MyMedR

Socioeconomic consequences of the 2004 tsunami: policy implications for natural disaster management

Su TT, Saimy BI, Bulgiba AM

Prev Med, 2013;57 Suppl:S74-6.

PMID: 23313790 DOI: 10.1016/j.ypmed.2012.12.024

The objective of the study is to assess the socioeconomic status of the households affected by the tsunami of 2004 & to determine the factors associated with the recovery of household economic status.

Fulltext Impact of a Workplace Health Promotion Program on Employees' Blood Pressure in a Public University

Eng JY, Moy FM, Bulgiba A

PLoS One, 2016;11(2):e0148307.

PMID: 26840508 DOI: 10.1371/journal.pone.0148307

INTRODUCTION: Workplace health promotion is important in the prevention of non-communicable diseases among employees. Previous workplace health programs have shown benefits such as lowered disease prevalence, reduced medical costs and improved productivity. This study aims to evaluate the impact of a 6-year workplace health promotion program on employees' blood pressure in a public university.

METHODS: In this prospective cohort study, we included 1,365 employees enrolled in the university's workplace health promotion program, a program conducted since 2008 and using data from the 2008-2013 follow-up period. Participants were permanent employees aged 35 years and above, with at least one follow up measurements and no change in antihypertensive medication during the study period. Baseline socio-demographic information was collected using a questionnaire while anthropometry measurements and resting blood pressure were collected during annual health screening. Changes in blood pressure over time were analyzed using a linear mixed model.

RESULTS: The systolic blood pressure in the hypertension subgroup decreased 2.36 mmHg per year (p<0.0001). There was also significant improvement in systolic blood pressure among the participants who were at risk of hypertension (-0.75 mmHg, p<0.001). The diastolic blood pressure among the hypertensive and at risk subgroups improved 1.76 mmHg/year (p<0.001) and 0.56 mmHg/year (p<0.001), respectively. However, there was no change in both systolic and diastolic blood pressure among participants in the healthy subgroup over the 6-year period.

CONCLUSION: This study shows that continuing participation in workplace health promotion program has the potential to improve blood pressure levels among employees.

Impairment of psychomotor responses after conscious sedation in cirrhotic patients undergoing therapeutic upper GI endoscopy

Vasudevan AE, Goh KL, Bulgiba AM

Am J Gastroenterol, 2002 Jul;97(7):1717-21.

PMID: 12135024

The aim of this study was to determine whether the number connection test (NCT) times of a group of cirrhotic patients without clinically overt hepatic encephalopathy and a group of healthy patients without liver disease who were undergoing endoscopy were prolonged after sedation with short acting i.v. benzodiazepines.

Prevalence and Risk Factors for Dangerous Abbreviations in Malaysian Electronic Clinical Notes

Mohd Sulaiman I, Bulgiba A, Abdul Kareem S

Eval Health Prof, 2023 Mar;46(1):41-47.

PMID: 36444613 DOI: 10.1177/01632787221142623

Medical abbreviations can be misinterpreted and endanger patients' lives. This research is the first to investigate the prevalence of abbreviations in Malaysian electronic discharge summaries, where English is widely used, and elicit the risk factors associated with dangerous abbreviations. We randomly sampled and manually annotated 1102 electronic discharge summaries for abbreviations and their senses. Three medical doctors assigned a danger level to ambiguous abbreviations based on their potential to cause patient harm if misinterpreted. The predictors for dangerous abbreviations were determined using binary logistic regression. Abbreviations accounted for 19% (33,824) of total words; 22.6% (7640) of those abbreviations were ambiguous; and 52.3% (115) of the ambiguous abbreviations were labelled dangerous. Increased risk of danger occurs when abbreviations have more than two senses (OR = 2.991; 95% CI 1.586, 5.641), they are medication-related (OR = 6.240; 95% CI 2.674, 14.558), they are disorders (OR = 7.771; 95% CI 2.054, 29.409) and procedures (OR = 3.492; 95% CI 1.376, 8.860). Reduced risk of danger occurs when abbreviations are confined to a single discipline (OR = 0.519; 95% CI 0.278, 0.967). Managing abbreviations through awareness and implementing automated abbreviation detection and expansion would improve the quality of clinical documentation, patient safety, and the information extracted for secondary purposes.

Insight into elder abuse among urban poor of Kuala Lumpur, Malaysia-a middle-income developing country

Sooryanarayana R, Choo WY, Hairi NN, Chinna K, Bulgiba A

J Am Geriatr Soc, 2015 Jan;63(1):180-2.

