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  1. HLA-B*58: 01 association in allopurinol-induced severe cutaneous adverse reactions: the implication of ethnicity and clinical phenotypes in multiethnic Malaysia
    Low DE, Nurul-Aain AF, Tan WC, Tang JJ, Bakhtiar MF, Murad S, et al.
    Pharmacogenet Genomics, 2020 09;30(7):153-160.
    PMID: 32433341 DOI: 10.1097/FPC.0000000000000408
    OBJECTIVE: The association between human leukocyte antigen (HLA)-B*58:01 and risk of allopurinol-induced severe cutaneous adverse reactions (AIS) was observed across different populations. We explore the association between HLA-B*58:01 and AIS risk in multiethnic Malaysian population. The HLA-B*58:01 risk for different AIS clinical phenotypes and ethnicity was determined.

    METHODS: We performed a case-control association study by genotyping the HLA-B alleles of 55 patients with AIS [11 toxic epidermal necrolysis (TEN), 21 Steven Johnson syndrome (SJS) 22 drug reaction wit eosinophilia and systemic symptoms (DRESS) and one acute generalized exanthematous pustulosis (AGEP)] and 42 allopurinol-tolerant controls (ATC).

    RESULTS: HLA-B*58:01 was positive in 89.1 and 14.3% of the AIS and ATC study groups [odds ratio (OR) = 49.0, 95% confidence interval (CI) = 14.6-164.4, P < 0.0001)], respectively. Our data showed that 93.8% of the AIS-SJS/TEN patients and 86.4% of the AIS-DRESS patients were HLA-B*58:01 positive (AIS-SJS/TEN, OR = 90, 95% CI = 16.9-470.1, P < 0.0001 and AIS-DRESS OR = 38, 95% CI = 8.5-169.2, P < 0.0001). Stratification by ethnicity and clinical phenotypes revealed a significant increased risk between HLA-B*58:01 and Chinese-AIS patients (OR = 137.5, 95% CI = 11.3-1680.2, P < 0.0001), in particular Chinese patients with AIS-SJS/TEN phenotype (100% HLA-B*58:01 positive). HLA-B*58:01 was positive in 90.9% Chinese AIS-DRESS (P < 0.0001). Highly significant associations of HLA-B*58:01 were observed in Malay AIS-SJS/TEN (OR = 78, 95% CI = 9.8-619.9, P < 0.0001) and Malay AIS-DRESS (OR = 54, 95% CI = 6.6-442.9, P < 0.0001). Although the number of Indian-AIS patients was relatively small (n = 2), both were HLA-B*58:01 positive.

    CONCLUSION: Our data suggest strong associations between HLA-B*58:01 and AIS in Malaysian population with Chinese and Malays ethnicity. The strong association was also observed in three different clinical phenotypes of AIS, mainly the AIS-SJS/TEN.

    Matched MeSH terms: Malaysia/ethnology
  2. Fulltext Food, culture, and identity in multicultural societies: Insights from Singapore
    Reddy G, van Dam RM
    Appetite, 2020 06 01;149:104633.
    PMID: 32084519 DOI: 10.1016/j.appet.2020.104633
    The choice of food practices can be influenced by one's identity in many societies, but has mostly been evaluated in light of the maintenance of cultural identity in migrant populations. This study focused on understanding the influence of identity on food practices among individuals in multicultural societies. We conducted 18 focus group discussions (n = 130) among Indian, Chinese and Malay women in Singapore. Focus group transcripts were analysed using Thematic Analysis both inductively and deductively. Deductive analysis was framed within a Social Representations Approach, a social psychological theory that allows a deeper understanding of the contextual aspects of identity. Participants highlighted the central position of food in social events, cultural celebrations, and persistent traditional beliefs about health (such as 'hot-cold balance'). These beliefs extended to the perception of certain traditional foods possessing medicinal properties. Importantly, the consumption of these traditional foods was accepted as necessary for the maintenance of health by the women. We propose that while cultural food practices are integral to identity preservation and identity continuity for Singaporean women from all three racial groups, this is different to other multicultural societies such as Canada where communities preserve their cultural food practices, in part, due to fear of cultural identity loss. In addition, cross-cultural food practices are readily adopted in participants' daily lives for a number of reasons such as the promotion of health, convenience, and variety. At times, this adoption blurred boundaries between different cultural cuisines. Food practices in multicultural societies like Singapore are thus a reflection of everyday multiculturalism, multicultural social policies, and attitudes towards traditional healthful food practices, and these aspects need to be considered in the development of public health policies and interventions.
