Displaying publications 21 - 40 of 956 in total

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  1. Fulltext Varicella-zoster virus seroprevalence in healthcare workers in Kuala Lumpur, Malaysia
    Sam IC, Tariman H, Chan YF, Bador MK, Yusof MY, Hassan H
    Med J Malaysia, 2008 Dec;63(5):429-30.
    PMID: 19803311 MyJurnal
    Varicella-zoster virus (VZV) infections are a particular problem in healthcare settings. A survey of chickenpox was carried out amongst healthcare workers (HCWs) following potential ward exposures. A prior history of chickenpox was given by 61/98 (62.2%). Of 64 HCWs tested for VZV IgG, 10 (15.6%) were seronegative, indicating susceptibility. The sensitivity, specificity, positive predictive value, and negative predictive value of a history of prior chickenpox were 57.4%, 90%, 96.4%, and 31.0%, respectively. VZV screening of HCWs without a history of chickenpox, and vaccination of susceptible HCWs should be undertaken in this hospital.
    Matched MeSH terms: Hospitals, University/statistics & numerical data
  2. Fulltext Value of Shock Index in prognosticating the short-term outcome of death for patients presenting with severe sepsis and septic shock in the emergency department
    Yussof SJM, Zakaria MI, Mohamed FL, Bujang MA, Lakshmanan S, Asaari AH
    Med J Malaysia, 2012 Aug;67(4):406-11.
    PMID: 23082451
    INTRODUCTION: The importance of early recognition and treatment of sepsis and its effects on short-term survival outcome have long been recognized. Having reliable indicators and markers that would help prognosticate the survival of these patients is invaluable and would subsequently assist in the course of effective dynamic triaging and goal directed management.
    STUDY OBJECTIVES: To determine the prognosticative value of Shock Index (SI), taken upon arrival to the emergency department and after 2 hours of resuscitation on the shortterm outcome of severe sepsis and septic shock patients.
    METHODOLOGY: This is a retrospective observational study involving 50 patients admitted to the University of Malaya Medical Centre between June 2009 and June 2010 who have been diagnosed with either severe sepsis or septic shock. Patients were identified retrospectively from the details recorded in the registration book of the resuscitation room. 50 patients were selected for this pilot study. The population comprised 19 males (38%) and 31 females (62%). The median (min, max) age was 54.5 (17.0, 84.0) years. The number of severe sepsis and septic shock cases were 31 (62%), and 19 (38%) respectively. There were 17 (34%) cases of pneumonias, 13 (26%) cases of urological sepsis, 8 (16%) cases of gastro intestinal tract related infections and 12 (24%) cases of other infections. There were a total of 23 (46%) survivors and 27 (54%) deaths. The value of the shock index is defined as systolic blood pressure divided by heart rate was calculated. Shock Index on presentation to ED (SI 1) and after 2 hours of resuscitation in the ED (SI 2). The median, minimum and maximum variables were tested using Mann-Whitney U and Chi square analysis. The significant parameters were re-evaluated for sensitivity, specificity and cut-off points. ROC curves and AUC values were generated among these variables to assess prognostic utility for outcome.
    RESULTS: Amongst all 7 variables tested, 2 were tested to be significant (p: < 0.05). From the sensitivity, specificity and ROC analysis, the best predictor for death was (SI 2) with a sensitivity of 80.8%, specificity of 79.2%, AUC value of 0.8894 [CI 95 0.8052, 0.9736] at a cut-off point of > or = 1.0.
    CONCLUSION: (SI 2) may potentially be utilized as a reliable predictor for death in patients presenting with septic shock and severe sepsis in an emergency department. This parameters should be further analyzed in a larger scale prospective study to determine its validity.
    Matched MeSH terms: Hospitals, University
  3. Fulltext Validity and reliability of the Malay version of the Structured Migraine Interview (SMI) Questionnaire
    Shaik MM, Hassan NB, Tan HL, Bhaskar S, Gan SH
    J Headache Pain, 2015 Mar 14;16:22.
    PMID: 25903056 DOI: 10.1186/s10194-015-0509-5
    BACKGROUND: The Structured Migraine Interview (SMI) is a valid and reliable instrument for migraine diagnosis. However, a Malay version of the SMI is not available to be applied to the local Malaysian population. This study was designed to access the validity and reliability of a new Malay version of the SMI questionnaire.
