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Fulltext The In Vitro Antibiotic Susceptibility of Malaysian Isolates of Burkholderia pseudomallei

Ahmad N, Hashim R, Mohd Noor A

Int J Microbiol, 2013;2013:121845.
PMID: 24194761 DOI: 10.1155/2013/121845

Acute melioidosis may present as localised or septicaemic infections and can be fatal if left untreated. Burkholderia pseudomallei resistant to antibiotics used for the treatment of melioidosis had been reported. The aim of this study was to determine the in vitro antibiotic susceptibility patterns of Burkholderia pseudomallei isolated in Malaysia to a panel of antibiotics used for the treatment of melioidosis and also to potential alternative antibiotics such as tigecycline, ampicillin/sulbactam, and piperacillin/tazobactam. A total of 170 Burkholderia pseudomallei isolates were subjected to minimum inhibitory concentration determination using E-test method to eleven antibiotics. All isolates were sensitive to meropenem and piperacillin/tazobactam. For ceftazidime, imipenem, amoxicillin/clavulanic acid, and doxycycline resistance was observed in 1 isolate (0.6%) for each of the antibiotics. Trimethoprim/sulfamethoxazole resistance was observed in 17 (10%) isolates. For other antibiotics, ampicillin/sulbactam, chloramphenicol, tigecycline, and ciprofloxacin resistance were observed in 1 (0.6%), 6 (3.5%), 60 (35.3%) and 98 (57.7%) isolates respectively. One isolate B170/06 exhibited resistance to 4 antibiotics, namely, ciprofloxacin, chloramphenicol, trimethoprim/sulfamethoxazole, and tigecycline. In conclusion, the Malaysian isolates were highly susceptible to the current antibiotics used in the treatment of melioidosis in Malaysia. Multiple resistances to the antibiotics used in the maintenance therapy are the cause for a concern.
Fulltext Understanding Myths in Pregnancy and Childbirth and the Potential Adverse Consequences: A Systematic Review

Ahmad N, Nor SFS, Daud F

Malays J Med Sci, 2019 Jul;26(4):17-27.
PMID: 31496890 MyJurnal DOI: 10.21315/mjms2019.26.4.3

The trend of choosing natural birth at home without proper supervision is gaining more attention and popularity in Malaysia. This is partly due to wrong beliefs of modern medical care. It prompts the need to explore further into other myths and wrong beliefs present in communities around the world surrounding pregnancy and childbirth that may lead to harmful consequences. A total of 25 literatures were selected and reviewed. The most reported wrong belief is the eating behaviour such as avoiding certain nutritious fruits besides eating saffron to produce fairer skinned babies which in fact contains high doses of saffron that may lead to miscarriage. The most worrying myth however, is that unregulated birth attendants such as doulas have the necessary knowledge and skills to manage complications in labour which may well end up in perinatal or even maternal death. Other myths suggested that modern medical care such as vaginal examinations and baby's heart monitoring in labour as unnecessary. A well-enforced health education programme by well-trained healthcare personnel besides sufficient number of antenatal care visits are needed to overcome these myths, wrong beliefs and practices. In conclusion, potential harmful beliefs and practices in pregnancy and childbirth are still abound in today's communities, not just in least developed and developing countries but also in developed countries. Women and children are two very vulnerable groups, therefore debunking myths and eliminating harmful practices should be one of a healthcare provider priority especially those in the primary care settings as they are the closest to the community.
Fulltext Split-Course Radiotherapy in Stage IV Head & Neck Cancer

