MyMedR

Maternal and child health in urban Sabah, Malaysia: a comparison of citizens and migrants

Zulkifli SN, U KM, Yusof K, Lin WY

Asia Pac J Public Health, 1994;7(3):151-8.

PMID: 7794653 DOI: 10.1177/101053959400700302

This paper describes selected maternal and child health indicators based on a cross-sectional study of citizens and migrants in Sabah, Malaysia. A total of 1,515 women were interviewed from a multi-stage random sample of households in eight urban centers. Among the 1,411 women in the sample who had experienced a pregnancy before, 76% were local citizens and 24% were migrants. There were statistically significant differences between citizens and migrants in ethnicity, religion, education, household income, and access to treated water supply and sanitary toilet facilities. Significantly fewer migrants practiced any form of contraception and obtained any antenatal care during any pregnancy. Furthermore, citizens tended to initiate care as early as three months but migrants as late as seven months. Despite these differences, only the infant mortality rate, and not pregnancy wastage, was statistically significantly higher among migrants. Pregnancy interval was also similar between the two groups. The influence of several socioeconomic factors on pregnancy wastage and infant mortality was explored.

Fulltext Sexual activities of Malaysian adolescents

Zulkifli SN, Low WY, Yusof K

Med J Malaysia, 1995 Mar;50(1):4-10.

PMID: 7752975

This paper examines data on the sexual activities of 1,200 Malaysian adolescents aged 15-21 years based on a probability household sampled survey carried out in Kuala Lumpur in 1986. Sexual behaviours like premarital sexual intercourse, contraceptive usage and masturbation were presented. Of the 1,181 unmarried respondents, 9% (105) reported having had sexual intercourse; males were significantly more experienced compared to females. Older age groups were also found to be more sexually active than the younger ones. Among those who had experience dating (n = 521), 20% (105) have experienced sexual intercourse, 44% (228) have kissed and necked, and 35% (183) have experienced petting, while 24% (130) have had no physical intimacies. Poor use of contraception was also revealed. The most commonly used were condoms, oral contraceptives and withdrawal. With regard to masturbation, males begin this practice relatively earlier than females. Almost half of those who indulged in masturbation were worried by the act, especially the females. Implications of the findings are discussed.

Role of schools of public health on maternal and child health programmes in the Asia-Pacific region

Zulkifli SN, Yun-Low W, Yusof K

Asia Pac J Public Health, 1998;10(1):10-6.

PMID: 10050201

This paper assessed the role of public health schools on maternal and child health programmes in the Asia Pacific region. Economic development and its associated effects, particularly in the ASEAN countries, for example, migrant labour, ageing, environmental health, turbulence and social climate, has a tremendous impact on maternal and child health. Based on these current issues, it is evident that public health schools can play a major role in maternal and child health in terms of policy formulation and programme development. Several areas were proposed as to what schools of public health can do, namely, through networking, communication, research and training.

Fulltext Population 70 million: a consideration of health aspects

Zulkifli SN, Yusof K

Med J Malaysia, 1985 Jun;40(2):62-79.

PMID: 3834289

A 70 million population for Malaysia by the year 2010 has been officially targetted for in the Mid-Term Review of the Fourth Malaysia Plan, 1981-1985. In response to this, a preliminary investigation was undertaken into the health aspects of population growth. For this exercise, infant mortality rate was used as the health indicator. From trends seen vis-a-vis population growth, it appears that thus far, population growth has not been associated negatively with health (as measured by IMR). In recognition of the relevance of the medical, economic and education factors to health, trends in Malaysia's population ratio, per capita GNP and rates of school enrolment were also drawn; the selection of these as proxies being based on completeness of time-serial records. Although statistical regressions established the high correlation between medical doctors.population ratio and school enrolment rate with IMR, the limitations in this analysis did not permit any reliable inferences. In view of the difficulties in projections of trends, a comparison of health and related variables was carried out for several countries with high populations as near to 70 million as were available. The characteristics associated with low mortality and high life expectancy (health indices) were identified as low population growth, high literacy and high per capita GNP; this being stated with explicit qualifications. Other determinants of health were also discussed in brief, and the need for careful planning in the distribution of human and material resources was noted.

