Displaying publications 1 - 20 of 153 in total

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  1. Mohamad N, de Oliveira-Souza AIS, de Castro-Carletti EM, Müggenborg F, Dennett L, McNeely ML, et al.
    Disabil Rehabil, 2024 Feb 15.
    PMID: 38357796 DOI: 10.1080/09638288.2024.2310766
    PURPOSE: To determine the effectiveness of different types of acupuncture in reducing pain, improving maximum mouth opening and jaw functions in adults with orofacial pain.

    METHODS: Six databases were searched until 15 June 2023. The Cochrane risk of bias tool and GRADE were employed to evaluate bias and overall evidence certainty.

    RESULTS: Among 52 studies, 86.5% (n = 45) exhibited high risk of bias. Common acupoints, including Hegu LI 4, Jiache ST 6, and Xiaguan ST 7, were used primarily for patients with temporomandibular disorder [TMDs]. Meta-analyses indicated that acupuncture significantly reduced pain intensity in individuals with myogenous TMD (MD = 26.02 mm, I2=89%, p = 0.05), reduced tenderness in the medial pterygoid muscle (standardised mean differences [SMD] = 1.72, I2 = 0%, p 

  2. Chenappan NK, Ibrahim YS, Anuar ST, Yusof KMKK, Jaafar M, Ahamad F, et al.
    Environ Monit Assess, 2024 Feb 07;196(3):242.
    PMID: 38324118 DOI: 10.1007/s10661-024-12381-z
    Microplastics (MPs) pose a threat to ecosystems due to their capacity to bind with toxic chemicals. While the occurrence of MPs in aquatic environmental matrices like water, sediments, and biota is well studied, their presence in the atmosphere remains less understood. This study aimed to determine the presence of airborne MPs and their characteristics through ground-based sampling in the coastal city of Kuala Nerus, Terengganu, Malaysia. Airborne MP samples were collected using passive sampling technique in December 2019. MPs were manually counted and identified using a stereomicroscope based on their colour and shape. The average deposition rate of airborne MPs during the sampling period was 5476 ± 3796 particles/m2/day, ranging from 576 to 15,562 particles/m2/day. Various colours such as transparent (38%), blue (25%), black (20%), red (13%), and others (4%) were observed. The predominant shape of airborne MPs was fibres (> 99%). The morphology structure of MPs observed using a scanning electron microscope (SEM) showed a cracked surface on MPs, suggesting weathering and irregular fragmentation. Further elemental analysis using energy dispersive X-ray spectroscopy (EDS) showed the presence of heavy metals such as aluminium (Al) and cadmium (Cd) on the surface of MPs, attributed to the adsorption capacities of MPs. Polymer types of airborne MPs were analysed using attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), which revealed particles composed of polyester (PES), polyethylene (PE), and polypropylene (PP). The preliminary findings could provide additional information for further investigations of MPs, especially in the atmosphere, to better understand their sources and potential human exposure.
  3. Adnan MN, Ahmad WMAW, Shahzad HB, Awais F, Aleng NA, Noor NF, et al.
    Cureus, 2024 Feb;16(2):e54387.
    PMID: 38505445 DOI: 10.7759/cureus.54387
    Background Hypertension, or high blood pressure, is a common medical condition that affects a significant portion of the global population. It is a major risk factor for cardiovascular diseases (CVD), stroke, and kidney disorders. Objective The objective of this study is to create and validate a model that combines bootstrapping, ordered logistic regression, and multilayer feed-forward neural networks (MLFFNN) to identify and analyze the factors associated with hypertension patients who also have dyslipidemia. Material and methods A total of 33 participants were enrolled from the Hospital Universiti Sains Malaysia (USM) for this study. In this study, advanced computational statistical modeling techniques were utilized to examine the relationship between hypertension status and several potential predictors. The RStudio (Posit, Boston, MA) software and syntax were implemented to establish the relationship between hypertension status and the predictors. Results The statistical analysis showed that the developed methodology demonstrates good model fitting through the value of predicted mean square error (MSE), mean absolute deviance (MAD), and accuracy. To