Alpha thalassaemia is one of the haemoglobin disordersin which the carriers of alpha thalassaemia may have normal haemoglobin level and are eligible to donate blood which may bring complications. This study is to investigate the interaction of haematological parameter with α-globin genotypes among eligible blood donors. Materials & Methods: A cohort study with 270 eligible blood donors were analysed for red cell indices. Alpha-globin (α-globin) genotyping was performed for seven deletions, six point mutations and two triplications. Statistical analyses were performed to compare the α-globin genotypes with haematological data. Results: High prevalence of α-thalassaemia carriers (7.7%, 21/270) was found among blood donors. All of them did not show anaemic pictures with a normal Hb level (>12 gm/dl). Five genotypes were identified consisting of 249 αα/αα (92.2%), nine -α3.7/αα (3.3%), nine--SEA/αα (3.3%), two -α4.2/αα (0.7%) and one ααCS/αα (0.4%). Different α-globin genotypes showed a significant difference in RBC, MCV, MCH, MCHC, RDW, and Hct/Hb ratio (p
Hypercholesterolaemia affects Sertoli and Leydig cells secretory functions, impairs steroid hormones biosynthesis, and disrupts the hypothalamic-pituitary-gonadal axis. The use of honey in previous studies resulted in an improvement of male reproductive hormonal disturbances. This study aimed to investigate the protective effects of Trihoney on hypercholesterolaemia-induced male reproductive hormonal changes in male rabbits and compare its effects with atorvastatin. Materials and methods: Forty-eight male New Zealand white rabbits were assigned into 6 groups as follows; Control: commercial pellet; CH: commercial pellet with 0.6 g/kg/day Trihoney; HCD: 1% cholesterol diet; DH1: 1% cholesterol diet with 0.3 g/kg/day Trihoney; DH2: 1% cholesterol diet with 0.6 g/kg/day Trihoney and DAt: 1% cholesterol diet with 2mg/kg/day atorvastatin. After 12 weeks, the rabbits were sacrificed and blood samples were collected for analysis of hormones and pro-inflammatory cytokines and calculation of HOMA-IR. The testes were homogenized for intra-testicular testosterone measurement. Results:Serum testosterone reduced significantly in HCD (p
Colour vision deficiencies may raise behavioural changes among children. This study explores the presence of any behavioural issues faced by primary schoolchildren with congenital red-green colour vision deficiency (CRGCVD). Materials and Methods:Male schoolchildren, aged 8-11 years old, from 10 randomly selected schools in Klang Valley were screened using Ishihara plates and Farnsworth D-15 test. Children with CRGCVD (study group) and without CRGCVD (control group) were asked to complete the Strength and Difficulties Questionnaire (SDQ) for children (self-report) while their class teachers completed the SDQ for teachers (teacher-report). Difficulty scores were calculated. The test categorised behaviour into 3 categories based on the difficulty scores into ‘normal’, ‘borderline’ and ‘abnormal’ behaviours. Non-parametric test was used to compare the median of difficulty scores between control group and study group. Spearman correlation was used to determine association between self-report SDQ and teacher-report SDQ. Results:A total of 134 schoolchildren were recruited in this study, of which 44 had CRGCVD and 90 were in the control group. Teacher-reported SDQ for the children were obtained from 134 teachers. No statistically significant differences (p>0.05) were noted between the total SDQ scores of children with and without CRGCVD using self-report SDQ and teacher-report SDQ. The total difficulty scores of self-report SDQ and teacher-report SDQ were poorly but significantly correlated. Teachers rated 9.09% of children with CRGCVD as falling under the ‘abnormal’ category, slightly higher than self-rated of 2.27%. Conclusion:This study found no prominent behavioural issues among schoolchildren with CRGCVD.
