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  1. 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)
  2. Fulltext Diagnostic value of the C methacetin breath test in various stages of chronic liver disease
    Razlan H, Marzuki NM, Tai ML, Shamsul AS, Ong TZ, Mahadeva S
    Gastroenterol Res Pract, 2011;2011:235796.
    PMID: 21687605 DOI: 10.1155/2011/235796
    The accuracy of the (13)C-methacetin breath test ((13)C-MBT) in differentiating between various stages of liver disease is not clear. A cross-sectional study of Asian patients was conducted to examine the predictive value of the (13)C-MBT in various stages of chronic liver diseases. Diagnostic accuracy of the breath test was determined by sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve analysis. Seventy-seven patients (47 men/30 women, mean age 50 ± 16 years) were recruited. Forty-seven patients had liver cirrhosis (Child Pugh A = 11, Child Pugh B = 15, and Child Pugh C = 21), 21 had fibrosis, and 9 had chronic inflammation. The sensitivity and positive predictive value for liver fibrosis, cirrhosis (all stages), Child-Pugh A, Child-Pugh B, and Child-Pugh C were 65% and 56%, 89% and 89%, 67% and 42%, 40% and 40%, and 50% and 77%, respectively. Area under curve values for fibrosis was 0.62 (0.39-0.86), whilst that for cirrhosis (all stages) was 0.95 (0.91-0.99). The (13)C-methacetin breath test has a poor predictive value for liver fibrosis but accurately determines advanced cirrhosis.
  3. A cross-sectional study of diastolic dysfunction in rheumatoid arthritis and its association with disease activity
    Abdul Muizz AM, Mohd Shahrir MS, Sazliyana S, Oteh M, Shamsul AS, Hussein H
    Int J Rheum Dis, 2011 Feb;14(1):18-30.
    PMID: 21303478 DOI: 10.1111/j.1756-185X.2010.01593.x
    AIMS: The aim of this study was to evaluate the left ventricular (LV) diastolic dysfunction in rheumatoid arthritis (RA) patients without clinically evident cardiovascular manifestations and to estimate whether there is any correlation between RA disease severity and disability and LV diastolic dysfunction.
    METHODS: The study was a cross-sectional study involving 53 patients (47 female and 6 male) with RA without clinically evident heart disease and 53 healthy subjects (47 female and 6 male) who served as a control group. Both groups were matched for age and sex. Echocardiographic and Doppler studies were conducted in all patients with RA and control subjects.
    RESULTS: Of 17 cardiac parameters assessed, only two were abnormal. None of the specific cardiac diastolic dysfunction parameters were significantly different in RA patients compared to the control group. There was no significant correlation between diastolic function values in RA patients and value of Disease Activity Score 28 (DAS-28) and value of Health Assessment Questionnaires Disability Index (HAQDI). Atrial (A) wave velocity was greater in RA patients compared to the control group (0.71 [0.58-0.83] vs. 0.61 [0.51-0.71]; P < 0.04). However, interventricular relaxation time (IVRT) ([73.08 ± 9.92 vs. 70.74 ± 9.02], P = 0.207), lower E/A ratio (1.27 [1.02-1.56] vs. 1.42 [1.20-1.68], P = 0.102), diastolic dysfunction parameters according to Redfield Classification (25 [47.2%] vs. 27 [50.9%] P = 0.56), diastolic dysfunction using E/A (P = 0.321) and tissue doppler imaging (E/E') (P = 0.148) were not different.
    CONCLUSION: Prevalence of diastolic dysfunction in the rheumatoid arthritis group (47.2%) was not different from controls (50.9%). LV diastolic function had no significant correlation with RA disease severity and duration of disease.
  4. 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.

  5. 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.
  6. 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.
  7. 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.
  8. Fulltext Apolipoprotein E genotypes and behavioural and psychological symptoms of dementia (BPSD) in Malaysian patients with dementia
    Rosdinom Razali, Zanariah Mat Saher, Elinda Tunan, Wan Zurinah Wan Ngah, Then Sue Mian, Suriati Mohamed Saini, et al.
    Sains Malaysiana, 2013;42(3):409-416.
    The aim of this study was to determine the relationships between ApoE genotypes and ‘behavioural and psychological symptoms of dementia’ (BPSD). A cross-sectional study was conducted on 46 outpatients with dementia (aged 60 and above) and their caregivers attending the psychogeriatric clinics at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and Hospital Kuala Lumpur. Neuropsychiatric Inventory (NPI) was used for the assessment of BPSD. The patients’ blood samples were taken for Apolipoprotein genotyping after consented by the caregivers. There were more female (69.6%) and Chinese (50%) patients with a mean age of 73.7 years. ApoE ε3/ε3 was the most common ApoE allele (60.7%) and mostly found in Chinese patients. ApoE genotype was significantly associated with ethnicity (p=0.03) and marital status (p=0.01). Alzheimer disease was the most common subtype of dementia (41.3%) and the highest carrier of ApoE ε3/ε3 (30.4%). The ApoE ε4/ ε4 scored highest in BPSD median score 44 (17.5 to 90) but the relationships
    between ApoE genotypes and subtypes of dementia or BPSD scores were not significant (p=0.20; p=0.64). Agitation was the most common symptom, with delusions showing the highest scores on the NPI with no significant association to ApoE 4 allele. In conclusion, there was no significant relationship between ApoE genotypes and severity or types of BPSD in dementia patients.