    Matched MeSH terms: Malaysia/ethnology
  3. Maternal adiposity and blood pressure in pregnancy: varying relations by ethnicity and gestational diabetes
    Lim WY, Kwek K, Chong YS, Lee YS, Yap F, Chan YH, et al.
    J Hypertens, 2014 Apr;32(4):857-64.
    PMID: 24390251 DOI: 10.1097/HJH.0000000000000096
    OBJECTIVE: Greater maternal adiposity is a potentially modifiable risk factor for elevated blood pressure during pregnancy; however, the association has been little studied in Asian populations, and no study has evaluated potential differences in the adiposity-blood pressure relation between ethnic groups or interaction with gestational diabetes.

    METHODS: We performed a cross-sectional evaluation of a Singapore mother-offspring cohort comprising 799 pregnant Chinese, Malay and Indian women. Data on body weight, height, skinfold thickness and glycaemia (oral glucose tolerance test) were collected during the 2nd trimester; peripheral SBP and DBP were measured using an oscillometric device and central pressures by noninvasive radial applanation tonometry. The associations between adiposity measures BMI and sum of skinfold thickness and blood pressure outcomes were examined by linear regression with adjustment for potential confounders.

    RESULTS: Higher maternal BMI was associated with elevated peripheral and central pressures: the increases in pressure (mmHg) for each kg/m(2) increase in BMI were 1.19 (95% confidence interval, 1.03-1.36) for peripheral SBP, 0.76 (0.63-0.89) for peripheral DBP, 1.02 (0.87-1.17) for central systolic pressure and 0.26 (0.16-0.37) for central pulse pressure. The associations were generally stronger in Chinese women (P-interaction = 0.03 for central pulse pressure) and individuals with gestational diabetes (P-interaction = 0.03 for DBP and P-interaction = 0.046 for central systolic pressure). Similar patterns of results were found when using skinfold thickness as the measure of adiposity.

    CONCLUSION: Maternal adiposity is associated with higher peripheral and central blood pressures during pregnancy. Stronger associations in Chinese women and individuals with gestational diabetes warrant further investigation.
    Matched MeSH terms: Malaysia/ethnology
  4. Headache characteristics and race in Singapore: results of a randomized national survey
    Ho KH, Ong BK
    Headache, 2001 Mar;41(3):279-84.
    PMID: 11264688 DOI: 10.1046/j.1526-4610.2001.111006279.x
    This study presents the first account of the racial differences in headache prevalence and characteristics in the Singapore population. A questionnaire was administered to 2096 individuals from a randomized sample of 1400 households to test the hypothesis that race was independently correlated with headache diagnosis and morbidity. The overall lifetime prevalence of headaches in the study population was 82.7%; this did not vary between racial groups. The modal age of headache onset in all races was in the second decade and was similar in all races. Multivariate analysis showed that headache morbidity was independent of age, sex, income level, marital status, shift duties, and educational level, and correlated only with race and a positive family history of severe headache. Non-Chinese were more likely to suffer from severe headaches than Chinese, were more likely to seek medical attention, and were more likely to require medical leave for their symptoms. Non-Chinese had more migrainous headaches than Chinese, although characteristics of headache both groups experienced that were unrelated to severity differed only in a few aspects. We conclude that racial factors account for differences in headache classification, perception of headache severity and health-seeking behavior.
    Matched MeSH terms: Malaysia/ethnology
  5. Attitudes towards deprescribing among multi-ethnic community-dwelling older patients and caregivers in Malaysia: a cross-sectional questionnaire study
    Kua KP, Saw PS, Lee SWH
    Int J Clin Pharm, 2019 Jun;41(3):793-803.