    METHODS: Patients with headache attending the Neurology Clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, were screened against the inclusion/exclusion criteria before recruitment. A standard translation procedure was used to translate and adapt the questionnaire into the Malay language. The translated version was tested for face, content and construct validities. Subsequently, validity and reliability studies were conducted (1(st) compilation), followed by retesting seven days later (2(nd) compilation).
    RESULTS: A total of 157 patients between 15 and 60 years of age were enrolled in this study. The kappa value was 0.70 (p 
    Matched MeSH terms: Hospitals, University
  4. Fulltext Validity and reliability of the Malay version of Sleep Apnea Quality of Life Index--preliminary results
    Saddki N, Mohamad H, Mohd Yusof NI, Mohamad D, Mokhtar N, Wan Bakar WZ
    Health Qual Life Outcomes, 2013 Jun 20;11:100.
    PMID: 23786866 DOI: 10.1186/1477-7525-11-100
    BACKGROUND: The objective of this study was to determine the validity and reliability of the Malay translated Sleep Apnea Quality of Life Index (SAQLI) in patients with obstructive sleep apnea (OSA).

    METHODS: In this cross sectional study, the Malay version of SAQLI was administered to 82 OSA patients seen at the OSA Clinic, Hospital Universiti Sains Malaysia prior to their treatment. Additionally, the patients were asked to complete the Malay version of Medical Outcomes Study Short Form (SF-36). Twenty-three patients completed the Malay version of SAQLI again after 1-2 weeks to assess its reliability.

    RESULTS: Initial factor analysis of the 40-item Malay version of SAQLI resulted in four factors with eigenvalues >1. All items had factor loadings >0.5 but one of the factors was unstable with only two items. However, both items were maintained due to their high communalities and the analysis was repeated with a forced three factor solution. Variance accounted by the three factors was 78.17% with 9-18 items per factor. All items had primary loadings over 0.5 although the loadings were inconsistent with the proposed construct. The Cronbach's alpha values were very high for all domains, >0.90. The instrument was able to discriminate between patients with mild or moderate and severe OSA. The Malay version of SAQLI correlated positively with the SF-36. The intraclass correlation coefficients for all domains were >0.90.

    CONCLUSIONS: In light of these preliminary observations, we concluded that the Malay version of SAQLI has a high degree of internal consistency and concurrent validity albeit demonstrating a slightly different construct than the original version. The responsiveness of the questionnaire to changes in health-related quality of life following OSA treatment is yet to be determined.

    Matched MeSH terms: Hospitals, University
  5. Fulltext Validity and reliability of the Malay version of 12-item short form health survey among postpartum mothers
    Norhayati Mohd Noor, Aniza Abd Aziz
    Malaysian Journal of Public Health Medicine, 2014;14(2):56-66.
    MyJurnal
    The Short Form Health Survey SF-36 is a well-known generic health-related quality of life measure that has widely been used worldwide. However, given the cultural, social and ethnic differences in some countries, it might not follow the intended structure of the instrument. Hence, this study aims to determine the psychometric properties of the Malay version of Short Form Health Survey (SF-12) among postpartum mothers. A cross-sectional study was conducted among 1-month postpartum mothers attending Obstetric and Gynecology clinic, Universiti Sains Malaysia Hospital, Kelantan, Malaysia. Reliability was estimated using internal consistency and the factor structure was extracted by performing confirmatory factor analysis using SPSS v. 20 and AMOS v. 20. A total of 108 women responded. The mean (SD) score for the Physical Component Summary (PCS) score and Mental Component Summary (MCS) score were 43.3 (7.08) and 42.4 (6.87) respectively. The Cronbach alpha for PCS-12 was 0.749 and MCS-12 was 0.701. Spearman correlations of individual items and the SF-12 component summary scores showed PF, RP, BP and GH items correlated higher with the PCS score, whereas the VT, SF, RE, and MH items correlated higher with the MCS score lending support to its good convergent validity. The confirmatory factor solution showed final model with two factors structure and six items each with acceptable factor loadings, satisfactory absolute and parsimonious fitness (RMSEA=0.1, x2/df=2.4). The psychometric tests of the Malay version of SF-12 generally showed acceptable validity and reliability among postpartum women.
    Study site: Obstretic and gynecology Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Hospitals, University
  6. Validation study of the Mini-Mental State Examination in a Malay-speaking elderly population in Malaysia
    Ibrahim NM, Shohaimi S, Chong HT, Rahman AH, Razali R, Esther E, et al.
