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Risk factors and predictors of levodopa-induced dyskinesia among multiethnic Malaysians with Parkinson's disease

Hashim HZ, Norlinah MI, Nafisah WY, Tan HJ, Raymond AA, Tamil AM

Int J Neurosci, 2014 Mar;124(3):187-91.
PMID: 23952588 DOI: 10.3109/00207454.2013.833511

Chronic pulsatile levodopa therapy for Parkinson's disease (PD) leads to the development of motor fluctuations and dyskinesia. We studied the prevalence and predictors of levodopa-induced dyskinesia among multiethnic Malaysian patients with PD.

Matched MeSH terms: Malaysia/ethnology
Dietary changes during pregnancy and the postpartum period in Singaporean Chinese, Malay and Indian women: the GUSTO birth cohort study

Chen LW, Low YL, Fok D, Han WM, Chong YS, Gluckman P, et al.

Public Health Nutr, 2014 Sep;17(9):1930-8.
PMID: 23806144 DOI: 10.1017/S1368980013001730

OBJECTIVE: To examine changes in food consumption during pregnancy and the postpartum period in women of major Asian ethnic groups.
DESIGN: Using interviewer-administered questionnaires, we assessed changes in food consumption during pregnancy (26-28 weeks' gestation) and the postpartum period (3 weeks after delivery) as compared with the usual pre-pregnancy diet.
SETTING: Singapore.
SUBJECTS: Pregnant women (n 1027) of Chinese, Malay and Indian ethnicity (mean age 30·4 (SD 5·2) years) who participated in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) study.
RESULTS: During pregnancy, participants tended to increase their consumption of milk, fruit and vegetables and decrease their consumption of tea, coffee, soft drinks and seafood (all P < 0·001). Most participants reported adherence to traditional restrictions ('confinement') during the early postpartum period (Chinese: 94·8 %, Malay: 91·6 %, Indian: 79·6 %). During the postpartum period, participants tended to increase their consumption of fish and milk-based drinks and decrease their consumption of noodles, seafood, and chocolates and sweets (all P < 0·001). Ethnic differences in food consumption were pronounced during the postpartum period. For example, most Chinese participants (87·2 %) increased their ginger consumption during the postpartum period as compared with smaller percentages of Malays (31·8 %) and Indians (40·8 %; P for ethnic difference <0·001). Similar ethnic differences were observed for cooking wine/alcohol, herbs and spices, and herbal tea consumption.
CONCLUSIONS: Marked changes in food consumption that reflect both modern dietary recommendations and the persistence of traditional beliefs were observed in Singaporean women during pregnancy and the postpartum period. Traditional beliefs should be considered in interventions to improve dietary intakes during these periods.

Matched MeSH terms: Malaysia/ethnology
Fulltext Medication adherence in patients with type 2 diabetes mellitus treated at primary health clinics in Malaysia

Ahmad NS, Ramli A, Islahudin F, Paraidathathu T

Patient Prefer Adherence, 2013;7:525-30.
PMID: 23814461 DOI: 10.2147/PPA.S44698

Diabetes mellitus is a growing global health problem that affects patients of all ages. Even though diabetes mellitus is recognized as a major chronic illness, adherence to antidiabetic medicines has often been found to be unsatisfactory. This study was conducted to assess adherence to medications and to identify factors that are associated with nonadherence in type 2 diabetes mellitus (T2DM) patients at Primary Health Clinics of the Ministry of Health in Malaysia.

Matched MeSH terms: Malaysia/ethnology
Fulltext Community-based cardiovascular Risk Factors Intervention Strategies (CORFIS) in managing hypertension: A pragmatic non-randomised controlled trial

Low WHH, Seet W, Ramli AS, Ng KK, Jamaiyah H, Dan SP, et al.