Homeless children are prone to inadequate energy and nutrient intake which may highly influence their cognitive performance. However, few studies have been done in assessing diet adequacy and cognitive performance among homeless children in Malaysia. Materials and Methods:This cross-sectional study aims to assess the dietary adequacy and cognitive performance of 120 homeless children age 7-12 years living in Klang Valley. The dietary adequacy of these homeless children was assessed through two days of 24 hours of dietary recall. Dietary adequacy achievement was determined by fulfilling at least 50% of Recommended Nutrients Intake (RNI). Raven’s Coloured Progressive Matrices (RCPM) test was used to assess their cognitive performance. Results:The homeless children had an adequate intake of energy, iron, zinc, and vitamin B12. Seventy percent of homeless children had a poor cognitive performance. This study shows that there was no association between energy, iron, and vitamin B12 adequacy with cognitive performance, whereas there was a significant (p=0.028) association between zinc adequacy and children’s cognitive performance. Conclusion:These findings provide solid evidence-based for dietary adequacy and cognitive performance of the homeless children in Klang Valley. It is clear from the findings that both dietary intake and cognitive of these children require improvement for a better quality of life in the future. This study suggests that dietary adequacy does not relatively reflect the cognitive performance of these homeless children in Malaysia.
The diabetic foot at risk is the diabetic foot which is at risk of ulceration, hence the importance of identifying the foot at this stage. This study aims to assess the prevalence of diabetic foot at risk and its associated factors among type 2 diabetes mellitus patients’ attending primary health clinics in Kuantan.Methods and methods: This was a cross-sectional study conducted at four primary health clinics in Kuantan involving 450 study participants who were selected by using universal sampling method. Foot examination was carried out and foot at risk was classified based on the Kings’ Classification. Multiple logistic regressions were performed to identify the predictors for diabetic foot at risk. Results: The prevalence of diabetic foot at risk was 31.3%. Multivariate logistic regression analysis identified age (OR 1.04, 95% CI: 1.01-1.06), smoker (OR 4.11, 95% CI: 1.96-8.63) and duration of diabetes more than 10 years (OR1.77, 95% CI: 1.05-2.98) as risk factors for diabetic foot at risk. Respondents with higher diabetic foot practice score (OR 0.87, 95% CI: 0.77-0.98) have lesser risk of developing diabetic foot at risk. Conclusion: Patients who are older, smoker and/or have chronic diabetes are predicted to be at higher risk to develop the diabetic foot at risk. This study also showed that patients with better foot care practice has lesser risk. Therefore, these are the groups of patients that need to be targeted for early detection and intervention to prevent serious complications.
Oral health literacy is an essential element of an individual to make better oral health decision. Low oral health literacy (OHL) is associated with poor oral health decision and outcome. This study aimed to determine factors associated with oral health literacy among undergraduate students in one of the public universities of Malaysia. Materials and methods:This is a cross-sectional study which was undertaken among the undergraduate students of Universiti Sains Islam Malaysia (USIM). Sample selection was done randomly. A validated oral health literacy index of Malay version was used throughout the study. Ethical approval was obtained from the University Research Ethics Committee and respondents had given their consent prior to the data collection. Data analysis was performed using IBM SPSS software version 24.0 and the significant level was set at p< 0.05. Results:The mean oral health literacy of the university undergraduate students was 77.7 (95% CI= 76.75, 78.71). Multiple linear regression indicated that female has higher OHL (β= 4.19; 95% CI= 1.99, 6.39; p< 0.001), social science stream has lower OHL (β= -9.14; 95% CI= -11.20, -7.07; p< 0.001) and higher education level of father had higher OHL (β= 1.97; 95% CI= 0.10, 3.83;p= 0.039) than their counterparts. Conclusion:Oral health literacy is higher among the science streams students compared to the social sciences streams. This suggests that science education might play a significant role in health literacy and improving health outcomes.