Biswal BM, Ruzman N, Ahmad NM, Zakaria A

Malays J Med Sci, 2000 Jan;7(1):54-9.
PMID: 22844216 MyJurnal

Short course hypo-fractionated radiotherapy is a standard regime for the palliation of stage IV head and neck cancers. However few patients respond favorably and require further radiotherapy in curative intent. We have used split-course radiotherapy technique to find out this conversion rate from palliative to curative intent. This was a prospective study conducted from November 1998 to October 1999; twenty-six (26) patients with stage IV head & neck cancers were treated with a hypofractionated regime of radiotherapy. A tumor dose of 30 Gy in 10 fractions [time dose fraction (TDF) 62] over 2 weeks was delivered using a 6 MV linear accelerator. A conventional 2 field or 3 field technique was used. Patients were assessed for the regression of tumor on fifth day, tenth day of radiotherapy and 4 weeks after the completion of radiotherapy. Patients showing complete response and good partial response were allowed to receive further radiotherapy of 30 Gy in 15 fractions [TDF 49]. There were 21 males and 5 females in the study with a median age of 44 years (range 19-77 years). All patients completed the initial regime. Complete responses were observed among 14 patients (54%); partial response in 6 patients (23%), and no response was seen among 6 patients (23%). Sixteen patients (61%) were suitable for radical radiotherapy after phase-I course of the above schedule. Seventeen patients (65%) showed an improvement in the general well being with a better quality of life. One year actuarial survival was (76%), with a median survival time of 12 months. Split-course technique is a useful radiotherapy treatment in stage IV head and neck cancers to distinguish between the subset of patients who would require curative treatment and who would not.
Negative effects of nicotine on bone-resorbing cytokines and bone histomorphometric parameters in male rats

Hapidin H, Othman F, Soelaiman IN, Shuid AN, Luke DA, Mohamed N

J. Bone Miner. Metab., 2007;25(2):93-8.
PMID: 17323178

The effects of nicotine administration on bone-resorbing cytokines, cotinine, and bone histomorphometric parameters were studied in 21 Sprague-Dawley male rats. Rats aged 3 months and weighing 250-300 g were divided into three groups. Group 1 was the baseline control (BC), which was killed without treatment. The other two groups were the control group (C) and the nicotine-treated group (N). The N group was treated with nicotine 7 mg/kg body weight and the C group was treated with normal saline only. Treatment was given by intraperitoneal injection for 6 days/week for 4 months. The rats were injected intraperitoneally with calcein 20 mg/kg body weight at day 9 and day 2 before they were killed. ELISA test kits were used to measure the serum interleukin-1 (IL-1), interleukin-6 (IL-6), and cotinine (a metabolite of nicotine) levels at the beginning of the study and upon completion of the study. Histomorphometric analysis was done on the metaphyseal region of the trabecular bone of the left femur by using an image analyzer. Biochemical analysis revealed that nicotine treatment for 4 months significantly increased the serum IL-1, IL-6, and cotinine levels as compared to pretreatment levels. In addition, the serum cotinine level was significantly higher in the N group than in the C group after 4 months treatment. Histomorphometric analysis showed that nicotine significantly decreased the trabecular bone volume (BV/TV), trabecular thickness (Tb.Th), double-labeled surface (dLS/BS), mineralizing surface (MS/BS), mineral appositional rate (MAR), and bone formation rate (BFR/BS), while causing an increase in the single-labeled surface (sLS/BS), osteoclast surface (Oc.S/BS), and eroded surface (ES/BS) as compared to the BC and C groups. In conclusion, treatment with nicotine 7 mg/kg for 4 months was detrimental to bone by causing an increase in the bone resorbing cytokines and cotinine levels. Nicotine also exerted negative effects on the dynamic trabecular histomorphometric parameters.
Fulltext IntFOLD: an integrated web resource for high performance protein structure and function prediction

McGuffin LJ, Adiyaman R, Maghrabi AHA, Shuid AN, Brackenridge DA, Nealon JO, et al.

Nucleic Acids Res, 2019 07 02;47(W1):W408-W413.
PMID: 31045208 DOI: 10.1093/nar/gkz322

