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Fulltext Usage of Health Belief Model (HBM) in Health Behavior: A Systematic Review

Haryati Anuar, Shamsul Azhar Shah, Halim Gafor, Mohd Ihsani Mahmood, Hasanain Faisal Ghazi

Malaysian Journal of Medicine and Health Sciences, 2020;16(111):201-209.
MyJurnal

Introduction: The Health Belief Model has gained widespread popularity and acceptance in the community,
yet little is known about its effectiveness as a basis for health behavior intervention. The purpose of this
study is to systematically review the evidence on the use of the model in health behavior for
Chronic Kidney Disease and the effectiveness of Health Belief Model as a model intervention for
facilitating health-related behavioral changes. Methods: The databases were manually searched
for references and gray literature. Overall, the methodological quality of trials was variable, and there
was limited evidence for the effectiveness of Health Belief Model in improving health
behavior. Results: There are few new trials published that describe the application of
Health Belief Model. Limited evidence supports any benefits of Health Belief Model for improving
health behavior. Conclusion: Studies on the usage of Health Belief Model need to be explored in depth
to assess the importance of Health Belief Model.
Fulltext Determining method for dengue epidemic threshold in Negeri Sembilan, Malaysia

Lokman Rejali, Shamsul Azhar Shah, Norzaher Ismail, Syafiq Taib, Siti Nor Mat, Mohd Rohaizat Hassan, et al.

Int J Public Health Res, 2020;10(2):1228-1241.
MyJurnal

Dengue fever is an illness by arthropod-borne viral disease that become known pandemic to the most tropical countries. In 2014, Malaysia reported 108 698 cases of dengue fever with 215 deaths which increased tremendously compared to 49 335 cases with 112 deaths in 2008 and 30 110 cases with 69 deaths in 2009. This study aimed to identify the best method in determining dengue outbreak threshold for Negeri Sembilan and hopefully these methods can be standardized as it can help to send uniform messages to inform the general public and make the outbreak analysis comparable within and between countries. Methodology : Using retrospective Negeri Sembilan country dataset from 1st epid week of 2011 till the 52nd epid week of 2016. The data were split into two periods: 1) a 3-year historic period (2011–2013), used to calibrate and parameterise the model, and a 1-year evaluation period (2014); 2) a 2-year historic period (2014–2016), used to calibrate and parameterise the model, and a 1-year evaluation period (2016), used to test the model. E-dengue is a registration system for confirm case dengue by Ministry of Health. Data include details of cases, district locality, records on the outbreak and epidemiological week (Sunday to Saturday). The variables were captured using the Excel spreadsheet. Analysis method included endemic channel method, moving average or deviation bar chart and recent mean. Result: Seremban as big district and facing with heavy dengue cases, all three methods (endemic curve, current mean and moving mean) showed promising results. Meanwhile comparing with small district of Port Dickson and Tampin with fewer dengue cases and outbreak recorded, the suitable method is by using endemic channel for epidemic threshold. Conclusion: Simpler methods such as the endemic channel, recent mean and moving mean may be more appropriate in urban district. Whereas in rural or district with minimal dengue cases, Endemic Channel would be the most suitable method for epidemic threshold. However, both methods require a consistent updated graph threshold as time progress.
Fulltext Internal consistency study of EORTC QLQ-C30 and QLQ-PR25 questionnaires for quality of life assessment among prostate cancer patients in a University Hospital, Kuala Lumpur, Malaysia

Norzaher Ismail, Shamsul Azhar Shah, Nazarudin Safian, Syafiq Taib, Siti Nor Mat

Int J Public Health Res, 2020;10(1):1158-1165.
MyJurnal

Prostate cancer is forth most common diagnosed tumors in Malaysian male. The use of a self-reported, quality of life assessment is important for clinical practice, care taker and researcher to evaluate the level of quality of life. The aim of this study was to measure the internal consistency of the translated Malay Language EORTC QLQ-C30 and EORTC PR-25 questionnaires among prostate cancer patient at National University of Malaysia hospital in Kuala Lumpur, Malaysia.
Fulltext Spatial clustering of cholera in Sabah, Malaysia

