Displaying publications 1 - 20 of 97 in total

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  1. Fulltext Prevalence, transitions and factors predicting transition between frailty states among rural community-dwelling older adults in Malaysia
    Ahmad NS, Hairi NN, Said MA, Kamaruzzaman SB, Choo WY, Hairi F, et al.
    PLoS One, 2018;13(11):e0206445.
    PMID: 30395649 DOI: 10.1371/journal.pone.0206445
    OBJECTIVES: This study aims to describe the prevalence and transitions of frailty among rural-community dwelling older adults in Malaysia and to analyse factors associated with different states of frailty transition. Frailty was conceptualized using modified Fried phenotype from the Cardiovascular Health Study.

    DESIGN: This is a prospective longitudinal study with 12-months follow up among older adults in Malaysia.

    SETTING: Kuala Pilah, a district in Negeri Sembilan, which is one of the fourteen states in Malaysia.

    PARTICIPANTS: 2,324 community-dwelling older Malaysians aged 60 years and older.

    RESULTS: The overall prevalence of frailty in this study was 9.4% (95% CI 7.8-11.2). The prevalence increased at least three-fold with every 10 years of age. This increase was seen higher in women compared to men. Being frail was significantly associated with older age, women, and respondents with a higher number of chronic diseases, poor cognitive function and low socioeconomic status (p<0.05). During the 12-months follow-up, our study showed that the transition towards greater frailty states were more likely (22.9%) than transition toward lesser frailty states (19.9%) while majority (57.2%) remained unchanged. Multivariate logistic regression analysis showed that presence of low physical activity increased the likelihood of worsening transition towards greater frailty states by three times (OR 2.9, 95% CI 2.2-3.7) and lowered the likelihood of transition towards lesser frailty states (OR 0.3, 95% CI 0.2-0.4).

    CONCLUSION: Frailty is reported among one in every eleven older adults in this study. The prevalence increased across age groups and was higher among women than men. Frailty possesses a dynamic status due to its potential reversibility. This reversibility makes it a cornerstone to delay frailty progression. Our study noted that physical activity conferred the greatest benefit as a modifiable factor in frailty prevention.

  2. Tooth mortality in smokers and nonsmokers in a selected population in Sana'a, Yemen
    Al-Bayaty FH, Wahid NA, Bulgiba AM
    J Periodontal Res, 2008 Feb;43(1):9-13.
    PMID: 18230101 DOI: 10.1111/j.1600-0765.2007.00988.x
    Tobacco smoking has been shown to be a major risk factor for tooth loss. The present study was designed to examine tooth mortality and the patterns of tooth loss in smokers and nonsmokers over a wide age range in a selected population from Sana'a, Yemen.
  3. Maternal, prenatal and traditional practice factors associated with perinatal mortality in Yemen
    Al-Shahethi AH, Zaki RA, Al-Serouri AWA, Bulgiba A
    Women Birth, 2019 Apr;32(2):e204-e215.
    PMID: 30030021 DOI: 10.1016/j.wombi.2018.06.016
    BACKGROUND: Perinatal mortality remains a major international problem responsible for nearly six million stillbirths and neonatal deaths.

    OBJECTIVES: To estimate the perinatal mortality rate in Sana'a, Yemen and to identify risk factors for perinatal deaths.

    METHODS: A community-based prospective cohort study was carried out between 2015 and 2016. Nine-hundred and eighty pregnant women were identified and followed up to 7 days following birth. A multi-stage cluster sampling was used to select participants from community households', residing in the five districts of the Sana'a City, Yemen.

    RESULTS: Total of 952 pregnant women were tracked up to 7 days after giving birth. The perinatal mortality rate, the stillbirth rate and the early neonatal mortality rate, were 89.3 per 1000, 46.2 per 1000 and 45.2 per 1000, respectively. In multivariable analysis older age (35+ years) of mothers at birth (Relative Risk=2.83), teenage mothers' age at first pregnancy (<18 years) (Relative Risk=1.57), primipara mothers (Relative Risk=1.90), multi-nuclear family (Relative Risk=1.74), mud house (Relative Risk=2.02), mothers who underwent female genital mutilation (Relative Risk=2.92) and mothers who chewed khat (Relative Risk=1.60) were factors associated with increased risk of perinatal death, whereas a positive mother's tetanus vaccination status (Relative Risk=0.49) were significant protective factors against perinatal deaths.

    CONCLUSION: Rates of perinatal mortality were higher in Sana'a City compared to perinatal mortality at the national level estimated by World Health Organization. It is imperative there be sustainable interventions in order to improve the country's maternal and newborn health.

