MyMedR

Utilization of maternal and child health facilities by the urban poor of Kuala Lumpur

Gan CY, Yusof K

Southeast Asian J. Trop. Med. Public Health, 1993 Jun;24(2):302-6.

A survey conducted to assess the extent which the urban poor in rapidly expanding Kuala Lumpur utilize maternal and child health services available to them. The sample consisted of 1,380 households with children below 6 years and yielded 1,233 children below 6 years of age. 74% of the children had been delivered in government hospitals and 86% of the pregnancies had antenatal care in governmental establishments. 89.2% had BCG immunization before they were 1 year old but 13.3% had not received DPT by that age. Immunization was mainly done in government clinics. The overall immunization coverage for the whole of Kuala Lumpur is expected to be higher than these figures limited to the urban poor. Health planners should increase health facilities in the city to accommodate the expanding population. There is a need to continually campaign for immunization to improve coverage among the urban poor.

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.

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 Drug addiction--current trends

Low Wah Yun, Yusof K

Med J Malaysia, 1988 Mar;43(1):34-9.

PMID: 3244317

Fulltext Complete heart block complicating acute myocardial infarction: a six-year review

Chin K, Yusof K

Med J Malaysia, 1987 Jun;42(2):93-6.

PMID: 3503197

The clinical course of 68 patients who had temporary transvenous pacing for complete heart block in acute myocardial infarction is reviewed. There were 59 male and 9 female patients, of which 32 were Indians, 20 were Malays and 16 Chinese. 48 patients had inferior infarct, 16 patients developed anterior infarct and 4 patients presented with combined anteriorinferior infarction. The overall mortality for complete heart block in this study is 44%. The mortality pattern is 25% for inferior infarct; 87% for anterior infarct and 100% for combined anterior and inferior infarct.

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.

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.

Eclampsia - a review of 48 cases

Ong SK, Foo J, Wong WP, Yusof K

Med J Malaysia, 1978 Mar;32(3):206-11.

PMID: 683043

Myocardial infarction in pregnancy. Case report and brief review

Lim MA, Yusof K

Med J Malaysia, 1973 Dec;28(2):129-31.

PMID: 4276231

Maternal mortality amongst the rural Malays

Yusof K

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

PMID: 4278186

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

A psychosexual study of abortion - seeking behaviour

Vachher M, Yusof K

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

PMID: 750897

Hydatidiform mole: problems in early diagnosis

Yusof K

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

PMID: 4270785

Amnioscopy in high risk pregnancy

Kuah KB, Yusof K

Med J Malaysia, 1972 Sep;27(1):63-68.

PMID: 35158539

No abstract available.

Amnioscopy in high risk pregnancy

Kuah KB, Yusof K

Med J Malaya, 1972 Sep;27(1):63-8.

PMID: 4264828

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.

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 Eliciting local knowledge of ecosystem services using participatory mapping and Photovoice: A case study of Tun Mustapha Park, Malaysia

Lim VC, Justine EV, Yusof K, Wan Mohamad Ariffin WNS, Goh HC, Fadzil KS

PLoS One, 2021;16(7):e0253740.

PMID: 34242233 DOI: 10.1371/journal.pone.0253740

Protected areas in Malaysia have always been managed using top-down approach that often exclude the local communities, who are the main users of ecosystem services, from the planning and management. However, a newly established multiple-use marine park in Malaysia, Tun Mustapha Park (TMP), aims for inclusivity in managing the park. This research explores different participatory approaches (i.e. participatory mapping and Photovoice) to understand the ecosystem services and the dynamics surrounding the services in TMP. Community-based organisations and a mariculture farm in TMP were invited to participate in this work. The participants mapped the ecosystem services and provided in-depth qualitative data that supported the maps, besides highlighting ecological, sociocultural and economic issues surrounding the ecosystem services. Furthermore, the participants provided suggestions and recommendations that carry political effects. Therefore, the participatory approaches employed here had provided rich visual and spatial data to enhance the ecosystem-based management of TMP besides empowering the participants to voice out for their communities. The results generated from this work were also further utilised to fill in the gaps of knowledge in a separate ecosystem service assessment matrix. However, the output from participatory approaches should not be considered as the ultimate outcome but rather as supplement to the planning and management of TMP due to potential human errors and biases. Although the participatory approaches came with limitations and challenges that may have affected the findings here, these nonetheless had provided support to the capability of local communities to provide information crucial for management of protected areas as well as room for improvement for further work.

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.

Characterization of pR18, a novel rolling-circle replication plasmid from Lactobacillus plantarum

Jalilsood T, Baradaran A, Ling FH, Mustafa S, Yusof K, Rahim RA

Plasmid, 2014 May;73:1-9.

PMID: 24785193 DOI: 10.1016/j.plasmid.2014.04.004

Lactobacillus plantarum PA18, a strain originally isolated from the leaves of Pandanus amaryllifolius, contains a pR18 plasmid. The pR18 plasmid is a 3211bp circular molecule with a G+C content of 35.8%. Nucleotide sequence analysis revealed two putative open reading frames, ORF1 and ORF2, in which ORF2 was predicted (317 amino acids) to be a replication protein and shared 99% similarity with the Rep proteins of pLR1, pLD1, pC30il, and pLP2000, which belong to the RCR pC194/pUB110 family. Sequence analysis also indicated that ORF1 was predicted to encode linA, an enzyme that enzymatically inactivates lincomycin. The result of Southern hybridization and mung bean nuclease treatment confirmed that pR18 replicated via the RCR mechanism. Phylogenetic tree analysis of pR18 plasmid proteins suggested that horizontal transfer of antibiotic resistance determinants without genes encoding mobilization has not only occurred between Bacillus and Lactobacillus but also between unrelated bacteria. Understanding this type of transfer could possibly play a key role in facilitating the study of the origin and evolution of lactobacillus plasmids. Quantitative PCR showed that the relative copy number of pR18 was approximately 39 copies per chromosome equivalent.

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