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Fulltext The relationship of socio-demographic characteristics and knowledge of breast cancer on stage of behavioral adoption of breast self-examination

Moey SF, Mutalib AMA, Mohamed NC, Saidin N

AIMS Public Health, 2020;7(3):620-633.
PMID: 32968682 DOI: 10.3934/publichealth.2020049

Background/aim: In Malaysia, breast cancer is the most common cancer among women. As such, early diagnosis and screening practices are important to increase the survival rate. Breast self-examination (BSE) is one of the main screening methods for breast cancer. Socio-demographic characteristics and knowledge of breast cancer are amongst the crucial roles in determining women's behavioral adoption in performing BSE. This study aims to assess the relationship of socio-demographic factors and knowledge of breast cancer on the stage of behavioral adoption of BSE among Malaysian women in Kuantan, Pahang.
Materials and methods: A cross-sectional study was conducted on 520 women from three different government health clinics in Kuantan and IIUM Family Health Clinic from February to April 2018. Data were collected using a self-administered questionnaire on socio-demographic factors and knowledge of breast cancer and its effect on the behavioral adoption of BSE.
Results: Significant difference was found between socio-demographic characteristics and behavioral adoption of BSE. However, only breast screening and the best time for screening were found to be significant with the behavioral adoption of BSE and knowledge of breast cancer.
Conclusion: It is found that most women in Kuantan, Pahang perform BSE but were still unaware of the importance of performing BSE for early breast cancer detection. This study was expected to enhance women's awareness of the benefits of performing BSE.

Matched MeSH terms: Family Health
Colorectal cancer in Asians: a demographic and anatomic survey in Malaysian patients undergoing colonoscopy

Goh KL, Quek KF, Yeo GT, Hilmi IN, Lee CK, Hasnida N, et al.

Aliment Pharmacol Ther, 2005 Nov 1;22(9):859-64.
PMID: 16225496

Colorectal cancer is one of the most common forms of gastrointestinal cancer in the world today. In the Asia-Pacific area, it is the fastest emerging gastrointestinal cancer.

Matched MeSH terms: Family Health
Fulltext OFD1 is mutated in X-linked Joubert syndrome and interacts with LCA5-encoded lebercilin

Coene KL, Roepman R, Doherty D, Afroze B, Kroes HY, Letteboer SJ, et al.

Am J Hum Genet, 2009 Oct;85(4):465-81.
PMID: 19800048 DOI: 10.1016/j.ajhg.2009.09.002

We ascertained a multi-generation Malaysian family with Joubert syndrome (JS). The presence of asymptomatic obligate carrier females suggested an X-linked recessive inheritance pattern. Affected males presented with mental retardation accompanied by postaxial polydactyly and retinitis pigmentosa. Brain MRIs showed the presence of a "molar tooth sign," which classifies this syndrome as classic JS with retinal involvement. Linkage analysis showed linkage to Xpter-Xp22.2 and a maximum LOD score of 2.06 for marker DXS8022. Mutation analysis revealed a frameshift mutation, p.K948NfsX8, in exon 21 of OFD1. In an isolated male with JS, a second frameshift mutation, p.E923KfsX3, in the same exon was identified. OFD1 has previously been associated with oral-facial-digital type 1 (OFD1) syndrome, a male-lethal X-linked dominant condition, and with X-linked recessive Simpson-Golabi-Behmel syndrome type 2 (SGBS2). In a yeast two-hybrid screen of a retinal cDNA library, we identified OFD1 as an interacting partner of the LCA5-encoded ciliary protein lebercilin. We show that X-linked recessive mutations in OFD1 reduce, but do not eliminate, the interaction with lebercilin, whereas X-linked dominant OFD1 mutations completely abolish binding to lebercilin. In addition, recessive mutations in OFD1 did not affect the pericentriolar localization of the recombinant protein in hTERT-RPE1 cells, whereas this localization was lost for dominant mutations. These findings offer a molecular explanation for the phenotypic spectrum observed for OFD1 mutations; this spectrum now includes OFD1 syndrome, SGBS2, and JS.

