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Fulltext The development and validation of the Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia

Toh LS, Lai PS, Wu DB, Wong KT, Low BY, Anderson C

PLoS One, 2015;10(5):e0124553.
PMID: 25938494 DOI: 10.1371/journal.pone.0124553

Objectives: To develop and validate Osteoporosis Prevention and Awareness Tool (OPAAT) in Malaysia.
Methods: The OPAAT was modified from the Malaysian Osteoporosis Knowledge Tool and developed from an exploratory study on patients. Face and content validity was established by an expert panel. The OPAAT consists of 30 items, categorized into three domains. A higher score indicates higher knowledge level. English speaking non-osteoporotic postmenopausal women 50 years of age and pharmacists were included in the study.
Results: A total of 203 patients and 31 pharmacists were recruited. Factor analysis extracted three domains. Flesch reading ease was 59.2. The mean±SD accuracy rate was 0.60±0.22 (range: 0.26-0.94). The Cronbach’s α for each domain ranged from 0.286-0.748. All items were highly correlated (Spearman’s rho: 0.761-0.990, p<0.05), with no significant change in the overall test-retest scores, indicating that OPAAT has achieved stable reliability. Pharmacists had higher knowledge score than patients (80.9±8.7vs63.6±17.4, p<0.001), indicating
that the OPAAT was able to discriminate between the knowledge levels of pharmacists and patients.
Conclusion: The OPAAT was found to be a valid and reliable instrument for assessing patient’s knowledge about osteoporosis and its prevention in Malaysia. The OPAAT can be used to identify individuals in need of osteoporosis educational intervention.
Study site:: Primary care clinic, tertiary hospital, Malaysia

Matched MeSH terms: Malaysia/ethnology
Distribution of the four groups of iso-haemagglutinins in the malays.

Ando K

Malayan Medical Journal, 1929;4:13.

Matched MeSH terms: Malaysia/ethnology
Fulltext Categorization of low cardiorespiratory fitness using obesity indices in non-smoking Singaporean women

Pua YH, Lim CK, Ang A

Obesity (Silver Spring), 2006 Nov;14(11):1992-9.
PMID: 17135616 DOI: 10.1038/oby.2006.233

OBJECTIVE: To revisit cut-off values of BMI, waist circumference (WC), and waist-to-stature ratio (WSR) based on their association with cardiorespiratory fitness (CRF). The derived cut-off points were compared with current values (BMI, 25.0 kg/m(2); WC, 80 cm) as recommended by the World Health Organization.
RESEARCH METHODS AND PROCEDURES: Anthropometric indices were measured in a cross sectional study of 358 Singaporean female employees of a large tertiary hospital (63% Singaporean Chinese, 28% Malays, and 9% Indians). CRF was determined by the 1-mile walk test. Receiver operating characteristic curves were constructed to determine cut-off points.
RESULTS: The cut-off points for BMI, WC, and WSR were 23.6 kg/m(2), 75.3 cm, and 0.48, respectively. The areas under the curve of BMI, WC, and WSR were 0.68, 0.74, and 0.74, respectively. For a given BMI, women with low CRF had higher WSR compared with women with high CRF.
DISCUSSION: These findings provide convergent evidence that the cut-off points for Singaporean women were lower than the World Health Organization's criteria but were in good agreement with those reported for Asians.

Matched MeSH terms: Malaysia/ethnology
Herbal medicines in Malaysia

Ang HH

Clin. Pharmacol. Ther., 2005 May;77(5):451.
PMID: 15900291
Matched MeSH terms: Malaysia/ethnology
The relationship of hostility, negative affect and ethnicity to cardiovascular responses: an ambulatory study in Singapore

Enkelmann HC, Bishop GD, Tong EM, Diong SM, Why YP, Khader M, et al.