Syed Sharizman Syed Abdul Rahim, Shamsul Azhar Shah, Zahir Izuan Azhar, Mohammad Saffree Jeffree, Mohd Rohaizat Hassan, Nazarudin Safian

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):54-54.
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Introduction: Cholera epidemics can produce devastating public health outcomes. Cholera distribution is influenced by temperature, precipitation, elevation, distance to the coastline and oceanic environmental factors such as sea surface temperature, sea surface height and ocean chlorophyll concentration. The purpose of this study is to describe the spatial epidemiology of cholera in the four districts of Sabah. Methods: This is a retrospective review of 4 years (2011 to 2014) data from the districts of Kota Kinabalu, Penampang, Putatan and Papar, Sabah. All reported cases of cholera from those areas are included. Coordinates for locations of the cases are based on home addresses. SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: Cholera showed several clustering of cases, such as in 2011 and 2014 in Kota Kinabalu. In the year 2011 and 2013, Penampang and Papar districts had the nearest neighbour index of less than 1, but p value was not significant, meaning the pattern did not appear to be significant. Nearest neighbour hierarchical clustering analysis further revealed cholera had 7 clusters, of those 6 were first order and 1 was a second order cluster. Conclusion: Cholera shows disease clustering which could mean it is due to its common point source or localised human to human transmission. Using GIS as a tool may help in surveillance and control of cholera infections.
Fulltext Risk factors of insulin refusal among type 2 diabetes mellitus patients with poor glycaemic control at Tanglin Health Clinic, Kuala Lumpur

Puvanese Rebecca Pillai Simon, Salmiah Md. Said, Ahmad Zaid Fattah, Shamsul Azhar Shah

Malaysian Journal of Medicine and Health Sciences, 2019;15(2):84-92.
MyJurnal

Introduction: The number of patients with poor glycaemic control who refuse insulin therapy is alarming. Factors that contribute to insulin refusal are important to study to identify high risk groups so that appropriate measures can be taken to prevent progression of uncontrolled diabetes. The objective of this study is to determine the risk factors of insulin refusal among type 2 diabetes mellitus patients with poor glycaemic control at Tanglin Health Clinic, Kuala Lumpur, Malaysia. Methods: A case control study was conducted among 216 cases and 230 controls using stratified sampling method. Cases were defined as patients with HbA1C more than 7.5% but not on insulin therapy despite being offered by the doctor whereas controls consist of patients with HbA1C of more than 7.5% but already on insulin therapy. Data was collected from April until May 2018, using a self-administered questionnaire. Analysis was done via IBM SPSS version 23.0. Results: Response rate for cases was 93.9% and response rate for controls was 100%. Risk factors of insulin refusal among poor glycaemic control includes age above 60 years old, tertiary level education, duration of diabetes less than 10 years, poor level of knowledge on insulin, fear on injection pain and fear to bruising due to injections. Conclusion: Hence, efforts must be taken to tackle the modifiable factors such as knowledge on insulin and diabetes, and fear on injections and bruises.
Fulltext Prevalence and factors associated with overweight and obesity among healthcare workers in Pejabat Kesihatan Daerah Melaka Tengah

Syafiq Taib, Siti Nor Mat, Norzaher Ismail, Fairuz Rahmat, Noor Aizam Said, Shamsul Azhar Shah

Int J Public Health Res, 2019;9(2):117-1126.
MyJurnal

Overweight and obesity are a serious public health problem globally. Healthcare workers in some countries have been reported to be having a high prevalence of being overweight despite them being well informed of the aetiology and risks of excessive body weight. However, the problem of being overweight and obese among Malaysian healthcare workers is still poorly understood. The aim of this study is to assess the prevalence and factors associated with overweight and obesity among healthcare workers in Pejabat Kesihatan Daerah (PKD) Melaka Tengah.
Neighbourhood influences and its association with the mental health of adolescents in Kuala Lumpur, Malaysia

Zahir Izuan A, Shamsul Azhar S, Tan MKS, Syed-Sharizman SAR

Asian J Psychiatr, 2018 Dec;38:35-41.
PMID: 30408711 DOI: 10.1016/j.ajp.2018.10.018

