Displaying publications 61 - 80 of 88 in total

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  1. Chan YY, Lim KK, Omar MA, Mohd Yusoff MF, Sooryanarayana R, Ahmad NA, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:49-56.
    PMID: 33370865 DOI: 10.1111/ggi.13977
    AIM: Physical inactivity in older adults is linked to increased risk of chronic diseases, disability and various poor health outcomes. As the aging population rises, the prevalence of diseases associated with aging also increases. Regular physical activity in older adults is important to improve overall health and promote healthy aging. This study aimed to determine the prevalence and factors associated with physical inactivity among older adults in Malaysia.

    METHODS: This study was based on 3969 Malaysian older adults aged ≥60 years who completed the physical activity module in the National Health and Morbidity Survey 2018, a population-based cross-sectional survey. Physical activity was measured using the Global Physical Activity Questionnaire through a face-to-face interview. Participants were classified as physically active or inactive. Associations between physical inactivity, sociodemographic characteristics and a range of selected independent variables were examined using multivariable logistic regression.

    RESULTS: Overall, three out of 10 (29.8%) Malaysian older adults were physically inactive. Results of multivariable analysis showed that older age group (≥80 years), of Bumiputera Sarawak ethnicity, unemployed/retirees/homemakers, functional limitation, diabetes mellitus and dementia were significantly associated with a higher risk of physical inactivity. Women, with secondary education level and good social support were less likely to be physically inactive.

    CONCLUSIONS: The present study reported the status of physical inactivity among older adults in Malaysia. There is the need to design effective public health programs and interventions to promote active living and healthy aging among Malaysian older adults, particularly in those at-risk older population subgroups. Geriatr Gerontol Int 2020; 20: 49-56.
  2. Ahmad NA, Abd Razak MA, Kassim MS, Sahril N, Ahmad FH, Harith AA, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:21-25.
    PMID: 33370850 DOI: 10.1111/ggi.14012
    AIM: This study aimed to assess the relationship between functional limitations and depression among community-dwelling older adults in Malaysia.

    METHODS: Data from a nation-wide community-based cross-sectional study were analyzed. This study was conducted using a two-stage stratified random sampling design. In total, 3772 older adults aged ≥60 years responded to the survey. Depression was identified using a validated Malay version of the Geriatric Depression Scale (M-GDS-14), with those scored ≥6 categorized as having depression. Functional limitations were assessed using both Barthel's Activities of Daily Living (ADL) and Lawton's Instrumental Activities of Daily Living (IADL). The relationship was determined by multivariate logistic regression, adjusted for other variables.

    RESULTS: The prevalence of depression was 11.5% (95% confidence interval [CI] 9.4, 13.4). Multiple logistic regression analysis found that older adults with limitations in ADL were 2.6 times more likely of having depression (adjusted odds ratio [aOR] 2.58, 95% CI 2.01, 3.32), while those with limitations in IADL the risk of having depression was almost doubled (aOR 1.68, 95% CI: 1.32, 2.14). Other significant factors were incontinence (aOR 3.33, 95% CI: 2.33, 4.74), chronic medical illness (aOR 1.44, 95% CI: 1.15, 1.81), current smoker (aOR 4.19, 95% CI: 1.69, 10.39), poor social support (aOR 4.30, 95% CI: 2.98, 6.20), do not have partner, ethnic minorities and low individual monthly income.

    CONCLUSIONS: Older adults with functional limitation in both basic ADL and complex IADL are independently at higher risk of having depression. Geriatr Gerontol Int 2020; 20: 21-25.

  3. Ahmad NA, Mat Ludin AF, Shahar S, Mohd Noah SA, Mohd Tohit N
    BMJ Open, 2020 Mar 16;10(3):e033870.
    PMID: 32184309 DOI: 10.1136/bmjopen-2019-033870
    INTRODUCTION: The world's older population continues to grow at an unprecedented rate. An ageing population poses a great challenge to our healthcare system that requires new tool to tackle the complexity of health services as well as the increasing expenses. Mobile health applications (mHealth app) is seen to have the potential to address these challenges, alleviating burdens on the healthcare system and enhance the quality of life for older adults. Despite the numerous benefits of mHealth apps, relatively little is known about whether older adults perceive that these apps confer such benefits. Their perspectives towards the use of mobile applications for health-related purposes have also been little studied. Therefore, in this paper, we outline our scoping review protocol to systematically review literature specific to older adults' willingness, perceived barriers and motivators towards the use of mobile applications to monitor and manage their health.

