METHOD: This was an unmatched case-control study in which children with ASD were recruited from an autism early intervention center and typically developed (TD) children were recruited from government-run nurseries and preschools. Urine samples were collected at home, assembled temporarily at study locations, and transported to the laboratory within 24 h. The Al concentration in the children's urine samples was determined using inductively coupled plasma mass spectrometry (ICP-MS).
RESULT: A total of 155 preschool children; 81 ASD children and 74 TD children, aged 3 to 6 years, were enlisted in the study. This study demonstrated that ASD children had significantly higher urinary Al levels than TD children (median (interquartile range (IQR): 2.89 (6.77) µg/dL versus 0.96 (2.95) µg/dL) (p 1, p Malaysia.
METHODS: This is a cross-sectional study design, and a survey was conducted from May to July 2018 among general public in Kuantan, Pahang state, Malaysia.
RESULTS: A total of 393 respondents recruited. Slightly more than one-fourth of the respondents (26.35%) were aware of HA symptoms like pain and/or discomfort in the jaw, neck, or back, while 71.65% showed awareness only of chest pain or discomfort as symptoms. Only 35.6% reported to call an ambulance if they experience someone suffering from HA symptoms, while 82% recognized ≥1 symptom, and only 11.5% recognized all five HA symptoms. Very few respondents, i.e., 1.3% reported awareness about correct recognition of all five HA symptoms. Respondents who had diabetes and hypercholesteremia were more likely to recognize all five HA symptoms. For those who had excellent awareness of all five HA symptoms, the odds ratio (OR) were significantly higher among single respondents (OR 0.023; 95% CI 0.001-0.594), Malay (OR 0.376; 95% CI 0.193-0.733), and those who received information associated with HA (OR 7.540; 95% CI 2.037-27.914). However, those who were aware that HA requires quick treatment had significantly low odds ratio (OR 0.176; 95% CI 0.044-0.710).
CONCLUSIONS: The awareness of and action towards the signs and symptoms of HA among the public were poor.
METHODS: A pragmatic healthcentre-based cluster randomised controlled trial-within trial on 151 post stroke patients from 10 public primary care facilities in Peninsular Malaysia was conducted to evaluate QALY of patients managed with iCaPPS© (n = 86) vs conventional care (n = 65) for 6 months. Costs from societal perspective were calculated, using combination of top down and activity-based costing methods. The 5-level EQ5D (EQ-5D-5 L) was used to calculate health state utility scores. Cost per QALY and incremental cost effectiveness ratio (ICER) were determined. Differences within groups were determined using Mann-Whitney tests.
RESULTS: Total costs for 6 months treatment with iCaPPS© was MYR790.34, while conventional care cost MYR527.22. Median QALY for iCaPPS© was 0.55 (0,1.65) compared to conventional care 0.32 (0, 0.73) (z = - 0.21, p = 0.84). Cost per QALY for iCaPPS© was MYR1436.98, conventional care was MYR1647.56. The ICER was MYR1144.00, equivalent to 3.7% of per capita GDP (2012 prices).
CONCLUSIONS: Management of post stroke patients in the community using iCaPPS© costs less per QALY compared to current conventional care and is very cost effective.
TRIAL REGISTRATION: Trial Registration number ACTRN12616001322426. Registered 21 September 2016. (Retrospectively registered).
METHODOLOGY: A cross-sectional two-phase study was carried out to develop the scale. In phase 1, a preliminary parent-report measure questionnaire was developed in Bahasa Malaysia. Later, it was sent to four experts for content validity followed by face validity. In Phase 2, a total of 386 parents of pre-school children aged 4 to 6 years old, split into two samples, were involved in the field study for exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).
RESULT: Sample 1 was used to perform EFA to determine the factorial structure of the SDS. All items with a factor loading of >0.4 were included. Sample 2 was used to perform the CFA. RMSEA and CFI analysis showed that the SDS has a good fit and confirms the dimensional structure found via EFA. The final questionnaire consists of 15 items with a 4 factors' structure and has excellent internal consistency reliability.
CONCLUSIONS: The Screen Dependency Scale (SDS) is a reliable and valid questionnaire to detect screen dependency among pre-school children aged 4 to 6 years old in Malaysia.
METHODS: A cross-sectional study was conducted among randomly selected group of 450 parents using a self-administered questionnaire. Optimum utilization of the book was defined as respondents reading all sections and recording comments in the book. Independent variables studied were sociodemographic characteristics; antenatal and breastfeeding history; child health and immunization status; perceptions and level of knowledge on the book and child health; and healthcare providers' performance. A multiple logistic regression analysis was used to identify the associated factors of optimum utilization.
RESULTS: Out of 450 study participants, 415 completed the questionnaire and 150 (36.1%) were found to optimally utilized the book. Participants who read all sections totalled 245 (59.0%), and 242 (58.3%) respondents reported to record some comments in the book. Optimum utilization of the book was associated with older parents' age (adjusted odds ratio [AOR]: 1.06, 95% confidence interval [CI] 1.01-1.11) and higher education attainment (AOR: 2.21, 95% CI 1.24-3.91), with a good level of knowledge on child health record books and general child health (AOR: 3.87, 95% CI 2.27-6.61; AOR: 2.05, 95% CI 1.25-3.36) and among parents who delivered their children in government hospitals (AOR: 2.93, 95% CI 1.11-7.73).
CONCLUSIONS: The prevalence of child health record book utilization was low at 36.1% but difficult to compare with other studies. Based on the findings, improving the parents' knowledge of the book and general child health, particularly among younger parents with lower educational levels, and delivering the book to institutions outside government hospitals might be useful to increase the utilization.
Design: Prospective exploratory study of infants born at <34 weeks gestational age (GA).
Setting: Two neonatal units, one in Malaysia and one in the UK (May 2019 to March 2020).
Methods: Data collected from birth until discharge and compared between units.
Results: From 100 infants included, median GA (IQR) was 31 (30-33) and mean±SD birth weight was 1549±444 g. There were more small-for-gestational age infants in Malaysian unit: 12/50 (24%) vs UK: 3/50 (6%), p=0.012 and more morbidities. More Malaysian infants received breast milk (Malaysia: 49 (98%) vs UK: 38 (76%), p=0.001), fortified breast milk (Malaysia: 43 (86%) vs UK: 13 (26%), p<0.001) and exclusive breast milk at discharge (Malaysia: 26 (52%) vs UK: 16 (32%), p=0.043). There was higher parenteral nutrition use among Malaysian infants (40/50 (80%)) vs UK (19/50 (38%)) (p<0.001) with higher protein intake (mean±SD Malaysia: 3.0±0.5 vs UK: 2.7±0.6 g/kg/d, p=0.004) in weeks 1-4 and smaller cumulative protein deficits (mean±SD Malaysia: 11.4±6.1 vs UK: 15.4±8.0 g/kg, p=0.006). There were no significant differences in short-term growth between units and more than half of the infants in both units had ≥1.28 changes in weight-for-age Z-score at discharge (p=0.841).
Conclusions: An exploratory comparison of practices showed differences in patient characteristics and nutritional practices which impacted growth. Future studies with larger sample sizes and detailed analysis of maternal characteristics and infants' outcomes are needed for improving care of preterm infants in all settings.