evaluate model fitting, the data in this study was divided into distinct training and testing datasets. The findings revealed that the results strongly support the superior predictive capability of the hybrid model technique. In this case, five variables are considered: marital status, smoking status, systolic blood pressure, fasting blood sugar levels, and high-density lipoprotein levels. It is important to note that all of them affect the hazard ratio: marital status (β1, -17.12343343; p < 0.25), smoking status (β2, 1.86069121; p < 0.25), systolic blood pressure (β3, 0.05037332; p < 0.25), fasting blood sugar (β4, -0.53880322; p < 0.25), and high-density lipoprotein (β5, 5.38065556; p < 0.25). Conclusion This research aims to develop and extensively evaluate the hybrid approach. The statistical methods employed in this study using R language show that regression modeling surpasses R-squared values in predicting the mean square error. The study's conclusion provides strong evidence for the superiority of the hybrid model technique.
  4. Sharma D, Pooja, Nirban S, Ojha S, Kumar T, Jain N, et al.
    AAPS PharmSciTech, 2023 Dec 04;24(8):252.
    PMID: 38049695 DOI: 10.1208/s12249-023-02708-3
    Tuberculosis (TB) is among the top 10 infectious diseases worldwide. It is categorized among the leading killer diseases that are the reason for the death of millions of people globally. Although a standardized treatment regimen is available, non-adherence to treatment has increased multi-drug resistance (MDR) and extensive drug-resistant (XDR) TB development. Another challenge is targeting the death of TB reservoirs in the alveoli via conventional treatment. TB Drug resistance may emerge as a futuristic restraint of TB with the scarcity of effective Anti-tubercular drugs. The paradigm change towards nano-targeted drug delivery systems is mostly due to the absence of effective therapy and increased TB infection recurrent episodes with MDR. The emerging field of nanotechnology gave an admirable opportunity to combat MDR and XDR via accurate diagnosis with effective treatment. The new strategies targeting the lung via the pulmonary route may overcome the new incidence of MDR and enhance patient compliance. Therefore, this review highlights the importance and recent research on pulmonary drug delivery with nanotechnology along with prevalence, the need for the development of nanotechnology, beneficial aspects of nanomedicine, safety concerns of nanocarriers, and clinical studies.
  5. Mohd Tambeh SN, Yaman MN
    J Taibah Univ Med Sci, 2023 Dec;18(6):1480-1492.
    PMID: 37434867 DOI: 10.1016/j.jtumed.2023.06.002
    OBJECTIVES: Clinical reasoning (CR) is important in health professions, because it ensures patient safety and decreases morbidity. CR should be introduced early in medical school. Health educators play a major role in advocating for the use of CR among students; however, educators themselves can be a barrier to the incorporation of CR; consequently, CR training sessions for educators have been proposed as a potential solution. This scoping review was conducted to highlight studies on CR training among health educators.

    METHODS: A scoping review was performed to identify studies on CR training sessions for health educators. PubMed, SciVerse Scopus, Web of Science Core Collection, EBSCO Medline Complete and ERIC databases were searched with terms including clinical reasoning, diagnostic reasoning, teacher and trainer, to identify articles published between 1991 and 2021.

    RESULTS: The initial search yielded 6587 articles; after careful selection, n = 12 articles were included in this scoping review. Most CR training sessions were in the medical field, were conducted in North America, and involved clinical educators. The sessions focused on the fundamentals and steps of CR; biases and debiasing strategies; and learners' difficulties with various teaching formats, such as didactic presentations, facilitated small group sessions with case discussions, roleplay, and use of tools and a mobile application. Educators and students had positive perceptions regarding the conduct and effectiveness of the training sessions.

    CONCLUSIONS: These training sessions were rated highly; however, longitudinal feedback regarding the application of learnt CR teaching strategies is necessary.