    Dement Geriatr Cogn Disord, 2009;27(3):247-53.
    PMID: 19246909 DOI: 10.1159/000203888
    BACKGROUND/AIMS: In view of the differing sensitivity and specificity of the Mini-Mental State Examination (MMSE) in the non-English-speaking populations, we conducted the first validation study of the Malay version (M-MMSE) in Malaysia among 300 subjects (from the community and outpatient clinics).
    METHODS: Three versions were used: M-MMSE-7 (serial 7), M-MMSE-3 (serial 3) and M-MMSE-S (spell 'dunia' backwards). Dementia was assessed using the criteria of the Diagnostic and Statistical Manual of Mental Disorders IV. The optimal cutoff scores were obtained from the receiver operating characteristics curves.
    RESULTS: Seventy-three patients (24.3%) had dementia and 227 (75.7%) were controls. Three hundred patients completed the M-MMSE-7, 160 the M-MMSE-3 and 145 the M-MMSE-S. All 3 versions were valid and reliable in the diagnosis of dementia. The optimal cutoff scores varied with each version and gender. In the control group, significant gender differences were observed in the patients with the lowest educational status. Increasing educational levels significantly improved the M-MMSE performance in both genders.
    CONCLUSION: All 3 versions of the M-MMSE are valid and reliable as a screening tool for dementia in the Malaysian population, but at different cutoff scores. In those with the lowest educational background, gender-adjusted cutoff scores should be applied.
    Study site: Community, neurology and dementia outpatient clinics, Perubatan Universiti Kebangsaan Malaysia (PPUKM), University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Hospitals, University
  7. Fulltext Validation of the pooled cohort risk score in an Asian population - a retrospective cohort study
    Chia YC, Lim HM, Ching SM
    BMC Cardiovasc Disord, 2014 Nov 20;14:163.
    PMID: 25410585 DOI: 10.1186/1471-2261-14-163
    BACKGROUND: The Pooled Cohort Risk Equation was introduced by the American College of Cardiology (ACC) and American Heart Association (AHA) 2013 in their Blood Cholesterol Guideline to estimate the 10-year atherosclerotic cardiovascular disease (ASCVD) risk. However, absence of Asian ethnicity in the contemporary cohorts and limited studies to examine the use of the risk score limit the applicability of the equation in an Asian population. This study examines the validity of the pooled cohort risk score in a primary care setting and compares the cardiovascular risk using both the pooled cohort risk score and the Framingham General Cardiovascular Disease (CVD) risk score.
    METHODS: This is a 10-year retrospective cohort study of randomly selected patients aged 40-79 years. Baseline demographic data, co-morbidities and cardiovascular (CV) risk parameters were captured from patient records in 1998. Pooled cohort risk score and Framingham General CVD risk score for each patient were computed. All ASCVD events (nonfatal myocardial infarction, coronary heart disease (CHD) death, fatal and nonfatal stroke) occurring from 1998-2007 were recorded.
    RESULTS: A total of 922 patients were studied. In 1998, mean age was 57.5 ± 8.8 years with 66.7% female. There were 47% diabetic patients and 59.9% patients receiving anti-hypertensive treatment. More than 98% of patients with pooled cohort risk score ≥7.5% had FRS >10%. A total of 45 CVD events occurred, 22 (7.2%) in males and 23 (3.7%) in females. The median pooled cohort risk score for the population was 10.1 (IQR 4.7-20.6) while the actual ASCVD events that occurred was 4.9% (45/922). Our study showed moderate discrimination with AUC of 0.63. There was good calibration with Hosmer-Lemeshow test χ2 = 12.6, P = 0.12.
    CONCLUSIONS: The pooled cohort risk score appears to overestimate CV risk but this apparent over-prediction could be a result of treatment. In the absence of a validated score in an untreated population, the pooled cohort risk score appears to be appropriate for use in a primary care setting.
    Matched MeSH terms: Hospitals, University
  8. Validation of the Schizophrenia Quality of Life Scale Revision 4 among chronic schizophrenia patients in Malaysia
    Taha NA, Ibrahim MI, Rahman AF, Shafie AA, Rahman AH
    Value Health Reg Issues, 2012 May;1(1):82-86.
