Displaying publications 41 - 60 of 111 in total

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  1. Tung SE, Ng XH, Chin YS, Mohd Taib MN
    Child Care Health Dev, 2016 Jul;42(4):478-85.
    PMID: 27272607 DOI: 10.1111/cch.12355
    BACKGROUND: This study aimed to evaluate parental perception of neighbourhood environments and safety in association with children's physical activity among primary school children in Klang, Selangor, Malaysia.

    METHODS: A total of 250 children (9-12 years of age) and their parents participated in this cross-sectional study. Physical Activity Questionnaire for Older Children and Neighbourhood Environmental Walkability Scale as well as questions on constrained behaviours (avoidance and defensive behaviours) were used to assess the children's physical activity and parental perception of neighbourhood environment and safety, respectively.

    RESULTS: More than one-third (36.0%) of the children were physically inactive compared with only a small percentage (4.8%) who were physically active, with boys achieving higher physical activity levels than girls (t = 2.564, P = 0.011). For the environmental scale, parents' perception of land-use mix (access) (r = 0.173, P = 0.006), traffic hazards (r = -0.152, P = 0.016) and defensive behaviour (r = -0.024, P = 0.143) correlated significantly with children's physical activity. In multiple linear regression analysis, child's gender (β = -0.226; P = 0.003), parent's education (β = 0.140; P = 0.001), household income (β = 0.151; P = 0.024), land-use mix (access) (β = 0.134; P = 0.011) and defensive behaviour (β = -0.017; P = 0.038) were significantly associated with physical activity in children (R = 0.349, F = 6.760; P 

  2. Tuan Sharif SE, Alzallal O, Wan Ismail WF, Md Zin RR
    Malays J Pathol, 2020 Apr;42(1):121-125.
    PMID: 32342941
    INTRODUCTION: Sarcomas of the Ewing family of tumours are aggressive neoplasms occurring in bone and soft tissue of mostly children and young adults. It usually affects male more than female with peak incidence 10 to 15 years of age, and rarely encountered in adults especially in more than 40 years old. It is an aggressive, rare tumour with a tendency toward recurrence after resection and early metastasis.

    CASE REPORT: We reported a rare case of Ewing Sarcoma in a 62-year-old woman who had an unusual clinical presentation. She had right painless buttock swelling only for a month. Magnetic resonance imaging (MRI) revealed soft tissue sarcoma originated from right gluteal muscle. The diagnosis of Ewing sarcoma (ES) was made in a limited diagnostic material in an initial tru-cut biopsy, followed by an excision supported by immunohistochemistry (IHC) and Fluorescent In-Situ Hybridization (FISH).

    DISCUSSION: The purpose of this study is to document ES in an adult woman and its diagnostic challenges in histopathologic perspective.

  3. Simon KD, Bakar Y, Temple SE, Mazlan AG
    J Zhejiang Univ Sci B, 2010 Nov;11(11):871-9.
    PMID: 21043056 DOI: 10.1631/jzus.B1000054
    A simple yet useful criterion based on external markings and/or number of dorsal spines is currently used to differentiate two congeneric archer fish species Toxotes chatareus and Toxotes jaculatrix. Here we investigate other morphometric and meristic characters that can also be used to differentiate these two species. Principal component and/or discriminant functions revealed that meristic characters were highly correlated with pectoral fin ray count, number of lateral line scales, as well as number of anal fin rays. The results indicate that T. chatareus can be distinguished from T. jaculatrix by having a greater number of lateral line scales, a lower number of pectoral fin rays, and a higher number of anal fin rays. In contrast, morphometric discriminant analyses gave relatively low distinction: 76.1% of fish were ascribed to the correct species cluster. The observed morphometric differences came from the dorsal and anal spines lengths, with T. chatareus having shorter dorsal and longer anal spines than T. jaculatrix. Overall, meristic traits were more useful than morphometrics in differentiating the two species; nevertheless, meristics and morphometrics together provide information about the morphological differentiation between these two closely related archer fishes.
  4. Santhna LP, Khalid Z, Selamat S, Ho SE, Mat S
    Clin Ter, 2013;164(6):507-12.
    PMID: 24424214 DOI: 10.7417/CT.2013.1628
    BACKGROUND: Smoking has always been a huge problem in Malaysia and its surrounding nations. The purpose of this study was to determine the prevalence of cigarette smoking and to identify the influencing factors associated with smoking habits among adolescents.