Med J Malaysia, 2013 Apr;68(2):129-35.
PMID: 23629558 MyJurnal

BACKGROUND: Hypertension is the number one cardiovascular risk factor in Malaysia. This study aimed to evaluate the effectiveness of a Community-Based Cardiovascular Risk Factors Intervention Strategies (CORFIS) in the management of hypertension in primary care.
METHODS: This is a pragmatic, non-randomized controlled trial. Seventy general practitioners (GPs) were selected to provide either CORFIS (44 GPs) or conventional care (26 GPs) for 6 months. A total of 486 hypertensive patients were recruited; 309 were in the intervention and 177 in the control groups. Primary outcome was the proportion of hypertensive patients who achieved target blood pressure (BP) of <140/90mmHg (for those without diabetes mellitus) and <130/80mmHg (with diabetes mellitus). Secondary outcomes include change in the mean/median BP at 6-month as compared to baseline.
RESULTS: The proportion of hypertensive patients who achieved target BP at 6-month was significantly higher in the CORFIS arm (69.6%) as compared to the control arm (57.6%), P=0.008. Amongst those who had uncontrolled BP at baseline, the proportion who achieved target BP at 6-month was also significantly higher in the CORFIS arm (56.6%) as compared to the control arm (34.1%), p<0.001. There was no difference in the patients who had already achieved BP control at baseline. There were significant reductions in SBP in the CORFIS arm (median -9.0mmHg; -60 to 50) versus control (median -2mmHg; -50 to 48), p=0.003; as well as in DBP (CORFIS arm: median -6.0mmHg; ranged from -53 to 30 versus control arm: median 0.0mmHg; ranged from -42 to 30), p<0.001.
CONCLUSIONS: Patients who received CORFIS care demonstrated significant improvements in achieving target BP.

Matched MeSH terms: Malaysia/ethnology
Fulltext Prevalence of asymptomatic atrial fibrillation in Malaysian patients with hypertension

Wong JS, Bau R, Ahmad F, Ismail R, Yip AFY

Med J Malaysia, 2013 Apr;68(2):141-3.
PMID: 23629560 MyJurnal

Atrial fibrillation (AF) is usually asymptomatic and often associated with established cardiovascular risk factors such as hypertension. The prevalence atrial fibrillation in patients admitted to Malaysian hospitals has been determined, but asymptomatic atrial fibrillation (AAF) in hypertensive patients in the primary care setting is not established. This study reports the prevalence of AAF in hypertensive patients in Malaysia, in a primary care setting. The overall prevalence of AAF was 0.75% with no differences between the gender. The prevalence of AAF increases with age - in the age groups of 30-39, >40-49, >50-59, >60-69, 70-79 and >80 years old were 0%, 0.17%, 0.35%, 2.32%, 2.59%, and 0% respectively. Hypertensive patients with age of ≥ 61 year old were associated with a probability of 10.6 times higher for AAF. We suggest the age threshold to screen for AAF to be age of 60. It is estimated that there are 49,029 Malaysians with AAF in 2010. A large population is at risk of AAF-related complications. There is justification for an even greater emphasis on diagnostic, primary and secondary prevention strategies.
Study site: Klinik Kesihatan Bintulu, Sarawak, Malaysia

Matched MeSH terms: Malaysia/ethnology
No association between AKT1 gene variants and schizophrenia: a Malaysian case-control study and meta-analysis

Loh HC, Chow TJ, Tang PY, Yong HS

Psychiatry Res, 2013 Oct 30;209(3):732-3.
PMID: 23747160 DOI: 10.1016/j.psychres.2013.05.017

We aim to replicate AKT1 gene variants studies using Malaysian samples. Seven AKT1 single nucleotide polymorphisms (SNPs) were studied in 417 patients and 429 controls. Haplotype showed significant association (p=0.036) with schizophrenia, especially in Malays and Indians. Meta-analysis of rs2494732 showed significant association worldwide (p=0.018) and in Asians (p=0.023).

Matched MeSH terms: Malaysia/ethnology
Public knowledge and beliefs about depression among urban and rural Chinese in Malaysia

Loo PW, Furnham A

Asian J Psychiatr, 2012 Sep;5(3):236-45.
PMID: 22981052 DOI: 10.1016/j.ajp.2012.02.003

The study compared knowledge and beliefs about depression among urban and rural Chinese in a Malaysian sample. A total of 409 participants were asked to identify cases of depression varying in intensity from two vignettes and rate their beliefs regarding a list of possible causes and treatments for depression. The urban Chinese were more likely to identify depression as the problem in the vignette. Beliefs about causes of depression were factored into five components, whereas beliefs about treatment for depression factored into four components. The results indicated that the causes most strongly endorsed were stress and pressure, and standard treatments rated the highest as treatments for depression. Overall, depression literacy was moderate for Chinese Malaysians. The results are discussed in relation to Chinese cultural beliefs about depression. Limitations of this preliminary study were acknowledged.

Matched MeSH terms: Malaysia/ethnology
Social skills, friendship and happiness: a cross-cultural investigation

Demir M, Jaafar J, Bilyk N, Ariff MR

J Soc Psychol, 2012 May-Jun;152(3):379-85.
PMID: 22558831 DOI: 10.1080/00224545.2011.591451

The present study investigated the associations between social skills, friendship quality, and happiness, and tested a mediational model positing that friendship quality would mediate the relationship between social skills and happiness among American and Malaysian college students. Although American students reported significantly higher levels of psychosocial well-being than Malaysian students, the study variables were positively associated with each other in both cultures. More importantly, findings supported the proposed model in both groups. Results suggest that part of the reason why social skills are associated with positive psychological well-being is because of friendship experiences. Overall, the findings of the present study reinforce, extend and cross-culturally generalize the presumed benefits of social skills in positive well-being elaborated by Segrin and Taylor (2007). The authors also provided suggestions for future research.