Int J Psychophysiol, 2005 May;56(2):185-97.
PMID: 15804452

This study tested the hypotheses that ambulatory heart rate and blood pressure would be higher for individuals high but not low in hostility when they experienced negative affect or social stress and that this interaction would be stronger for Indians compared with other Singapore ethnic groups. Ambulatory blood pressure monitoring was done on 108 male Singapore patrol officers as they went about their daily duties. After each BP measurement participants completed a computerized questionnaire including items on emotional experience. Individuals high in hostility showed higher systolic blood pressure when reporting negative affect whereas this was not true for those low in hostility. Ethnic differences were obtained such that Indians showed an increase in mean arterial pressure when angered whereas MAP was negatively related to anger for Malays and unrelated for Chinese. Also a three-way interaction between ethnicity, hostility, and social stress indicated that hostility and social stress interacted in their effects on DBP for Indian participants but not for Chinese or Malays. Finally, a three-way interaction was obtained between ethnicity, hostility and negative affect for heart rate in which heart rate increased with increasing levels of negative affect for Chinese high in hostility and Malays low in hostility but decreased with increasing negative affect for all other participants. These data are consistent with higher CHD rates among individuals high in hostility and also provide additional evidence on ethnic differences in cardiovascular reactivity in Singapore.

Matched MeSH terms: Malaysia/ethnology
Fulltext Effects of proton pump inhibitor on the human gut microbiome profile in multi-ethnic groups in Singapore

Koo SH, Deng J, Ang DSW, Hsiang JC, Lee LS, Aazmi S, et al.

Singapore Med J, 2019 Oct;60(10):512-521.
PMID: 30488079 DOI: 10.11622/smedj.2018152

INTRODUCTION: The objectives of this study were to examine the effects of ethnicity, gender and a proton pump inhibitor (PPI), omeprazole, on the human gut microbiome. PPIs are commonly used for the treatment of acid-related disorders. We hypothesised that PPI therapy might perturb microbial communities and alter the gut microbiome.
METHODS: Healthy subjects of Chinese (n = 12), Malay (n = 12) and Indian (n = 10) ancestry, aged 21-37 years, were enrolled. They provided a baseline stool sample (Day 1) and were then given a course of omeprazole at therapeutic dose (20 mg daily) for seven days. Stool samples were collected again on Day 7 and 14 (one week after stopping omeprazole). Microbial DNA was extracted from the stool samples, followed by polymerase chain reaction, library construction, 16S rRNA sequencing using Illumina MiSeq, and statistical and bioinformatics analyses.
RESULTS: The findings showed an increase in species richness (p = 0.018) after omeprazole consumption on Day 7, which reverted to baseline on Day 14. There were significant increases in the relative abundance of Streptococcus vestibularis (p = 0.0001) and Veillonella dispar (p = 0.0001) on Day 7, which diminished on Day 14. Faecalibacterium prausnitzii, Sutterella stercoricanis and Bacteroides denticanum were characteristic of Chinese, Malays and Indians, respectively. Lactobacillaceae and Bacteroides xylanisolvens were the signature taxa of male and female subjects, respectively.
CONCLUSION: The study demonstrated alterations in the gut microbiome following omeprazole treatment. This may explain the underlying pathology of increased risk of Clostridium difficile infections associated with omeprazole therapy.

Matched MeSH terms: Malaysia/ethnology
Fulltext Community-acquired bacteremia in Paediatrics: Epidemiology, aetiology and patterns of antimicrobial resistance in a tertiary care centre, Malaysia

Nor Azizah A, Mohd Nor F, Mohamad M, Zainal Abidin AS, Ariza A, Mohd Nor NS, et al.

Med J Malaysia, 2016 Jun;71(3):117-21.
PMID: 27495884 MyJurnal

Bacteremia continues to be one of the major causes of morbidity and mortality despite the existence of numerous antimicrobial agents. this study aimed to provide a Malaysian perspective on paediatric community-acquired bacteraemia based on the documentation of epidemiology and antimicrobial profile of the isolated pathogens.