  6. Habib Dzulkarnain SM, Hashim IF, Zainudeen ZT, Taib F, Mohamad N, Nasir A, et al.
    J Clin Immunol, 2023 Oct;43(7):1623-1639.
    PMID: 37328647 DOI: 10.1007/s10875-023-01532-5
    Purine nucleoside phosphorylase deficient severe combined immunodeficiency (PNP SCID) is one of the rare autosomal recessive primary immunodeficiency disease, and the data on epidemiology and outcome are limited. We report the successful management of a child with PNP SCID and present a systematic literature review of published case reports, case series, and cohort studies on PNP SCID listed in PubMed, Web of Science, and Scopus from 1975 until March 2022. Forty-one articles were included from the 2432 articles retrieved and included 100 PNP SCID patients worldwide. Most patients presented with recurrent infections, hypogammaglobulinaemia, autoimmune manifestations, and neurological deficits. There were six reported cases of associated malignancies, mainly lymphomas. Twenty-two patients had undergone allogeneic hematopoietic stem cell transplantation with full donor chimerism seen mainly in those receiving matched sibling donors and/or conditioning chemotherapy before the transplant. This research provides a contemporary, comprehensive overview on clinical manifestations, epidemiology, genotype mutations, and transplant outcome of PNP SCID. These data highlight the importance of screening for PNP SCID in cases presented with recurrent infections, hypogammaglobulinaemia, and neurological deficits.
  7. Yusof KMKK, Anuar ST, Mohamad Y, Jaafar M, Mohamad N, Bachok Z, et al.
    Mar Pollut Bull, 2023 Sep;194(Pt B):115268.
    PMID: 37451046 DOI: 10.1016/j.marpolbul.2023.115268
    Malaysia is bounded by the South China Sea with many islands that support species megadiversity and coral reef ecosystems. This study investigates the distribution of microplastics (MPs) in the surface water around the four marine park islands (Perhentian, Redang, Kapas, and Tenggol) during COVID-19. The global pandemic has reset human activities, impacting the environment while possibly reducing anthropogenic contributions of microplastic pollution near the South China Sea islands. It was found that Pulau Perhentian recorded the most abundance of MPs (588.33 ± 111.77 items/L), followed by Pulau Redang (314.67 ± 58.08 items/L), Pulau Kapas (359.8 ± 87.70 items/L) and Pulau Tenggol (294.33 ± 101.64 items/L). Kruskal-Wallis analysis indicates a significant difference in total MPs abundance between islands. There are moderate correlations between salinity, pH, temperature and MPs variability. Among these parameters, only temperature is significant (p 
  8. Mohamad N, Ismail R, Ibrahim MF, Abdul Shukor IH, Mohamad MZ, Mahmud MF, et al.
    Healthcare (Basel), 2023 Aug 18;11(16).
    PMID: 37628536 DOI: 10.3390/healthcare11162339
    During the COVID-19 pandemic, persons under surveillance (PUS) were isolated in quarantine centres instead of at home. However, there is limited knowledge regarding the mental health issues experienced by these persons. This study aimed to assess mental health outcomes and associated factors among PUS and frontline workers at quarantine centres. This study conducted an analysis of secondary data from a cross-sectional survey carried out by the Mental Health and Psychosocial Support Services (MHPSS). The MHPSS employed the Depression, Anxiety, and Stress Scale (DASS-21) to evaluate mental health outcomes across 49 quarantine centres in Malaysia. The study included a total of 4577 respondents. The prevalence of stress, anxiety, and depression was found to be 0.9%, 11.4%, and 10.2%, respectively. Frontline workers and being part of the younger age group were found to be associated with depression, anxiety, and stress. Other factors associated with mental health issues were being female, staying at an institution-type centre, and a longer duration of the stay or work at the centre. In conclusion, assessing the mental health status and its associated factors among quarantine centre occupants is crucial for developing future strategies to safeguard their mental well-being.
  9. Syed Abd Halim SA, Yusoff MSB, Yaman MN, Razali SA, Tengku Muda TFM, Ramli RR, et al.
    J Taibah Univ Med Sci, 2023 Aug;18(4):757-770.
    PMID: 36852241 DOI: 10.1016/j.jtumed.2022.12.007
    OBJECTIVES: Anatomy is a fundamental pillar of medical knowledge that bridges basic medical science knowledge and clinical practice. However, integrated modern medical curricula have reduced the anatomy teaching content, and cadaveric dissection is no longer conducted. Medical graduates who lack anatomy knowledge are anticipated to be inadequately equipped for safe clinical practice. This study was aimed at exploring clinical year students' experiences regarding their anatomy learning during the preclinical phase in Malaysian medical schools. The findings reflect how the students' preclinical anatomy training prepared them for their clinical years of study.

