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Fulltext Association between long-term exposure to ambient air pollution and prevalence of diabetes mellitus among Malaysian adults

Wong SF, Yap PS, Mak JW, Chan WLE, Khor GL, Ambu S, et al.

Environ Health, 2020 04 03;19(1):37.
PMID: 32245482 DOI: 10.1186/s12940-020-00579-w

BACKGROUND: Malaysia has the highest rate of diabetes mellitus (DM) in the Southeast Asian region, and has ongoing air pollution and periodic haze exposure.
METHODS: Diabetes data were derived from the Malaysian National Health and Morbidity Surveys conducted in 2006, 2011 and 2015. The air pollution data (NOx, NO2, SO2, O3 and PM10) were obtained from the Department of Environment Malaysia. Using multiple logistic and linear regression models, the association between long-term exposure to these pollutants and prevalence of diabetes among Malaysian adults was evaluated.
RESULTS: The PM10 concentration decreased from 2006 to 2014, followed by an increase in 2015. Levels of NOx decreased while O3 increased annually. The air pollutant levels based on individual modelled air pollution exposure as measured by the nearest monitoring station were higher than the annual averages of the five pollutants present in the ambient air. The prevalence of overall diabetes increased from 11.4% in 2006 to 21.2% in 2015. The prevalence of known diabetes, underdiagnosed diabetes, overweight and obesity also increased over these years. There were significant positive effect estimates of known diabetes at 1.125 (95% CI, 1.042, 1.213) for PM10, 1.553 (95% CI, 1.328, 1.816) for O3, 1.271 (95% CI, 1.088, 1.486) for SO2, 1.124 (95% CI, 1.048, 1.207) for NO2, and 1.087 (95% CI, 1.024, 1.153) for NOx for NHMS 2006. The adjusted annual average levels of PM10 [1.187 (95% CI, 1.088, 1.294)], O3 [1.701 (95% CI, 1.387, 2.086)], NO2 [1.120 (95% CI, 1.026, 1.222)] and NOx [1.110 (95% CI, 1.028, 1.199)] increased significantly from NHMS 2006 to NHMS 2011 for overall diabetes. This was followed by a significant decreasing trend from NHMS 2011 to 2015 [0.911 for NO2, and 0.910 for NOx].
CONCLUSION: The findings of this study suggest that long-term exposure to O3 is an important associated factor of underdiagnosed DM risk in Malaysia. PM10, NO2 and NOx may have mixed effect estimates towards the risk of DM, and their roles should be further investigated with other interaction models. Policy and intervention measures should be taken to reduce air pollution in Malaysia.
Fulltext A four-decade analysis of the incidence trends, sociodemographic and clinical characteristics of inflammatory bowel disease patients at single tertiary centre, Kuala Lumpur, Malaysia

Mokhtar NM, Nawawi KNM, Verasingam J, Zhiqin W, Sagap I, Azman ZAM, et al.

BMC Public Health, 2019 Jun 13;19(Suppl 4):550.
PMID: 31196184 DOI: 10.1186/s12889-019-6858-2

BACKGROUND: Inflammatory bowel disease (IBD) was once considered as a Western disease. However, recent epidemiological data showed an emerging trend of IBD cases in the Eastern Asia countries. Clinico-epidemiological data of IBD in Malaysia is scarce. This study aimed to address this issue.
METHODS: Retrospective analysis of ulcerative colitis (UC) and Crohn's disease (CD), diagnosed from January 1980 till June 2018 was conducted at our centre.
RESULTS: A total of 413 IBD patients (281 UC, 132 CD) were identified. Mean crude incidence of IBD has increased steadily over the first three decades: 0.36 (1980-1989), 0.48 (1990-1999) and 0.63 per 100,000 person-years (2000-2009). In the 2010 to 2018 period, the mean crude incidence has doubled to 1.46 per 100,000 person-years. There was a significant rise in the incidence of CD, as depicted by reducing UC:CD ratio: 5:1 (1980-1989), 5:1 (1990-1999), 1.9:1 (2000-2009) and 1.7:1 (2010-2018). The prevalence rate of IBD, UC and CD, respectively were 23.0, 15.67 and 7.36 per 100,000 persons. Of all IBD patients, 61.5% (n = 254) were males. When stratified according to ethnic group, the highest prevalence of IBD was among the Indians: 73.4 per 100,000 persons, followed by Malays: 24.8 per 100,000 persons and Chinese: 14.6 per 100,000 persons. The mean age of diagnosis was 41.2 years for UC and 27.4 years for CD. Majority were non-smokers (UC: 76.9%, CD: 70.5%). The diseases were classified as follows: UC; proctitis (9.2%), left-sided colitis (50.2%) and extensive colitis (40.6%), CD; isolated ileal (22.7%), colonic (28.8%), ileocolonic (47.7%) and upper gastrointestinal (0.8%). 12.9% of CD patients had concurrent perianal disease. Extra intestinal manifestations were observed more in CD (53.8%) as compared to UC (12%). Dysplasia and malignancy, on the other hand, occurred more in UC (4.3%, n = 12) than in CD (0.8%, n = 1). Over one quarter (27.3%) of CD patients and 3.6% of UC patients received biologic therapy.
CONCLUSION: The incidence of IBD is rising in Malaysia, especially in the last one decade. This might be associated with the urbanization and changing diets. Public and clinicians' awareness of this emerging disease in Malaysia is important for the timely detection and management.
Cigarette Smoking Among Secondary School-Going Male Adolescents in Malaysia: Findings From the National Health and Morbidity Survey 2017