The IntFOLD server provides a unified resource for the automated prediction of: protein tertiary structures with built-in estimates of model accuracy (EMA), protein structural domain boundaries, natively unstructured or disordered regions in proteins, and protein-ligand interactions. The component methods have been independently evaluated via the successive blind CASP experiments and the continual CAMEO benchmarking project. The IntFOLD server has established its ranking as one of the best performing publicly available servers, based on independent official evaluation metrics. Here, we describe significant updates to the server back end, where we have focused on performance improvements in tertiary structure predictions, in terms of global 3D model quality and accuracy self-estimates (ASE), which we achieve using our newly improved ModFOLD7_rank algorithm. We also report on various upgrades to the front end including: a streamlined submission process, enhanced visualization of models, new confidence scores for ranking, and links for accessing all annotated model data. Furthermore, we now include an option for users to submit selected models for further refinement via convenient push buttons. The IntFOLD server is freely available at: http://www.reading.ac.uk/bioinf/IntFOLD/.
Optimizing first line 7-day standard triple therapy for Helicobacter pylori eradication: Prolonging treatment or adding bismuth: which is better?

Leow AH, Azmi AN, Loke MF, Vadivelu J, Graham DY, Goh KL

J Dig Dis, 2018 Nov;19(11):674-677.
PMID: 30307122 DOI: 10.1111/1751-2980.12679

OBJECTIVE: The 7-day standard triple therapy (STT) gives unacceptablly low eradication rates of Helicobacter pylori (H. pylori). We aimed to examine whether extending STT from 7 days to 14 days or adding a bismuth compound to a 7-day STT would result in better eradication rates.
METHODS: H. pylori-positive patients were assigned to Group A (7-day STT; rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily, for 7 days), Group B (7-day STT with bismuth; rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily, clarithromycin 500 mg twice daily and bismuth subcitrate 240 mg twice daily, for 7 days) and Group C (14-day STT; rabeprazole 20 mg twice daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily for 14 days). Eradication was tested using 13 C-UBT at least 4 weeks after the completion of therapy.
RESULTS: A total of 364 patients were recruited. In the intention-to-treat analysis, eradication rates were 79.3% (96/121; 95% confidence interval [CI] 71.3-85.6%) for 7-day STT, 81.7% (98/120; 95% CI 73.8-87.6%) for 7-day STT with bismuth, and 88.6% (109/123; 95% CI 81.8-93.1%) for 14-day STT, respectively. Statistical significance was achieved between the 7-day and the 14-day STT treatment (P = 0.048).
CONCLUSIONS: Adding bismuth to the 7-day STT did not result in an increase in the eradication rate. Extending the STT to 14 days, however, achieved a significantly higher eradication rate. Nevertheless, this did not achieve the targeted 90% eradication rate on intention-to-treat analysis.
Is Diagnostic Performance of Quantitative 2D-Shear Wave Elastography Optimal for Clinical Classification of Benign and Malignant Thyroid Nodules?: A Systematic Review and Meta-analysis

Nattabi HA, Sharif NM, Yahya N, Ahmad R, Mohamad M, Zaki FM, et al.

Acad Radiol, 2017 Oct 18.
PMID: 29054676 DOI: 10.1016/j.acra.2017.09.002

RATIONALE AND OBJECTIVE: This study is a dedicated 2D-shear wave elastography (2D-SWE) review aimed at systematically eliciting up-to-date evidence of its clinical value in differential diagnosis of benign and malignant thyroid nodules.
METHODS: PubMed, Web of Science, and Scopus databases were searched for studies assessing the diagnostic value of 2D-SWE for thyroid malignancy risk stratification published until December 2016. The retrieved titles and abstracts were screened and evaluated according to the predefined inclusion and exclusion criteria. Methodological quality of the studies was assessed using the Quality Assessment of Studies of Diagnostic Accuracy included in Systematic Review 2 (QUADAS-2) tool. Extracted 2D-SWE diagnostic performance data were meta-analyzed to assess the summary sensitivity, specificity, and area under the receiver operating characteristic curve.
RESULTS: After stepwise review, 14 studies in which 2D-SWE was used to evaluate 2851 thyroid nodules (1092 malignant, 1759 benign) from 2139 patients were selected for the current study. Study quality on QUADAS-2 assessment was moderate to high. The summary sensitivity, specificity and area under the receiver operating characteristic curve of 2D-SWE for differential diagnosis of benign and malignant thyroid nodules were 0.66 (95% confidence interval [CI]: 0.64-0.69), 0.78 (CI: 0.76-0.80), and 0.851 (Q* = 0.85), respectively. The pooled diagnostic odds ratio, negative likelihood ratio, and positive likelihood ratio were 12.73 (CI: 8.80-18.43), 0.31 (CI: 0.22-0.44), and 3.87 (CI: 2.83-5.29), respectively.
CONCLUSION: Diagnostic performance of quantitative 2D-SWE for malignancy risk stratification of thyroid nodules is suboptimal with mediocre sensitivity and specificity, contrary to earlier reports of excellence.
Fulltext In-house ELISA screening using a locally-isolated Leptospira in Malaysia: determination of its cut-off points

