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  1. E-waste recycling intention paradigm of small and medium electronics store managers in Bangladesh: An S-O-R perspective
    Mahmud I, Sultana S, Rahman A, Ramayah T, Cheng Ling T
    Waste Manag Res, 2020 Dec;38(12):1438-1449.
    PMID: 32364437 DOI: 10.1177/0734242X20914753
    Each year Bangladesh produces around 400,000 metric tonnes of e-waste. E-waste accumulation is expected to increase by 20% annually. In order to facilitate e-waste recycling, it is crucial to identify the factors. In this study, building on the stimulus-organism-response framework, we develop a research model to explore the effect of information publicity, ascription of responsibility and convenience of recycling on the recycling attitude, subjective norm, personal norm and perceived behaviour control which lead to recycling intention. Data were gathered from 127 small and medium electronics store managers. The structural equation modelling technique was used to test the paths. The result suggests a significant influence of the element of stimulus (S) on the element of organism (O). The relationship between the element of organism (O) and the element of response (R) is partial. This paper contributes to the body of work dedicated to helping us better understand the recycling behaviour from the stimulus-organism-response perspective. From the viewpoint of practice, this research sheds light on some of the challenges that the implementer might face when making strategy and policy for e-waste management in Bangladesh.
  2. Fulltext Day Biting Habits of Mosquitoes Associated with Mangrove Forests in Kedah, Malaysia
    T Ismail TNS, A Kassim NF, A Rahman A, Yahya K, Webb CE
    Trop Med Infect Dis, 2018 Jul 23;3(3).
    PMID: 30274473 DOI: 10.3390/tropicalmed3030077
    Due to conservation and rehabilitation efforts, mangrove forests represent some of the largest environmental niches in Malaysia. However, there is little information on the potential risks posed by mosquitoes that are directly and indirectly associated with mangrove forests. To study the potential health risk to humans active within and in close vicinity of mangrove forests, this research focused on the day biting habits of mosquitoes in mangrove forests of Kedah, Malaysia. The bare leg catch (BLC) method was used to collect adult mosquitoes during a 12-h period from 7:30 a.m. to 7:30 p.m. in both disturbed and less disturbed areas of mangroves. In total, 795 adult mosquitoes from 5 genera and 8 species were collected, and over 65% of the total mosquitoes were collected from the less disturbed area. The predominant species from the less disturbed area was Verrallina butleri; in the disturbed area the dominant species was Culex sitiens. The peak biting hour differed for each species, with Aedes albopictus and Cx. sitiens recorded as having a bimodal biting activity peak during dawn and dusk. For Ve. butleri an erratic pattern of biting activity was recorded in the less disturbed area but it peaked during the early daytime for both collection points. Overall, the distinct pattern of day biting habits of mosquitoes within mangroves peaked during dawn and dusk for the less disturbed area but was irregular for the disturbed area throughout the day. The presence of vectors of pathogens such as Ae. albopictus for both areas raises the need for authorities to consider management of mosquitoes in mangrove forests.
  3. Fulltext Prospective surveillance of nosocomial device-associated bacteremia in three adult intensive units in Malaysia
    Gopal Katherason S, Naing L, Jaalam K, Kamarul Iman Musa K, Nik Abdullah NM, Aiyar S, et al.
    Trop Biomed, 2010 Aug;27(2):308-16.
    PMID: 20962730 MyJurnal
    Nosocomial blood stream infection (or nosocomial bacteremia) is a common problem in hospitals worldwide, including Malaysia. A three-year prospective cohort study (October 2003-March 2007) of the incidences, risk factors, and patterns of the microorganisms causing bacteremia was conducted using a validated surveillance form in three intensive care units (ICUs) in Malaysia. Center for Disease Control criteria were used to diagnose bacteremia. Patients were monitored from admission until the end point of study, which was the first detection of bacteremia in the blood in each patient. The frequency of occurrence of bacteremia with clinical symptoms was 10.7% (n=23). Bacteremia was observed to occur within a mean length of stay of 10 days in ICU. The rate of device-related infection was 10.4% per device utilization days with a device utilization rate of 95.9%/1000 patient days. The total number of patient days was 2309 and the period of device utilization was 2211 days. The common bacteria detected were extended-spectrum beta-lactamases (ESBLs) Klebsiella pneumoniae (n=6); Pseudomonas aeruginosa (n=6); Acinetobacter species (n=5); Methicillin-resistant Staphylococcus aureus (MRSA)(n=3); and (non- ESBL) Klebsiella pneumoniae (n=2). Multivariable analysis using Cox Proportional Hazard Model showed that the predictors for developing bacteremia were cancer, MRSA carriage, duration of central venous catheter (CVC) infusion, frequency change of CVC, and the administration of hydrocortisone drugs. These results indicate that a combination of nursing and medical interventions as well as patients' severity of illness could lead to bacteremia in ICU. Strategic implementation of quality assurance measures in ICUs could help to control this problem.