Ling MYJ, Rodzlan Hasani WS, Mohd Yusoff MF, Abd Hamid HA, Lim KH, Tee GH, et al.

Asia Pac J Public Health, 2019 11;31(8_suppl):80S-87S.
PMID: 31537102 DOI: 10.1177/1010539519874948

Smoking is a learned behavior during adolescence, and it is found predominantly among male adolescents in Malaysia. Our study aimed to investigate the prevalence and predictive factors of current cigarette smoking among school-going male adolescents in Malaysia. Data were derived from the National Health and Morbidity Survey: Adolescent Health Survey 2017, a cross-sectional study that utilized a 2-stage stratified cluster sampling to select a nationally representative sample of school-going adolescents in Malaysia (n = 27 497). Multiple logistic regression analysis was performed to identify factors associated with current cigarette smoking among male adolescents in Malaysia. Male adolescents aged 16 to 17 years (adjusted odds ratio [AOR] = 1.55; 95% confidence interval [CI] = 1.41-1.70), current illicit drug users (AOR = 8.14; 95% CI = 6.37-10.41), current alcohol users (AOR = 1.92; 95% CI = 1.65-2.23), those from rural schools (AOR = 1.60; 95% CI = 1.46-1.76), those whose parents were widowed/divorced/separated (AOR = 1.37; 95% CI = 1.21-1.55), and those whose parents/guardians were tobacco product users (AOR = 3.47; 95% CI = 2.33-5.16) were more likely to be current cigarette smokers. Tobacco control strategies should be aimed at both adolescents at risk and at promoting parental smoking cessation.
Fulltext Prevalence of chronic kidney disease and its associated factors in Malaysia; findings from a nationwide population-based cross-sectional study

Saminathan TA, Hooi LS, Mohd Yusoff MF, Ong LM, Bavanandan S, Rodzlan Hasani WS, et al.

BMC Nephrol, 2020 08 14;21(1):344.
PMID: 32795256 DOI: 10.1186/s12882-020-01966-8

BACKGROUND: The prevalence of chronic kidney disease (CKD) in Malaysia was 9.07% in 2011. We aim to determine the current CKD prevalence in Malaysia and its associated risk factors.
METHODS: A population-based study was conducted on a total of 890 respondents who were representative of the adult population in Malaysia, i.e., aged ≥18 years old. Respondents were randomly selected using a stratified cluster method. The estimated glomerular filtration rate (eGFR) was estimated from calibrated serum creatinine using the CKD-EPI equation. CKD was defined as eGFR has shown that CKD has become one of the leading public health issues in Malaysia. Thus, there is an urgent need to screen for CKD and prevent its progression, associated morbidity, and mortality at the national level.
Risk Factors for Illicit Drug Use Among Malaysian Male Adolescents

Rodzlan Hasani WS, Miaw Yn JL, Saminathan TA, Robert Lourdes TG, Ramly R, Abd Hamid HA, et al.

Asia Pac J Public Health, 2019 11;31(8_suppl):48S-56S.
PMID: 31347375 DOI: 10.1177/1010539519865053

This study was carried out to determine the prevalence of illicit drug use and its associated factors among male adolescents in Malaysia. Data of 13 135 adolescents were extracted from the National Health and Morbidity Survey 2017, a cross-sectional survey among school-going adolescents in Malaysia aged between 13 and 17 years, using a 2-stage stratified cluster sampling. A complex sample design analysis and multiple logistic regression analysis were applied. The overall prevalence of lifetime illicit drug use among male adolescents was 6.6%. The multivariable model showed that illicit drug use among male adolescents were associated with younger age, rural school area, marital status of parent, current smoker, ever having sex, truancy, involved in physical fight, and lack of peer support. The findings from this study can assist community and relevant authorities in their efforts to combat illicit drug usage among adolescents using intervention programs that diminishes risk factors and enhances the protective factors.
Fulltext Prevalence of obesity and its associated risk factors among the elderly in Malaysia: Findings from The National Health and Morbidity Survey (NHMS) 2015

Ariaratnam S, Rodzlan Hasani WS, Krishnapillai AD, Abd Hamid HA, Jane Ling MY, Ho BK, et al.