    PMID: 31020599 DOI: 10.1007/s11096-019-00829-z
    Background Deprescribing describes a process of medication regimen optimization with the aim to reduce adverse events and improve quality of life. There is limited research on perceptions of older adults, defined as those 60 years of age and older, about their willingness to cease a medication in developing countries. Objective To ascertain patients' attitudes, beliefs, perceptions, and experiences regarding the number of medications they were taking and their opinions regarding deprescribing. Setting A primary care health clinic and three community pharmacies in Malaysia. Method A multicenter cross-sectional study was conducted by administering the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire to older adults aged 60 years and over or caregivers attending a health clinic and three community pharmacies in Malaysia. Descriptive results were reported for participants' characteristics and questionnaire responses. Analysis of correlation between participant characteristics and their responses was performed using Spearman's correlation. Main outcome measure Patients' and caregivers' attitudes and beliefs towards reducing medications and characteristics of patients such as age, gender, education level, number of medication taken and number of medical center managing the patient. Results 650 participants were approached and the response rate was 85.2%. A total of 554 participants completed the questionnaire (502 older adults and 52 caregivers). Older adults in the study were taking a median of three medications and/or supplements compared to four in caregiver recipients. 88.1% of older adults were satisfied with their current medication regimen and 67.7% would like to try stopping or reducing the dose of their medicines when their doctor recommended. 82.7% of caregivers were satisfied with their care recipient's current medications and 65.4% were willing to stop taking or reduce the number of drugs taken by their care recipient's upon doctor's recommendation. Older adults (p = 0.003) and those with lower education level (p 
    Matched MeSH terms: Malaysia/ethnology
  6. Contribution of TIMP4 rs3755724 polymorphism to susceptibility to focal epilepsy in Malaysian Chinese
    Haerian BS, Sha'ari HM, Fong CY, Tan HJ, Wong SW, Ong LC, et al.
    J Neuroimmunol, 2015 Jan 15;278:137-43.
    PMID: 25595263 DOI: 10.1016/j.jneuroim.2014.12.016
    Neuroinflammation can damage the brain and plays a critical role in the pathophysiology of epilepsy. Tissue inhibitor of metalloproteinase 4 (TIMP4) is an inflammation-induced apoptosis and matrix turnover factor involved in several neuronal disorders and inflammatory diseases. Evidence has shown linkage disequilibrium between rs3755724 (-55C/T) of this gene with synapsin 2 (SYN2) rs3773364 and peroxisome proliferator-activated G receptor (PPARG) rs2920502 loci, which contribute to epilepsy in Caucasians. The aim of this study was to examine the association of these loci alone or their haplotypes with the risk of epilepsy in the Malaysian population. Genomic DNA of 1241 Malaysian Chinese, Indian, and Malay subjects (670 patients with epilepsy and 571 healthy individuals) was genotyped for the candidate loci by using the Sequenom MassArray method. Allele and genotype association of rs3755724 with susceptibility to epilepsy was significant in the Malaysian Chinese with focal epilepsy under codominant and dominant models (C vs. T: 1.5 (1.1-2.0), p=0.02; CT vs. TT: 1.8 (1.2-2.8), p=0.007 and 1.8 (1.2-2.7), p=0.006, respectively). The T allele and the TT genotype were more common in patients than in controls. No significant association was found between rs2920502 and rs3773364-rs3755724-rs2920502 haplotypes for susceptibility to epilepsy in each ethnicity. This study provides evidence that the promoter TIMP4 rs3755724 is a new focal epilepsy susceptibility variant that is plausibly involved in inflammation-induced seizures in Malaysian Chinese.
    Matched MeSH terms: Malaysia/ethnology
  7. Fulltext Age-related reference intervals for free and total prostate-specific antigen in a Singaporean population
    Saw S, Aw TC
    Pathology, 2000 Nov;32(4):245-9.
