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Modelling COVID-19 Scenarios for the States and Federal Territories of Malaysia

Ahmad NA, Mohd MH, Musa KI, Abdullah JM, Othman NA

Malays J Med Sci, 2021 Oct;28(5):1-9.
PMID: 35115883 DOI: 10.21315/mjms2021.28.5.1

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 disease, which has become pandemic since December 2019. In the recent months, among five countries in the Southeast Asia, Malaysia has the highest per-capita daily new cases and daily new deaths. A mathematical modelling approach using a Singular Spectrum Analysis (SSA) technique was used to generate data-driven 30-days ahead forecasts for the number of daily cases in the states and federal territories in Malaysia at four consecutive time points between 27 July 2021 and 26 August 2021. Each forecast was produced using SSA prediction model of the current major trend at each time point. The objective is to understand the transition dynamics of COVID-19 in each state by analysing the direction of change of the major trends during the period of study. The states and federal territories in Malaysia were grouped in four categories based on the nature of the transition. Overall, it was found that the COVID-19 spread has progressed unevenly across states and federal territories. Major regions like Selangor, Kuala Lumpur, Putrajaya and Negeri Sembilan were in Group 3 (fast decrease in infectivity) and Labuan was in Group 4 (possible eradication of infectivity). Other states e.g. Pulau Pinang, Sabah, Sarawak, Kelantan and Johor were categorised in Group 1 (very high infectivity levels) with Perak, Kedah, Pahang, Terengganu and Melaka were classified in Group 2 (high infectivity levels). It is also cautioned that SSA provides a promising avenue for forecasting the transition dynamics of COVID-19; however, the reliability of this technique depends on the availability of good quality data.
Fulltext Factors associated with the severity of hypertension among Malaysian adults

Mahadir Naidu B, Mohd Yusoff MF, Abdullah S, Musa KI, Yaacob NM, Mohamad MS, et al.

PLoS One, 2019;14(1):e0207472.
PMID: 30605462 DOI: 10.1371/journal.pone.0207472

High blood pressure is a worldwide problem and major global health burden. Whether alone or combined with other metabolic diseases, high blood pressure increases the risk of cardiovascular disease. This study is a secondary data analysis from the National Health and Morbidity Survey 2015, a population-based study that was conducted nationwide in Malaysia using a multi-stage stratified cluster sampling design. A total of 15,738 adults ≥18-years-old were recruited into the study, which reports the prevalence of hypertension stages among adults in Malaysia using the JNC7 criteria and determinants of its severity. The overall prevalence of raised blood pressure was 66.8%, with 45.8% having prehypertension, 15.1% having Stage 1 hypertension, and 5.9% having Stage 2 hypertension. In the multivariate analysis, a higher likelihood of having prehypertension was observed among respondents with advancing age, males (OR = 2.74, 95% CI: 2.41-3.12), Malay ethnicity (OR = 1.21, 95% CI: 1.02-1.44), lower socioeconomic status, and excessive weight. The factors associated with clinical hypertension (Stages 1 and 2) were older age, rural residency (Stage 1 OR = 1.22, Stage 2 OR = 1.28), Malay ethnicity (Stage 2 OR = 1.64), diabetes (Stage 2 OR = 1.47), hypercholesterolemia (Stage 1 OR = 1.34, Stage 2 OR = 1.82), being overweight (Stage 1 OR = 2.86, Stage 2 OR = 3.44), obesity (Stage 1 OR = 9.01, Stage 2 OR = 13.72), and lower socioeconomic status. Almost 70% of Malaysian adults are at a risk of elevated blood pressure. The highest prevalence was in the prehypertension group, which clearly predicts a future incurable burden of the disease. Public health awareness, campaigns through mass and social media, and intervention in the work place should be a priority to control this epidemic.
Fulltext Measuring Time-Varying Effective Reproduction Numbers for COVID-19 and Their Relationship with Movement Control Order in Malaysia

Musa KI, Arifin WN, Mohd MH, Jamiluddin MS, Ahmad NA, Chen XW, et al.