BACKGROUND: Mental health problems are affecting more children and adolescents worldwide. Individual, family and school factors are often linked with mental health problems among adolescents.
AIM: To determine the neighbourhood factors influencing the prevalence of abnormal mental health status among adolescents in an urban population.
METHOD: A cross-sectional study was conducted among adolescents aged 13, 14 and 16 years old from thirteen secondary schools in Kuala Lumpur using validated questionnaires. A total of 567 adolescents participated in this study.
RESULTS: The prevalence of abnormal mental health status in this study was 4.4%. In multivariable analysis, female (OR = 1.79, 95%CI: 1.11-2.89), having divorced parents (OR = 3.53, 95%CI: 1.96-6.36), high educational stress (OR = 8.18, 95%CI: 4.25-15.75), medium educational stress (OR = 2.99, 95%CI: 1.53-5.83), whose house has been broken in before (OR = 2.02, 95%CI: 1.11-3.68) and living in a neighbourhood with low socioeconomic status (OR = 2.09, 95%CI: 1.23-3.56) were more likely to have abnormal mental health status.
CONCLUSIONS: Neighbourhood factors were found to be significant in determining adolescents' mental health status. The findings emphasize the importance of those in the public health sector to highlight these significant neighbourhood factors to the Ministry of Housing and Local Government. Swift action needs to be taken by the Ministry to provide solutions related to the neighbourhood factors and this can contribute to improvement in the adolescents' mental health.
Evaluating cardiovascular risk in chronic kidney disease patients: a biomarker approach

Abdul Halim Abdul Gafor, Rozita Mohd, Rizna Cader, Kong Wei Yen, Marlyn Mohamad, Shamsul Azhar Shah, et al.

Sains Malaysiana, 2018;47:149-155.

Cardiovascular disease (CVD) is a major cause of morbidity and mortality in chronic kidney disease (CKD) patients. This study aimed to determine the roles of CVD biomarkers in CKD patients. This was a case-control study which recruited consecutive patients with stage 2-4 CKD patients with and without CVD. Serum levels of highly-sensitive C reactive protein (hs-CRP), cystatin C (CysC), asymmetrical dimetylarginine (ADMA) and symmetrical dimethylarginine (SDMA) were measured. Sixty two stage 2-4 CKD patients with a mean age of 60.3 ± 10.4 years were recruited. Twenty three (37.1%) of them had CVD. Those CKD patients with CVD were older (64.1±8.0 vs 58.1± 1.1, p<0.05) and had significantly higher systolic blood pressure (139.4 ± 16.2 vs 129.4 ± 14.8 mmHg, p<0.05). Diabetic patients had 8 times (95% CI 1.25-51.77, p< 0.05) higher risk to develop CVD. CKD patients with CVD had a higher serum creatinine (185.0 ± 54.1 vs 154.1 ± 54.4 μmol/L, p<0.05), a lower estimated glomerular filtration rate (33.7 ± 12.2 vs 42.2 ± 14.5 mL/min/1.73m2 p<0.05) and a lower triglyceride levels (1.3 (1.1-1.7) vs 1.8 (1.4-2.3) mmol/L, p<0.05), compared to those without CVD. Fasting blood sugar was 7.1 ± 2.7 mmol/L in CVD group and 6.3 ± 1.6 mmol/L in non CVD group (p>0.05). There were no differences in their mean serum levels of hs-CRP, CysC, ADMA and SDMA. Risk factors including age, diabetes mellitus, hypertension and renal functions were still the most important CVD risk factors in CKD patients.
Fulltext Geographical information system (GIS) application in tuberculosis spatial clustering studies: a systematic review

