Displaying all 16 publications

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  1. Syed Alwi SA, Zainal Ariffin A, Hanif H, Naresh G
    Med J Malaysia, 2012 Oct;67(5):503-5.
    PMID: 23770868
    This is our initial report on the first 4 cases of infra-renal abdominal aortic aneurysms undergoing Endovascular Aneurysm Repair (EVAR) with local anaesthesia, controlled sedation and monitoring by an anaesthetist. All 4 patients were males with a mean age of 66.7 years. Only one (1) required ICU stay of 2 days for cardiac monitoring due to bradycardia and transient hypotension post procedure. No mortality or major post operative morbidity was recorded and the mean hospital stay post procedure was 3.5 days (range 2-5 days).
  2. Kong WT, Chua SS, Alwi S
    Asia Pac J Public Health, 2002;14(2):99-104.
    PMID: 12862414 DOI: 10.1177/101053950201400208
    The practice of losing weight is gaining popularity globally with an increase in health consciousness among the general public. A survey was conducted in seven shopping centres in Kuala Lumpur and its neighbouring towns to assess the weight-loss practices of the general public. Out of the 1032 people approached by the researcher, 389 (37.7%) admitted that they had tried to lose weight before. Of these respondents, 50.4% had the wrong perceptions about their weight with 39.1% of the respondents having BMI lower than what they had perceived. The most common weight-loss method used was dieting (89.5%), followed by exercise (81%) and the use of slimming teas (24.9%). Exercise (79.0%) was perceived as the most effective method for losing weight, followed by dieting (71.6%). Most respondents (60.6%) obtained their weight-loss products from the pharmacies but only 34.9% of these respondents had consulted the pharmacists on these products. Therefore, pharmacists should play a more active role in assisting the general public to lose weight successfully and safely.
  3. Syed Alwi SAR, Brohi IB, Awi I
    BMC Womens Health, 2021 02 22;21(1):77.
    PMID: 33618693 DOI: 10.1186/s12905-021-01230-7
    BACKGROUND: Various factors, including menopausal status, educational and social background, culture, and physical and emotional health, may influence women's perceptions of menopause. This study documents the elements influencing attitudes towards menopause among women in Sarawak, Malaysia.

    METHODS: A face-to-face interview using a validated questionnaire was conducted with 324 Sarawakian women aged 40-65 to determine the mean age of menopause and perceptions and experiences of menopause among these women.

    RESULTS: The mean age ± standard deviation of the women was 51.37 ± 5.91 years. Ninety (27.8%) participants were premenopausal, 124 (38.5%) perimenopausal and 110 (33.7%) postmenopausal. The majority of these women (228; 70.4%) were local indigenous inhabitants of Sarawak. The findings show that 22.5% of the participants agreed that problems during menopause are a natural process. While 21.9% of the participants suggested that menopause should be treated medically, 32.3% argued that natural approaches for menopause symptoms are better than hormonal treatments. Seventy-five per cent of the women agreed that the absence of menses after menopause is a relief; meanwhile, 61.2% stated that menopause causes unpleasant symptoms. Notably, 51.7% were not sure whether women become less sexually attractive after menopause, and 51.1% were uncertain as to whether they feel less of a woman following menopause. Finally, 81.7% of participants were unsure if sexual activity is more enjoyable after menopause, and 71.9% were uncertain whether changes in life during menopause are more stressful. Among the different menopausal stages, the premenopausal group of women were noted to have more positive perceptions of menopause compared to the peri- and postmenopausal women. The study also observed that women with a better educational background generally had more positive perceptions of menopause.

    CONCLUSIONS: The women's perceptions of menopause in this study were found to correspond to those in other studies on Asian women. Women with higher levels of education and premenopausal women comparatively expressed more positive opinions regarding menopause. Lastly, most of the women noted that menopausal symptoms are unpleasant, but that the absence of menses after menopause is a relief.

