MyMedR

Displaying publications 21 - 33 of 33 in total

Abstract:

Sort:

Fulltext The Islamic Perspectives of Gender-Related Issues in the Management of Patients With Disorders of Sex Development

Zainuddin AA, Mahdy ZA

Arch Sex Behav, 2017 Feb;46(2):353-360.
PMID: 27102604 DOI: 10.1007/s10508-016-0754-y

In Islam, the person with somatic sex ambiguity due to a disorder of sex development (DSD), such as 46,XX congenital adrenal hyperplasia or 46,XY androgen insensitivity, is recognized as khunsa. Two types of khunsa are distinguished: wadhih (discernible) and musykil (intractable). A recent fatwa (religious edict) in Malaysia decreed that it is permissible for male-assigned patients from these two groups to have gender reassignment surgery to female following diagnosis; however, the religious authority has yet to rule on the reassignment from female to male, if requested. The different schools of law in Islam agree on some aspects of gender-related issues like the position of khunsa in prayer congregations, but differ in their opinions on others such as property inheritance and bathing rituals. For purposes of illustration, this article includes three case reports on Muslim patients with DSD in Malaysia, focusing on issues of gender assignment: (1) a patient with 46,XX CAH, assigned as female, requesting reassignment to male; (2) a patient with 46,XX CAH, assigned female, and gender dysphoric, but undecided on the gender to be; and (3) a patient with 46,XY complete gonadal dysgenesis, raised female due to her phenotype at birth, diagnosed late, at age 18 years, and content to remain female. Gender-related issues from the perspective of Islamic jurisprudence are highlighted and discussed. To ensure holistic care, health-service providers involved in the care of Muslim patients with DSDs need to be aware of the Islamic perspectives on gender-related issues and involve expert religious authorities.
Fulltext Abdominopelvic Tuberculosis Secondary to a Nontuberculous Mycobacterium in an Immunocompetent Patient

Ng BK, Yakob KA, Ng WYL, Lim PS, Abd Rahman R, Abdul Karim AK, et al.

Case Rep Med, 2017;2017:9016782.
PMID: 29259630 DOI: 10.1155/2017/9016782

Tuberculosis (TB) remained as one of the top 10 causes of death worldwide despite an overall decline in its incidence rate globally. Extrapulmonary TB is uncommon and only accounts for 10-20% of overall TB disease burden. Abdominopelvic TB is the sixth most common location of extrapulmonary TB. The symptoms and signs are often insidious and nonspecific. Diagnosing abdominopelvic TB can be very challenging at times and poses great difficulties to the clinician. Infection with nontuberculous Mycobacterium (NTM) is even rarer especially in an immunocompetent patient. We report a case of NTM in abdominopelvic TB. A 37-year-old foreign worker, para 3, presented with a one-week history of suprapubic pain associated with fever. An assessment showed presence of a right adnexal mass. She was treated as tuboovarian abscess with intravenous antibiotics. Unfortunately, she did not respond. She underwent exploratory laparotomy. Intraoperatively, features of the mass were suggestive of a right mature cystic teratoma with presence of slough and cheesy materials all over the abdominal cavity as well as presence of ascites. Diagnosis of NTM was confirmed with PCR testing using the peritoneal fluid. This case was a diagnostic dilemma due to the nonspecific clinical presentation. Management of such rare infection was revisited.
Fulltext Anti N-Methyl-D-Aspartate receptor encephalitis with ovarian teratoma: a dilemma in diagnosis

Lee, CL, Zainuddin AA, Abdul Karim AK, Yulianty A, Law, ZK, Md.Isa N, et al.

