MyMedR

Nutrition promotion: the role of monitoring physical growth

Zulkifli SN

Asia Pac J Public Health, 1992;6(4):210-6.

Growth monitoring has been included as one of the basic strategies for child survival. In this paper, the rationale for this is reiterated both for individual as well as population nutritional surveillance. Methods for and approaches to growth monitoring are described. In addition, potential problems in implementing growth monitoring projects and interpreting the results are discussed. Despite its lack of sensitivity and specificity as a diagnostic tool, its advantages in terms of low cost, simplicity, reliability and social acceptability justify its use in nutritional surveillance, particularly in populations at risk of malnutrition.
Publication year: 1992-1993

Fulltext Blood pressure tracking as an indicator of hypertension risk

Zulkifli SN

Singapore Med J, 1992 Oct;33(5):474-7.

PMID: 1455271

The significance of high blood pressure to cardio- and cerebrovascular disease is well recognized. The associated mortality and morbidity risks call for multiple approaches to control the development of high blood pressure. Recent studies have shown that precursors of cardiovascular disorders may be apparent from a young age, and that these can persist and contribute to disease in later life. With regard to blood pressure, the phenomenon of persisting at the same rank has been referred to as tracking. This allows for the possible identification of high-risk groups, for whom early intervention can be initiated. In this paper, some of the findings of studies on blood pressure tracking are reviewed.

Demographic and fertility characteristics of 4 squatter settlements

Yusof K, Zulkifli SN

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

PMID: 12268887

Fulltext Risk factors associated with low bone mineral content in very low birth weight infants

Rohana J, Hasmawati J, Zulkifli SZ

Singapore Med J, 2007 Mar;48(3):191-4.

PMID: 17342285

We report part of the findings of a study conducted to determine the correlation between bone mineral content (BMC) and biochemical bone markers in very low birth weight (VLBW) infants.

Fulltext Knowledge, attitudes and beliefs related to HIV/AIDS among adolescents in Malaysia

Zulkifli SN, Wong YL

Med J Malaysia, 2002 Mar;57(1):3-23.

PMID: 14569713 MyJurnal

Findings on knowledge, attitudes and beliefs related to HIV/AIDS among 520 Malaysian adolescents, aged 15 to 21 years, based on a survey conducted in Peninsular Malaysia showed that the average score for knowledge on HIV/AIDS was high, and majority showed a positive attitude towards the disease. However, misconceptions regarding transmission and gender bias related to sexual behaviour and contracting the disease prevailed. Although 72 percent of the sexually-experienced did not use protection at first sexual intercourse, 80 percent did not perceive themselves to be at risk of contracting HIV/AIDS. A critical review of existing HIV/AIDS prevention programmes to focus on adolescent risk-taking behaviour and sexuality issues, including male-female negotiation skills, is warranted.

Sexual practices in Malaysia: determinants of sexual intercourse among unmarried youths

Zulkifli SN, Low WY

J Adolesc Health, 2000 Oct;27(4):276-80.

PMID: 11008091

This paper describes findings on selected determinants of sexual intercourse among 468 unmarried adolescents from a survey in Malaysia. Data on respondents' background, sexual experience, contraceptive use, and sexual attitudes are provided. Based on multiple logistic regressions, factors significantly predictive of sexual experience are gender, employment, and sexual attitudes.

Fulltext Cytogenetic study of spontaneous abortion

Salwati S, Sharifah NA, Nafisah A, Zulkifli S

Med J Malaysia, 2002 Sep;57(3):374-5.

PMID: 12440281

Sexual health education for youths--a Malaysian experience

Zulkifli SN, Low WY

Asia Pac J Public Health, 2000;12 Suppl:S58-66.

