The study aims to create a composite risk index of CVD among adolescents and examine the influence of demographic, socioeconomic and lifestyle-related risk factors on the composite risk index of biological CVD risk factors among adolescents in Malaysia. A Malaysian adolescent cohort of 1320 adolescents were assessed at 13, 15 and 17 years. Seven biological CVD risk factors with moderate correlation were identified, standardized and averaged to form a composite CVD risk index. Generalised estimating equation using longitudinal linear regression was used to examine the effects of changes in adolescent lifestyle-related risk factors on the composite CVD risk index over time. From the ages 13 to 17 years, physical fitness (β = - 0.001, 90% CI = - 0.003, 0.00002) and BMI (β = 0.051, 95% CI = 0.042, 0.060) were significant predictors of attaining high scores of CVD risk. Female (β = 0.118, 95% CI = 0.040, 0.197), Chinese (β = 0.122, 95% CI = 0.006, 0.239), Indians (β = - 0.114, 95% CI = - 0.216, - 0.012) and adolescents from rural schools (β = 0.066, 95% CI = - 0.005, 0.136) were also found to be considerably significant. A more robust and gender-specific intervention programme focusing on healthy lifestyle (including achieving ideal BMI and improving physical fitness) need to be implemented among school-going adolescents.
Despite the wide accessibility to internet, pornography activities among youths are not well described in conservative countries like Malaysia. This study aimed to determine the prevalence, elicit gender differences and identify associated factors of pornographic exposure including perceived realism among college students. This cross-sectional study was conducted among students aged 18 to 25 years from seven colleges in Penang, Malaysia. A self-administered questionnaire was used to obtain data on socio-demographic characteristics, pornography exposure, pattern of use, sexual exposure and perceived realism. Among 986 participants, the prevalence of lifetime pornography exposure was 74.5%. More males (71.7%) were exposed to pornography, had started at earlier age, were frequent users and using the internet alone at home (p
Food variety scores (FVS) and dietary diversity scores (DDS) were estimated based on foods consumed weekly by 285 Malaysian households using a food frequency questionnaire. The scoring system of FVS and DDS was based on a scale of 0-7 and 0-6 respectively. The mean household FVS and DDS was 164.1 ± 93 and 6 ± 0.4. The age of respondents (husbands or wives; p < .01), sex (p < .05), and household food expenditure (p < .01) had a significant influence on both FVS and DDS. The food-intake pattern of Malaysian households showed that their typical diets had high protein and energy-based foods.
Limited data are available on optic neuritis in Asian children. Clinical profiles tend to vary with different races. We aimed to determine the clinical manifestations, visual outcomes, and etiologies of optic neuritis in Malaysian children, and discuss the literature of optic neuritis in Asian children. A retrospective study involving 14 children with optic neuritis was performed at Hospital Universiti Sains Malaysia between July 2005 and January 2010 (follow-up, 18-60 months). Clinical features, laboratory results, possible etiologies, and visual acuity after 1 year were studied. Females were predominant (mean age at presentation, 11.1 years). All patients manifested bilateral involvement. Swollen optic discs were observed in 92.9% of eyes; 60.7% of patients demonstrated a visual acuity of 6/60 (or 20/200) or worse on presentation, whereas 14.3% remained at 6/60 (or 20/200) or worse, 1 year after their attack. Cecocentral scotoma comprised the most common visual field defect. Infection contributed to 50.0% of cases; 14.3% progressed to multiple sclerosis during follow-up, with no evidence of recurrent optic neuritis. The clinical profiles and etiologies of optic neuritis in Malay children differ slightly compared with other optic neuritis studies of Asian children. The frequency of progression to multiple sclerosis is relatively lower.
It is clear that population-specific norms should be used when planning plastic and reconstructive surgery for selected patients. In this study, we aimed to generate nasal and labial reference values by applying a stereophotogrammetric technique. A further aim was to investigate the effect of sexual dimorphism, age-related changes, and the interrelation between nasal and labial morphology.
The formant frequencies of Malaysian Malay children have not been well studied. This article investigates the first four formant frequencies of sustained vowels in 360 Malay children aged between 7 and 12 years using acoustical analysis. Generally, Malay female children had higher formant frequencies than those of their male counterparts. However, no significant differences in all four formant frequencies were observed between the Malay male and female children in most of the vowels and age groups. Significant differences in all formant frequencies were found across the Malay vowels in both Malay male and female children for all age groups except for F4 in female children aged 12 years. Generally, the Malaysian Malay children showed a nonsystematic decrement in formant frequencies with age. Low levels of significant differences in formant frequencies were observed across the age groups in most of the vowels for F1, F3, and F4 in Malay male children and F1 and F4 in Malay female children.
