Displaying publications 1 - 20 of 65 in total

Abstract:
Sort:
  1. Fulltext A Southeast Asia Consensus on the Definition and Management of Treatment-Resistant Depression
    Tor PC, Amir N, Fam J, Ho R, Ittasakul P, Maramis MM, et al.
    Neuropsychiatr Dis Treat, 2022;18:2747-2757.
    PMID: 36444218 DOI: 10.2147/NDT.S380792
    INTRODUCTION: Despite the abundance of literature on treatment-resistant depression (TRD), there is no universally accepted definition of TRD and available treatment pathways for the management of TRD vary across the Southeast Asia (SEA) region, highlighting the need for a uniform definition and treatment principles to optimize the management TRD in SEA.

    METHODS: Following a thematic literature review and pre-meeting survey, a SEA expert panel comprising 13 psychiatrists with clinical experience in managing patients with TRD convened and utilized the RAND/UCLA Appropriateness Method to develop consensus-based recommendations on the appropriate definition of TRD and principles for its management.

    RESULTS: The expert panel agreed that "pharmacotherapy-resistant depression" (PRD) is a more suitable term for TRD and defined it as "failure of two drug treatments of adequate doses, for 4-8 weeks duration with adequate adherence, during a major depressive episode". A stepwise treatment approach should be employed for the management of PRD - treatment strategies can include maximizing dose, switching to a different class, and augmenting or combining treatments. Non-pharmacological treatments, such as electroconvulsive therapy and repetitive transcranial magnetic stimulation, are also appropriate options for patients with PRD.

    CONCLUSION: These consensus recommendations on the operational definition of PRD and treatment principles for its management can be adapted to local contexts in the SEA countries but should not replace clinical judgement. Individual circumstances and benefit-risk balance should be carefully considered while determining the most appropriate treatment option for patients with PRD.

  2. A randomized, placebo-controlled trial of aripiprazole for the treatment of methamphetamine dependence and associated psychosis
    Sulaiman AH, Gill JS, Said MA, Zainal NZ, Hussein HM, Guan NC
    Int J Psychiatry Clin Pract, 2013 Jun;17(2):131-8.
    PMID: 22486597 DOI: 10.3109/13651501.2012.667116
    The objectives of this study were to determine the efficacy and safety of aripiprazole for treatment of psychosis, retention and abstinence in patients with methamphetamine dependence.
  3. Anhedonia in depressed patients on treatment with selective serotonin reuptake inhibitor anti-depressant--A two-centered study in Malaysia
    Yee A, Chin SC, Hashim AH, Harbajan Singh MK, Loh HS, Sulaiman AH, et al.
    Int J Psychiatry Clin Pract, 2015;19(3):182-7.
    PMID: 25874350 DOI: 10.3109/13651501.2015.1031139
    Anhedonia is the reduced ability to experience pleasure. It is a core symptom of depression and is particularly difficult to treat. This study aims to compare the level of anhedonia between depressed patients on anti-depressants and healthy subjects.
  4. Antidepressant decision aid for major depressive disorder patients (ADAM): Development and pilot testing
    Abousheishaa AA, Lazim NHM, Tang SL, Sulaiman AH, Huri HZ, Guan NC
    Patient Educ Couns, 2022 Jul;105(7):2466-2474.
    PMID: 34844812 DOI: 10.1016/j.pec.2021.11.007
    OBJECTIVES: This study aimed to develop and assess the effectiveness of an encounter decision aid for Malaysian patients with MDD to support treatment decision-making during the consultation.

    METHODS: The decision aid prototype was developed following a literature review and six focus groups. Alpha testing assessed its comprehensibility, acceptability, usability and desirability through user-centered cognitive interviews. Beta-testing evaluated preliminary evidence on its efficacy using the SDM Scale and PDMS. Feasibility was assessed by timing the consultation.