Norazman Mohd Rosli, Shamsul Azhar Shah, Mohd Ihsani Mahmood

Malaysian Journal of Public Health Medicine, 2018;18(1):0-0.
MyJurnal

Tuberculosis (TB) is known as a disease that prone to spatial clustering. Recent development has seen a sharp rise in the number of epidemiologic studies employing Geographical Information System (GIS), particularly in identifying TB clusters and evidences of etiologic factors. The aim of this systematic review is to determine evidence of TB clustering, type of spatial analysis commonly used and the application of GIS in TB surveillance and control. A literature search of articles published in English language between 2000 and November 2015 was performed using MEDLINE and Science Direct using relevant search terms related to spatial analysis in studies of TB cluster. The search strategy was adapted and developed for each database using appropriate subject headings and keywords. The literature reviewed showed strong evidence of TB clustering occurred in high risk areas in both developed and developing countries. Spatial scan statistics were the most commonly used analysis and proved useful in TB surveillance through detection of outbreak, early warning and identifying area of increased TB transmission. Among others are targeted screening and assessment of TB program using GIS technology. However there were limitations on suitability of utilizing aggregated data such as national cencus that were pre-collected in explaining the present spatial distribution among population at risk. Spatial boundaries determined by zip code may be too large for metropolitan area or too small for country. Nevertheless, GIS is a powerful tool in aiding TB control and prevention in developing countries and should be used for real-time surveillance and decision making.
Fulltext Perceived susceptibility to chronic disease among healthy people questionnaire: development, validity and reliability among young Iraqi adults

Harith Alaa, Shamsul Azhar Shah

Malaysian Journal of Public Health Medicine, 2018;18(1):1-7.
MyJurnal

Chronic non-communicable diseases are the new emerging epidemic, and they are thought to challenge only rich countries; cardiovascular disease, cancer, diabetes, and other non-communicable diseases (NCDs) are now the leading cause of death and disability in low-income and middle-income countries, where they killed almost 8 million people younger than 60 years in 2013. Therefore, there is a need to develop a valid and reliable tool to measure the beliefs that influence people’s general behaviour, and a used to measure beliefs about chronic disease perceived susceptibility. The purpose of this study was to develop and validate the use of perception questionnaire among the young Iraqi adults. A total of 200 young adults participated who are free from any chronic diseases under study, and are living in Baghdad. The questionnaire, validated by an expert’s panel, translated to Arabic language, and pretested. Analyses included descriptive statistics of all the study variables, reliability estimates, and construct validity using confirmatory factor analysis (CFA). Results showed that mean age of respondents was 30 years old, majority were males 71.5%, and EFA showed that factor loading was more than 0.4. CFA results show that Chi-square (df) = 1.213(2); p value (>0.05) = 0.297. Internal consistency reliability analysis on health-related behaviour; special practice, information seeking and perceived probability of diseases have good Cronbach’s α value of between 0.8 - 0.9. These findings revealed that validation is favourable and can be utilized on larger scale of sample to proceed with main study on chronic disease perceived susceptibility among healthy people.
Fulltext Barriers and motivation factors towards treatment compliance from the perspective of defaulted tuberculosis patients in Kuala Lumpur

Noorsuzana Mohd Shariff, Shamsul Azhar Shah, Fadzilah Kamaludin

Jurnal Sains Kesihatan Malaysia, 2017;15(1):75-87.
MyJurnal

There is a large volume of published studies describing the adverse relationship between treatment non-adherence with tuberculosis treatment outcome. Non-adherence could result in increased risks of prolonged infectiousness, drug resistance, relapse cases and poor survival among tuberculosis patients. Nevertheless, few studies are to be found providing detailed on the reason of defaulting treatment among tuberculosis patients in Malaysia. Hence the goal of this paper is to find out the barriers and motivations factors that affect patients’ treatment compliance among our local tuberculosis patients. This is a qualitative study which included 12 in-depth interviews with tuberculosis non-compliance patients who were treated at Institute of Respiratory Medicine, Kuala Lumpur. All the conversations were recorded, transcribed and analysed by using thematic analysis. It was found that low knowledge, self-negative attitudes, traditional believes, negative perceptions towards health caregiver, drug side effects, stigma, financial problems, less family support and work commitments are the barriers that prevent the patients from religiously taking their anti-tuberculosis treatment. Meanwhile, factors that encourage them to continue their treatment were the believes of bad effects of the disease onto their lives and health, good relationship between patient and health caregiver and social support from people around them. In conclusion, non-adherence involved a dynamic influence of individual, socio-economic and treatment-related factors on the patients. The results presented here may facilitate improvement in the activities in promoting compliance among tuberculosis patients in the future which tailored to the patients’ specific needs.
Fulltext What it takes to set up travel health services: a review from countries with established service