Intraoperative frozen section (FS) is an important tool in the management of neoplastic and non-neoplastic central nervous system (CNS) lesions. Although the final pathological diagnosis is based on the findings in paraffin tissue sessions, interpreting FS of CNS lesion is to assist the neurosurgeon in making the accurate judgment regarding the nature of the lesion and tissue adequacy. This study was to evaluate the agreement between FS and paraffin sections (PS) results; and to highlight the possible causes of error in discrepancy between FS and PS. Materials & Methods:This is a retrospective study of 85 cases of FS. H&E stained sections of both FS and PS of all these cases were reviewed with their histopathological reports. FS and PS results were compared. Possible causes of errors were reviewed and recorded.Results:Out of 85 cases; 76 cases (89.4%) showed no discrepancy, 2 cases (2.4%) minor discrepancy and 7 cases (8.2%) discrepancy. Sensitivity and specificity of FS were 90.1% and 85.7% respectively. Positive predictive value was 97.0% and negative predictive value was 63.1%. The false positive rate was 14.2% and false negative rate was 36.8%. The overall accuracy of FS was 89.4%. Conclusion:Our results showed high accuracy and specificity of FS. Therefore, FS is still useful, an effective tool for neurosurgeon although there are some challenges for histopathologists in reporting FS. The commonest discrepancy was seen between reactive gliosis and low-grade glioma. Over-diagnosis or under-diagnosis of FS can be reduced by closed cooperation among pathologist, neurosurgeon and radiologist.
The WOMAC questionnaire is used extensively in the assessment of knee osteoarthritis but not as an indicator of total knee arthroplasty (TKA). We aimed to assess if the WOMAC score can be used as an assessment tool to indicate TKA in primary knee osteoarthritis. Materials and Methods:Patients with primary knee osteoarthritis Kellgren and Lawrence grades 3 or 4 were assessed separately by either one of two arthroplasty surgeons for indications to undergo TKA and evaluated using the WOMAC score. Patients who had received any form of intra-articular knee injection within six months before assessment were excluded. Patients were divided into two groups; indicated for TKA, and for non-surgical treatment. The mean WOMAC score of patients from both groups was compared using Independent t-test. The accuracy at different cut-off points in the score indicated for TKA was determined using the receiver operating characteristic (ROC) curve plotted on sensitivity and 1-specificity graph. Results:The study included 74 patients with a mean age of 62.5 years (SD=8.26). There was a significant difference in the total WOMAC score (p
Forest clearing for agriculture plantations and local community settlements may trigger food insecurity, which causes poor development, predominantly in Orang Asli children. This cross-sectional study was conducted to determine the relationships between food security and anthropometric and cognitive function among Orang Asli children in Temerloh, Pahang. Materials and methods:A total of one hundred and sixty-seven children (ages 7 to 11) from five selected Orang Asli villages (Kampung Sungai Enggang, Kampung Penderas, Kampung Pasu, Kampung Lubok Wong, and Kampung Pian) were involved in this study. The food security index was assessed using the Radimer/Cornell Hunger and Food Insecurity Instrument. Anthropometric indices were based on height-for-age and BMI-for-age Z-scores, while cognitive performance was tested using Raven’s Coloured Progressive Matrices (R-CPM). Results:A majority (91.6%) of the respondents reported some kind of food insecurity (12.6% household food insecure, 74.2% individual food insecure, and 4.8% child hunger). Rates of stunting, thinness, and overweight/obesity were 25.8%, 16.2%, and 18.0%, respectively. A majority (46.1%) of the children had average cognitive scores, followed by below average (38.3%) and above average (15.6%), respectively. Height-for-age was significantly associated with cognitive function (p=0.008). Among sociodemographic factors, household size (p=0.007) and household income (p
Currently, the world is facing immediate and unexpected changes every day due to the coronavirus disease 2019 (COVID-19) pandemic. These environmental stimulations have an impact on mental health, particularly in the case of children. Worldwide measures such as quarantine, social and physical distancing, and school closure can potentially take a toll on children's mental health, in both the short and long terms. Grief, adjustment disorder and acute stress disorder (ASD) are some of the mental health issues that children are prone to suffer during a pandemic, leading to mood disorder, psychosis and even suicidal tendency, if not addressed and treated timely. As the pandemic continues, it is crucial to monitor children's mental health status. Parents/caregivers must receive continuous guidance on handling the situation appropriately. Both professionals and families/caregivers must tend to children's mental health needs to safeguard their overall well-being.