PMID: 11338741

A survey was conducted to assess student's sexual knowledge and attitudes using a questionnaire based on the Sex Knowledge and Attitude Test (SKAT-II) to compare medical and nursing students with students (non-medical/nursing) who registered for a sexual health course. 85 Sexual Health, 115 medical and 81 nursing students voluntarily participated in the survey. This study showed that all the student groups showed relatively low scores in knowledge. Furthermore, average knowledge scores differed significantly between the three student groups with medical students scoring highest and nursing students lowest. Besides student groups, several other factors were found to be significantly associated with Knowledge score namely, race, religion, age, perception of the importance of religion and the extent to which religious beliefs influence sexual attitudes. Furthermore, multivariate statistical analyses showed that among these factors, student group, race/religion and religious importance were significant predictors of sexual knowledge. Specifically, being a medical student was associated with higher scores relative to a non-medical student, being a Malay student was independently associated with a lower average score compared to other races, and perceiving religion as extremely important was associated with a lower score.

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.

Chromosomes of gaur cross domestic cattle hybrids

Bongso TA, Hilmi M, Sopian M, Zulkifli S

Res Vet Sci, 1988 Mar;44(2):251-4.

PMID: 3387680

The chromosomes of five gaur (Bos gaurus hubbacki) domestic cattle (B indicus cross B taurus) hybrids (three females, two males) were studied using the leucocyte culture method and centromeric (C) banding technique. All the hybrids had a diploid chromosome number of 2n = 58, made up of two submetacentric autosomes (different in size) and 54 acrocentric autosomes, most of which could be arranged in pairs in descending order of size. The sex (X) chromosomes in females were a pair of submetacentric chromosomes smaller than the submetacentric autosomes. The Y chromosome in males was a small submetacentric chromosome. The C banding patterns were useful in identifying the X and Y chromosomes and the inherited submetacentric autosomes from the gaur sire. Phenotypically, the hybrids resembled normal B indicus cross B taurus calves except for the presence of a distinct hump-like dorsal ridge containing the spinous processes of the third to 11th thoracic vertebrae, upright 'deer-like' ears and long lean legs. The potential of these hybrids as important genetic resources for meat production is stressed.

Notes on the occurrence of the tropical eel Anguilla bicolor bicolor in Peninsular Malaysia, Malaysia

Arai T, Chino N, Zulkifli SZ, Ismail A

J Fish Biol, 2012 Mar;80(3):692-7.

PMID: 22380562 DOI: 10.1111/j.1095-8649.2011.03154.x

Previous studies indicated that a tropical freshwater eel Anguilla bicolor bicolor occurs in Africa, India, Sri Lanka, Bangladesh, Myanmar, Indonesia and Australia, but an intensive survey has indicated an extended distribution range for the species into Peninsular Malaysia. Thus, A. b. bicolor is a native subspecies of Malaysia.

Case report post-splenectomy sepsis in thalassemic patients

Zarina AL, Hamidah A, Zulkifli SZ, Jamal R

Southeast Asian J. Trop. Med. Public Health, 2005 Mar;36(2):471-3.

PMID: 15916058

Thalassemia is the commonest hemoglobinopathy in Malaysia. Patients with thalassemia major are transfusion dependent, and a large proportion of them will require splenectomy. As this particular group of patients is immunocompromized, overwhelming sepsis is a recognized complication. We report a series of three patients who all developed intra-abdominal abscesses following splenectomy.

Risk assessment and microbiological profile of infections in paediatric cancer patients with febrile neutropenia

Latiff Z, Zulkifli SZ, Jamal R

Malays J Pathol, 2002 Dec;24(2):83-9.

PMID: 12887165

Febrile neutropenia is a common and potentially fatal problem encountered in cancer patients undergoing chemotherapy. We carried out an observational study to evaluate the possible risk factors of developing fever amongst neutropenic children with an underlying malignancy. We also looked at the microbiological profile of causative pathogens in patients with febrile neutropenia. During a study period of 1 year, a total of 90 neutropenic episodes were recorded amongst 57 patients who were on treatment and follow-up during the study period. Multivariate analysis showed that factors such as chemotherapy status, underlying disease, existing central venous catheters, presenting white blood cell counts at chemotherapy, use of steroid therapy or hospitalisation at the onset of neutropenia, were not significant risk factors for developing fever during neutropenic episodes. Although the presence of a central venous catheter was associated with a higher risk of developing fever, it did not reach statistical significance (p=0.11). Of the 90 neutropenic episodes, 59 (65.6%) developed fever and 25 of these had positive blood cultures. The causative organisms include gram-negative bacteria (64%), gram positive bacteria (16%) and fungus (20%). Of the gram-negative organisms, Klebsiella spp. predominated (28%) with the extended spectrum beta-lactamase producing strain forming the majority (16%). Amongst those with fungaemia, Candida spp. and Candida tropicalis formed the majority (8% each) of the isolates.