PLoS One, 2020;15(9):e0238566.
PMID: 32915860 DOI: 10.1371/journal.pone.0238566

BACKGROUND: Obesity is a crucial public health problem and is rising globally. This study was conducted to determine the prevalence of obesity and its associated factors among the elderly in Malaysia.
METHODS: Data were obtained from the National Health and Morbidity Survey (NHMS) 2015. This was a cross sectional population-based study using a two stage stratified random sampling design. Elderly population aged 60 years and above was selected. Data were collected using pre-tested self-administered questionnaire in the form of sociodemographic profile, non-communicable diseases (NCD) comorbidities (status on hypertension, diabetes and hypercholesterolemia) and NCD risk factors (current smoker and physical activity). Obesity has been defined using the World Health Organization (WHO) Body Mass Index (BMI) guideline, 1998. A complex sampling design analysis was used for the descriptive statistics. The associated risk factors for obesity were identified using Multiple Logistic Regression analysis.
RESULTS: A total of 3794 respondents were included in this study. The prevalence of obesity among Malaysian elderly was 30.2%. The prevalence of obesity among the elderly was significantly higher in females, respondents from urban areas and Indians. Approximately one third of the elderly with non-communicable diseases such as hypertension (33.1%) and diabetes (38.8%), respectively, were obese. Among elderly who were obese, majority of them (89.8%) had at least one NCD. The prevalence of obesity was 16.8% among current smokers (aOR 0.59). Multiple logistic regression analysis revealed that elderly females (aOR [adjusted odds ratio] 1.52), having secondary education (aOR 1.96) with household income of RM 3000 and above (aOR 1.57) as well as being hypertensive (aOR 1.61) and diabetic (aOR 1.50) were more likely to be obese. In contrast, the Chinese elderly respondents (aOR 0.62) and current smokers (aOR 0.59) were less likely to be obese. There were no significant associations of obesity with hypercholesterolemia or with physical activity.
CONCLUSIONS: A substantial proportion of Malaysian elderly were obese, and factors associated with obesity among them were being female, having secondary education with a household income of RM 3000 and above and being hypertensive or diabetic. Enhanced health promotion and education should be targeted at younger people in order to prevent obesity in the later years.
Study name: National Health and Morbidity Survey (NHMS-2015)
Fulltext Prevalence of cigarette smoking and its associated factors among male adolescents in Malaysia [Abstract]

Ling JMY, Hasani WSR, Mohd Yusoff MF, Abd Hamid HA, Lim KH, Tee GH, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):34-34.
MyJurnal

ABSTRACTS FOR THE 1ST INTERNATIONAL BORNEO HEALTHCARE AND PUBLIC HEALTH CONFERENCE AND 4TH BORNEO TROPICAL MEDICINE AND INFECTIOUS DISEASE CONGRESS. New Frontiers in Health: Expecting the Unexpected
Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia. 3rd-5th September 2019
Introduction: Smoking kills 5 million people a year and it is known to cause several types of cancer and chronic diseases. Majority of smokers started smoking during adolescence and therefore preventing tobacco use among adolescents is critical to prevent them from future smoking. Our study aims to investigate the prevalence of current cigarette smoking and its associated factors among male adolescents in Malaysia.
Methods: Data was obtained from the National Health and Morbidity Survey (NHMS): Adolescent Health Survey (AHS) 2017 which was a cross-sectional study. A two-stage stratified cluster sampling design was used to select a nationally representative sample of school-going adolescents in Malaysia. Data collection was conducted using a validated self-administered questionnaire. Multiple logistic regression analysis was performed to identify the associated factors of current cigarette smoking among male adolescents in Malaysia.
Results: Approximately one-fifth (22.4%) of male adolescents were current cigarette smokers. Male adolescents who aged 16-17 years, from rural schools, those whose parents were widowed/ divorced/ separated, those who had either one or both parents/guardians who used tobacco product, those who were current illicit drug users and current alcohol users were more likely to be current cigarette smokers.
Conclusion: A substantial percentage of Malaysian male adolescents were current cigarette smokers. Anti-smoking campaigns and tobacco prevention initiatives should be targeted at adolescents at risk to prevent them from becoming cigarette smokers.
Study name: National Health and Morbidity Survey (NHMS-2017)
Fulltext Polysubstance use among adolescents in Malaysia: Findings from the National Health and Morbidity Survey 2017

Rodzlan Hasani WS, Saminathan TA, Ab Majid NL, Miaw Yn JL, Mat Rifin H, Abd Hamid HA, et al.