  4. Cheah, W. L., Lee, P. Y., Kamarudin, K., Syed Alwi, S. A. R., Albela, H., Lau, E. H., et al.
    MyJurnal
    Introduction: Acute gastroenteritis (AGE) is one of the frequent causes of hospitalization in children under the age of five, particularly in a rural setting. This study was conducted to determine the epidemiology of acute gastroenteritis in indigenous children admitted to a rural district hospital in Sarawak. Methods: A retrospective review of indigenous paediatrics cases of acute gastroenteritis
    admitted to the ward of Serian District Hospital, a rural district hospital in Sarawak, between the years
    2006-2007. The data was collected from the patients’ case notes, obtained with permission from the
    hospital management. Data was entered and analyzed using SPSS version 16. Results: During the study period, 234 indigenous children with acute gastroenteritis were admitted with the highest prevalence in 2006 (53.4%). The findings showed higher prevalence was found in children aged 3 years and below (76.5%) and male (56.4%) The minimum duration of hospital stay is 1 day, and the maximum stay is 5 days. The clinical findings showed that the majority of the cases presented with vomiting, diarrhea, dry mouth and tongue, sunken eye, with the majority (76%) reported having mild dehydration. The most common treatment used is oral rehydration solutions (85.4%), followed by intravenous bolus or drip (82.3%), paracetamol (79%) and antibiotic (36.2%). Peak incidence of admissions was between November to January. About 38.5% of the AGE cases admitted were found to be underweight (weight for- age below -2SD). Conclusion: The findings indicated children aged 3 years and below are the most vulnerable to AGE and malnutrition could be one of the predisposing factors. The peak incidence during the raining season at the end of the year indicated a possible relationship between AGE and seasonal type of virus infection. Prevention in the form of proper hygiene at the household level probably will prove to be useful.
  5. Sahari, Y., Abdul Wahid, R., Mhd Adnan, A. S., Sairi, M., Hosni, H., Engku Abdullah, E. H., et al.
    MyJurnal
    The drying performance of industrial inclined bed dryer (IBD) and the milling quality of dried paddy was evaluated and compared in two main granary areas of Muda Agricultural Development Authority (MADA) and Integrated Agricultural Development Areas (IADA KETARA). A mix of MARDI’s paddy variety (MR 220 CL2 and MR 219) was used and the study on both granary area of MADA and IADA KETARA were carried out in local paddy mills located at Yan, Kedah and Besut, Terengganu respectively. The results indicated that the average drying rate in MADA was 119.93 kg water removed/hr whereas only 73.67 kg water removed/hr was recorded in IADA KETARA. Therefore, normalized water removal value of paddy mill in MADA was found higher than paddy mill in IADA KETARA. In terms of milling quality, average percentage of head rice yield of paddy mill in MADA and IADA KETARA was 76.89% and 73.87% respectively. The milling quality analysis of rice resulted from ANOVA found that there was no significant difference in the HRY and total broken between IBDs in both locations.
  6. Chew B, Mastura I, Cheong A, Syed Alwi S
    Malays Fam Physician, 2010;5(3):134-9.
    PMID: 25606205 MyJurnal
    INTRODUCTION: Hypertension is a common co-morbidity in diabetes mellitus (DM) that may lead to serious complications if not adequately controlled.

    METHOD: This is a descriptive study based on data from the Audit of Diabetes Control and Management (ADCM) registry. This audit assessed the treatment and standard of control of hypertension in diabetic patients aged 18 years and above. Data were analysed using STATA version 9.

    RESULTS: From a total of 20 646 cases, about two third of them, 13 417 (65%) were reported to have hypertension. 19 484 (94.4%) had their blood pressure (BP) recorded and out of these, 11 414 (58.5%) were found to have BP >130/80 mmHg. 13 601 cases (65.9%) of the total sample were on antihypertensive drugs. 64.1% of those on antihypertensive drugs were prescribed angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers. 14.2% were on more than two types of antihypertensive drugs. Older patients and those with longer duration of DM were less likely to achieve the target BP of ≤130/80. In general, about 40% of diabetic cases registered in the ADCM project had their hypertension well controlled.

