MyMedR

AMI screening using linguistic fuzzy rules

Ainon RN, Bulgiba AM, Lahsasna A

J Med Syst, 2012 Apr;36(2):463-73.

PMID: 20703704 DOI: 10.1007/s10916-010-9491-2

This paper aims at identifying the factors that would help to diagnose acute myocardial infarction (AMI) using data from an electronic medical record system (EMR) and then generating structure decisions in the form of linguistic fuzzy rules to help predict and understand the outcome of the diagnosis. Since there is a tradeoff in the fuzzy system between the accuracy which measures the capability of the system to predict the diagnosis of AMI and transparency which reflects its ability to describe the symptoms-diagnosis relation in an understandable way, the proposed fuzzy rules are designed in a such a way to find an appropriate balance between these two conflicting modeling objectives using multi-objective genetic algorithms. The main advantage of the generated linguistic fuzzy rules is their ability to describe the relation between the symptoms and the outcome of the diagnosis in an understandable way, close to human thinking and this feature may help doctors to understand the decision process of the fuzzy rules.

Fulltext Peri-operative blood pressure changes in normotensive and hypertensive patients

Poh KS, Lim TA, Airini IN

Med J Malaysia, 2007 Jun;62(2):97-103.

PMID: 18705438

Controversy surrounds the acceptance of hypertension as an independent risk factor for anaesthesia. In an attempt to identify variables that are associated with increased haemodynamic instability during surgery, the blood pressure profiles of 128 patients were analysed. The two variables that contributed most to the instability were pre-operative control of blood pressure and anaesthetic technique. To reduce the fluctuation in blood pressure, it is advisable for patients to be given a regional anaesthetic. Current therapy for hypertension appears to exaggerate the depressant effects of anaesthetic drugs. Care must be taken not only to prevent hypertensive episodes during surgery, but also hypotension.

Fulltext Prevalence of thiamine deficiency at a drug rehabilitation centre in Malaysia

Fozi K, Azmi H, Kamariah H, Azwa MS

Med J Malaysia, 2006 Dec;61(5):519-25.

PMID: 17623950 MyJurnal

A possible outbreak of beriberi occurred at a drug detention and rehabilitation centre, Pusat Serenti Bukit Cabang, Perlis, Malaysia in February 2004. This outbreak was identified following the presentation of a large number of inmates at a health centre with signs and symptoms of ankle oedema and shortness of breath. Further investigations revealed the death of three inmates at the General Hospital with similar clinical presentations during the period from October 2003 till February 2004. A cross sectional comparative study was carried out at the rehabilitation centre to find out the prevalence of thiamine deficiency among the inmates both symptomatic and asymptomatic. A total of 154 inmates were examined (57 symptomatic and 97 asymptomatic cases). It was found that 74% from the sample study (114 cases) had thiamine deficiency (44 symptomatic and 70 asymptomatic). Further statistical analysis showed that ankle oedema is consistent with the diagnosis of thiamine deficiency but lack sensitivity (p < 0.05, sensitivity 24.6%, specificity 95%). This outbreak could have been triggered by poor diet intake of thiamine by the inmates coupled with possible intake of certain thiamine antagonists in their diet.

Fulltext Lifestyle factors and breast cancer: a case-control study in Kuala Lumpur, Malaysia

Kamarudin R, Shah SA, Hidayah N

Asian Pac J Cancer Prev, 2006 Jan-Mar;7(1):51-4.

PMID: 16629515

Breast cancer is the most common female cancer and the commonest cause of death due to cancer for women in Malaysia. This study was performed to identify the relationship with lifestyle factors. A case-control study was conducted among females with breast cancer who came for treatment to the Breast Clinic Hospital Kuala Lumpur in July until September 2004. A total of 203 female patients were recruited as cases along with 203 patients who attended the Outpatient Clinic, Hospital Kuala Lumpur during the study period as the controls. The study showed women who did not exercise regularly to have four times higher risk (adjusted odds ratio is 3.49, 95% CI is 1.84 to 6.62) compared to those who exercised regularly. Women with a high fat diet were also at elevated risk (adjusted odds ratio 3.84, 95% CI is 1.20 to 12.34) compared to those consuming a low fat diet. Women without breast cancer generally had a longer duration of lifetime lactation with a median of thirty-three months compared to women with breast cancer (twenty months, p<0.05). Women who did not take oral contraceptive pills but had breast-fed their child have a 56.0% lower risk (crude odds ratio 0.44, CI is 0.22 to 0.87) compared to women who did not take oral contraceptive pill and also did not breast-feed their child. If they had breast fed for thirteen months and above, they faced a 61.0% lower risk (crude odds ratio 0.39, 95% CI is 0.17 to 0.87). There was a significant inverse trend for lifetime lactation and breast cancer risk. In conclusion certain life styles of women are associated with a higher risk of breast cancer development. Therefore, the promotion of a healthy life style should be emphasized.
Study site: Breast Clinic, Outpatient clinic, Hospital Kuala Lumpur, Malaysia

Prenatal detection of birth defects in a Malaysian population: estimation of the influence of termination of pregnancy on birth prevalence in a developing country

Ho JJ, Thong MK, Nurani NK

Aust N Z J Obstet Gynaecol, 2006 Feb;46(1):55-7.

