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Fulltext Work-family conflict and sleep disturbance: the Malaysian working women study

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.
Fulltext Work related determinants of breastfeeding discontinuation among employed mothers in Malaysia

Amin RM, Said ZM, Sutan R, Shah SA, Darus A, Shamsuddin K

Int Breastfeed J, 2011;6(1):4.
PMID: 21342506 DOI: 10.1186/1746-4358-6-4

This cross-sectional study assesses factors that contribute to discontinuing breastfeeding among employed mothers in Malaysia.
Fulltext Weighted analysis of prevalence and risk factors of hepatitis B infection among antenatal mothers in Ipoh

Shamsuddin K, Marmuji LZ

Singapore Med J, 2010 Oct;51(10):800-5.
PMID: 21103816

Several strategies have been developed to reduce hepatitis B infections. These include antenatal screening, universal immunisation of newborns and immunoglobulin therapy for babies who are at risk. Antenatal screening for hepatitis B is not routinely performed, but all newborns in Malaysia are immunised against hepatitis B. We assessed the prevalence of hepatitis B and the factors associated with it among antenatal mothers in Ipoh. This information is useful in decision-making for future hepatitis B screening programmes for antenatal mothers, allowing for immunoglobulin therapies for newborns if their mother's hepatitis B virus (HBV) status is known.
Fulltext Weight perception among non-pregnant urban Malaysian women: is it reliable?

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.
Voluntary Fasting to Control Post-Ramadan Weight Gain among Overweight and Obese Women

Ismail S, Shamsuddin K, Latiff KA, Saad HA, Majid LA, Othman FM

Sultan Qaboos Univ Med J, 2015 Feb;15(1):e98-e104.
PMID: 25685394

OBJECTIVES: This study aimed to examine the effectiveness of an Islamic voluntary fasting intervention to control post-Ramadan weight gain.
METHODS: This study was conducted between July and November 2011. Two weight loss intervention programmes were developed and implemented among groups of overweight or obese Malay women living in the Malaysian cities of Putrajaya and Seremban: a standard programme promoting control of food intake according to national dietary guidelines (group B) and a faith-based programme promoting voluntary fasting in addition to the standard programme (group A). Participants' dietary practices (i.e., voluntary fasting practices, frequency of fruit/vegetable consumption per week and quantity of carbohydrates/protein consumed per day), body mass index (BMI), blood pressure, fasting blood high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC):HDL-C ratio were assessed before Ramadan and three months post-Ramadan.
RESULTS: Voluntary fasting practices increased only in group A (P <0.01). Additionally, the quantity of protein/carbohydrates consumed per day, mean diastolic pressure and TC:HDL-C ratio decreased only in group A (P <0.01, 0.05, 0.02 and <0.01, respectively). Frequency of fruit/vegetable consumption per week, as well as HDL-C levels, increased only in group A (P = 0.03 and <0.01, respectively). Although changes in BMI between the groups was not significant (P = 0.08), BMI decrease among participants in group A was significant (P <0.01).
CONCLUSION: Control of post-Ramadan weight gain was more evident in the faith-based intervention group. Healthcare providers should consider faith-based interventions to encourage weight loss during Ramadan and to prevent post-Ramadan weight gain among patients.
Fulltext Validation of the Malay version of the Parental Bonding Instrument among Malaysian youths using exploratory factor analysis

Muhammad NA, Shamsuddin K, Omar K, Shah SA, Mohd Amin R

Malays J Med Sci, 2014 Sep-Oct;21(5):51-9.
PMID: 25977634 MyJurnal

Parenting behaviour is culturally sensitive. The aims of this study were (1) to translate the Parental Bonding Instrument into Malay (PBI-M) and (2) to determine its factorial structure and validity among the Malaysian population.
Fulltext Utility of Pap Smears and Mammograms in Midlife Urban Malaysian Women

Adeeb, N., Nur-Azurah, A.G., Ong, F.B., Seri, S.S., Shamsuddin, K., Noor-Aini, M.Y., et al.