    PMID: 11186419
    Cancer of the prostate is the sixth most frequently found cancer in Singapore. Prostate-specific antigen (PSA) is the most clinically useful tumour marker available today for the diagnosis and management of prostate cancer. To enhance the value of PSA as a screening test we developed age-specific intervals for our ethnic population. The measurement of free PSA was included in the study to calculate the free:total ratio which enhances the differential diagnosis of prostate cancer from benign prostatic hyperplasia or prostatitis. The total PSA upper limits of 10-year intervals, beginning at 30-years-old, were 1.4, 1.7, 2.3, 4.0, 6.3 and 6.6 microg/l. Free PSA cut-off limits were 0.4, 0.5, 0.5, 1.0, 1.5 and 1.6 microg/l. The free:total ratio of PSA was not age dependent. Abbott AxSym standardised their calibration material for both free and total PSA assays with the Stanford 90:10 reference material. This laboratory has implemented these age-specific reference intervals and are currently following up their pick-up rate in the detection of prostate cancer.
    Matched MeSH terms: Malaysia/ethnology
  8. Impact of IL1B gene polymorphisms and interleukin 1B levels on susceptibility to spontaneous preterm birth
    Langmia IM, Apalasamy YD, Omar SZ, Mohamed Z
    Pharmacogenet Genomics, 2016 Nov;26(11):505-509.
    PMID: 27602547
    OBJECTIVE: Genetic factors influence susceptibility to preterm birth (PTB) and the immune pathway of PTB that involves the production of cytokines such as interleukins has been implicated in PTB disease. The aim of this study is to investigate the association of interleukin 1β (IL1B) gene polymorphisms and IL1B levels with spontaneous PTB.

    STUDY DESIGN: Peripheral maternal blood from 495 women was used for extraction of DNA and genotyping was carried out using the Sequenom MassARRAY platform. Maternal plasma was used to measure IL1B levels.

    RESULTS: There was no significant association between the allelic and genotype distribution of IL1B single nucleotide polymorphism (SNP) (rs1143634, rs1143627, rs16944) and the risk of PTB among Malaysian Malay women (rs1143634, P=0.722; rs1143627, P=0.543; rs16944, P=0.615). However, IL1B levels were significantly different between women who delivered preterm compared with those who delivered at term (P=0.030); high mean levels were observed among Malay women who delivered at preterm (mean=32.52) compared with term (mean=21.68). IL1B SNPs were not associated with IL1B plasma levels.

    CONCLUSION: This study indicates a significant association between IL1B levels and reduced risk of PTB among the Malaysian Malay women. This study shows the impact of IL1B levels on susceptibility to PTB disease; however, the high levels of IL1B observed among women in the preterm group are not associated with IL1B SNPs investigated in this study; IL1B high levels may be because of other factors not explored in this study and therefore warrant further investigation.

    Matched MeSH terms: Malaysia/ethnology
  9. Allelic variants of acidic proline-rich proteins observed in Japanese, Chinese, and Malays
    Shintani M, Minaguchi K, Suzuki K, Lim KA
    Biochem Genet, 1990 Apr;28(3-4):173-84.
    PMID: 2383244
    Three new variants of acidic proline-rich proteins (At, Au, Aw) were found in human parotid saliva by isoelectric focusing and basic gel electrophoresis. Electrophoretic comparison of the purified proteins and their tryptic peptides suggested minor charge and size differences from other acidic PRPs. Genetic and biochemical studies indicate that the At and Aw proteins are allelic products of the PRH1 locus. Gene frequencies of the At productive allele (PRH1(6)) in Japanese, Chinese, and Malays were 0.008, 0.012, and 0.004, respectively. The Au protein was also found in Japanese (2 in 746 samples), Chinese (1 in 215 samples), and Malays (1 in 220 samples), however, the Aw protein was found only in one Japanese (n = 746). These three proteins were not found in 106 Indian subjects.
    Matched MeSH terms: Malaysia/ethnology
  10. Prevalence and molecular study of G6PD deficiency in Malaysian Orang Asli
    Amini F, Ismail E, Zilfalil BA
    Intern Med J, 2011 Apr;41(4):351-3.