    RESULTS: The alpha testing demonstrated that the decision aid was patient-oriented, comprehensible, comprehensive, concise and objective with an appealing design. Beta-testing indicated that PtDA significantly increased patients satisfaction with SDM from patients' [83.32 (13.92) vs 85.76 (13.80); p 

  5. Anxiety and Depression in Cancer Patients: The Association with Religiosity and Religious Coping
    Ng GC, Mohamed S, Sulaiman AH, Zainal NZ
    J Relig Health, 2017 Apr;56(2):575-590.
    PMID: 27287259 DOI: 10.1007/s10943-016-0267-y
    There is a lack of studies looking into religiosity and religious coping in cancer patient. In this cross-sectional study, we examined the religiosity using Duke University Religion Index, religious coping using Brief Religious Coping Scale, anxiety and depression based on Hospital Anxiety and Depression Scale among 200 cancer patients. The association between religiosity and religious coping with anxiety and depression was studied. The findings showed that subjects with anxiety or depression used more negative religious coping and had lower non-organization religiosity. Hence, measurements in reducing negative religious coping and encouraging religious activities could help to reduce psychological distress in cancer patients.
  6. Fulltext Anxiety, depression, perceived social support and quality of life in Malaysian breast cancer patients: a 1-year prospective study
    Ng CG, Mohamed S, See MH, Harun F, Dahlui M, Sulaiman AH, et al.
    Health Qual Life Outcomes, 2015;13:205.
    PMID: 26715073 DOI: 10.1186/s12955-015-0401-7
    Depression and anxiety are common psychiatric morbidity among breast cancer patient. There is a lack of study examining the correlation between depression, anxiety and quality of life (QoL) with perceived social support (PSS) among breast cancer patients. This study aims to study the level of depression, anxiety, QoL and PSS among Malaysian breast cancer women over a period of 12 months and their associations at baseline, 6 and 12 months.
  7. Association between painful physical symptoms and clinical outcomes in East Asian patients with major depressive disorder: a 3-month prospective observational study
    Ang QQ, Wing YK, He Y, Sulaiman AH, Chiu NY, Shen YC, et al.
    Int J Clin Pract, 2009 Jul;63(7):1041-9.
    PMID: 19570122 DOI: 10.1111/j.1742-1241.2009.02107.x
    Reports from non-Asian populations indicate that painful physical symptoms (PPS) are associated with poorer clinical and functional outcomes in major depressive disorder (MDD). The purpose of this study is to report comparative changes in disease severity, treatment patterns and quality of life observed in East Asian patients with MDD, with and without PPS, as assessed prospectively over a 3-month observation period.
  8. Fulltext Association between polarity of first episode and solar insolation in bipolar I disorder
    Bauer M, Glenn T, Achtyes ED, Alda M, Agaoglu E, Altınbaş K, et al.
    J Psychosom Res, 2022 Sep;160:110982.
    PMID: 35932492 DOI: 10.1016/j.jpsychores.2022.110982
    OBJECTIVE: Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth.

    METHODS: Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer.

    RESULTS: The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001).

    CONCLUSION: Increased awareness and research into circadian dysfunction throughout the course of BD is warranted.

  9. Association between solar insolation and a history of suicide attempts in bipolar I disorder
    Bauer M, Glenn T, Alda M, Andreassen OA, Angelopoulos E, Ardau R, et al.
    J Psychiatr Res, 2019 06;113:1-9.
    PMID: 30878786 DOI: 10.1016/j.jpsychires.2019.03.001
    In many international studies, rates of completed suicide and suicide attempts have a seasonal pattern that peaks in spring or summer. This exploratory study investigated the association between solar insolation and a history of suicide attempt in patients with bipolar I disorder. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area on Earth. Data were collected previously from 5536 patients with bipolar I disorder at 50 collection sites in 32 countries at a wide range of latitudes in both hemispheres. Suicide related data were available for 3365 patients from 310 onset locations in 51 countries. 1047 (31.1%) had a history of suicide attempt. There was a significant inverse association between a history of suicide attempt and the ratio of mean winter solar insolation/mean summer solar insolation. This ratio is smallest near the poles where the winter insolation is very small compared to the summer insolation. This ratio is largest near the equator where there is relatively little variation in the insolation over the year. Other variables in the model that were positively associated with suicide attempt were being female, a history of alcohol or substance abuse, and being in a younger birth cohort. Living in a country with a state-sponsored religion decreased the association. (All estimated coefficients p 
  10. Clinical and socio-demographic correlates of anxious distress in Asian outpatients with major depressive disorder
    Maneeton N, Suttajit S, Maneeton B, Likhitsathian S, Eurviyanukul K, Udomratn P, et al.
    Nord J Psychiatry, 2017 Oct;71(7):503-508.
    PMID: 28632428 DOI: 10.1080/08039488.2017.1335344
    BACKGROUND: Anxious distress in major depressive disorder (MDD) is common and associated with poor outcomes and management difficulties.