Matched MeSH terms: Malaysia/ethnology
Fulltext Gender and ethnic differences in cardiovascular risks in Songkhla province, Thailand: the interASIA-south

Chongsuvivatwong V, YipIntsoi T, Apakupakul N

J Med Assoc Thai, 2008 Apr;91(4):464-70.
PMID: 18556853

The subset of data on southern Thai InterAsia study conducted in 2000 was revisited in order to document gender and ethnic breakdown of prevalence of risk factors for cardiovascular diseases (CVD). Three hundred and seventy-five men and 630 women with overall mean +/- SD age of 53.2 +/- 11.7 years were recruited. Combined gender prevalences were: 21.1% for smoking, 15.5% for drinking, 21.8% for hypertension (systemic blood pressure > or = 140/90 mmHg), 49.8% for impaired fasting plasma glucose (FPG 110-125 mg/dl), 9.9% for diabetes mellitus (FPG > or = 126 mg/dl), 10% for body mass index > or = 30 kg/m2, 43.5% for large waist circumference (WC > or = 90 cm in men and > or = 80 in women), 62.8% for total serum cholesterol (TC), > 200 mg/dl, 38.5% for TC divided by high density lipoprotein cholesterol (HDL-C) > or = 5 and 61.6% for low-density-lipoprotein cholesterol (LDL-C), > or = 130 mg/dl. After using logistic regression, adjusting the effects of age and community of residence, women were less likely than men to be smokers, drinkers, or showed impaired FPG but significantly more likely to have large WC, TC > or = 200 mg/dl and LDL-C > or = 130 mg/dl. Muslims showed significantly lower risk for drinking and large WC but higher risk for low HDL-C. The differences require further research. In conclusion, gender and age have stronger association with various risk factors than ethnicity in this selected population.

Matched MeSH terms: Malaysia/ethnology
Fulltext Laryngopharyngeal tuberculosis mimicking hypopharyngeal carcinoma

Adam, M., Irfan, M., Muhammad Nasri AB, Arfahiza S.

Journal of Biomedical and Clinical Sciences, 2018;3(1):8-10.
MyJurnal

Laryngopharyngeal tuberculosis (TB) is a rare disease and usually associated with pulmonary tuberculosis. Mostly, it occurs in adults without BCG vaccination or in immuno-compromised patients (such as AIDS patients). A 34-year-old gentleman with odynophagia and poor oral intake was referred to us to rule out malignancy. Direct laryngoscopy examination revealed ulcerative lesion involving right tonsillar fossa extending downward till right pyriform sinus. Panendoscopy and biopsy was performed. Laryngopharyngeal TB was diagnosed based on the histopathological examination and Ziehl-Neelsen staining.

Matched MeSH terms: Malaysia/ethnology
Social skills, friendship and happiness: a cross-cultural investigation

Demir M, Jaafar J, Bilyk N, Ariff MR

J Soc Psychol, 2012 May-Jun;152(3):379-85.
PMID: 22558831 DOI: 10.1080/00224545.2011.591451

The present study investigated the associations between social skills, friendship quality, and happiness, and tested a mediational model positing that friendship quality would mediate the relationship between social skills and happiness among American and Malaysian college students. Although American students reported significantly higher levels of psychosocial well-being than Malaysian students, the study variables were positively associated with each other in both cultures. More importantly, findings supported the proposed model in both groups. Results suggest that part of the reason why social skills are associated with positive psychological well-being is because of friendship experiences. Overall, the findings of the present study reinforce, extend and cross-culturally generalize the presumed benefits of social skills in positive well-being elaborated by Segrin and Taylor (2007). The authors also provided suggestions for future research.