    PMID: 21507164 DOI: 10.1111/j.1445-5994.2011.02456.x
    This study aims to define the prevalence and the molecular basis of G6PD deficiency in the Negrito tribe of the Malaysian Orang Asli. Four hundred and eighty seven consenting Negrito volunteers were screened for G6PD deficiency through the use of a fluorescent spot test. DNA from deficient individuals underwent PCR-RFLP analysis using thirteen recognized G6PD mutations. In the instances when the mutation could not be identified by PCR-RFLP, the entire coding region of the G6PD gene was subjected to DNA sequencing. In total, 9% (44/486) of the sample were found to be G6PD-deficient. However, only 25 samples were subjected to PCR-RFLP and DNA sequencing. Of these, three were found to carry Viangchan, one Coimbra and 16, a combination of C1311T in exon 11 and IVS11 T93C. Mutation(s) for the five remaining samples are unknown. The mean G6PD enzyme activity ranged 5.7 IU/gHb in deficient individuals. Our results demonstrate that the frequency of G6PD deficiency is higher among the Negrito Orang Asli than other Malaysian races. The dual presence of C1311T and IVS11 T93C in 64% of the deficient individuals (16/44) could well be a result of genetic drift within this isolated group.
    Matched MeSH terms: Malaysia/ethnology
  11. Is a re-evaluation of WHO body mass index cut-off values needed? The case of Asians in Singapore
    Deurenberg-Yap M, Deurenberg P
    Nutr Rev, 2003 May;61(5 Pt 2):S80-7.
    PMID: 12828197
    This paper describes body composition and dietary intakes of the three major ethnic groups residing in Singapore and how these are related to cardiovascular risk factors in these groups. When the relationship between body mass index (BMI, kg/m2) and body fat percentage was studied, Singaporeans were found to have higher percentage of body fat compared with Caucasians with the same BMI. At BMIs that are much lower than WHO-recommended cut-off values for obesity, both the absolute and relative risks of developing cardiovascular risk factors are markedly elevated for all three ethnic groups. The excessive fat accumulation and increased risks at lower BMIs signal a need to re-examine cut-off values for obesity among Chinese, Malays, and Indians.
    Matched MeSH terms: Malaysia/ethnology
  12. Effect of blood pressure on the retinal vasculature in a multi-ethnic Asian population
    Jeganathan VS, Sabanayagam C, Tai ES, Lee J, Sun C, Kawasaki R, et al.
    Hypertens Res, 2009 Nov;32(11):975-82.
    PMID: 19713968 DOI: 10.1038/hr.2009.130
    Blood pressure has a significant effect on retinal arterioles. There are few data on whether this effect varies by race/ethnicity. We examined the relationship of blood pressure and retinal vascular caliber in a multi-ethnic Asian population. The study is population-based and cross sectional in design. A total of 3749 Chinese, Malay and Indian participants aged > or =24 years residing in Singapore were included in the study. Retinal vascular caliber was measured using a computer program from digital retinal photographs. The associations of retinal vascular caliber with blood pressure and hypertension in each racial/ethnic group were analyzed. The main outcome measures are retinal arteriolar caliber and venular caliber. The results show that retinal arterioles were narrower in persons with uncontrolled/untreated hypertension (140.0 microm) as compared with persons with controlled hypertension (142.1 microm, P=0.0001) and those with no hypertension (146.0 microm, P<0.0001). On controlling for age, gender, body mass index, lipids and smoking, each 10 mm Hg increase in mean arterial blood pressure was associated with a 3.1 microm decrease in arteriolar caliber (P<0.0001), with a similar magnitude seen in all three racial/ethnic groups: 3.1 microm in Chinese, 2.8 microm in Malays and 3.2 microm in Indians (P<0.0001 for all). Each 10 mm Hg increase in mean arterial blood pressure was associated with a 1.8 microm increase in venular caliber (P<0.0001); furthermore, the magnitude of this effect was similar across the three racial/ethnic groups. The effect of blood pressure on the retinal vasculature was similar across three major racial/ethnic groups in Asia.
    Matched MeSH terms: Malaysia/ethnology
  13. Fulltext Asian medical students' attitudes towards professionalism
    Parthiban N, Boland F, Fadil Azim DH, Pawlikowska T, O'Shea MT, Jaafar MH, et al.
    Med Educ Online, 2021 Dec;26(1):1927466.