    PMID: 29702832 DOI: 10.1016/j.vhri.2012.03.006
    OBJECTIVES: To explore the validity and reliability of a disease-specific health-related quality-of-life questionnaire-the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4)-in patients with schizophrenia in Malaysia.
    METHODS: A total of 222 outpatients with schizophrenia receiving treatment at the Universiti Kebangsaan Malaysia Medical Centre completed the SQLS-R4 in either the Malay or the English language. A generic self-report health-related quality-of-life measure-the EuroQoL group EuroQol five-dimensional questionnaire-and a measure of symptom severity-the Clinical Global Impression-Schizophrenia scale-were also administered to assess validity.
    RESULTS: Good internal consistency reliability was found for both the psychosocial and vitality domains (Cronbach's α = 0.95 and 0.85, respectively). Most items were also significantly correlated with their own scale score (rs ranging from 0.29 to 0.74). There was a moderate correlation between the SQLS-R4 "vitality" domain and the EuroQol five-dimensional questionnaire "usual activities" domain (rs = 0.44) and a large correlation between the SQLS-R4 "psychosocial" domain and the EuroQol five-dimensional questionnaire "anxiety/depression" domain (rs = 0.44-0.57). Most of the symptom dimensions of the Clinical Global Impression-Schizophrenia scale were also moderately correlated with the SQLS-R4 subscale scores.
    CONCLUSIONS: The SQLS-R4 is a valid and reliable health-related quality-of-life instrument for use in minimally ill patients with schizophrenia in Malaysia, but some of the items may be redundant and irrelevant. Validation of SQLS-R4 in different types of patients and various levels of illness severity is required to further verify its application.
    Study site: Psychiatry clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  9. Fulltext Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study
    Chia YC, Gray SY, Ching SM, Lim HM, Chinna K
    BMJ Open, 2015;5(5):e007324.
    PMID: 25991451 DOI: 10.1136/bmjopen-2014-007324
    OBJECTIVE: This study aims to examine the validity of the Framingham general cardiovascular disease (CVD) risk chart in a primary care setting.
    DESIGN: This is a 10-year retrospective cohort study.
    SETTING: A primary care clinic in a teaching hospital in Malaysia.
    PARTICIPANTS: 967 patients' records were randomly selected from patients who were attending follow-up in the clinic.
    MAIN OUTCOME MEASURES: Baseline demographic data, history of diabetes and smoking, blood pressure (BP), and serum lipids were captured from patient records in 1998. Each patient's Framingham CVD score was computed from these parameters. All atherosclerotic CVD events occurring between 1998 and 2007 were counted.
    RESULTS: In 1998, mean age was 57 years with 33.8% men, 6.1% smokers, 43.3% diabetics and 59.7% hypertensive. Median BP was 140/80 mm Hg and total cholesterol 6.0 mmol/L (1.3). The predicted median Framingham general CVD risk score for the study population was 21.5% (IQR 1.2-30.0) while the actual CVD events that occurred in the 10 years was 13.1% (127/967). The median CVD points for men was 30.0, giving them a CVD risk of more than 30%; for women it is 18.5, a CVD risk of 21.5%. Our study found that the Framingham general CVD risk score to have moderate discrimination with an area under the receiver operating characteristic curve (AUC) of 0.63 [c-statistic or c-index]. It also discriminates well for Malay (AUC 0.65, p=0.01), Chinese (AUC 0.60, p=0.03), and Indians (AUC 0.65, p=0.001). There was good calibration with Hosmer-Lemeshow test χ(2)=3.25, p=0.78.
    CONCLUSIONS: Taking into account that this cohort of patients were already on treatment, the Framingham General CVD Risk Prediction Score predicts fairly accurately for men and overestimates somewhat for women. In the absence of local risk prediction charts, the Framingham general CVD risk prediction chart is a reasonable alternative for use in a multiethnic group in a primary care setting.
    Study site: Primary care clinic,University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.
    Matched MeSH terms: Hospitals, University
  10. Fulltext Validation of Malay Version of Snaith-Hamilton Pleasure Scale: Comparison between Depressed Patients and Healthy Subjects at an Out-Patient Clinic in Malaysia
    Ng CG, Chin SC, Yee AH, Loh HS, Sulaiman AH, Sherianne Sook Kuan W, et al.
    Malays J Med Sci, 2014 May;21(3):62-70.
