In a previous study, it was noted that "a strong desire to be held or cuddled correlated with a general leaning toward openness in emotional expression." As is well known, some cultures foster openness, while others do not. This project was designed to assess the influence of cultural attitudes on the wish to be held. To do so, questionnaires were given to five groups of Asian women living in Kuala Lumpur, Malaysia. The most striking differences found were between two groups of Chinese women, one Chinese-educated, and the other, English-educated. The Chinese-educated group inhibited the expression of sensual needs. An English education overturned the traditional mode of response; women in this group scored highest in their wish to be held and lowest in their inclination to keep their body-contact desires secret. This study demonstrates that cultural as well as psychological forces exert a profound influence on the wish to be held.
The ABO, MN and Rh blood types, and the Hp, Tf, and Gm [Gm (a), Gm (x), Gm(b), and Gm-like] factors were determined for 128 unrelated Indians (parents of families, 63 with two parents tested and two with one parent tested), and 90 unrelated Chinese (parents of 46 families, 44 with two parents tested and two with one parent tested), and for the offspring from these families. The frequencies of the several blood types are presented. They were done primarily to aid in paternity testing. They compare favorably with the findings of previous studies. The allele Hp1 is rare in the Indian population (.09) and relatively infrequent in the Chinese (.29). Unfortunately, the data shed no light on the problem of the inheritance of the phenotype Hp O. Only Tf C was found among the Indians. About four per cent of the Chinese were heterozygous for Tf CD,, all other were Tf CC. The Indians have a high frequency of Gm(a) and of Gm (x), and a low frequency of Gm (b). They appear to have alleles Gma, Gmax, and Gmb in the following frequencies: .535, .234(5), and .230(5), respectively. Three families appear to have a GMxb allele, providing the offspring are not extra-marital. The Chinese appear to have the alleles Gm^ab, Gm^a, and Gm^ax in the following frequencies: .741, .231, and .028, respectively.
A survey was conducted to investigate the level of consumption of ‘ulam’ in Selangor State among 252 adults (> 17 years) (male 28.6%, female 71.4%) of major ethnics (Malays-51.6%; Chinese-30.5%; Indians-17.5%) with the mean age of 42.7 ± 13.9 years. Consumption data were collected using 24 hours duplicate samples together with questionnaire on perceptions of ‘ulam.’ Results showed that ‘ulam’ was preferred by majority of the subjects (82.1%), especially amongst Malays (92.3%). A total of 52% of the subjects consumed partially or boiled ‘ulam.’ Factors that affect their preferences on ‘ulam’ were the perception of therapeutic effects of the ‘ulam’ towards health, its good taste and unique
aroma. The most consumed ‘ulam’ were cucumber (Cucumis sativus) (60.6%) ‘kacang botol’ (Psophocarpus tetragonolobus) (33%), Indian pennywort (Hydrocotyle asiatica) (31.5%), lettuce (Lactuca sativa) (27.6%), ‘petai’ (Parkia speciosa) (29%) and ‘ulam raja’ (Cosmos caudatus) (21.9%). The most preferred partially or boiled ‘ulam’
were tapioca shoot (Manihot esculenta) (31.5%), ocra (Hibiscus esculentus) (12.5%) and ‘jantung pisang’ (Musa sapientum) (20.1%). There was no significant difference (P > 0.05) amongst the three different ethnic groups on the consumption of ‘ulam’ and the median for total intake per day was within the range of 30-39 g/day. Ulam is a potential
source for increasing vegetable consumption to meet recommendation by World Health Organization (WHO), which is 400 g per day.
Keywords: Adults; perception; ‘ulam;’ Selangor State
Past research indicates that socioeconomic status (SES) accounts for differences in sensitivity across ethnic groups. However, comparatively little work has been conducted in Asia, with none examining whether ethnicity moderates the relation between SES and sensitivity. We assessed parenting behavior in 293 Singaporean citizen mothers of 6-month olds (153 Chinese, 108 Malay, 32 Indian) via the Maternal Behavioral Q-Sort for video interactions. When entered into the same model, SES (F(1,288) = 17.777, p
Objective: Although osteoarthritis (OA) is widely accepted as a degenerative disease, autoimmune processes are believed to be involved in the pathogenesis. There are limited studies in this area and most of them focused on antibodies against chondrocyte membrane. In an attempt to address the paucity of evidence in this regard, we explored the clinical significance of antinuclear antibody (ANA) in primary osteoarthritis of the knee (OAK).