Matched MeSH terms: Malaysia/ethnology
Deleted in Colorectal Cancer (DCC) gene polymorphism is associated with H. pylori infection among susceptible Malays from the north-eastern region of Peninsular Malaysia

Maran S, Lee YY, Xu S, Rajab NS, Hasan N, Mustaffa N, et al.

Hepatogastroenterology, 2013 Jan-Feb;60(121):124-8.
PMID: 22829558

Using genome-wide case-control association approach, the current study aimed to determine whether genetic polymorphism(s) is/are associated with H. pylori infection among ethnic Malays from the north-eastern region of Peninsular Malaysia, a region with an exceptionally low prevalence for H. pylori infection and gastric cancer.

Matched MeSH terms: Malaysia/ethnology
Fulltext Preliminary study on association of beta2-adrenergic receptor polymorphism with hypertension in hypertensive subjects attending Balok Health Centre, Kuantan

Atia AE, Norsidah K, Nor Zamzila A, Rafidah Hanim M, Samsul D, Aznan MA, et al.

Med J Malaysia, 2012 Feb;67(1):25-30.
PMID: 22582545

Polymorphisms within the beta2-adrenergic receptor (ADRB2) gene have been repeatedly linked to hypertension. Among the ADRB2 polymorphisms detected, Arg16Gly and Gln27Glu codons are considered the two most important variations. The amino acid substitution at these codons may lead to abnormal regulation of ADRB2 activity. The aim of the present study was to assess the association between ADRB2 polymorphisms and hypertension. This case-control study consisted of 100 unrelated subjects (50 hypertensive and 50 matched normal controls). Arg16Gly and the Gln27Glu polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism assay. There were no significant evidence of association in allelic and genotypes distribution of Arg16Gly and Glu27Gln with blood pressure and hypertension. These findings suggest that the variation within codon 16 and 27 of ADRB2 gene were unlikely to confer genetic susceptibility for hypertension in our population samples.

Matched MeSH terms: Malaysia/ethnology
Fulltext A skin lesion and fever of unknown origin - a case study

Wong S, Ng CJ

Aust Fam Physician, 2012 Jan-Feb;41(1-2):41-4.
PMID: 22276283
Matched MeSH terms: Malaysia/ethnology
Fulltext Pseudoparaphimosis: a hairy affair

Ng KL, Mahadevan DT, Htun TH, Razack AH, Dublin N

Med J Malaysia, 2011 Aug;66(3):268-9.
PMID: 22111458
Matched MeSH terms: Malaysia/ethnology
Fulltext Perception of quality of life among people with diabetes

Cheah WL, Lee PY, Lim PY, Fatin Nabila AA, Luk KJ, Nur Iwana AT

Malays Fam Physician, 2012;7(2-3):21-30.
PMID: 25606252 MyJurnal

Diabetes is a chronic disease that affects a patient's quality of life. This cross-sectional study aimed to determine the socio-demographic and disease profile factors associated with poor quality of life among patients with diabetes. The study was conducted at a primary health care clinic in Kuching between August to November 2010. Short Form - 36 (SF - 36) questionnaire was used to assess the quality of life of diabetic patients aged ≥ 18. A total of 142 respondents participated in the survey. After adjusting for age, those with no education scored lower at vitality (p=0.043) and emotional health (p=0.033) compared with those who have tertiary education. Those working in the private sector scored better for physical functioning (p=0.042) compared with pensioners and the unemployed. Patients with uncontrolled diabetes scored lower in the role-emotional domain (p=0.003). Participants who were on <3 (p=0.014) and ≥3 (p=0.024) oral medications had better score for role-physical than those on insulin. Those on insulin had worse score for bodily pain than those on oral medication only (vs <3 oral drugs, p=0.026; vs ≥3 oral drugs, p=0.001). Various socio-demographic factors, uncontrolled diabetes and insulin usage were found to have negative impact on a diabetic patient's quality of life. Programmes addressing the physical and emotional needs of diabetic patients at the primary health care setting are essential to help improve their quality of life.

