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Risk factors for hemorrhage in severe dengue infections

Lum LC, Goh AY, Chan PW, El-Amin AL, Lam SK

J Pediatr, 2002 May;140(5):629-31.
PMID: 12032535

The purpose of this study was to identify the early indicators of hemorrhage in severe dengue infections in 114 patients; 24 patients had severe hemorrhage and 92 had no hemorrhage. The platelet counts were not predictive of bleeding. The duration of shock (OR, 2.11; 95% CI, 1.13 to 3.92; P =.019) and low-normal hematocrit at the time of shock (OR, 0.72; 95% CI, 0.55 to 0.95; P =.020) were risk factors of severe hemorrhage.

Matched MeSH terms: Logistic Models
Comparison of the effectiveness of major trauma services provided by tertiary and secondary hospitals in malaysia

Sethi D, Aljunid S, Saperi SB, Zwi AB, Hamid H, Mustafa AN, et al.

J Trauma, 2002 Sep;53(3):508-16.
PMID: 12352489

The effectiveness of trauma services provided by three hospitals operating at different levels of care, district general (DGH), tertiary care, and central tertiary, were compared in Malaysia.

Matched MeSH terms: Logistic Models
Risk factors for hypoxemia and respiratory failure in respiratory syncytial virus bronchiolitis

Chan PW, Lok FY, Khatijah SB

Southeast Asian J. Trop. Med. Public Health, 2002 Dec;33(4):806-10.
PMID: 12757230

Respiratory syncytial virus (RSV) bronchiolitis is a common infection in young children and may result in hospitalization. We examined the incidence of, and risk factors associated with, hypoxemia and respiratory failure in 216 children aged < 24 months admitted consecutively for proven RSV bronchiolitis. Hypoxemia was defined as SpO2 < 90% in room air and severe RSV bronchiolitis requiring intubation and ventilation was categorized as respiratory failure. Corrected age at admission was used for premature children (gestation < 37 weeks). Hypoxemia was suffered by 31 (14.3%) children. It was more likely to occur in children who were Malay (OR 2.56, 95%CI 1.05-6.23, p=0.03) or premature (OR 6.72, 95%CI 2.69-16.78, p<0.01). Hypoxemia was also more likely to develop in children with failure to thrive (OR 2.96, 95%CI 1.28-6.82, p<0.01). The seven (3.2%) children who were both premature (OR 11.94, 95%CI 2.50-56.99, p<0.01) and failure to thrive (OR 6.41, 95%CI 1.37-29.87, p=0.02) were more likely to develop respiratory failure. Prematurity was the only significant risk factor for hypoxemia and respiratory failure by logistic regression analysis (OR 1.17, 95%CI 1.06-1.55, p<0.01 and OR 1.14 95%CI 1.02-2.07, p=0.02 respectively). Prematurity was the single most important risk factor for both hypoxemia and respiratory failure in RSV bronchiolitis.

Matched MeSH terms: Logistic Models
Outcome of children with different accessibility to tertiary pediatric intensive care in a developing country--a prospective cohort study

Goh AY, Abdel-Latif Mel-A, Lum LC, Abu-Bakar MN

Intensive Care Med, 2003 Jan;29(1):97-102.
PMID: 12528029 DOI: 10.1007/s00134-002-1534-9

Objective: Lack of direct access to tertiary pediatric intensive care services in rural hospitals may be associated with poorer outcome among critically ill children. Inter-hospital transport by non-specialized teams may also lead to increased morbidity and even mortality. We therefore studied the outcome of children with different accessibility to tertiary pediatric care in Malaysia.

Methods: We prospectively compared the Pediatric Risk of Mortality (PRISM II) adjusted standardized mortality ratio (SMR), unanticipated deaths and length of stay of 131 patients transported from rural hospitals (limited access) with 215 transferred from the casualty wards or other in-hospital wards (direct access) to a tertiary pediatric ICU.

Results: The transported patients were younger than the in-hospital patients (median age 1.0 versus 6.0 months, p=0.000) and were more likely to have respiratory diseases. Other baseline characteristics did not differ significantly. Differences in access to tertiary intensive care from community hospitals was associated with an extended median length of stay (4.0 versus 2.0 days, p=0.000) but did not affect SMR (0.92 versus 0.84, rate ratio 1.09, 95% CI 0.57-2.01; p=0.348) or percentage of unexpected deaths (4.8% versus 2.8%, p=0.485). The adjusted odds ratio for mortality (1.7, 95% CI 0.7-4.3) associated with transfer was not statistically significant (p=0.248).