Physical activity is an essential element in our daily life that leads to long-term health benefits. Physical activity refers to movement of the body that requires energy. Body mass index (BMI) indicates a ratioof body weight to squared height, which is a useful health indicator. On the contrary, body composition describes the body by measuring percentages offatand muscleinhuman bodies. MATERIALS AND METHODS: This cross-sectional study aimed to determine the relationship betweenphysical activities, BMI and body composition among pre-university students from one of the universities in Selangor, Malaysia. Stratified random sampling was employed to recruit 70 pre-university students into this study. RESULTS: From the study, 50% of the respondents are categorized as minimally active. In addition, there is significant difference between the physical activity levels of male and female respondents. The relationship between physical activity and BMI indicates a very weak negative correlation. Similarly, the correlation between physical activity and fat mass is a weak negative relationship. Meanwhile, there is a weak positive correlation between physical activity and muscle mass. CONCLUSION:Therefore, it can be concluded that when physical activity increases, BMI and body fat mass will decrease, while muscle mass will increase. Moreover, it was shown that there was a significant relationship between physical activity and body composition.
Thyroid antibodies are closely related to autoimmune thyroid disorders. To date, there are no data on the prevalence of these antibodies among the Malaysian population. This study aimed to determine the prevalence of thyroid antibodies; and the factors associated with thyroid antibodies in the Malaysian adult population. MATERIALS AND METHODS: A cross-sectional study was performed in 5 pre-assigned regions in Peninsular Malaysia. Participants’ sociodemographic profile and medical history were recorded. Physical examinations were done looking for abnormalities of the thyroid gland and signs of thyroid dysfunctions. Fifteen mils of blood were withdrawn and analysed for thyroid function, anti-thyroperoxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies at a central laboratory. RESULTS: Among the total of 2190 respondents, the overall prevalence of positive anti-TPO and anti-TG antibodies were 12.2% and 12.1%, respectively; mainly found in urban and coastal areas. Only 7% to 9% of those with positive anti-TPO or anti-TG antibodies had either hypo-or hyperthyroidism. The predictors for positive anti-TPO antibody were female [adjusted OR 1.7 (95%CI: 1.2–2.4); p=0.001], Indian [adjusted OR 1.9 (95%CI: 1.1–3.1); p=0.020], and having a goitre [adjusted OR 1.8 (95%CI: 1.2–2.8), p=0.004]. The predictors of positive anti-TG antibody was female [adjusted OR 2.3 (95%CI: 1.6–3.3); p
An increase in the prevalence of non-communicable diseases (NCDs) among Orang Asli in Malaysia was reported to be associated with their lifestyle changes. This study aimed to determine the level of knowledge, attitude, and practice (KAP) on NCDs among the Orang Asli community and its association with demographic factors of gender, age, and education level.MATERIAL AND METHODS:A cross-sectional study among consented adult Orang Asli in Jelebu, Negeri Sembilan, was conducted by a face-to-face interview using a validated questionnaire. Their knowledge, attitude, and practice on selected NCD risk factors, complications, and treatment was recorded. Bivariate analysis was performed to test the association between their demographic profile and KAP score.RESULTS:A total of 325 respondents with a mean age of 39.9 (±13.2) ranged from 18 to 83 years old participated in this study. Majority of the participants (72.3%) had inadequate knowledge. Despite the inadequacy, they have a good attitude (72.3%) and a moderate practice level (63.4%). Respondents with higher education backgrounds had significantly better knowledge scores compared to lower education background (p
Objective. To examine pharmacy students' performance on and perceptions regarding the use of an interactive online tool for practicing to take objective structured clinical examinations (OSCEs).Methods. The Monash OSCE Virtual Experience (MOVE), an online module consisting of 20 pharmacy case scenarios with virtual patients, was piloted with final-year pharmacy students at Monash University campuses in Australia and Malaysia. A mixed methods approach that included reviewing user attempts and comparing grades, collecting student-administered questionnaires, and holding focus groups was used to examine students' perception and performance.Results. More than 99% of all students attempted at least one online case scenario in preparation for their final in-person OSCE, and 81% attempted all 20 scenarios two or more times. Ninety percent of students at the Malaysia campus and 70% of students at the Australia campus reported that MOVE was a helpful study tool for their OSCE preparation. However, a raw comparison of user attempts and OSCE grades did not find a direct correlation between online module attempts and assessment grades. Self-administered questionnaire and focus group results indicated that MOVE prepared students for targeted and time-restricted history-taking and problem-solving skills. Overall, students perceived MOVE to be a useful learning tool and a less overwhelming learning experience than were face-to-face sessions. Nevertheless, students still preferred face-to-face OSCE practice with simulated patients over online practice with virtual patients.Conclusion. The Monash OSCE Virtual Experience was perceived by our students as a flexible and useful online learning aid in preparing for their final-year OSCE However, there was no direct correlation between online practice attempts and students' exam grades.