    MATERIALS AND METHODS: This cross-sectional study was carried out on 226 respondents, using a questionnaire which had 4 sections: socio-demographic data, personal information, family information and social information. Data was analyzed using SPSS® version 16. For categorical variables, comparisons were made using Chi-square and for numerical variables a t-test was performed.

    RESULTS: The current smoker prevalence rate was 20.8% which showed a significant association between smoking and individual factors: level of knowledge on the effects of smoking (p < 0.05), significant association was seen between smoking and marital status of parents, smoking status of male siblings and various other aspects of the individuals themselves.

    CONCLUSIONS: Concerted efforts involving various parties should be taken to curb or prevent this problem or the number of teenage smokers in the country will increase. This in the long run will invite problems to the well being of the adolescents themselves, their families, community and the nation as a whole.

  5. Md Rifin S, Shalihin MSE, Mat Jidin M
    Med J Malaysia, 2021 05;76(3):419-421.
    PMID: 34031344
    A 35-year-old lady presented at the Klinik Kesihatan Bandar 32 Bera, Pahang with a one-month history of multiple cervical swelling and ulcers over her neck area. The lesions began as papules and later progressively developed into nodules and pustules. She also had low grade fever associated with weight loss for one month duration. Chest xray revealed normal findings and sputum direct smear for acid fast bacilli was noted to be negative. Histopathologic finding of skin biopsy revealed central epidermal necrosis surrounded by granulomatous tissue forming an abscess and histiocyte infiltrates, confirming the diagnosis of Scrofuloderma. In view of the report of the fine needle aspiration cytology (FNAC) of the cervical lymph nodes suggestive for tuberculous lymphadenitis, the patient was given anti-tuberculosis therapy. Fortunately, six months later, the ulcers began to solve and heal gradually.
  6. Peyrot WJ, Lee SH, Milaneschi Y, Abdellaoui A, Byrne EM, Esko T, et al.
    Mol Psychiatry, 2015 Jun;20(6):735-43.
    PMID: 25917368 DOI: 10.1038/mp.2015.50
    An association between lower educational attainment (EA) and an increased risk for depression has been confirmed in various western countries. This study examines whether pleiotropic genetic effects contribute to this association. Therefore, data were analyzed from a total of 9662 major depressive disorder (MDD) cases and 14,949 controls (with no lifetime MDD diagnosis) from the Psychiatric Genomics Consortium with additional Dutch and Estonian data. The association of EA and MDD was assessed with logistic regression in 15,138 individuals indicating a significantly negative association in our sample with an odds ratio for MDD 0.78 (0.75-0.82) per standard deviation increase in EA. With data of 884,105 autosomal common single-nucleotide polymorphisms (SNPs), three methods were applied to test for pleiotropy between MDD and EA: (i) genetic profile risk scores (GPRS) derived from training data for EA (independent meta-analysis on ~120,000 subjects) and MDD (using a 10-fold leave-one-out procedure in the current sample), (ii) bivariate genomic-relationship-matrix restricted maximum likelihood (GREML) and (iii) SNP effect concordance analysis (SECA). With these methods, we found (i) that the EA-GPRS did not predict MDD status, and MDD-GPRS did not predict EA, (ii) a weak negative genetic correlation with bivariate GREML analyses, but this correlation was not consistently significant, (iii) no evidence for concordance of MDD and EA SNP effects with SECA analysis. To conclude, our study confirms an association of lower EA and MDD risk, but this association was not because of measurable pleiotropic genetic effects, which suggests that environmental factors could be involved, for example, socioeconomic status.
  7. Yau MQ, Emtage AL, Chan NJY, Doughty SW, Loo JSE
    J Comput Aided Mol Des, 2019 05;33(5):487-496.
    PMID: 30989574 DOI: 10.1007/s10822-019-00201-3
    The recent expansion of GPCR crystal structures provides the opportunity to assess the performance of structure-based drug design methods for the GPCR superfamily. Molecular Mechanics/Poisson-Boltzmann Surface Area (MM/PBSA)-based methods are commonly used for binding affinity prediction, as they provide an intermediate compromise of speed and accuracy between the empirical scoring functions used in docking and more robust free energy perturbation methods. In this study, we systematically assessed the performance of MM/PBSA in predicting experimental binding free energies using twenty Class A GPCR crystal structures and 934 known ligands. Correlations between predicted and experimental binding free energies varied significantly between individual targets, ranging from r = - 0.334 in the inactive-state CB1 cannabinoid receptor to r = 0.781 in the active-state CB1 cannabinoid receptor, while average correlation across all twenty targets was relatively poor (r = 0.183). MM/PBSA provided better predictions of binding free energies compared to docking scores in eight out of the twenty GPCR targets while performing worse for four targets. MM/PBSA binding affinity predictions calculated using a single, energy minimized structure provided comparable predictions to sampling from molecular dynamics simulations and may be more efficient when computational cost becomes restrictive. Additionally, we observed that restricting MM/PBSA calculations to ligands with a high degree of structural similarity to the crystal structure ligands improved performance in several cases. In conclusion, while MM/PBSA remains a valuable tool for GPCR structure-based drug design, its performance in predicting the binding free energies of GPCR ligands remains highly system-specific as demonstrated in a subset of twenty Class A GPCRs, and validation of MM/PBSA-based methods for each individual case is recommended before prospective use.