Fulltext Seroprevalence of hepatitis B, hepatitis C, CMV and HIV in multiply transfused thalassemia patients: results from a thalassemia day care center in Malaysia

Jamal R, Fadzillah G, Zulkifli SZ, Yasmin M

Southeast Asian J. Trop. Med. Public Health, 1998 Dec;29(4):792-4.

PMID: 10772566

Regular blood transfusions for patients with thalassemia have improved their overall survival although these transfusions carry a definite risk of the transmission of certain viruses. Infection with hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV) leads to complications which contribute to the morbidity and mortality of patients with thalassemia. We analyzed the blood samples taken from 85 transfusion dependent thalassemics receiving treatment at the day care center in Hospital Universiti Kebangsaan Malaysia and found that the seroprevalence rates for HBV, HCV and CMV were 2.4%, 22.4% and 91.8% respectively. None of the patients tested positive for HIV. Those positive for HBV and HCV will require further tests and treatment if chronic hepatitis is confirmed.

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 Ludwig's angina: the importance of oral cavity examination in patients with a neck mass

Mohamad I, Zulkifli S, Soleh M, Rahman R

Malays Fam Physician, 2012;7(2-3):51-3.

PMID: 25606258 MyJurnal

Neck mass is a common condition in primary care. The most common affected area is the cervical lymph node. The neck region is also prone infection as structurally the nodes and spaces are in close contact with the upper respiratory tract and the alimentary tract. Oral cavity is one of the most common route for harbouring infection. Poor oral hygeine and periapical dental problems are the main causes. Thus, it is important to perform a complete oral cavity examination even when trismus is present. Besides dental caries, floor of the mouth should be inspected for oedema that may impose threat to the upper airway. We report a case of Ludwig's angina originating from a periapical lesion of the lower molar stressing the importance of oral examination in patient with neck mass.

A study on nurses' perception on the medication error at one of the hospitals in East Malaysia

Hassan H, Das S, Se H, Damika K, Letchimi S, Mat S, et al.

Clin Ter, 2009;160(6):477-9.

PMID: 20198291

Medication error is defined as any preventable event that might cause or lead to an inappropriate use or harming of the patient. Such events could be due to compounding, dispensing, distribution, administration and monitoring. The aim of the present study was to determine the nurses' perception on medication error that were related directly or indirectly to the process of administration of drugs. MATERIALS AND METHODS. This was a descriptive cross sectional study conducted on 92 staff nurses working in the selected wards in one of the hospitals in East Malaysia. Data was obtained through structured questionnaires. RESULTS. Analysis of data was done through SPSS program for descriptive inferential statistics. Out of a total of 92 subjects, sixty-eight (73.9%) indicated medication error occurred because the nurses were tired and exhausted. Seventy nine subjects (85.9%) believed that any medication error should be reported to the doctors; another 74 (80.2%) knew that their colleagues committed medication error and 52 (56.5%) did not report the case. Forty eight (52.17%) subjects committed medication error at least once throughout their life. Of the 48 committed medication, 45 (93.75%) nurses believed that the error committed was not serious; while 39 (81.25%) believed the error occurred during the 1st 5 years of their working experience.

Fulltext Growth velocity in transfusion dependent prepubertal thalassemia patients: results from a thalassemia center in Malaysia

Hamidah A, Arini MI, Zarina AL, Zulkifli SZ, Jamal R

Southeast Asian J. Trop. Med. Public Health, 2008 Sep;39(5):900-5.