    PMID: 25246837
    BACKGROUND: The Snaith-Hamilton Pleasure Scale (SHAPS) is a self-assessment scale designed to evaluate anhedonia in various psychiatric disorders. In order to facilitate its use in Malaysian settings, our current study aimed to examine the validity of a Malay-translated version of the SHAPS (SHAPS-M).
    METHODS: In this cross-sectional study, a total of 44 depressed patients and 82 healthy subjects were recruited from a university out-patient clinic. All participants were given both the Malay and English versions of the SHAPS, Fawcett-Clark Pleasure Scale (FCPS), General Health Questionnaire 12 (GHQ-12), and the Beck Depression Inventory (BDI) to assess their hedonic state, general mental health condition and levels of depression.
    RESULTS: The results showed that the SHAPS-M has impressive internal consistency (α = 0.96), concurrent validity and good parallel-form reliability (intraclass coefficient, ICC = 0.65).
    CONCLUSION: In addition to demonstrating good psychometric properties, the SHAPS-M is easy to administer. Therefore, it is a valid, reliable, and suitable questionnaire for assessing anhedonia among depressed patients in Malaysia.
    KEYWORDS: Malaysia; anhedonia; depression; neuroscience; pleasure; psychiatry; psychology; validation
    Study site: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  11. Validation Study of the Malay version of the Neuropsychiatric Inventory
    Rosdinom R, Ng IT, Teh EE, Norhayati A, Ng CG, Yeoh SH, et al.
    Clin Ter, 2014;165(6):287-93.
    PMID: 25524183 DOI: 10.7417/CT.2014.1770
    OBJECTIVES: There is a lack of local instruments to assess behavioural and psychological symptoms of dementia (BPSD). This 2-stage cross-sectional study was aimed at validating a Malay translated version of the Neuropsychiaric Inventory (MvNPI).

    MATERIALS AND METHODS: It was conducted on a selected group of 138 elderly outpatients with dementia and their caregivers in Hospital Pulau Pinang. Severity of dementia was assessed using the Malay-translated version of Mini Mental State Examination (MMSE). The original NPI was translated and then back-translated before it was pilot-tested. The MvNPI was administered twice, a week apart on the same caregiver by the same investigator.

    RESULTS: The individual items and total scale score of MvNPI had high internal consistency, with Corrected Item-Total Correlation ranging from satisfactory to good (0.41 to 0.77). The Cronbach's alpha for all the NPI domains showed high internal consistency (0.83), and subtotal for severity and distress scores were perfect (0.998 to 1.00). There was no significant difference between test-retest mean scores (p>0.05) and their correlations were perfect (0.996 to 1.00). Content validity indicated mild and inverse relationship between MMSE scores and severity, and distress score (-0.281 and -0.268, respectively, with p<0.001). Discriminant validity calculated using Mann-Whitney U test was found to be significant (p<0.001) in differentiating severity of cognitive impairment. Factor analysis revealed four possible components existed in MvNPI.

    CONCLUSIONS: The MvNPI is a valid and reliable tool for assessing BPSD among Malay speaking populations of Malaysia and its neighbouring South East Asian countries.

    Study site: Hospital Pulau Pinang
    Matched MeSH terms: Hospitals, University
  12. Utilization of the emergency department by older residents in Kuala Lumpur, Malaysia
    Mohd Mokhtar MA, Pin TM, Zakaria MI, Hairi NN, Kamaruzzaman SB, Vyrn CA, et al.
    Geriatr Gerontol Int, 2015 Aug;15(8):944-50.
    PMID: 25311907 DOI: 10.1111/ggi.12369
    AIM: To determine the pattern of utilization of emergency department (ED) services by older patients in Kuala Lumpur, Malaysia, compared with younger patients in the same setting.
    METHODS: The sociodemographics, clinical characteristics and resource utilization of consecutive patients attending the adult ED at the University Malaya Medical Center were recorded during a typical week.
    RESULTS: A total of 1649 patients were included in the study; 422/1649 (25.6%) were aged ≥60 years and 1077 (74.4%) were aged <60 years. Older adult patients were more likely to be diagnosed with ischemic heart disease (12.6% vs 2.5%, P 
    Matched MeSH terms: Hospitals, University
  13. Fulltext Utilization of beta blockers post-myocardial infarction
    Ong WM, Che Zuraini S, Wan Azman WA, Rajasuriar R
    Med J Malaysia, 2013;68(1):58-63.