Int J Environ Res Public Health, 2021 03 22;18(6).
PMID: 33809958 DOI: 10.3390/ijerph18063273

To curb the spread of SARS-CoV-2 virus (COVID-19) in Malaysia, the government imposed a nationwide movement control order (MCO) from 18 March 2020 to 3 May 2020. It was enforced in four phases (i.e., MCO 1, MCO 2, MCO 3 and MCO 4). In this paper, we propose an initiative to assess the impact of MCO by using time-varying reproduction number (Rt). We used data from the Johns Hopkins University Centre for Systems Science and Engineering Coronavirus repository. Day 1 was taken from the first assumed local transmission of COVID-19. We estimated Rt by using the EpiEstim package and plotted the epidemic curve and Rt. Then, we extracted the mean Rt at day 1, day 5 and day 10 for all MCO phases and compared the differences. The Rt values peaked around day 43, which was shortly before the start of MCO 1. The means for Rt at day 1, day 5, and day 10 for all MCOs ranged between 0.665 and 1.147. The average Rt gradually decreased in MCO 1 and MCO 2. Although spikes in the number of confirmed cases were observed when restrictions were gradually relaxed in the later MCO phases, the situation remained under control with Rt values being stabilised to below unity level (Rt value less than one).
Fulltext Characteristics of paediatric patients with tuberculosis and associated determinants of treatment success in Malaysia using the MyTB version 2.1 database over five years

Awaluddin SM, Ismail N, Zakaria Y, Yasin SM, Razali A, Mutalip MHA, et al.

BMC Public Health, 2020 Dec 10;20(1):1903.
PMID: 33302908 DOI: 10.1186/s12889-020-10005-y

BACKGROUND: Tuberculosis (TB) among children remains a significant public health problem in many parts of the world. The objective of this study was to describe the characteristics of TB patients and to determine the predictors of treatment success among children in Malaysia.
METHODS: Secondary data from MyTB version 2.1, a national database, were analysed using R version 3.6.1. Descriptive analysis and multivariable logistic regression were conducted to identify treatment success and its determinants.
RESULTS: In total, 3630 cases of TB cases were registered among children in Malaysia between 2013 and 2017. The overall treatment success rate was 87.1% in 2013 and plateaued between 90.1 and 91.4% from 2014 to 2017. TB treatment success was positively associated with being a Malaysian citizen (aOR = 3.43; 95% CI = 2.47, 4.75), being a child with BCG scars (aOR = 1.93; 95% CI = 1.39, 2.68), and being in the older age group (aOR = 1.06; 95% CI = 1.03, 1.09). Having HIV co-infection (aOR = 0.31; 95% CI = 0.16, 0.63), undergoing treatment in public hospitals (aOR = 0.38; 95% CI =0.25, 0.58), having chest X-ray findings of advanced lesion (aOR = 0.48; 95% CI = 0.33, 0.69), having EPTB (aOR = 0.58; 95% CI = 0.41, 0.82) and having sputum-positive PTB (aOR = 0.58; 95% CI = 0.43, 0.79) were negatively associated with TB treatment success among children.
CONCLUSIONS: The overall success rate of treatment among children with TB in Malaysia has achieved the target of 90% since 2014 and remained plateaued until 2017. The socio-demographic characteristics of children, place of treatment, and TB disease profile were associated with the likelihood of TB treatment success among children. The treatment success rate can be increased by strengthening contact tracing activities and promoting early identification targeting the youngest children and non-Malaysian children.
Sex differences in stroke metrics among Southeast Asian countries: Results from the Global Burden of Disease Study 2015

Hwong WY, Bots ML, Selvarajah S, Sivasampu S, Reidpath DD, Law WC, et al.