  9. 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.
    MyJurnal
    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.
  10. 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.
  11. Fulltext HPV positivity and its' influencing factors among invasive cervical cancer women in Malaysia
    Sharifa Ezat Wan Puteh, Norin Rahayu Samsuddin, Sharifah Noor Akmal Syed Hussain, Shamsul Azhar Shah, Syed Mohamed Aljunid
    Int J Public Health Res, 2011;1(1):13-22.
    MyJurnal
    Accepted 10 August 2011.
    Introduction Cervical cancer (CC) is the second most prevalent female cancer in Malaysia. Almost 70% of its’ causal factors are attributable to oncogenic human papillomavirus (HPV) types 16, 18 and other risk factors. HPV genotypes distributions are also noted to differ by geographical area.
    Methods This was cross sectional study conducted in 2007, to determine the influencing factors of HPV positivity and prevalence of HPV infections among patients with cervical cancer in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Patients’ paraffin-embedded cervical tissues kept in the Pathology Department from 1999 to 2007 were randomly selected. A total of 81 medical records with complete information were chosen as samples and patients were contacted for consent. Tissue samples were further derived for PCR DNA for HPV genotyping. Analyses included descriptive statistics; bivariate χ2 test and correlation were used to determine relationship between factors and HPV positivity. Significance level of less than 0.05 was taken as statistically significant.
    Results Mean age of cancer diagnosis was at 52 ± 12.2 years. Women of Chinese ethnicity was the highest ethnicity to be HPV positive at 65.4% and squamous cell carcinoma was more commonly found (59.3%) compared with other types of cancers. The prevalence of HPV positivity was 92.6% with type 16 being the most common (74.1%), followed by type 33 (30.9%) and 18 (22.2%). Multiple HPV infections were a common finding at 54.3%. Factors thought to influence positivity i.e. age of intercourse, number of sexual partners, number of parity, smoking status of patients and their partners, oral contraceptive usage, presence of chronic illnesses and cancer stage were not significantly associated with HPV positivity. Increased CC severity level was not associated with increased number of HPV infections (Pearson correlation 0.58; p =0.607).
    Conclusions High HPV positivity at 92.6% was found among ICC patients. Factors thought to influence HPV positivity were not significant. The top three HPV genotypes were type 16 followed by type 33 and 18. However, local women HPV serotypes findings need to be replicated in a larger population sample.
  12. Fulltext Psycho-behavioural factors contributing to truancy among malay secondary school students in Malaysia
    Shamsul Azhar Shah, Azura Abdullah, Azimatun Noor Aizuddin, Mohd Rohaizat Hassan, Nazarudin Safian, Rozita Hod, et al.
    ASEAN Journal of Psychiatry, 2012;13(2):128-137.
    MyJurnal
    Objective: Truancy is a disciplinary problem, which frequently occurs among school students and it has many contributory as well as inter-related factors. It is a growing problem in this country and it often becomes a prelude to other delinquent behaviours. The study objective is to determine the prevalence of truancy as well as factors related to it including psycho-behavioural factors. Methods: A cross-sectional study involving 556 Malay student’s selected using multi-stage sampling was conducted. Results: The overall prevalence of truancy is 30.2%. The predictors to truancy are age, students who frequenting entertainment centre, students who have not completed Quran recital, coping strategies using problems solving methods and time spent watching television/video. There is a significant association between truancy and psycho-behaviour such as watching video/internet pornography, frequenting entertainment centre, smoking, motorcycle racing and dating a special friend. Conclusion: Truancy is a social issue, which must be given serious attention by all concerned components of the society.
  13. 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,
  14. 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.
  15. 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.
  16. Fulltext Chlorpyrifos blood level and exposure symptoms among paddy farmers in Sabak Bernam, Malaysia
    Rozita Hod, Azimatun Noor Aizuddin, Shamsul Azhar Shah, Mohd Rohaizat Hassan, Nazarudin Safian, Mohd Hasni Jaafar
    Int J Public Health Res, 2011;1(1):1-6.
    MyJurnal
    Accepted 21 July 2011.
    Introduction The extensive and intensive use of pesticides in agricultural practices has exposed farmers to various hazards resulting in varying degrees of health
    outcomes.