    METHODS: A qualitative phenomenology study using the focus group discussion method was conducted on 30 final-year students from four public universities. Four focus group discussion sessions were conducted, and students' responses were transcribed and converted to electronic formats. The transcripts were analyzed thematically with ATLAS.ti software.

    RESULTS: The first-cycle coding of the text analysis generated 157 open codes based on the phrases used by the participants. The subsequent coding cycle produced 16 axial codes-groups of open codes with similar features. During the final coding cycle, the content and interrelations between the axial codes were categorized into six codes: (1) preclinical anatomy learning experience, (2) anatomy content and teaching, (3) anatomy-related competency, (4) the importance of anatomy knowledge in clinical practice, (5) the importance of early exposure to applied clinical anatomy, and (6) suggestions for future anatomy education.

    CONCLUSIONS: The six identified themes reflected students' perceptions of their anatomy learning experience, the challenges that they faced during their preclinical years, and their opinions regarding the anatomy knowledge and skills that are functionally relevant during the clinical years. Their responses also echoed the need to improve anatomy teaching and learning, thereby emphasizing the importance of early clinical integration and application.

  10. de Castro-Carletti EM, Müggenborg F, Dennett L, Sobral de Oliveira-Souza AI, Mohamad N, Pertille A, et al.
    Clin Rehabil, 2023 Jul;37(7):891-926.
    PMID: 36594219 DOI: 10.1177/02692155221149350
    OBJECTIVE: Summarize the evidence from randomized controlled trials and controlled trials that examined the effectiveness of electrotherapy in the treatment of patients with orofacial pain.

    DATA SOURCE: Medline, Embase, CINAHL PLUS with Full text, Cochrane Library Trials, Web of Science, and Scopus.

    REVIEW METHODS: A data search (last update, July 1, 2022) and a manual search were performed (October 5, 2022). Trials involving adults with orofacial pain receiving electrotherapy compared with any other type of treatment were included. The main outcome was pain intensity; secondary outcomes were mouth opening and tenderness. The reporting was based on the new PRISMA Guidelines.

    RESULTS: From the electronics databases and manual search 43 studies were included. Although this study was open to including any type of orofacial pain, only studies that investigated temporomandibular disorders were found. The overall quality of the evidence for pain intensity was very low. Although the results should be carefully used, transcutaneous electric nerve stimulation therapy showed to be clinically superior to placebo for reducing pain after treatment (2.63 [-0.48; 5.74]) and at follow-up (0.96 [-0.02; 1.95]) and reduce tenderness after treatment (1.99 [-0.33; 4.32]) and at follow-up (2.43 [-0.24; 5.10]) in subjects with mixed temporomandibular disorders.

    CONCLUSION: The results of this systematic review support the use of transcutaneous electric nerve stimulation therapy for patients with mixed temporomandibular disorders to improve pain intensity, and tenderness demonstrating that transcutaneous electric nerve stimulation is superior to placebo. There is inconsistent evidence supporting the superiority of transcutaneous electric nerve stimulation against other therapies.

  11. Ahmed Meelad R, Abd Hamid IJ, Zainudeen ZT, Hashim IF, Azizuddin MNA, Mangantig E, et al.
    J Clin Immunol, 2023 Jul;43(5):999-1006.
    PMID: 36882668 DOI: 10.1007/s10875-023-01463-1
    PURPOSE: Primary immunodeficiency disease (PID) affects various aspects of a patient's life. However, the health-related quality of life (HRQOL) of PID among Malaysian patients is poorly described. This study aimed to determine the quality of life of PID patients and their respective parents.

