Displaying publications 1 - 20 of 54 in total

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  1. Nor Azmaniza A, Shamsuddin K, Aazami S
    MyJurnal
    There is a growing interest in research on satisfaction with healthcare provider (HCP) and HCP- patient communication as a measure of healthcare quality of HCP’s communication competency. However, many communication assessments were not comprehensive measures and are not entirely accurate in measuring what is supposed to be measured. This study aimed at assessing the validity and reliability of a newly developed HCP-PC instrument in a Malaysian primary care setting. The HCP-PC instrument was developed using items adapted from existing instruments as well as self-developed items. A pilot study involving 277 clients of an outpatient clinic was conducted in HKL using the proposed instrument which was distributed immediately after face to face consultation. The content validity and Cronbach alpha reliability were assessed. Factor analysis constructed 3 components, exchanging information (EI), socioemotional behaviour (SB) and communication style (CS). All items loaded on the corresponding component with factor loading ≥0.6, suggesting that all items in the respective component are measuring the same direction. PCA of the final 30 items explain 61.98% of the total variance with 6.66%, 47.18% and 8.13% explained by EI, SB and CS respectively. Component-based reliability show strong internal consistency with Cronbach alpha, αEI= 0.92, αSB= 0.96 and αCS= 0.70. The pilot study supported the instrument validity and reliability after initial tests. However, further study needs to be done to confirm its construct validity to help establish a valid and reliable HCP-PC instrument for measuring patient satisfaction with HCP-PC that can be used in primary care setting.

    Study site: outpatient clinic was conducted in HKL
  2. Zainuddin AA, Grover SR, Abdul Ghani NA, Wu LL, Rasat R, Abdul Manaf MR, et al.
    Health Qual Life Outcomes, 2020 Aug 01;18(1):258.
    PMID: 32738912 DOI: 10.1186/s12955-020-01515-9
    BACKGROUND: This study investigates the health-related quality of life (HRQOL) of female patients with congenital adrenal hyperplasia (CAH) in Malaysia. The objectives were to attain socio-demographic and medical data on these Malaysian females with CAH and establish their health-related quality of life (HRQOL) in comparison to age matched diabetic controls.

    METHODS: A cross-sectional study was conducted over 6 months in the two main tertiary centres for CAH patients in Malaysia. Participants including 59 female-raised CAH patients (mean age ± SD = 16.3 ± 4.2 years, range 10-28 years) compared to 57 age-matched female diabetic patients (mean age ± SD = 16.5 ± 3.4 years, range 10-26 years). Socio-demographic and medical profiles was obtained through semi-structured interviews. HRQOL of participants were evaluated utilising validated, Malay translated questionnaires which were age appropriate: Pediatric Quality of Life Inventory (PedsQL v4.0) scales for Child (8-12) and Adolescent (13-18) and Medical Outcome Survey 36-item Short Form version. These were then compared to the diabetic controls.

    RESULTS: The CAH participants consisted of children (ages 10-12 years, n = 12), adolescents (ages 13-17 years, n = 29) and adults (≥ 18 years, n = 18). The majority were Malays (64.4%) and had salt-wasting CAH (67.8%). There were no significant differences between the total mean score of the HRQOL of the combined children and adolescents CAH group (total mean score ± SD = 81.6 ± 17.9, 95% CI = 75.6-87.6) when compared to age-matched diabetic patients (total mean score ± SD = 80.8 ± 11.0, 95% CI = 77.0-84.5, P = 0.81, effect size = 0.05); no significant difference between the adult CAH and diabetic controls in the physical [median score (IQR) CAH vs diabetics; 49.3 (11.4) vs. 50.2 (6.1), P = 0.60, effect size = 0.09] and the mental composite scores [median score (IQR) CAH vs. diabetics; 47.8 (14.1) vs. 50.0 (10.8), P = 0.93, effect size = 0.01].

    CONCLUSIONS: The HRQOL of the Malaysian CAH cohort were comparable to the diabetic controls.