    PMID: 33999787 DOI: 10.1080/10872981.2021.1927466
    Background: Professionalism is the basis of trust in patient-physician relationships; however, there is very limited evidence focusing on attitudes towards professionalism among medical students. Hence, the main aim of our study was to investigate Malaysian medical students' attitudes towards professionalism with specific emphasis on the comparison between pre-clinical and clinical students. Our secondary aim was to compare the differences in perception of medical students in Malaysia (pre-clinical and clinical) with Asian medical students studying in Dublin, IrelandMethods: This study utilized the Professionalism Mini-Evaluation Exercise (P-MEX) instrument which consists of 25 items that represent four skill categories: Doctor-Patient Relationship skills, Reflective skills, Time Management and Inter-Professional Relationship skills. Descriptive statistics were used to describe the demographic information of students and given the ordinal nature of the data, Mann-Whitney U-tests were used.Results: Overall, students have positive attitudes to all the professionalism items with more than 80% of the students agreeing that each of the professionalism attributes is important or very important. There was evidence of a significant difference between Malaysian pre-clinical and clinical students in relation to 'avoiding derogatory language' only (p = 0.015). When comparing between Malaysian and Dublin Asian students, there was a statistically significant difference in relation to 'show interest in patient as a person' (p 
    Matched MeSH terms: Malaysia/ethnology
  14. Pharmacokinetics of propofol infusion in Asian patients undergoing coronary artery bypass grafting
    Lee HS, Khoo YM, Chua BC, Ng AS, Tan SS, Chew SL
    Ther Drug Monit, 1995 Aug;17(4):336-41.
    PMID: 7482686
    The pharmacokinetics of propofol was studied in 11 Asian patients with fentanyl-isoflurane anaesthesia during cardiopulmonary bypass (CPB) and undergoing elective coronary artery bypass grafting (CABG). Instead of the usual increments of morphine and a benzodiazepine, propofol (4 mg/kg/h) was initiated at the start of CPB and ceased at CPB separation. Whole blood propofol concentrations were determined during and postinfusion using high-performance liquid chromatography with fluorescence detection. Data from four patients seemed to fit a two-compartment model, whereas those from seven patients were significantly (F test, p < 0.05) better fitted to a three-compartment model. The pharmacokinetic parameters were as follows: The mean (SD) of the initial distribution phase t1/2 pi, intermediate distribution phase t1/2 alpha, and elimination phase t1/2 beta were 2.22 (1.04) min, 42.9 (16.4) min, and 370 (138) min, respectively. The mean clearance of 1.31 (0.50) L/min was lower than those reported from other studies, whereas the mean blood concentration of 2.2 (1.0) mg/L at the 1-h infusion period was higher. The mean calculated apparent Css was 3.9 (1.5) mg/L. The low clearance is likely to be due to hemodynamic changes during CPB and CABG, thereby affecting drug distribution and blood flow to the liver.
    Matched MeSH terms: Malaysia/ethnology
  15. Traditional diets and meal patterns in South Africa
    Labadarios D, Walker AR, Blaauw R, Walker BF
    World Rev Nutr Diet, 1996;79:70-108.
    PMID: 9111811
    Matched MeSH terms: Malaysia/ethnology
  16. Fulltext Validity and reliability of the Multidimensional Body Image Scale in Malaysian university students
    Gan WY, Mohd NM, Siti AH, Zalilah MS
    Malays J Nutr, 2012 Dec;18(3):295-306.
    PMID: 24568070 MyJurnal
    This study aimed to evaluate the validity and reliability of the Multidimensional Body Image Scale (MBIS), a seven-factor, 62-item scale developed for Malaysian female adolescents. This scale was evaluated among male and female Malaysian university students.
    Matched MeSH terms: Malaysia/ethnology
  17. Fulltext Development and validation of a Food Frequency Questionnaire (FFQ) for assessing sugar consumption among adults in Klang Valley, Malaysia
    Shanita NS, Norimah AK, Abu Hanifah S
    Malays J Nutr, 2012 Dec;18(3):283-93.