  4. Prolonging the interval from ovarian hyperstimulation to laparoscopic ovum pick-up improves oocyte yield, quality, and developmental competence in goats
    Abdullah RB, Liow SL, Rahman AN, Chan WK, Wan-Khadijah WE, Ng SC
    Theriogenology, 2008 Sep 15;70(5):765-71.
    PMID: 18579196 DOI: 10.1016/j.theriogenology.2008.04.052
    The objective was to evaluate the effect of the interval between ovarian hyperstimulation and laparoscopic ovum pick-up (LOPU) on quality and developmental competence of goat oocytes before and after in vitro maturation (IVM) and intracytoplasmic sperm injection (ICSI). Estrus was synchronized with an intravaginal insert containing 0.3g progesterone (CIDR) for 10d, combined with a luteolytic treatment of 125 microg cloprostenol 36 h prior to CIDR removal. Ovaries were hyperstimulated with 70 mg FSH and 500 IU hCG given im 36, 60, or 72 h prior to LOPU (n=15, 16, and 7 does, respectively). For these groups, oocyte retrieval rates (mean+/-S.E.M.) were 24.7+/-2.9, 54.5+/-4.7, and 82.8+/-4.6% (P<0.001), and the proportions of cumulus-oocyte complexes (COC) with more than five layers of cumulus cells were 29.7+/-8.3, 37.6+/-6.9, and 37.3+/-7.0% (P<0.001). The proportion of IVM oocytes was highest at 72 h (82.1+/-2.8%; P<0.05), with no significant difference between 36 and 60 h (57.3+/-8.9% and 69.0+/-8.4%). Cleavage rates of ICSI embryos were 4.2+/-4.2, 70.9+/-8.4, and 78.9+/-8.2% with LOPU 36, 60, and 72 h post FSH/hCG (P<0.01), with a lower proportion of Grade-A embryos (P<0.05) following LOPU at 36 h compared to 60 and 72 h (29.7+/-8.3%, 37.6+/-6.9%, and 37.3+/-7.0%). In summary, a prolonged interval from FSH/hCG to LOPU improved oocyte retrieval rate and oocyte quality. Therefore, under the present conditions, LOPU 60 or 72 h after FSH/hCG optimized yields of good-quality oocytes for IVM and embryo production in goats.
  5. Fulltext Norepinephrine in Septic Shock: A Systematic Review and Meta-analysis
    Ruslan MA, Baharuddin KA, Noor NM, Yazid MB, Noh AYM, Rahman A
    West J Emerg Med, 2021 Feb 16;22(2):196-203.
    PMID: 33856300 DOI: 10.5811/westjem.2020.10.47825
    INTRODUCTION: Most experts recommend norepinephrine as the first-line agent in septic shock. Our objective was to determine the effectiveness and safety of norepinephrine in patients with septic shock.

    METHODS: We searched the Cochrane Central Register of Controlled Trials and Epistemonikos, as well as MEDLINE from 1966 till August 2019. Screening of full texts, evaluation for eligibility, and data extraction were done by four independent reviewers. We estimated risk ratios (RR) and mean differences (MD) using a random-effects model with 95% confidence intervals (CI). The primary outcomes included the number of participants who achieved the target mean arterial pressure (MAP), time to achieve the target MAP, and number of participants with all-cause 28-day mortality. The secondary outcomes included the length of stay in the intensive care unit, length of hospital stay, incidence of arrhythmia and myocardial infarction, vasopressor-free days, and number of participants with all-cause 90-day mortality.