    METHOD: This cross-sectional study was performed from August 2020 to November 2020. Patients with PID and their families were invited to answer the PedsQL Malay version (4.0) questionnaire, the tool used to assess the HRQOL. A total of 41 families and 33 patients with PID answered the questionnaire. A comparison was performed with the previously published value of healthy Malaysian children.

    RESULT: Parents of respondents recorded a lower mean of total score than the parents of healthy children (67.26 ± 16.73 vs. 79.51 ± 11.90, p-value = 0.001, respectively). PID patients reported lower mean total score to healthy children (73.68 ± 16.38 vs. 79.51 ± 11.90, p-value = 0.04), including the psychosocial domain (71.67 ± 16.82 vs. 77.58 ± 12.63, p-value = 0.05) and school functioning (63.94 ± 20.87 vs. 80.00 ± 14.40, p-value = 0.007). No significant difference of reported HRQOL when comparing between subgroup of PID on immunoglobulin replacement therapy and those without immunoglobulin replacement (56.96 ± 23.58 vs. 65.83 ± 23.82, p-value 0.28). Socioeconomic status was found to be predictive of the lower total score of PedsQL in both parent and children reports.

    CONCLUSION: Parents and children with PID, especially those from middle socioeconomic status, have lower HRQOL and school function impairment than healthy children.

  12. Wong KC, Mohamad N, Md Yusoff BAH
    Cureus, 2023 May;15(5):e38655.
    PMID: 37288232 DOI: 10.7759/cureus.38655
    The acute locked knee is a common presentation of meniscal tears or other intra-articular injuries. However, a popliteus tendon tear, an uncommon cause of acute locked knee, is often overlooked as a possible diagnosis. Here, we present the case of a 29-year-old male who experienced an acute locked knee following a sports injury. An arthroscopic examination revealed an intrasubstance tear in the popliteus tendon and a complete anterior cruciate ligament tear, while the menisci remained intact. Due to the extension lag caused by the popliteus tendon tear, the anterior cruciate ligament reconstruction was postponed. The patient then underwent a course of physiotherapy before the anterior cruciate ligament reconstruction and eventually achieved full knee extension after six weeks. Further surgical intervention was then performed to address the ligament injury. Our case highlights the importance of considering a popliteus tendon tear as a possible cause of an acute locked knee. Proper diagnosis and management are crucial for achieving optimal outcomes for patients with an acute locked knee and concomitant ligamentous injury.
  13. Loh SY, Zakaria R, Mohamad N
    Medeni Med J, 2023 Mar 28;38(1):45-53.
    PMID: 36974481 DOI: 10.4274/MMJ.galenos.2023.14478
    OBJECTIVE: Tuberculosis (TB) is an old disease and it has infected millions of people worldwide. Since it is a highly infectious disease, many people became TB contact due to prolonged exposure to a person with TB infection. This group of people is at a higher risk of getting latent and active TB infection, hence a vulnerable group for active TB screening. This study explored the factors that determined the attitude score, the level of knowledge, attitude, and stigma (KAS) regarding TB disease among TB contact.

    METHODS: This cross-sectional study used a validated KAS questionnaire, performed among 338 TB contacts from 5 health clinics in Kedah, Malaysia. The respondents were selected via convenience sampling. Simple and multiple linear regressions were used to analyze the data.

    RESULTS: The mean KAS scores of participants are 73.5% [standard deviation (SD)=17.06], 83.0% (SD=10.33), and 67.0% (SD=16.72), respectively. Higher income (p=0.001), better knowledge score (p<0.001), and higher stigma score (p=0.003) are the significant associated factors for the attitude score.

    CONCLUSIONS: This study revealed that most of the TB contacts have good knowledge and constructive attitude toward TB prevention and screening, but their level of stigma on TB is high. The implementation of TB education and intervention programs among TB contacts are required especially among low-income groups.