  4. Fulltext Prevalence and determinants of cardiovascular disease risk factors among the residents of urban community housing projects in Malaysia
    Amiri M, Majid HA, Hairi F, Thangiah N, Bulgiba A, Su TT
    BMC Public Health, 2014;14 Suppl 3:S3.
    PMID: 25436515 DOI: 10.1186/1471-2458-14-S3-S3
    Objectives: The objectives are to assess the prevalence and determinants of cardiovascular disease (CVD) risk factors among the residents of Community Housing Projects in metropolitan Kuala Lumpur, Malaysia.
    Method: By using simple random sampling, we selected and surveyed 833 households which comprised of 3,722 individuals. Out of the 2,360 adults, 50.5% participated in blood sampling and anthropometric measurement sessions. Uni and bivariate data analysis and multivariate binary logistic regression were applied to identify demographic and socioeconomic determinants of the existence of having at least one CVD risk factor.
    Results: As a Result, while obesity (54.8%), hypercholesterolemia (51.5%), and hypertension (39.3%) were the most common CVD risk factors among the low-income respondents, smoking (16.3%), diabetes mellitus (7.8%) and alcohol consumption (1.4%) were the least prevalent. Finally, the results from the multivariate binary logistic model illustrated that compared to the Malays, the Indians were 41% less likely to have at least one of the CVD risk factors (OR = 0.59; 95% CI: 0.37 - 0.93).
    Conclusion: In Conclusion, the low-income individuals were at higher risk of developing CVDs. Prospective policies addressing preventive actions and increased awareness focusing on low-income communities are highly recommended and to consider age, gender, ethnic backgrounds, and occupation classes.
  5. Fulltext Use of the united theory of acceptance and use of technology model to study information communication technology - adoption in five Saudi Arabian private hospitals
    Amnah, A.B., Bulgiba, A., Omar, R.
    JUMMEC, 2015;18(2):1-7.
    MyJurnal
    We conducted a multi-institutional case study to identify the issues associated with the adoption of information and communication technology (ICT) in five private care hospitals in the Kingdom of Saudi Arabia. We conducted interviews with 37 respondents primarily comprising IT professionals.
    We found that there were three determinants of behavioural intentions in this case study: organisation objectives, facilitating conditions and social influence where there are no effects of performance expectancy or effort expectancy. In all five cases, none of the moderators (age, gender, experience and voluntariness) in the original united theory of acceptance and use of technology model were considered critically important by IT professionals. In the present paper, all qualitative elements such as themes, patterns and overarching in the data were analysed to reach a conclusion. In addition, the various perspectives of using ICT are discussed.
  6. Fulltext Genetic associations of the INSIG2 rs7566605 polymorphism with obesity-related metabolic traits in Malaysian Malays
    Apalasamy YD, Moy FM, Rampal S, Bulgiba A, Mohamed Z
    Genet. Mol. Res., 2014;13(3):4904-10.
    PMID: 25062423 DOI: 10.4238/2014.July.4.4
    A genome-wide association study showed that the tagging single nucleotide polymorphism (SNP) rs7566605 in the insulin-induced gene 2 (INSIG2) was associated with obesity. Attempts to replicate this result in different populations have produced inconsistent findings. We aimed to study the association between the rs7566605 SNP with obesity and other metabolic parameters in Malaysian Malays. Anthropometric and obesity-related metabolic parameters and DNA samples were collected. We genotyped the rs7566605 polymorphism in 672 subjects using real-time polymerase chain reaction. No significant associations were found between the rs7566605 tagging SNP of INSIG2 with obesity or other metabolic parameters in the Malaysian Malay population. The INSIG2 rs7566605 SNP may not play a role in the development of obesity-related metabolic traits in Malaysian Malays.
  7. Association of ADIPOQ gene with obesity and adiponectin levels in Malaysian Malays
    Apalasamy YD, Rampal S, Salim A, Moy FM, Bulgiba A, Mohamed Z
    Mol Biol Rep, 2014 May;41(5):2917-21.
    PMID: 24449366 DOI: 10.1007/s11033-014-3147-0
    Studies have shown that single-nucleotide polymorphisms (SNPs) on the ADIPOQ gene have been linked with obesity and with adiponectin levels in various populations. Here, we aimed to investigate the association of ADIPOQ rs17366568 and rs3774261 SNPs with obesity and with adiponectin levels in Malaysian Malays. Obesity parameters and adiponectin levels were measured in 574 subjects. Genotyping was performed using real-time polymerase chain reaction and Sequenom MassARRAY. A significant genotypic association was observed between ADIPOQ rs17366568 and obesity. The frequencies of AG and AA genotypes were significantly higher in the obese group (11%) than in the non-obese group (5%) (P=0.024). The odds of A alleles occurring among the obese group were twice those among the non-obese group (odds ratio 2.15; 95% confidence interval 1.13-4.09). However, no significant association was found between allelic frequencies of ADIPOQ rs17366568 and obesity after Bonferroni correction (P>0.025) or between ADIPOQ rs3774261 and obesity both at allelic and genotypic levels. ADIPOQ SNPs were not significantly associated with log-adiponectin levels. GA, GG, and AG haplotypes of the ADIPOQ gene were not associated with obesity. We confirmed the previously reported association of ADIPOQ rs17366568 with the risk of obesity. ADIPOQ SNPs are not important modulators of adiponectin levels in this population.