Int J Stroke, 2019 10;14(8):826-834.
PMID: 30843480 DOI: 10.1177/1747493019832995

BACKGROUND: Sex differences in cardiovascular diseases generally disadvantage women, particularly within developing regions.
AIMS: This study aims to examine sex-related differences in stroke metrics across Southeast Asia in 2015. Furthermore, relative changes between sexes are compared from 1990 to 2015.
METHODS: Data were sourced from the Global Burden of Disease Study. Incidence and mortality from ischemic and hemorrhagic strokes were explored with the following statistics derived: (1) women-to-men incidence/mortality ratio and (2) relative percentage change in rate.
RESULTS: Women had lower incidence and mortality from stroke compared to men. Notable findings include higher ischemic stroke incidence for women at 30-34 years in high-income countries (women-to-men ratio: 1.3, 95% CI: 0.1, 16.2 in Brunei and 1.3, 95% CI: 0.5, 3.2 in Singapore) and the largest difference between sexes for ischemic stroke mortality in Vietnam and Myanmar across most ages. Within the last 25 years, greater reductions for ischemic stroke metrics were observed among women compared to men. Nevertheless, women below 40 years in some countries showed an increase in ischemic stroke incidence between 0.5% and 11.4%, whereas in men, a decline from -4.2% to -44.2%. Indonesia reported the largest difference between sexes for ischemic stroke mortality; a reduction for women whereas an increase in men. For hemorrhagic stroke, findings were similar: higher incidence among young women in high-income countries and greater reductions for stroke metrics in women than men over the last 25 years.
CONCLUSIONS: Distinct sex-specific differences observed across Southeast Asia should be accounted in future stroke preventive guidelines.
Fulltext Contribution of Genetic Polymorphisms of Inflammation Response Genes on Sporadic Colorectal Cancer Predisposition Risk in Malaysian Patients - A Case Control Study

Ankathil R, Mustapha MA, Abdul Aziz AA, Mohd Shahpudin SN, Zakaria AD, Abu Hassan MR, et al.

Asian Pac J Cancer Prev, 2019 06 01;20(6):1621-1632.
PMID: 31244280 DOI: 10.31557/APJCP.2019.20.6.1621

AIM: To investigate the frequencies and association of polymorphic genotypes of IL-8 -251 T>A, TNF-α -308
G>A, ICAM-1 K469E, ICAM-1 R241G, IL-6 -174 G>C, and PPAR-γ 34 C>G in modulating susceptibility risk in
Malaysian colorectal cancer (CRC) patients. Methods: In this case-control study, peripheral blood samples of 560
study subjects (280 CRC patients and 280 controls) were collected, DNA extracted and genotyped using PCR-RFLP
and Allele Specific PCR. The association between polymorphic genotype and CRC susceptibility risk was determined
using Logistic Regression analysis deriving Odds ratio (OR) and 95% CI. Results: On comparing the frequencies of
genotypes of all single nucleotide polymorphisms ( SNPs ) in patients and controls, the homozygous variant genotypes
IL-8 -251 AA and TNF-α -308 AA and variant A alleles were significantly higher in CRC patients. Investigation on
the association of the variant alleles and genotypes singly, with susceptibility risk showed the homozygous variant A
alleles and genotypes IL-8 -251 AA and TNF-α -308 AA to be at higher risk for CRC predisposition. Analysis based
on age, gender and smoking habits showed that the polymorphisms IL8 -251 T>A and TNF – α 308 G>A contribute
to a significantly higher risk among male and female who are more than 50 years and for smokers in this population.
Conclusion: We observed an association between variant allele and genotypes of IL-8-251 T>A and TNF-α-308
G>A polymorphisms and CRC susceptibility risk in Malaysian patients. These two SNPs in inflammatory response
genes which undoubtedly contribute to individual risks to CRC susceptibility may be considered as potential genetic
predisposition factors for CRC in Malaysian population.
Fulltext Treatment-seeking behavior among male civil servants in northeastern Malaysia: A mixed-methods study

Arumugam P, Tengku Ismail TA, Daud A, Musa KI, A Hamid NA, Ismail SB, et al.

Int J Environ Res Public Health, 2020 04 15;17(8).
PMID: 32326447 DOI: 10.3390/ijerph17082713