Conclusions: The outcome of critically ill children transferred from community hospitals did not differ from that of those who develop ICU needs in the wards of a tertiary center, despite being transported by non-specialized teams. Outcome was not affected by initial inaccessibility to intensive care if the children finally received care in a tertiary center.

Matched MeSH terms: Logistic Models
Epidemiology of childhood nocturnal enuresis in Malaysia

Kanaheswari Y

J Paediatr Child Health, 2003 Mar;39(2):118-23.
PMID: 12603800 DOI: 10.1046/j.1440-1754.2003.00105.x

OBJECTIVES: To estimate the prevalence of nocturnal enuresis in primary school children in Malaysia and to determine the factors associated with primary nocturnal enuresis.

METHODS: This was a cross-sectional survey. A total of 3371 self-administered questionnaires were distributed to parents of children aged 7, 9 and 12 years attending four primary schools in the city. The ICD-10 definition of enuresis was used.

RESULTS: From an overall response rate of 73.8%, nocturnal enuresis was reported in 200 children (8%), primary nocturnal enuresis in 156 children (6.2%) and secondary nocturnal enuresis in 44 children (1.8%). Fifty-three percent of those with primary enuresis had a positive family history, and 54% had two or more wet nights per week. Eighty-seven percent had not sought any form of treatment despite 74% admitting to being embarrassed. Using logistic regression analysis, only three factors were significant predictors of primary nocturnal enuresis. These were: (i) younger age (P < 0.001); (ii) male sex (P < 0.033); and (iii) Indian ethnic group (P < 0.044) compared to Chinese.

CONCLUSION: The prevalence of nocturnal enuresis in urban-dwelling Malaysian children is similar to that reported from Korea and Taiwan but appears to be lower than that reported from developed countries. Predictive factors associated with primary nocturnal enuresis included lower age group, male sex and Indian ethnicity.

Matched MeSH terms: Logistic Models
Relation between sick leave and selected exposure variables among women semiconductor workers in Malaysia

Chee HL, Rampal KG

Occup Environ Med, 2003 Apr;60(4):262-70.
PMID: 12660374

To determine the relation between sick leave and selected exposure variables among women semiconductor workers.

Matched MeSH terms: Logistic Models
Fulltext The need for drug and poison information--the Singapore physicians' perspective

Ponampalam R, Anantharaman V

Singapore Med J, 2003 May;44(5):231-42.
PMID: 13677359

There appears to be a significant prevalence of poisoning and adverse drug reactions in Singapore. However, the resources needed by physicians to assist them in the management of such cases are limited. This study examines the information resources currently utilised by medical professionals in assisting them in the management of poisonings and adverse drug reactions. The preferred features of an ideal Drug and Poison Information Centre in the local setting were also explored.

Matched MeSH terms: Logistic Models
Fulltext Exposure to second-hand smoke and the risk of non-syndromic oral cleft among Malay children in Kelantan

Ayu, A., Samsudin, A.R., Ismail, N.M., Isa, M.N.

Malaysian Journal of Public Health Medicine, 2003;3(2):41-47.
MyJurnal

The prevalence of cleft lip and palate in human is 1 in 500 live births worldwide. Non·syndromic clefts are a complex trait with both genetic and environmental etiology. The aim ofthe study was to assess the association between maternal exposure to second-hand smoke during pregnancy and ruk of having cleft child. Unmatched case-control study was carried out among Malays in Kelantan.
1 Case and control subjects were denned as mothers of cleft children and mothers of normal children respectively. The cleft children were recruited from the Combined Cleft Clinic at Kota Bharu Dental Clinic. Normal chiMren were selected at Orthodontic Clinic, Kota Bharu. A total of 184 cases and controb with age range from 17 to 50 years were interviewed using the standard craniofacial
registration form. Multiple Logistic Regression modeling was used to estimate adjusted odds ratio of factors associated with non-syndromic oral cleft. Signijicant factors include history of miscarriage (OR: 3.40; 95% C1:1.05, 11 .08) p=0.042; duration of exposure to second-hand smoke for 15-30 minutes (OR: 2.41; 95% C1:1.42, 4.09) p 30 minutes (OR: 5.16; 95% C1:Z.87, 9.28) p

Matched MeSH terms: Logistic Models
Fulltext Are doctors in the university-based primary care clinic more evidence-based?