Method: We studied 106 patients with primary osteoarthritis of at least 1 knee and 63 healthy controls from two tertiary centres in Malaysia from September 2005 to May 2012. All subjects were tested for ANA by immunofluorescence testing, and a titer of 1:40 and above was considered positive. Besides, the radiographs of bilateral knees were evaluated for grading, tibiofemoral compartment involvement and total knee replacement (TKR) implants. We compared the clinical characteristics between the ANA positive and ANA negative OAK cases.
Results: The incidence of ANA positivity among the cases (39.4 %) was higher than the controls (27 %) but this difference was statistically insignificant (p=0.754). ANA positive cases showed significantly higher incidence of bilateral and Grade IV OAK with higher frequency of TKR. In the multiple regression analysis, bilateral OAK (p< 0.0001; odds ratio 9.00), Grade IV OAK (p<0.001, odds ratio 3.44) and TKR (p=0.009; odds ratio 2.97) remained associated with ANA positivity.
Conclusions: ANA test is a potential prognostic tool in primary OAK and its positivity is associated with the clinical outcomes of bilateral, Grade IV OAK and TKR.
Study site: Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur; Putrajaya Hospital, Wilayah Persekutuan
Aim: To investigate the association between smoking status and body-mass-index (BMI) categories.
Subject and methods: Data are obtained from 2,340 observations from the Malaysia Non-Communicable Disease Surveillance-1. An ordered probability model for BMI categories with ordinal smoking treatment categories is developed and estimated. Marginal and treatment effects are calculated.
Results: Socio-demographic and health-lifestyle factors play significant roles in body weight categories, conditional upon smoking status. Education levels are inversely correlated with BMI categories amongst non-smokers only. Age and income levels are associated with BMI within non-smokers and compulsive smokers. Gender (female), family history of serious illnesses, individual health conditions (hypercholesterolemic, hypertensive), ethnicity (Malays and Indians) and regional locations (metropolitan) are associated with higher BMI levels, irrespective of smoking status. Additionally, BMI categories and levels are closely associated with smoking habits. As individuals switch from non-smoking to casual smoking, the probability of being overweight or obese increases, with an upsurge of 1.89 BMI units. As the casual smoking habit evolves into compulsive smoking, overweight or obese likelihoods are lowered as individuals are more likely to be in the underweight, normal weight or at-risk weight BMI ranges instead, while experiencing a decline of 1.75 BMI units.
Conclusions: There exists close association between BMI categories and levels with smoking habits. As smoking tendencies develop from being a non-smoker to a casual (compulsive) smoker, overweight or obese likelihoods increase (decrease), as individuals realize an upsurge (reduction) in BMI levels.