  14. Anuar ST, Abdullah NS, Yahya NKEM, Chin TT, Yusof KMKK, Mohamad Y, et al.
    Environ Res, 2023 Mar 23;227:115717.
    PMID: 36963716 DOI: 10.1016/j.envres.2023.115717
    Microplastics (MPs) with the size of 1 μm-5 mm are pollutants of great concern ubiquitously found in the environment. Existing efforts have found that most of the MPs present in the seas mainly originated from land via riverine inputs. Asian rivers are known to be among the top in microplastic emissions. However, field data are scarce, especially in Malaysia. This study presents the distribution and characteristics of MPs in the surface water of two major river basins of Malaysia, namely Langat River (West Coast/Straits of Malacca) and Kelantan River (East Coast/South China Sea). Water samples were collected at 21-22 locations in Kelantan and Langat rivers, covering the river, estuary and sea. MPs were physically classified based on sizes, shapes, colours and surface morphology (SEM-EDS). The average of 179.6 items/L and 1464.8 items/L of MPs had been quantified from Kelantan and Langat rivers, respectively. Fibre (91.90%) was highly recorded at Kelantan, compared to Langat whereby both fibre (59.21%) and fragment (38.87%) were prevalence. Anthropogenic activities and urbanised areas contribute to high microplastic abundance, especially in the Langat River. Micro-FTIR analysis identified 14 polymers in Kelantan River, whereas 20 polymers were found in Langat River. Polypropylene, polyethylene, polyethylene terephthalate, nylon, phenoxy resins, poly(methyl acrylate), poly(methyl methacrylate), polystyrene, polytetrafluoroethylene, polyurethane and rayon were discovered in both rivers, although only polyethylene was significant (>1 ppm) when further analysed using pyrolysis-GC/MS. Correlation analysis and multiple linear regression were used to explain the relationship between water quality and MP abundance, suggesting only turbidity was positively significant to the microplastic occurrence. This comprehensive study is first to suggest a full-scale monitoring protocol for MPs in Malaysian riverine system and is significant in understanding MPs abundance in correlation to in-situ environmental factors. Consequently, this will allow the right authorities to develop mitigation strategies to address riverine plastic pollution in major river basins in Malaysia and the South East Asia.
  15. Gan TS, Ghazali NI, Voo SYM, Low DE, Tang JJ, Kiing JW, et al.
    Int J Rheum Dis, 2023 Feb;26(2):327-336.
    PMID: 36382593 DOI: 10.1111/1756-185X.14492
    OBJECTIVE: To describe the clinical characteristics, management and quality of life of psoriasis patients with and without coexistent lupus erythematosus (LE).

    METHODS: This retrospective cross-sectional study uses data from the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018.

    RESULTS: Of 21 735 psoriasis patients, 34 (0.16%) had coexistent LE. The male to female ratio among psoriasis patients with coexistent LE was 1:5.8 versus 1.3:1 in patients with psoriasis but without LE. Nearly 70% presented with LE preceding psoriasis. Psoriasis patients with LE had an earlier age of psoriasis onset (27.56 ± 11.51 versus 33.31 ± 16.94 years, P = 0.006), a higher rate of psoriatic arthropathy (26.5% versus 13.0%, P = 0.02), and a significantly greater impairment of quality of life (Dermatology Quality of Life Index >10; 57.6% versus 40.3%, P = 0.04) compared with psoriasis patients without LE. The majority (87.5%) had systemic LE. The incidences of lupus nephritis (72.7% versus 40%) and hematological abnormalities (50% versus 20%) were higher among patients with LE preceding psoriasis compared with those with psoriasis preceding LE. Antinuclear antibody and double-stranded DNA were positive in 59.4% and 28.1% of psoriasis patients with LE, respectively. Hydroxychloroquine triggered the onset of psoriasis in 7 (24.1%) patients. Patients with LE were more likely to receive systemic treatment for psoriasis compared with those without LE (30.3% versus 14.2%, P = 0.008).