Background: Men's health in Malaysia is slowly gaining more attention, but minimal research has examined how Malaysian men behave and seek treatment. While few studies have investigated men's treatment-seeking behavior (TSB), those that have been conducted seem to be inconclusive and tend to yield contradictory findings.
Objectives: This paper aims to determine the proportion of inappropriate TSB and to explore in-depth treatment-seeking behavior among male civil servants in northeastern Malaysia.
Methods: This paper adopted a mixed-methods approach, specifically a concurrent parallel study design. A quantitative study using a self-administered questionnaire was performed to identify the proportion of appropriate and inappropriate TSB among male civil servants in northeastern Malaysia. Concurrently, a qualitative study was conducted involving six focus group discussion sessions, and the results of both parts were integrated to provide a detailed explanation of TSB among the participants.
Results: A total of 381 participants were involved in the quantitative study, yielding a response rate of 94.8%; 246 (64.6%) engaged in inappropriate TSB. Some of the reported morbidities among the participants were hypertension (26.5%) and diabetes mellitus (26.2%). From the qualitative study, a main theme related to TSB emerged with several sub-themes, which were health literacy, stage of seeking treatment, preference for alternative treatment, perceived threat of illness, self-treatment, and the influence of family members and others.
Conclusions: TSB among male civil servants in northeastern Malaysia is poor, and the factors contributing to it are multidimensional. This study has provided new valuable evidence on men's TSB in northeastern Malaysia. The findings can be used to facilitate and improve current policies and the implementation of men's health services throughout the country.
Fulltext Over-the-Counter Breast Cancer Classification Using Machine Learning and Patient Registration Records

Hanis TM, Ruhaiyem NIR, Arifin WN, Haron J, Wan Abdul Rahman WF, Abdullah R, et al.

Diagnostics (Basel), 2022 Nov 16;12(11).
PMID: 36428886 DOI: 10.3390/diagnostics12112826

This study aims to determine the feasibility of machine learning (ML) and patient registration record to be utilised to develop an over-the-counter (OTC) screening model for breast cancer risk estimation. Data were retrospectively collected from women who came to the Hospital Universiti Sains Malaysia, Malaysia for breast-related problems. Eight ML models were used: k-nearest neighbour (kNN), elastic-net logistic regression, multivariate adaptive regression splines, artificial neural network, partial least square, random forest, support vector machine (SVM), and extreme gradient boosting. Features utilised for the development of the screening models were limited to information in the patient registration form. The final model was evaluated in terms of performance across a mammographic density. Additionally, the feature importance of the final model was assessed using the model agnostic approach. kNN had the highest Youden J index, precision, and PR-AUC, while SVM had the highest F2 score. The kNN model was selected as the final model. The model had a balanced performance in terms of sensitivity, specificity, and PR-AUC across the mammographic density groups. The most important feature was the age at examination. In conclusion, this study showed that ML and patient registration information are feasible to be used as the OTC screening model for breast cancer.
Fulltext Experiences and needs of the caregivers of stroke survivors in Malaysia-A phenomenological exploration

Sidek NN, Kamalakannan S, Tengku Ismail TA, Musa KI, Ibrahim KA, Abdul Aziz Z, et al.

Front Neurol, 2022;13:996620.
PMID: 36212650 DOI: 10.3389/fneur.2022.996620

INTRODUCTION: Informal caregivers play a crucial role in supporting the activities of daily living, rehabilitation, and the road to recovery for stroke survivors. However, these informal caregivers are often reported as experiencing neglect and lack of recognition despite their primary contribution to stroke recovery. This study investigated the experiences of the caregivers of stroke survivors and access to stroke care in Malaysia.
METHOD: This qualitative study with a phenomenological approach utilized in-depth interviews, including ten primary caregivers, one formal caregiver, and stroke healthcare providers as the participants. The interviews were done until the data saturation was achieved, and the data was analyzed using thematic analysis.
RESULT: Three primary themes and 14 subthemes were identified from the interviews. The role of primary caregivers of stroke survivors had tremendous physical, mental and social impact on the caregivers. Caregivers had two primary needs. The need for information about comprehensive stroke care at home and the need for psychological support to themselves. The key internal driver for providing care was identified to be the motivation level of the stroke survivor and the external driver was identified to be the societal support with access to comprehensive stroke care.
CONCLUSION: The role of informal caregivers becomes critical for continuum of stroke care. As caregivers take up the roles and responsibilities of those who contribute to stroke rehabilitation single-handedly soon after hospital discharge. Results of this study highlights the needs for providing systematic support to caregivers for engaging them in effective stroke care, particularly in the community. Stroke service providers, policy makers and program planners must be sensitized to empower caregivers of stroke survivors in effectively supporting stroke survivor in their family on the road of recovery.
Fulltext Machine Learning Application: A Bibliometric Analysis From a Half-Century of Research on Stroke