Matched MeSH terms: Malaysia/ethnology
Feminism in Malaysia: a historical and present perspective of women's struggles in Malaysia

Ariffen R

Womens Stud Int Forum, 1999;22(4):417-23.
PMID: 22593983
Matched MeSH terms: Malaysia/ethnology
Fulltext Health status and differential use of medical resources: a survey sample in Kuala Lumpur

Armstrong RW

Med J Malaysia, 1984 Dec;39(4):257-63.
PMID: 6544930
Matched MeSH terms: Malaysia/ethnology
Fulltext p53 and p21/WAF-1 overexpressions in prostatic adenocarcinoma

Wan Muhaizan WM, Ahmad PK, Phang KS, Arni T

Malays J Pathol, 2006 Dec;28(2):93-9.
PMID: 18376798 MyJurnal

This study was carried out to determine the role of p53 and p21 in the pathogenesis of prostatic adenocarcinoma and their association with tumour grade.

Matched MeSH terms: Malaysia/ethnology
Fulltext The trends of DMARDS prescribed in rheumatoid arthritis patients in Malaysia

Sulaiman W, Toib A, Chandrashekhar G, Arshad A

Oman Med J, 2009 Oct;24(4):260-06.
PMID: 22216379 DOI: 10.5001/omj.2009.53

OBJECTIVES: To evaluate the trends of disease-modifying anti-rheumatic drugs (DMARDs) used in the treatment of rheumatoid arthritis (RA).
METHODS: Patients who fulfilled the ACR criteria for RA from 1995 to 2006 and who attended the Rheumatology clinic at Ipoh Hospital were selected and their records were evaluated to determine the changing trends in the use of DMARDs.
RESULTS: 128 patients with RA were identified. The most commonly prescribed DMARD as monotherapy was sulphasalazine (47.7%), followed by methotrexate (35.9%) and hydroxychloroquine. Methotrexate and sulphasalazine were the most frequently prescribed DMARDs, of which the use of methotrexate has increased 6 folds from 1997 to 2007 and the use of sulphasalazine remains around 30% to 50%. The combination of methotrexate with leflunomide has significantly increased in usage by 4 folds during the study period whilst methotrexate with sulphasalazine combination usage had slightly declined.
CONCLUSION: DMARDs are still the cornerstone in the treatment of RA. Changes in the trend and aggressive use of DMARDs has been markedly influenced by the patient's awareness of early treatment, the incapacitating damage, availability of recently introduced leflunomide and the advancement of current recommended treatment protocol.
Study site: Rheumatology clinic, Hospital Raja, Parmaisuri Bainum (HRBP), Ipoh, Perak, Malaysia

Matched MeSH terms: Malaysia/ethnology
Fulltext Effective implementation of a structured psychoeducation programme among caregivers of patients with schizophrenia in the community

Paranthaman V, Satnam K, Lim JL, Amar-Singh HS, Sararaks S, Nafiza MN, et al.

Asian J Psychiatr, 2010 Dec;3(4):206-12.
PMID: 23050889 DOI: 10.1016/j.ajp.2010.07.002

Background: Psychoeducation has shown promising benefits in managing patients with schizophrenia. In Malaysia, the use of psychoeducation is rather limited and its impact indeterminate.
Aims: To assess the effectiveness of a structured psychoeducation programme for the community in improving caregiver knowledge, decreasing caregivers’ burden, reducing patients’ readmission and defaulter follow up rates.
Method: In a controlled interventional study, 109 caregivers were included, 54 and 55 in the intervention and control groups respectively. Caregivers were assessed at baseline, 3 and 6 months post-intervention for knowledge and burden. Patients were monitored for relapse and defaulting follow up in the clinic.
Results: Caregivers in the intervention group showed significant improvement in knowledge, reduction in burden in assistance in daily living (severity) and a reduced defaulter rate was seen in the patients’ follow up.
Conclusion: The findings shows that structured psychoeducation programme among caregivers has the potential to improve outcome of care for patients with schizophrenia.
Keywords: Schizophrenia; Psychoeducation; Community; Caregiver Questionnaire: Family Burden Interview Schedule–Short Form (FBIS/SF)

Matched MeSH terms: Malaysia/ethnology
Fulltext The effectiveness of a cultural-based support group for Malay dementia caregivers in Kelantan, Malaysia: a pre-post intervention study