    CONCLUSIONS: Psoriasis patients with coexistent LE were uncommon, displayed a female preponderance, were more likely to have joint involvement, and had greater quality of life impairment than those without LE. LE preceded psoriasis in most of these patients, and systemic LE was the most common subtype.

  16. Md Yusoff BAH, Ramlan MKR, Mohd Don AF, Muhammed Ali Noor MI, Mohamad N
    Cureus, 2023 Jan;15(1):e33726.
    PMID: 36788828 DOI: 10.7759/cureus.33726
    A ganglion cyst is a benign cystic lesion that can occur intraosseously. It is commonly a multiloculated lesion that consists of fibrous tissue with mucoid change and is usually located in the subchondral bone adjacent to the joint. Here, we present a rare case of a 33-year-old woman who presented to our orthopedic clinic with a five-year history of shoulder pain that gradually worsened. The pain was worst after any activity involving the right shoulder, and it also occurred at night and disturbed her sleep. Physical examination showed that the patient had limitations on the extreme range of movement. MRI revealed a subchondral bone cyst at the glenoid fossa. The ganglion cyst was subsequently curetted and packed with a bone graft from the iliac bone. Postoperatively, the pain resolved and the patient's range of movement improved. At the six-month follow-up, new bone formation over the void area caused by the cyst was observed on MRI.
  17. Pahrol MA, Ismail R, Mohamad N, Lim YC, Muhamad Robat R, Rajendiran S, et al.
    Front Public Health, 2023;11:1028443.
    PMID: 36935685 DOI: 10.3389/fpubh.2023.1028443
    INTRODUCTION: Healthcare workers (HCWs) have been continually exposed to patients with COVID-19 and are at higher risk of contracting the disease. Their psychological health is important for overall wellbeing and productivity, which could lead to a reduction in human errors during the pandemic crisis. This study aimed to measure the level of concerns, work practices, adequacy of preventive measures among HCWs, and the impacts on their life and work, including mental health status during the second wave of the COVID-19 pandemic in Malaysia.

    METHODS: An online questionnaire was distributed randomly to 1,050 HCWs from the Ministry of Health facilities in the Klang Valley who were involved directly in managing or screening COVID-19 cases from May to August 2020. The questionnaire was divided into five domains, which were concerns, impact on life and work, practice, perceived adequacy of preventive measures, and Revised Impact of Event Scale (IES-R). Logistic regression was used to identify sociodemographic predictors of the five domains.

    RESULTS: A total of 907 respondents (86.4%) participated in this survey. Approximately half of the respondents had a low concern (50.5%), most of them had a good practice (85.1%), with 67.5% perceiving there were adequate preventive measures, and they perceived the outbreak had a low impact (92%) on their life and work. From the IES-R domain, 18.6% of respondents potentially suffered from post-traumatic stress disorder (PTSD).

    CONCLUSION: During the second wave of the COVID-19 outbreak in Malaysia, HCWs practiced high levels of precautions and preventive measures because they were aware of the risk of infection as an occupational hazard. With the adequate implementation of policy and control measures, the psychological wellbeing of the majority HCWs remained well and adequately supported.