Che Nawi CMNH, Mohd Hairon S, Wan Yahya WNN, Wan Zaidi WA, Hassan MR, Musa KI

Cureus, 2023 Aug;15(8):e44142.
PMID: 37753006 DOI: 10.7759/cureus.44142

The quick advancement of digital technology through artificial intelligence has made it possible to deploy machine learning to predict stroke outcomes. Our aim is to examine the trend of machine learning applications in stroke-related research over the past 50 years. We used search terms stroke and machine learning to search for English versions of original and review articles and conference proceedings published over the past 50 years in Scopus and Web of Science databases. The Biblioshiny web application was utilized for the analysis. The trend of publication and prominent authors and journals were analyzed and identified. The collaborative network between countries was mapped, and a thematic map was used to monitor the authors' trending keywords. In total, 10,535 publications authored by 44,990 authors from 2,212 sources were retrieved. Two distinct clusters of collaborative network nodes were observed, with the United States serving as a connecting node. Three terms - deep learning, algorithms, and neural networks - are observed in the early stages of the emerging theme. Overall, international research collaborations, the establishment of global research initiatives, the development of computational science, and the availability of big data have facilitated the pervasive use of machine learning techniques in stroke research.
Fulltext Exploring the Need for Mobile Application in Stroke Management by Informal Caregivers: A Qualitative Study

Haji Mukhti MI, Ibrahim MI, Tengku Ismail TA, Nadal IP, Kamalakannan S, Kinra S, et al.

Int J Environ Res Public Health, 2022 Oct 10;19(19).
PMID: 36232257 DOI: 10.3390/ijerph191912959

BACKGROUND: Mobile health (mHealth) has been considered as a prominent concept in digital health and is widely used and easily accessible. Periodic follow-up visits, previously planned procedures, and rehabilitation services for stroke survivors have been cut down during the recent COVID-19 pandemic. Therefore, in this qualitative study we aimed to explore the need for a mobile application in stroke management by informal caregivers.
METHODS: A phenomenological qualitative study was conducted from November 2020 to June 2021. Thirteen respondents were recruited from two public rehabilitation centers in Kota Bharu, Kelantan, Malaysia. In-depth interviews were conducted. A comprehensive representation of perspectives from the respondents was achieved through purposive sampling. The interviews were conducted in the Kelantanese dialect, recorded, transcribed, and analyzed by using thematic analysis.
RESULTS: Thirteen participants were involved in the interviews. All of them agreed with the need for a mobile application in stroke management. They believed the future stroke application will help them to seek information, continuous stroke home care, and help in the welfare of caregivers and stroke patients.
CONCLUSIONS: The current study revealed two themes with respective subthemes that were identified, namely, self-seeking for information and reasons for using a stroke mobile application in the future. This application helps in reducing healthcare costs, enhancing the rehabilitation process, facilitating patient engagement in decision making, and the continuous monitoring of patient health.
Fulltext Tobacco Denormalization Indicator in the Prevalence of Positive Smoker Identity and Its Associated Factors

Ahmad MH, Ibrahim MI, Ab Rahman A, Musa KI, Mohd Zain F, Mohd Zain R, et al.

Int J Environ Res Public Health, 2020 Mar 31;17(7).
PMID: 32244417 DOI: 10.3390/ijerph17072363