Rozanizam Zakaria, Asrenee Ab Razak

ASEAN Journal of Psychiatry, 2017;18(1):20-30.
MyJurnal

Objective: The psychological impact of care giving responsibility for dementia patients is significant regardless of the cultural background. Most of the current advanced caregivers’ interventions, originating from developed western countries, do not necessarily apply to local settings. Hence, there is a need for an effective culturally competent psychological intervention for these caregivers. The aim of the study is to assess the effectiveness of the cultural-based support group for Malay caregivers of dementia patients in Kelantan towards their burden, anxiety and depression level, and quality of life.
Methods: This was an experimental study, without control, investigating pre and post support group intervention effectiveness in reducing caregiver burden, anxiety and depression, and improving the quality of life. Sixteen caregivers completed the program, which involved seven fortnightly support group sessions with duration of 2 hours each, conducted over twelve weeks. Caregivers’ burden was assessed using Caregiver Strain Index (CSI) while their psychological well-being was objectively assessed using Hospital Anxiety and Depression Scale (HADS). WHO Quality of Life questionnaire (WHOQOL-BREF) was used to measure the quality of life. The validated Malay versions of the questionnaires were used.
Results: There was a statistically significant reduction in the level of caregiver burden (p = or < 0.001). Measurement of both scores of anxiety and depression comparing pre and post intervention also showed improvement, but statistically were not significant. Assessment of caregivers’ quality of life showed statistically significant improvement in the domains of social, psychological and physical (all with the p-value <0.05). Discussion: Our cultural-based support group is an effective intervention to improve burden, psychological well-being and quality of life among local caregivers of dementia patients.
Keyword: Dementia Caregivers, Support Group, Malay, Burden, Quality of Life
Study site: Memory clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Malaysia/ethnology
Fulltext Antibiotic prescribing for childhood febrile illness by primary care doctors in Malaysia

Teng CL, Hanafi NS, Ng CJ, Chia YC, Atiya AS

J Paediatr Child Health, 2006 Oct;42(10):612-7.
PMID: 16972968 DOI: 10.1111/j.1440-1754.2006.00937.x

AIM: Fever in children, a mostly benign and self-limiting illness, is often viewed with consternation by the care givers. It results in early consultation and excessive use of antipyretics and antibiotics. In this study, we document the prescribing practice of doctors from three primary care settings in Malaysia and identify the predictors of antibiotic prescription.
METHODS: Interview of care givers bringing febrile children (age = 12 years) to three primary care settings: public primary care clinics, private general practice clinics and a university-based primary care clinic.
RESULTS: Data from 649 children were analysed. Mean age of children 4.1 years and 55% were boys. One-third of the children had prior consultation for the same episode of fever. About 80% of the febrile children were diagnosed to have upper respiratory tract infection, viral fever and gastroenteritis. Overall antibiotic prescribing rate was 36.6% (public primary care clinic 26.8%, private general practice clinic 70.0% and university-based primary care clinic 32.2%). Independent predictors of antibiotic prescription were: clinic setting, longer duration of fever (>7 days), higher temperature (>38 degrees C) and the diagnosis of upper respiratory tract infections. After controlling for demographic and clinical factors, antibiotic prescription in private general practice clinic was seven times higher than public primary care clinic (odds ratio 7.1, 95% confidence interval 4.0-12.7), and 1.6 times higher than university-based primary care clinic (odds ratio 1.6, 95% confidence interval 1.0-2.5).
CONCLUSION: Differences in the patients' demographic and clinical characteristics could not adequately explain the high antibiotic prescribing rate in private general practice clinics. This inappropriately high antibiotic prescribing for febrile children in private general practice clinics is a suitable target for future intervention.