Fulltext Perinatal mortality: selected data from a survey

Zulkifli SN, Yusof K

Med J Malaysia, 1986 Dec;41(4):292-9.

PMID: 3670150

This paper describes the findings of a survey on perinatal cases in Kuala Lumpur. Information on the deceased infants and their deliveries were documented as well as selected social, demographic and anthropometric data on the mothers. This includes quality of the home environment in terms of presence of basic amenities. It was evident that the lower classes were better represented in the sample.
This paper also highlights a major problem in retrospective studies, that of successfully tracing eligible respondents. There were also cases of non-cooperation. Another problem which emerged, and one common to many developing countries, was the incompleteness of birth weight records.

Role of teleconsultation in moving the healthcare system forward

Yusof K, Neoh KH, bin Hashim MA, Ibrahim I

Asia Pac J Public Health, 2002;14(1):29-34.

PMID: 12597515

The equitable access to quality healthcare by Malaysians has consistently been the primary objective of the Ministry of Health (MOH). The epidemiological transition to chronic illnesses, advances in medical technology, escalating healthcare costs and rising patient expectations has necessitated the strategic use of information systems in healthcare delivery. Malaysia has broken new ground by implementing a nationwide network to address inadequate access to healthcare, as well as to lower costs and achieve better health outcomes. Teleconsultation refers to the electronic transmission of medical information and services from one site to another using telecommunication technologies. This technology transforms the healthcare system by rapidly matching patient needs with the appropriate level of care however geographically remote they may be. Our findings suggest that even in these early stages of implementation, teleconsultation has led to cost savings, a more efficient allocation of resources, enhanced diagnostic options and better health outcomes.

Child care services in Malaysia: an overview

Yusof K, Wong YL, Ooi GL, Hamid-Don P

Asia Pac J Public Health, 1987;1(3):11-6.

PMID: 3452401

Maternal mortality amongst the rural Malays

Yusof K

Med J Malaysia, 1974 Mar;28(3):149-53.

PMID: 4278186

Hydatidiform mole: problems in early diagnosis

Yusof K

Med J Malaysia, 1973 Jun;27(4):275-9.

PMID: 4270785

Fulltext Urbanization and its effects on health in squatter areas (with special reference to Kuala Lumpur, Malaysia)

Yusof K, Kwai-Sim L

J Hum Ergol (Tokyo), 1990 Dec;19(2):171-84.

PMID: 2130090 DOI: 10.11183/jhe1972.19.171

Demographic and fertility characteristics of 4 squatter settlements

Yusof K, Zulkifli SN

Malays J Reprod Health, 1985;3(1):31-45.

PMID: 12268887

Development and evaluation of a computer expert system for the management of fetal distress

Wong KK, Ng KH, Nah SH, Yusof K, Rajeswari K

Asia Oceania J Obstet Gynaecol, 1994 Mar;20(1):19-23.

PMID: 8172522

The general lack of specialist obstetricians in a developing country such as Malaysia prompted us to develop a computer expert system for the management of fetal distress in rural hospitals. It was based on accepted production rules and implemented on a microcomputer. The clinical prototype was evaluated by 8 specialist obstetricians and 21 non-specialist doctors involved in obstetric care. The initial impression was that this type of expert system may help in diagnosis, decision-making and teaching.

Fulltext Clinical inertia in type 2 diabetes management in a middle-income country: A retrospective cohort study

Wan KS, Moy FM, Mohd Yusof K, Mustapha FI, Mohd Ali Z, Hairi NN

PLoS One, 2020;15(10):e0240531.

PMID: 33035261 DOI: 10.1371/journal.pone.0240531

BACKGROUND: Clinical inertia can lead to poor glycemic control among type 2 diabetes patients. However, there is paucity of information on clinical inertia in low- and middle-income countries including Malaysia. This study aimed to determine the time to treatment intensification among T2D patients with HbA1c of ≥7% (≥53 mmol/mol) in Malaysian public health clinics. The proportion of patients with treatment intensification and its associated factors were also determined.