PMID: 25597571 DOI: 10.1111/jgs.13217

Fulltext Genetic associations of the INSIG2 rs7566605 polymorphism with obesity-related metabolic traits in Malaysian Malays

Apalasamy YD, Moy FM, Rampal S, Bulgiba A, Mohamed Z

Genet. Mol. Res., 2014;13(3):4904-10.

PMID: 25062423 DOI: 10.4238/2014.July.4.4

A genome-wide association study showed that the tagging single nucleotide polymorphism (SNP) rs7566605 in the insulin-induced gene 2 (INSIG2) was associated with obesity. Attempts to replicate this result in different populations have produced inconsistent findings. We aimed to study the association between the rs7566605 SNP with obesity and other metabolic parameters in Malaysian Malays. Anthropometric and obesity-related metabolic parameters and DNA samples were collected. We genotyped the rs7566605 polymorphism in 672 subjects using real-time polymerase chain reaction. No significant associations were found between the rs7566605 tagging SNP of INSIG2 with obesity or other metabolic parameters in the Malaysian Malay population. The INSIG2 rs7566605 SNP may not play a role in the development of obesity-related metabolic traits in Malaysian Malays.

A systematic review of statistical methods used to test for reliability of medical instruments measuring continuous variables

Zaki R, Bulgiba A, Nordin N, Azina Ismail N

Iran J Basic Med Sci, 2013 Jun;16(6):803-7.

PMID: 23997908

Reliability measures precision or the extent to which test results can be replicated. This is the first ever systematic review to identify statistical methods used to measure reliability of equipment measuring continuous variables. This studyalso aims to highlight the inappropriate statistical method used in the reliability analysis and its implication in the medical practice.

Genetic association of SNPs in the FTO gene and predisposition to obesity in Malaysian Malays

Apalasamy YD, Ming MF, Rampal S, Bulgiba A, Mohamed Z

Braz. J. Med. Biol. Res., 2012 Dec;45(12):1119-26.

PMID: 22911346

The common variants in the fat mass- and obesity-associated (FTO) gene have been previously found to be associated with obesity in various adult populations. The objective of the present study was to investigate whether the single nucleotide polymorphisms (SNPs) and linkage disequilibrium (LD) blocks in various regions of the FTO gene are associated with predisposition to obesity in Malaysian Malays. Thirty-one FTO SNPs were genotyped in 587 (158 obese and 429 non-obese) Malaysian Malay subjects. Obesity traits and lipid profiles were measured and single-marker association testing, LD testing, and haplotype association analysis were performed. LD analysis of the FTO SNPs revealed the presence of 57 regions with complete LD (D' = 1.0). In addition, we detected the association of rs17817288 with low-density lipoprotein cholesterol. The FTO gene may therefore be involved in lipid metabolism in Malaysian Malays. Two haplotype blocks were present in this region of the FTO gene, but no particular haplotype was found to be significantly associated with an increased risk of obesity in Malaysian Malays.

Do older people with visual impairment and living alone in a rural developing country report greater difficulty in managing stairs?

Hairi NN, Bulgiba A, Peramalah D, Mudla I

Prev Med, 2013 Jan;56(1):8-11.

PMID: 23103916 DOI: 10.1016/j.ypmed.2012.10.016

Managing stairs is a challenging activity of daily living (ADL) for older people. This study aims to examine the association between visual impairment and difficulty in managing stairs among older people living alone and those living with others.

The clinical features of hand-arm vibration syndrome in a warm environment--a review of the literature

Su AT, Darus A, Bulgiba A, Maeda S, Miyashita K

J Occup Health, 2012;54(5):349-60.

PMID: 22863899

The internationally accepted limit values and the health effects of hand-transmitted vibration exposure have been described extensively in the literature from temperate climate countries but not from a tropical climate environment.

OBJECTIVES: We conducted a systematic review of the health effects of hand-transmitted vibration exposure in tropical countries to determine the characteristics of hand-arm vibration syndrome in a warm environment and compared the findings with the results of the systematic reviews published by the US NIOSH.

METHODS: We searched major medical databases including MEDLINE, PubMed, Embase, CINAHL, Ovid and Cochrane based on the terms "hand arm vibration syndrome," "hand transmitted vibration," "vibration white finger" and "Raynaud" up to January 2011. Only studies conducted in a tropical or subtropical environment were selected for the review. The quality of the selected papers was assessed independently by two investigators using predefined criteria. A standard set of information was abstracted from the papers for review.

RESULTS: Only six papers from tropical countries and three papers from subtropical countries were available in the literature. No vibration white finger was reported in the tropical countries. Neurological symptoms were prevalent in the vibration-exposed workers. Finger coldness seems to be an important surrogate for vascular disorder in a tropical environment. Meta-analysis could not be performed due to inadequacy of the information reported in these papers.