PLoS One, 2021;16(1):e0245593.
PMID: 33476329 DOI: 10.1371/journal.pone.0245593

BACKGROUND: Polysubstance use is defined as the use of more than one non-prescribed licit or illicit substance either concurrently or simultaneously. This study aimed to determine the prevalence of single substance users and polysubstance users and 'their associated factors among adolescents in Malaysia.
METHODS: This study was a secondary data analysis from the National Health and Morbidity Survey (NHMS) 2017, a cross-sectional survey conducted among Malaysian school-going adolescents aged 13 to 17. The NHMS utilised a two-stage stratified cluster sampling. Multivariate Multinomial Logistic Regression analysis was applied.
RESULTS: The overall prevalence of single substance use and polysubstance use among adolescents were 17.2% and 5.1% respectively. The multinomial model showed a higher likelihood of being single or polysubstance user among male (single user OR = 3.0, poly user OR = 4.6), others Bumiputeras vs Malay (single user OR = 1.7, poly user OR = 5.3), those who live with a single parent (single user OR = 1.2, poly user OR = 1.4), involved in truancy (single user OR = 1.7, poly user OR = 3.6) and being bullied (single user OR = 1.3, poly user OR = 3.4), those who had lack of peer support (single user OR = 1.3, poly user OR = 1.4), poor parental bonding (single user OR = 1.4, poly user OR = 1.8), depression (single user OR = 1.4, poly user OR = 3.2) and those who had no close friend (single user OR = 1.3, poly user OR = 2.7).
CONCLUSION: Our study highlighted multiple significant associated factors of single and polysubstance use among adolescents in Malaysia. This result can assist in the development of specific intervention and prevention programs targeting high-risk groups.
Fulltext The Effect of Graphene Oxide and SEBS-g-MAH Compatibilizer on Mechanical and Thermal Properties of Acrylonitrile-Butadiene-Styrene/Talc Composite

Joynal Abedin FN, Hamid HA, Alkarkhi AFM, Amr SSA, Khalil NA, Ahmad Yahaya AN, et al.

Polymers (Basel), 2021 Sep 19;13(18).
PMID: 34578081 DOI: 10.3390/polym13183180

In this study, acrylonitrile butadiene styrene (ABS)/talc/graphene oxide/SEBS-g-MAH (ABS/Talc/GO/SEBS-g-MAH) and acrylonitrile butadiene styrene/graphene oxide/SEBS-g-MAH (ABS/GO/SEBS-g-MAH) composites were isolated with varying graphene oxide (0.5 to 2.0 phr) as a filler and SEBS-g-MAH as a compatibilizer (4 to 8 phr), with an ABS:talc ratio of 90:10 by percentage. The influences of graphene oxide and SEBS-g-MAH loading in ABS/talc composites were determined on the mechanical and thermal properties of the composites. It was found that the incorporation of talc reduces the stiffness of composites. The analyses of mechanical and thermal properties of composites revealed that the inclusion of graphene oxide as a filler and SEBS-g-MAH as a compatibilizer in the ABS polymer matrix significantly improved the mechanical and thermal properties. ABS/talc was prepared through melt mixing to study the fusion characteristic. The mechanical properties showed an increase of 30%, 15%, and 90% in tensile strength (TS), flexural strength (FS), and flexural modulus (FM), respectively. The impact strength (IS) resulted in comparable properties to ABS, and it was better than the ABS/talc composite due to the influence of talc in the composite that stiffens and reduces the extensibility of plastic. The incorporation of GO and SEBS-g-MA also shows a relatively higher thermal stability in both composites with and without talc. The finding of the present study reveals that the graphene oxide and SEBS-g-MAH could be utilized as a filler and a compatibilizer in ABS/talc composites to enhance the thermo-mechanical stability because of the superior interfacial adhesion between the matrix and filler.
Fulltext Sexual dysfunction in patients with polycystic ovary syndrome in Malaysia

Dashti S, Latiff LA, Hamid HA, Sani SM, Akhtari-Zavare M, Abu Bakar AS, et al.