    PMID: 23466769 MyJurnal
    Beta blockers provide both morbidity and mortality benefits for post-myocardial infarction (MI) patients. Despite this, beta blockers are still often underused or used at suboptimal dosages. This was a retrospective observational study with the objectives of estimating the proportion of post-MI patients who are receiving beta-blocker therapy in University Malaya Medical Centre (UMMC), assessing the number of them receiving beta blockers at optimal dosages and determining the factors associated with beta-blocker prescribing post-MI. Of 315 patient case notes reviewed, 77.5% were prescribed beta blockers. However, dosages were optimized in only 39.3% of patients. Reasons for not optimizing the dosages were typically not due to the presence of contraindications to beta blockers. Elderly (> 65 years old), ejection fraction (EF) < 40%, a history of cerebrovascular accident (CVA) or mild asthma, use of calcium channel blocker (CCB), digoxin or anti-asthmatic agents were all significantly associated with a reduced rate of beta-blocker prescribing post-MI. More effort should be placed in improving its use in specific patient populations. Initiatives to optimize the dosage of beta blockers to recommended dosages that matched those in clinical trials with proven mortality benefits will also need to be intensified.
    Study site: University Malaya Medical Centre, Kuala Lumpur
    Matched MeSH terms: Hospitals, University
  14. Using Non-Professional Interpreters in a Multiethnic Primary Care Clinic
    Fredericks C
    In multiethnic countries such as Malaysia more than six different languages are spoken by patients in publicly-funded clinics. Sometimes doctors are unable to speak the patient's language and there are no professional interpreters. Research on doctor-patient communication has rarely included the language variable and its impact on information exchange and patient outcome in consultations where the doctor does not speak the patient's language. The few studies carried out in linguistically plural societies show that doctors and patients can face language barriers and trained interpreters are not always available. This paper illustrates some of the problems of using untrained interpreters in a primary care setting. Consultations were audiotaped and the transcripts were used to show how messages underwent distortion, condensation, and omission in interpreter-mediated consultations. Research needs to be carried out based on a model of doctor-patient communication which reflects the realities of the multilingual consultation.
    Matched MeSH terms: Hospitals, University
  15. Fulltext Use of pressurised aerosol inhalers among patients attending the Chest Clinic and Primary Care Department of University Hospital, Kuala Lumpur
    Liam CK, Lo YL, Yap BH, Low SH, Ariwalagam M
    Med J Malaysia, 1993 Sep;48(3):273-9.
    PMID: 8183138
    Eighty consecutive patients who came to collect their prescriptions for pressurised aerosol inhalers at the Pharmacy of the University Hospital, Kuala Lumpur, were interviewed regarding their use of the pressurised inhaler. Their inhaler technique was also assessed. A significant proportion inhaled the steroid aerosol before the bronchodilator and 23.5% used the steroid inhaler for relief of acute dyspnoea. Only 28.8% of the 80 patients performed correctly all 6 steps necessary for the proper use of inhalers. The most common mistake was the failure to inhale slowly and deeply. Patients who had used the device for more than 5 years performed better, while correct inhaler technique was not dependent on the patient's sex, age or level of education.

    Study site: Chest clinic, University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Hospitals, University
  16. Fulltext Use of glycated hemoglobin (HbA(1C)) and impaired glucose tolerance in the screening of undiagnosed diabetes in the Malaysian population
    Qvist R, Ismail IS, Chinna K, Muniandy S
    Indian J Clin Biochem, 2008 Jul;23(3):246-9.
    PMID: 23105763 DOI: 10.1007/s12291-008-0055-x
    Although HbA(1C) is widely accepted as a useful index of mean blood glucose in type 2 diabetic patients its usefulness as screening test for diabetes has been controversial. The present study was undertaken to determine whether the level of HbA(1C) predicted diabetes in a prediabetic group of subjects. Plasma lipids, oral glucose tolerance, HbA(1C) was determined in 90 normal control subjects, 57 offspring of one type 2 diabetes mellitus parent and 11 diagnosed type 2 diabetes mellitus individuals. The mean age of participants was 44.5 yrs (not significantly different amongst the three groups) and the mean body mass index was 26.8 (not significantly different amongst the three groups). Two hours after a 75 g glucose challenge, the offspring had a significantly higher plasma glucose level (mean = 7.1 mmol/L, p value = 0.002) than the normals. Similarly the HbA(1C) values were higher in the offspring than in the normals (mean = 5.78%, p value = 0.016). Besides the significantly higher values for oral glucose tolerance test and HbA(1C), the diabetics also were significantly higher for triglycerides (mean = 2.25mmol/L), total cholesterol (mean = 6.24mmol/L) and systolic blood pressure (mean = 138.45mm Hg) than the offspring (P value = 0.031, 0.006, 0.010) and the normals (P value = 0.026, 0.018, 0.002) respectively. The mean values of diastolic blood pressure, LDL cholesterol and HDL cholesterol were not significantly different amongst the three groups.