    AIMS: This post hoc analysis aimed to examine the socio-demographic and clinical correlates of anxiety distress in Asian outpatients with MDD.

    METHODS: Instead of two out of five specifiers defined by the Diagnostic and Statistical Manual Version-5, anxious distress defined in this study was operationalized as the presence of at least two out of four proxy items drawn from the 90-item Symptom Checklist, Revised (SCL-90-R). Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale, the Sheehan Disability Scale and the Multidimensional Scale of Perceived Social Support.

    RESULTS: The data of 496 patients with MDD were included. Anxious distress was found in 371 participants (74.8%). The binary logistic regression analysis found that anxious distress was independently and significantly correlated with working status, higher MADRS scores, severe insomnia and functional impairment.

    CONCLUSIONS: Three-fourths of Asian patients with MDD in tertiary care settings may have DSM-5 anxious distress of at least moderate distress. Its prevalence may vary among working groups. The specifier was associated with greater depressive symptom severity, severe insomnia and functional impairment.

    Study site: n tertiary care
    settings in China, Korea, Malaysia, Singapore, Taiwan and
    Thailand
  11. Clinical and sociodemographic correlates of severe insomnia in psychotropic drug-free, Asian outpatients with major depressive disorder
    Srisurapanont M, Likhitsathian S, Chua HC, Udomratn P, Chang S, Maneeton N, et al.
    J Affect Disord, 2015 Nov 1;186:26-31.
    PMID: 26226430 DOI: 10.1016/j.jad.2015.06.032
    BACKGROUND: Little has been known regarding the correlates of severe insomnia in major depressive disorder (MDD). This post-hoc analysis aimed to examine the sociodemographic and clinical correlates of severe insomnia in psychotropic drug-free, Asian adult outpatients with MDD.
    METHODS: Participants were psychotropic drug-free patients with MDD, aged 18-65 years. By using the Symptom Checklist-90 Items, Revised (SCL-90-R), a score of 4 (severe distress) on any one of three insomnia items was defined as severe insomnia. Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), the Fatigue Severity Scale (FSS), the nine psychopathology subscales of SCL-90-R, the Physical and Mental Component Summaries of Short Form Health Survey (SF-36 PCS and SF-36 MCS), and the Sheehan Disability Scale (SDS).
    RESULTS: Of 528 participants, their mean age being 39.5 (SD=13.26) years, 64.2% were females, and 239 (45.3%) had severe insomnia. The logistic regression model revealed that low educational qualifications (less than secondary school completion), high SCL-90-R Depression scores, high SCL-90-R Anxiety scores, and low SF-36 PCS scores were independently correlated with severe insomnia (p's
  12. Comparable efficacy and safety of 8 weeks treatment with agomelatine 25-50mg or fluoxetine 20-40mg in Asian out-patients with major depressive disorder
    Shu L, Sulaiman AH, Huang YS, Fones Soon Leng C, Crutel VS, Kim YS
    Asian J Psychiatr, 2014 Apr;8:26-32.
    PMID: 24655622 DOI: 10.1016/j.ajp.2013.09.009
    OBJECTIVE: This randomized, double-blind study evaluates the efficacy and tolerability of agomelatine, using fluoxetine as an active comparator, in Asian patients suffering from moderate to severe major depressive disorder (MDD).
    METHOD: Patients were randomly assigned to receive either agomelatine (25-50mg/day, n=314) or fluoxetine (20-40mg/day, n=314) during an 8-week treatment period. The main outcome measure was the change in Hamilton Depression Rating Scale 17 items (HAM-D17) scores. Secondary efficacy criteria included scores on Clinical Global Impression Severity of illness (CGI-S) and Improvement of illness (CGI-I), patient sleeping improvement using the self-rating Leeds Sleep Evaluation Questionnaire (LSEQ) and anxiety using the Hamilton Anxiety Rating Scale (HAM-A) scores. Tolerability and safety evaluations were based on emergent adverse events.
    RESULTS: Agomelatine and fluoxetine exert a comparable antidepressant efficacy in the Asian population. Mean changes over 8 weeks were clinically relevant and similar in both groups (-14.8±7.3 and -15.0±8.1 on HAM-D17 scale in agomelatine and fluoxetine groups, respectively). The between-group difference reached statistical significance on non-inferiority test (p=0.015). Clinically relevant decreases in CGI-S and CGI-I scores were observed over the treatment period in both groups. The two treatments were equally effective on the symptoms of both anxiety and sleep. The good tolerability profile and safety of both doses of agomelatine was confirmed in the Asian population.
    CONCLUSIONS: Agomelatine and fluoxetine are equally effective in the treatment of MDD-associated symptoms in Asian depressed patients.
    KEYWORDS: Agomelatine; Antidepressant; Asian population; Fluoxetine
    Study site in Malaysia: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  13. Comparison of psychotropic prescriptions between oncology and cardiology inpatients: result from a pharmacy database in a teaching hospital in Malaysia
    Ng CG, Mohamed S, Wern TY, Haris A, Zainal NZ, Sulaiman AH
    Asian Pac J Cancer Prev, 2014;15(10):4261-4.
    PMID: 24935381
    OBJECTIVE: To examine the prescription rates in cancer patients of three common psychotropic drugs: anxiolytic/ hypnotic, antidepressant and antipsychotic.