CONCLUSIONS: The current dose-response relationship in ISO5349-1 for hand-transmitted vibration exposure is not applicable to a tropical environment. Further studies on hand-arm vibration syndromes in tropical countries are needed.

Gender-dependent association of a β(2)-adrenergic gene variant with obesity parameters in Malaysian Malays

Apalasamy YD, Ming MF, Rampal S, Bulgiba A, Mohamed Z

Asia Pac J Public Health, 2015 Mar;27(2):NP154-65.

PMID: 22199155 DOI: 10.1177/1010539511430250

Recent findings have shown that the rs1042714 (Gln27Glu) single-nucleotide polymorphism (SNP) on the β2-adrenoceptor gene may predispose to obesity. The findings from other studies carried on different populations, however, have been inconsistent. The authors investigated the association between the rs1042714 SNP with obesity-related parameters. DNA of 672 Malaysian Malays was analyzed using real-time polymerase chain reaction. Univariate and multivariate linear regression analyses revealed significant associations between rs1042714 and diastolic blood pressure in the pooled Malaysian Malay subjects under additive and recessive models. After gender stratification, however, a significant association was found between the rs1042714 and triglyceride and the rs1042714 and log-transformed high-density lipoprotein cholesterol levels in Malaysian Malay men. No significant association was found between the SNP and log-transformed body mass index. This polymorphism may have an important role in the development of obesity-related traits in Malaysian Malays. Gender is an effect modifier for the effect of the rs1042714 polymorphism on obesity-related traits in Malaysian Malays.

Chronic diseases, depressive symptoms and functional limitation amongst older people in rural Malaysia, a middle income developing country

Hairi NN, Bulgiba A, Mudla I, Said MA

Prev Med, 2011 Oct;53(4-5):343-6.

PMID: 21864564 DOI: 10.1016/j.ypmed.2011.07.020

To determine prevalence and prevalence ratio of functional limitation amongst older people with combined chronic diseases and co-morbid depressive symptoms compared with older people with either chronic disease or depressive symptoms alone.

Design of a fuzzy-based decision support system for coronary heart disease diagnosis

Lahsasna A, Ainon RN, Zainuddin R, Bulgiba A

J Med Syst, 2012 Oct;36(5):3293-306.

PMID: 22252606 DOI: 10.1007/s10916-012-9821-7

In the present paper, a fuzzy rule-based system (FRBS) is designed to serve as a decision support system for Coronary heart disease (CHD) diagnosis that not only considers the decision accuracy of the rules but also their transparency at the same time. To achieve the two above mentioned objectives, we apply a multi-objective genetic algorithm to optimize both the accuracy and transparency of the FRBS. In addition and to help assess the certainty and the importance of each rule by the physician, an extended format of fuzzy rules that incorporates the degree of decision certainty and importance or support of each rule at the consequent part of the rules is introduced. Furthermore, a new way for employing Ensemble Classifiers Strategy (ECS) method is proposed to enhance the classification ability of the FRBS. The results show that the generated rules are humanly understandable while their accuracy compared favorably with other benchmark classification methods. In addition, the produced FRBS is able to identify the uncertainty cases so that the physician can give a special consideration to deal with them and this will result in a better management of efforts and tasks. Furthermore, employing ECS has specifically improved the ability of FRBS to detect patients with CHD which is desirable feature for any CHD diagnosis system.

Stop smoking clinics in Malaysia: characteristics of attendees and predictors of success

Wee LH, Shahab L, Bulgiba A, West R

Addict Behav, 2011 Apr;36(4):400-3.

PMID: 21195553 DOI: 10.1016/j.addbeh.2010.11.011

INTRODUCTION: As Stop Smoking Clinics (SSCs) become more common across the globe, it is important to know how far one can make broad generalisations concerning characteristics of smokers who attend these clinics and factors that predict their success. This involves accumulation of data from different countries.
OBJECTIVE: The aim of this study was to identify characteristics of smokers and factors leading up to quitting with clinics in Malaysia.
METHOD: Records from 629 smokers who had sought help from five selected SSCs in Malaysia from January 2006 to June 2007 were analysed.
RESULTS: The characteristics of smokers attending Malaysian smoking clinics were broadly similar to those in Western countries. Consistent with the findings from other countries, older age and longest duration of previous quit attempts were associated with successful smoking cessation. Greater baseline carbon-monoxide readings (OR 0.96, 95% CI 0.93-0.99; p=0.013), but not Fagerstrom Test for Nicotine Dependence (FTND), predicted failure to quit at six-month in multivariate analysis. Success rates varied greatly between clinics even after adjusting for all other predictors.
CONCLUSION: In these rare data from a non-Western culture some predictors of successful smoking cessation appeared to generalise from Western smokers but the universal validity of the FTND in particular needs to be examined further.