Study name: Malaysia Non-Communicable Disease Surveillance-1 (MyNCDS-1) survey
Poor glycaemic control among diabetic patient often relates to poor nutrition knowledge. The present study investigated level of nutrition knowledge and health awareness among diabetic patients at Cheras Health Clinic. A total of 132 respondents (62 men and 70 women) were divided into two categories, adults (30 – 69 years old) (50.8%) and elderly (60 years and above) (49.2%) were involved in this research. An interview based questionnaire was used to collect data of demographic, socioeconomic, level of nutrition knowledge and health awareness. Anthropometric measurements were also recorded. The respondents consisted of 36.4% Malays, 45.5% Chinese and 18.2% Indians. Majority of the respondents had poor glycaemic control (93.6%). Overall, 37.1% respondents were categorized as having poor nutrition knowledge, followed by 31.8% moderate and only 31.1% good. Adults showed a higher (65.6 + 22.1%) nutrition knowledge score than elderly (50.5 + 22.9%) (p<0.05). Besides, respondents with formal education also showed a higher (60.7 + 22.5%) nutrition knowledge score than those without formal education (26.9 + 12.7%) (p<0.05). Majority respondents answered ‘incorrectly’ to question regarding foods to be consumed most (72.0%) and ‘did not know’ foods that were needed to repair body tissues (44.7%). Respondents who had made an effort in finding nutrition information, willing to join health program, bought health insurance and had received dietary advise showed higher nutrition knowledge score (p<0.05). In conclusion, nutritional knowledge and health awareness among diabetic patients were poor. Therefore, an intervention program and health promotion are needed to be carried out to improve health awareness and nutrition knowledge among patients with diabetis mellitus type II. Keywords: Diabetes mellitus; health awareness; health clinic; nutrition knowledge
Study site: Klinik Kesihatan Cheras, Kuala Lumpur, Malaysia
This study aimed to established baseline data on patients' demographic and morbidity patterns over three months in the Outpatients Department (OPD) Ipoh Hospital. Entry of the first ten thousand patients into a computerised database for analysis showed that the majority were unemployed and from the low income group. There were more Malays and Indians, less Chinese. Respiratory infections accounted for 18.5 % while major chronic diseases (hypertension, diabetes mellitus, asthma) were common. Overall a wide spectrum of illnesses were seen. A career structure for OPD doctors and incorporation of Family Medicine concepts were proposed to improve primary care in OPD.
Study site: Outpatients Department (OPD), Hospital Ipoh, Perak, Malaysia
Introduction. The aim of this study is to determine pregnant women's knowledge regarding AIDS and to identify factors affecting their knowledge This information would provide some baseline data in designing health education measures for this target group.
Methods. A face-to-face interview was carried out on one-hundred pregnant women attending an urban antenatal clinic in Malaysia between October and November 1999.
Results. The mean age of the women was 27.8 years old (SD = 5.0, range 20 - 40 years). In general, these women had good knowledge of HIV and AIDS. More than 80% of them were aware of the main modes of HIV transmission. However, only half knew that HIV could be transmitted through breastfeeding. Sixty percent of women had the misconception that the virus could be acquired through blood donation. There was a lack of knowledge regarding the symptoms and the progression of AIDS. More than 90% of the women knew that AIDS is incurable. Three quarters of them were aware that early treatment can slow down the progression of the disease, but only 16% knew that maternal HIV transmission can be reduced by treatment. Good knowledge was positively correlated with higher level of education (p<0.05).
Discussion. Although health education programs in Malaysia have succeeded in educating pregnant women regarding AIDS in general, certain important information is still not being disseminated. Future health education should formulate targeted strategies to overcome this problem.
A quality assurance exercise for non-insulin dependent diabetes mellitus in the Family Practice Clinic, University Hospital Kuala Lumpur, was conducted using HbA1c as an indicator. We found that about 60% of the 163 patients with non-insulin dependent diabetes mellitus had fair to optimal control. The HbA1c correlated well with fasting and post-prandial blood glucose level (r=0.79 and r=0.54, respectively, p<0.001). The mean HbA1c was significantly higher in Malay compared to the other races, in those with longer duration of diabetes and in patients on two types of oral hypoglycaemic agent.
Study site: Family Practice Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Aim: This is a rheumatoid arthritis (RA) descriptive study, the first of its kind carried out in Malaysia.
Methods: This descriptive study involved 1084 RA patients' epidemiological and clinical data taken from Selayang, Putrajaya, Taiping and Seremban hospitals from June 2004 to December 2005.
Results: One thousand and eighty-four RA patients'data were analysed; 960 (88.6%) patients were female and 124 (11.4%) were male, approximately 8 : 1 M : F ratio. The majority of the patients were Indian (591; 54.5%), followed by the Malays (340; 31.4%), Chinese (126; 11.6%), indigenous (13; 1.2%) and others (14; 1.3%). Mean age was 49.6 ± 11.8 years with the youngest being 15 years and the oldest 88 years of age. Mean age for males was 52.0 ± 12.0 and females 49.3 ± 11.7 years (P =; 0.017). Most of these patients were housewives (565; 52.1%), followed by paid workers (266; 24.5%), retired patients (80; 7.4%), unemployed (76; 7.0%) and others (97; 8.9%). Mean duration of illness was 8.4 ± 6.7 years; 805 (74.3%) patients were relatively new patients (≤ 2 years illness duration) and 279 (25.7%) patients had illness duration > 2 years. Eight hundred and six (74.4%) were seropositive RA patients and 385 (35.5%) had presence of deformity. The majority of patients were treated with methotrexate (178; 16.4%), followed by combination of methotrexate, sulfasalazine and hydroxychloroquine (143; 13.2%), leflunomide (140; 12.9%), sulfasalazine (133; 12.3%) and combination of methotrexate and sulfasalazine (108; 10%).