  8. Genetic association of SNPs in the FTO gene and predisposition to obesity in Malaysian Malays
    Apalasamy YD, Ming MF, Rampal S, Bulgiba A, Mohamed Z
    Braz. J. Med. Biol. Res., 2012 Dec;45(12):1119-26.
    PMID: 22911346
    The common variants in the fat mass- and obesity-associated (FTO) gene have been previously found to be associated with obesity in various adult populations. The objective of the present study was to investigate whether the single nucleotide polymorphisms (SNPs) and linkage disequilibrium (LD) blocks in various regions of the FTO gene are associated with predisposition to obesity in Malaysian Malays. Thirty-one FTO SNPs were genotyped in 587 (158 obese and 429 non-obese) Malaysian Malay subjects. Obesity traits and lipid profiles were measured and single-marker association testing, LD testing, and haplotype association analysis were performed. LD analysis of the FTO SNPs revealed the presence of 57 regions with complete LD (D' = 1.0). In addition, we detected the association of rs17817288 with low-density lipoprotein cholesterol. The FTO gene may therefore be involved in lipid metabolism in Malaysian Malays. Two haplotype blocks were present in this region of the FTO gene, but no particular haplotype was found to be significantly associated with an increased risk of obesity in Malaysian Malays.
  9. Gender-dependent association of a β(2)-adrenergic gene variant with obesity parameters in Malaysian Malays
    Apalasamy YD, Ming MF, Rampal S, Bulgiba A, Mohamed Z
    Asia Pac J Public Health, 2015 Mar;27(2):NP154-65.
    PMID: 22199155 DOI: 10.1177/1010539511430250
    Recent findings have shown that the rs1042714 (Gln27Glu) single-nucleotide polymorphism (SNP) on the β2-adrenoceptor gene may predispose to obesity. The findings from other studies carried on different populations, however, have been inconsistent. The authors investigated the association between the rs1042714 SNP with obesity-related parameters. DNA of 672 Malaysian Malays was analyzed using real-time polymerase chain reaction. Univariate and multivariate linear regression analyses revealed significant associations between rs1042714 and diastolic blood pressure in the pooled Malaysian Malay subjects under additive and recessive models. After gender stratification, however, a significant association was found between the rs1042714 and triglyceride and the rs1042714 and log-transformed high-density lipoprotein cholesterol levels in Malaysian Malay men. No significant association was found between the SNP and log-transformed body mass index. This polymorphism may have an important role in the development of obesity-related traits in Malaysian Malays. Gender is an effect modifier for the effect of the rs1042714 polymorphism on obesity-related traits in Malaysian Malays.
  10. Polymorphisms of the resistin gene and their association with obesity and resistin levels in Malaysian Malays
    Apalasamy YD, Rampal S, Salim A, Moy FM, Su TT, Majid HA, et al.
    Biochem Genet, 2015 Jun;53(4-6):120-31.
    PMID: 25991560 DOI: 10.1007/s10528-015-9678-9
    Single nucleotide polymorphisms (SNP) in the resistin gene (RETN) are linked to obesity and resistin levels in various populations. However, results have been inconsistent. This study aimed to investigate association between polymorphisms in the resistin gene with obesity in a homogenous Malaysian Malay population. This study is also aimed to determine association between resistin levels with certain SNPs and haplotypes of RETN. A total of 631 Malaysian Malay subjects were included in this study and genotyping was carried out using Sequenom MassARRAY. There was no significant difference found in both allelic and genotype frequencies of each of the RETN SNPs between the obese and non-obese groups after Bonferroni correction. RETN rs34861192 and rs3219175 SNPs were significantly associated with log-resistin levels. The GG genotype carriers are found to have higher levels of log-resistin compared to A allele carriers. The RETN haplotypes (CAG, CGA and GA) were significantly associated with resistin levels. However, the haplotypes of the RETN gene were not associated with obesity. Resistin levels were not correlated to metabolic parameters such as body weight, waist circumference, body mass index, and lipid parameters. RETN SNPs and haplotypes are of apparent functional importance in the regulation of resistin levels but are not correlated with obesity and related markers.
  11. Association of melanocortin-4 receptor gene polymorphisms with obesity-related parameters in Malaysian Malays