    METHODS AND ANALYSIS: Arksey and O'Malley's scoping review methodology framework will guide the conduct of this scoping review. The search strategy will involve electronic databases including PubMed, Excerpta Medica Database, Cumulative Index of Nursing and Allied Health Literature, Cochrane Library, Google Scholar and ScienceDirect, in addition to grey literature sources and hand-searching of reference lists. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data will be charted and sorted through an iterative process by the research team. The extracted data will undergo a descriptive analysis and simple quantitative analysis will be conducted using descriptive statistics. Engagement with relevant stakeholders will be carried out to gain more insights into our data from different perspectives.

    ETHICS AND DISSEMINATION: Since the data used are from publicly available sources, this study does not require ethical approval. Results will be disseminated through academic journals, conferences and seminars. We anticipate that our findings will aid technology developers and health professionals working in the area of ageing and rehabilitation.

  4. Ahmad NA, Mohamed Zulkifli R, Hussin H, Nadri MH
    J Mol Graph Model, 2021 06;105:107872.
    PMID: 33765525 DOI: 10.1016/j.jmgm.2021.107872
    Aptamers are short oligonucleotides that possess high specificity and affinity against their target. Generated via Systematic Evolution of Ligands by Exponential Enrichment, (SELEX) in vitro, they were screened and enriched. This review covering the study utilizing bioinformatics tools to analyze primary sequence, secondary and tertiary structure prediction, as well as docking simulation for various aptamers and their ligand interaction. Literature was pooled from Web of Science (WoS) and Scopus databases until December 18, 2020 using specific search string related to DNA aptamers, in silico, structure prediction, and docking simulation. Out of 330 published articles, 38 articles were assessed in the analysis based on the predefined inclusion and exclusion criteria. It was found that Mfold and RNA Composer web server is the most popular tool in secondary and tertiary structure prediction of DNA aptamers, respectively. Meanwhile, in docking simulation, ZDOCK and AutoDock are preferred to analyze binding interaction in the aptamer-ligand complex. This review reports a brief framework of recent developments of in silico approaches that provide predictive structural information of ssDNA aptamer.
  5. Rajasegaran S, Ahmad NA, Tan SK, Lechmiannandan A, Mohamed OM, Cheng JQ, et al.
    Arch Dis Child, 2024 Apr 22.
    PMID: 38649254 DOI: 10.1136/archdischild-2023-326724
    PURPOSE: Children with anorectal malformation (ARM) and Hirschsprung's disease (HD) often experience bowel symptoms into adulthood, despite definitive surgery. This study evaluates the quality of life (QOL) and bowel functional outcome of children treated for ARM and HD in comparison to healthy controls.

    METHODS: Between December 2020 and February 2023, we recruited patients with ARM and HD aged 3-17 years at four tertiary referral centres, who had primary corrective surgery done >12 months prior. Healthy controls were age-matched and sex-matched. All participants completed the Pediatric Quality of Life Inventory Generic Core Scales 4.0, General Well-Being (GWB) Scale 3.0 and Family Impact (FI) Module 2.0 Questionnaires. Bowel Function Score (BFS) Questionnaires were also administered. We also performed subgroup analysis according to age categories. Appropriate statistical analysis was performed with p<0.05 significance. Ethical approval was obtained.

    RESULTS: There were 306 participants: 101 ARM, 87 HD, 118 controls. Patients with ARM and HD had significantly worse Core and FI Scores compared with controls overall and in all age categories. In the GWB Scale, only ARM and HD adolescents (13-17 years) had worse scores than controls. ARM and HD had significantly worse BFSs compared with controls overall and in all age categories. There was significant positive correlation between BFS and Core Scores, GWB Scores and FI Scores.

    CONCLUSION: Patients with ARM and HD had worse QOL than controls. Lower GWB Scores in adolescents suggests targeted interventions are necessary. Bowel function influences QOL, indicating the need for continuous support into adulthood.