Asian Pac J Cancer Prev, 2016;17(8):3747-51.
PMID: 27644611

BACKGROUND: Polycystic ovary syndrome (PCOS) is a combination of chronic anovulation, obesity, and hyperandrogenism and can affect sexual function in women of reproductive age. It is also associated with endometrial cancer. Our aim was to evaluate the frequency and predisposing factors of sexual dysfunction in PCOS patients.

MATERIALS AND METHODS: In this cross-sectional study, 16 married women with a definite diagnosis of PCOS were recruited. Sexual function was assessed in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain using the female sexual function index (FSFI) questionnaire. Patients were also assessed for mental health using the depression, anxiety and stress (DASS-21) questionnaire. Presence of hirsutism was assessed using the Ferriman-Gallwey (FG) scoring system. Demographic data were obtained from patients during in-person interview.

RESULTS: Sexual dysfunction was present in 62.5% of patients with the domains of arousal and lubrication particularly affected (93.8% and 87.5%, respectively). Patients with symptoms of depression and anxiety were significantly more likely to suffer sexual dysfunction than those without these symptoms (p=0.04 and p=0.03 respectively). Patients with stress symptoms reported higher orgasm dysfunction than those without (p=0.02). No significant difference in any of the FSFI score domains was observed between patients with and without hirsutism.

CONCLUSIONS: PCOS patients markedly suffer from sexual dysfunction and therefore it seems appropriate to be screened for intervention. Poor mental health conditions that may be the result of infertility or other complications of PCOS should also be considered as curable causes of sexual dysfunction in these patients.
Factors Associated With E-Cigarette Usage and the Reasons for Initiation Among Malaysian Adolescents

Robert Lourdes TG, Abd Hamid HA, Mohd Yusoff MF, Rodzlan Hasani WS, Mat Rifin H, Saminathan TA, et al.

Asia Pac J Public Health, 2019 10;31(7_suppl):44S-52S.
PMID: 31522514 DOI: 10.1177/1010539519870663

Electronic cigarettes (e-cigarettes) are handheld devices that deliver an aerosol by heating a solution made up of propylene glycol and/or glycerol with or without flavoring agents and nicotine. This nationwide cross-sectional survey examined factors associated with e-cigarette usage and reasons for its initiation among 13 162 Malaysian adolescents. Data from TECMA (Tobacco and E-Cigarette Survey among Malaysian Adolescents) were used. Nine percent of adolescents had used e-cigarettes in the past month. Males (adjusted odds ratio [aOR] = 4.08; 95% confidence interval [CI] = 3.36-4.95), 16 to 19 year olds (aOR = 2.64; 95% CI = 2.13-3.26), Malays (aOR = 2.25; 95% CI = 1.79-2.83), Sabah and Sarawak Bumiputeras (aOR = 2.25; 95% CI = 1.61-3.15), and cigarette smokers (aOR = 13.16; 95% CI = 11.14-15.54) were more likely to use e-cigarettes. Three main reasons for e-cigarette initiation among adolescents were its taste and smell, experimentation, and popularity. Sale of e-cigarettes with or without nicotine to people aged younger than 18 years should be banned. Flavored e-cigarettes should also be banned since there is evidence suggesting increased appeal among the younger generation.
Fulltext Norfloxacin Loaded Lipid Polymer Hybrid Nanoparticles for Oral Administration: Fabrication, Characterization, In Silico Modelling and Toxicity Evaluation

Khan MA, Khan S, Kazi M, Alshehri SM, Shahid M, Khan SU, et al.

Pharmaceutics, 2021 Oct 06;13(10).
PMID: 34683925 DOI: 10.3390/pharmaceutics13101632

Norfloxacin (NOR), widely employed as an anti-bacterial drug, has poor oral bioavailability. Nano based drug delivery systems are widely used to overcome the existing oral bioavailability challenges. Lipid-Polymer Hybrid Nanoparticles (LPHNs) exhibit the distinctive advantages of both polymeric and liposomes nanoparticles, while excluding some of their disadvantages. In the current study, NOR loaded LPHNs were prepared, and were solid amorphous in nature, followed by in vitro and in vivo evaluation. The optimized process conditions resulted in LPHNs with the acceptable particle size 121.27 nm, Polydispersity Index (PDI) of 0.214 and zeta potential of -32 mv. The addition of a helper lipid, oleic acid, and polymers, ethyl cellulose, substantially increased the encapsulation efficiency (EE%) (65% to 97%). In vitro study showed a sustained drug release profile (75% within 12 h) for NOR LPHNs. The optimized NOR LPHNs showed a significant increase (p < 0.05) in bioavailability compared to the commercial product. From the acute toxicity study, the LD50 value was found to be greater than 1600 mg/kg. The molecular modelling studies substantiated the experimental results with the best combination of polymers and surfactants that produced highly stable LPHNs. Therefore, LPHNs proved to be a promising system for the delivery of NOR, as well as for other antibiotics and hydrophobic drugs.
Fulltext A review on the assessment of the efficacy of common treatments in polycystic ovarian syndrome on prevention of diabetes mellitus

Dashti S, Latiff LA, Zulkefli NABM, Baharom AB, Minhat HS, Hamid HA, et al.