Matched MeSH terms: Family Health
Psychiatric morbidity in the first-degree relatives of schizophrenic patients

Varma SL, Zain AM, Singh S

Am. J. Med. Genet., 1997 Feb 21;74(1):7-11.
PMID: 9033998

There is increasing evidence that genetic factors play a role in the etiology of schizophrenic disorders. One thousand eighty-nine first-degree relatives of schizophrenics and 1,137 controls were studied to discover their psychiatric morbidity. Psychiatric morbidity was found in 16.34% of the first-degree relatives (FDR) of schizophrenics (parents, 5.69%; siblings, 7.71%; offspring, 2.94%) as compared to 6.9% in the controls (P < 0.001). Schizophrenia was found in 8.3% of the patient group, which was significantly higher (0.2%) as compared to the controls. Schizoid-schizotypal personality disorder was found in 3.03% of FDRs of the schizophrenic group. Depressive disorder was found in 4.4% and 2.1% in the control and patient group, respectively, which was statistically significant. Morbidity risk of schizophrenia was found in 16.97%, 6.22% and 5.79% of schizophrenia, schizoid-schizotypal personality disorder and depressive disorder, respectively, in the FDR of schizophrenic group.

Matched MeSH terms: Family Health
Fulltext Parental body mass index is associated with adolescent overweight and obesity in Mashhad, Iran

Shafaghi K, Shariff ZM, Taib MN, Rahman HA, Mobarhan MG, Jabbari H

Asia Pac J Clin Nutr, 2014;23(2):225-31.
PMID: 24901091 DOI: 10.6133/apjcn.2014.23.2.11

OBJECTIVE: This cross-sectional study was carried out to determine the prevalence of overweight and obesity among secondary school children aged 12 to 14 years in the city of Mashhad, Iran and its association with parental body mass index.
METHODS: A total of 1189 secondary school children (579 males and 610 females) aged 12- 14 years old were selected through a stratified multistage random sampling. All adolescents were measured for weight and height. Household socio-demographic information and parental weight and height were self-reported by parents. Adolescents were classified as overweight or obese based on BMI-for age Z-score. Multivariable logistic Regression (MLR) determined the relationship between parental BMI and adolescent overweight and obesity.
RESULTS: The overall prevalence of overweight and obesity among secondary school children in Mashhad was 17.2% and 11.9%, respectively. A higher proportion of male (30.7%) than female (27.4%) children were overweight or obese. BMI of the children was significantly related to parental BMI (p<0.001), gender (p= 0.02), birth order (p<0.01), parents' education level (p<0.001), father's employment status (p<0.001), and family income (p<0.001). MLR showed that the father's BMI was significantly associated with male BMI (OR: 2.02) and female BMI (OR: 1.59), whereas the mother's BMI was significantly associated with female BMI only (OR: 0.514).
CONCLUSION: The high prevalence of overweight/obesity among the research population compared with previous studies in Iran could be related to the changing lifestyle of the population. The strong relationship with parental BMI was probably related to a combination of genetic and lifestyle factors. Strategies to address childhood obesity should consider the interaction of these factors.

Matched MeSH terms: Family Health/statistics & numerical data*
Sociodemographic and health-lifestyle determinants of obesity risks in Malaysia

Tan AK, Dunn RA, Samad MI, Feisul MI

Asia Pac J Public Health, 2011 Apr;23(2):192-202.
PMID: 20460299 DOI: 10.1177/1010539509359535

The purpose of this study was to examine the sociodemographic and health-lifestyle factors that affect the likelihood of obesity among Malaysians. Data were obtained from the Malaysian Non-Communicable Disease Surveillance-1. The cross-sectional population-based survey consisted of 2447 observations, with an obesity prevalence rate of 17.2%. Based on logit regression analysis, the results suggest that obesity risks in Malaysia are affected by gender, education level, family history, health conditions, smoking status, and ethnic backgrounds. Specifically, Malaysians more likely to be obese are females (5.3%), lower educated (0.9%), those with history of family illnesses (4.8%), and nonsmokers (6.4%). However, Chinese (9.3%) and other (5.5%) ethnic groups are less likely to be obese when compared with Malays. Based on these results, several policy implications are discussed vis-à-vis obesity risks in Malaysia.
Study name: Malaysia Non-Communicable Disease Surveillance-1 (MyNCDS-1) survey

Matched MeSH terms: Family Health
Fulltext Risk factors for wheeze in the last 12 months in preschool children