Tan XT, Amran F, Chee Cheong K, Ahmad N

BMC Infect Dis, 2014;14:563.
PMID: 25338815 DOI: 10.1186/s12879-014-0563-7

Leptospirosis is a zoonotic disease caused by Leptospira species and is distributed globally. Microscopic agglutination test (MAT) is the serological 'gold standard' for diagnosis of leptospirosis but it is time-consuming and labour-intensive. An alternative serological method that is rapid, sensitive and specific is important for early treatment to reduce morbidity and mortality. The use of local Leptospira isolation may improve the sensitivity and specificity of the test because it may varies from one geographical region to another region. The objective of this study was to determine the sensitivity, specificity and cut-off points for an in-house Immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) using a locally isolated Leptospiral strain IMR/175 as the antigen for the detection of anti-Leptospiral IgM.
Sexual activity among Malaysian school-going adolescents: what are the risk and protective factors?

Ahmad N, Awaluddin SM, Ismail H, Samad R, NikAbdRashid N

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):44S-52S.
PMID: 25070693 DOI: 10.1177/1010539514544700

This study aimed to identify risk and protective factors associated with sexual activity among Malaysian adolescents. Data from the World Health Organization Global School-based Student Health Survey 2012 were analyzed. A total of 23 645 students aged 12 to 17 years responded using self-administered validated questionnaire. The overall prevalence of reported ever-had sex was 8.3%. Logistic regression analysis revealed that ever-had sex was positively significantly associated with ever-used drugs (adjusted odds ratio [aOR] = 7.71; 95% confidence interval [CI] = 6.51-9.13), and to a lesser extent, ever-smoked (aOR = 1.83; 95% CI = 1.62-2.07) and ever-consumed alcohol (aOR = 1.33; 95% CI = 1.15-2.53). Protective factors against ever-had sex were having a close friend (aOR = 0.63; 95% CI = 0.50-0.81), parental bonding (aOR = 0.72; 95% CI = 0.65-0.81), supportive peers (aOR = 0.77; 95% CI = 0.69-0.86), and parental connectedness (aOR = 0.88; 95% CI = 0.78-0.99). Although the prevalence of sexual activity among school-going adolescents in Malaysia is relatively low, identifying the risk and protective factors is crucial toward developing an integrated multiple approach to preventing sexual-related problems.
Study name: Global School-Based Student Health Survey (GSHS)
Fulltext Land use/cover change detection and urban sprawl analysis in Bandar Abbas city, Iran

Dadras M, Shafri HZ, Ahmad N, Pradhan B, Safarpour S

ScientificWorldJournal, 2014;2014:690872.
PMID: 25276858 DOI: 10.1155/2014/690872

The process of land use change and urban sprawl has been considered as a prominent characteristic of urban development. This study aims to investigate urban growth process in Bandar Abbas city, Iran, focusing on urban sprawl and land use change during 1956-2012. To calculate urban sprawl and land use changes, aerial photos and satellite images are utilized in different time spans. The results demonstrate that urban region area has changed from 403.77 to 4959.59 hectares between 1956 and 2012. Moreover, the population has increased more than 30 times in last six decades. The major part of population growth is related to migration from other parts the country to Bandar Abbas city. Considering the speed of urban sprawl growth rate, the scale and the role of the city have changed from medium and regional to large scale and transregional. Due to natural and structural limitations, more than 80% of barren lands, stone cliffs, beach zone, and agricultural lands are occupied by built-up areas. Our results revealed that the irregular expansion of Bandar Abbas city must be controlled so that sustainable development could be achieved.
Suicidal ideation among Malaysian adolescents