  8. Yau MQ, Emtage AL, Loo JSE
    J Comput Aided Mol Des, 2020 Nov;34(11):1133-1145.
    PMID: 32851579 DOI: 10.1007/s10822-020-00339-5
    Recent breakthroughs in G protein-coupled receptor (GPCR) crystallography and the subsequent increase in number of solved GPCR structures has allowed for the unprecedented opportunity to utilize their experimental structures for structure-based drug discovery applications. As virtual screening represents one of the primary computational methods used for the discovery of novel leads, the GPCR-Bench dataset was created to facilitate comparison among various virtual screening protocols. In this study, we have benchmarked the performance of Molecular Mechanics/Poisson-Boltzmann Surface Area (MM/PBSA) in improving virtual screening enrichment in comparison to docking with Glide, using the entire GPCR-Bench dataset of 24 GPCR targets and 254,646 actives and decoys. Reranking the top 10% of the docked dataset using MM/PBSA resulted in improvements for six targets at EF1% and nine targets at EF5%, with the gains in enrichment being more pronounced at the EF1% level. We additionally assessed the utility of rescoring the top ten poses from docking and the ability of short MD simulations to refine the binding poses prior to MM/PBSA calculations. There was no clear trend of the benefit observed in both cases, suggesting that utilizing a single energy minimized structure for MM/PBSA calculations may be the most computationally efficient approach in virtual screening. Overall, the performance of MM/PBSA rescoring in improving virtual screening enrichment obtained from docking of the GPCR-Bench dataset was found to be relatively modest and target-specific, highlighting the need for validation of MM/PBSA-based protocols prior to prospective use.
  9. Francis J, Toh LS, Sellappans R, Loo JSE
    Int J Clin Pharm, 2021 Jun;43(3):604-612.
    PMID: 33507463 DOI: 10.1007/s11096-020-01169-z
    Background The incidence of osteoporosis in Malaysia is increasing due to a fast-ageing population. Because of its silent nature, various osteoporosis risk assessment tools exist to detect high-risk patients and facilitate referrals for bone mineral density measurements. As an accessible point of contact, community pharmacists would benefit from the utilization of these tools and familiarity with guideline recommendations for osteoporosis screening. Aim This study aimed to investigate the awareness of osteoporosis risk assessment tools, practice behaviour towards osteoporosis, and knowledge of guideline recommendations among community pharmacists in the Klang Valley, Malaysia. Setting Community pharmacies. Methods This study was a cross-sectional study which sampled 284 community pharmacists practicing in the Klang Valley, using a stratified sampling approach. The study was conducted using a self-administered questionnaire which was divided into three sections: demographic data, knowledge of osteoporosis risk assessment tools and guideline recommendations, and practice behaviour towards osteoporosis. Practice behaviour was assessed with 15 items using a 5-point Likert scale. Main outcome measure. Proportion of respondents aware of osteoporosis risk assessment tools and respondent knowledge on guideline recommendations for osteoporosis screening. Results A total of 284 community pharmacists participated in the study. 84.1% of the respondents were aware of at least one risk assessment tool. However, only a small proportion of pharmacists (14.9%) regularly used these tools in their practice. Respondents perceived these tools to be relevant and beneficial, but perception towards their accessibility, ease-of-use, and administration time was mixed, suggesting unfamiliarity. Respondents preferred to conduct clinical assessments based on risk factors, with respondents identifying a mean of 10.1 ± 3.4 out of 15 risk factors. However, several clinically relevant risk factors were frequently unidentified. Knowledge of guideline recommendations among respondents was low. Conclusion There is some awareness of osteoporosis risk assessment tools but use in practice remains low among community pharmacists in Malaysia. There is potential to increase the use of these tools and knowledge of recommendations for osteoporosis screening and referral among community pharmacists.
  10. Foong RTK, Sellappans R, Loo JSE
    J Eval Clin Pract, 2020 Feb;26(1):165-171.
    PMID: 31168913 DOI: 10.1111/jep.13180
    BACKGROUND: Potentially inappropriate medications (PIMs) in older adults are detrimental to both clinical outcomes and health care costs, with their prominence set to increase in tandem with a fast-growing ageing population. Beers Criteria is one of the most commonly used guidelines that lists specific PIMs. Community pharmacists would therefore benefit from knowledge of Beers Criteria in detecting PIMs in primary care. This study therefore investigates the awareness of Beers Criteria and knowledge of PIMs among community pharmacists in the Klang Valley, Malaysia.