In the present paper, a fuzzy rule-based system (FRBS) is designed to serve as a decision support system for Coronary heart disease (CHD) diagnosis that not only considers the decision accuracy of the rules but also their transparency at the same time. To achieve the two above mentioned objectives, we apply a multi-objective genetic algorithm to optimize both the accuracy and transparency of the FRBS. In addition and to help assess the certainty and the importance of each rule by the physician, an extended format of fuzzy rules that incorporates the degree of decision certainty and importance or support of each rule at the consequent part of the rules is introduced. Furthermore, a new way for employing Ensemble Classifiers Strategy (ECS) method is proposed to enhance the classification ability of the FRBS. The results show that the generated rules are humanly understandable while their accuracy compared favorably with other benchmark classification methods. In addition, the produced FRBS is able to identify the uncertainty cases so that the physician can give a special consideration to deal with them and this will result in a better management of efforts and tasks. Furthermore, employing ECS has specifically improved the ability of FRBS to detect patients with CHD which is desirable feature for any CHD diagnosis system.
There is a lack of data on tobacco use in the Syrian Arab Republic. This cross-sectional questionnaire survey estimated the prevalence of smoking among university students in Damascus and identified factors related to smoking. Among the 583 respondents, the overall prevalence of cigarette smoking was 20.8%. The mean age of smokers [25 (SD 2.2) years] was significantly higher than non-smokers [21 (SD 1.8) years]. Smoking prevalence among males (26.1%) was significantly higher than among females (9.5%). However, female students consumed a significantly higher number of cigarettes per day than did males [mean 21 (SD 5) versus 9 (SD 2)]. The smoking prevalence among students in non-health faculties (27.8%) was significantly higher than that of health professional students (14.5%) and was higher among students living away from their families (27.8%) than those living with their families (16.2%). The study raised concerns about smoking in student residences and women's smoking patterns.
The aim of this 5-year longitudinal cohort study was to assess the prevalence, severity, and trends in caries increment and impact of the School Dental Incremental Care Programme (SDICP). Data were gathered from school dental records as part of the SDICP. A sample of 1830 children were included and checked for caries experience annually using World Health Organization criteria. In total, 95.4% of the children were caries free in 2004, and caries experience declined to 70.5% in 2009 with an average of 4.9% annually. At baseline, the mean DMFT (confidence interval [CI]) was 0.06 (0.05-0.08) and increased to 0.58 (0.53-0.63) in 2009. Children with active caries were 4.4% in 2004, and figures rose to 9.6% in 2009. The FT component increased most rapidly during these 5 years from 0.2% to 25.1%. Overall caries prevalence and increment was low in this study. Proportions of FT component were higher as compared with DT component with low rate of extractions during the latter years of the study.
BACKGROUND: Nearly four-fifths of estimated 1.1 million smokers live in low or middle-income countries. We aimed to provide national estimates for Nepal on tobacco use prevalence, its distribution across demographic, socio-economic and spatial variables and correlates of tobacco use.
METHODS: A secondary data analysis of 2006 Nepal Demographic and Health Survey (DHS) was done. A representative sample of 9,036 households was selected by two-stage stratified, probability proportional to size (PPS) technique. We constructed three outcome variables 'tobacco smoke', 'tobacco chewer' and 'any tobacco use' based on four questions about tobacco use that were asked in DHS questionnaires. Socio-economic, demographic and spatial predictor variables were used. We computed overall prevalence for 'tobacco smoking', 'tobacco chewing' and 'any tobacco use' i.e. point estimates of prevalence rates, 95% confidence intervals (CIs) after adjustment for strata and clustering at primary sampling unit (PSU) level. For correlates of tobacco use, we used multivariate analysis to calculate adjusted odds ratios (AORs) and their 95% CIs. A p-value < 0.05 was considered as significant.