Conclusion: In the above study, the majority of patients were female (960; 88.6%), Indian (591; 54.5%), had a mean age of 49.6 ± 11.8 years, most were housewives with a mean duration of illness of 8.4 ± 6.7 years and were treated with methotrexate (178; 16.4%). The results of the study may help Malaysian rheumaologists to understand their patients better and treat RA holistically.
Comment in: Yeap SS. Comment on: Multicentre survey of rheumatoid arthritis patients from Ministry of Health rheumatology centres in Malaysia. Int J Rheum Dis. 2009 Jul;12(2):177-8; author reply 179. doi: 10.1111/j.1756-185X.2009.01403.x. PubMed PMID: 20374340.
A cross-sectional study was carried out to assess the physical activity levels among patients with type 2 diabetes mellitus (DM) at Cheras Health Clinic in Kuala Lumpur. A total of 132 subjects (62 men and 70 women) aged 30 years and above participated in this study. Data was collected using an interview based questionnaire to obtain socio-demographic and health profile information. Physical activity was assessed using a shortened version of the International Physical Activity Questionnaire (IPAQ). Anthropometric measurements and body fat were also taken. Glycaemic status, that is, HbA1c, fasting blood sugar (FBS) and 2 hours post-prandial (2-HPP) were obtained from medical records. Results showed that the mean age of the patients was 51.9 + 5.8 years. The majority of patients had poor glycaemic control based on HbA1c (70.7%), FBS (71.9%) and 2HPP (85.4%). Patients who were unmarried and aged(60 years and above had a lower physical activity level (p< 0.05). In the older age group, low physical activity was associated with poor glycaemic control (p< 0.05). Patients in the moderate and high physical activity level were motivated to perform physical activity so as to be healthy (68.1%). Low physical activity level among patients was due to lack of time (54.5%) and lack of energy (21.2%). In conclusion, physical activity levels of the patients were unsatisfactory and associated with poor glycaemic control, especially in the elderly. There is a need to encourage diabetic patients to undertake regular physical activity in order to achieve optimal glycaemic control.
Study site: Klinik Kesihatan Cheras, Kuala Lumpur, Malaysia
Background: Despite the numerous health education programmes provided to the type 2 diabetes patients worldwide, the outcome of the diabetic management remains a challenge globally. Health literacy plays an important role in determining the outcomes from the diabetes management.
Materials and Methods: This study was aimed to determine the level of health literacy and its associated factors among type 2 diabetes mellitus patients attending a government health clinic. This study also aimed to determine the association between the associated factors, such as sociodemographic, socioeconomic characteristics, type of treatment, diabetes duration, and knowledge on diabetes and the level of health literacy as well as the predictors of the level of health literacy. This was a cross-sectional study that was conducted from 1st February 2016 to 30th July 2016. A total of 360 participants were randomly selected from a government health clinic through a systematic random sampling method. A validated, self-administered questionnaire incorporating sociodemographic characteristics, socioeconomic characteristics, history of type 2 diabetes, diabetes knowledge and health literacy level was used in this study. Data was analysed using IBM Statistical Package for Social Science Version 22.0. Chi square test, Fisher’s Exact test and simple logistic regression were used to measure the association between the associated factors and health literacy level. Multiple logistic regression analysis was used to analyse the predictors influencing health literacy level among type 2 diabetes mellitus patients.