Quah BS, Mazidah AR, Simpson H

Asian Pac J Allergy Immunol, 2000 Jun;18(2):73-9.
PMID: 10928618

Most children with asthma develop their symptoms before the age of 5 years and many preschool wheezers continue to wheeze in the early school years. It is thus important to investigate the factors that predispose young children to wheeze. The objective of this study was to investigate the relevant environmental and family influences on recent wheeze (wheeze within the last 12 months) in preschool children. A cross-sectional study was conducted in five primary health clinics in the district of Kota Bharu from April to October 1998. Nurses from these clinics distributed Bahasa Malaysia questionnaires containing questions on asthma symptoms, environmental risk factors, family's social status and family history of atopy and wheeze to preschool children aged 1-5 years during their home visits. The respondents were parent(s) or carer(s) of the children. A total of 2,524 (87.7%) complete questionnaires were available for analysis of risk factors. One hundred and fifty six (6.2%) children had current wheeze. Significant risk factors associated with current wheeze were a family history of asthma (O.R. = 6.36, 95% C.I. = 4.45-9.09), neonatal hospital admission (O.R. = 2.38, 95% C.I. = 1.51 - 3.75), and a maternal (O.R. = 2.12, 95% C.I. = 1.31-3.41) or paternal (O.R. = 1.52, 95% C.I. = 0.95-2.43) history of allergic rhinitis. Among environmental factors examined, namely, household pets, carpeting in bedroom, use of fumigation mats, mosquito coils and aerosol insect repellents, maternal and paternal smoking, and air conditioning, none were associated with an increased risk of wheeze. In conclusion, the strongest association with current wheeze was a family history of asthma. Also significant were neonatal hospital admission and a history of allergic rhinitis in either the mother or father. None of the environmental factors studied were related to current wheeze in preschool children.
Study site: Klinik Kesihatan, Kelantan, Malaysia

Matched MeSH terms: Family Health
Predictors of breast cancer among women in a northern state of Malaysia: a matched case-control study

Matalqah L, Radaideh K, Yusoff ZM, Awaisu A

Asian Pac J Cancer Prev, 2011;12(6):1549-53.
PMID: 22126497

BACKGROUND: Breast cancer has been increased in South East Asia countries, but there are limited data for breast cancer risk factors in these countries. To clarify the risk for breast cancer among the Malaysian women, a matched case-control study was conducted.
METHOD: Between October 2009 and April 2010, a survey was prospectively conducted among women admitted to clinics of Penang General Hospital for examination and/or treatment by using a questionnaire. Therefore, characteristics of patients diagnosed with breast cancer (n=150) were compared with control cases (n=150) admitted to hospital for non-neoplastic, non-hormone related diseases.
RESULTS: Family history of a distant relative with breast cancer (OR=2.84), history of first-degree relatives with breast cancer (OR=2.95), history of benign breast disease (OR=2.43), menstrual irregularity (OR=4.24), and use of oral contraceptive pills (OCP) (OR=2.15) were found to be significant risk factors for breast cancer in our population. Furthermore, education more than 11 years (OR=0.40), breastfeeding (OR=0.50), being employed (OR=0.45) and practicing low fat diet (OR=0.53) were strongly protective against breast cancer development.
CONCLUSION: The results emphasize the importance of conducting a series of awareness campaigns that highlights the protective role of longer breastfeeding period against breast cancer and the negative relationships between OCP use and high fat diet with this disease.

Matched MeSH terms: Family Health
Fulltext Does a positive family history influence the presentation of breast cancer?

Yip CH, bt Mohd Taib NA, Lau PC

Asian Pac J Cancer Prev, 2008 Jan-Mar;9(1):63-5.
PMID: 18439076

INTRODUCTION: An important risk factor for developing breast cancer is a positive family history of breast cancer. In Malaysia, there is no population-based breast screening programme, but the clinical practice guidelines suggest increased surveillance for those with a positive family history ie mammography for those 40 years old and above, breast self-examination and clinical breast examination yearly.
OBJECTIVE: To determine if women with a family history of breast cancer present with earlier stages of disease.
METHODOLOGY: From Jan 2001 to Dec 2006, 1553 women with breast cancer presenting to the University Malaya, where family history was recorded, were eligible for this study. Women with a first or second degree relative with breast cancer were compared with those who have no family history with regard to their race, age, stage, size and duration of symptoms. The Chi Square test of significance was used for analysis.
RESULTS: Out of 1553 patients, 252 (16.2%) were found to have a relative with breast cancer out of which 174 (11.2%) had at least one affected first degree relative. There were no significant difference in the incidence of positive family history between the Malays, Chinese and Indians. 20% below the age of 40 years old had a positive family history compared with 12.6% in women with no family history. (p<0.05). There was no significant difference in stage at diagnosis between those with and without family history, ie 24.2% late stages (Stage 3 and 4) in the group with no family history compared with 21.8% in the group with family history. (p>0.05). The mean size in the group with no family history was 4.4 cm compared to 4.1 cm in the group with family history. There was a significant difference in screen-detected cancers in the women with family history, 10.7% compared with 5.1% of screen-detected cancers in the group without a family history. However there was no difference in the duration of symptoms between the 2 groups--25.8% in the women without a family history presented after 1 year of symptoms compared with 22.4% in the group with a family history (p>0.05).
CONCLUSION: Having a family history of breast cancer does not appear to have much impact on the health-seeking behavior of women. Even though there were more screen detected cancers, these comprised only 10% of the group with family history. Public education should target women at risk ie with family history to encourage these women to present earlier and to undergo screening for breast cancer.