Medicine & Health, 2008;3(1):59-68.
MyJurnal

Cancers of the breast and cervix made up 30.4% and 12% of all cancer cases in Malaysia. Thus screening for reproductive organ cancers as women approached menopause becomes exceedingly important. The study reports the baseline assessment tests of 495 disease free urban Malaysian women aged 45 years and above who volunteered in a healthy lifestyle intervention study. The sample comprised of 58.0% premenopaused and 42.0% postmenopaused women with an average age of 51.27±5.35 years old. Over two thirds were Chinese followed by Malays and Indians. Overall, abnormal Pap smears were seen in 7.6% comprising of 1.3% cervical intraepithelial neoplasia (CIN), 6.1% human papilloma virus (HPV) infection and 0.2% atypical squmous cells of undetermined significances (ASCUS). Yeast and other infections were found in 6.9% and 1.9% respectively. Comparatively, postmenopausal women had a 2.8 fold higher cancerous changes whereas premenopausal women had a higher infection rate, 11.8% vs. 4.7% respectively (p=0.024) with comparable HPV infection rates in both. This study found 1.3% had breast cancer (BC) with 3.6% requiring a biopsy while 3.4% needed regular follow up. Postmenopaused women had more abnormal mammograms (p
Fulltext Use of traditional medicine among type 2 diabetic Libyans

Ashur ST, Shah SA, Bosseri S, Shamsuddin K

East Mediterr Health J, 2017 Jul 16;23(5):375-382.
PMID: 28730591 DOI: 10.26719/2017.23.5.375

The use of traditional medicines is common among patients with chronic illnesses and this practice might pose health risks. The use among Libyan patients with diabetes is unknown. Therefore, this study aimed to estimate the prevalence of traditional medicine use in the previous year among Libyans with type 2 diabetes and to examine the association between its use and sociodemographic and clinical characteristics of the patients. A cross-sectional study was conducted at a large diabetes centre in Tripoli. A self-reported questionnaire was used for data collection. Of the 523 respondents, 28.9% used traditional remedies. Sex was the only variable significantly associated with traditional medicine use; more women used traditional medicines (P = 0.01). A total of 77 traditional medicine items were reported to be used, of which herbs were the most common. The use of traditional medicine for diabetes is prevalent and some of the reported items could pose health risks. Health education programmes are suggested to raise the awareness of the health risks of this practice.
Traditional Postpartum Practices Among Malaysian Mothers: A Review

Fadzil F, Shamsuddin K, Wan Puteh SE

J Altern Complement Med, 2016 Jul;22(7):503-8.
PMID: 26167656 DOI: 10.1089/acm.2013.0469

To briefly describe the postpartum practices among the three major ethnic groups in Malaysia and to identify commonalities in their traditional postpartum beliefs and practices.
Fulltext The effect of the Malaysian Food Guideline guidance on a group of overweight and obese women during Ramadan

Suriani I, Shamsuddin K, Abdul Latif K, Saad HA

Saudi Med J, 2015 Jan;36(1):40-5.
PMID: 25630003 DOI: 10.15537/smj.2015.1.9661

To determine the effect of imparting knowledge of the Malaysian Food Guideline (MFG) on a group of overweight and obese women during Ramadan.
Fulltext The Relationship Between Job Satisfaction and Psychological/Physical Health among Malaysian Working Women

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).
Smoking among young urban Malaysian women and its risk factors

Manaf RA, Shamsuddin K

Asia Pac J Public Health, 2008;20(3):204-13.
PMID: 19124314 DOI: 10.1177/1010539508316973

This study was conducted to measure the prevalence of cigarette smoking and to determine the individual, family, and environmental factors associated with smoking among young urban women. A cross-sectional study through self-administered questionnaire was conducted on female students enrolled in private higher learning institutions in Kuala Lumpur and Selangor, Malaysia, between July and October 2005. Analysis on 408 respondents showed that current smoker prevalence rate was 18.6%. Adjusted analyses showed significant association between smoking and individual factors, which are the importance of slim image, average monthly allowance, and car ownership. For family factors, analyses showed significant association between smoking and parental marital status and smoking status of male siblings. Strong associations were seen between female smoking and environmental factors, such as having more smoker friends, having smokers as best friends, keeping cigarette-brand items, being offered free cigarette, and perceiving female smoking as normal. The identified risk factors could be used to develop more effective prevention programs to overcome smoking among young urban women.
Fulltext Serological assessment of the establishment of herd immunity against measles in a health district in Malaysia

Hazlina Y, Marlindawati MA, Shamsuddin K

BMC Infect Dis, 2016 Dec 08;16(1):740.
PMID: 27931192

BACKGROUND: Malaysia still faces challenges optimizing resources to effectively eliminate measles through high immunization and herd immunity, with sporadic outbreaks of measles as evidence. The objective of this study is to determine the age-specific positive measles antibodies seroprevalence used for assessing the establishment of herd immunity against measles in different age groups. This is useful for identifying vulnerable age groups requiring supplementary immunization.