RESULTS: Total number of households, eligible women and men interviewed was 8707, 10793 and 4397 respectively. The overall prevalence for 'any tobacco use', 'tobacco smoking' and 'tobacco chewing' were 30.3% (95% CI 28.9, 31.7), 20.7% (95% CI 19.5, 22.0) and 14.6% (95% CI 13.5, 15.7) respectively. Prevalence among men was significantly higher than women for 'any tobacco use' (56.5% versus 19.6%), 'tobacco smoking' (32.8% versus 15.8%) and 'tobacco chewing' (38.0% versus 5.0%). By multivariate analysis, older adults, men, lesser educated and those with lower wealth quintiles were more likely to be using all forms of tobacco. Divorced, separated, and widowed were more likely to smoke (OR 1.49, 95% CI 1.14, 1.94) and chew tobacco (OR 1.36, 95% CI 0.97, 1.93) as compared to those who were currently married. Prevalence of 'tobacco chewing' was higher in eastern region (19.7%) and terai/plains (16.2%). 'Tobacco smoking' and 'any tobacco use' were higher in rural areas, mid-western and far western and mountainous areas.
CONCLUSIONS: Prevalence of tobacco use is considerably high among Nepalese people. Demographic and socioeconomic determinants and spatial distribution should be considered while planning tobacco control interventions.
Malaysian students ages 12 to 15 years (N = 330; 165 girls, 165 boys) took the Australian Institute of Sport Talent Identification Test (AIST) and the Balance and Movement Coordination Test (BMC), developed specifically to identify sport talent in Malaysian adolescents. To investigate evidence for general aptitude ("g") in motor ability, a higher-order factor analysis was applied to the motor skills subtests from the AIST and BMC. First-order principal components analysis indicated that scores for the adolescent boys and girls could be described by similar sets of specific motor abilities. In particular, sets of skills identified as Movement Coordination and Postural Control were found, with Balancing Ability also emerging. For the girls, a factor labeled Static Balance was indicated. However, for the boys a more general balance ability labeled Kinesthetic Integration was found, along with an ability labeled Explosive Power. These first-order analyses accounted for 45% to 60% of the variance in the scores on the motor skills tests for the boys and girls, respectively. Separate second-order factor analyses for the boys and girls extracted a single higher-order factor, which was consistent with the existence of a motoric "g".
This study examines the sociodemographic factors associated with daily fruit and vegetable (FV) consumption in Malaysia. Based on a cross-sectional sample of 2447 individuals from the Malaysia Non-Communicable Disease Surveillance-1, a multivariate sample selection system is developed and estimated, to accommodate high frequencies of daily FV consumption and the days of servings among nondaily consumers. Results indicate that the authors' attempt to account for endogenous sample selectivity and cross-equation correlations is justified. There exist positive correlations between FV consumption likelihoods and longer work hours, higher levels of education, high income, female gender, nonsmoking status, and being from East Malaysia. Among nondaily consumers, those with longer work hours, singles, and people with diabetes are less inclined to eat fruits on more days. Overall, higher-educated, affluent people, nonsmokers, and East Malaysians display more days of FV consumption. Based on these outcomes, several policy implications are recommended vis-à-vis FV consumption patterns in Malaysia.
This study aimed to assess the variability of the lower third molar (tooth 38 and 48) development in Northeast Malaysian population with respect to the side of dentition, to generate age prediction models and to compare the outcome with other studies. A total of 1080 orthopantomograms of Northeast Malaysian population aged between 14 and 25 years (540 males and 540 females) from the Hospital Universiti Sains Malaysia's archive which met the inclusion and exclusion criteria were selected and the maturity stages of tooth 38 and 48 were scored using Demirjian's stages (A-H). The findings showed a wide variation of the development of lower third molars in the Northeast Malaysian population. The roots developed earlier in males than in females. The development of the dentition on opposite sides of the mandible was synchronously in females and males. A multiple regression analysis shows that 71.1% of variance in age was explained by sex and developmental stage of tooth 48. An age prediction model was generated from the regression analysis: [Age = 7.117 + 1.907*(stage of tooth 48) - 0.432*(sex)] with mean prediction errors between -0.17 to 3.14 years. The obtained data in the current study are useful for references and determining age of unidentified human remains for identification investigation.
Childhood nocturnal enuresis (NE) and incontinence has been shown to be associated with increased behavioural problems and reduced self-esteem (SE) in Western populations. The impact on Asian children, however, is not known. This study investigates the relationship between SE and monosymptomatic NE in Malaysian children aged 6 to 16 years.
