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Fulltext Effect of Aging, Antioxidant, and Mono- and Divalent Ions at High Temperature on the Rheology of New Polyacrylamide-Based Co-Polymers

Akbari S, Mahmood SM, Tan IM, Ling OL, Ghaedi H

Polymers (Basel), 2017 Oct 04;9(10).
PMID: 30965788 DOI: 10.3390/polym9100480

The viscosity of four new polymers was investigated for the effect of aging at high temperature, with varying degrees of salinity and hardness. The four sulfonated based polyacrylamide co-polymers were FLOCOMB C7035; AN132 VHM; SUPERPUSHER SAV55; and THERMOASSOCIATIF copolymers. All polymer samples were aged at 80 °C for varying times (from zero to at least 90 days) with and without isobutyl alcohol (IBA) as an antioxidant. To see the effect of divalent ions on the polymer solution viscosity, parallel experiments were performed in a mixture of CaCl₂-NaCl of the same ionic strength as 5 wt % NaCl. The polymers without IBA showed severe viscosity reduction after aging for 90 days in both types of preparation (5 wt % NaCl or CaCl₂-NaCl). In the presence of IBA, viscosity was increased when aging time was increased for 5 wt % NaCl. In CaCl₂-NaCl, on the other hand, a viscosity reduction was observed as aging time was increased. This behavior was observed for all polymers except AN132 VHM.
Fulltext Identification of Predictive DNA Methylation Biomarkers for Chemotherapy Response in Colorectal Cancer

Baharudin R, Ab Mutalib NS, Othman SN, Sagap I, Rose IM, Mohd Mokhtar N, et al.

Front Pharmacol, 2017;8:47.
PMID: 28243201 DOI: 10.3389/fphar.2017.00047

Resistance to 5-Fluorouracil (5-FU) is a major obstacle to the successful treatment of colorectal cancer (CRC) and posed an increased risk of recurrence. DNA methylation has been suggested as one of the underlying mechanisms for recurrent disease and its contribution to the development of drug resistance remains to be clarified. This study aimed to determine the methylation phenotype in CRC for identification of predictive markers for chemotherapy response. We performed DNA methylation profiling on 43 non-recurrent and five recurrent CRC patients using the Illumina Infinium HumanMethylation450 Beadchip assay. In addition, CRC cells with different genetic backgrounds, response to 5-FU and global methylation levels (HT29 and SW48) were treated with 5-FU and DNA methylation inhibitor 5-aza-2'-deoxycytidine (5-azadC). The singular and combined effects of these two drug classes on cell viability and global methylation profiles were investigated. Our genome-wide methylation study on the clinical specimens showed that recurrent CRCs exhibited higher methylation levels compared to non-recurrent CRCs. We identified 4787 significantly differentially methylated genes (P < 0.05); 3112 genes were hyper- while 1675 genes were hypomethylated in the recurrent group compared to the non-recurrent. Fifty eight and 47 of the significantly hypermethylated and hypomethylated genes have an absolute recurrent/non-recurrent methylation difference of ≥20%. Most of the hypermethylated genes were involved in the MAPK signaling pathway which is a key regulator for apoptosis while the hypomethylated genes were involved in the PI3K-AKT signaling pathway and proliferation process. We also demonstrate that 5-azadC treatment enhanced response to 5-FU which resulted in significant growth inhibition compared to 5-FU alone in hypermethylated cell lines SW48. In conclusion, we found the evidence of five potentially biologically important genes in recurrent CRCs that could possibly serve as a new potential therapeutic targets for patients with chemoresistance. We postulate that aberrant methylation of CCNEI, CCNDBP1, PON3, DDX43, and CHL1 in CRC might be associated with the recurrence of CRC and 5-azadC-mediated restoration of 5-FU sensitivity is mediated at least in part by MAPK signaling pathway.
Fulltext Helicobacter pylori cagA gene variants in Malaysians of different ethnicity

Mohamed R, Hanafiah A, Rose IM, Manaf MR, Abdullah SA, Sagap I, et al.