Muhammad Haikal Ghazali, Shamsul Azhar Shah, Mohd Rizal Abd Manaf

Malaysian Journal of Public Health Medicine, 2017;17(3):0-0.
MyJurnal

As air travelling now becomes cheaper and available to almost all people of any walk of life, travelling across international borders is fast becoming a lifestyle of many. Having travel health service as part of health care services is important to address the issues of travel related illnesses among travellers. However, lacks of published guidelines pertaining to travel health service rendering many countries to overlook its importance. The aim of this paper is to review published literatures and authoritative websites on the components needed to develop guideline to establish travel health services. A systematic literature search was done using pre-specified keywords for literatures published between years 2000 – 2016. Literatures written in English and fully accessible were all included. No exclusion criteria was set before the search. Online authoritative websites pertaining to travel health were also referred. A total of six literatures ranging from expert opinion, review paper and original study, together with three authoritative websites related to travel health were reviewed. Among the important components needed to be considered for developing the guideline for establishing travel health services are to prioritise pre-travel health service, to set up specialised travel health clinic, to produce travel health/medicine specialist, to emphasize on continuous education and training of the practitioners and to apply multiagency and multidisciplinary approach with adequate fund for research in travel health. As a conclusion, policy makers should prioritise and select the most important components in developing guideline for travel health service.
Fulltext What it takes to set up travel health services: a review from countries with established service

Muhammad Haikal Ghazali, Shamsul Azhar Shah, Mohd Rizal Abd Manaf

Malaysian Journal of Public Health Medicine, 2017;17(2):47-57.

As air travelling now becomes cheaper and available to almost all people of any walk of life, travelling across international borders is fast becoming a lifestyle of many. Having travel health service as part of health care services is important to address the issues of travel related illnesses among travellers. However, lacks of published guidelines pertaining to travel health service rendering many countries to overlook its importance. The aim of this paper is to review published literatures and authoritative websites on the components needed to develop guideline to establish travel health services. A systematic literature search was done using pre-specified keywords for literatures published between years 2000 – 2016. Literatures written in English and fully accessible were all included. No exclusion criteria was set before the search. Online authoritative websites pertaining to travel health were also referred. A total of six literatures ranging from expert opinion, review paper and original study, together with three authoritative websites related to travel health were reviewed. Among the important components needed to be considered for developing the guideline for establishing travel health services are to prioritise pre-travel health service, to set up specialised travel health clinic, to produce travel health/medicine specialist, to emphasize on continuous education and training of the practitioners and to apply multiagency and multidisciplinary approach with adequate fund for research in travel health. As a conclusion, policy makers should prioritise and select the most important components in developing guideline for travel health service.
Fulltext Prevalence of premature ejaculation and erectile dysfunction and their associated factors among urban andrural population of Malaysia

Mohd Rohaizat Hassan, Mohd Fadhli Samsuri1, Shamsul Azhar Shah, Nazarudin Safian, Zulkifli Md Zainuddin, Hasanain Faisal Ghazi

Malaysian Journal of Public Health Medicine, 2017;17(3):86-96.

The purpose of this study was to determine the prevalence and factors associated with of Premature Ejaculation &Erectile Dysfunctionamong Malaysian men.A cross-sectional study was conducted in urban and rural areas using standardized and validated self-administeredquestionnaires.A total of 319 samples were recruited for PE screening. The overall prevalence of PE was 31.7% with 20.7% and 40.8% for urban and rural arearespectively. Depression, anxiety and frequent masturbation were significantly associated with PE. While For ED, infrequent sexual intercourse was the sole factor significantly associated with ED.PE and ED were highly prevalent in both urban and rural areas; with several significant preventable associated factors.
Fulltext Neighbourhood factors on mental health questionnaire: development, validity, and reliability among Malaysian adolescents

Zahir Izuan Azhar, Shamsul Azhar Shah, Tan, Susan, M.K., Syed Sharizman Syed Abdul Rahim

Int J Public Health Res, 2016;6(1):713-718.
MyJurnal

Introduction The risk factors associated with mental health among adolescents are usually
described by researchers at an individual level. Neighbourhood factors and
health have opened a new insight into the field of epidemiology. The aim of
this study was to assess the reliability and validity of a newly developed
Neighbourhood Factors on Mental Health Questionnaire among Malaysian
adolescents.