  6. Hasani WSR, Ganapathy SS, Lin CZ, Rifin HM, Bahari MN, Ghazali MH, et al.
    Western Pac Surveill Response J, 2021 02 16;12(1):46-52.
    PMID: 34094624 DOI: 10.5365/wpsar.2020.11.3.007
    Background: Pre-existing comorbidities can predict severe disease requiring intensive care unit (ICU) admission among COVID-19 cases. We compared comorbidities, clinical features and other predictive factors between COVID-19 patients requiring ICU admission for intubation/mechanical ventilation and all other COVID-19 cases in Selangor, Malaysia.

    Method: Field data collected during the COVID-19 outbreak in Selangor, Malaysia, up to 13 April 2020 were used, comprising socio-demographic characteristics, comorbidities and presenting symptoms of COVID-19 cases. ICU admission was determined from medical records. Multiple logistic regression analysis was performed to identify factors associated with ICU admission requiring intubation/mechanical ventilation among COVID-19 cases.

    Results: A total of 1287 COVID-19-positive cases were included for analysis. The most common comorbidities were hypertension (15.5%) and diabetes (11.0%). More than one third of cases presented with fever (43.8%) or cough (37.1%). Of the 25 cases that required intubation/mechanical ventilation, 68.0% had hypertension, 88.0% had fever, 40.0% had dyspnoea and 44.0% were lethargic. Multivariate regression showed that cases that required intubation/mechanical ventilation had significantly higher odds of being older (aged 360 years) [adjusted odds ratio (aOR) = 3.9] and having hypertension (aOR = 5.7), fever (aOR = 9.8), dyspnoea (aOR = 9.6) or lethargy (aOR = 7.9) than cases that did not require intubation/mechanical ventilation.

    Conclusion: The COVID-19 cases in Selangor, Malaysia requiring intubation/mechanical ventilation were significantly older, with a higher proportion of hypertension and symptoms of fever, dyspnoea and lethargy. These risk factors have been reported previously for severe COVID-19 cases, and highlight the role that ageing and underlying comorbidities play in severe outcomes to respiratory disease.

  7. Taresh SM, Morett LM, Zaid SM, Roslan S, Taresh Taleb M, Song P, et al.
    Autism, 2024 Jan;28(1):239-253.
    PMID: 37982401 DOI: 10.1177/13623613231211850
    Preschool teachers can play a critical role in early detection of autism. Equipping preschool teachers with prerequisite knowledge and skills would allow them to identify children with probable autism and referral to diagnostic services. This study aimed to investigate the impact of an educational module (EMiASD) that prepared preschool teachers to identify autism symptoms. The sample included 144 preschool teachers, of which 120 were stratified and randomly assigned to an intervention arm receiving training in EMiASD (n = 60) or a comparison arm receiving standard training (n = 60) using a parallel mixed-methods design. Responses to open-ended questions about video case studies revealed improvement in the identification of autism symptoms in preschool teachers in the intervention arm, in contrast to preschool teachers in the comparison arm. Moreover, significant changes in knowledge, belief, and self-efficacy about autism favoured EMiASD. Overall, these results demonstrate the influence of EMiASD in the Yemeni cultural context.
  8. Ahmad NA, Mohd MH, Musa KI, Abdullah JM, Othman NA
    Malays J Med Sci, 2021 Oct;28(5):1-9.
    PMID: 35115883 DOI: 10.21315/mjms2021.28.5.1