Eur J Clin Microbiol Infect Dis, 2009 Jul;28(7):865-9.
PMID: 19247698 DOI: 10.1007/s10096-009-0712-x

We have defined DNA repeat variability in the 3'-terminus of the cagA gene of Helicobacter pylori strains from Malaysian patients of different ethnicities. We identified different alleles based on the EPIYA repeats. cagA types A-B-D and A-B-B-D are more similar to the sequence of Japanese strains, whereas cagA types A-B-C, A-B-C-C, A-B and A-C displayed similarity to strain 26695 sequences. A significant association was found between cagA genotypes and patients' ethnicity, with cagA type A-B-D being predominantly isolated from Chinese patients and cagA type A-B-C from Malays and Indians. Our data further corroborate the possibility that variant biological activity of CagA may affect the host specificity and/or pathogenicity of H. pylori.
Fulltext Current trends in water-in-diesel emulsion as a fuel

Yahaya Khan M, Abdul Karim ZA, Hagos FY, Aziz AR, Tan IM

ScientificWorldJournal, 2014;2014:527472.
PMID: 24563631 DOI: 10.1155/2014/527472

Water-in-diesel emulsion (WiDE) is an alternative fuel for CI engines that can be employed with the existing engine setup with no additional engine retrofitting. It has benefits of simultaneous reduction of both NO x and particulate matters in addition to its impact in the combustion efficiency improvement, although this needs further investigation. This review paper addresses the type of emulsion, the microexplosion phenomenon, emulsion stability and physiochemical improvement, and effect of water content on the combustion and emissions of WiDE fuel. The review also covers the recent experimental methodologies used in the investigation of WiDE for both transport and stationary engine applications. In this review, the fuel injection pump and spray nozzle arrangement has been found to be the most critical components as far as the secondary atomization is concerned and further investigation of the effect of these components in the microexplosion of the emulsion is suggested to be center of focus.
Influenza B outbreak in female psychiatric ward of Hospital Kuala Lumpur, Malaysia

Mohamad Isa MF, Tan JM, Abdul Aziz MF, Leong CL

Med J Malaysia, 2018 12;73(6):405-406.
PMID: 30647214

Influenza outbreaks in tropical countries are rarely reported. This article reports four cases of influenza within a psychiatric ward of a tertiary hospital in Malaysia. These were patients with severe mental illness who were involuntarily admitted and did not show the classical triad of influenza-like-illness (ILI) at the beginning. However, severe respiratory complications developed requiring intubation. Referral and cooperation with the infectious disease team was initiated to help manage the outbreak while continuing psychiatric treatment. Incidences of influenza among hospitalised psychiatric patients should be treated seriously with immediate multidisciplinary approach to prevent severe unwanted complications.
Fulltext A successful pregnancy outcome in treated vulval rhabdomyosarcoma

Ariza M, Rafaee T, Adeeb N, Muhaizan WM, Isa MR

Med J Malaysia, 1999 Sep;54(3):371-3.
PMID: 11045067

A 14 year old girl presented in 1986 with a huge perineal swelling which was progressively increasing in size and associated with loss of weight and loss of appetite. Biopsy from the mass revealed rhabdomyosarcoma of the vulva. She was treated with chemotherapy and radium implant. She responded well to the regime. Fibrosis of the vulva and vagina caused difficulty in consummation. Once it was corrected, she conceived easily and proceeded to a normal pregnancy and delivery.
Identification of chromosome 21 materials using the whole chromosome 21 specific library

Isa MN, Boyd E, Turner TL, Tolmie J, Connor JM

Southeast Asian J Trop Med Public Health, 1995;26 Suppl 1:92-5.
PMID: 8629150

The chromosome in situ suppression hybridization or chromosome painting technic was applied to confirm and eliminate the markers involving chromosome 21 segments using a chromosome 21 DNA library. The library ATCCLL21SNO2 was amplified, directly biotinylated using the polymerase chain reaction. The results demonstrated a translocation of chromosome 21 material on chromosome 2 and X and eliminate the origin of the marker. Thus, the technique provides an important tool to complement the conventional G-banding technic.
Fulltext Continent pouch ileostomy