    MATERIALS AND METHODS: In this retrospective cohort study, data were extracted from the pharmacy database of University Malaya Medical Center (UMMC) responsible for dispensing records of patients stored in the pharmacy's Medication Management and Use System (Ascribe). We analyzed the use of psychotropics in patients from the oncology ward and cardiology from 2008 to 2012. Odds ratios (ORs) were adjusted for age, gender and ethnicity.

    RESULTS: A total of 3,345 oncology patients and 8,980 cardiology patients were included. Oncology patients were significantly more often prescribed psychotropic drugs (adjusted OR: anxiolytic/hypnotic=5.55 (CI: 4.64-6.63); antidepressants=6.08 (CI: 4.83-7.64) and antipsychotics=5.41 (CI: 4.17-7.02). Non-Malay female cancer patients were at significantly higher risk of anxiolytic/hypnotic use.

    CONCLUSIONS: Psychotropic drugs prescription is common in cancer patients. Anxiolytic/hypnotic prescription rates are significantly higher in non-Malay female patients in Malaysia.

  14. Conceptualizing and measuring youth-adult partnership in community programs: a cross national study
    Zeldin S, Krauss SE, Collura J, Lucchesi M, Sulaiman AH
    Am J Community Psychol, 2014 Dec;54(3-4):337-47.
    PMID: 25216734 DOI: 10.1007/s10464-014-9676-9
    Youth participation in program and community decision making is framed by scholars as an issue of social justice, a platform for positive youth development and effective citizenry, and a strategy for nation building. Recent literature reviews have consistently identified youth-adult partnership (Y-AP) as an effective type of youth participation across highly diverse contexts. These same reviews, however, note that indicators of Y-AP have not been conceptualized and validated for measurement purposes. The present study addresses this limitation by developing a brief measure of Y-AP that is explicitly grounded in current theory, research, and community practice. The measure was administered to youth in the United States, Malaysia, and Portugal (N = 610). Validation was assessed through factor analysis and tests of factorial, discriminant, and concurrent validity. Results confirmed the two predicted dimensions of the Y-AP measure: youth voice in decision making and supportive adult relationships. These two dimensions were also found to be distinct from other measures of program quality: safety and engagement. As predicted, they also significantly correlated with measures of agency and empowerment. It is concluded that the measure has the potential to support community efforts to maximize the quality of youth programs.
  15. Fulltext Core Symptoms of Major Depressive Disorder among Palliative Care Patients
    Huey NS, Guan NC, Gill JS, Hui KO, Sulaiman AH, Kunagasundram S
    Int J Environ Res Public Health, 2018 08 16;15(8).
    PMID: 30115817 DOI: 10.3390/ijerph15081758