Matched MeSH terms: Malaysia/ethnology
Fulltext Phylogenetic relationships of the Orang Asli and Iban of Malaysia based on maternal markers

Ang KC, Leow JW, Yeap WK, Hood S, Mahani MC, Md-Zain BM

Genet. Mol. Res., 2011;10(2):640-9.
PMID: 21491374 DOI: 10.4238/vol10-2gmr1011

Malaysia remains as a crossroad of different cultures and peoples, and it has long been recognized that studying its population history can provide crucial insight into the prehistory of Southeast Asia as a whole. The earliest inhabitants were the Orang Asli in Peninsular Malaysia and the indigenous groups in Sabah and Sarawak. Although they were the earliest migrants in this region, these tribes are divided geographically by the South China Sea. We analyzed DNA sequences of 18 Orang Asli using mitochondrial DNA extracted from blood samples, each representing one sub-tribe, and from five Sarawakian Iban. Mitochondrial DNA was extracted from hair samples in order to examine relationships with the main ethnic groups in Malaysia. The D-loop region and cytochrome b genes were used as the candidate loci. Phylogenetic relationships were investigated using maximum parsimony and neighbor joining algorithms, and each tree was subjected to bootstrap analysis with 1000 replicates. Analyses of the HVS I region showed that the Iban are not a distinct group from the Orang Asli; they form a sub-clade within the Orang Asli. Based on the cytochrome b gene, the Iban clustered with the Orang Asli in the same clade. We found evidence for considerable gene flow between Orang Asli and Iban. We concluded that the Orang Asli, Iban and the main ethnic groups of Malaysia are probably derived from a common ancestor. This is in agreement with a single-route migration theory, but it does not dismiss a two-route migration theory.

Matched MeSH terms: Malaysia/ethnology
Fulltext Factors associated with breast self-examination among Malaysian women teachers

Parsa P, Kandiah M, Parsa N

East Mediterr Health J, 2011 Jun;17(6):509-16.
PMID: 21796969

The purpose of this study was to examine factors related to breast self-examination (BSE) among teachers in Selangor, Malaysia. A cross-sectional study was conducted among 425 female teachers in 20 randomly selected secondary schools. A self-administered questionnaire based on the health belief model was randomly selected secondary schools. A self-administered questionnaire based on the health belief model was used, including sociodemographic background and knowledge, beliefs and practices about breast cancer and BSE. Only 19% of the women performed BSE on a regular basis. Higher knowledge about breast cancer, greater confidence in performing BSE and regular visits to a physician were significant predictors for practising BSE. To promote BSE practice among Malaysian women, tailored health education and health promotion programmes should be developed based on a specific understanding of women's health beliefs.

Matched MeSH terms: Malaysia/ethnology
Fulltext Population genetic structure of peninsular Malaysia Malay sub-ethnic groups

Hatin WI, Nur-Shafawati AR, Zahri MK, Xu S, Jin L, Tan SG, et al.

PLoS One, 2011;6(4):e18312.
PMID: 21483678 DOI: 10.1371/journal.pone.0018312

Patterns of modern human population structure are helpful in understanding the history of human migration and admixture. We conducted a study on genetic structure of the Malay population in Malaysia, using 54,794 genome-wide single nucleotide polymorphism genotype data generated in four Malay sub-ethnic groups in peninsular Malaysia (Melayu Kelantan, Melayu Minang, Melayu Jawa and Melayu Bugis). To the best of our knowledge this is the first study conducted on these four Malay sub-ethnic groups and the analysis of genotype data of these four groups were compiled together with 11 other populations' genotype data from Indonesia, China, India, Africa and indigenous populations in Peninsular Malaysia obtained from the Pan-Asian SNP database. The phylogeny of populations showed that all of the four Malay sub-ethnic groups are separated into at least three different clusters. The Melayu Jawa, Melayu Bugis and Melayu Minang have a very close genetic relationship with Indonesian populations indicating a common ancestral history, while the Melayu Kelantan formed a distinct group on the tree indicating that they are genetically different from the other Malay sub-ethnic groups. We have detected genetic structuring among the Malay populations and this could possibly be accounted for by their different historical origins. Our results provide information of the genetic differentiation between these populations and a valuable insight into the origins of the Malay sub-ethnic groups in Peninsular Malaysia.

Matched MeSH terms: Malaysia/ethnology
Shifting subjects of health-care: placing "medical tourism" in the context of Malaysian domestic health-care reform

Ormond M

Asia Pac Viewp, 2011;52(3):247-59.
PMID: 22216474

"Medical tourism" has frequently been held to unsettle naturalised relationships between the state and its citizenry. Yet in casting "medical tourism" as either an outside "innovation" or "invasion," scholars have often ignored the role that the neoliberal retrenchment of social welfare structures has played in shaping the domestic health-care systems of the "developing" countries recognised as international medical travel destinations. While there is little doubt that "medical tourism" impacts destinations' health-care systems, it remains essential to contextualise them. This paper offers a reading of the emergence of "medical tourism" from within the context of ongoing health-care privatisation reform in one of today's most prominent destinations: Malaysia. It argues that "medical tourism" to Malaysia has been mobilised politically both to advance domestic health-care reform and to cast off the country's "underdeveloped" image not only among foreign patient-consumers but also among its own nationals, who are themselves increasingly envisioned by the Malaysian state as prospective health-care consumers.