    RESULTS: We identified 11 randomized controlled trials with a total of 4,803 participants. There was no difference in the number of participants who achieved the target MAP between those patients receiving norepinephrine and other vasopressors (RR 1.44; 95% CI, 0.32 to 6.54; P = 0.640; I2 = 94%; two trials, 116 participants). There was no significant difference in time to achieve the target MAP (MD -0.05; 95%, CI, -0.32 to 0.21; P = 0.690; I2 = 26%; two trials, 1763 participants) and all-cause 28-day mortality (RR 0.95; 95% CI, 0.89 to 1.02; P = 0.160; I2 = 0%; seven trials, 4,139 participants). Regarding the secondary outcome, norepinephrine may significantly reduce the incidence of arrhythmia as compared to other vasopressors (RR 0.64; 95% CI, 0.42 to 0.97; P = 0.030; I2 = 64%; six trials, 3974 participants). There was no difference in the incidence of myocardial infarction (RR 1.28; 95% CI, 0.79 to 2.09), vasopressor-free day (RR 0.46; 95% CI, -1.82 to 2.74) and all-cause 90-day mortality (RR 1.08; 95% CI, 0.96 to 1.21) between norepinephrine and vasopressors.

    CONCLUSION: In minimizing the occurrence of an arrhythmia, norepinephrine is superior to other vasopressors, making it safe to be used in septic shock. However, there was insufficient evidence concerning mortality and achievement of the target MAP outcomes.

  6. Fulltext Knowledge, attitude and perception of second-hand smoke and factors promoting smoking in Malaysian adolescents
    Abidin NZ, Zulkifli A, Abidin EZ, Rasdi I, Ismail SN, Rahman AA, et al.
    Int J Tuberc Lung Dis, 2014 Jul;18(7):856-61.
    PMID: 24902566 DOI: 10.5588/ijtld.13.0906
    OBJECTIVE: To identify the relationship between knowledge, attitude and perception regarding environmental tobacco smoke (ETS) and smoking among Malaysian adolescents living in states with complete or partial smoke-free legislation (SFL).
    METHODS: A total of 898 respondents aged 13-14 years were randomly selected from 21 secondary schools. The Malay version of the modified Global Youth Tobacco Survey questionnaire was used. Hierarchical logistic regression was performed in examining predictors of smoking attempt among adolescents.
    RESULTS: Participants exposed to ETS >5 h/day were more likely to have smoked compared to those exposed to ETS <1 h/day (OR 4.1, 95%CI 1.03-16.0). Living in a state with partial SFL was associated with a two-fold increase in self-reported smoking attempts (OR 1.95, 95%CI 1.10-3.43) compared to living in a state with complete SFL. Negative attitudes and perceptions towards smoking and ETS exposure were linked to lower smoking attempts in states with complete SFL.
    CONCLUSIONS: Adolescents with limited ETS exposure who lived in a state with complete SFL were less likely to attempt smoking compared to those exposed more regularly to ETS and living in a state with partial SFL. Preventing adolescents from becoming smokers is the key to reducing national prevalence rates in smoking. There is a need to implement comprehensive smoke-free legislation nationally across Malaysia.
  7. Factors affecting dengue fever knowledge, attitudes and practices among selected urban, semi-urban and rural communities in Malaysia
    Al-Dubai SA, Ganasegeran K, Mohanad Rahman A, Alshagga MA, Saif-Ali R
    Southeast Asian J. Trop. Med. Public Health, 2013 Jan;44(1):37-49.
    PMID: 23682436
    Dengue fever is a major public health problem in Malaysia. This study aimed to assess factors affecting knowledge, attitudes, and practices regarding dengue fever among a selected population in Malaysia. A descriptive, community-based, cross sectional study was conducted with 300 participants from three different geographical settings in urban, semi-urban, and rural areas within the states of Selangor and Kuala Lumpur. The questionnaire included questions on demographic data, knowledge, attitudes, and practices regarding dengue fever. Mean age of respondents was 34.4 (+/- 5.7) years, and the age ranged from 18 to 65 years. The majority of respondents were married (54.7%), Malays (72.7%) and heard about dengue fever (89.7%). Television was the common source of information about dengue fever (97.0%). Participants answered 4 out of 15 items of knowledge incorrectly. There was no significant association between knowledge score and socio-demographic factors. About one-fifth of the respondents (24%) believed that immediate treatment is not necessary for dengue fever, and the majority of them were not afraid of the disease (96.0%). Attitudes toward dengue fever were significantly associated with the level of education and employment status (p < 0.05). Practice was associated significantly with age, marital status, and geographic area (p < 0.05) and knowledge on dengue fever (p = 0.030). There is a need to increase health promotion activities through campaigns and social mobilization to increase knowledge regarding dengue fever. This would help to mold positive attitudes and cultivate better preventive practices among the public to eliminate dengue in the country.