  18. Ab Lloh S, Mohamad N, Badrin S, Abu Bakar R, Ahmad I
    J Ethn Subst Abuse, 2023;22(1):45-59.
    PMID: 33472556 DOI: 10.1080/15332640.2021.1871696
    The study aimed to determine the prevalence of continuity of illicit drug use and its associated factors among Malay opioid users receiving methadone treatment in Kelantan, Malaysia. This cross-sectional study involved a total of 150 respondents. Sociodemographic characteristic of participants, level of religiosity, and quality of life were collected using the self-administered questionnaires. The prevalence of continuity illicit drug use was 38.7% (n = 58) by self-report and 40.7% (n = 61) by positive urine test result for drugs. Positive hepatitis C status and high quality of life in the psychological health domain were associated with low continuity of illicit drug use by self-reported data and urine drug test results. In conclusion, the continuity of illicit drug use among methadone program users is still high, especially among those on methadone therapy for less than 2 years.
  19. Rashid SA, Nazakat R, Muhamad Robat R, Ismail R, Suppiah J, Rajendran K, et al.
    Front Public Health, 2023;11:1208348.
    PMID: 37965510 DOI: 10.3389/fpubh.2023.1208348
    Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) may transmit through airborne route particularly when the aerosol particles remain in enclosed spaces with inadequate ventilation. There has been no standard recommended method of determining the virus in air due to limitations in pre-analytical and technical aspects. Furthermore, the presence of low virus loads in air samples could result in false negatives. Our study aims to explore the feasibility of detecting SARS-CoV-2 ribonucleic acid (RNA) in air samples using droplet digital polymerase chain reaction (ddPCR). Active and passive air sampling was conducted between December 2021 and February 2022 with the presence of COVID-19 confirmed cases in two hospitals and a quarantine center in Klang Valley, Malaysia. SARS-CoV-2 RNA in air was detected and quantified using ddPCR and real-time reverse transcriptase-polymerase chain reaction (RT-PCR). The comparability of two different digital PCR platforms (QX200 and QIAcuity) to RT-PCR were also investigated. Additionally negative staining transmission electron microscopy was performed to visualize virus ultrastructure. Detection rates of SARS-CoV-2 in air samples using ddPCR were higher compared to RT-PCR, which were 15.2% (22/145) and 3.4% (5/145), respectively. The sensitivity and specificity of ddPCR was 100 and 87%, respectively. After excluding 17 negative samples (50%) by both QX200 and QIAcuity, 15% samples (5/34) were found to be positive both ddPCR and dPCR. There were 23.5% (8/34) samples that were detected positive by ddPCR but negative by dPCR. In contrast, there were 11.7% (4/34) samples that were detected positive by dPCR but negative by ddPCR. The SARS-CoV-2 detection method by ddPCR is precise and has a high sensitivity for viral RNA detection. It could provide advances in determining low viral titter in air samples to reduce false negative reports, which could complement detection by RT-PCR.
  20. Khairul Hasni NA, Ismail R, Muhamad Robat R, Mohamad N, Suib FA, Pahrol MA, et al.
    PLoS One, 2023;18(11):e0288105.
    PMID: 38019763 DOI: 10.1371/journal.pone.0288105
    This study examined the association of various brands of NIOSH-certified N95 filtering face-piece respirators (FFR) fit with facial dimensions and gender. One hundred and thirty-five participants (77 females and 58 males) were recruited from the previous facial anthropometry study among Malaysians in 2020. Quantitative respirator fit testing of six FFR were performed using the TSI Portacount Pro+ 8038 which comprised of four exercises (bending over, talking, up-down head movement, and side to side head movement). An overall fit factor (FF) of ≥ 100 was considered a pass for each FFR. Analysis was done using T-test, Pearson's correlations, and generalised linear regression. The passing rates for the six FFR were 36.3% (Cup B), 50.4% (Trifold A), 54.1% (Duckbill A), 57.0% (Cup A), 74.1% (Trifold B), and 83.7% (Duckbill B). Both Duckbill B and Trifold B had the highest passing rates for both genders. However, certain FFR models (Cup B, Trifold A, Trifold B, and Duckbill A) fit better for participants with large facial size who were mostly males, while others (Cup A and Duckbill B) specifically fit better for those with small facial size, who were mostly females. This study showed significant positive effect of nose protrusion, nasal root and subnasale-sellion and the negative effect of menton-sellion, bigonial breadth and nose breadth on fit factors of various FFR. The results of this study emphasized the importance of choosing and designing FFR based on local anthropometry data, with careful consideration on the dimensions that affect the respirator fit. Since N95 are commonly used in the healthcare settings to prevent airborne transmission, the practice of respirator fit testing and selecting N95 with high passing rates for healthcare workers need to be emphasized.
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