J Family Reprod Health, 2017 Jun;11(2):56-66.
PMID: 29282412

Objective: Polycystic ovarian syndrome (PCOS) is a common condition amongst women of reproductive age that can result in increased mortality and morbidity in women due to increased risk of diabetes mellitus and cardiovascular diseases. The aim of this systematic review was to assess the effectiveness of common treatments of PCOS on the predictors of diabetes in non-diabetic PCOS women. Materials and methods: An extensive search was performed on the publications in three medical databases including pubmed, scopus and google scholar from 1995 till 2017. The articles were screened based on their quality and included in this systematic review. A total of 25 articles including cohort, randomised controlled trial, review and meta-analysis were included in the review. Results: This systematic review revealed that the effect of lifestyle modification might be low in PCOS subjects due to high drop-out rate while the benefits of this intervention including weight and fat reduction may not be achieved by medical interventions. Metformin treatment may result in improvements in insulin sensitivity while its weight reduction effect is still not documented in PCOS subjects. Thiazolidendiones might be tolerated by the PCOS subjects and may result in similar effects as metformin but this effect should be documented by further studies. Conclusion: Combination of lifestyle modification with metformin or thiazolidinedions might improve the outcome of the prevention strategies. On the other hand this study revealed a different response to treatments in non-obese compared with obese PCOS subjects.
Fulltext Prevalence, Awareness, Treatment and Control of hypertension in the Malaysian population: findings from the National Health and Morbidity Survey 2006-2015

Ab Majid NL, Omar MA, Khoo YY, Mahadir Naidu B, Ling Miaw Yn J, Rodzlan Hasani WS, et al.

J Hum Hypertens, 2018 Sep;32(8-9):617-624.
PMID: 29899376 DOI: 10.1038/s41371-018-0082-x

Hypertension is strongly associated with chronic diseases such as myocardial infarction, stroke, heart failure, and renal failure. The objective of this study is to determine the trend of prevalence, awareness, treatment, and control of hypertension among Malaysian population since 2006 to 2015. The study used the data from National Health and Morbidity Survey (NHMS) 2006, 2011, and 2015. It was a cross-sectional with two-stage stratified random sampling throughout Malaysia for eligible respondents 18 years old and above. Respondents were interviewed face to face and blood pressure was recorded as the average reading from two electronic pressure monitoring measurements. Data was analyzed using the Complex sample module in SPSS Version 20. The prevalence of hypertension in Malaysia was 34.6% (95% CI: 33.9, 35.3) in 2006, 33.6% (95% CI: 32.6, 34.6) in 2011 and 35.3% (95% CI: 34.5, 36.3) in 2015. Awareness of hypertension in 2006, 2011, and 2015 was 35.6% (95% CI: 34.6, 36.6), 40.7% (95% CI: 39.3, 42.1), and 37.5% (95% CI: 36.1, 38.9) respectively. The trend of receiving treatment from 2006 to 2015 was 78.9% (95% CI: 77.5, 80.2) to 83.2% (95% CI: 81.3, 84.8). The control of hypertension increased significantly from 27.5% (95% CI: 25.9, 29.2) in 2006 to 37.4% (95% CI: 35.3, 39.5) in 2015. Despite higher proportions receiving treatment over time, the control of hypertension remained below 40% since NHMS 2006 until 2015. The strategies to further reduce the prevalence and increase awareness of hypertension should be enhanced particularly among the targeted age group to ensure early detection, treatment, and control thus preventing from long-term complications.
The performance of ultrasound and upper gastrointestinal study in diagnosing malrotation in children, with or without volvulus

Mohamed Burhan MS, Hamid HA, Zaki FM, Ning CJ, Zainal IA, Ros IAC, et al.