  3. Abdullah NN, Idris IB, Shamsuddin K, Abdullah NMA
    Support Care Cancer, 2020 Apr;28(4):1891-1899.
    PMID: 31359181 DOI: 10.1007/s00520-019-05007-5
    PURPOSE: Gastrointestinal (GI) cancer has emerged as a major health problem. Cancer patients receive informal care from their families beyond formal care. There has been little evidence showing how the health-related quality of life (HRQOL) of the caregivers differs from that of the GI patients in Malaysia. A cross-sectional study was conducted in three referral hospitals in Malaysia. The objectives of this study were to determine the HRQOL of GI cancer patients and their family caregivers, and assess whether there is any significant relationship between the demographic factors, and the physical component summary (PCS) and mental component summary (MCS) scores for patients and caregivers.

    METHODS: A total of 323 dyads of GI cancer patients and their caregivers completed the Medical Outcomes Study 12-item Short Form (MOS SF-12) questionnaire to measure their HRQOL during face-to-face interviews. The analyses were performed using SF-12 scoring software to compute PCS and MCS scores (HRQOL parameters). The independent t test, one-way ANOVA, and the Pearson correlation test were conducted to determine the demographic factors related to the HRQOL of the dyads.

    RESULTS: The caregivers had higher scores in all domains for the SF-12 than the patients. There were significant differences found in the MCS scores of the patients according to ethnicity, origin of cancer, duration of cancer, and surgery. None of these factors had a significant relationship with the caregivers' HRQOL.

    CONCLUSION: Caregivers had better HRQOL than cancer patients. Early intervention for cancer patients in the form of counselling and personalised pain management may enhance the HRQOL of patients.

  4. Abdullah NN, Idris IB, Shamsuddin K, Abdullah NMA
    Asian Pac J Cancer Prev, 2019 Apr 29;20(4):1191-1197.
    PMID: 31030494
    Objective: This study examined the quality of life (QOL) of caregivers for gastrointestinal (GI) cancer patients, and associated factors. Methods: A cross-sectional study was conducted at three referral hospitals in Klang Valley, Malaysia. A total of 323 pairs of patients and caregivers from the oncology units of these hospitals completed questionnaires in Malay. The QOL of caregivers was measured using The Malay Caregiver Quality of Life questionnaire. The independent variables were caregiver and patient factors, care-related factors, the Caregiver Strain Index-Malay, and the Multidimensional Scale of Perceived Social Support-Malay. Simple and multiple linear regression analyses were performed to determine the factors associated with the QOL. Variables with p < 0.05 were considered significant in the multiple analyses. Results: Female caregivers were 68.1% of the total, and 46.4% caregivers were spouses to cancer patients. Their mean age was 44.50 (13.29) years old. About 51.7% were of Malay ethnicity. The mean score for QOL was 80.17 (21.58). Being a male caregiver (beta = 5.165, p = 0.011) and of Indian ethnicity (beta = -9.163, p = 0.001) were strongly associated with caregiver QOL. Male patients contributed higher QOL scores for the caregivers compared to female patients. There was an inverse relationship among caregiving strain, duration of caregiving, and caregiver QOL. Conclusion: The identification of factors that affect QOL will allow healthcare providers to develop appropriate interventions. It is important that caregivers be in good health so as not to compromise the care they provide to their patients.
  5. Syazwani NH, Koh DCL, Shamsuddin K, Ahmad S
    Movement Health & Exercise, 2020;9(1):19-29.
    MyJurnal
    Women with previous history of gestational diabetes mellitus (GDM) have been found to have higher risk of developing type 2 diabetes mellitus (T2DM). Participation in adequate physical activity during and after pregnancy has been found to mitigate this risk. The main purpose of this study was to determine the status of physical activity among women with recent GDM during pregnancy and 8-weeks post-partum. A secondary aim of the study was to explore factors associated with physical activity during and 8-weeks post-partum. Physical activity status was measured using the International Physical Activity Questionnaire (IPAQ). The data were collected during pregnancy through a self-reported questionnaire (n=336) and via telephone interview 8-weeks post-partum (n=117). The results uncovered a significant association between physical activity and status of GDM during pregnancy. Women who reported higher physical activity participation during pregnancy were less likely to have GDM. However, there were no significant association between physical activity participation and GDM status post-partum. Age was associated with participation in physical activity during pregnancy. Self-efficacy and risk perception of developing T2DM were associated with physical activity participation at 8-weeks post-partum. In conclusion, this study highlighted the different factors that should be targeted (for during pregnancy and post-partum) to promote physical activity among this high-risk population.
  6. Fadzil F, Shamsuddin K, Wan Puteh SE, Mohd Tamil A, Ahmad S, Abdul Hayi NS, et al.
    Obes Res Clin Pract, 2018 06 28;12(6):493-499.
    PMID: 29960869 DOI: 10.1016/j.orcp.2018.06.003
    BACKGROUND: Women of childbearing age are predisposed to becoming overweight or obese. This study determines the mean, prevalence and factors associated with 6 months postpartum weight retention among urban Malaysian mothers.