PMID: 16441696

We studied 253 women with a pregnancy complicated by a birth defect and 506 controls to determine the frequency and type of prenatal tests and the types of defects detected antenatally. Most women had at least one ultrasound examination, but the frequency of other screening tests was low. Only 38 (15%) of defects were detected antenatally (37 by ultrasound). Birth prevalence is unlikely to be affected by pregnancy termination.

Fulltext Bayesian inference of the Weibull model based on interval-censored survival data

Guure CB, Ibrahim NA, Adam MB

Comput Math Methods Med, 2013;2013:849520.

PMID: 23476718 DOI: 10.1155/2013/849520

Interval-censored data consist of adjacent inspection times that surround an unknown failure time. We have in this paper reviewed the classical approach which is maximum likelihood in estimating the Weibull parameters with interval-censored data. We have also considered the Bayesian approach in estimating the Weibull parameters with interval-censored data under three loss functions. This study became necessary because of the limited discussion in the literature, if at all, with regard to estimating the Weibull parameters with interval-censored data using Bayesian. A simulation study is carried out to compare the performances of the methods. A real data application is also illustrated. It has been observed from the study that the Bayesian estimator is preferred to the classical maximum likelihood estimator for both the scale and shape parameters.

Testing the agreement of medical instruments: overestimation of bias in the Bland-Altman analysis

Zaki R, Bulgiba A, Ismail NA

Prev Med, 2013;57 Suppl:S80-2.

PMID: 23313586 DOI: 10.1016/j.ypmed.2013.01.003

The Bland-Altman method is the most popular method used to assess the agreement of medical instruments. The main concern about this method is the presence of proportional bias. The slope of the regression line fitted to the Bland-Altman plot should be tested to exclude proportional bias. The aim of this study was to determine whether the overestimation of bias in the Bland-Altman analysis is still present even when the proportional bias has been excluded.

Fulltext Chemotherapy-induced nausea and vomiting: exploring patients' subjective experience

Salihah N, Mazlan N, Lua PL

J Multidiscip Healthc, 2016;9:145-51.

PMID: 27110121 DOI: 10.2147/JMDH.S97695

This study aimed to explore the subjective experience of nausea and vomiting during chemotherapy treatment among breast cancer patients and the impacts on their daily lives.

Fulltext A rare 47 XXY/46 XX mosaicism with clinical features of Klinefelter syndrome

Mohd Nor NS, Jalaludin MY

Int J Pediatr Endocrinol, 2016;2016:11.

PMID: 27257411 DOI: 10.1186/s13633-016-0029-3

BACKGROUND: 47 XXY/46 XX mosaicism with characteristics suggesting Klinefelter syndrome is very rare and at present, only seven cases have been reported in the literature.

CASE PRESENTATION: We report an Indian boy diagnosed as variant of Klinefelter syndrome with 47 XXY/46 XX mosaicism at age 12 years. He was noted to have right cryptorchidism and chordae at birth, but did not have surgery for these until age 3 years. During surgery, the right gonad was atrophic and removed. Histology revealed atrophic ovarian tissue. Pelvic ultrasound showed no Mullerian structures. There was however no clinical follow up and he was raised as a boy. At 12 years old he was re-evaluated because of parental concern about his 'female' body habitus. He was slightly overweight, had eunuchoid body habitus with mild gynaecomastia. The right scrotal sac was empty and a 2mls testis was present in the left scrotum. Penile length was 5.2 cm and width 2.0 cm. There was absent pubic or axillary hair. Pronation and supination of his upper limbs were reduced and x-ray of both elbow joints revealed bilateral radioulnar synostosis. The baseline laboratory data were LH

Fulltext Managing burn wounds with SMARTPORE Technology polyurethane foam: two case reports

Imran FH, Karim R, Maat NH

J Med Case Rep, 2016;10(1):120.

PMID: 27170287 DOI: 10.1186/s13256-016-0918-3

Successful wound healing depends on various factors, including exudate control, prevention of microbial contaminants, and moisture balance. We report two cases of managing burn wounds with SMARTPORE Technology polyurethane foam dressing.