    A valid method to diagnose depression in palliative care has not been established. In this study, we aim to determine the prevalence of depression and the discriminant validity of the items of four sets of diagnostic criteria in palliative care. This is a cross-sectional study on 240 palliative care patients where the presence of depression was based on the Diagnostic and Statistical Manual of Mental Disorders, DSM⁻IV Criteria, Modified DSM⁻IV Criteria, Cavanaugh Criteria, and Endicott's Criteria's. Anxiety, depression, and distress were measured with Hospital Anxiety and Depression Scale and Distress Thermometer. The prevalence of depression among the palliative care patients was highest based on the Modified DSM⁻IV Criteria (23.3%), followed by the Endicott's Criteria (13.8%), DSM⁻IV Criteria (9.2%), and Cavanaugh Criteria (5%). There were significant differences (p < 0.05) in the depressive symptoms showed by DSM⁻IV item 1 (dysphoric mood), item 2 (loss of interest or pleasure), and Endicott's criteria item 8 (brooding, self-pity, or pessimism) among the palliative patients, even after adjustment for the anxiety symptoms and distress level. We found that dysphoric mood, loss of interest, and pessimism are the main features of depression in palliative patients. These symptoms should be given more attention in identifying depression in palliative care patients.
  16. Correlates of disability in Asian patients with major depressive disorder
    Eurviriyanukul K, Srisurapanont M, Udomratn P, Sulaiman AH, Liu CY
    Perspect Psychiatr Care, 2016 Oct;52(4):265-272.
    PMID: 26031315 DOI: 10.1111/ppc.12127
    PURPOSE: To examine correlates of disability in Asian patients with major depressive disorder (MDD).
    DESIGN AND METHODS: Participants were outpatients with DSM-IV MDD. Global disability and three disability domains (i.e., work/school, social life/leisure, and family/home life) were key outcomes. Several socio-demographic and clinical characteristics were determined for their associations with disability.
    FINDINGS: The sample was 493 MDD patients. Apart from the number of hospitalizations, the global disability was significantly associated with depression severity, fatigue, physical health, and mental health. Several clinical but only few socio-demographic characteristics associated with the other three disability domains were similar.
    PRACTICE IMPLICATIONS: Disability among Asian patients with MDD correlates with the severity of psychiatric symptoms and the hospitalizations due to depression. Socio-demographic characteristics have little impact on the overall disability.
    Study site: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  17. Corrigendum to "Antidepressant decision aid for major depressive disorder patients (ADAM): Development and pilot testing" [Patient Education and Counseling 105 7 (2022) 2466-2474]
    Abousheishaa AA, Lazim NHM, Tang SL, Sulaiman AH, Huri HZ, Guan NC
    Patient Educ Couns, 2023 Sep;114:107852.
    PMID: 37379756 DOI: 10.1016/j.pec.2023.107852
  18. Fulltext Depression and associated factors in patients with type 2 diabetes mellitus
    Hashim NA, Ariaratnam S, Salleh MR, Said MA, Sulaiman AH
    East Asian Arch Psychiatry, 2016 Jun;26(2):77-82.
    PMID: 27377489
    OBJECTIVES: To determine the prevalence of major depressive disorder and its association with socio-demographic and clinical factors in patients with type 2 diabetes mellitus.