Methods A cross-sectional study was conducted in four secondary schools in Kuala
Lumpur, Malaysia using a newly developed questionnaire which comprised
of two main domains and seven items. Exploratory factor analysis and
Cronbach‟s alpha were used to measure the instrument‟s construct validity
and reliability.

Results A total of 106 adolescents participated in this research. The majority of
adolescents were 13 years old (40.6%), female (55.7%), Malays (68.9%),
have parents who only studied until secondary school (66.0%) and lived in
flats (32.1%). Bartlett‟s Test of Sphericity was significant (Chi-square =
258.361, p
Fulltext Prevalence and risk factors of premature coronary artery disease: a comparative cross-sectional study between two time frames in Malaysia

Shamsul Azhar Shah, Lee, Jing, Muhammad Syahmi Khalid, Fatimah Najid, Intan Sabrina Haniff, Azmee Mohd Ghazi

Malaysian Journal of Public Health Medicine, 2015;15(3):157-166.
MyJurnal

Limited studies on prevalence and risk factors of Premature Coronary Artery Disease (PCAD) were done in Malaysia, primarily on lipid profile. This cross sectional study aims to identify any changing patterns in prevalence and risk factors of Premature CAD between 2000 and 2012. From 2000 to 2012 we included 21862 patients who underwent the first Percutaneous Coronary Intervention (PCI). Analysis of risk factors was done to 1660 and 2098 patients from year 2007 and 2012 respectively. Age of less than 45 years was taken as PCAD. Data was collected from PCI database of National Heart Institute (NHI), NHI TrakCare System, and patients’ medical records. PCAD significantly decreased from 18.8% (2000) to 11.6% (2012). Malay ethnicity showed increasing trend over the years from 55.1% to 66.9%. Multiple logistic regression analysis in 2007 showed that smoking had the higher risk (AOR=2.52), followed by male gender (AOR=2.06), family history of PCAD (AOR=1.96), Indian ethnicity, (AOR=1.65), triglycerides level (AOR=1.20) and BMI (AOR=1.06). In 2012, family history of PCAD had the highest risk (AOR=2.00) followed by smoking (AOR=1.91) and BMI (AOR=1.11). There are changes in risk factors patterns of premature CAD between 2007 and 2012. Most of them are preventable at earlier stage.
Fulltext Anxiety and depressive symptoms among ischaemic heart disease patients in a Malaysian tertiary university hospital

Suzaily Wahab, Shamsul Azhar Shah, Soo, Tze Hui, Siti Juliana Hussin, Mohd Fekri Ahmat Nazri, Izzatul Izzanis Abd Hamid, et al.

Int J Public Health Res, 2015;5(1):531-537.
MyJurnal

Introduction Anxiety and depression were known to bring detrimental outcome in patients
with ischemic heart disease (IHD). Notwithstanding their high prevalence
and catastrophic impact, anxiety and depression were unrecognized and
untreated. The aim of this study was to determine the prevalence of anxiety
and depression among IHD patients and the association of this condition with
clinical and selected demographic factors.

Methods This was a cross-sectional study on 100 IHD patients admitted to medical
ward in UKMMC. Patients diagnosed to have IHD were randomly assessed
using Hospital Anxiety and Depression Scale (HADS) and Perceived Social
Support (PSS) Questionnaire. Socio-demographic data were obtained by
direct interview. Fifteen percent of IHD patients in this sample were noted to
have anxiety, fourteen percent noted to have depression while thirty two
percent was noted to have both anxiety and depression. Patients’ age group
and the duration of illness were found to have significant association with
anxiety. Socio-demographic data were obtained by direct interview.

Results Fifteen percent of IHD patients in this sample were noted to have anxiety,
fourteen percent noted to have depression while thirty two percent was noted
to have both anxiety and depression. Patients’ age group and the duration of
illness were found to have significant association with anxiety. The other
clinical and selected demographic factors such as gender, race, marital status,
education level, occupation, co-existing medical illness and social support
were not found to be significantly associated with anxiety or depression
among the IHD patients.