Matched MeSH terms: Malaysia/ethnology
Self reported pain severity among multiethnic older Singaporeans: does adjusting for reporting heterogeneity matter?

Chan A, Malhotra C, Do YK, Malhotra R, Ostbye T

Eur J Pain, 2011 Nov;15(10):1094-9.
PMID: 21646030 DOI: 10.1016/j.ejpain.2011.05.006

The objective of this paper is to test and correct for systematic differences in reporting of pain severity among older adults by age, gender, ethnic group and socio-economic status using anchoring vignettes. Data from a national survey of community-dwelling older Singaporeans (aged 60 years and over) conducted in 2009 was used. Respondents were asked to rate the severity of their own pain as well as that of others described in the vignettes on a five-point scale ranging from none to extreme. An ordered probit model was used to estimate the coefficients of the independent variables (age, gender, ethnic group, education, housing type) on self-reported pain. Reporting heterogeneity in pain severity was then corrected using a Hierarchical Ordered Probit model. The results showed that before correcting for reporting heterogeneity, women, those older, and those of Malay ethnicity reported greater severity of pain, while there was no association of reported pain severity with housing type and education. However, after correcting for reporting heterogeneity, while women and those older were found to have an even greater severity of pain than what they had reported, Malays were found to have a lower severity of pain than what they had reported. We conclude that there are systematic differences in reporting pain severity by age, gender and ethnic group. We propose that pain management may be improved if medical professionals take into account reporting heterogeneity for pain severity among various population sub-groups in Singapore.

Matched MeSH terms: Malaysia/ethnology
'Rallying around the flag': Can an intergroup contact intervention promote national unity?

Al Ramiah A, Hewstone M

Br J Soc Psychol, 2012 Jun;51(2):239-56.
PMID: 21793860 DOI: 10.1111/j.2044-8309.2011.02041.x

A longitudinal study evaluated the success of a contact-based nation-building intervention (the Malaysian National Service Programme) in promoting various facets of national unity. The study assessed how post-test measures of quality of intergroup contact, outgroup evaluations, and levels of identification changed compared to their respective pre-test levels, for both National Service and control group participants. The intervention did not lead to a worsening of any of the constructs related to intergroup relations, which is noteworthy given the novelty for many participants of mixing in a multi-ethnic setting. Furthermore, all rater groups (Malays, Chinese, and Indians) maintained their ethnic identity, even in the presence of high levels of national identity, which we discuss with respect to past research on the effects of positive intergroup contact on minority group identification. However, the changes associated with the intervention yielded only small effect sizes, and, on the whole, National Service participants did not show significantly greater improvement than that experienced by control participants. We discuss the value of intergroup contact in this novel setting, considering various features of this programme that may have limited its effectiveness and discuss how such interventions can more successfully meet their goals.

Matched MeSH terms: Malaysia/ethnology
Fulltext The prevalence and characteristics associated with mother-infant bed-sharing in Klang district, Malaysia

Tan KL, Ghani SN, Moy FM

Med J Malaysia, 2009 Dec;64(4):311-5.
PMID: 20954557 MyJurnal

This was a cross-sectional study to determine the prevalence and characteristics of mother-infant bed-sharing practice in Klang district, Malaysia. Data was collected by face-to-face interview using a structured questionnaire for a four month period in 2006. A total of 682 mother-infant pairs attending government health clinics were included in the study. Data regarding socio-demographic characteristics of the mothers, information on the infants, bed-sharing and breastfeeding practices were collected. The mean maternal age was 28.4 +/- 5.1 years while the mean infant gestational age was 38.8 +/- 1.8 weeks. The study showed the prevalence of bed-sharing was 73.5% (95% CI: 70.0, 76.7). In multivariate analysis; area of interview, maternal occupation, family income, breastfeeding and infant birth weight were associated with bed-sharing after adjusted for maternal ethnicity, age, marital status, educational level, parity, infant gender and infant gestational age. In conclusion, bed-sharing is a common practice in Klang district, Malaysia, not specific to ethnicity, but strongly associated with low family income and breastfeeding.

Matched MeSH terms: Malaysia/ethnology

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