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 disease, which has become pandemic since December 2019. In the recent months, among five countries in the Southeast Asia, Malaysia has the highest per-capita daily new cases and daily new deaths. A mathematical modelling approach using a Singular Spectrum Analysis (SSA) technique was used to generate data-driven 30-days ahead forecasts for the number of daily cases in the states and federal territories in Malaysia at four consecutive time points between 27 July 2021 and 26 August 2021. Each forecast was produced using SSA prediction model of the current major trend at each time point. The objective is to understand the transition dynamics of COVID-19 in each state by analysing the direction of change of the major trends during the period of study. The states and federal territories in Malaysia were grouped in four categories based on the nature of the transition. Overall, it was found that the COVID-19 spread has progressed unevenly across states and federal territories. Major regions like Selangor, Kuala Lumpur, Putrajaya and Negeri Sembilan were in Group 3 (fast decrease in infectivity) and Labuan was in Group 4 (possible eradication of infectivity). Other states e.g. Pulau Pinang, Sabah, Sarawak, Kelantan and Johor were categorised in Group 1 (very high infectivity levels) with Perak, Kedah, Pahang, Terengganu and Melaka were classified in Group 2 (high infectivity levels). It is also cautioned that SSA provides a promising avenue for forecasting the transition dynamics of COVID-19; however, the reliability of this technique depends on the availability of good quality data.
  9. Firdaus F, Ahmad NA, Sahibuddin S
    Sensors (Basel), 2019 Dec 15;19(24).
    PMID: 31847488 DOI: 10.3390/s19245546
    Wireless local area networks (WLAN)-fingerprinting has been highlighted as the preferred technology for indoor positioning due to its accurate positioning and minimal infrastructure cost. However, its accuracy is highly influenced by obstacles that cause fluctuation in the signal strength. Many researchers have modeled static obstacles such as walls and ceilings, but few studies have modeled the people's presence effect (PPE), although the human body has a great impact on signal strength. Therefore, PPE must be addressed to obtain accurate positioning results. Previous research has proposed a model to address this issue, but these studies only considered the direct path signal between the transmitter and the receiver whereas multipath effects such as reflection also have a significant influence on indoor signal propagation. This research proposes an accurate indoor-positioning model by considering people's presence and multipath using ray-tracing, we call it (AIRY). This study proposed two solutions to construct AIRY: an automatic radio map using ray tracing and a constant of people's effect for the received signal strength indicator (RSSI) adaptation. The proposed model was simulated using MATLAB software and tested at Level 3, Menara Razak, Universiti Teknologi Malaysia. A K-nearest-neighbor (KNN) algorithm was used to define a position. The initial accuracy was 2.04 m, which then reduced to 0.57 m after people's presence and multipath effects were considered.
  10. Smran A, Abdullah M, Ahmad NA, Alrahlah A, Al-Maflehi N, Samran A
    BMC Oral Health, 2023 Sep 18;23(1):673.
    PMID: 37723511 DOI: 10.1186/s12903-023-03377-1
    BACKGROUND: The aim of this study was to evaluate the effect of thermal and mechanical cyclic aging using a mastication simulator on push-out bond strength of mandibular premolars obturated with AH Plus and BioRoot RCS root canal sealers.