METHODS: A seroprevalence study was conducted among respondents aged 6-9 years, 15-24 years and 45-54 years attending government health clinics in Seremban between September 2014 and January 2015. A total of 1541 measles IgG antibody status were determined using ELISA technique (NovaTec Immundiagnostica GMBH) and assessment of establishment of herd immunity was based on indicators developed by Plans. Data on socio-demographic background as well as medical and medication history were also gathered.

RESULTS: Seropositive rate for all respondents were 87% (95% CI 85-89), while the rest had either indeterminate [6% (95% CI 5-7)] or negative titre [7% (95% CI 6-8)]. None of the factors analyzed except for age were significant predictors of positive measles antibodies. Seropositive rate differed by age with the highest rate seen in adults (94%; CI 92-96), followed by children (90%; 95% CI 87-94) and adolescents, and young adults (74%; 95% CI 70-78). Based on Plans' indicators, herd immunity was established in adults and children, but not in adolescents and young adults.

CONCLUSIONS: To tackle the most susceptible group in the present study, it is advisable to give booster vaccination to secondary school students and freshmen who enter colleges and universities in Malaysia.
Role of Religion in Preventing Youth Sexual Activity in Malaysia: A Mixed Methods Study

Muhammad NA, Shamsuddin K, Sulaiman Z, Amin RM, Omar K

J Relig Health, 2017 Dec;56(6):1916-1929.
PMID: 26809242 DOI: 10.1007/s10943-016-0185-z

One of the popular approaches of preventing youth sexual activity in Malaysia is using religion to promote premarital sexual abstinence. Despite this intervention, youth continue to practise premarital sex. Thus, the purpose of this exploratory mixed methods study was to understand the role of religion on sexual activity among college students in Klang Valley, Malaysia. A self-administered questionnaire survey to determine the relationship between religiosity and youth sexual activity was carried out on 1026 students recruited from 12 randomly selected colleges. Concurrently, face-to-face interviews were conducted on 15 students to explore how religiosity had influenced their decision on sexual activity. The survey data were analysed using logistic regression, while the qualitative data from the interviews were examined using thematic analysis with separate analysis for each gender. Both quantitative and qualitative results were then compared and integrated. Religious activity significantly reduced the risk of continuing sexual activity among female students (AOR = 0.67, CI = 0.47, 0.95, p = 0.02) but not male students. There was no significant relationship of religious affiliation and intrinsic religiosity (inner faith) to sexual activity by gender. Having faith in religion and strong sexual desire were the main themes that explained participants' sexual behaviour. Engaging in religious activity might be effective at preventing female students from being sexually active. However, when sexual urges and desires are beyond control, religiosity might not be effective.
Fulltext Risk factors for antenatal hypovitaminosis D in an urban district in Malaysia

Bukhary NBI, Isa ZM, Shamsuddin K, Lin KG, Mahdy ZA, Hassan H, et al.

BMC Pregnancy Childbirth, 2016 07 13;16(1):156.
PMID: 27411716 DOI: 10.1186/s12884-016-0939-3

BACKGROUND: Pregnant women form one of the high risk groups facing hypovitaminosis D. Low level of vitamin D will affect directly or indirectly both mother and fetus. Screening vitamin D in the first trimester of pregnancy is important to determine the necessary preventive action. Therefore, this study was aimed to determine the prevalence of hypovitaminosis D and its risk factors among pregnant women in the first trimester.
METHODS: A cross sectional study was carried out among first trimester pregnant women during their first antenatal visit. Samples were taken from different ethnicities in an urban district in Malaysia. A total of 396 respondents (99 % response rate) aged 18-40 years completed self-administered and guided questionnaire (characteristics and risk factors), validated semi-quantitative food frequency questionnaire for vitamin D in Malaysia (FFQ vitamin D/My), anthropometric measures (weight and height), blood test for serum 25(OH)D, skin measurement using Mexameter (MX 18) and Fitzpatrick Skin Type Chart Measurement (FSTCM). Data were analyzed to determine the association between risk factors and hypovitaminosis D.
RESULTS: The prevalence of hypovitaminosis D (serum 25(OH)D
Risk factor screening for abnormal glucose tolerance in pregnancy

Shamsuddin K, Mahdy ZA, Siti Rafiaah I, Jamil MA, Rahimah MD

Int J Gynaecol Obstet, 2001 Oct;75(1):27-32.
PMID: 11597616 DOI: 10.1016/s0020-7292(01)00468-4

OBJECTIVES: To assess the prevalence and association of frequently used screening risk factors for gestational diabetes mellitus (GDM) and to compare the validity and cost of universal screening with risk factor screening.