MATERIAL AND METHODS: This was a five-year retrospective open cohort study using secondary data from the National Diabetes Registry. The study setting was all public health clinics (n = 47) in the state of Negeri Sembilan, Malaysia. Time to treatment intensification was defined as the number of years from the index year until the addition of another oral antidiabetic drug or initiation of insulin. Life table survival analysis based on best-worst case scenarios was used to determine the time to treatment intensification. Discrete-time proportional hazards model was fitted for the factors associated with treatment intensification.

RESULTS: The mean follow-up duration was 2.6 (SD 1.1) years. Of 7,646 patients, the median time to treatment intensification was 1.29 years (15.5 months), 1.58 years (19.0 months) and 2.32 years (27.8 months) under the best-, average- and worst-case scenarios respectively. The proportion of patients with treatment intensification was 45.4% (95% CI: 44.2-46.5), of which 34.6% occurred only after one year. Younger adults, overweight, obesity, use of antiplatelet medications and poorer HbA1c were positively associated with treatment intensification. Patients treated with more oral antidiabetics were less likely to have treatment intensification.

CONCLUSION: Clinical inertia is present in the management of T2D patients in Malaysian public health clinics. We recommend further studies in lower- and middle-income countries to explore its causes so that targeted strategies can be developed to address this issue.

Fulltext Predictors of glycosylated haemoglobin A1C trend among type 2 diabetes patients in a multi-ethnic country

Wan KS, Hairi NN, Mustapha FI, Mohd Yusof K, Mohd Ali Z, Moy FM

Sci Rep, 2021 03 24;11(1):6803.

PMID: 33762665 DOI: 10.1038/s41598-021-86277-0

Good control of glycosylated haemoglobin A1C in diabetes patients prevents cardiovascular complications. We aim to describe the A1C trend and determine the predictors of the trend among type 2 diabetes patients in Malaysia. Longitudinal data in the National Diabetes Registry from 2013 to 2017 were analysed using linear mixed-effects modelling. Among 17,592 patients, 56.3% were females, 64.9% Malays, and the baseline mean age was 59.1 years. The U-shaped A1C trend changed marginally from 7.89% in 2013 to 8.07% in 2017. The A1C excess of 1.07% as reported in 2017 represented about 22% higher risk of diabetes-related death, myocardial infarction, and stroke, which are potentially preventable. The predictors for higher baseline A1C were non-Chinese ethnicity, younger age groups, longer diabetes duration, patients on insulin treatment, polypharmacy use, patients without hypertension, and patients who were not on antihypertensive agents. Younger age groups predicted a linear increase in the A1C trend, whereas patients on insulin treatment predicted a linear decrease in the A1C trend. Specifically, the younger adults and patients of Indian and Malay ethnicities had the poorest A1C trends. Targeted interventions should be directed at these high-risk groups to improve their A1C control.

A psychosexual study of abortion - seeking behaviour

Vachher M, Yusof K

Med J Malaysia, 1978 Sep;33(1):50-6.

PMID: 750897

Fulltext A qualitative exploration of tuberculosis patients who were lost to follow-up in Malaysia

Tok PSK, Wong LP, Liew SM, Razali A, Mahmood MI, Chinnayah T, et al.

PLoS One, 2023;18(9):e0289222.

PMID: 37676902 DOI: 10.1371/journal.pone.0289222

BACKGROUND: Loss to follow-up (LTFU) is an unsuccessful treatment outcome for tuberculosis (TB) patients. In Malaysia, LTFU affects around 1 in 20 TB patients. Integration of qualitative research methods and evidence will provide a better understanding of LTFU and its underlying issues. In this study, we qualitatively explored TB patients' experiences in receiving treatment and their reasons for leaving TB care.

METHOD: In-depth interviews of 15 patients with a history of LTFU were conducted from January to September 2020. Interview guides were developed to explore TB patients' experiences while receiving treatment, including challenges faced and reasons for treatment interruption. Data were thematically analysed using the framework method.