Journal of Surgical Academia, 2016;6(1):66-69.
MyJurnal

We report a rare case of altered mental status in a young patient with immature ovarian teratoma. A 22-year-old woman presented with seizures, hallucination, amnesia and orofacial dyskinesia. Examination and investigation revealed an ovarian massand asalphing-oophorectomy was performed. The histopathological examination result showed an immature teratoma grade 2 with thepresence of immature primitive glial tissue. Her CSF N-Methyl-D-Aspartic acid receptor (Anti-NMDAR) antibodytest was positive. N-Methyl-D-Aspartic acid receptor antibody associated limbic encephalitis is an autoimmune antibody-mediated neuropsychiatric disorder. Resection of the tumour and immunotherapy resulted in full recovery.
Update on the management of ovarian torsion in children and adolescents

Nur Azurah AG, Zainol ZW, Zainuddin AA, Lim PS, Sulaiman AS, Ng BK

World J Pediatr, 2015 Feb;11(1):35-40.
PMID: 25557598 DOI: 10.1007/s12519-014-0536-3

Ovarian torsion is commonly seen in young girls. Unfortunately it is often misdiagnosed because of its non-specific symptoms and lack of diagnostic modalities. This article focuses on the diagnostic challenge and also the changes in the management of ovarian torsion.
Factors associated with physical inactivity among school-going adolescents: data from the Malaysian School-Based Nutrition Survey 2012

Baharudin A, Zainuddin AA, Manickam MA, Ambak R, Ahmad MH, Naidu BM, et al.

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):27S-35S.
PMID: 25070696 DOI: 10.1177/1010539514543682

The importance of physical activity to health is well recognized. Good health habits should begin from a young age. This article aims to explore physical activity among Malaysian school adolescents and factors associated with it. Data from the Malaysian School-Based Nutrition Survey (MSNS), comprising a nationally representative sample of school-going children aged 10 to 17 years, were used. The overall prevalence of physically inactive adolescents was 57.3%. Age in years (adjusted odds ratio = 1.2; 95% confidence interval = 1.16-1.23), gender - females (adjusted odds ratio = 2.9; 95% confidence interval = 2.66-3.10), afternoon school session, breakfast consumption (no breakfast and irregular breakfast), body mass index status (obese and underweight), and body weight perception (underweight perceivers) were significant factors associated with physical inactivity among Malaysian adolescents. Thus, there is evidence that programs to promote physical activity in this group should consider the combination of the aforementioned factors at the household, school, and community levels.
Self-perception of body weight status and weight control practices among adolescents in Malaysia

Zainuddin AA, Manickam MA, Baharudin A, Omar A, Cheong SM, Ambak R, et al.

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):18S-26S.
PMID: 25070695 DOI: 10.1177/1010539514542422

The prevalence of overweight and obesity among adolescents is rising rapidly in many countries, including Malaysia. This article aims to present the associations between body mass index-based body weight status, body weight perception, and weight control practices among adolescents in Malaysia. The Malaysia School Based Nutrition Survey 2012, which included a body weight perception questionnaire and anthropometric measurements, was conducted on a representative sample of 40 011 students from Standard 4 until Form 5, with a 90.5% response rate. Comparing actual and perceived body weight status, the findings show that 13.8% of adolescents underestimated their weight, 35.0% overestimated, and 51.2% correctly judged their own weight. Significantly more normal weight girls felt they were overweight, whereas significantly more overweight boys perceived themselves as underweight. The overall appropriateness of weight control practices to body weight was 72.6%. Adolescents attempting to lose or gain weight need to have better understanding toward desirable behavioral changes.
Optimal waist circumference cut-off values for predicting cardiovascular risk factors in a multi-ethnic Malaysian population

Cheong KC, Ghazali SM, Hock LK, Yusoff AF, Selvarajah S, Haniff J, et al.

Obes Res Clin Pract, 2014 Mar-Apr;8(2):e154-62.
PMID: 24743011 DOI: 10.1016/j.orcp.2013.03.004