    METHODS: This was a cross-sectional study of patients with type 2 diabetes mellitus who attended the hospital-based primary care clinics at the University Malaya Medical Centre, Kuala Lumpur, Malaysia. The patients were interviewed using the Mini-International Neuropsychiatric Interview to diagnose depression based on the DSM-IV criteria. The socio-demographic and clinical data were obtained by interviewing the patients and subsequently verified against their respective case notes.

    RESULTS: A total of 204 patients were recruited. The prevalence of major depressive disorder was 15.7%. Major depressive disorder was significantly associated with younger age of patients (mean ± standard deviation, 57.8 ± 15.1 years, p = 0.04), younger age at diagnosis of diabetes mellitus (46.2 ± 13.0 years, p = 0.01), having secondary education (p = 0.02), and having a history of depression (p = 0.002). Multivariate analysis showed that current age (p = 0.04), duration of diabetes mellitus (p = 0.04), age at diagnosis of diabetes mellitus (p = 0.01), and secondary education (p = 0.01) were significant factors.

    CONCLUSIONS: The prevalence of major depressive disorder was high among patients with type 2 diabetes mellitus. Screening of patients with type 2 diabetes mellitus for depression should be performed periodically or routinely, especially in the primary care setting.
  19. Depressive symptoms in residents of a tertiary training hospital in Malaysia: The prevalence and associated factors
    Nair N, Ng CG, Sulaiman AH
    Asian J Psychiatr, 2021 Feb;56:102548.
    PMID: 33454562 DOI: 10.1016/j.ajp.2021.102548
    The mental wellbeing of doctors is becoming an increasing concern in the world today. In Malaysia, residency is a challenging period in a doctor's life, with many changes professionally and possibly in their personal lives as well. This study aims to determine the prevalence of depressive symptoms and the socio-demographic correlates among residents in a tertiary training hospital in Malaysia. It is a cross sectional study and all residents were approached to participate in the study. The instruments used were a socio-demographic questionnaire and the Patient Health Questionnaire 9 (PHQ-9). Chi-square test was used to explore the association between the socio-demographic correlates, and those that were found to have significant associations were further tested using multivariate logistic regression. The prevalence of depression among residents was 25.1 %. Longer working hours, missing meals, and working in Department of Surgery and Department of Anaesthesia was significantly positively associated while having protected study time, CME/lectures, leisure/hobbies and exercise were negatively associated with depression. The Department of Rehabilitation Medicine had a significantly negative association with depression. After logistic regression, longer working hours and a lack of protected study time was significantly associated with depression in the respective departments. In summary, the prevalence of depression among residents is high and is associated with longer working hours, missing meals and a lack of protected study time are significantly associated with depression. Remedial steps should be taken to improve the mental health among residents.
  20. Fulltext Development of a Strategic Tool for Shared Decision-Making in the Use of Antidepressants among Patients with Major Depressive Disorder: A Focus Group Study
    Zaini S, Manivanna Bharathy HA, Sulaiman AH, Singh Gill J, Ong Hui K, Zaman Huri H, et al.
    Int J Environ Res Public Health, 2018 07 03;15(7).
    PMID: 29970848 DOI: 10.3390/ijerph15071402
    Shared decision-making (SDM) has been recognized as an important tool in the mental health field and considered as a crucial component of patient-centered care. Therefore, the purpose of this study was to develop a strategic tool towards the promotion and implementation of SDM in the use of antidepressants among patients with major depressive disorder. Nineteen doctors and 11 major depressive disorder patients who are involved in psychiatric outpatient clinic appointments were purposively selected and recruited to participate in one of six focus groups in a large teaching hospital in Malaysia. Focus groups were transcribed verbatim and analyzed using a thematic approach to identify current views on providing information needed for SDM practice towards its implementation in near future. Patients’ and doctors’ views were organized into six major themes, which are; summary of treatment options, correct ways of taking medication, potential side effects of treatments related to patients, sharing of case study related to the treatment options, cost of treatment options, and input from pharmacist. The information may be included in the SDM tool which can be useful to inform further research efforts and developments that contribute towards the successful implementation of SDM into clinical practice.

    Study site: University Malaya Medical Centre (UMMC)
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links