Conclusions In conclusion, proper assessment of anxiety and depression in IHD patients,
with special attention to patients’ age and duration of illness should be
carried out routinely to help avert detrimental consequences.
Are predictors of future suicide attempts and the transition from suicidal ideation to suicide attempts shared or distinct: a 12-month prospective study among patients with depressive disorders

Chan LF, Shamsul AS, Maniam T

Psychiatry Res, 2014 Dec 30;220(3):867-73.
PMID: 25240940 DOI: 10.1016/j.psychres.2014.08.055

Our study aimed to examine the interplay between clinical and social predictors of future suicide attempt and the transition from suicidal ideation to suicide attempt in depressive disorders. Sixty-six Malaysian inpatients with a depressive disorder were assessed at index admission and within 1 year for suicide attempt, suicidal ideation, depression severity, life event changes, treatment history and relevant clinical and socio-demographic factors. One-fifth of suicidal ideators transitioned to a future suicide attempt. All future attempters (12/66) had prior ideation and 83% of attempters had a prior attempt. The highest risk for transitioning from ideation to attempt was 5 months post-discharge. Single predictor models showed that previous psychiatric hospitalization and ideation severity were shared predictors of future attempt and ideation to attempt transition. Substance use disorders (especially alcohol) predicted future attempt and approached significance for the transition process. Low socio-economic status predicted the transition process while major personal injury/illness predicted future suicide attempt. Past suicide attempt, subjective depression severity and medication compliance predicted only future suicide attempt. The absence of prior suicide attempt did not eliminate the risk of future attempt. Given the limited sample, future larger studies on mechanisms underlying the interactions of such predictors are needed.
Fulltext Interleukin-23 and its correlation with disease activity, joint damage, and functional disability in rheumatoid arthritis

Dalila AS, Mohd Said MS, Shaharir SS, Asrul AW, Low SF, Shamsul AS, et al.

Kaohsiung J. Med. Sci., 2014 Jul;30(7):337-42.
PMID: 24924839 DOI: 10.1016/j.kjms.2014.02.010

The purpose of this study was to compare the serum interleukin (IL)-23 levels between rheumatoid arthritis (RA) patients and healthy controls and to determine the correlation of IL-23 levels with disease activity, joint damage and functional disability in RA. Serum samples were obtained from 45 patients with RA and 45 healthy controls. The enzyme-linked immunosorbent assay method was used for quantitative analysis of IL-23. All the RA patients were assessed for disease activity based on the 28-joint disease activity score, joint damage based on modified Sharp score, and functional ability using the Health Assessment Questionnaire-Disability Index. The mean serum IL-23 level was much higher among the RA patients (24.50 ± 13.98 pg/mL) compared to the controls (5.98 ± 3.40 pg/mL; p < 0.01). There was a significant positive relationship between IL-23 levels and disease activity and questionnaire scores (p = 0.003 and 0.020, respectively). On logistic regression analysis, IL-23 levels were significantly higher in patients with moderate to high disease activity (p = 0.008, odds ratio = 1.073, 95% confidence interval = 1.019-1.130) and patients with significant functional disability (p = 0.008, odds ratio = 1.085, 95% confidence interval = 1.021-1.153). RA patients have significantly higher levels of serum IL-23. The IL-23 levels correlate well with disease activity and functional disability but not with radiographic joint damage.

Study site: Rheumatology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Fulltext Factors related to low birth weight babies in Baghdad City, Iraq

Mohammed A. Abdal Qader, Shamsul Azhar Shah, Zaleha Md Isa, Hasanain Faisal Ghazi, Idayu Badilla, Tiba Nezar Hasan

Malaysian Journal of Public Health Medicine, 2014;14(2):45-49.
MyJurnal

Great importance has been attributed to birth weight all over the world because it is considered as one of the best predictors of prenatal survival and a good indicator of quality life. The objective of this study was to determine the prevalence of low birth weight babies (LBW) and factors related to it in Baghdad city. A cross sectional study was carried out in four general hospitals in Baghdad city, Iraq. A total of 225 newborn babies, alive, singleton and without congenital malformation were selected randomly from these four general hospitals.The result of the study showed the prevalence rate of low birth weights was 21.3%. Mothers’ educational level, monthly family income, mothers with chronic hypertension, mothers with history of previous low birth weight infants and anemic mothers were significantly associated with low birth weight babies (P= 0.03, 0.01, 0.02,

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