Khoo EM, Teng CL, Wong KC

Med J Malaysia, 2004 Mar;59(1):129.
PMID: 15535352
Matched MeSH terms: Logistic Models
Fractal characterization of bpn weights evolution

Gunasekaran S, Venkatesh B, Sagar BS

Int J Neural Syst, 2004 Apr;14(2):139-45.
PMID: 15112371

Training methodology of the Back Propagation Network (BPN) is well documented. One aspect of BPN that requires investigation is whether or not the BPN would get trained for a given training data set and architecture. In this paper the behavior of the BPN is analyzed during its training phase considering convergent and divergent training data sets. Evolution of the weights during the training phase was monitored for the purpose of analysis. The evolution of weights was plotted as return map and was characterized by means of fractal dimension. This fractal dimensional analysis of the weight evolution trajectories is used to provide a new insight to understand the behavior of BPN and dynamics in the evolution of weights.

Matched MeSH terms: Logistic Models
Fulltext Prevalence and risk factors of job strain among laboratory technicians in Hospital Universiti Sains Malaysia

Aziah BD, Rusli BN, Winn T, Naing L, Tengku MA

Singapore Med J, 2004 Apr;45(4):170-5.
PMID: 15094986

Several sources of job stress exist. Some of these stressors are intrinsic to the job, while some are related to psychosocial and other factors.

Matched MeSH terms: Logistic Models
Gastro-oesophageal reflux disease, reflux oesophagitis and non-erosive reflux disease in a multiracial Asian population: a prospective, endoscopy based study

Rosaida MS, Goh KL

Eur J Gastroenterol Hepatol, 2004 May;16(5):495-501.
PMID: 15097043

OBJECTIVE: To determine the prevalence of and risk factors for gastro-oesophageal reflux disease (GORD), reflux oesophagitis and non-erosive reflux disease (NERD) amongst Malaysian patients undergoing upper gastrointestinal endoscopic examination.
DESIGN: A cross-sectional study on consecutive patients with dyspepsia undergoing upper gastrointestinal endoscopy.
SETTING: A large general hospital in Kuala Lumpur, Malaysia.
PARTICIPANTS: Consecutive patients undergoing endoscopy for upper abdominal discomfort were examined for the presence of reflux oesophagitis, hiatus hernia and Barrett's oesophagus. The diagnosis and classification of reflux oesophagitis was based on the Los Angeles classification. Patients with predominant symptoms of heartburn or acid regurgitation of at least one per month for the past 6 months in the absence of reflux oesophagitis were diagnosed as having NERD. The prevalence of GORD, reflux oesophagitis and NERD were analysed in relation to age, gender, race, body mass index (BMI), presence of hiatus hernia, Helicobacter pylori status, alcohol intake, smoking and level of education.
RESULTS: One thousand patients were studied prospectively. Three hundred and eighty-eight patients (38.8%) were diagnosed as having GORD based on either predominant symptoms of heartburn and acid regurgitation and/or findings of reflux oesophagitis. One hundred and thirty-four patients (13.4%) had endoscopic evidence of reflux oesophagitis. Two hundred and fifty-four (65.5%) were diagnosed as having NERD. Hiatus hernia was found in 6.7% and Barrett's oesophagus in 2% of patients. Of our patients with reflux oesophagitis 20.1% had grade C and D oesophagitis. No patients had strictures. Following logistic regression analysis, the independent risk factors for GORD were Indian race (odds ratio (OR), 3.25; 95% confidence interval (CI), 2.38-4.45), Malay race (OR, 1.67; 95% CI, 1.16-2.38), BMI > 25 (OR, 1.41; 95% CI, 1.04-1.92), presence of hiatus hernia (OR, 4.21; 95% CI, 2.41-7.36), alcohol consumption (OR, 2.42; 95% CI, 1.11-5.23) and high education level (OR, 1.52; 95% CI, 1.02-2.26). For reflux oesophagitis independent the risk factors male gender (OR, 1.64; 95% CI, 1.08-2.49), Indian race (OR, 3.25; 95% CI, 2.05-5.17), presence of hiatus hernia (OR, 11.67; 95% CI, 6.40-21.26) and alcohol consumption (OR, 3.22; 95% CI, 1.26-8.22). For NERD the independent risk factors were Indian race (OR, 3.45; 95% CI, 2.42-4.92), Malay race (OR, 1.80; 95% CI, 1.20-2.69), BMI > 25 (OR, 1.47; 95% CI, 1.04, 2.06) and high education level (OR, 1.66; 95% CI, 1.06-2.59).
CONCLUSIONS: Reflux oesophagitis and Barrett's oesophagus were not as uncommon as previously thought in a multiracial Asian population and a significant proportion of our patients had severe grades of reflux oesophagitis. NERD, however, still constituted the larger proportion of patients with GORD. Indian race was consistently a significant independent risk factor for reflux oesophagitis, NERD and for GORD overall.