Tay SK, Meah FA, Isa MR, Phang KS

Med J Malaysia, 1994 Sep;49(3):310-4.
PMID: 7845289

Continent pouch ileostomy is fashioned for patients who need a proctocolectomy. It is usually indicated for cases of ulcerative colitis and familial adenomatous polyposis where the anal sphincter can no longer maintain normal function or has to be removed. A case of familial adenomatous polyposis with features of Gardner's syndrome is reported. The patient presented with carcinoma of the rectum. Abdominoperineal resection followed by completion pancolectomy was performed. A continent pouch ileostomy was fashioned for him. He resumed work as a labourer within six months. The pouch was troublefree, needed to emptied four to six times a day and was fully continent of fluid, flatus and faeces until his demise three years later from liver secondaries. Continent pouch ileostomy is a better alternative than permanent end ileostomy. All care should be taken to rule out the existence of Crohn's disease. It is proposed that continent pouch ileostomy should be offered to patients needing permanent ileostomy if the expertise is available.
Fulltext Technique for Early Reliability Prediction of Software Components Using Behaviour Models

Ali A, N A Jawawi D, Adham Isa M, Imran Babar M

PLoS One, 2016 Sep 26;11(9):e0163346.
PMID: 27668748 DOI: 10.1371/journal.pone.0163346

Behaviour models are the most commonly used input for predicting the reliability of a software system at the early design stage. A component behaviour model reveals the structure and behaviour of the component during the execution of system-level functionalities. There are various challenges related to component reliability prediction at the early design stage based on behaviour models. For example, most of the current reliability techniques do not provide fine-grained sequential behaviour models of individual components and fail to consider the loop entry and exit points in the reliability computation. Moreover, some of the current techniques do not tackle the problem of operational data unavailability and the lack of analysis results that can be valuable for software architects at the early design stage. This paper proposes a reliability prediction technique that, pragmatically, synthesizes system behaviour in the form of a state machine, given a set of scenarios and corresponding constraints as input. The state machine is utilized as a base for generating the component-relevant operational data. The state machine is also used as a source for identifying the nodes and edges of a component probabilistic dependency graph (CPDG). Based on the CPDG, a stack-based algorithm is used to compute the reliability. The proposed technique is evaluated by a comparison with existing techniques and the application of sensitivity analysis to a robotic wheelchair system as a case study. The results indicate that the proposed technique is more relevant at the early design stage compared to existing works, and can provide a more realistic and meaningful prediction.
Fulltext Lymphangioleiomyomatosis with chylous ascites

Raymond AA, Isa MR, Abdullah T, Kudva MV

Singapore Med J, 1993 Jun;34(3):276-8.
PMID: 8266193

A 41-year-old Malay housewife presented with recurrent chylous ascites and progressive cachexia over 17 years. A diagnosis of lymphangioleiomyomatosis (LAM) was established by laparotomy where biopsy of the liver, peritoneum and adhesions from previous surgery showed smooth muscle proliferation in the blood vessels and lymphatics. Clinically and radiologically, there was no evidence of pulmonary involvement. She was treated with dietary fat restriction and medium-chain triglycerides. This is the first case of LAM reported in Malaysia.
Heterogeneity of the CYP2D6 gene among Malays in Malaysia

Teh LK, Ismail R, Yusoff R, Hussein A, Isa MN, Rahman AR

J Clin Pharm Ther, 2001 Jun;26(3):205-11.
PMID: 11422605

Although Malays shared an origin with Chinese, their evolution saw substantial divergences. Phenotyping studies suggested that they differed in CYP2D6 polymorphism, with higher PM prevalence but lesser right-shift for debrisoquine MRs.
Dermatoglyphics of Down's syndrome patients in Malays--a comparative study

Than M, Myat KA, Khadijah S, Jamaludin N, Isa MN

Anthropol Anz, 1998 Dec;56(4):351-65.
PMID: 10027045

There has been no recent report on the dermatoglyphics of the Malays (normal population as well as patients with Down's syndrome). A study on the frequencies of the dermal patterns (dermatoglyphics) of the digits, palms and hallucal areas was done therefore in 40 Malay patients with Down's syndrome and 200 unrelated normal controls. Only the patients with the standard 21 trisomy karyotype were included in the study. Comparison was made with the published data on studies done in various racial groups. Significant differences of the dermal patterns were found not only between the controls but also among patients of different races.
The nearly complete mitogenome of the Southeast Asian firefly Pteroptyx tener (Coleoptera: Lampyridae)

Cheng S, Mat-Isa MN, Sapian IS, Ishak SF

Mol Biol Rep, 2021 Feb;48(2):1281-1290.
PMID: 33582950 DOI: 10.1007/s11033-021-06189-0