    Study site: Diabetic clinic, University of Malaya Medical centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  17. Fulltext Use of chronic kidney disease to enhance prediction of cardiovascular risk in those at medium risk
    Chia YC, Lim HM, Ching SM
    PLoS One, 2015;10(10):e0141344.
    PMID: 26496190 DOI: 10.1371/journal.pone.0141344
    Based on global cardiovascular (CV) risk assessment for example using the Framingham risk score, it is recommended that those with high risk should be treated and those with low risk should not be treated. The recommendation for those of medium risk is less clear and uncertain. We aimed to determine whether factoring in chronic kidney disease (CKD) will improve CV risk prediction in those with medium risk. This is a 10-year retrospective cohort study of 905 subjects in a primary care clinic setting. Baseline CV risk profile and serum creatinine in 1998 were captured from patients record. Framingham general cardiovascular disease risk score (FRS) for each patient was computed. All cardiovascular disease (CVD) events from 1998-2007 were captured. Overall, patients with CKD had higher FRS risk score (25.9% vs 20%, p = 0.001) and more CVD events (22.3% vs 11.9%, p = 0.002) over a 10-year period compared to patients without CKD. In patients with medium CV risk, there was no significant difference in the FRS score among those with and without CKD (14.4% vs 14.6%, p = 0.84) However, in this same medium risk group, patients with CKD had more CV events compared to those without CKD (26.7% vs 6.6%, p = 0.005). This is in contrast to patients in the low and high risk group where there was no difference in CVD events whether these patients had or did not have CKD. There were more CV events in the Framingham medium risk group when they also had CKD compared those in the same risk group without CKD. Hence factoring in CKD for those with medium risk helps to further stratify and identify those who are actually at greater risk, when treatment may be more likely to be indicated.
    Matched MeSH terms: Hospitals, University
  18. Fulltext Usage of traditional and complementary medicine among dengue fever patients in the northeast region of Peninsular Malaysia
    Ismail IS, Hairon SM, Yaacob NM, Besari AM, Abdullah S
    Malays J Med Sci, 2019 May;26(3):90-101.
    PMID: 31303853 MyJurnal DOI: 10.21315/mjms2019.26.3.7
    BACKGROUND: The recent epidemic of dengue fever (DF) in Malaysia was alarming. The treatment of DF remains supportive as there is no anti-viral agent or vaccine available as yet. Traditional and complementary medicine (T&CM) provides an alternative option for the treatment of DF but there is limited evidence with regard to its usage. The aim of this study was to determine the prevalence, types and predictor factors of T&CM usage among DF patients in the northeast region of Peninsular Malaysia.
    METHODOLOGY: This was a cross-sectional study of DF patients in the northeast region of Peninsular Malaysia who had been admitted to a tertiary centre from January 2014 until December 2015. Serologically-confirmed DF patients aged 18 years and above were randomly selected. Phone interviews were conducted to obtain information regarding the use of T&CM during hospitalisation. Notes were made regarding the prevalence and type of T&CM used. Binary logistic regressions were used to identify the predictor factors of T&CM usage.
    RESULTS: A total of 241 DF patients with a mean age of 36.62 (SD = 14.62) years were included. The estimated prevalence of T&CM usage was 84.6% (95%CI: 80.1%, 89.2%). The most common T&CM used were crab soup (85.3%), papaya leaf extract (64.2%) and isotonic drinks (61.8%). The significant predictors for T&CM usage were age [adjusted odds ratio (AOR) 0.97; 95%CI: 0.94, 0.99], tertiary education (AOR 3.86; 95%CI: 1.21, 12.32) and unemployment (AOR 2.55; 95%CI: 1.02, 6.42).
