglobinopathies can lead to various clinical phenotypes and pose diagnostic challenges. We reported a pair of siblings from a Malay family, who presented with pallor and hepatosplenomegaly at the ages of 21 months and 14 months old. The red cell indices and peripheral blood smears of both patients showed features of thalassaemia intermedia. Other laboratory investigations of the patients showed conflicting results. However, laboratory investigation results of the parents had led to a presumptive diagnosis of compound heterozygote Hb Lepore/β-thalassaemia and co-inheritance α+ -thalassaemia (-α3.7). Hb Lepore has rarely been detected in Southeast Asian countries, particularly in Malaysia. These two cases highlight the importance of family studies for accurate diagnosis, hence appropriate clinical management and genetic counseling.
    MeSH terms: Erythrocyte Indices; Genetic Counseling; Hemoglobinopathies; Hemoglobins, Abnormal; Heterozygote; Humans; Malaysia; Pallor; Parents; Phenotype; alpha-Thalassemia; beta-Thalassemia; Siblings; alpha-Globins
  19. Chow, Tak-kuan, Looi, Lai-meng, Cheah, Phaik-leng
    Malaysian Journal of Pathology, 2015;37(3):239-246.
    MyJurnal
    Background: In the past, lupus nephritis was histologically classified according to the 1995 WHO Classification. With the introduction of the 2003 ISN/RPS Classification, many nephropathology services converted to this new classification. This study was undertaken to compare both classification systems in a single centre practice. Methods: 103 consecutive adequate renal biopsies initially reported as lupus nephritis in the Department of Pathology, Faculty of Medicine, University of Malaya were reassessed using the criteria of both the 1995 WHO Classification and the 2003 ISN/ RPS Classification. Results: The relative prevalence for each class using the WHO Classification were: Class I (1%), Class II (8.7%), Class III (6.8%), Class IV (60.2%), Class V (20.4%), Class VI (2.9%) while the prevalence using the 2003 ISN/RPS Classification were: Class I (1%), Class II (8.7%), Class III (6.8%), Class IV (61.2%), Class V (21.3%), Class VI (1%). Both classifications were essentially comparable with regards to Classes I, II and III. The differences in Classes IV, V and VI were significant in potential to alter patient management. The identification of segmental lesions (Class IV-S) over and above a global nephritis (Class IV-G) deserves more focused clinicopathological studies to gauge whether these groups have different clinical manifestations and outcomes. With regards Class V, the ISN/RPS system, by requiring that all mixed classes be stipulated in the diagnostic line, minimizes the chances of patients missing out on additional treatment. The ISN/ RPS system has stricter criteria for Class VI, which again minimizes patients missing out on therapy. On the whole, the ISN/RPS system is more user-friendly as criteria are more clearly defined which translates to more benefits to patient care.
    MeSH terms: Biopsy; Faculty; Patient Care; Humans; Lupus Nephritis; Medicine; Prevalence
  20. Pathmanathan Rajadurai
    Malaysian Journal of Pathology, 2015;37(2):175-211.
    MyJurnal
    The pathological diagnosis of lung cancer has transformed over the past several years from a morphological characterisation of the disease to one where molecular characterisation has become increasingly important. Molecular characterization of lung carcinoma contributes valuable information in terms of diagnosis, prognosis, and the potential for treatment with targeted therapy. Hence, the simple separation of lung cancer into small cell and non-small cell is insufficient for the modern day management of this cancer. Over the past few decades, the concept of “oncogene addiction” in malignancies has led to the documentation of a number of reproducible molecular alterations in lung cancer- the so called “driver mutations”. This has permitted the identification of specific molecular cohorts of patients who may benefit from therapy targeted at these driver mutations. Among other challenges for the pathologist of today is the demand to extract a vast body of information from increasingly small diagnostic specimens and scanty cell aspirates. The pathologist plays a pivotal role in balancing the need to preserve tissue for molecular studies, over performing other ancillary, potentially wasteful studies. With additional evidence that targeted therapy is a major improvement over conventional chemotherapy when applied to the appropriately selected patients, evaluation for epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) and ROS-1 rearrangements are now considered by many to be the standard of care in advanced-stage pulmonary adenocarcinomas. Personalized precision medicine is real, and is here, and having a firm grasp of the processes involved in molecular testing of tumour specimens should be an overriding concern for the pathologist. As more sophisticated and sensitive testing modalities evolve, it behoves the astute practicing pathologist to remain ‘future-proof’ and relevant in facing the challenges ahead.
    MeSH terms: Adenocarcinoma; Documentation; Humans; Lung Neoplasms; Mutation; Prognosis; Receptor, Epidermal Growth Factor; Hand Strength; Receptor Protein-Tyrosine Kinases; Precision Medicine; Standard of Care
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