Positive smoker identity (PSI) is a construct that evaluates the degree of smokers' positive thoughts, images and feeling about smoking behavior and culture. PSI encompasses the indicators related to tobacco denormalization strategy, which is one of the four WHO tobacco endgame strategies. PSmoQi is a newly validated instrument which could reliably assess PSI. This study's objectives were to determine the prevalence of positive smoker identity and its associated factors using PSmoQi. A sample of 253 smokers from government agencies in Kota Bharu City, Malaysia were recruited using invitation letters sent to their head of agencies. Data collection was done in a briefing session voluntary attended by the smokers. Factors associated with PSI were analyzed using Multiple Logistic Regression. The prevalence of smokers with positive smoker identity was 72.3%. Factors associated with positive smoker identity were older age (Adjusted Odds ratio; AOR: 1.042; 95% confident interval; CI: 1.004, 1.081); p = 0.028), higher smoking self-concept scale Malay version (SSCS-M) score (AOR: 1.216; 95% CI: 1.112, 1.329; p < 0.001), higher heaviness index (AOR: 1.002; 95% CI: 1.001, 1.004; p = 0.011) and lower educational attainment (AOR: 0.458; 95% CI: 0.233, 0.900; p = 0.024). This study shows a high prevalence of PSI among smokers from government agencies in Kota Bharu City. Factors such as age, SSCS-M score, heaviness index and educational attainment influenced the level of positive smoker identity in a smoker. The finding would contribute an evidentiary guideline in screening smokers for smoking cessation clinic enrollment to achieve the best interventional outcome, as well as it would provide an objective indicator for tobacco denormalization status in a population.
Fulltext Prevalence of abnormal glucose tolerance and risk factors in urban and rural Malaysia

Mustafa N, Kamarudin NA, Ismail AA, Khir AS, Ismail IS, Musa KI, et al.

Diabetes Care, 2011 Jun;34(6):1362-4.
PMID: 21498788 DOI: 10.2337/dc11-0005

OBJECTIVE:
To determine the prevalence of prediabetes and diabetes among rural and urban Malaysians.
RESEARCH DESIGN AND METHODS:
This cross-sectional survey was conducted among 3,879 Malaysian adults (1,335 men and 2,544 women). All subjects underwent the 75-g oral glucose tolerance test (OGTT).
RESULTS:
The overall prevalence of prediabetes was 22.1% (30.2% in men and 69.8% in women). Isolated impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were found in 3.4 and 16.1% of the study population, respectively, whereas 2.6% of the subjects had both IFG and IGT. Based on an OGTT, the prevalence of newly diagnosed type 2 diabetes was 12.6% (31.0% in men and 69.0% in women). The prediabetic subjects also had an increased prevalence of cardiovascular disease risk factors.
CONCLUSIONS:
The large proportion of undiagnosed cases of prediabetes and diabetes reflects the lack of public awareness of the disease.
Sociocultural and dietary practices among Malay subjects in the north-eastern region of Peninsular Malaysia: a region of low prevalence of Helicobacter pylori infection

Lee YY, Ismail AW, Mustaffa N, Musa KI, Majid NA, Choo KE, et al.

Helicobacter, 2012 Feb;17(1):54-61.
PMID: 22221617 DOI: 10.1111/j.1523-5378.2011.00917.x

The prevalence of Helicobacter pylori infection is exceptionally low among the Malays in the north-eastern region of Peninsular Malaysia. The reasons are unknown. Our aim was to compare environmental factors that differed in relation to H. pylori prevalence among Malays born and residing in Kelantan.
Fulltext Traditional cardiovascular risk-factors among healthcare workers in Kelantan, Malaysia

Hazmi H, Ishak WR, Jalil RA, Hua GS, Hamid NF, Haron R, et al.

Southeast Asian J. Trop. Med. Public Health, 2015 May;46(3):504-11.
PMID: 26521525

We conducted a cross sectional study of cardiovascular risk factors among healthcare workers at four government hospitals in Kelantan, Malaysia. We randomly selected 330 subjects fulfilling the following study criteria: those who had been working for at least one year at that health facility, Malaysians citizens and those with some form of direct contact with patients. We conducted an interview, obtained physical measurements, a fasting blood sugar and fasting lipid profiles among 308 subjects. The mean age of the subjects was 43.5 years, 82% were female; 30.8%, 14.3%, 10.4%, 1.3% and 1.6% of the subjects had dyslipidemia, hypertension, diabetes mellitus, a history of stroke and a history of ischemic heart disease, respectively. Forty-two percent of subjects had at least one medical condition. The mean body mass index (BMI) was 27.0 kg/M2 (SD=4.8) and 24.3% had a BMI > or =30 kg/M2. The mean systolic and diastolic blood pressures were 121.5 mmHg (SD=14.0) and 76.5 mmHg (SD=9.7), respectively and the mean waist-hip ratio was 0.84 (SD=0.1). The mean fasting blood sugar, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein were 5.8 mmol/l (SD=2.4), 5.5 mmol/l (SD=1.0), 1.4 mmol/l (SD=0.9), 1.5 mmol/l (SD=0.3) and 3.5 mmol/l (SD=0.9), respectively. Our study population had a smaller proportion of hypertension than that of the general Malaysian population. They had higher fasting total cholesterol, slightly lower fasting blood sugar, with a large proportion of them, obese and had diabetes. Immediate intervention is needed to reduce the traditional cardiovascular risk factors in this population. Keywords: cardiovascular risk factors, health care workers, Malaysia
Fulltext Neurodevelopmental effects of childhood malnutrition: A neuroimaging perspective