Matched MeSH terms: Malaysia/ethnology
Fulltext The nutritional status of children in resettlement villages in Kelantan

Zulkifli A, Khairul Anuar A, Atiya AS

Southeast Asian J. Trop. Med. Public Health, 1999 Mar;30(1):122-8.
PMID: 10695800

A cross-sectional survey of the nutritional status of children aged 1-10 years old from the Kuala Betis resettlement villages was carried out. A total of 620 children were examined, of which 329 were preschool children and 291 were schoolchildren. The age was determined and anthropometric measurements such as weight, height and MUAC were taken. The nutritional status was assessed by looking at the distributions of the z-scores of weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ) in relation to the growth charts of the National Center for Health Statistics reference population. It was found that the nutritional status of the Orang Asli children was poor, with a prevalence of 33.7-65.3% underweight, 55.3-74.4% stunting and 4.4-29.7% wasting based on the NCHS reference values. The prevalence of malnutrition among the Malay children was lower, underweight--7.3-34.1%, stunting--9.8-34.1% and wasting--1.7-17.1%. The nutritional status of the Orang Asli children were poorer compared to the Malay children. More preschool Orang Asli children were stunted compared to the Orang Asli schoolchildren. This may be due to the poor economic base of the Orang Asli community during the transformation period after resettlement. A comprehensive primary health care program is essential, especially targeting the preschool Orang Asli children in these resettlement villages.

Matched MeSH terms: Malaysia/ethnology
Ethnic variability in dementia: results from Singapore

Ampil ER, Fook-Chong S, Sodagar SN, Chen CP, Auchus AP

Alzheimer Dis Assoc Disord, 2005 Oct-Dec;19(4):184-5.
PMID: 16327344

The diversity of Singapore's population affords a unique opportunity to study ethnic variability in the dementias. We sought to explore the effects of ethnicity on the frequency of Alzheimer disease and vascular dementia in a large Singaporean sample. A total of 357 patients were studied: 190 with vascular dementia and 167 with Alzheimer disease. Vascular dementia was more common among Chinese and Malays, whereas Alzheimer disease was more common in Indians and Eurasians. Factors that may contribute to the observed ethnic variability in dementia etiologies include differential frequency of the ApoE-e4 allele, frequency of vascular risk factors, lifestyle choices, and cultural attitudes toward health care utilization.

Matched MeSH terms: Malaysia/ethnology
Cardiovascular risk factors in non-insulin-dependent diabetics compared to non-diabetic controls: a population-based survey among Asians in Singapore

Hughes K, Choo M, Kuperan P, Ong CN, Aw TC

Atherosclerosis, 1998 Jan;136(1):25-31.
PMID: 9544728

Cardiovascular risk factors were compared between 126 people with non-insulin-dependent diabetes mellitus (NIDDM) and 530 non-diabetics (controls), in a random sample of people (Chinese, Malays, and Asian Indians) aged 40-69 years from the general population of Singapore. Data were adjusted for age and ethnicity. For both genders, people with NIDDM had higher mean body mass indices, waist-hip ratios and abdominal diameters. They also had a higher prevalence of hypertension, higher mean levels of fasting serum triglyceride, slightly lower mean levels of serum high-density-lipoprotein cholesterol, and higher mean levels of plasma plasminogen activator inhibitor-1 and tissue plasminogen activator (antigen). These factors are components of syndrome X (metabolic syndrome) and increase the risk of atherosclerosis and thrombosis. In contrast, there were no important differences for cigarette smoking, serum total and low-density-lipoprotein cholesterol, serum apolipoproteins A1 and B, plasma factor VIIc and plasma prothrombin fragment 1 + 2. Females with NIDDM, but not males, had a higher mean serum fibrinogen level than non-diabetics, which could explain why NIDDM has a greater cardiovascular effect in females than males. Serum lipoprotein(a) concentrations were lower in people with NIDDM. Mean levels of serum ferritin, a pro-oxidant, were higher in people with NIDDM than controls, but there were no important differences for plasma vitamins A, C and E, and serum selenium, which are anti-oxidants.

Matched MeSH terms: Malaysia/ethnology

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