    METHODS: A prospective cohort study was conducted at baseline (after delivery), 2, 4 and 6 months postpartum. From 638 eligible mothers initially recruited, 420 completed until 6 months. Dependent variable was weight retention, defined as difference between weight at 6 months postpartum and pre-pregnancy weight, and weight retention ≥5kg was considered excessive. Independent variables included socio-demographic, history of pregnancy and delivery, lifestyle, practices and traditional postpartum practices.

    RESULTS: Average age was 29.61±4.71years, majority (83.3%) were Malays, 58.8% (low education), 70.0% (employed), 65.2% (middle income family), 33.8% (primiparous) and 66.7% (normal/instrumental delivery). Average gestational weight gain was 12.90±5.18kg. Mean postpartum weight retention was 3.12±4.76kg, 33.8% retaining ≥5kg. Bivariable analysis showed low income, primiparity, gestational weight gain ≥12kg, less active physically, higher energy, protein, carbohydrate and fat intake in diet, never using hot stone compression and not continuing breastfeeding were significantly associated with higher 6 months postpartum weight retention. From multivariable linear regression analysis, less active physically, higher energy intake in diet, gestational weight gain ≥12kg, not continuing breastfeeding 6 months postpartum and never using hot stone compression could explain 55.1% variation in 6 months postpartum weight retention.

    CONCLUSION: Women need to control gestational weight gain, remain physically active, reduce energy intake, breastfeed for at least 6 months and use hot stone compression to prevent high postpartum weight retention.