METHOD: A cross-sectional survey of 768 pregnant women at > or = 24 weeks' gestation who were attending the antenatal clinic at the Hospital Universiti Kebangsaan Malaysia (HUKM) was made. Risk factors were determined using a questionnaire. An abnormal oral glucose tolerance test was defined as a 2-h post-prandial blood sugar level of > or = 7.8 mmol/l.

RESULTS: A total of 191 pregnant mothers (24.9%) had GDM. The most commonly identified screening factors were positive family history of diabetes mellitus (31.4%), history of spontaneous abortion (17.8%), vaginal discharge and pruritus vulvae in current pregnancy (16.0%), and maternal age greater than 35 years (14.7%). Five hundred and thirteen mothers (66.8%) had at least one risk factor. All screening risk factors, except past history of diabetes mellitus in previous pregnancy and maternal age, were not significantly associated with abnormal glucose tolerance (GT). Risk factor screening gave a sensitivity of 72.2% and a specificity of 35.0%. Universal screening would cost RM 12.06 while traditional risk factor screening would cost RM 11.15 per identified case and will have missed 53 of the 191 cases.

CONCLUSIONS: Risk factor screening scored poorly in predicting GDM. Cost analysis of universal compared with traditional risk factor screening showed a negligible difference. Thus universal screening appears to be the most reliable method of diagnosing GDM.
Research on quality of life in female patients with congenital adrenal hyperplasia and issues in developing nations

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.
Fulltext Remeasurement, evaluation and comparison the health services utilization among women staff at Universiti Kebangsaaan Malaysia after eleven years period (2001-2012)

Siti Fatimah, A.G., Aniza, I., Shamsuddin, K., Zailiza, S.

Malaysian Journal of Public Health Medicine, 2013;13(2):48-64.
MyJurnal

A cross-sectional study was carried out in July-October 2012 in UKM to remeasure, evaluate and compare the changes in health services utilization level among women staff in UKM with a previous study done in 2001 and its influencing factors. The services studied were blood pressure (BP) measurement and Pap smear test. A total of 234 respondents aged between 18 and 55 were selected using stratified random sampling from Bangi, Kuala Lumpur and UKMMC, Malaysia. Data was collected via self-administered questionnaire and was analyzed by using SPSS version 17.0. Majority 85.9% of the respondents were found to have utilized at least one BP measurement which is higher compared to previous study. The Pap smear test, 64.5% of women have had a Pap smear test done also higher compared to previous study. Multivariate analysis shows the factors associated with BP measurement are age (OR 2.7, CI 95% 1.2, 6.3), family history of general health problems (OR 3.4, CI 95% 1.5, 7.6), and health staff influence (OR 5.2, CI 95% 1.1, 25.5). The factors associated with Pap smear test are marital status (OR 62.8, CI 95% 7.2, 546.4), general health problems (OR 2.3, CI 95% 1.2, 4.5), family planning (OR 6.9, CI 95% 3.0, 16.5) and self-interest (OR 3.3, CI 95%, 1.3, 8.6). The level of health services utilization on BP measurement and Pap smear test in 2012 is higher than 2001. For both BP measurement and Pap smear test the determinant factors are differed in the aforesaid years.
Fulltext Reliability and validity testing of the healthcare provider-patient communication instrument: a pilot study in a Malaysian primary care setting

Nor Azmaniza A, Shamsuddin K, Aazami S

Malaysian Journal of Public Health Medicine, 2014;14(2):12-20.
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
Fulltext Reliability and known-group validity of the Arabic version of the 8-item Morisky Medication Adherence Scale among type 2 diabetes mellitus patients

Ashur ST, Shamsuddin K, Shah SA, Bosseri S, Morisky DE

East Mediterr Health J, 2015 Dec 13;21(10):722-8.
PMID: 26750162 DOI: 10.26719/2015.21.10.722

No validation study has previously been made for the Arabic version of the 8-item Morisky Medication Adherence Scale (MMAS-8(©)) as a measure for medication adherence in diabetes. This study in 2013 tested the reliability and validity of the Arabic MMAS-8 for type 2 diabetes mellitus patients attending a referral centre in Tripoli, Libya. A convenience sample of 103 patients self-completed the questionnaire. Reliability was tested using Cronbach alpha, average inter-item correlation and Spearman-Brown coefficient. Known-group validity was tested by comparing MMAS-8 scores of patients grouped by glycaemic control. The Arabic version showed adequate internal consistency (α = 0.70) and moderate split-half reliability (r = 0.65). Known-group validity was supported as a significant association was found between medication adherence and glycaemic control, with a moderate effect size (ϕc = 0.34). The Arabic version displayed good psychometric properties and could support diabetes research and practice in Arab countries.

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