PMID: 19058587

Growth impairment is commonly seen in children with thalassemia despite regular blood transfusions and desferrioxamine treatments. We investigated the growth velocity of 26 prepubertal patients with beta-thalassemia or HbE-beta thalassemia who were transfusion dependent aged between 2 and 13 years. The prevalence of impaired growth velocity (ie, growth velocity less than the third percentile) amongst the transfusion dependent prepubertal thalassemics was 57.7% compared to 19.2% in the control group. The mean height velocity of the thalassemics was 11.1% less than controls but this difference was not statistically significant (4.23cm/year vs 4.76cm/year, p = 0.08). The mean serum ferritin level of the thalassemics with a height < 3rd percentile was higher compared to those with a height > 3rd percentile (4,567.0 vs 2,271.0, p = 0.01). Our study showed that there was a high prevalence of impaired growth velocity amongst our transfusion dependent prepubertal thalassemics. This highlights the problem of inadequate chelation therapy, and compliance with chelation therapy amongst our patients. This study emphasizes the importance of monitoring growth parameters and optimal iron chelation therapy in these patients.

What Malaysian women believe about Viagra: a qualitative inquiry

Low WY, Zulkifli SN, Wong YL, Tan HM

Aging Male, 2002 Mar;5(1):57-63.

PMID: 12040977 DOI: 10.1080/tam.5.1.57.63

This paper highlights women's perceptions of sildenafil citrate (Viagra, Pfizer). It is based on a qualitative study on perceptions of erectile dysfunction in the Malaysian multicultural society. Six focus groups were conducted, consisting of 69 women, aged between 40 and 70 years, recruited from the general public and who had given informed consent. The findings revealed that the women were aware of erectile dysfunction and Viagra. Due to their concern about the negative aspects of Viagra, the Chinese and Malay traditional methods of treatment were commonly mentioned. The women from three ethnic groups viewed the possibility of their husband starting to take Viagra with lots of suspicion, mistrust and fear. They would prefer their husband discussing with them the issue of resorting to taking Viagra. The Chinese and Indian women perceived that if a man takes Viagra, it will boost his ego and he will feel more manly. Indian women felt that a man taking Viagra is proof of his love for his wife. The Malay women felt that a man would be ashamed and have a low self-esteem if he were to resort to taking Viagra. Although Viagra is meant for the male, understanding of women's perception of it is beneficial for a couple's sexual relationship.

Risk factors associated with umbilical vascular catheter-associated thrombosis in newborn infants

Boo NY, Wong NC, Zulkifli SS, Lye MS

J Paediatr Child Health, 1999 Oct;35(5):460-5.

PMID: 10571759

OBJECTIVE: To determine the risk factors associated with umbilical vascular catheter-associated thrombosis.

METHODS: All consecutive inborn infants with umbilical arterial (UAC) and/or umbilical venous catheters (UVC) inserted for more than 6 h duration were included in the study. Each infant was screened for thrombosis in the abdominal aorta and inferior vena cava by 2-D abdominal ultrasonography within 48-72 h of insertion of umbilical vascular catheters. Subsequent serial scanning was performed at intervals of every 5-7 days, and within 48 h after removal of catheters.

RESULTS: Upon removal of umbilical catheters, abdominal aortic thrombi were detected in 32/99 (32.3%) infants with UAC. Small thrombi were detected in the inferior vena cava of 2/49 (4.1%) infants with UVC (one of whom had both UAC and UVC). When compared with those who received only UVC (n = 18), infants who received either UAC alone (n = 68) or both UAC and UVC (n = 31) had significantly higher risk of developing thrombosis (odds ratio (OR): 7.6, 95% confidence interval (CI): 1.1, 325.5)). Logistic regression analysis of various potential risk factors showed that the only significant risk factor associated with the development of abdominal aortic thrombosis following insertion of UAC was longer duration of UAC in situ (for every additional day of UAC in situ, adjusted OR of developing thrombosis was: 1.2, 95% CI: 1.1, 1.3; P = 0.002).

CONCLUSION: Umbilical arterial catheter-associated thrombosis was common. Umbilical arterial catheter should be removed as soon as possible when not needed. Upon removal of UAC, all infants should be screened for abdominal aortic thrombus by 2-D ultrasonography.

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