  7. Zainal AI, Zulkarnaen M, Norlida DK, Syed Alwi SA
    Med J Malaysia, 2012 Feb;67(1):60-5.
    PMID: 22582550
    Acral melanoma involve the non-pigmented palmoplantar and subungual areas and are commonly seen among Asians. Patients commonly display advanced stage of disease at presentation. It may appear unnoticed and mimic benign lesions.
  8. Wan Alwi SR, Manan ZA, Samingin MH, Misran N
    J Environ Manage, 2008 Jul;88(2):219-52.
    PMID: 17449168
    Water pinch analysis (WPA) is a well-established tool for the design of a maximum water recovery (MWR) network. MWR, which is primarily concerned with water recovery and regeneration, only partly addresses water minimization problem. Strictly speaking, WPA can only lead to maximum water recovery targets as opposed to the minimum water targets as widely claimed by researchers over the years. The minimum water targets can be achieved when all water minimization options including elimination, reduction, reuse/recycling, outsourcing and regeneration have been holistically applied. Even though WPA has been well established for synthesis of MWR network, research towards holistic water minimization has lagged behind. This paper describes a new holistic framework for designing a cost-effective minimum water network (CEMWN) for industry and urban systems. The framework consists of five key steps, i.e. (1) Specify the limiting water data, (2) Determine MWR targets, (3) Screen process changes using water management hierarchy (WMH), (4) Apply Systematic Hierarchical Approach for Resilient Process Screening (SHARPS) strategy, and (5) Design water network. Three key contributions have emerged from this work. First is a hierarchical approach for systematic screening of process changes guided by the WMH. Second is a set of four new heuristics for implementing process changes that considers the interactions among process changes options as well as among equipment and the implications of applying each process change on utility targets. Third is the SHARPS cost-screening technique to customize process changes and ultimately generate a minimum water utilization network that is cost-effective and affordable. The CEMWN holistic framework has been successfully implemented on semiconductor and mosque case studies and yielded results within the designer payback period criterion.
  9. Syed Alwi SA, Zainal AA, Lau JH
    Med J Malaysia, 2015 Feb;70(1):45-7.
    PMID: 26032531 MyJurnal
    Isolated internal iliac aneurysms are rare. We report a case of an uncommon presentation of perineal pain and tenesmus in a man caused by the pressure effects of the aneurysm. He had a successful endovascular exclusion and thrombosis of his aneurysm. On follow up of more than 3 years he remains free of all symptoms and no recurrence of the aneurysm.
  10. Shim YW, Chua SS, Wong HC, Alwi S
    Ther Clin Risk Manag, 2018;14:1115-1125.
    PMID: 29942134 DOI: 10.2147/TCRM.S146218
    Background: The elderly population is the largest consumer of medications as this age group is at high risk for developing chronic diseases. However, medication use among elderly people is complicated by an increased risk of drug-related problems. Therefore, the present study was conducted to investigate the effects of collaborative interventions between pharmacists and physicians on health-related outcomes of elderly patients.
    Patients and methods: This was a randomized controlled trial (RCT) conducted on elderly outpatients who sought treatment in the Medical Outpatient Department of a public tertiary hospital in Malaysia and who were taking at least five medications. The participants were randomly allocated to the intervention and control groups. The intervention group received pharmaceutical care from a pharmacist in collaboration with physicians and was followed-up for 6 months, while the control group received usual care in the outpatient pharmacy.
    Results: A total of 73 participants in the intervention group and 79 participants in the control group completed the study. Participants in the intervention group had significantly better medication adherence (median =7.0 vs 5.0, U=1224.5, p<0.001, r=0.503) and better Medication Appropriateness Index (MAI) score (median =8.0 vs 20.0, U=749.5, p<0.001, r=0.639).
    Conclusion: Collaborative interventions between pharmacists and physicians improved medication adherence and MAI scores of the elderly patients. Therefore, such services should be implemented in all hospitals, especially in countries where pharmacists are still not playing a substantial role in patient care.
    Trial registration: NMRR-12-958-13020.
    Study site: Outpatient clinic (MOPD), Duchess of Kent Hospital, Sandakan, Sabah, Malaysia
  11. Syed Alwi SAR, Rafidah E, Zurraini A, Juslina O, Brohi IB, Lukas S
    BMC Public Health, 2021 06 12;21(1):1129.
    PMID: 34118897 DOI: 10.1186/s12889-021-11071-6
    BACKGROUND: Vaccination is an effective way to curtail the burden of COVID-19 in which success depends on a high acceptance of the vaccine. However, addressing concerns among vaccine-hesitant individuals is essential to avoid failure of the immunisation programme. This study sought to assess the concerns and acceptance rates regarding the COVID-19 vaccine among Malaysians.