Matched MeSH terms: Logistic Models
Fulltext Breast cancer and lifestyle risks among Chinese women in the Klang Valley in 2001

Hejar AR, Chong FB, Rosnan H, Zailina H

Med J Malaysia, 2004 Jun;59(2):226-32.
PMID: 15559174 MyJurnal

Breast cancer is one of the commonest cancers among women in Malaysia. The relation between lifestyle practices and the risk of breast cancer in Chinese women aged 21-55 years were assessed using data collected from June to October 2001, via a face-to face interview in a case control study in the Breast Clinics of Kuala Lumpur Hospital and University Malaya Medical Centre. A total of 89 cases with breast cancer were compared with 85 controls without the disease. Our study showed that breastfeeding had an odds ratio of 4.43 after adjustment for confounders. The results add to the evidence of a protective association between breast feeding practices and breast cancer particularly among Chinese women receiving treatment at two government hospitals in the Klang Valley.

Matched MeSH terms: Logistic Models
Fulltext Psychological stress among undergraduate medical students

Sherina MS, Rampal L, Kaneson N

Med J Malaysia, 2004 Jun;59(2):207-11.
PMID: 15559171 MyJurnal

The aim of this study was to determine the prevalence of psychological stress among medical students and to identify its symptoms and association with depression. A cross-sectional study design was used. Three-hundred and ninety-six medical students at a university in Malaysia were included in the study. Tools similar to the General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI) were used to screen for psychological stress and depression, respectively. 41.9% of the medical students were found to have psychological stress, which was significantly associated with depression (chi2=4.636, df=1, p<0.05). Psychological stress is common among medical students and is associated with depression.

Matched MeSH terms: Logistic Models
Adult community-acquired pneumonia in Malaysia: prediction of mortality from severity assessment on admission

Loh LC, Khoo SK, Quah SY, Visvalingam V, Radhakrishnan A, Vijayasingham P, et al.

Respirology, 2004 Aug;9(3):379-86.
PMID: 15363012

Prediction of mortality in patients with community-acquired pneumonia (CAP) can be assessed using clinical severity scores on admission to hospital. The clinical benefit of such tools is untested in Asian countries. The aim of this study was to determine the early adverse prognostic factors in patients hospitalized with CAP in Malaysia and to assess the usefulness of the British Thoracic Society (BTS) severity criteria.

Matched MeSH terms: Logistic Models
Gender differences in economic support and well-being of older Asians

Ofstedal MB, Reidy E, Knodel J

J Cross Cult Gerontol, 2004 Sep;19(3):165-201.
PMID: 15243197

This report provides a comprehensive analysis of gender differences in economic support and well-being in eight countries in Southern and Eastern Asia (Bangladesh, Malaysia, Indonesia, Singapore, Thailand, Vietnam, Philippines, and Taiwan). We examine multiple economic indicators, including sources of income, receipt of financial and material support, income levels, ownership of assets, and subjective well-being. Results show substantial variation in gender differences across indicators and provide an important qualification to widely held views concerning the globally disadvantaged position of older women. Whereas men tend to report higher levels of income than women, there is generally little gender difference in housing characteristics, asset ownership, or reports of subjective economic well-being. Unmarried women are economically advantaged compared to unmarried men in some respects, in part because they are more likely to be embedded in multigenerational households and receive both direct and indirect forms of support from family members.