  8. Fulltext Knowledge of sexual and reproductive health among adolescents attending school in Kelantan, Malaysia
    Ab Rahman A, Ab Rahman R, Ibrahim MI, Salleh H, Ismail SB, Ali SH, et al.
    Southeast Asian J. Trop. Med. Public Health, 2011 May;42(3):717-25.
    PMID: 21706952
    The objectives of this study were to describe the knowledge of sexual and reproductive health among adolescents attending school and to compare the levels of knowledge between males and females and between older and younger groups of adolescents. A cross-sectional study was conducted among 1,034 secondary school students using a self administered validated questionnaire. The items with the fewest correct responses included: whether one can get pregnant after a single act of sexual intercourse (30.4%), whether sexual intercourse causes sexually transmitted diseases (STDs) (12.4%) and whether washing the vagina after sexual intercourse prevents pregnancy (17.0%). Their main source of sexual information was friends (64.4%). An independent t-test revealed the mean knowledge score was significantly higher among females than males on items assessing whether the genitalia may be touched freely by family members, females having attained menarche may become pregnant if having sex, whether pregnancy will occur if there is penetration of the penis into the vagina, whether premarital sexual intercourse causes pregnancy and if there is a relationship between abandoned babies and premarital pregnancies. The mean knowledge score assessing whether pregnancy can be prevented using condoms was higher among males than females. The mean knowledge scores were significantly higher among form four and form five students than forms one, two and three students. Lack of knowledge regarding important aspects of sexual and reproductive health warrant the need to strengthen sexual and reproductive health education.
  9. The use of herbal medicines during pregnancy and perinatal mortality in Tumpat District, Kelantan, Malaysia
    Ab Rahman A, Ahmad Z, Naing L, Sulaiman SA, Hamid AM, Daud WN
    Southeast Asian J. Trop. Med. Public Health, 2007 Nov;38(6):1150-7.
    PMID: 18613559
    The objective of this case-control study was to determine the association between herbal medicine use during pregnancy and perinatal mortality in Tumpat District, Kelantan, Malaysia. Cases were mothers who gave birth from June 2002 to June 2005 with a history of perinatal mortality, while controls were those without a history of perinatal infant mortality. A total of 316 mothers (106 cases and 210 controls) were interviewed. The use of unidentified herbs prepared by traditional midwives and other types of herbal medicines during the first trimester of pregnancy were positively associated with perinatal mortality (OR = 5.24, 95% CI = 1.13; 24.23 and OR = 8.90, 95%, CI = 1.35; 58.53, respectively). The use of unidentified "Orang Asli" herbs and coconut oil during the third trimester of pregnancy were negatively associated with perinatal mortality in Tumpat (OR = 0.10, 95% CI = 0.02; 0.59 and OR = 0.48, 95% CI = 0.25; 0.92, respectively). These findings suggest the use of unidentified "Orang Asli" herbs and coconut oil in late pregnancy are protective against perinatal mortality, while the use of unidentified herbs prepared by traditional midwives and other types of herbal medicines in early pregnancy has an increased risk of perinatal infant mortality. Pharmacological studies to confirm and identify the compounds in these herbs and their effects on the fetus should be conducted in the future.
  10. Fulltext Molecular medicine: the way forward
    Rahman AJA
    Med J Malaysia, 2004 Oct;59(4):441-2.
    PMID: 15779574
  11. Fulltext World Health Organization Quality of Life Assessment: brief version in Bahasa Malaysia
    Hasanah CI, Naing L, Rahman ARA
    Med J Malaysia, 2003 Mar;58(1):79-88.