    Apalasamy YD, Ming MF, Rampal S, Bulgiba A, Mohamed Z
    Ann Hum Biol, 2013 Jan;40(1):102-6.
    PMID: 22989167 DOI: 10.3109/03014460.2012.720709
    Melanocortin-4 receptor (MC4R) is an important regulator of body weight and energy intake. Genetic polymorphisms of the MC4R gene have been found to be linked to obesity in many recent studies across the globe.
  12. Advancing Global Precision Medicine: An Overview of Genomic Testing and Counseling Services in Malaysia
    Balasopoulou A, Mooy FM, Baker DJ, Mitropoulou C, Skoufas E, Bulgiba A, et al.
    OMICS, 2017 12;21(12):733-740.
    PMID: 29173101 DOI: 10.1089/omi.2017.0136
    Precision medicine, genomic and diagnostic services are no longer limited to developed countries. This broadening in geography of biomarker applications and omics diagnostics also demands empirical study of implementation, diagnostic testing, and counseling practices in the field. For example, the Malaysian population has large ethnic diversity and high prevalence of genetic disorders such as hemoglobinopathies and metabolic disorders. Increased morbidity and mortality from such diseases have a direct impact on society and health system sustainability and for this, decision-making becomes of outmost importance. We report here on our findings on the landscape of genomic testing and genetic counseling services in Malaysia. We first defined the framework of all Malaysian stakeholders that offer genomics services and next, we identified the related information gaps, as depicted through the service providers' online websites. Our research framework revealed that there is a very diverse spectrum of genomics services in Malaysia, in which wet- and dry-laboratory services integrate. Moreover, we identify the current gaps and possible remedies to improve the quality of genomic and predictive analytics, not to mention considerations to ensure robust ethics and responsible innovation. To our knowledge, this is the first such study to be performed for a Southeast Asian country. Our genomics and precision medicine services mapping strategy presented in this study may serve as a model for field assessment at regional, national, and international levels as precision medicine is expanding globally and new governance challenges and opportunities continue to emerge for smart implementation science.
  13. Guidelines for Complementary Feeding of Infants in the Asia Pacific Region: APACPH Public Health Nutrition Group
    Binns C, Lee MK, Yun Low W, Baker P, Bulgiba A, Dahlui M, et al.
    Asia Pac J Public Health, 2020 05;32(4):179-187.
    PMID: 32475150 DOI: 10.1177/1010539520931328
    Good nutrition in the first "1000 days," including breastfeeding and appropriate complementary foods, prepares for a healthy childhood and adult life, also contributes to the prevention of the double burden of malnutrition. Exclusive breastfeeding provides all required nutrients until an infant is around 6 months of age when complementary foods are needed. A literature review was undertaken of complementary foods in the Asia Pacific region. The foods being used at present are often of low nutrient density may provide insufficient amounts of some critical nutrients, and generally the variety is limited. Guidelines for complementary feeding are provided to assist in education and in public health planning.
  14. Internet-Based Research in Public Health: Can It Ever Be Reliable?
    Binns C, Yun Low W, Shunnmugam B, Minh Pham N, Lee A, Bulgiba A, et al.
    Asia Pac J Public Health, 2023 Mar 16.
    PMID: 36924228 DOI: 10.1177/10105395231162470
  15. Infant Feeding Guidelines for the Asia Pacific Region
    Binns C, Lee MK, Kagawa M, Low WY, Scott J, Lee A, et al.
    Asia Pac J Public Health, 2018 Nov 23.
    PMID: 30466298 DOI: 10.1177/1010539518809823
    Good nutrition for infants, during the first 1000 days from conception, is one of the most important determinants of a healthy long life. Breastfeeding is the most important component of infant nutrition and reduces morbidity and mortality. With the changes to the climate currently occurring, issues of nutrition and food supply are only going to increase in importance. The Sustainable Development Goals of the United Nations, place nutrition at the forefront of world development and a sustainable planet. The vision of Asia-Pacific Academic Consortium for Public Health (APACPH) is to "achieve the highest possible level of health of all the people of the nations of the Asia-Pacific region." Much of the burden of disease, early deaths, and disability in the Asia Pacific region could be reduced with public health efforts to address the major risk factors, including nutrition-related causes and smoking. The United Nations Decade of Action on Nutrition 2016-2025 has recently been launched with the aim of reducing the global burden of inappropriate nutrition. The goals include increasing rates of exclusive breastfeeding to 6 months, reducing wasting and stunting, and reducing the rates of low birthweight. This is the position endorsed in these guidelines along with the principles of the Baby Friendly Hospital Initiative. These guidelines expand the information on infants that was included in the 2016 APACPH Dietary Guidelines. APACPH covers many different environments, geographical areas, cultures, and socioeconomic groups. These guidelines are generally applicable to all infants in our region, specific local advice may sometimes be needed.