INTRODUCTION: Previous studies have proposed the lower waist circumference (WC) cutoffs be used for defining abdominal obesity in Asian populations.
OBJECTIVE: To determine the optimal cut-offs of waist circumference (WC) in predicting cardiovascular (CV) risk factors in the multi-ethnic Malaysian population.
METHODS: We analysed data from 32,703 respondents (14,980 men and 17,723 women) aged 18 years and above who participated in the Third National Health and Morbidity Survey in 2006. Gender-specific logistic regression analyses were used to examine associations between WC and three CV risk factors (diabetes mellitus, hypertension, and hypercholesterolemia). The Receiver Operating Characteristic (ROC) curves were used to determine the cut-off values of WC with optimum sensitivity and specificity for detecting these CV risk factors.
RESULTS: The odds ratio for having diabetes mellitus, hypertension, and hypercholesterolemia, or at least one of these risks, increased significantly as the WC cut-off point increased. Optimal WC cut-off values for predicting the presence of diabetes mellitus, hypertension, hypercholesterolemia and at least one of the three CV risk factors varied from 81.4 to 85.5 cm for men and 79.8 to 80.7 cm for women.
CONCLUSIONS: Our findings indicate that WC cut-offs of 81 cm for men and 80 cm for women are appropriate for defining abdominal obesity and for recommendation to undergo cardiovascular risk screening and weight management in the Malaysian adult population.
Study name: National Health and Morbidity Survey (NHMS-2006)
Research on quality of life in female patients with congenital adrenal hyperplasia and issues in developing nations

Zainuddin AA, Grover SR, Shamsuddin K, Mahdy ZA

J Pediatr Adolesc Gynecol, 2013 Dec;26(6):296-304.
PMID: 23507003 DOI: 10.1016/j.jpag.2012.08.004

Congenital adrenal hyperplasia (CAH) is the commonest cause of ambiguous genitalia for female newborns and is one of the conditions under the umbrella term of "Disorders of Sex Development" (DSD). Management of these patients require multidisciplinary collaboration and is challenging because there are many aspects of care, such as the most appropriate timing and extent of feminizing surgery required and attention to psychosexual, psychological, and reproductive issues, which still require attention and reconsideration, even in developed nations. In developing nations, however, additional challenges prevail: poverty, lack of education, lack of easily accessible and affordable medical care, traditional beliefs on intersex, religious, and cultural issues, as well as poor community support. There is a paucity of long-term outcome studies on DSD and CAH to inform on best management to achieve optimal outcome. In a survey conducted on 16 patients with CAH and their parents in a Malaysian tertiary center, 31.3% of patients stated poor knowledge of their condition, and 37.5% did not realize that their medications were required for life. This review on the research done on quality of life (QOL) of female patients with CAH aims: to discuss factors affecting QOL of female patients with CAH, especially in the developing population; to summarize the extant literature on the quality of life outcomes of female patients with CAH; and to offer recommendations to improve QOL outcomes in clinical practice and research.
Optimal BMI cut-off values for predicting diabetes, hypertension and hypercholesterolaemia in a multi-ethnic population

Cheong KC, Yusoff AF, Ghazali SM, Lim KH, Selvarajah S, Haniff J, et al.

Public Health Nutr, 2013 Mar;16(3):453-9.
PMID: 22647482 DOI: 10.1017/S1368980012002911

OBJECTIVE: To determine the optimal cut-offs of BMI for Malaysian adults.
DESIGN: Population-based, cross-sectional study. Receiver operating characteristic curves were used to determine the cut-off values of BMI with optimum sensitivity and specificity for the detection of three cardiovascular risk factors: diabetes mellitus, hypertension and hypercholesterolaemia. Gender-specific logistic regression analyses were used to examine the association between BMI and these cardiovascular risk factors.
SETTING: All fourteen states in Malaysia.
SUBJECTS: Malaysian adults aged ≥18 years (n 32 703) who participated in the Third National Health and Morbidity Survey in 2006.
RESULTS: The optimal BMI cut-off value for predicting the presence of diabetes mellitus, hypertension, hypercholesterolaemia or at least one of these cardiovascular risk factors varied from 23.3 to 24.1 kg/m2 for men and from 24.0 to 25.4 kg/m2 for women. In men and women, the odds ratio for having diabetes mellitus, hypertension, hypercholesterolaemia or at least one cardiovascular risk factor increased significantly as BMI cut-off point increased.
CONCLUSIONS: Our findings indicate that BMI cut-offs of 23.0 kg/m2 in men and 24.0 kg/m2 in women are appropriate for classification of overweight. We suggest that these cut-offs can be used by health professionals to identify individuals for cardiovascular risk screening and weight management programmes.
Diagnostic pitfalls in the evaluation and management of amenorrhea in adolescents