Matched MeSH terms: Family Health
Fulltext A qualitative study on the implementation of family health team: the perspectives of providers and patients

Mohd Hanafiah AN, Johari MZ, Azam S

BMC Fam Pract, 2020 08 09;21(1):162.
PMID: 32772931 DOI: 10.1186/s12875-020-01217-7

BACKGROUND: Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, particularly the family doctor concept. The Enhanced Primary Health Care (EnPHC) initiative was implemented to address the worrying upward trend of non-communicable disease prevalence, and incorporates the Family Health Team (FHT) concept. The aim of this paper is to describe the implementation of the FHT as part of the EnPHC intervention.
METHODS: In-depth interviews and focus group discussions were conducted with the intervention design team, healthcare providers and patients in two rounds during the implementation period. A total of 121 individuals in the two rounds, split into different groups, where some of the participants of the FGD were also interviewed individually. Data were analysed using a thematic analysis, with codes being organised into larger themes.
RESULTS: Themes that emerged from the data were around the process of FHT implementation and the advantages of the FHT, which included continuity of health care and improved quality of care. Patients and health care providers were receptive to the FHT concept, and took the effort to adapt the concept in the local settings.
CONCLUSIONS: The FHT concept implemented at 20 public primary health clinics has benefits appreciated by health care providers and patients. Addressing the viable shortcomings would better prepare the current primary healthcare system to scale up the FHT concept nationwide and enhance its feasibility and sustainability.
TRIAL REGISTRATION: The study is registered with the National Medical Research Register, Ministry of Health Malaysia ( NMRR-17-295-34711 ).

Matched MeSH terms: Family Health*
Fulltext The integrated care pathway for post stroke patients (iCaPPS): a shared care approach between stakeholders in areas with limited access to specialist stroke care services

Abdul Aziz AF, Mohd Nordin NA, Ali MF, Abd Aziz NA, Sulong S, Aljunid SM

BMC Health Serv Res, 2017 Jan 13;17(1):35.
PMID: 28086871 DOI: 10.1186/s12913-016-1963-8

BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking.

METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted. In Phase One, experts chartered current care processes in public healthcare facilities, from acute stroke till discharge and also patients who presented late with stroke symptoms to public primary care health centres. In Phase Two, modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices. Care algorithms were designed around existing work schedules at public health centres.

RESULTS: Indication for patients eligible for monitoring by primary care at public health centres were identified. Gaps in transfer of care occurred either at post discharge from acute care or primary care patients diagnosed at or beyond subacute phase at health centres. Essential information required during transfer of care from tertiary care to primary care providers was identified. Care algorithms including appropriate tools were summarised to guide primary care teams to identify patients requiring further multidisciplinary interventions. Shared care approaches with Specialist Stroke care team were outlined. Components of the iCaPPS were developed simultaneously: (i) iCaPPS-Rehab© for rehabilitation of stroke patients at community level (ii) iCaPPS-Swallow© guided the primary care team to screen and manage stroke related swallowing problems.

CONCLUSION: Coordinated post stroke care monitoring service for patients at community level is achievable using the iCaPPS and its components as a guide. The iCaPPS may be used for post stroke care monitoring of patients in similar fragmented healthcare delivery systems or areas with limited access to specialist stroke care services.

TRIAL REGISTRATION: No.: ACTRN12616001322426 (Registration Date: 21st September 2016).

Matched MeSH terms: Family Health
Fulltext Impact of a standardized protocol for the Management of Prolonged Neonatal Jaundice in a regional setting: an interventional quasi-experimental study

Tan HS, Balasubramaniam IS, Hss AS, Yeong ML, Chew CC, Singh RP, et al.