  16. 1st Asia Pacific Clinical Epidemiology and Evidence Based Medicine Conference. Kuala Lumpur, Malaysia. Editorial
    Bulgiba A, Wong YL, Hairi NN
    Prev Med, 2013;57 Suppl:S1-2.
    PMID: 23528958 DOI: 10.1016/j.ypmed.2013.03.005
  17. How well does self-reported adherence fare compared to therapeutic drug monitoring in HAART?
    Bulgiba A, Mohammed UY, Chik Z, Lee C, Peramalah D
    Prev Med, 2013;57 Suppl:S34-6.
    PMID: 23313585 DOI: 10.1016/j.ypmed.2013.01.002
    The aim of the study was to determine how well self-reported adherence fares compared to therapeutic drug monitoring in monitoring HAART adherence.
  18. Adaptive Leadership and Independent Opinions: Lessons From the National COVID-19 Immunisation Programme
    Bulgiba A
    Asia Pac J Public Health, 2021 Dec 15.
    PMID: 34911369 DOI: 10.1177/10105395211065309
    Malaysia was slow to begin its COVID-19 immunization program for various reasons. However, it is one of the fastest developing countries to vaccinate 80% of its adult population. Nontraditional health leadership played a large role in the implementation of the National COVID-19 Immunisation Programme (NCIP). Independent opinions from academia also helped the NCIP and may be useful as a way of pushing forward recommendations that may otherwise be difficult to make.
  19. Information technology in health care--what the future holds
    Bulgiba AM
    Asia Pac J Public Health, 2004;16(1):64-71.
    PMID: 18839870 DOI: 10.1177/101053950401600111
    In 1998, Malaysia opened its first hospital based on the "paperless and filmless" concept. Two are now in operation, with more to follow. Telemedicine is now being used in some hospitals and is slated to be the technology to watch. Future use of technology in health care will centre on the use of centralised patient databases and more effective use of artificial intelligence. Stumbling blocks include the enormous capital costs involved and difficulty in getting sufficient bandwidth to support applications on a national scale. Problems with the use of information technology in developing countries still remain; mainly inadequate skilled resources to operate and maintain the technology, lack of home-grown technology, insufficient experience in the use of information technology in health care and the attitudes of some health staff. The challenge for those involved in this field will not be in building new "paperless and filmless" institutions but in transforming current "paper and film-based" institutions to "paperless and filmless" ones and changing the mindset of health staff. Universities and medical schools must be prepared to respond to this new wave by incorporating elements of medical/health informatics in their curriculum and assisting governments in the planning and implementation of these projects. The experience of the UMMC is highlighted as an example of the difficulty of transforming a paper-based hospital to a "paperless and filmless" hospital.
  20. How well can signs and symptoms predict AMI in the Malaysian population?
    Bulgiba AM, Razaz M
    Int J Cardiol, 2005 Jun 22;102(1):87-93.
    PMID: 15939103
    The aim of the study was to use data from an electronic medical record system (EMR) to look for factors that would help us diagnose acute myocardial infarction (AMI) with the ultimate aim of using these factors in a decision support system for chest pain. We extracted 887 records from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. We cleaned the data, extracted 69 possible variables and performed univariate and multivariate analysis. From the univariate analysis we find that 22 variables are significantly associated with a diagnosis of AMI. However, multiple logistic regression reveals that only 9 of these 22 variables are significantly related to a diagnosis of AMI. Race (Indian), male sex, sudden onset of persistent crushing pain, associated sweating and a history of diabetes mellitus are significant predictors of AMI. Pain that is relieved by other means and history of heart disease on treatment are important predictors of a diagnosis other than AMI. The degree of accuracy is high at 80.5%. There are 13 factors that are significant in the univariate analysis but are not among the nine significant factors in the multivariate analysis. These are location of pain, associated palpitations, nausea and vomiting; pain relieved by rest, pain aggravated by posture, cough, inspiration and exertion; age more than 40, being a smoker and abnormal chest wall and face examination. We believe that these findings can have important applications in the design of an intelligent decision support system for use in medical care as the predictive capability can be further refined with the use of intelligent computational techniques.
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