    METHODS: The study was conducted using a self-administered questionnaire. Knowledge of PIMs was assessed using 10 clinical vignettes based on the 2015 Beers Criteria. Practice behaviour towards older customers was assessed using 10 items with a 5-point Likert scale. Descriptive and inferential statistics were used to analyse the data.

    RESULTS: A total of 277 community pharmacists participated in the study. Only 27.1% of the pharmacists were aware of Beers Criteria, and of these, only 37.3% were aware of the latest 2015 update. The respondents demonstrated moderate knowledge of PIMs with a mean total score of 5.46 ± 1.89 out of a maximum of 10. Pharmacists who were aware of Beers Criteria had significantly higher scores (6.31 vs 5.14, P 

  11. Su WS, Thum CM, Loo JSE
    Int J Pharm Pract, 2022 Jan 07;30(1):59-66.
    PMID: 34962576 DOI: 10.1093/ijpp/riab075
    OBJECTIVES: To determine the prescribing patterns and identify potentially inappropriate prescribing practices among general practitioners in the private primary care sector by analysing a large electronic health insurance claims database.

    METHODS: Medical claims records from February 2019 to February 2020 were extracted from a health insurance claims database. Data cleaning and data analysis were performed using Python 3.7 with the Pandas, NumPy and Matplotlib libraries. The top five most common diagnoses were identified, and for each diagnosis, the most common medication classes and medications prescribed were quantified. Potentially inappropriate prescribing practices were identified by comparing the medications prescribed with relevant clinical guidelines.

    KEY FINDINGS: The five most common diagnoses were upper respiratory tract infection (41.5%), diarrhoea (7.7%), musculoskeletal pain (7.6%), headache (6.7%) and gastritis (4.0%). Medications prescribed by general practitioners were largely as expected for symptomatic management of the respective conditions. One area of potentially inappropriate prescribing identified was inappropriate antibiotic choice. Same-class polypharmacy that may lead to an increased risk of adverse events were also identified, primarily involving multiple paracetamol-containing products, non-steroidal anti-inflammatory drugs (NSAIDs), and antihistamines. Other areas of non-adherence to guidelines identified included the potential overuse of oral corticosteroids and oral salbutamol, and inappropriate gastroprotection for patients receiving NSAIDs.