  7. Fadzil F, Shamsuddin K, Wan Puteh SE, Ahmad S, Abdul Hayi NS, Abdul Samad A, et al.
    Int J Public Health Res, 2015;5(2):637-642.
    MyJurnal
    Introduction: In maternal healthcare, pre-pregnancy weight is used to predict pregnancy outcomes. Since no recorded data on pre-pregnancy weight, perceived weight is used alternatively. This study examines the relationship between perceived and actual weight among non-pregnant urban Malaysian women of childbearing age and identifies differences in perceived and actual weight by selected socio-demographic characteristics.
    Methods: A cross-sectional study was conducted between April and June 2013 among urban Malaysian women attending public health clinics in the Klang Valley. Information on height, perceived current weight and time when their weight was last taken were obtained and actual weight was the average of two measurements (TANITA-HD-323-digital-scale). Socio-demographic data collected were age, ethnicity, education level, marital and employment status and total household income.
    Results: Mean age of 371 women in this study was 28.81±5.65, 82.2% were Malays, 62.8% had tertiary education, over 75% were married and employed, with more than half from middle-income households. Overall, the mean perceived and actual weight was 59.29±11.59 and 59.20±11.90 respectively. Pearson‟s Correlation test showed a very strong positive correlation between perceived and actual weight (r=0.957;p<0.0001), ranging between 0.852 to 0.994 among subgroups; 258 (69.5%) perceived their weight accurately (±2.0 kg of actual weight), 49 (13.2%) under and 64 (17.3%) overestimated their weight.Main outliers were among younger women, Malays, tertiary educated, employed, middle-income and had weight last measured a month or more ago.
    Conclusion: Strong correlation between perceived and actual weight among women in this study reassured weight perception can be used more confidently in patients‟ history taking and future research among urban Malaysian women using public health services.
  8. Aazami S, Shamsuddin K, Akmal S
    ScientificWorldJournal, 2015;2015:343075.
    PMID: 25695097 DOI: 10.1155/2015/343075
    We examined the mediating role of behavioral coping strategies in the association between work-family conflict and psychological distress. In particular, we examined the two directions of work-family conflict, namely, work interference into family and family interference into work. Furthermore, two coping styles in this study were adaptive and maladaptive coping strategies. This cross-sectional study was conducted among 429 Malaysian working women using self-reported data. The results of mediational analysis in the present study showed that adaptive coping strategy does not significantly mediate the effect of work-family conflict on psychological distress. However, maladaptive coping strategies significantly mediate the effect of work-family conflict on psychological distress. These results show that adaptive coping strategies, which aimed to improve the stressful situation, are not effective in managing stressor such as work-family conflict. We found that experiencing interrole conflict steers employees toward frequent use of maladaptive coping strategies which in turn lead to psychological distress. Interventions targeted at improvement of coping skills which are according to individual's needs and expectation may help working women to balance work and family demands. The important issue is to keep in mind that effective coping strategies are to control the situations not to eliminate work-family conflict.
  9. Aazami S, Mozafari M, Shamsuddin K, Akmal S
    Ind Health, 2016;54(1):50-7.
    PMID: 26423332 DOI: 10.2486/indhealth.2015-0086
    This study aimed at assessing effect of the four dimensions of work-family conflicts (strain and time-based work interference into family and family interference into work) on sleep disturbance in Malaysian working women. This cross-sectional study was conducted among 325 Malaysian married working women. Multiple-stage simple random sampling method was used to recruit women from public service departments of Malaysia. Self-administrated questionnaires were used to measure the study variables and data were analyzed using SPSS version 21. We found that high level of the four dimensions of work-family conflicts significantly increase sleep disturbance. Our analyses also revealed an age-dependent effect of the work-family conflict on sleep disturbance. Women in their 20 to 30 yr old suffer from sleep disturbance due to high level of time-based and strain-based work-interference into family. However, the quality of sleep among women aged 30-39 were affected by strain-based family-interference into work. Finally, women older than 40 yr had significantly disturbed sleep due to strain-based work-interference into family as well as time-based family interference into work. Our findings showed that sleep quality of working women might be disturbed by experiencing high level of work-family conflict. However, the effects of inter-role conflicts on sleep varied among different age groups.
  10. Aazami S, Shamsuddin K, Akmal S
    Int J Public Health Res, 2015;5(2):606-612.
    MyJurnal
    Introduction Family satisfaction is referred to the extent in which family members feel happy and fulfilled with each other. However, there has been lack of evidences on the family satisfaction scale within the Malaysian context. Therefore, the aim of this study was to assess validity of the Malay version of the Olson’s Family Satisfaction Scale. This is to allow Malaysian researchers to bring family satisfaction in line with the different field of studies.
    Methods This study was conducted among 567 Malaysian working women. Data were collected using self-administrated questionnaires. This study conducted exploratory and confirmatory factor analysis, convergent validity and internal consistency using Cronbach’s alpha.
    Results The findings of this study support the uni-dimensionality of the Malay version of the family satisfaction scale. The 10 items of the scale account for 68.1% of the total variance and the un-rotated factor loadings ranged from 0.76 to 0.87. Confirmatory factor analysis was run and supported the structure of family satisfaction scale. The results of confirmatory factor analysis using AMOS 21 in the current study reported the following indices: RMSEA= 0.06, CFI= 0.94, NFI= 0.94, TLI= 0.93. The convergent validity (average variance extracted= 0.65) and the internal consistency (Cronbach’s alpha= 0.94) of this construct were adequately supported.
    Conclusions The findings support the factor structure, convergent validity and the internal consistency of the examined construct. Therefore, Malay version of the family satisfaction scale is a valid and reliable instrument among Malaysian working women.
  11. Dahlui, M., Hishamshah, M.I., Rahman, A.J. A, Shamsuddin, K., Aljunid, S.M.
    MyJurnal
    A cost-utility analysis was performed desferrioxamine treatment in thalctssaemia patients at two tertiary hospitals in Malaysia in 2004. A hundred and twelve transfusion dependent thalassaemia patients were grouped according to the status of desferrioxamine; optimum and sulwptimum. Cost analysis was from a patient and hospital perspectives while Quality Adjusted Life Years (QALYs) was the health outcome of choice. Incremental Cost·Effectiveness Ratio (ICER) was also stipulated to show the difference in cost for an additional QALY if patient currently on suboptimum desferrioxamine to switch using optimum desferrioxamine. Results on cost analysis showed the mean cost of treatment for thalassaemia patients on optimum desferrioxamirie was higher than those on sub·optimum desferrioxamine; (RM14, 775.00+SDRM4,737.00 and RM10,780+RM3,655, respectively). QALYs were 19.186+6.591 and 9.859+5275 in the optimum and suboptirnum group, respectively. Costutility analysis showed the cost per QALYs in optimum desferrioxamine group was RM59,045.00 compared to RM44,665.00 in suboptimum desferrioxamine group. ICER of patients on sub-optimum desferrioxamine switching to optimum desferrioxarnine was only RM420.39. Sensitivity analysis showed that the results were robust in the best and worst scenarios. In conclusion, although it is expensive for thalassaemia patients to use optimum desferrioxamine compared to sub-optimum desferrioxamine, the cost per QALYs gained was undoubtedly low.
  12. Aazami S, Shamsuddin K, Akmal S, Azami G
    Malays J Med Sci, 2015 Jul-Aug;22(4):40-6.
    PMID: 26715907 MyJurnal
    The workplace environment has a great influence on employees' health. Job dissatisfaction has been widely recognised as a workplace stressor that can influence employees' psychological and physical health statuses. However, job satisfaction is a multi-dimensional concept, and it is necessary to investigate its different facets and their unique consequences. Therefore, the aim of this study was to assess the relationship between the nine facets of job satisfaction and psychological health and somatic complaints (i.e., sleep disorders, headache, gastro-intestinal and respiratory problems).
  13. Mazlan SA, bin Mohamed Said MS, Hussein H, binti Shamsuddin K, Shah SA, Basri H
    Acta Medica (Hradec Kralove), 2009;52(3):107-16.
    PMID: 20073422 DOI: 10.14712/18059694.2016.114
    INTRODUCTION: Psoriatic Arthritis (PsA) is an inflammatory arthritis associated with Psoriasis. Its recognition as an inflammatory disease distinct from Rheumatoid Arthritis has put forward for consideration several questions regarding its specific CVS mortality and morbidity (9, 11, 16, 26). Carotid intima media thickness is a useful surrogate and sensitive marker to determine atherosclerosis even in its subclinical stages (6, 14, 22, 27, 32).