Emerg Radiol, 2024 Apr;31(2):151-165.
PMID: 38289574 DOI: 10.1007/s10140-024-02201-9

BACKGROUND: Rapid diagnosis is crucial for pediatric patients with midgut volvulus and malrotation to prevent serious complications. While the upper gastrointestinal study (UGIS) is the traditional method, the use of ultrasound (US) is gaining prominence.
OBJECTIVES: To assess the diagnostic sensitivity and specificity of US compared to UGIS for malrotation and midgut volvulus.
METHODS: A cross-sectional study was performed on 68 pediatric patients who underwent US and/or UGIS before surgery for suspected midgut volvulus or malrotation in Kuala Lumpur (PPUKM and HTA), referencing surgical outcomes as the gold standard.
RESULTS: US demonstrated a higher specificity (100%) than UGIS (83%) for diagnosing malrotation, with a slightly lower sensitivity (97% vs. 100%). For midgut volvulus, US surpassed UGIS in sensitivity (92.9% vs. 66.7%) while maintaining comparable specificity. The SMA/SMV criteria showed better sensitivity (91.1%) than the D3 assessment (78.9%) on US, though both had high specificity.
CONCLUSION: US is equivalent to UGIS for identifying malrotation and is more sensitive for detecting midgut volvulus, supporting its use as a primary diagnostic tool. The study advocates for combined US and UGIS when either yields inconclusive results, optimizing diagnostic precision for these conditions.
Fulltext Overweight among primary school-age children in Malaysia

Naidu BM, Mahmud SZ, Ambak R, Sallehuddin SM, Mutalip HA, Saari R, et al.

Asia Pac J Clin Nutr, 2013;22(3):408-15.
PMID: 23945411 DOI: 10.6133/apjcn.2013.22.3.18

This study is a secondary data analysis from the National Health Morbidity Survey III, a population-based study conducted in 2006. A total of 7,749 children between 7 and 12 years old were recruited into the study. This study seeks to report the prevalence of overweight (including obesity) children in Malaysia using international cut-off point and identify its associated key social determinants. The results show that the overall prevalence of overweight children in Malaysia was 19.9%. The urban residents, males, Chinese, those who are wealthy, have overweight or educated guardians showed higher prevalence of overweight. In multivariable analysis, higher likelihood of being overweight was observed among those with advancing age (OR=1.15), urban residents (OR=1.16, 95% CI: 1.01-1.36), the Chinese (OR=1.45, 95% CI: 1.19-1.77), boys (OR=1.23, 95% CI: 1.08-1.41), and those who came from higher income family. In conclusion, one out of five of 7-12 year-old-children in Malaysia were overweight. Locality of residence, ethnicity, gender, guardian education, and overweight guardian were likely to be the predictors of this alarming issue. Societal and public health efforts are needed in order to reduce the burden of disease associated with obesity.
Study name: National Health and Morbidity Survey (NHMS-2006)
Fulltext Prevalence and factors associated with physical inactivity among Malaysian adults

Chan YY, Lim KK, Teh CH, Lim KH, Abd Hamid HA, Omar MA, et al.

Southeast Asian J. Trop. Med. Public Health, 2014 Mar;45(2):467-80.
PMID: 24968689

Using data from the Third National Health and Morbidity Survey (NHMS III) in 2006, this study examined the association between socio-demographic factors and physical inactivity in a sample of 33,949 adults aged 18 years and above by gender. Physical activity levels were measured using the Global Physical Activity Questionnaire (GPAQ vers 1). Physical inactivity was defined as having a total physical activity level of less than 600 metabolic equivalents-minutes per week (METs-minutes/week) contributed by all three different life domains.Logistic regression analyses were conducted.The prevalence of overall physical inactivity was 43.7% (95% CI: 42.9-44.5). The mean total physical activity level was 894.2 METs-minutes/ week. The means METs-minutes/week for the domain of work, travelling, and leisure time were 518.4, 288.1, and 134.8, respectively. Multivariable logistic regression analyses indicated that females were more likely to be physically inactive than males were (aOR=1.62; 95% CI: 1.53-1.72). Among women, being a housewife (aOR = 1.78; 95% CI: 1.56-2.03), widow/divorcee (aOR = 1.23; 95% CI: 1.05-1.43), and those with no formal education (aOR = 1.20; 95% CI: 1.01-1.43) were found to be significantly associated with physical inactivity.Urban residents, older adults aged 65 years and above, private employees, nonworking group, and those with a monthly household income level of MYR5,000 and above appeared to be consistently associated with physical inactivity across men, women, and combined group (both). Specific health intervention strategies to promote physical activity should be targeted on population subgroups who are inactive.
Study name: National Health and Morbidity Survey (NHMS-2006)
Enhanced Mechanical and Thermal Properties of Modified Oil Palm Fiber-Reinforced Polypropylene Composite via Multi-Objective Optimization of In Situ Silica Sol-Gel Synthesis

Mat Rozi N, Hamid HA, Hossain MS, Khalil NA, Ahmad Yahaya AN, Syimir Fizal AN, et al.