RESULTS: We identified 11 emerging themes that occurred at four levels of interaction with TB patients. First, at the patient personal level, TB beliefs referring to patients' perception of illness and wellness, patients' perceived role of traditional and complementary medicine, and substance abuse were important. Second, the healthcare system and treatment factors that were highlighted included the organisation of care and treatment, interaction with healthcare professionals, particularly in communication and counselling, and TB medications' side effects. Third, structural factors including financial burden, logistical and transportation issues and work-related factors were identified to be barriers to treatment continuation. Fourth, the interpersonal level interaction of patients should not be neglected; this includes family relationships and support as well as peer influence.

CONCLUSION: Study findings put forth issues and challenges faced by TB patients while receiving treatment and underscore areas where actions can be taken. This will contribute to informing the development and implementation of future TB control strategies that are responsive to TB patients' needs and concerns, to effectively address LTFU and ensure better treatment completion rates among TB patients in Malaysia.

A preliminary study of plasma estriol levels in Malaysian pregnancies

Thambyrajah V, Yusof K, Kin FC

Med J Malaysia, 1978 Jun;32(4):308-12.

PMID: 732629

Fulltext Carcinoma of the vulva--a Malaysian experience

Sivanesaratnam V, Adlan A, Sinnathuray TA, Yusof K, Kulenthran A, Looi LM

Med J Malaysia, 1982 Jun;37(2):170-4.

PMID: 7132837

The technique of radical vulvectomy with lymphadenectomy in which primary skin. closure of the large defect is achieved is described. Experience with this operative technique at the University Hospital, Kuala Lurnpur from 1968 to 1980 is reviewed. The technique allows for wide clearance of the tumour and of regional lymphatic channels and nodes in continuity. We have been impressed by the good immediate results and at the primary skin closure achieved in all our cases.

Pattern of acute pelvic inflammatory disease in abortion-related admissions

Sinnathuray TA, Yusof K, Palan VT, Fong CK, Adeep N, Chong CH, et al.

Am J Obstet Gynecol, 1980 Dec 01;138(7 Pt 2):868-71.

PMID: 7468674

We evaluated 3,066 consecutive women admitted during 1 year to two major hospitals of Kuala Lumpur and the adjacent urban area of Malaysia. Indicators of acute pelvic inflammatory disease were more common among patients with induced abortions. PID was thought to be a major contributor to the higher costs associated with management of patients with induced abortions.

Fulltext Gelam Honey Attenuates the Oxidative Stress-Induced Inflammatory Pathways in Pancreatic Hamster Cells

Safi SZ, Batumalaie K, Qvist R, Mohd Yusof K, Ismail IS

Evid Based Complement Alternat Med, 2016;2016:5843615.

PMID: 27034691 DOI: 10.1155/2016/5843615

Purpose. Type 2 diabetes consists of progressive hyperglycemia and insulin resistance, which could result from glucose toxicity, inflammatory cytokines, and oxidative stress. In the present study we investigated the effect of Gelam honey and quercetin on the oxidative stress-induced inflammatory pathways and the proinflammatory cytokines. Methods. HIT-T15 cells were cultured and preincubated with the extract of Gelam honey (20, 40, 60, and 80 μg/mL), as well as quercetin (20, 40, 60, and 80 μM), prior to stimulation by 20 and 50 mM glucose. Results. HIT-T15 cells cultured under hyperglycemic condition showed a significant increase in the inflammatory pathways by phosphorylating JNK, IKK-β, and IRS-1 at Ser307 (p < 0.05). There was a significant decrease in the phosphorylation of Akt at Ser473 (p < 0.05). Pretreatment with Gelam honey and quercetin reduced the expression of phosphorylated JNK, IKK-β, and IRS-1, thereby significantly reducing the expression of proinflammatory cytokines like TNF-α, IL-6, and IL-1β (p < 0.05). At the same time there was a significant increase in the phosphorylated Akt showing the protective effects against inflammation and insulin resistance (p < 0.05). In conclusion, our data suggest the potential use of the extract from Gelam honey and quercetin in modulating the inflammation induced insulin signaling pathways.

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