    OBJECTIVE: Prevalence of carotid intima media thickness in patients with Psoriatic arthritis is unknown in Asian population. We aim to identify the presence of subclinical atherosclerosis in patients with psoriatic arthritis and disease activity association and its predictors in a series of patients with PsA attended to the rheumatology clinic, tertiary hospitals.

    METHODS: A total of 63 patients with PsA who fulfilled the CASPAR criteria were recruited from UKM Medical Centre and Hospital Putrajaya. Common carotid intima media thickness (IMT) was measured in both right and left carotid artery by using high resolution B-mode ultrasound. This was a cross sectional study first done in Malaysia for PsA patients.

    RESULTS: The positive IMT (IMT > 1.00 mm) among PsA was observed in 10 out of 63 patients (15.9 %) regardless of background cardiovascular risk. The mean +/- SD of IMT was 0.725 +/-0.260 mm for this study. Variables significantly associated with positive IMT (p < 0.05) included age at the time of study (p = 0.005), waist circumference (p = 0.001), Hypertension (p = 0.007), Diabetes (p = 0.002) and Metabolic syndrome (p = 0.001) and not associated with gender, ethnicity, duration of PsA disease, pattern of PsA, disease activity and severity. Above all, only age had positive IMT independent predictor (p = 0.032), with OR 1.116; 95 % CI (1.010-1.234).