The estuarine firefly, Pteroptyx tener, aggregates in the thousands in mangrove trees lining tidal rivers in Southeast Asia where they engage one another in a nocturnal, pre-mating ritual of synchronised courtship flashes. Unfortunately, populations of the species by virtue of being restricted to isolated estuarine rivers systems in the region, are at risk of genetic isolation. Because of this concern we undertook the task of sequencing and characterising the mitochondrial DNA genome of P. tener, as the first step towards helping us to characterise and better understand their genetic diversity. We sequenced and assembled the mitochondrial DNA genome of P. tener from two male and female specimens from the district of Kuala Selangor in Peninsular Malaysia and announce the molecules in this publication. We also reconstructed the phylogenetic trees of all available lampyrids mitogenomes and suggest the need to re-examine our current understanding of their classification which have largely been based on morphological data and the cox1 gene. Separately, our analysis of codon usage patterns among lampyrid mitogenomes showed that the codon usage in a majority of the protein-coding genes were non-neutral. Codon usage patterns between mitogenome sequences of P. tener were, however, largely neutral. Our findings demonstrate the usefulness of mitochondrial genes/mitogenomes for analysing both inter- and intra- specific variation in the Lampyridae to aid in species discovery in this highly variable genus; and elucidate the phylogenetic relationships of Pteroptyx spp. from the region.
Fulltext Predominance of G to A codon 12 mutation K-ras gene in Dukes' B colorectal cancer

Zulhabri O, Rahman J, Ismail S, Isa MR, Wan Zurinah WN

Singapore Med J, 2012 Jan;53(1):26-31.
PMID: 22252179

K-ras gene mutations in codons 12 and 13 are one of the earliest events in colon carcinogenesis.
Outcome of cardiopulmonary resuscitation in the emergency department of a tertiary hospital in Malaysia

Iqhbal KM, Mokhtar NAM, Isa MR, Mokhtar MF

Med J Malaysia, 2023 Sep;78(5):639-645.
PMID: 37775492

INTRODUCTION: There are insufficient data available regarding the outcome of cardiac arrest (CA) resuscitated in the emergency department in Malaysia. This study aims to determine the incidence of CA, the return of spontaneous circulation (ROSC), survival to admission (STA), survival to discharge (STD) and factors influencing the overall outcome of CA.
MATERIAL AND METHODS: This is a retrospective observational study done in Hospital Sg Buloh (HSB), a tertiary referral centre in an urban area located north of Kuala Lumpur, Malaysia's capital city, from January until December 2018, involving 289 patients. All cases with CPR and a sustained return of spontaneous circulation (ROSC) were included in the study and followed up until discharged or died in the hospital.
RESULTS: Out of 236 patients recruited, 25.8% achieved ROSC, 15.7% survived on admission, and 4.2% of patients were discharged alive. Of 74.1% of witnessed OHCA, only 17.5% received bystander CPR. Factors with favourable outcomes include CA in ED (p<0.001), the initial rhythm of ventricular fibrillation (p=0.003), defibrillation (p=0.024), OHCA witnessed by emergency medical services (EMS) (p=0.024) and intravenous adrenaline administration (p=0.001). When using multivariate regression analysis, positive outcomes were associated with the cardiac and respiratory cause of CA (Adjusted Odd Ratio (AOR) 3.66; 95% Confidence Intervals, 95%CI: 2.52 - 12.61 and AOR 8.76; 95%CI: 5.76- 15.46, respectively) as well as OHCA witnessed by EMS (AOR 10.81; 95%CI: 1.84- 19.52).
CONCLUSIONS: Despite being an upper-middle-income country and having advancements in the healthcare system, a relatively lower STD rate among survivors of CA in the ED was observed in this study. There was underutilization of the EMS among patients with CA. The bystander CPR rate among patients with CA in Malaysia is also worryingly low. Aggressive community participation in cardiac arrest awareness programmes is much required. Additionally, in achieving better outcomes, implementing standardized post-resuscitation care protocols with existing resources will be a challenge for physicians managing cardiac arrest cases.
Fulltext Purtscher's Retinopathy Following Long Bone Fracture: A Case Report