Matched MeSH terms: Logistic Models
Novel direct and self-regulating approaches to determine optimum growing multi-experts network structure

Loo CK, Rajeswari M, Rao MV

IEEE Trans Neural Netw, 2004 Nov;15(6):1378-95.
PMID: 15565767

This paper presents two novel approaches to determine optimum growing multi-experts network (GMN) structure. The first method called direct method deals with expertise domain and levels in connection with local experts. The growing neural gas (GNG) algorithm is used to cluster the local experts. The concept of error distribution is used to apportion error among the local experts. After reaching the specified size of the network, redundant experts removal algorithm is invoked to prune the size of the network based on the ranking of the experts. However, GMN is not ergonomic due to too many network control parameters. Therefore, a self-regulating GMN (SGMN) algorithm is proposed. SGMN adopts self-adaptive learning rates for gradient-descent learning rules. In addition, SGMN adopts a more rigorous clustering method called fully self-organized simplified adaptive resonance theory in a modified form. Experimental results show SGMN obtains comparative or even better performance than GMN in four benchmark examples, with reduced sensitivity to learning parameters setting. Moreover, both GMN and SGMN outperform the other neural networks and statistical models. The efficacy of SGMN is further justified in three industrial applications and a control problem. It provides consistent results besides holding out a profound potential and promise for building a novel type of nonlinear model consisting of several local linear models.

Matched MeSH terms: Logistic Models*
Esthetic perception and psychosocial impact of developmental enamel defects among Malaysian adolescents

Sujak SL, Abdul Kadir R, Dom TN

J Oral Sci, 2004 Dec;46(4):221-6.
PMID: 15901066

The aim of this study was to investigate the prevalence and psychosocial impact of enamel defects among 16-year-old school children on the island of Penang. The data were collected through a self-administered questionnaire survey and an oral examination, using the Modified Developmental Defects of Enamel Index (FDI, 1992). In all, 1024 subjects were selected using a multistage random sampling technique. About two-thirds of the sample (67.1%) had at least one tooth affected by enamel defects. Enamel opacities accounted for 85.6% of the total condition. Diffuse-type opacity predominated (63.5%). Among subjects who expressed dissatisfaction, 18.8% reported covering their mouths when smiling, 8.7% avoided going out with friends and 39.1% had consulted their dentists. About 17% of the subjects reported that their parents had complained about the color of their front teeth but only 5.7% had experienced being teased by their friends about the problem. Two-thirds of the subjects were affected by enamel defects involving at least one tooth; however, the esthetic perception and psychosocial impact of those affected were minor.

Matched MeSH terms: Logistic Models
Fulltext Body mass index and factors related to overweight among women workers in electronic factories in Peninsular Malaysia

Chee HL, Kandiah M, Khalid M, Shamsuddin K, Jamaluddin J, Nordin NA, et al.

Asia Pac J Clin Nutr, 2004;13(3):248-54.
PMID: 15331336

Factors related to overweight were examined in a cross-sectional survey that included 1612 women workers from 10 large electronics assembly factories in Peninsular Malaysia. Respondents were Malaysian citizens, direct production workers below the supervisory level, and had worked at least a year in the factory where they were presently employed. Heights and weights were taken to calculate the body mass index (BMI). Weights and BMI increased with increasing age. After adjusting for age, odds ratios for overweight were significantly raised for married women in relation to not married women (OR 1.5, 95% CI=1.15-2.02), lower secondary education in relation to higher than upper secondary education (OR 1.8, 95% CI=1.06-3.14), monthly income RM800-999 (OR 1.7, 95% CI=1.21-2.45) and >/=RM1,000 (OR 1.8, 95% CI=1.23-2.72) in relation to

Matched MeSH terms: Logistic Models
Fulltext Factors associated with severity of motorcyclist inqiuries seen in Hospital University Sains Malaysia (HUSM), Kelantan

Nik Rosmawati, N.H., Manaf, A.H., Ahmad Zaki, I., Naing, L.

Malaysian Journal of Public Health Medicine, 2004;4(2):45-53.
MyJurnal

All road users are at risk of being involved in motor vehicle crashes (MVCs). Approximately 52.2% of all fatalities and 70.9% of all casualties related to MVCs in Kelantan were motorcycle riders and pilliori riders. A number of risk factors have been established in the relationship between traffic accidents and road-user, the vehicle as well as road and traffic conditions. The study was a cross-sectional study to identify factors associated with the severity of injury sustained by motorcyclist accident patients admitted to the Emergency Department, Hospital Universiti Sains Malaysia (HUSM), assessed through face to face interview based questionnaire and, at the same time the severity of injury was determined through Revised Trauma Score. Data analysis was done using simple and multiple logistic regressions. The study revealed that age more than 5O years, no motorcycle license, no stressful condition and crashes on two·way road showed higher risk of sustaining a more severe injury. However, sleep time of six to less than nine hours per day, crash on a straight roadway and wet road surface were associated with less severe injury. We recommend that public education, licensing and enforcement on accident prevention and safety riding should be given a priority.

Matched MeSH terms: Logistic Models

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