Polymers (Basel), 2021 Sep 29;13(19).
PMID: 34641152 DOI: 10.3390/polym13193338

A multi-objective optimization of in situ sol-gel process was conducted in preparing oil palm fiber-reinforced polypropylene (OPF-PP) composite for an enhancement of mechanical and thermal properties. Tetraethyl orthosilicate (TEOS) and butylamine were used as precursors and catalysts for the sol-gel process. The face-centered central composite design (FCCD) experiments coupled with response surface methodology (RSM) has been utilized to optimize in situ silica sol-gel process. The optimization process showed that the drying time after the in-situ silica sol-gel process was the most influential factor on silica content, while the molar ratio of TEOS to water gave the most significant effect on silica residue. The maximum silica content of 34.1% and the silica residue of 35.9% were achieved under optimum conditions of 21.3 h soaking time, 50 min drying time, pH value of 9.26, and 1:4 molar ratio of TEOS to water. The untreated oil palm fiber (OPF) and silica sol-gel modified OPF (SiO2-OPF) were used as the reinforcing fibers, with PP as a matrix and maleic anhydride grafted polypropylene (MAgPP) as a compatibilizer for the fiber-reinforced PP matrix (SiO2-OPF-PP-MAgPP) composites preparation. The mechanical and thermal properties of OPF-PP, SiO2-OPF-PP, SiO2-OPF-PP-MAgPP composites, and pure PP were determined. It was found that the OPF-S-PP-MAgPP composite had the highest toughness and stiffness with values of tensile strength, Young's modulus, and elongation at break of 30.9 MPa, 881.8 MPa, and 15.1%, respectively. The thermal properties analyses revealed that the OPF-S-PP-MAgPP exhibited the highest thermally stable inflection point at 477 °C as compared to pure PP and other composites formulations. The finding of the present study showed that the SiO2-OPF had the potential to use as a reinforcing agent to enhance the thermal-mechanical properties of the composites.
Fulltext Hypoxia-Induced Neuroinflammation in Alzheimer's Disease: Potential Neuroprotective Effects of Centella asiatica

Hambali A, Kumar J, Hashim NFM, Maniam S, Mehat MZ, Cheema MS, et al.

Front Physiol, 2021;12:712317.
PMID: 34721056 DOI: 10.3389/fphys.2021.712317

Alzheimer's disease (AD) is a neurodegenerative disorder that is characterised by the presence of extracellular beta-amyloid fibrillary plaques and intraneuronal neurofibrillary tau tangles in the brain. Recurring failures of drug candidates targeting these pathways have prompted research in AD multifactorial pathogenesis, including the role of neuroinflammation. Triggered by various factors, such as hypoxia, neuroinflammation is strongly linked to AD susceptibility and/or progression to dementia. Chronic hypoxia induces neuroinflammation by activating microglia, the resident immune cells in the brain, along with an increased in reactive oxygen species and pro-inflammatory cytokines, features that are common to many degenerative central nervous system (CNS) disorders. Hence, interests are emerging on therapeutic agents and plant derivatives for AD that target the hypoxia-neuroinflammation pathway. Centella asiatica is one of the natural products reported to show neuroprotective effects in various models of CNS diseases. Here, we review the complex hypoxia-induced neuroinflammation in the pathogenesis of AD and the potential application of Centella asiatica as a therapeutic agent in AD or dementia.
Fulltext The NLRP3 Inflammasome in Age-Related Cerebral Small Vessel Disease Manifestations: Untying the Innate Immune Response Connection

Che Mohd Nassir CMN, Damodaran T, Ismail NI, Hashim S, Jaffer U, Hamid HA, et al.

Life (Basel), 2023 Jan 12;13(1).
PMID: 36676165 DOI: 10.3390/life13010216

In this narrative review, we present the evidence on nucleotide-binding and oligomerization (NOD) domain-like receptor (NLR) family pyrin domain (PYD)-containing 3 (NLRP3) inflammasome activation for its putative roles in the elusive pathomechanism of aging-related cerebral small vessel disease (CSVD). Although NLRP3 inflammasome-interleukin (IL)-1β has been implicated in the pathophysiology of coronary artery disease, its roles in cerebral arteriothrombotic micro-circulation disease such as CSVD remains unexplored. Here, we elaborate on the current manifestations of CSVD and its' complex pathogenesis and relate the array of activators and aberrant activation involving NLRP3 inflammasome with this condition. These neuroinflammatory insights would expand on our current understanding of CSVD clinical (and subclinical) heterogenous manifestations whilst highlighting plausible NLRP3-linked therapeutic targets.

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