    PMID: 14556329 MyJurnal
    WHOQOL-100, a 100 items quality of life assessment by WHO is too lengthy to be applicable in researches where the quality of life is one of the many variables of interest. The abbreviated version with 26 items is more acceptable by subjects, especially those with illness. The generic and the abbreviated Malay version were given to subjects who were healthy and with illness. Results showed that the domain scores produced by WHOQOL-BREF correlate highly with that of WHOQOL-100. WHOQOL-BREF domain scores demonstrated good discriminant validity, construct validity, internal consistency and test-retest reliability. The study indicates that WHOQOL-BREF in its brevity offers a valid and reliable assessment of quality of life.
  12. Fulltext Rheumatic heart disease: how big is the problem?
    Ibrahim A, Rahman AR
    Med J Malaysia, 1995 Jun;50(2):121-4.
    PMID: 7565179
  13. Fulltext How good are doctors as drug prescribers?
    Rahman AR, Noor AR, Hassan Y
    Med J Malaysia, 1994 Dec;49(4):364-8.
    PMID: 7674972
    The training of doctors in therapeutics has created interesting discussions internationally. A survey of senior hospital pharmacists currently practising throughout West Malaysia was embarked on during a recent postgraduate seminar. About sixty per cent said prescribing errors were common amongst doctors. Sixteen per cent of the prescribing errors were potentially serious. Most of the time errors were due to carelessness, lack of knowledge on drug action or a combination of both. Nearly 35% of prescribing errors were not acknowledged by doctors. Most doctors did not give reasons for not acknowledging pharmacists' intervention. About half (46.5%) of the respondents thought that doctors were not adequately trained in the use of drugs.
  14. Fulltext Female sterilization with Hulka clips--initial experience at the University Hospital, Kuala Lumpur
    Abdul Rahman A, Sivanesaratnam V, Nuruddin AA
    Med J Malaysia, 1982 Sep;37(3):276-80.
    PMID: 7177012
    An analysis of 86 patients sterilized laparoscopically with Hulka clips is presented. We find that the method is simple, acceptable and has minimal complication. The failure rate is similar to that reported by others. However, this method could be done under local anaesthesia thus shortening the hospital stay for the patients. This method has the advantage of safety and prospects for reversal when desired.
  15. Fulltext Laparoscopic sterilization with fallope rings - a Malaysian experience
    Abdul Rahman A, Sinnathuray TA, Sivanesaratnam V, Ng KH
    Med J Malaysia, 1981 Jun;36(2):92-9.
    PMID: 6211595
    The early Malaysian experience of laparoscopic sterilisation with the Fallope tubal rings, as undertaken at the Obstetrical and Gynaecological Unit of the University Hospital, University of Malaya in Kuala Lumpur, Malaysia is reported in a study of 291 consecutive females that had had the procedure undertaken during the one year period, May 1975 to April 1976. Of the 291 cases, 247 women were sterilised in the "interval" period, 43 after "menstrual regulation" procedure and one after a spontaneous abortion. General anaesthesia was used in all except one case. The salient socio-demographic, contraceptive and reproductive characteristics of study cases are presented and discussed. The technical problems, the early complications and morbidity encountered in this study are presented and discussed in the light of other similar studies, and in relation to sterilisation by laparoscopic tubal electrocoagulation. The overall impression is that laparoscopic sterilisation with the Fallope tubal rings is preferred to that by tubal electrocoagulation, in view of the possible inadvertent serious electrical burns of other structures during the use of the latter procedure.
  16. Fulltext Vasectomy--experience in a Malaysian hospital
    Sivanesaratnam V, Abd Rahman A
    Med J Malaysia, 1984 Mar;39(1):69-72.
    PMID: 6513843
    A review of our experience of 916 cases ofpartial bilateral vasectomy performed under local anaesthesia at the University Hospital, Kuala Lumpur during the
    period between January 1971 and June 1980 is presented. Minor post-operative complications occurred in 5.8% of cases with a low post-operative infection rate of 1.2%. In 35% ofpatients, persistence of non-motile sperms in the semen were seen after at least ten ejaculations in each instance. In four of these cases non-motile sperms continued to persist into the sixth month of follow-up even after at least 50 ejaculations in each instance.
  17. Fulltext Therapeutic drug monitoring for gentamicin in Hospital Universiti Sains Malaysia
    Ismail R, Sarriff A, Abdul Rahman AF
    Med J Malaysia, 1990 Mar;45(1):57-64.