Ahmad N, Cheong SM, Ibrahim N, Rosman A

Asia Pac J Public Health, 2014 Sep;26(5 Suppl):63S-9S.
PMID: 25005932 DOI: 10.1177/1010539514540746

Adolescence is the time of greatest risk for the first onset of suicidal behaviors. This study aimed to identify the risk and protective factors associated with suicidal ideation among Malaysian adolescents. Data from the 2012 Malaysia Global School-based Student Health Survey, a nationwide study using a 2-stage cluster sampling design, were analyzed. The survey used a self-administered validated bilingual questionnaire and the Depression Anxiety and Stress Scale. The prevalence of suicidal ideation was 7.9%. Analysis revealed that suicidal ideation was positively associated with depression, anxiety, stress, substance use, being bullied, and being abused at home, either physically or verbally. In addition, suicidal ideation was significantly higher among females and among the Indians and Chinese. Having close friends and married parents were strongly protective against suicidal ideation. Understanding the risk and protective factors is important in providing comprehensive management for suicidal ideation.
Study name: Global School-Based Student Health Survey (GSHS)
Fulltext Modeling, control, and simulation of battery storage photovoltaic-wave energy hybrid renewable power generation systems for island electrification in Malaysia

Samrat NH, Bin Ahmad N, Choudhury IA, Bin Taha Z

ScientificWorldJournal, 2014;2014:436376.
PMID: 24892049 DOI: 10.1155/2014/436376

Today, the whole world faces a great challenge to overcome the environmental problems related to global energy production. Most of the islands throughout the world depend on fossil fuel importation with respect to energy production. Recent development and research on green energy sources can assure sustainable power supply for the islands. But unpredictable nature and high dependency on weather conditions are the main limitations of renewable energy sources. To overcome this drawback, different renewable sources and converters need to be integrated with each other. This paper proposes a standalone hybrid photovoltaic- (PV-) wave energy conversion system with energy storage. In the proposed hybrid system, control of the bidirectional buck-boost DC-DC converter (BBDC) is used to maintain the constant dc-link voltage. It also accumulates the excess hybrid power in the battery bank and supplies this power to the system load during the shortage of hybrid power. A three-phase complex vector control scheme voltage source inverter (VSI) is used to control the load side voltage in terms of the frequency and voltage amplitude. Based on the simulation results obtained from Matlab/Simulink, it has been found that the overall hybrid framework is capable of working under the variable weather and load conditions.
pH dependent poly[2-(methacryloyloxyethyl)trimetylammonium chloride-co-methacrylic acid]hydrogels for enhanced targeted delivery of 5-fluorouracil in colon cancer cells

Mishra RK, Ramasamy K, Ahmad NA, Eshak Z, Majeed AB

J Mater Sci Mater Med, 2014 Apr;25(4):999-1012.
PMID: 24398912 DOI: 10.1007/s10856-013-5132-x

Stimuli responsive hydrogels have shown enormous potential as a carrier for targeted drug delivery. In this study we have developed novel pH responsive hydrogels for the delivery of 5-fluorouracil (5-FU) in order to alleviate its antitumor activity while reducing its toxicity. We used 2-(methacryloyloxyethyl) trimetylammonium chloride a positively charged monomer and methacrylic acid for fabricating the pH responsive hydrogels. The released 5-FU from all except hydrogel (GEL-5) remained biologically active against human colon cancer cell lines [HT29 (IC50 = 110-190 μg ml(-1)) and HCT116 (IC50 = 210-390 μg ml(-1))] but not human skin fibroblast cells [BJ (CRL2522); IC50 ≥ 1000 μg ml(-1)]. This implies that the copolymer hydrogels (1-4) were able to release 5-FU effectively to colon cancer cells but not normal human skin fibroblast cells. This is probably due to the shorter doubling time that results in reduced pH in colon cancer cells when compared to fibroblast cells. These pH sensitive hydrogels showed well defined cell apoptosis in HCT116 cells through series of events such as chromatin condensation, membrane blebbing, and formation of apoptotic bodies. No cell killing was observed in the case of blank hydrogels. The results showed the potential of these stimuli responsive polymer hydrogels as a carrier for colon cancer delivery.
Fulltext The discrimination of d-tartrate positive and d-tartrate negative S. enterica subsp. enterica serovar Paratyphi B isolated in Malaysia by phenotypic and genotypic methods