    CONCLUSIONS: There was a significant association between CVS risk and positive Intima Media Thickness in Psoriatic Arthritis patients. Otherwise, there was no association in disease activity, disease severity and DMARDS therapy with positive Intima Media Thickness in Psoriatic Arthritis patients. The study was approved by Research and Ethics Committee of the faculty of medicine, Universiti Kebangsaan Malaysia with project code FF-114-2008 and by Community Research Center (CRC) of National Institutes of Health (NIH) for the case study in Hospital Putrajaya with the project code NMRR-08-970-2125.
  14. Alsaad MA, Shamsuddin K, Fadzil F
    Asian Pac J Cancer Prev, 2012;13(3):879-83.
    PMID: 22631665
    Cervical cancer is caused by HPV infection and can be prevented by early vaccination.

    OBJECTIVE: To assess Syrian women's level of knowledge and determinants of good knowledge of cervical cancer, HPV infection and its vaccines.

    METHODS: A cross sectional survey was undertaken among mothers with daughters in sixth grade classes enrolled in primary schools in Aleppo city, Syria. Samples were selected through cluster sampling and data collected using a self-administered questionnaire.

    RESULTS: Less than a third of the mothers had heard of HPV infection and vaccines against cervical cancer and levels of knowledge were generally low. Good knowledge was associated with high education level, higher family monthly income, having few--less than four children, positive history of cervical cancer screening, and working or having relatives working in the medical field. The main source of information was television and few reported health care providers as a source of knowledge on HPV infection and vaccine.

    CONCLUSION: Since knowledge of HPV infection and its connection with cervical cancer and its vaccine are low, more efforts must be made to educate Syrians prior to introduction of any HPV vaccination programme. Public health efforts must focus on educating mothers, the public as well as health care providers.