    Methods We conducted a cross-sectional study among paddy farmers in Sabak Bernam district, Malaysia. The objective of this study was to gather baseline information on chlorpyrifos blood level and its relationship with pesticides exposure symptoms.
    Results We detected chlorpyrifos in farmers’ blood in 7 percent of the respondents, with mean 7.29 nanogram per millilitre blood (sd 5.84 nanogram per millilitre). The percentage of farmers who experienced at least one pesticide exposure symptoms was 75 percent. However, we found no significant association between chlorpyrifos blood level and its exposure symptoms. The farmers had low scores on safe practice of pesticide use even though they have high marks on knowledge and attitude. We found no significant association between the scores on knowledge, attitude and practice on pesticide use and the chlorpyrifos blood level.
    Conclusions The presence of pesticide exposure symptoms proved that most of the farmers were exposed to hazardous effects of pesticides. Specific trainings on safe use and handling of pesticides should be given on regular basis to these farmers to ensure they are protected from hazardous effects of pesticides exposure.
  17. Fulltext Penggunaan aplikasi GIS dalam penyakit tuberkulosis di Cheras, Kuala Lumpur, Malaysia
    Shamsul Azhar Shah, Md. Idris Mohd. Nor, Abdul Hadi Harman Shah, Tahir Aris
    Malaysian Journal of Public Health Medicine, 2002;2(2):15-26.
    MyJurnal
    Tuberkulosis merupakan penyakit yang masih meigadi masalah kesihatan di seluruh dunia amnya dan di Malaysia khasnya. Kajian telah dilakukan ali Cheras, Kuala Lumpur menggunakan aplikasi GIS untuk mengenalpasti taburan geografi dan tren tuberkulosis daripada tahun 1996 sehingga tahun 2000. Kajian ini juga dilakukan untuk melihat kebolehan GIS sebagai alat surveilan penyakit beyangkit. Hasil kajian dengan menggunakan aplikasi GIS mendapati tren peningkatan tuberkulosis di kawasan·kawasan yang tertentu di Cheras. Penumpuan kes-kes tuberkulosis dapat dilihat di kawasan taburan penduduk yang kepadatan tinggi dan sederhana tinggi terutama di kawasan Kampung Pandan, kawasan penempatan Jalan Cheras dan Bandar Tun Razak. Kes—kes tersebut juga kebanyakannya adalah dalam lingkungan 100 meter ke 200 meter di antara satu sama lain. Kesimpulannya secara am, aplikasi GIS memberikan dimensi baru dalam kawalan penyakit dan ia pasti dapat digunakan dalam membantu aktiviti surveilan penyakit tuberkulosis.
  18. Fulltext Students’ perception of schooling in associations with externalizing/internalizing syndromes and truancy
    Nik Ruzyanei Nik Jaafar, Tuti Iryani Mohd, Shamsul Azhar Shah, Rozhan Shariff Mohamed Radzi, Hatta Sidi
    ASEAN Journal of Psychiatry, 2008;9(2):85-92.
    MyJurnal
    Objectives: To determine the association of students’ perception of schooling with externalizing/internalizing scores; and to examine the different perceptions related to truancy. Methods:A total of 373 predominantly 16 year-old students attending three high risk schools in Pudu, Kuala Lumpur completed the questionnaires on schooling variables (four items) and externalizing/internalizing syndromes (Youth Self-Report, 112 items). Results: Certain negative perceptions (uncertainty of the schooling purpose, thinking schooling as time wasting) were significantly associated with higher internalizing (p
  19. 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.
  20. Spatial analysis of environmental factors influencing typhoid endemicity in Kelantan, Malaysia
    Shamsul Azhar Shah, Suzuki H, Mohd Rohaizat Hassan, Saito R, Nazarudin Safian, Shaharudin Idrus
    Sains Malaysiana, 2012;41:911-919.
    The determination of the high-risk area and clusters of typhoid cases is critical in typhoid control. The purpose of this study was to identify and describe the epidemiology and spatial distribution of typhoid in four selected districts in Kelantan using GIS (geographical information system). A total of 1215 (99%) of the cases were coordinated with GPS (global positioning system) and mapping was done using ArcGIS 9.2. Spatial analysis was performed to determine the cluster and high-risk area of typhoid. Results showed that typhoid incidence was not associated with race and sex. Most affected were from the age group of 5-14 followed by 15-24 year olds. Nine sub-districts were categorized as highly endemic. In addition typhoid has shown a significant tendency to cluster and a total of 22 hotspots were found in Kota Bharu, Bachok and Tumpat with a few sub districts identified as high risk for typhoid. No significant relationships between the treated water ratio and flood risk area were found with the cluster of cases. The cluster of typhoid cases in the endemic area did not appear to be related to environmental risk factors. Understanding the characteristics of these clusters would enable the prevention of typhoid disease in the future.
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