BMC Pediatr, 2019 05 29;19(1):174.
PMID: 31142302 DOI: 10.1186/s12887-019-1550-3

BACKGROUND: Prolonged neonatal jaundice (PNNJ) is often caused by breast milk jaundice, but it could also point to other serious conditions (biliary atresia, congenital hypothyroidism). When babies with PNNJ receive a routine set of laboratory investigations to detect serious but uncommon conditions, there is always a tendency to over-investigate a large number of well, breastfed babies. A local unpublished survey in Perak state of Malaysia revealed that the diagnostic criteria and initial management of PNNJ were not standardized. This study aims to evaluate and improve the current management of PNNJ in the administrative region of Perak.
METHODS: A 3-phase quasi-experimental community study was conducted from April 2012 to June 2013. Phase l was a cross-sectional study to review the current practice of PNNJ management. Phase ll was an interventional phase involving the implementation of a new protocol. Phase lll was a 6 months post-interventional audit. A registry of PNNJ was implemented to record the incidence rate. A self-reporting surveillance system was put in place to receive any reports of biliary atresia, urinary tract infection, or congenital hypothyroidism cases.
RESULTS: In Phase I, 12 hospitals responded, and 199 case notes were reviewed. In Phase II, a new protocol was developed and implemented in all government health facilities in Perak. In Phase III, the 6-month post-intervention audit showed that there were significant improvements when comparing mean scores of pre- and post-intervention: history taking scores (p

Matched MeSH terms: Family Health
The 4-item family resilience scale: psychometric evaluation and measurement invariance of the malay version in adolescents and young adults

Hamzah H, Tan CS, Ramlee F, Zulkifli SS

BMC Psychol, 2023 Nov 13;11(1):392.
PMID: 37957763 DOI: 10.1186/s40359-023-01435-5

BACKGROUND: The original Family Resilience Scale (FRS) is a reliable tool to assess family resilience. However, the FRS is based on the United States and parental context. Thus, the usefulness of the FRS for the adolescent and young adult population in Asian countries, particularly Malaysia remains unknown. This study translated the FRS into the Malay language and validated it on Malaysian adolescents and young adults to identify its potential as a self-report tool to assess the resilience level of their family.
METHODS: A total of 351 participants (Mage = 19.75, SDage = 3.29) were recruited in the study using purposive sampling. Confirmatory factor analysis was conducted to examine the factorial structure of the Family Resilience Scale-Malay (FRS-Malay) and measurement invariance between adolescents and young adults. Then, the scale's reliability was investigated using Cronbach's alpha, McDonald's omega coefficients, and composite reliability index. Finally, we examined the discriminant validity of the FRS-Malay by correlating its score with individual resilience score and examined the incremental validity of the scale using hierarchical multiple regression analysis to test if family resilience can explain individual well-being levels beyond and above individual resilience.
RESULTS: The findings of the confirmatory factor analysis suggest that a single-factor model is supported for both age groups. Furthermore, the scale exhibited scalar invariance between adolescents and young adults. The scale also exhibited good reliability, as the value of Cronbach's alpha, McDonald omega coefficients, and composite reliability index were above 0.80. Additionally, the Pearson correlation analysis showed a positive correlation between the FRS-Malay and individual resilience scores, which supports the discriminant validity of the scale. Similarly, the incremental validity of the scale is also supported. Specifically, family resilience had a positive correlation with well-being, even after controlling for individual resilience in the regression analysis.
CONCLUSIONS: The FRS-Malay has demonstrated good reliability and validity. The scale measures the same construct of family resilience across adolescents and young adults, making it suitable for comparisons. Therefore, this unidimensional tool is appropriate for self-reporting their perceived level of family resilience. It is also useful for studying the development and fluctuation of family resilience in the Malaysian context.

Matched MeSH terms: Family Health*
Heredity factor in myopia development among a sample in Klang Valley, Malaysia

Kaur S, Ramli NI, Narayanasamy S

Chin Med J (Engl), 2012 Oct;125(19):3522-5.
PMID: 23044317

Development of myopia among young children is often contributed to the refractive status of the parents. This study was conducted to determine whether myopia can be inherited across the generation among a sample in the Klang Valley. Three generations involved are: G1 (grandparents), G2 (parents) and G3 (children).