Depressive symptoms, visual impairment, and its influence on physical disability and functional limitation

Hairi NN, Bulgiba A, Cumming RG, Naganathan V, Mudla I

J Am Geriatr Soc, 2011 Mar;59(3):557-9.

PMID: 21391950 DOI: 10.1111/j.1532-5415.2010.03301.x

Fulltext Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country

Hairi NN, Bulgiba A, Cumming RG, Naganathan V, Mudla I

BMC Public Health, 2010;10:492.

PMID: 20716377 DOI: 10.1186/1471-2458-10-492

The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries.

The prevalence of enamel opacities in permanent teeth of 11-12 year-old school children in Kuala Lumpur, Malaysia

Yusoff N, Jaafar N, Razak IA, Chew YY, Ismail N, Bulgiba AM

Community Dent Health, 2008 Mar;25(1):55-8.

PMID: 18435236

To determine the prevalence, distribution, severity and treatment need of enamel opacities among 11-12 year-old school children in a fluoridated urban community.

How well does self-reported adherence fare compared to therapeutic drug monitoring in HAART?

Bulgiba A, Mohammed UY, Chik Z, Lee C, Peramalah D

Prev Med, 2013;57 Suppl:S34-6.

PMID: 23313585 DOI: 10.1016/j.ypmed.2013.01.002

The aim of the study was to determine how well self-reported adherence fares compared to therapeutic drug monitoring in monitoring HAART adherence.

Consistency and Generalizability of Dietary Patterns in a Multiethnic Working Population

Eng JY, Moy FM, Bulgiba A, Rampal S

J Acad Nutr Diet, 2018 07;118(7):1249-1262.e3.

PMID: 29615325 DOI: 10.1016/j.jand.2018.01.014

BACKGROUND: Dietary pattern analysis is a complementary method to nutrient analysis in evaluating overall diet-disease hypotheses. Although studies have been conducted to derive dietary patterns among Malaysians, their consistency across subgroups has not been examined.

OBJECTIVE: The study aimed to derive dietary patterns empirically and to examine the consistency and generalizability of patterns across sex, ethnicity, and urban status in a working population.

DESIGN: This was a cross-sectional study using data from the Clustering of Lifestyle Risk Factors and Understanding its Association with Stress on Health and Well-Being among School Teachers in Malaysia study collected between August 2014 and November 2015. Dietary intake was assessed using a food frequency questionnaire, and dietary patterns were derived using factor analysis.

PARTICIPANTS/SETTING: Participants were teachers from selected public schools from three states in Peninsular Malaysia (n=4,618).

MAIN OUTCOME MEASURES: Dietary patterns derived using factor analysis.

STATISTICAL ANALYSES PERFORMED: Separate factor analysis was conducted by sex, ethnicity, and urban status to identify dietary patterns. Eigenvalue >2, scree plot, Velicer's minimum average partial analysis, and Horn's parallel analysis were used to determine the number of factors to retain. The interpretability of each dietary pattern was evaluated. The consistency and generalizability of dietary patterns across subgroups were assessed using the Tucker congruence coefficient.

RESULTS: There was no subgroup-specific dietary pattern found. Thus, dietary patterns were derived using the pooled sample in the final model. Two dietary patterns (Western and Prudent) were derived. The Western dietary pattern explained 15.4% of total variance, characterized by high intakes of refined grains, animal-based foods, added fat, and sugar-sweetened beverages as well as fast food. The Prudent dietary pattern explained 11.1% of total variance and was loaded with pulses, legumes, vegetables, and fruits.

CONCLUSIONS: The derived Western and Prudent dietary patterns were consistent and generalizable across subgroups of sex, ethnicity, and urban status. Further research is needed to explore associations between these dietary patterns and chronic diseases.

Association of melanocortin-4 receptor gene polymorphisms with obesity-related parameters in Malaysian Malays

Apalasamy YD, Ming MF, Rampal S, Bulgiba A, Mohamed Z

Ann Hum Biol, 2013 Jan;40(1):102-6.

PMID: 22989167 DOI: 10.3109/03014460.2012.720709

Melanocortin-4 receptor (MC4R) is an important regulator of body weight and energy intake. Genetic polymorphisms of the MC4R gene have been found to be linked to obesity in many recent studies across the globe.

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