Azurah AG, Zainuddin AA, Jayasinghe Y

J Reprod Med, 2013 Jul-Aug;58(7-8):324-36.
PMID: 23947083

Amenorrhea is a common menstrual problem seen in adolescents. Amenorrhea has been shown to have a negative impact on adolescents' quality of life. In this paper we discuss the various causes and investigations of amenorrhea in adolescents and address management dilemmas for specific conditions. Specific approaches in dealing with adolescents using the HEADSS (Home, Education, Activity, Drugs, Sexual activity, Suicidal) approach are discussed.
Fulltext Iodine deficiency status and iodised salt consumption in Malaysia: findings from a national iodine deficiency disorders survey

Selamat R, Mohamud WN, Zainuddin AA, Rahim NS, Ghaffar SA, Aris T

Asia Pac J Clin Nutr, 2010;19(4):578-85.
PMID: 21147721

A nationwide cross-sectional school-based survey was undertaken among children aged 8-10 years old to determine the current iodine deficiency status in the country. Determination of urinary iodine (UI) and palpation of the thyroid gland were carried out among 18,012 and 18,078 children respectively while iodine test of the salt samples was done using Rapid Test Kits and the iodometric method. The results showed that based on WHO/ ICCIDD/UNICEF criteria, the national median UI was 109 μg/L [25th, 75th percentile (67, 166)] showing borderline adequacy. The overall national prevalence of iodine deficiency disorders (IDD) with UI<100 μg/L was 48.2% (95% CI: 46.0, 50.4), higher among children residing in rural areas than in urban areas. The highest prevalence of UI<100 μg/L was noted among the aborigines [(81.4% (95% CI: 75.1, 86.4)]. The national total goitre rate (grade 1 and grade 2 goitre) was 2.1%. Of 17,888 salt samples brought by the school children, 28.2% (95% CI: 26.4, 30.2) were found to have iodine content. However, the overall proportion of the households in Malaysia using adequately iodised salt as recommended by Malaysian Food Act 1983 of 20-30 ppm was only 6.8% (95% CI: 5.1, 9.0). In conclusion, although a goitre endemic was not present in Malaysia, almost half of the states in Peninsular Malaysia still have large proportion of UI level <100 μg/L and warrant immediate action. The findings of this survey suggest that there is a need for review on the current approach of the national IDD prevention and control programme.
Carbetocin versus syntometrine in prevention of post-partum hemorrhage following vaginal delivery

Nirmala K, Zainuddin AA, Ghani NA, Zulkifli S, Jamil MA

J Obstet Gynaecol Res, 2009 Feb;35(1):48-54.
PMID: 19215547 DOI: 10.1111/j.1447-0756.2008.00829.x

To compare the efficacy of a single dose of 100 microg intramuscular carbetocin to a single dose of intramuscular syntometrine (0.5 mg ergometrine and 5IU oxytocin), in preventing post-partum hemorrhage (PPH) in high risk patients following vaginal delivery.
Mother with post-partum group B Streptococcus meningitis and cerebellar abscess

Ghani NA, Jaafar R, Ishak S, Zainuddin AA, Mukari SA, Mahdy ZA

J Obstet Gynaecol Res, 2007 Apr;33(2):195-8.
PMID: 17441895

We report the case of a 25-year-old Malay woman, admitted for preterm delivery at 35 weeks' gestation. Vaginal swab did not isolate any organism. She delivered a baby girl who developed respiratory distress syndrome, requiring ventilation. Although chest radiograph showed hyaline membrane disease with pneumonia, septic workout was negative. The mother was discharged on the next day. Seven days postpartum, the mother presented with fever and fits and was diagnosed to have meningo-encephalitis. Lumbar puncture isolated group B Streptococcus (GBS) and MRI revealed a superior cerebellar abscess. She was treated and survived the episode. This case illustrates the uncommon situation where GBS infection was confirmed via maternal septic workout rather than neonatal, although both presented with severe disease.

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links