Fulltext Metasynthesis: Experiences of Women with Severe Maternal Morbidity and Their Perception of the Quality of Health Care

Norhayati MN, Surianti S, Nik Hazlina NH

PLoS One, 2015;10(7):e0130452.

PMID: 26132107 DOI: 10.1371/journal.pone.0130452

To explore the experiences of women with severe maternal morbidity and their perception of the quality of health care.

Review of air pollution and health impacts in Malaysia

Afroz R, Hassan MN, Ibrahim NA

Environ Res, 2003 Jun;92(2):71-7.

PMID: 12854685

In the early days of abundant resources and minimal development pressures, little attention was paid to growing environmental concerns in Malaysia. The haze episodes in Southeast Asia in 1983, 1984, 1991, 1994, and 1997 imposed threats to the environmental management of Malaysia and increased awareness of the environment. As a consequence, the government established Malaysian Air Quality Guidelines, the Air Pollution Index, and the Haze Action Plan to improve air quality. Air quality monitoring is part of the initial strategy in the pollution prevention program in Malaysia. Review of air pollution in Malaysia is based on the reports of the air quality monitoring in several large cities in Malaysia, which cover air pollutants such as Carbon monoxide (CO), Sulphur Dioxide (SO2), Nitrogen Dioxide (NO2), Ozone (O3), and Suspended Particulate Matter (SPM). The results of the monitoring indicate that Suspended Particulate Matter (SPM) and Nitrogen Dioxide (NO2) are the predominant pollutants. Other pollutants such as CO, O(x), SO2, and Pb are also observed in several big cities in Malaysia. The air pollution comes mainly from land transportation, industrial emissions, and open burning sources. Among them, land transportation contributes the most to air pollution. This paper reviews the results of the ambient air quality monitoring and studies related to air pollution and health impacts.

Introduction to management: Organization and Management of Health Services (OMHS) in Malaysia

Saimy I, Ghani SN, Teoh ST

Med J Malaysia, 2002 Dec;57 Suppl E:99-101.

PMID: 12733202

Fulltext Effect of exposure to dust on lung function of cement factory workers

Noor H, Yap CL, Zolkepli O, Faridah M

Med J Malaysia, 2000 Mar;55(1):51-7.

PMID: 11072491 MyJurnal

Exposure to Portland cement dust has long been associated with the prevalence of respiratory symptoms and varying degrees of airway obstruction in man. Apart from respiratory diseases, it was also found to be the cause of lung and laryngeal cancer, gastrointestinal tumours and also dermatitis. This study was done to investigate the effect of dust exposure on ventilatory lung function of Portland cement factory workers in Rawang, Selangor. Spirometry tests of 62 male workers (exposed to total dust concentration of 10,180 micrograms/m3 and PM10 of 8049 micrograms/m3) and 70 subjects from UPM (exposed to mean total dust of 192 micrograms/m3 and PM10 of 177 micrograms/m3--controls) revealed significant differences in spirometry values between the groups. The workers showed i) significantly lower FEV1% and FEF25-75%, and higher FMFT, ii) reduced FEV1% with increasing level of dust exposure and iii) higher prevalence of respiratory symptoms. Therefore, we suggest that exposure to dust in the cement factory leads to higher incidence of respiratory symptoms and impaired lung function.

Fulltext Childhood atopic dermatitis: a measurement of quality of life and family impact

Aziah MSN, Rosnah T, Mardziah A, Norzila MZ

Med J Malaysia, 2002 Sep;57(3):329-39.

PMID: 12440273 MyJurnal

Atopic dermatitis is the commonest skin disease in children, causing psychological, social and functional disability to them and their families. This study assessed the family impact and quality of life using the translated Malay version of The Dermatology Family Impact (DFI) and The Children's Dermatology Life Quality Index (CDLQI) questionnaires. Seventy-two children, aged between 6 months and 16 years attending the Paediatric Dermatology Clinic at the Paediatric Institute and the Dermatology Department, Hospital Kuala Lumpur participated in this study. Thirty-nine patients (54.2%) were males and 33 patients (45.8%) were females. The median age of the patients was 74 months (Q1 6, Q3 104 months). The median age of diagnosis was 22 months (Q1 1, Q3 36 months). The median disease duration was 44 months (Q1 3, Q3 65). The severity of eczema was assessed using the SCORAD severity index (maximum score = 83). The median SCORAD (European Task Force On Atopic Dermatitis) score was 36 (n = 72, SD = 16.2). The majority of patients in this study suffered from moderately severe eczema (n = 40, mean, SCORAD = 29.3) followed by severe eczema (n = 27, mean SCORAD = 54.3). The mildly affected patients formed the minority group (n = 5, mean SCORAD = 9.0). The family impact was shown to be greater in severe atopic dermatitis compared to moderate atopic dermatitis (Anova, p = 0.02). The children's quality of life impairment was also greater in severe atopic dermatitis compared to moderate atopic dermatitis (Anova p = 0.08). This study confirms that quality of life and family impact are related to the severity of atopic dermatitis.