The aim of this study was to assess nutritional supplement use among fitness club participants in Tehran, Iran. A cross sectional study was conducted in 24 fitness clubs throughout the city of Tehran, Iran. A total of 1625 fitness club participants were recruited to participate in this study. They were asked to complete a self-administered pre-tested questionnaire. Descriptive statistics and chi-square test were performed to determine the characteristics of participants, reasons for supplement use, sources of information and also the influential advisors regarding nutritional supplement use. A high prevalence rate of nutritional supplement use (66.7%) was reported. Overall, multivitamin-mineral (43.8%) and iron tablets (30.5%) were the common nutritional supplements used and only a small number of participants used illegal substances (0.5%). Younger participants were more likely to use ergogenic aids, whereas, older participants were more likely to use vitamin D. Males were more likely than females to use creatine and amino acids, whereas, iron tablets and mint water were more common among females. Also, males were more likely to use nutritional supplements for increasing energy, whereas, females were more likely to use nutritional supplements for nutritional deficiencies. In conclusion, a high prevalence rate of nutritional supplement use was seen among participants.
This community based cross-sectional study examined the prevalence and factors associated with depression among urban poor in Peninsular Malaysia. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depression. The prevalence of depression among the urban poor was 12.3%. Factors significantly associated with depression included respondents under 25 years old, male gender, living in the area for less than four years and those who do not exercise regularly. It is important to identify individuals with depression and its associated factors early because depression can severely affect the quality of life.
This study was conducted to investigate pervasiveness of the musculoskeletal disorder (MSD) among staffs in a specialized healthcare centre. Sixty-eight staffs from three departments namely Cardiovascular Lab (CVL), Nuclear Radiology, and General Radiography were recruited in this study. A modified Nordic Musculoskeletal Questionnaire (NMQ) was distributed among study population. The result shows that the prevalence of MSD was highest in lower back (88.2%), neck (76.5%) and shoulder (60.3%) for the past 12 months followed by lower back and elbow (44.1%), and wrist (39.1%) correspondingly, for the past 7 days. Present results suggest that healthcare professionals - radiographers, patient assistants and nurses incurs MSD risks through work tasks as well as psychosocial factors. These include awkward posture during patient handling, workload, work stress and time pressure. Therefore, an ergonomics improvement on the job design and workspace are needed in order to reduce the MSD risks.
Sleep disordered breathing (SDB) is increasingly being diagnosed in children. However, there is no prevalence study done in Malaysia. The study objective was to evaluate the prevalence of SDB symptoms based on parental reports and associated risk factors among Malay school children aged 6 to 10 years old in a primary school using a translated University Michigan Paediatric Sleep Questionnaire (Malay UM-PSQ). The children whose parents responded to the questionnaire and consented were examined, documenting height, weight, skin fold thickness, neck and abdominal circumference, tonsillar size, nostril examination and presence of micrognathia or retrognathia. There were 550 respondents. The prevalence of parental report of SDB symptoms was 14.9 % (95 % CI 11.9, 17.9). Two hundred and eighty-five (51.8%) school children were males with mean age of 8.5 years (SD 1.1). The associated risk factors for SDB symptoms are male, obesity, large neck and waist circumference, positive history of asthma, history of recurrent tonsillitis, enlarged tonsil (> 4+) and enlarged nasal turbinate. Multivariate analysis showed that male gender is the only significant independent risk factor of SDB symptoms
Designing a system for the elderly is crucial, as aging is associated with physiological changes that may impair perception, cognition and other social aspects; therefore, many aspects need consideration, especially in interface design. This study was conducted to develop a digital nutritional education package (WE Sihat) by following appropriate guidelines for elderly people to achieve better design interface and interaction. Touch-screen technology was used as a platform for user interaction. The nutritional content was based on previous nutrition studies and a lifestyle education package on healthy aging, which contains four modules. The questionnaires were distributed to 31 Malay subjects aged 60-76 years old, containing an evaluation about the overall content, graphics, design layout, colour, font size, audio/video, user-perceived satisfaction and acceptance levels. The findings showed positive feedback and acceptance. Most subjects agreed that the digital nutritional education package can increase their nutritional knowledge for a healthy lifestyle and is easy to use. The touch-screen technology was also well accepted by elderly people and can be used as a kiosk for disseminating nutrition education for healthy aging.