Mad Isa M, Azhany Y, Alias R, Wan Hitam WH

Cureus, 2024 Jan;16(1):e53087.
PMID: 38414683 DOI: 10.7759/cureus.53087

Purtscher's retinopathy represents an occlusive retinal microvasculopathy that poses a potential threat to vision and is linked to traumatic events. This condition typically manifests in individuals following trauma, commonly associated with long bone fractures, head injuries, or thoracic compression. We report a rare case of unilateral Purtscher's retinopathy after sustaining a long bone fracture. A 27-year-old healthy man sustained an open, comminuted midshaft fracture of the right femur after an alleged motor vehicle accident. On day 3 post trauma, he developed sudden right eye painless reduced vision. Visual acuity in the right eye was 6/12 pinhole 6/12 and the left eye was 6/9 pinhole 6/6. The pupillary reflex was normal in both eyes. Both anterior segments were unremarkable. Fundoscopy showed the presence of multiple cotton wool spots and fleckens in the right eye. Macula optical coherence tomography of the right eye confirmed hyperreflective lesions within the retinal nerve fiber layer. He was diagnosed with Purtscher's retinopathy. The patient was treated conservatively given the fairly good visual acuity. There was complete resolution of fundus lesions with good visual acuity of 6/6 after one month. Ophthalmologic evaluation is crucial in cases of post-traumatic visual impairment, particularly in scenarios involving long bone fractures, to effectively exclude the possibility of Purtscher's retinopathy.
A scoping review on socioeconomic factors affecting tuberculosis loss to follow-up in Southeast Asia

Abd Rani AY, Ismail N, Zakaria Y, Isa MR

Med J Malaysia, 2024 Jul;79(4):470-476.
PMID: 39086346

INTRODUCTION: Tuberculosis (TB) is a global public health issue. The Southeast Asian region grapples with numerous challenges in TB management, with loss to follow-up (LTFU) emerging as a critical barrier to effective control of the disease. This review synthesised published articles to identify socioeconomic factors contributing to the burden of TB losses for follow-up in Southeast Asia.
MATERIALS AND METHODS: This scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework developed by the Joanna Briggs Institute (JBI). A total of 10 studies were identified as eligible from the title and abstract review. The mixed method quality appraisal tool (MMAT) version 2018 was used to assess the quality of the included quantitative studies.
RESULTS: The results showed that poverty, unemployment, low education levels, migrant status, community support, male gender, substance abuse, and regional disparities significantly impact the occurrence of TB LTFU in Southeast Asia.
CONCLUSION: The findings have significant implications for public health in Southeast Asia. Addressing these socioeconomic barriers through community-based strategies, educational initiatives, and policy reforms is vital for improving treatment outcomes and overall public health.
Complementary role of p57kip2 immunostaining in diagnosing hydatidiform mole subtypes

Zainal N, Kampan NC, Rose IM, Ghazali R, Shafiee MN, Yussoff NH, et al.

Horm Mol Biol Clin Investig, 2021 May 21;42(3):311-316.
PMID: 34018382 DOI: 10.1515/hmbci-2020-0086

OBJECTIVES: Gestational trophoblastic disease comprises of a spectrum of pregnancy-related tumours which includes complete (CHM) and partial hydatidiform moles (PHM). Accurate diagnosis and subclassification of HM subtypes are crucial as prognosis differs. Histopathological examination using haemotoxylin and eosin (H&E) staining remains the basis for diagnosing HM, with only 80% accuracy. p57kip2 is a cyclin-dependent kinase inhibitor (CDKI) protein and is strongly paternally imprinted, being expressed from maternal allele. Therefore, complete mole (CHM) with only paternal genome has nearly absent expression of p57kip2 compared to partial mole (PHM) having both paternal and maternal genomes. This study is aimed to determine usefulness of p57kip2 immunohistochemistry (IHC) analysis in the diagnosis of HM subtypes.
METHODS: A total of 82 archived paraffin embedded HM tissues with subtypes classified based on H&E staining - 39 (47.5%) CHM, 41 (50.0%) PHM and two (2.43%) unclassified molar pregnancy were retrieved. All tissue samples were subjected for p57kip2 IHC analysis and HM subtypes were then reclassified.
RESULTS: A total of 66 cases (80.5%) were re-classified as CHM, 14 cases (17.1%) as PHM and two cases (2.4%) were decidual and cystic tissues. Analysis using p57kip2 immunostaining showed a diagnostic discrepancy of 33.0% from routine H&E staining and helps to improve the characterisation of the HM subtypes specifically at early gestations which have less distinctive morphologies.
CONCLUSIONS: IHC using p57kip2 monoclonal antibody should be considered as a routine ancillary test to H&E in improving the diagnosis of HM subtypes particularly in developing countries with limited resources.
Fulltext Molecular Characterization of Somatic Alterations in Dukes' B and C Colorectal Cancers by Targeted Sequencing

Abdul SN, Ab Mutalib NS, Sean KS, Syafruddin SE, Ishak M, Sagap I, et al.