Phage display of recombinant antibodies toward Burkholderia pseudomallei exotoxin

Nathan S, Li H, Mohamed R, Embi N

J. Biochem. Mol. Biol. Biophys., 2002 Feb;6(1):45-53.

PMID: 12186782

We have used the phagemid pComb3H to construct recombinant phages displaying the single chain variable fragment (ScFv) towards exotoxin of Burkholderia pseudomallei. Variable heavy and light chain fragments were amplified from the hybridoma 6E6A8F3B line, with a wide spectrum of primers specific to mouse antibody genes. Through overlapping extension polymerase chain reaction, the heavy and light chain fragments were linked to form the ScFv which was subsequently cloned into the phage display vector and transformed into ER2537 cells to yield a complexity of 10(8) clones. The transformants were screened by four rounds of biopanning against the exotoxin and resulted in selective enrichment of exotoxin-binding antibodies by 301 fold. The phage pool from the final round of selection displayed antibodies of high-affinity to the exotoxin as demonstrated by ELISA. Several clones were selected randomly from this pool and analysed by restriction enzyme digestion, fingerprinting and sequencing. Restriction analysis confirmed that all clones carried a 700-800 bp insert whose sequences, in general, corresponded to that of mouse IgG. Fingerprinting profiles delineated the antibodies into two families with different CDR sequences.

Fulltext Amoebiasis with multiple colonic perforations and ruptured liver abscess - a case report

Manukaran MN, Ahmad H, Abdullah I

Med J Malaysia, 1983 Mar;38(1):71-3.

PMID: 6633343

A case of amoebiasis with colonic perforation and ruptured liver abscess is reported. It is rare for both these complications to occur in the same patient. The management is described and the literature reviewed

Fulltext Dataset on the green consumption behaviour amongst Malaysian consumers

Ghani NAM, Yusop FD, Kamarulzaman Y

Data Brief, 2020 Oct;32:106302.

PMID: 32995394 DOI: 10.1016/j.dib.2020.106302

This dataset contains information of 375 respondents on green consumption behaviour. The questionnaire was developed using Theory of Planned Behaviour as the foundation. The variables available in the dataset are Environmental Concern (EC), Social Influence (SI), Perceived behavioural control (PBC), Consumer novelty seeking (CNS) and Green consumption behaviour (GC). In addition to the variables related to green consumption, the dataset also includes demographic and media preference information of the respondents. The data was collected via self-administered questionnaire in seven major cities in Klang Valley, namely Shah Alam, Bangsar, Petaling Jaya, Subang Jaya, Puchong, Serdang and Putrajaya. The dataset can have an important role for research in consumer behaviour towards developing green consumers.

Short-Term Results of Trial of Topical Insulin for Treatment of Dry Eyes in Diabetics

Aniah Azmi N, Bastion MC

Eye Contact Lens, 2020 Jan;46 Suppl 1:S25-S32.

PMID: 31145207 DOI: 10.1097/ICL.0000000000000623

OBJECTIVES: To assess the short-term effects of topical insulin (TI) 1 unit/drop 4 times per day for 4 weeks on the symptoms and signs of diabetic with dry eye disease (DED).

METHODS: In this randomized, double-blind interventional study, diabetics with DED aged 18 to 60 years were randomly assigned to TI or standard artificial tears (SAT). Baseline Ocular Surface Disease Index (OSDI), Schirmer I test (ST), tear break-up time (TBUT), and ocular Sjögren's International Collaborative Clinical Alliance (SICCA) score were compared 4 weeks after treatment.

RESULTS: A total of 160 participants (involving 320 eyes) received either TI (n=80) or SAT (n=80). After 4 weeks of treatment, a significant number of participants in both TI and SAT groups showed improvement in their OSDI score, 66% and 63%, respectively (P=0.0001), but were not significantly better than each other (P=0.453). However, most participants in both groups showed worsening of ST and TBUT (P>0.05). Most of the participants in both groups showed no change in their ocular SICCA score (P>0.05).

CONCLUSION: The study has shown a significant and similar improvement in the OSDI score for TI 1 unit/drop four times daily and SAT in treating diabetics with DED. Further research is required to understand the long-term effects of TI on the ocular surface.

Fulltext Maternal and perinatal outcomes in teenage pregnancy between indigenous and non-indigenous. Is there a difference?

Malek NNA, Suharjono H, Shetty A

Clin Med (Lond), 2019 Jun;19(Suppl 3):26.

PMID: 31345869 DOI: 10.7861/clinmedicine.19-3-s26

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