    CONCLUSIONS: While prescribing practices are generally appropriate within the private primary care sector, there remain several areas where some potentially inappropriate prescribing occurs. The areas identified should be the focus in continuing efforts to improve prescribing practices to obtain the optimal clinical outcomes while reducing unnecessary risks and healthcare costs.

  12. Ng HL, Sellappans R, Loo JSE
    Int J Pharm Pract, 2023 Sep 30;31(5):489-495.
    PMID: 37526297 DOI: 10.1093/ijpp/riad042
    OBJECTIVES: To determine the adoption and perception of mobile health (mHealth) applications among community pharmacists in Malaysia.

    METHODS: A cross-sectional survey using a self-administered questionnaire was conducted with 300 community pharmacists in the Klang Valley, Malaysia using a stratified sampling approach. The questionnaire consisted of 36 questions with three sections: demographic data, adoption of mHealth applications and perception towards mHealth applications. Descriptive and inferential tests as well as exploratory factor analysis were used to analyse the data.

    KEY FINDINGS: Adoption of mHealth applications by community pharmacists for both professional and personal use was relatively high at 79.7%. Utilised mHealth applications were primarily from the medical references category, while applications for patient monitoring, personal care and fitness were used to a lesser degree. Among mHealth application users, only 65.7% recommended them to their patients. Overall perception towards mHealth applications was positive, but perception towards the benefits and favour of mHealth applications for their patients was lower. This was corroborated by the factor analysis, which identified four main factors explaining 59.9% of variance in the dataset. These factors were perception towards use in their own professional practice, perception on benefits and use in their patients, perception on specific features of mHealth applications, and reliability of mHealth applications.

    CONCLUSIONS: Adoption of mHealth applications among community pharmacists in Malaysia is high. Community pharmacists are more likely to use mHealth applications professionally and personally but less likely to recommend them to patients due to less favourable perceptions on how patients will benefit from mHealth applications.

  13. Lim SE
    Family Practitioner, 1975;2:43-47.
  14. Ho SE, Ho CC, Hng SH, Liu CY, Jaafar MZ, Lim B
    Clin Ter, 2013;164(5):407-11.
    PMID: 24217826 DOI: 10.7417/CT.2013.1604
    Hand hygiene is the most important measure in the prevention of healthcare-associated infections (HCAI). Adherence to hand hygiene protocols in hospital by nurses enables in prevention and control the HCAI. The main aim of the present study was to assess nurses' compliance to hand hygiene practice and knowledge in a hospital.
  15. Subramani S, Khor SE, Livingstone BI, Kulkarni UV
    Med J Malaysia, 2010 Mar;65(1):36-40.
    PMID: 21265246 MyJurnal
    To investigate the possible association between serum uric acid levels, serum C-Reactive Protein (CRP), and age-related macular degeneration (ARMD). A total 232 patients of the eye department at Hospital Tuanku Ja'afar, Negeri Sembilan, Malaysia were recruited over 9 weeks. Participants were divided into ARMD (Non-Neovascular ARMD, and Neovascular ARMD) and control groups. 107 participants with non-neovascular ARMD, 6 with neovascular ARMD, and 119 controls participated in the study. The control patients had a similar average Serum Uric Acid level to the average of all patients with ARMD (P = 0.617).
  16. Choon SE, Khoo JJ
    Br J Dermatol, 1999 Mar;140(3):557-8.
    PMID: 10233296
  17. Thorlacius L, Garg A, Ingram JR, Villumsen B, Theut Riis P, Gottlieb AB, et al.
    Br J Dermatol, 2018 03;178(3):715-721.
    PMID: 29080368 DOI: 10.1111/bjd.16093
    BACKGROUND: A core outcomes set (COS) is an agreed minimum set of outcomes that should be measured and reported in all clinical trials for a specific condition. Hidradenitis suppurativa (HS) has no agreed-upon COS. A central aspect in the COS development process is to identify a set of candidate outcome domains from a long list of items. Our long list had been developed from patient interviews, a systematic review of the literature and a healthcare professional survey, and initial votes had been cast in two e-Delphi surveys. In this manuscript, we describe two in-person consensus meetings of Delphi participants designed to ensure an inclusive approach to generation of domains from related items.