Front Pharmacol, 2017;8:465.
PMID: 28769798 DOI: 10.3389/fphar.2017.00465

Despite global progress in research, improved screening and refined treatment strategies, colorectal cancer (CRC) remains as the third most common malignancy. As each type of cancer is different and exhibits unique alteration patterns, identifying and characterizing gene alterations in CRC that may serve as biomarkers might help to improve diagnosis, prognosis and predict potential response to therapy. With the emergence of next generation sequencing technologies (NGS), it is now possible to extensively and rapidly identify the gene profile of individual tumors. In this study, we aimed to identify actionable somatic alterations in Dukes' B and C in CRC via NGS. Targeted sequencing of 409 cancer-related genes using the Ion Ampliseq(TM) Comprehensive Cancer Panel was performed on genomic DNA obtained from paired fresh frozen tissues, cancer and normal, of Dukes' B (n = 10) and Dukes' C (n = 9) CRC. The sequencing results were analyzed using Torrent Suite, annotated using ANNOVAR and validated using Sanger sequencing. A total of 141 somatic non-synonymous sequence variations were identified in 86 genes. Among these, 64 variants (45%) were predicted to be deleterious, 38 variants (27%) possibly deleterious while the other 39 variants (28%) have low or neutral protein impact. Seventeen genes have alterations with frequencies of ≥10% in the patient cohort and with 14 overlapped genes in both Dukes' B and C. The adenomatous polyposis coli gene (APC) was the most frequently altered gene in both groups (n = 6 in Dukes' B and C). In addition, TP53 was more frequently altered in Dukes' C (n = 7) compared to Dukes' B (n = 4). Ten variants in APC, namely p.R283(∗), p.N778fs, p.R805(∗), p.Y935fs, p.E941fs, p.E1057(∗), p.I1401fs, p.Q1378(∗), p.E1379(∗), and p.A1485fs were predicted to be driver variants. APC remains as the most frequently altered gene in the intermediate stages of CRC. Wnt signaling pathway is the major affected pathway followed by P53, RAS, TGF-β, and PI3K signaling. We reported the alteration profiles in each of the patient which has the potential to affect the clinical decision. We believe that this study will add further to the understanding of CRC molecular landscape.
Adaption, translation and validation of the Diabetes Mellitus in the Offspring Questionnaire (DMOQ): The Malay version

Sham SF, Ramli AS, Isa MR, Han YW, Whitford DL

Med J Malaysia, 2018 02;73(1):16-24.
PMID: 29531198 MyJurnal

BACKGROUND: The Diabetes Mellitus in the Offspring Questionnaire (DMOQ) assesses the perceptions of Type 2 diabetes mellitus (T2DM) patients on the risk of their offspring developing T2DM and the possibility of intervention to reduce this risk. It has 34 items framed within seven domains. This study aimed to adapt, translate and validate the DMOQ from English into the Malay language.
METHODS: This was a cross-sectional validation study among 159 T2DM patients attending a public primary care clinic in Selangor. The DMOQ English version underwent adaptation, translation, face validation and field testing to produce the Malay version. Psychometric analysis was performed using Exploratory Factor Analysis, internal consistency and testretest reliability.
RESULTS: The DMOQ domains were conceptually equivalent between English and Malay language. A total of 13 items and two domains were removed during the validation process (three items during the content validation, three items due to poor factor loadings, five items as they loaded onto two domains which were not interpretable, one item as it did not fit conceptually into the factor it loaded onto and one openended question as it did not fit into the retained domains). Therefore, the final DMOQ Malay version consisted of 21- items within five domains. The Cronbach alpha was 0.714 and the intraclass-correlation coefficient was 0.868.
CONCLUSION: The DMOQ Malay version is a valid and reliable tool which is consistent over time. It can be used to examine the perception of T2DM patients towards the risk of their offspring developing diabetes and possibility of intervention in Malay-speaking patients.

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