    PMID: 24568069 MyJurnal
    The aim of this study was to develop and validate a semiquantitative food frequency questionnaire (FFQ) for assessing habitual added sugar consumption of adults in the Klang Valley.
    Matched MeSH terms: Malaysia/ethnology
  18. Prevalence and risk factors of ocular trauma in an urban south-east Asian population: the Singapore Malay Eye Study
    Loon SC, Tay WT, Saw SM, Wang JJ, Wong TY
    Clin Exp Ophthalmol, 2009 May;37(4):362-7.
    PMID: 19594562 DOI: 10.1111/j.1442-9071.2009.02035.x
    To describe the prevalence and risk factors of ocular trauma in an urban Asian population.
    Matched MeSH terms: Malaysia/ethnology
  19. Views and experiences of Malaysian family medicine trainees of female sexual dysfunction
    Lai PS, Tan SY, Liew SM
    Arch Sex Behav, 2016 Nov;45(8):2081-2089.
    PMID: 27502351 DOI: 10.1007/s10508-016-0796-1
    Sociocultural factors have been shown to be important influencers of sexual health and sexuality. Hence, the aim of our study was to explore the views and experiences of family medicine trainees regarding female sexual dysfunction (FSD) with a focus on the barriers and facilitators towards the initiation of conversation on this topic. A qualitative study design involving semi-structured focus group discussions (FGDs) was conducted with 19 family medicine trainees in Malaysia. The conceptual framework used was based on the Theory of Planned Behavior. Thematic approach was used to analyze the data. Participants perceived FSD as being uncommon and unimportant. According to our participants, patients often presented with indirect complaints, and doctors were not proactive in asking about FSD. Three main barriers were identified: doctor factors, perceived patient factors, and system factors. Lack of confidence, knowledge, experience, time, and embarrassment were the key barriers identified at the doctors' level. Lack of awareness, among patients regarding FSD, and local cultural and religious norms were the perceived patient barriers. System barriers were lack of time and privacy. Various facilitators, such as continuous medical education and public forums, were suggested as means to encourage family medicine trainees to initiate discussion on sexual matters during consultations. In conclusion, family medicine trainees found it difficult to initiate conversation on FSD with patients. Interventions to encourage conversation on FSD should target this and other identified barriers.
    Matched MeSH terms: Malaysia/ethnology
  20. Fulltext Assessment of Risk and Sero-Prevalence of Helicobacter pylori Colonization among Remote Orang Asli Tribes in Peninsula Malaysia
    Thevakumar K, Chandren JR, Perez-Perez GI, Chua EG, Teh LK, Salleh MZ, et al.
    PLoS One, 2016;11(7):e0159830.
    PMID: 27441568 DOI: 10.1371/journal.pone.0159830
    The epidemiology of Helicobacter pylori (H. pylori) infection is related to human poverty with marked differences between developing and developed countries. Socioeconomic factors and living standards are the main determinants of the age-dependent acquisition rate of H. pylori, and consequently its prevalence. The aim of this study was to assess the risk and sero-prevalence of H. pylori colonization among Orang Asli in Peninsula Malaysia. This cross-sectional study was conducted on Orang Asli subjects in seven isolated settlements spanning across all three major tribes (Negrito, Proto Malay and Senoi) in Malaysia. Socio-demographic characteristics of the subjects were obtained through interview. Subjects were tested for H. pylori colonization based on CagA and whole cell (WC) antigen serological assays. A total of 275 subjects participated in this study. Among these subjects, 115 (44.7%) were H. pylori sero-positive with highest sero-prevalence among Negrito (65.7%). Among subjects who were H. pylori sero-positive, CagA sero positivity was also significantly higher among Negrito. The highest proportion of respondents reported to be H. pylori sero-positive was from age group 30 years old and below (57.9%), males (56.2%), Negrito (48.6%) and live in bamboo house (92.3%). The highest proportion of respondents reported to be CagA sero-positive was from age group 30 years old and below (41.4%), males (35.6%) and Negrito (48.6%). The results of this study demonstrate that H. pylori colonization can be related to age, gender, tribes and house materials and CagA sero-positive stain closely associated with age, gender and tribes.
    Matched MeSH terms: Malaysia/ethnology
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