    METHODS: An online questionnaire was distributed to 1411 respondents via a snowball sampling method among Malaysians aged 18 years and above.

    RESULTS: The majority of the respondents were young adults (40.7%), female (62.8%), Malay (63.8%), Muslim (72.3%), married (52.9%), with tertiary education (86.8%) and without medical illness (85%). Social media (97.4%) was the primary source of information regarding COVID-19. The overall acceptance rate was high (83.3%), with the lowest rates among the elderly aged 60 years and above (63.4%) and pensioners (64.6%). Hesitance was caused by concerns regarding side effects (95.8%), safety (84.7%), lack of information (80.9%), effectiveness (63.6%) and religious (20.8%) and cultural factors related to the COVID-19 vaccine (6.8%). Respondents with diabetes mellitus (24.7%) and hypercholesterolemia (23%) were more hesitant to accept the COVID-19 vaccine, at 16.1 and 15.8%, respectively. Predictors of COVID-19 vaccine hesitance were age, religion, and current residence.

    CONCLUSIONS: The results indicate a high rate of acceptance of the COVID-19 vaccine among Malaysians. Thus, the Malaysian government and other related agencies should increase their campaign and prepare to implement the COVID-19 mass immunisation programme among Malaysians. However, despite the high acceptance rate, it remains important to address concerns among hesitant individuals by building trust in vaccine safety and effectiveness through adequate information regarding the vaccine.

  12. Syed Alwi SA, Lee PY, Awi I, Mallik PS, Md Haizal MN
    Climacteric, 2009 Dec;12(6):548-56.
    PMID: 19905907 DOI: 10.3109/13697130902919519
    OBJECTIVES:
    To document the common menopausal symptoms and quality of life in indigenous women of Sarawak in Malaysia.

    METHODS:
    A face-to-face interview using the Menopause-specific Quality of Life questionnaire was conducted with 276 indigenous Sarawakian women aged 40-65 years to determine the mean age of menopause and common symptoms (divided into vasomotor, psychosocial, physical and sexual domains) associated with menopause.

    RESULTS:
    The mean age at menopause of postmenopausal women was 50.78 +/- 2.47 years (range 47.3-58.2 years). The most common symptoms reported were aching in muscles and joints (82.6%), lack of energy (77.5%) and low backache (77.2%). The typical menopausal symptoms of hot flushes, night sweats, sweating and vaginal dryness were experienced by 42.4%, 34.8%, 29.7% and 49.3%, respectively of the women studied. Perimenopausal women (n = 114) experienced the most physical and psychosocial symptoms, while postmenopausal women (n = 102) experienced most sexual symptoms. Perimenopausal and postmenopausal women were reported to suffer more than premenopausal women (p < 0.001) within the four domains of symptoms (vasomotor, psychosocial, physical and sexual).