Result: The response rate was 80%. Majority of the respondents have limited health literacy level (85.8%). There were significant association between ethnic group and health literacy level (χ2=6.317, P=0.042), level of education and health literacy level (χ2=6.304, P=0.043) and diabetes knowledge score and health literacy level [Odds Ratio (OR)=1.254, 95% Confidence Interval (CI) (1.063,1.479)]. Finally, the significant predictors for adequate health literacy level were the Chinese ethnic group [Adjusted OR (AOR)=4.441, 95% CI (1.472,13.392)] and diabetes knowledge score [AOR=1.238, 95% CI (1.031,1.488)].
Conclusion: In conclusion, level of health literacy among type 2 diabetes mellitus patients was significantly associated with the ethnic group, level of education and diabetes knowledge score. It can also be concluded that Chinese ethnic group and diabetes knowledge score were the significant predictors for adequate health literacy level among type 2 diabetes mellitus patients.
1. The vitamin A content of human liver tissue was determined in 363 autopsy samples. The sample comprised a total of 181 subjects dying after accidents and 182 dying from coronary heart disease among Singapore ethnic groups of both sexes. 2. The medium vitamin A reserve was 146 mg/kg in accident victims and 141 mg/kg in those who had died of coronary heart disease. Of all the samples 16% contained less than 40 mg/kg, 45% had 100-300 mg/kg, while 9% contained more than 500 mg/kg liver. 3. Among the accident victims, Indians had the lowest median liver vitamin A reserve (118 mg/kg) compared with that in other ethnic groups (137 mg/kg in Chinese, 191 mg/kg in Malays, 155 mg/kg in Caucasians). 4. The ethnic distribution of vitamin A reserve in coronary deaths was similar to that in accident victims. 5. There was no significant difference between the sexes in hepatic vitamin A reserve. 6. The distribution of vitamin A reserve in all the groups was skewed to the right.
The distribution of plasma coagulation factor XXIIB polymorphism was determined by PAG isoelectric focusing and immunoblotting in a group of 670 subjects comprising 375 Chinese, 110 Malays and 185 Indians. The frequencies of FXIIIB*1, FXIIIB*2, and FXIIIB*3 were found to be 0.27, 0.03 and 0.70 in the Chinese; 0.33, 0.05 and 0.64 in the Malays and 0.58, 0.08 and 0.33 in the Indians. The phenotypic distribution of FXIIIB alleles was at Hardy-Weinberg equilibrium in all three populations. A two-dimensional principal-components analysis on the basis of three common alleles at the FXIIIB locus among 19 populations, so far studied, clearly differentiates the Negroid, Mongoloid and Caucasoid populations into three major groups with the exception of Amerindians (Minnesota) and US Blacks showing some Caucasoid influence.
Three genetic markers, red-cell UMPK, PGP and serum AMY2 were investigated in Malaysians of Malay, Chinese and Indian ancestries using starch-gel and agarose-gel electrophoresis. UMPK was found to be polymorphic in all three races. Variants were observed for PGP in Malays; in Indians it is a polymorphic marker whereas it is monomorphic in Chinese. AMY2 was polymorphic only in Indians. The UMPK1 frequencies in Malays, Chinese and Indians, respectively, are 0.851, 0.880 and 0.942. The PGP1 frequencies are 0.991, 1.000, 0.962, and the AMY1(2) frequencies are 1.000, 1.000 and 0.983.
Micropenis is an important sign in congenital hypopituitarism and various disorders. Documented norms for penile length exist only for babies of Caucasian and Middle-Eastern origin. This study was carried out to establish such norms for Asian newborns. We studied 228 male live births within their first three days of life. Stretched penile lengths were marked off on unmarked wooden spatulas, which were placed vertically along the dorsal aspect of the penis, with one rounded end on the pubic bone. The mean penile length +/- S.D. for the full-term Asian baby was 3.6 +/- 0.4 cm. Race had a significant effect: Chinese 3.5 cm, Malay 3.6 cm and Indian 3.8 cm. Penile length correlated with birth weight and gestational age. Asian babies thus have similar norms to Caucasian babies. An Asian newborn whose penis measures less than 2.6 cm has micropenis and may need prompt investigation for underlying endocrine disorders.