    PMID: 2152070
    We evaluated the usefulness of therapeutic drug monitoring (TDM) for gentamicin and the use of a two-point peak and trough pair concentration method to adjust its dose. Of the 194 patients included, initial concentrations were appropriate in only sixty nine. In the seventy one cases of dosage adjustments using this method, those attaining therapeutic levels increased overall from 38% to 67%. It is concluded that TDM for gentamicin with dosage adjustment using this simple pharmacokinetic approach is useful and adequate in monitoring for gentamicin therapy.
  18. Fulltext Trends in inquiries on poisoning: a five-year report from the National Poison Centre, Malaysia
    Awang R, Abd Rahman AF, Wan Abdullah WZA, Lajis R, Abdul Majid MI
    Med J Malaysia, 2003 Aug;58(3):375-9.
    PMID: 14750377
    This report describes inquiries relating to poisoning cases which were received by the National Poison Centre of Malaysia from the years 1996 to 2000. The study utilized data from the NPC report forms. Only data relating to patient contact with a poison or chemical were included in the analysis. The poison centre received an average of 186 poisoning inquiries per year. Doctors remained the highest group of caller to the poison centre throughout the five-year period. Nearly 50% of all inquiries was regarding pesticide poisoning and this trend remained constant during the five-year period. Overall, the findings showed that poisoning inquiries relating to patient care were lower than in Japan and the United States.
  19. Milk-alkali syndrome: The forgotten diagnosis for altered sensorium
    Yap WL, Rahman A, Baharuddin KA
    Med J Malaysia, 2022 Jan;77(1):107-109.
    PMID: 35087007
    Milk-alkali syndrome (MAS) is one of the causes of hypercalcaemia. We report a case of a 75-year-old lady with a history of thyroidectomy, presented with an altered mental state and had an extremely high calcium concentration of 4.96mmol/L. The hypercalcemia was attributed to the ingestion of large doses of calcium supplements, including calcium carbonate and calcium lactate, leading to MAS. She was managed with intravenous fluids, diuretics and withdrawal of calcium supplements. The patient responded well to treatment and regained consciousness. Details of the case including clinical presentations, electrocardiogram (ECG) findings and treatment plan, are discussed in this article.
  20. Factors associated with severe envenomation of snakebite cases at emergency department, Hospital Sultan Abdul Halim, Kedah, Malaysia
    Mhd Nizar MNF, Rahman A, Baharuddin KA, Ahmad MZ, Mohamed Ismail M
    Med J Malaysia, 2022 Jan;77(1):20-25.
    PMID: 35086990
    INTRODUCTION: Snakebite envenomation is a medical emergency and cases continue to be encountered in Malaysian hospitals. This study aims to determine the prevalence of snakebite presentations and the associated factors with severe envenomation of snakebite in Sungai Petani, Kedah, Malaysia.

    MATERIALS AND METHODS: This was a retrospective, crosssectional study involving snakebite patients presented at the Emergency Department (ED), Hospital Sultan Abdul Halim (HSAH), Kedah from 1 July 2015 to 30 June 2019. The cases were extracted from the computerized system and the case records of patients were retrieved from the Medical Record Unit. Patients that met the study criteria were included and their sociodemographic features, clinical presentations including use of anti-venom were collected. Logistic regression analysis was performed to determine the factors associated with severe envenomation.

    RESULTS: A total of 220 snakebite cases with the mean age of patients was 39.66 (SD±21.79) years old. Majority of them were Malay and males. 41.4% of snakebite cases occurred in late evenings and the mean time-lapsed to arrive at HSAH was 108.6 minutes. 81.4% of snakebite cases occurred while engaging in outdoor activities and 43.6% of the snakebite cases involved work-related incidents. 58.2% of the patients were bitten in the lower limb. 78.6% of patients were bitten by the identified snake species, predominantly from Viperidae family. The prevalence of severe envenomation was 50.9%. Malay ethnicity (adj. OR =2.549, 95% CI =1.277,5.089), bite to the upper limb (adj. OR =2.125, 95% CI =1.192, 3.790), and bite by snakes from Viperidae family (adj. OR =3.017, 95% CI =1.613, 5.642) were found to have significant associations with severe envenomation of snakebite.

    CONCLUSION: The prevalence of severe envenomation was more than 50% of snakebite cases. Malay ethnicity, upper limb snake bites, and snakebite from a Viperidae family had a higher chance of severe envenomation.

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