    CONCLUSION: The prevalence of T&CM usage in our population is high. Age, tertiary education and unemployment influence the use of T&CM.
    Study site: Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia,
    Matched MeSH terms: Hospitals, University
  19. Fulltext Usage of traditional and complementary medicine (T & CM): Prevalence, practice and perception among post stroke patients attending conventional stroke rehabilitation in a teaching hospital in Malaysia
    Ali MF, Abdul Aziz AF, Rashid MR, Che Man Z, Amir AA, Lim YS, et al.
    Med J Malaysia, 2015 Feb;70(1):18-23.
    PMID: 26032524
    INTRODUCTION: The lack of evidence that proves the benefit of traditional and complementary medicines (T & CM) in treating chronic medical conditions does not deter its usage among patients worldwide. Prevalence of usage among post-stroke patients in Malaysia especially is unknown. This study aims to determine the prevalence, practice and perception of T & CM use among stroke survivors attending an outpatient rehabilitation program in a teaching hospital.
    METHODS: A cross-sectional study was conducted among 104 post stroke patients attending an outpatient rehabilitation program. A structured self-administered questionnaire was used to collect data on sociodemographic and clinical profile of patients, as well as types of therapy used and perception on T & CM usage. Descriptive analysis was done, and bivariate analysis was used to determine associations between categorical data.
    RESULTS: Mean age of patients was 62 years (SD 12.2), 54% were Chinese and 75% of the patients had ischaemic stroke. Mean age of T & CM users was younger compared to non- T & CM users (61 years vs. 66 years, p=0.04). Two-thirds (66%) of patients admitted to concurrent T & CM usage while attending conventional post stroke rehabilitation. Acupuncture (40.4%), massage (40.4%) and traditional Chinese medicine (11.5%) were the most common T & CM used. Positive perception was recorded in terms of ability of T & CM usage to relieve post stroke symptoms (68%), and it was safe to use because it was made from 'natural sources'. Negative perception recorded: T & CM caused significant adverse effects (57.6%) and was not safe to be used in combination with other conventional medicines (62.5%).
    CONCLUSIONS: Concurrent T & CM usage among post-stroke patients attending structured outpatient rehabilitation program is widely practised especially acupuncture, massage and traditional Chinese medicines. Overall the perception towards its use is favourable.
    Study site: Medical Rehabilitation Services Department, Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  20. Fulltext Usage of home-based maternal health record in antenatal monitoring among Malaysian women attended University Kebangsaan Malaysia Medical Centre
    Leny, S.S., Shuhaila, A., Sutan, R.
    Malaysian Journal of Public Health Medicine, 2013;13(1):1-10.
    MyJurnal
    Maternal Home-based Record (MHR) is a concise medical record that can be kept by the pregnant women for regular documentation throughout pregnancy stages. This study was done to assess the usage of the MHR among the pregnant women and its associated factors. A good MHR usage was assigned using mean value as cut-off point that has been agreed by an expert group from scoring system which incorporates usage elements in term of follow-up, information documentation, knowledge seeking, continuity of care and self-monitoring of pregnancy. A cross-sectional survey was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) and a total of 79 pregnant women who attended the antenatal clinic were recruited. A validated self-administered questionnaire was used. The questionnaire was newly developed in Bahasa Malaysia. Content validity and reliability test for internal consistency for the knowledge, satisfaction and usage scale was performed. The Cronbach’s Alpha value for each domain was 0.764, 0.716 and 0.877 respectively. The results showed that the prevalence of good MHR usage was 51.3%. There were significant association found between level of education (Adj OR=0.32, 95% CI 0.12, 0.85, p=0.023) and doctor as birth attendant in previous pregnancies (Adj OR= 2.54, 95% CI 1.97, 6.59, p=0.045) with good usage of MHR. There was a positive significant relationship between satisfaction level among the respondent and the level of the usage (p=0.01, r=0.377), whereby with every increase in 1 score in satisfaction level will increase the usage score by 0.4 (95% CI 0.2 to 0.7) units, p<0.01. Therefore, MHR is still relevant as antenatal care monitoring instruments and it is important to make an effort to improve patient satisfaction in using MHR. Health care providers can use this validated self-administered questionnaire to assess function of MHR to remain relevant to the pregnant women population in their locality.
    Key words: Antenatal care, home-based maternal record, usage, satisfaction
    Study site: Antenatal clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
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