Galler JR, Bringas-Vega ML, Tang Q, Rabinowitz AG, Musa KI, Chai WJ, et al.

Neuroimage, 2021 05 01;231:117828.
PMID: 33549754 DOI: 10.1016/j.neuroimage.2021.117828

Approximately one in five children worldwide suffers from childhood malnutrition and its complications, including increased susceptibility to inflammation and infectious diseases. Due to improved early interventions, most of these children now survive early malnutrition, even in low-resource settings (LRS). However, many continue to exhibit neurodevelopmental deficits, including low IQ, poor school performance, and behavioral problems over their lifetimes. Most studies have relied on neuropsychological tests, school performance, and mental health and behavioral measures. Few studies, in contrast, have assessed brain structure and function, and to date, these have mainly relied on low-cost techniques, including electroencephalography (EEG) and evoked potentials (ERP). The use of more advanced methods of neuroimaging, including magnetic resonance imaging (MRI) and functional near-infrared spectroscopy (fNIRS), has been limited by cost factors and lack of availability of these technologies in developing countries, where malnutrition is nearly ubiquitous. This report summarizes the current state of knowledge and evidence gaps regarding childhood malnutrition and the study of its impact on neurodevelopment. It may help to inform the development of new strategies to improve the identification, classification, and treatment of neurodevelopmental disabilities in underserved populations at the highest risk for childhood malnutrition.
Significant association of high-risk human papillomavirus (HPV) but not of p53 polymorphisms with oral squamous cell carcinomas in Malaysia

Saini R, Tang TH, Zain RB, Cheong SC, Musa KI, Saini D, et al.

J Cancer Res Clin Oncol, 2011 Feb;137(2):311-20.
PMID: 20419384 DOI: 10.1007/s00432-010-0886-8

PURPOSE: The purpose of this study was to evaluate the role of HPV and p53 polymorphisms in oral squamous cell carcinomas (OSCC) affecting Malaysian population.
METHODS: We analysed frozen samples from 105 OSCC as well as 105 oral specimens derived from healthy individuals. PCR assays targeting two regions of the virus were used. PCR amplification for the analysis of p53 codon 72 arginine/proline alleles was carried out in a separate reaction.
RESULTS: HPV DNA was detected in 51.4% OSCC samples, while 24.8% controls were found to be HPV positive. HPV was found to be significantly associated with OSCC (P
Fulltext Development and Validation of Positive Smoker Identity Questionnaire (PSmoQi): A New Instrument for Smoking Cessation Correlates

Ahmad MH, Ibrahim MI, Ab Rahman A, Musa KI, Mohd Zin F, Mohd Zain R, et al.

Int J Environ Res Public Health, 2019 01 26;16(3).
PMID: 30691181 DOI: 10.3390/ijerph16030351