One of the most important and debilitating complication of diabetes mellitus is foot problem such as ulcers, infections and amputations. However, these complications are preventable by simple intervention such as regular foot care practice. This study aims to assess the foot care practice and its associated factors among type 2 diabetes mellitus patients attending primary health clinics in Kuantan. MATERIALS AND METHODS: This was a cross-sectional study conducted at four primary health clinics in Kuantan involving 450 study participants who were selected by using universal sampling method. Level of awareness and practice toward diabetic foot care was assessed using validated self-administered questionnaire. Multiple logistic regressions were performed to identify factors associated with poor foot care practice among the respondents. RESULTS:About 59.6% of respondents had poor foot care practice and 50.9% had poor awareness level. Multivariate logistic regression analysis identified that, increasing age (OR0.97, 95% CI: 0.955-0.993) and good awareness towards foot problem (OR0.43, 95%CI: 0.289-0.643) were less likely to have poor foot care practice. However, Malay ethnicity (OR 1.81, 95% CI: 1.002-3.271) and obesity (OR1.9, 95% CI: 1.225-2.976) were associated with poor foot care practice after controlling other variables. CONCLUSION:Majority of the respondents had poor foot care practice and poor awareness. Respondents who are older and have better awareness are less likely to have poor foot care practice. Diabetic patients who are Malays and/or obese are predicted to have poor diabetic foot practice and hence must be prioritized for a sustainable patient education and compliance towards foot care practice at primary care level.
Control of modifiable risk factors is important in recurrent stroke prevention strategies. This study aimed to determine the control of blood pressure and other cardiovascular risk profiles among post-stroke patients. Factors associated with uncontrolled blood pressure were also determined. MATERIAL ANDMETHODS:A cross-sectional study was conducted in the outpatient clinics of three hospitals located in the East Coast region of Peninsular Malaysia from May to August 2019. Information on socio-demographic characteristics, clinical profiles, and lifestyle practices were acquired. Univariate and multivariate logistic regression analyses were carried out. Crude odds ratio and adjusted odds ratio (aOR) were reported. RESULTS:From a total of 398 stroke patients, majority of the respondents were elderly with first-ever stroke, ischaemic type, and duration of stroke less than 24 months. Uncontrolled blood pressure (52%), overweight and obesity (65%), abdominal obesity (54%), and low physical activity level (65%) were common among the patients. Patients with hypertension (aOR= 3.11, 95% CI: 1.38, 6.99), diabetes mellitus (aOR 1.57, 95% CI: 1.03, 2.38), not taking prescribed medication every day (aOR 2.28, 95% CI: 1.29, 4.01), overweight (aOR 1.75, 95% CI:1.02, 2.99), obesity (aOR 1.99, 95% CI: 1.12, 3.53), and low physical activity level (aOR 2.10, 95% CI: 1.35, 3.27) were at a higher risk of having uncontrolled blood pressure. CONCLUSION:Uncontrolled blood pressure and other major cardiovascular risk factors were highly prevalent among post-stroke patients. Increased efforts must be made to optimise the risk profiles management of these high-risk patients to prevent recurrent vascular events in the future.