    OBJECTIVES: To consider which items from a long list of candidate items to exclude and which to cluster into outcome domains.

    METHODS: The study used an international and multistakeholder approach, involving patients, dermatologists, surgeons, the pharmaceutical industry and medical regulators. The study format was a combination of formal presentations, small group work based on nominal group theory and a subsequent online confirmation survey.

    RESULTS: Forty-one individuals from 13 countries and four continents participated. Nine items were excluded and there was consensus to propose seven domains: disease course, physical signs, HS-specific quality of life, satisfaction, symptoms, pain and global assessments.

    CONCLUSIONS: The HISTORIC consensus meetings I and II will be followed by further e-Delphi rounds to finalize the core domain set, building on the work of the in-person consensus meetings.

  18. Ho SE, Ting CK, Das S, Loo CY, Rohayu AB, Khor SY, et al.
    Clin Ter, 2011;162(3):217-22.
    PMID: 21717045
    Quality of life after acute coronary heart disease amongst patients is important outcome factor in deliberations of patient's care. The main aim of the study was to examine the quality of life amongst acute CHD patients.
  19. Lee YW, Choon SE, Izham S
    Med J Malaysia, 2019 08;74(4):259-265.
    PMID: 31424030
    BACKGROUND: Vitamin D deficiency has been shown to be a determinant of disease severity in patients with atopic dermatitis (AD). There is a lack of information on the prevalence of vitamin D deficiency in Malaysian children with AD. The objective of this study was to determine the association of vitamin D deficiency with AD severity, to compare vitamin D deficiency between children with and without AD and to determine prevalence of vitamin D deficiency in children with AD.

    METHODS: A case-control study to examine serum 25- hydroxyvitamin D [25(OH)D] levels in children with and without AD was done. Serum 25-hydroxyvitamin D [25(OH)D] level was measured by immunoassay. AD severity was evaluated using the SCORing Atopic Dermatitis (SCORAD) index.

    RESULTS: The serum levels of 25(OH)D, measured in 135 children with AD was not statistically different from 65 children without AD [median (IQR): 25.2ng/mL (15.45) vs 25.9ng/mL (15.87), p=0.616]. However, serum vitamin D levels were significantly lower in children with severe AD compared to those with mild-to-moderate AD [median (IQR): 16.0ng/mL (19.32) vs 26.3ng/mL (15.56), p=0.021]. The odds of having vitamin D deficiency in children with severe AD was 3.82 times that of children with non-severe AD (95% confidence level: 1.13, 12.87).

    CONCLUSION: This study suggests that there is an inverse association between vitamin D level and the severity of AD in Malaysian children.

  20. Akram W, Hussein MS, Ahmad S, Mamat MN, Ismail NE
    Saudi Pharm J, 2015 Oct;23(5):499-503.
    PMID: 26594115 DOI: 10.1016/j.jsps.2015.01.011
    There is no instrument which collectively assesses the knowledge, attitude and perceived practice of asthma among community pharmacists. Therefore, this study aimed to validate the instrument which measured the knowledge, attitude and perceived practice of asthma among community pharmacists by producing empirical evidence of validity and reliability of the items using Rasch model (Bond & Fox software®) for dichotomous and polytomous data. This baseline study recruited 33 community pharmacists from Penang, Malaysia. The results showed that all PTMEA Corr were in positive values, where an item was able to distinguish between the ability of respondents. Based on the MNSQ infit and outfit range (0.60-1.40), out of 55 items, 2 items from the instrument were suggested to be removed. The findings indicated that the instrument fitted with Rasch measurement model and showed the acceptable reliability values of 0.88 and 0.83 and 0.79 for knowledge, attitude and perceived practice respectively.
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