Background: The positive smoker identity construct, which was based on West's PRIME Theory, affected the smoking prevalence, quit attempts and cessation success. A validated questionnaire which could measure this rich and complex construct may facilitate prediction models of successful cessation. We aimed to develop and validate a questionnaire that assesses positive smoker identity based on West's PRIME Theory. Method: The initial item pool was developed based on a theoretical framework, empirical literature, existing scales and expert review. The questionnaire was conveniently distributed to 100 smokers. Exploratory factor analysis was utilized to explore domains in the questionnaire. Construct and criterion validity, internal consistency and reliability of the domains were analyzed. Results: The final positive smoker identity questionnaire (PSmoQi) has 26 items under four internally-consistent and reliable domains: Contributory factors, contextual and temporal patterning, identity related to smoking, and behaviour in relation to smoking. The full scale demonstrated good internal consistency (∝ = 0.78), acceptable convergent and divergent validity, and good concurrent validity with the smoker self-concept scale. Conclusion: The current study provides fundamental evidence for the PSmoQi as a valid instrument in research related to smoking cessation and interventional strategy. The PSmoQi contained validated domains which could measure almost a full spectrum of smoking cessation components.
Prevalence of metabolic syndrome and its risk factors in adult Malaysians: results of a nationwide survey

Mohamud WN, Ismail Aa, Khir AS, Ismail IS, Musa KI, Kadir KA, et al.

Diabetes Res Clin Pract, 2012 04;96(1):91-7.
PMID: 22553777 DOI: 10.1016/j.diabres.2011.11.020

Aim: To report the national prevalence of metabolic syndrome (MetS) and its risk factors among adult Malaysians (>18 years old) based on World Health Organization (WHO), the National Cholesterol Education Program Expert Panel III (ATP III), International Diabetes Federation (IDF) and the 'Harmonized' criteria.Methods: A multi-stage stratified sampling method was used to select 4341 subjects from Peninsular and East Malaysia. Subjects underwent physical and clinical examinations.Results: Based on the WHO, ATP III, IDF and Harmonized definitions, the overall crude prevalences of MetS were 32.1, 34.3, 37.1 and 42.5%, respectively. Regardless of the criteria used, MetS was higher in urban areas, in females, in the Indian population and increased significantly with age. Risk factors also increased with age; abdominal obesity was most prevalent (57.4%), was higher in females (64.2%) and was highest in Indians (68.8%).Hypertension was higher in males (56.5%) and highest among Malays (52.2%). In contrast,the Chinese had the highest prevalence of hypertriglyceridemia (47.4%).Conclusions: Malaysia has a much higher prevalence of MetS compared with other Asian countries and, unless there is immediate intervention to reduce risk factors, this may pose serious implications on the country's healthcare costs and services.
Fulltext Comparing the Biology of Young versus Old Age Estrogen-Receptor-Positive Breast Cancer through Gene and Protein Expression Analyses

Siddig A, Wan Abdul Rahman WF, Mohd Nafi SN, Sulong S, Yahya MM, Al-Astani Tengku Din TAD, et al.

Biomedicines, 2023 Jan 12;11(1).
PMID: 36672708 DOI: 10.3390/biomedicines11010200

Background: Breast cancer developed at a young age (≤45 years) is hypothesized to have unique biology; however, findings in this field are controversial. Methods: We compared the whole transcriptomic profile of young vs. old-age breast cancer using DNA microarray. RNA was extracted from 13 fresh estrogen receptor (ER)-positive primary breast cancer tissues of untreated patients (7 = young age ≤45 years and 6 = old age ≥55 years). In silico validation for the differentially expressed genes (DEGs) by young-age patients was conducted using The Cancer Genome Atlas (TCGA) database. Next, we analyzed the protein expression encoded by two of the significantly down-regulated genes by young-age patients, Glycine N-acyltransferase-like 1 (GLYATL-1) and Ran-binding protein 3 like (RANBP3L), using immunohistochemical analysis in an independent cohort of 56 and 74 ER-positive pre-therapeutic primary breast cancer tissues, respectively. Results: 12 genes were significantly differentially expressed by young-age breast cancers (fold change >2 or <2- with FDR p-value < 0.05). TCGA data confirmed the differential expression of six genes. Protein expression analysis of GLYATL-1 and RANBP3L did not show heterogeneous expression between young and old-age breast cancer tissues. Loss of expression of GLYATL-1 was significantly (p-value 0.005) associated with positive lymph node status. Higher expression of RANBP3L was significantly associated with breast cancers with lower histopathological grades (p-value 0.038). Conclusions: At the transcriptomic level, breast cancer developed in young and old age patients seems homogenous. The variation in the transcriptomic profiles can be attributed to the other clinicopathological characteristics rather than the age of the patient.

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