Poor sleep quality is a common problem experienced by medical students worldwide. Therefore, this study aimed to measure the prevalence of poor sleep quality among medical students in International Islamic University Malaysia (IIUM) and its association with mental health and other factors. MATERIALS AND METHODS: A cross-sectional study using convenience sampling was conducted among 500 medical students in IIUM Kuantan. A validated self-reported questionnaire including sociodemographic, socioeconomic, lifestyle, Pittsburgh Sleep Quality Index and Depression Anxiety Stress Score 21 was distributed from 15thJuly to 31stAugust 2019. Descriptive statistics were used to measure the prevalence of poor sleep quality. Chi-square test, Fisher’s exact test, independent sample T-test, and multiple logistic regression were used to measure the association between risk factors and sleep quality. RESULT: The response rate was 91.2%. The prevalence of poor sleep quality was 59.6%. Multiple logistic regression analysis revealed level of study (clinical year (AOR=0.44, 95% CI: 0.29 -0.66) and depression (yes (AOR: 1.71, 95% CI 1.03-2.83) contributed independently on poor sleep quality among medical students. There was no significant relationship between tahajjud practice and poor sleep quality. CONCLUSION: More than half of IIUM medical students have poor sleep quality. Those students who were in the pre-clinical year and had depression were independently associated with the occurrence of poor sleep quality. Early intervention is compulsory to overcome this problem among medical students in IIUM.
Recreational noise exposure has become a major threat to the hearing system, and this includes exposure to loud noise during group exercises such as Zumba Fitness, where loud music plays an important role. This study aimed to assess the noise exposure and hearing threshold profile among Zumba Fitness regulars in Kuantan, Malaysia.MATERIALS AND METHODS: Noise exposure and hearing profile threshold were measured during Zumba Fitness sessions at a fitness studio in Kuantan, Malaysia from 24thJune 2014 to 12thAugust 2014. Noise exposure was measured using a noise dosimeter for one hour of Zumba Fitness session with a total of nine sessions run by three different instructors while sound level pressure was taken using a sound level meter during ambient, peak session and during cooling down. Thirty participants answered questionnaires and underwent pure tone diagnostic audiometry test at a local clinic for hearing threshold documentation.RESULTS: Some areas of the hall posed higher risks of causing noise-induced hearing loss especially near the amplifiers. There were periods when the hearing level exceeded 115 dBA. Early abnormal pattern could be observed in the hearing profiles of some of the participants to suggest preliminary hearing problems.CONCLUSION: Zumba Fitness regulars have a risk of developing noise-induced hearing loss and preventive steps should be properly addressed as NIHL is permanent and irreversible.
Coronavirus disease (COVID-19) is a novel pandemic that affects every other country in the world. Various countries have adopted control measures involving restriction of movement. Several studies have used mathematical modelling to predict the dynamic of this pandemic. Forecasting techniques can be used to predict the incidence cases for the short term. The study aims to forecast the COVID-19 incidence using the Auto Regressive Integrated Moving Average (ARIMA) method. MATERIALS AND METHODS:Using publicly available data, we performed a forecast of Malaysia COVID-19 new cases using Expert Modeler Method in SPSS and ARIMA model in R to predict COVID-19 cases in Malaysia. We compare 3 different time frames based on different Movement Control Order (MCO) period. We compare the model fit and prediction across models.RESULTS:All models show static cases for each MCO 7-day prediction. For prediction until 12 May, the third MCO time frame shows the best model fit for both techniques. Both software shows a stationary trend of cases of below 100. CONCLUSION:These MCO models have shown to stabilize the rate of new cases. Further sub analysis and quality of data is needed to improve the accuracy of the model.