  15. Shamsuddin K, Haris MA
    Singapore Med J, 2000 Apr;41(4):167-71.
    PMID: 11063181
    Objectives: To measure the prevalence of cigarette smoking among male secondary school children and assess their family influence especially that of their fathers' smoking habits on their current smoking habits.
    Methodology: A cross-sectional study was carried out in Kota Bharu, Kelantan in April 1997 where 460 male form four students, aged 15-16 years were randomly selected from six secondary schools. Data on smoking habits, sociodemographic profile and family characteristics particularly parents and siblings' smoking habits, perceived parental supervision and communication were collected through self-administered questionnaires.
    Results: The prevalence of cigarette smoking among male secondary school children was 33.2%. Crude analysis shows family factors, fathers' and siblings' smoking habits, and lack of parental supervision were significantly associated with the students' current smoking habit. Among students who smoked compared to non-smokers, father's smoking habit gives a crude Odds Ratio = 1.8, 95% C.I. 1.08 - 3.16. Further analysis shows that the effect of their father's smoking habit on the student's current smoking habit is still significant after controlling for other familial and non-familial factors including parental supervision, academic performance, reported influence of cigarette advertisement, having friends who smoked and the student's poor knowledge of the ill-effects of smoking and other factors (Odds Ratio = 1.9, 95% C.I 1.05 - 3.32). In conclusion, family factors especially the father's smoking habit is an important factor that influences a student's current smoking habit and the presence of negative role models within the home need to be seriously considered in any cigarette smoking prevention programs among secondary school adolescents.
    Keywords: smoking, male students, adolescents, family influence, father’s smoking habit
  16. Chee H, Rashidah S, Shamsuddin K, Intan O
    BMC Womens Health, 2003 May 28;3(1):3.
    PMID: 12769827
    BACKGROUND: The Malaysian Ministry of Health promotes breast self-examination (BSE) for all women, and Pap smear screening every three years for all sexually active women ages 20 years and above. The objectives of this paper were to examine the practice of these two screening tests among women production workers in electronics factories, and to identify factors related to practice. METHODS: This was a cross-sectional survey of women production workers from ten electronics factories. Data was collected by a self-administered questionnaire from a total of 1,720 women. The chi-square test, odds ratio and binomial logistic regression were used in bivariate and multivariate analysis. RESULTS: Prevalence rates were 24.4% for BSE once a month, and 18.4% for Pap smear examination within the last three years. Women who were significantly more likely to perform BSE every month were 30 years and older, Malays, with upper secondary education and above, answered the BSE question correctly, and had a Pap smear within the last three years. The proportion of women who had a Pap smear within the last three years were significantly higher among those who were older, married, with young children, on the contraceptive pill or intra-uterine device, had a medical examination within the last five years, answered the Pap smear question correctly, and performed BSE monthly. CONCLUSION: Screening practice rates in this study were low when compared to national rates. Socio-demographic and health care factors significantly associated with screening practice are indicative of barriers which should be further understood so that more effective educational and promotional strategies could be developed.
  17. Shamsuddin K, Lieberman E
    Med J Malaysia, 1998 Dec;53(4):343-53.
    PMID: 10971976
    The Malaysian Family Life Survey--2 (MFLS-2) was a population-based survey conducted in Peninsular Malaysia in 1988-89. Through detailed birth histories, it attempted to collect information on all pregnancies and their outcomes from ever-married women, as well as socioeconomic and health services-utilization data that might have affected mortality. The survey did not, however, collect information on the causes of infant death. The two objectives of this study were to assess the feasibility of linking all reported deaths among live births of women interviewed in the MFLS-2 to the birth and death certificates kept by the National Registration Department, and to determine the causes of death from the successfully matched death certificates. This information could be used in the development of specific health programs to decrease infant and child mortality. In this study, the success rates for linking survey data to birth and death certificates were 34.5% and 31.8% respectively. Methodological problems faced during the study are discussed, as are the strengths and limitations of record linking as a means of increasing the utility of birth histories for studying the causes of death. Ways to improve linkage rates of survey data with the national birth and death registration are also suggested.
    Study name: Malaysian Family Life Survey (MFLS-2)
  18. Shamsuddin K, Fadzil F, Ismail WS, Shah SA, Omar K, Muhammad NA, et al.
    Asian J Psychiatr, 2013 Aug;6(4):318-23.
    PMID: 23810140 DOI: 10.1016/j.ajp.2013.01.014
    University students face not only challenges related with independent living, but also academic challenges. This predisposes them to depression, anxiety and stress, which are fairly common.
  19. Zainuddin AA, Grover SR, Shamsuddin K, Mahdy ZA
    J Pediatr Adolesc Gynecol, 2013 Dec;26(6):296-304.
    PMID: 23507003 DOI: 10.1016/j.jpag.2012.08.004
    Congenital adrenal hyperplasia (CAH) is the commonest cause of ambiguous genitalia for female newborns and is one of the conditions under the umbrella term of "Disorders of Sex Development" (DSD). Management of these patients require multidisciplinary collaboration and is challenging because there are many aspects of care, such as the most appropriate timing and extent of feminizing surgery required and attention to psychosexual, psychological, and reproductive issues, which still require attention and reconsideration, even in developed nations. In developing nations, however, additional challenges prevail: poverty, lack of education, lack of easily accessible and affordable medical care, traditional beliefs on intersex, religious, and cultural issues, as well as poor community support. There is a paucity of long-term outcome studies on DSD and CAH to inform on best management to achieve optimal outcome. In a survey conducted on 16 patients with CAH and their parents in a Malaysian tertiary center, 31.3% of patients stated poor knowledge of their condition, and 37.5% did not realize that their medications were required for life. This review on the research done on quality of life (QOL) of female patients with CAH aims: to discuss factors affecting QOL of female patients with CAH, especially in the developing population; to summarize the extant literature on the quality of life outcomes of female patients with CAH; and to offer recommendations to improve QOL outcomes in clinical practice and research.
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