Ahmad N, Hoon ST, Ghani MK, Tee KY

Malays J Pathol, 2012 Jun;34(1):35-9.
PMID: 22870596 MyJurnal

Serotyping is not sufficient to differentiate between Salmonella species that cause paratyphoid fever from the strains that cause milder gastroenteritis as these organisms share the same serotype Salmonella Paratyphi B (S. Paratyphi B). Strains causing paratyphoid fever do not ferment d-tartrate and this key feature was used in this study to determine the prevalence of these strains among the collection of S. Paratyphi B strains isolated from patients in Malaysia. A total of 105 isolates of S. Paratyphi B were discriminated into d-tartrate positive (dT+) and d-tartrate negative (dT) variants by two lead acetate test protocols and multiplex PCR. The lead acetate test protocol 1 differed from protocol 2 by a lower inoculum size and different incubation conditions while the multiplex PCR utilized 2 sets of primers targeting the ATG start codon of the gene STM3356. Lead acetate protocol 1 discriminated 97.1% of the isolates as S. Paratyphi B dT+ and 2.9% as dT while test protocol 2 discriminated all the isolates as S. Paratyphi B dT+. The multiplex PCR test identified all 105 isolates as S. Paratyphi B dT+ strains. The concordance of the lead acetate test relative to that of multiplex PCR was 97.7% and 100% for protocol 1 and 2 respectively. This study showed that S. Paratyphi B dT+ is a common causative agent of gastroenteritis in Malaysia while paratyphoid fever appears to be relatively uncommon. Multiplex PCR was shown to be a simpler, more rapid and reliable method to discriminate S. Paratyphi B than the phenotypic lead acetate test.
Assessing nursing clinical skills competence through objective structured clinical examination (OSCE) for open distance learning students in Open University Malaysia

Oranye NO, Ahmad C, Ahmad N, Bakar RA

Contemp Nurse, 2012 Jun;41(2):233-41.
PMID: 22800389 DOI: 10.5172/conu.2012.41.2.233

The objective structured clinical skills examination (OSCE) has over the years emerged as a method of evaluating clinical skills in most medical and allied professions. Although its validity and objectivity has evoked so much debate in the literature, little has been written about its application in non-traditional education systems such as in distance learning. This study examined clinical skills competence among practising nursing students who were enrolled in a distance learning programme. The study examined the effect of work and years of nursing practice on nurses' clinical skills competence.
Fulltext Urut Melayu, the traditional Malay massage, as a complementary rehabilitative care in postpartum stroke

Fadzil F, Anuar HM, Ismail S, Abd Ghani N, Ahmad N

J Altern Complement Med, 2012 Apr;18(4):415-9.
PMID: 22401300 DOI: 10.1089/acm.2010.0802

The case of a 32-year-old Malay woman who developed postpartum stroke is reported.
A new species of Leptolalax (Amphibia, Anura, Megophryidae) from Peninsular Malaysia

Matsui M, Belabut DM, Ahmad N, Yong HS

Zoolog Sci, 2009 Mar;26(3):243-7.
PMID: 19341347 DOI: 10.2108/zsj.26.243

A new megophryid species, Leptolalax kecil, is described from the Cameron Highlands of Peninsular Malaysia on the basis of acoustic and morphological characteristics. It has an advertisement call dissimilar to that of other, congeneric species, and is the smallest of the known Leptolalax. It is similar to L. pluvialis from Vietnam in small body size, but differs from it in ventral color, and in the size and color of the pectoral gland. The distributional pattern of the new species Is discussed.
Remediation of sulfidic wastewater by catalytic oxidation with hydrogen peroxide