Matched MeSH terms: Family Health
Prevalence and ethnic differences of autosomal-dominant cerebellar ataxia in Singapore

Zhao Y, Tan EK, Law HY, Yoon CS, Wong MC, Ng I

Clin Genet, 2002 Dec;62(6):478-81.
PMID: 12485197

We report the prevalence and ethnic differences of autosomal-dominant cerebellar ataxia (ADCA) in Singapore. Amongst 204 patients with ataxia who underwent genetic testing for dentatorubral-pallidoluysian atrophy (DRPLA) and for spinocerebellar ataxias (SCA) 1, 2, 3, 6, 7, 8, 10 and 12, 58 (28.4%) patients from 36 families tested positive. SCA 3 was identified in 31 (53.4%) patients from 15 families, SCA 2 in 17 (29.3%) patients from 12 families and SCA 1 in four (6.9%) patients from four families. Other SCA subtypes were rare. SCA 2 was the only subtype identified amongst ethnic Malay and ethnic Indian families. The estimated prevalence of ADCA in Singaporean families was at least 1 : 27,000. Based on the history and ancestry of Singaporeans, our study supported a founder effect for specific SCA subtypes and the association of ethnicity-specific SCA subtypes. Our findings suggest that SCA 2 is relatively common amongst the Malay race and that priority testing for SCA 3 and SCA 2 for ethnic Chinese, and SCA 2 for ethnic Malay, may be cost effective and relevant for the region.

Matched MeSH terms: Family Health
Familial cases of missing mandibular incisor: three case presentations

Chai WL, Ngeow WC

Dent Update, 1999 Sep;26(7):298-302.
PMID: 10765775

Hypodontia is the congenital absence of one or more teeth because of agenesis. The most commonly missing teeth are the third molars, the maxillary lateral incisors and the second premolars. Cases are presented of three patients with a missing mandibular incisor.

Matched MeSH terms: Family Health
Diagnosis and management of Duchenne muscular dystrophy in a developing country over a 10-year period

Thong MK, Bazlin RI, Wong KT

Dev Med Child Neurol, 2005 Jul;47(7):474-7.
PMID: 15991868

Clinical data on Duchenne muscular dystrophy (DMD) are lacking in developing countries. The objective of this study was to delineate the demographic characteristics, investigations, and outcome of 21 Malaysian males diagnosed with DMD over a period of 10 years. Mean age presentation was 3 years 8 months (SD 23mo; range 10 to 84mo), mean duration from first presentation to diagnosis was 3y 7mo (SD 26mo; range 5 to 84) and the mean age for loss of ambulation was 11 years (SD 25mo; range 102 to 168). There was family history of DMD in five of the 21 patients. Muscle biopsy showed confirmatory findings of DMD in the 16 patients tested. Molecular genetic analysis showed dystrophin gene deletions in 11 of these 16 patients. Four and seven of the students stopped schooling and had learning difficulties, respectively; only nine had satisfactory school performances. Eight out of 14 patients evaluated were classified as having severe to total dependency levels on the modified Barthel Index for activities of daily living assessment. DMD is associated with significant medical and social needs for a developing country such as Malaysia. Earlier referral, genetic counselling, and provision of support and rehabilitative services are the main priorities.

Matched MeSH terms: Family Health
Fulltext Lack of association of apolipoprotein E (Apo E) polymorphism with the prevalence of metabolic syndrome: the National Heart, Lung and Blood Institute Family Heart Study

Lai LY, Petrone AB, Pankow JS, Arnett DK, North KE, Ellison RC, et al.

Diabetes Metab Res Rev, 2015 Sep;31(6):582-7.
PMID: 25656378 DOI: 10.1002/dmrr.2638