    CONCLUSIONS:
    The menopausal symptoms in this study correspond to those in other studies on Asian women but the prevalence of typical and classical menopausal symptoms was lower compared to studies on Caucasian women. The perimenopausal women had the most significant decrease in quality of life, followed by postmenopausal women and premenopausal women. Vasomotor symptoms had a predominant influence on the quality of life.
  13. Alwi SA, Rubiah ZS, Lee PY, Mallika PS, Haizal MN
    Climacteric, 2010 Dec;13(6):553-60.
    PMID: 19958163 DOI: 10.3109/13697130903470319
    To determine the usage of hormone replacement therapy (HRT) and knowledge about HRT among women of Sarawak in Malaysia.
  14. Lee KT, Yeoh WC, Zainul NH, Syed Alwi SB, Low LL
    Med J Malaysia, 2021 09;76(5):653-657.
    PMID: 34508370
    INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic posed a significant and urgent threat to global health and economy. Currently, there is no effective treatment known to alter the course of COVID-19. Convalescent plasma (CP) has been used previously to treat several types of infections during pandemics. The aim of our study is to evaluate the efficacy of CP in the treatment of severe COVID-19 infections at Hospital Sultanah Bahiyah, Kedah, Malaysia.

    MATERIALS AND METHODS: A retrospective cross-sectional study of all severe COVID-19 patients who received CP treatment from 1st August 2020 until 31st December 2020 was conducted. Clinical outcomes were compared before and after CP transfusion.

    RESULTS: Thirty-four patients were enrolled and received CP transfusion during the study period. The most common presenting complaints were fever (64.7%) and cough (58.8%). Fourteen patients showed improvement in oxygen support after CP transfusion. Several laboratory parameters also improved such as increased lymphocyte count (1.48 vs 1.98, p=0.008) and decreased C-reactive protein levels (28.1 vs 10.6, p=0.004), and these were statistically significant. Median time from symptoms onset to CP transfusion was 6 days (range 1-11) while median time from PCR diagnosis to CP transfusion was 5 days (range 1-11). One patient developed urticaria after CP transfusion and no severe adverse events were observed. Two of our patients passed away due to secondary causes.

    CONCLUSION: This study showed CP treatment was well tolerated and could potentially prevent progression of COVID-19 to a severe disease if administered early during the viraemic phase. Further evaluation with randomized control trial should be conducted to help ascertain the optimal dose and effectiveness of CP treatment, in correlation with the IgG titer of the donated CP.

  15. Lim LM, McStea M, Chung WW, Nor Azmi N, Abdul Aziz SA, Alwi S, et al.
    PLoS One, 2017;12(3):e0173466.
    PMID: 28273128 DOI: 10.1371/journal.pone.0173466
    BACKGROUND: Polypharmacy has been associated with increased morbidity and mortality in the older population.

    OBJECTIVES: The aim of this study was to determine the prevalence, risk factors and health outcomes associated with polypharmacy in a cohort of urban community-dwelling older adults receiving chronic medications in Malaysia.

    METHODS: This was a baseline study in the Malaysian Elders Longitudinal Research cohort. The inclusion criteria were individuals aged ≥55years and taking at least one medication chronically (≥3 months). Participants were interviewed using a structured questionnaire during home visits where medications taken were reviewed. Health outcomes assessed were frequency of falls, functional disability, potential inappropriate medication use (PIMs), potential drug-drug interactions (PDDIs), healthcare utilisation and quality of life (QoL). Risk factors and health outcomes associated with polypharmacy (≥5 medications including dietary supplements) were determined using multivariate regression models.

    RESULTS: A total of 1256 participants were included with a median (interquartile range) age of 69(63-74) years. The prevalence of polypharmacy was 45.9% while supplement users made up 56.9% of the cohort. The risk factors associated with increasing medication use were increasing age, Indian ethnicity, male, having a higher number of comorbidities specifically those diagnosed with cardiovascular, endocrine and gastrointestinal disorders, as well as supplement use. Health outcomes significantly associated with polypharmacy were PIMS, PDDIs and increased healthcare utilisation.

    CONCLUSION: A significant proportion of older adults on chronic medications were exposed to polypharmacy and use of dietary supplements contributed significantly to this. Medication reviews are warranted to reduce significant polypharmacy related issues in the older population.

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