Ahmad N, Maitra S, Dutta BK, Ahmad F

J Environ Sci (China), 2009;21(12):1735-40.
PMID: 20131606

Oxidation of sulfide in aqueous solution by hydrogen peroxide was investigated in the presence of hydrated ferric oxide catalyst. The ferric oxide catalyst was synthesized by sol gel technique from ferric chloride and ammonia. The synthesized catalyst was characterized by Fourier transform infrared spectroscopy, X-Ray diffraction analysis, scanning electrom microscope and energy dispersive X-ray analysis. The catalyst was quite effective in oxidizing the sulfide by hydrogen peroxide. The effects of sulfide concentration, catalyst loading, H2O2 dosing and temperature on the kinetics of sulfide oxidation were investigated. Kinetic equations and activation energies for the catalytic oxidation reaction were calculated based on the experimental results.
SF-36v2 norms and its' discriminative properties among healthy households of tuberculosis patients in Malaysia

Atif M, Sulaiman SA, Shafie AA, Asif M, Ahmad N

Qual Life Res, 2013 Oct;22(8):1955-64.
PMID: 23239084 DOI: 10.1007/s11136-012-0337-x

BACKGROUND: The aim of the study was to obtain norms of the SF-36v2 health survey and the association of summary component scores with socio-demographic variables in healthy households of tuberculosis (TB) patients.
DESIGN: All household members (18 years and above; healthy; literate) of registered tuberculosis patients who came for contact tracing during March 2010 to February 2011 at the respiratory clinic of Penang General Hospital were invited to complete the SF-36v2 health survey using the official translation of the questionnaire in Malay, Mandarin, Tamil and English. Scoring of the questionnaire was done using Quality Metric's QM Certified Scoring Software version 4. Multivariate analysis was conducted to uncover the predictors of physical and mental health.
RESULTS: A total of 649 eligible respondents were approached, while 525 agreed to participate in the study (response rate = 80.1 %). Out of consenting respondents, 46.5 % were male and only 5.3 % were over 75 years. Internal consistencies met the minimum criteria (α > 0.7). Reliability coefficients of the scales were always less than their own reliability coefficients. Mean physical component summary scale scores were equivalent to United States general population norms. However, there was a difference of more than three norm-based scoring points for mean mental component summary scores indicating poor mental health. A notable proportion of the respondents was at the risk of depression. Respondents aged 75 years and above (p = 0.001; OR 32.847), widow (p = 0.013; OR 2.599) and postgraduates (p < 0.001; OR 7.865) were predictors of poor physical health while unemployment (p = 0.033; OR 1.721) was the only predictor of poor mental health.
CONCLUSION: The SF-36v2 is a valid instrument to assess HRQoL among the households of TB patients. Study findings indicate the existence of poor mental health and risk of depression among family caregivers of TB patients. We therefore recommend that caregivers of TB patients to be offered intensive support and special attention to cope with these emotional problems.
Study site: Respiratory clinic, Hospital Pulau Pinang, Malaysia
Fulltext Detection of Bordetella pertussis from Clinical Samples by Culture and End-Point PCR in Malaysian Patients

Ting TX, Hashim R, Ahmad N, Abdullah KH

Int J Bacteriol, 2013;2013:324136.
PMID: 26904725 DOI: 10.1155/2013/324136

Pertussis or whooping cough is a highly infectious respiratory disease caused by Bordetella pertussis. In vaccinating countries, infants, adolescents, and adults are relevant patients groups. A total of 707 clinical specimens were received from major hospitals in Malaysia in year 2011. These specimens were cultured on Regan-Lowe charcoal agar and subjected to end-point PCR, which amplified the repetitive insertion sequence IS481 and pertussis toxin promoter gene. Out of these specimens, 275 were positive: 4 by culture only, 6 by both end-point PCR and culture, and 265 by end-point PCR only. The majority of the positive cases were from ≤3 months old patients (77.1%) (P < 0.001). There was no significant association between type of samples collected and end-point PCR results (P > 0.05). Our study showed that the end-point PCR technique was able to pick up more positive cases compared to culture method.

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