OBJECTIVE: Metabolic syndrome (MetS), characterized by abdominal obesity, atherogenic dyslipidaemia, elevated blood pressure and insulin resistance, is a major public health concern in the United States. The effects of apolipoprotein E (Apo E) polymorphism on MetS are not well established.
METHODS: We conducted a cross-sectional study consisting of 1551 participants from the National Heart, Lung and Blood Institute Family Heart Study to assess the relation of Apo E polymorphism with the prevalence of MetS. MetS was defined according to the American Heart Association-National Heart, Lung and Blood Institute-International Diabetes Federation-World Health Organization harmonized criteria. We used generalized estimating equations to estimate adjusted odds ratios (ORs) for prevalent MetS and the Bonferroni correction to account for multiple testing in the secondary analysis.
RESULTS: Our study population had a mean age (standard deviation) of 56.5 (11.0) years, and 49.7% had MetS. There was no association between the Apo E genotypes and the MetS. The multivariable adjusted ORs (95% confidence interval) were 1.00 (reference), 1.26 (0.31-5.21), 0.89 (0.62-1.29), 1.13 (0.61-2.10), 1.13 (0.88-1.47) and 1.87 (0.91-3.85) for the Ɛ3/Ɛ3, Ɛ2/Ɛ2, Ɛ2/Ɛ3, Ɛ2/Ɛ4, Ɛ3/Ɛ4 and Ɛ4/Ɛ4 genotypes, respectively. In a secondary analysis, Ɛ2/Ɛ3 genotype was associated with 41% lower prevalence odds of low high-density lipoprotein [multivariable adjusted ORs (95% confidence interval) = 0.59 (0.36-0.95)] compared with Ɛ3/Ɛ3 genotype.
CONCLUSIONS: Our findings do not support an association between Apo E polymorphism and MetS in a multicentre population-based study of predominantly White US men and women.

Matched MeSH terms: Family Health
Metabolic, immunological and clinical characteristics in newly diagnosed Asian diabetes patients aged 12-40 years

Pan CY, So WY, Khalid BA, Mohan V, Thai AC, Zimmet P, et al.

Diabet Med, 2004 Sep;21(9):1007-13.
PMID: 15317606 DOI: 10.1111/j.1464-5491.2004.01287.x

AIM: To describe the clinical, biochemical and immunological characteristics of young-onset diabetes in Asia.
METHODS: Clinical, biochemical and immunological variables were assessed in 919 newly diagnosed (duration less than 12 months) young onset Asian diabetic patients aged between 12 and 40 years. The subjects constituted 57% Chinese, 29% Indians and 14% Malays, recruited from diabetes centres in China, Hong Kong, India, Malaysia and Singapore.
RESULTS: The mean age (+/- sd) was 31.6 +/- 7.2 years, with the majority (66%) in the 31-40 years age group. Mean body mass index (BMI) (+/- sd) was 25.3 +/- 5.0 kg/m2 with 47% exceeding the suggested Asian cut-off point for obesity (BMI > or = 25). Ethnic difference in clinical characteristics included BMI, blood pressure, mode of treatment and degree of insulin resistance. Most patients had a clinical presentation of Type 2 diabetes. About 10% had a classical combination of ketotic presentation, presence of autoimmune-markers and documented insulin deficiency indicative of Type 1 diabetes. Forty-eight percent were receiving oral hypoglycaemic agents (OHAs) while 31% were on diet only, 18% were receiving insulin and 2% were on a combination of insulin and OHA.
CONCLUSION: Young onset diabetes patients in Asia represent a heterogeneous group in terms of their clinical and biochemical characteristics and classical Type 1 diabetes is relatively uncommon. The 5-year follow up study will determine the progress of these patients and help to clarify the natural history.

Matched MeSH terms: Family Health
The analyze toddler growth and development according to family's economic status in Village Limau Manis, Districts Tanjung Morawa

Pangaribuan IK, Simanullang E, Poddar S

Enferm Clin, 2020 06;30 Suppl 5:92-95.
PMID: 32713594 DOI: 10.1016/j.enfcli.2019.11.029

The toddler stage is a golden period and at the same time a critical period for a child, since he / she will experience rapid brain growth and development so that he/ she need sufficient nutrition intake. Toddler's abnormal growth and development are usually found in low economic community because they cannot afford to provide their need for basic food for their toddler's growth and development. The objective of the research was to analyze toddler's growth and development according to family's economic status. The research used descriptive analytic method with cross-sectional design. It was conducted at Limau Manis Village, Tanjung Morawa Subdistrict, Deli Serdang Regency, from January to June 2016. The population was 1899 toddlers, and 113 of them were used as the samples, taken by using simple random sampling technique. The data were gathered by using questionnaires to find out toddler's growth and development according to family's economic status. The result of univariate analysis showed that 57 toddlers (50.4%) had abnormal growth and development. The result of bivariate analysis with chi-square test showed that there was the correlation of toddler's growth and development with economic status (p value=0.004), women's care pattern (p value=0.028), and environmental sanitation (p value=0.01). Therefore, empowerment of family's economy through the development of family's nutrition portfolio is necessary.

Matched MeSH terms: Family Health

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