    METHODS: With REVO-S files up to SU/0.06 taper, 48 single-rooted premolar teeth were instrumented. The teeth were randomly divided into two main groups (n = 24) based on the two root canal sealers used (AH Plus and BioRoot RCS). All teeth were obturated with h matched-taper single-cone. Each main group was then subdivided into three subgroups (A, B, and C) (n = 8). Group A served as the negative control group (no-thermocycling aging). While groups B and C were subjected to thermal changes in a thermocycler machine (15,000 and 30,000 thermal cycles, respectively), followed by two different dynamic loading periods, 3 × 105 and 6 × 105 in a masticatory simulator with a nominal load of 5 kg at 1.2 Hz which represent roughly 1½ and 3 years of clinical function respectively. 2 mm slice at 3 levels, apical, middle, and coronal, to obtain 3 sections were prepared and subjected to push-out test using a universal testing machine. Statistical analysis was performed using analysis of variance (ANOVA) followed by a Tukey post hoc comparisons test and an independent T-test. A significance level of 5% was used.

    RESULTS: After thermal-mechanical cyclic aging, the two root canal sealers showed a significantly decreased in push-out bond strength (p 

  11. Smran A, Abdullah M, Ahmad NA, Ben Yahia F, Fouda AM, Alturaiki SA, et al.
    PLoS One, 2024;19(3):e0299552.
    PMID: 38483853 DOI: 10.1371/journal.pone.0299552
    This research aimed to assess the stress distribution in lower premolars that were obturated with BioRoot RCS or AH Plus, with or without gutta percha (GP), and subjected to vertical and oblique forces. One 3D geometric model of a mandibular second premolar was created using SolidWorks software. Eight different scenarios representing different root canal filling techniques, single cone technique with GP and bulk technique with sealer only with occlusal load directions were simulated as follows: Model 1 (BioRoot RCS sealer and GP under vertical load [VL]), Model 2 (BioRoot RCS sealer and GP under oblique load [OL]), Model 3 (AH Plus sealer with GP under VL), Model 4 (AH Plus sealer with GP under OL), Model 5 (BioRoot RCS sealer in bulk under VL), Model 6 (BioRoot RCS in bulk under OL), Model 7 (AH Plus sealer in bulk under VL), and Model 8 (AH Plus sealer in bulk under OL). A static load of 200 N was applied at three occlusal contact points, with a 45° angle from lingual to buccal. The von Mises stresses in root dentin were higher in cases where AH Plus was used compared to BioRoot RCS. Furthermore, shifting the load to an oblique direction resulted in increased stress levels. Replacing GP with sealer material had no effect on the dentin maximum von Mises stress in BioRoot RCS cases. Presence of a core material resulted in lower stress in dentin for AH Plus cases, however, it did not affect the stress levels in dentin for cases filled with BioRoot RCS. Stress distribution in the dentin under oblique direction was higher regardless of sealer or technique used.
  12. Jeyaprakasam NK, Razak MF, Ahmad NA, Santhanam J
    Mycopathologia, 2016 Jun;181(5-6):397-403.
    PMID: 26847667 DOI: 10.1007/s11046-016-9984-8
    Although non-sporulating molds (NSM) are frequently isolated from patients and have been recognized as agents of pulmonary disease, their clinical significance in cutaneous specimens is relatively unknown. Therefore, this study aimed to identify NSM and to determine the keratinolytic activity of isolates from cutaneous sites. NSM isolates from clinical specimens such as skin, nail, and body fluids were identified based on their ribosomal DNA sequences. Of 17 NSM isolates (7 Ascomycota, 10 Basidiomycota), eleven were identified to species level while five were identified to the genus level. These include Schizophyllum commune, a known human pathogen, Phoma multirostrata, a plant pathogen, and Perenniporia tephropora, a saprophyte. To determine fungal pathogenicity, keratinolytic activity, a major virulence factor, was evaluated ex vivo using human nail samples by measuring dye release from keratin azure, for NSM along with pathogens (Trichophyton mentagrophytes, Trichophyton rubrum, Microsporum canis and Fusarium spp.) and nonpathogenic (endophyte) fungi for comparison. This study showed that pathogenic fungi had the highest keratinolytic activity (7.13 ± 0.552 keratinase units) while the nonpathogenic endophytes had the lowest activity (2.37 ± 0.262 keratinase units). Keratinolytic activity of two Ascomycota NSM (Guignardia mangiferae and Hypoxylon sp.) and one Basidiomycota NSM (Fomitopsis cf. meliae) was equivalent to that of pathogenic fungi, while Xylaria feejeensis showed significantly higher activity (p 
  13. Harith AA, Ahmad NA, Sahril N, Wahab NA, Kassim NA, Othman S, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:43-48.
    PMID: 33370862 DOI: 10.1111/ggi.14039
    AIM: An aging population is a potential burden for unprepared developing countries. Malaysia is foreseen to be an aging country by 2035. Thus, this study aimed to determine the prevalence and factors associated with hearing disability among older persons in Malaysia.

    METHODS: Data from a nationwide survey implemented using a stratified cluster sampling design were analyzed. This study was carried out through face-to-face interviews and guided questionnaires. The questions were based on the Washington Group of Disability (WG) questionnaires, which produce multiple disability identifiers. Hearing disability is defined as at least one domain or question out of four questions coded as "A lot of difficulty" or "Cannot hear at all".

    RESULTS: The prevalence of hearing disability among older persons aged ≥60 years was 6.4% (95% CI 5.0-8.3), whereas 1.5% (95% CI 0.90, 2.50) older persons were reported to be using a hearing aid. The determinants of hearing disability are being male (aOR 2.67, 95% CI 1.94-3.66), being unemployed (retired, homemaker, unemployed; aOR 1.86, 95% CI 1.86-4.14) and had no formal education (aOR 18.25, 95% CI 4.18-79.55).

    CONCLUSIONS: Promoting healthy aging is important and crucial for Malaysia, in preparation toward an aging nation, as it could reduce the country's financial burden in the long term. Health-related agencies should promote health awareness and treatment centers in relation to hearing disability among older persons, as they should be educated and informed about healthcare choices availability, which is aligned with the Global Disability Action Plan 2014-2021. Geriatr Gerontol Int 2020; 20: 43-48.

  14. Abdul Wahab RM, Zainal Ariffin SH, Yeen WW, Ahmad NA, Senafi S
    ScientificWorldJournal, 2012;2012:236427.
    PMID: 22629122 DOI: 10.1100/2012/236427
    Three specific orthodontic tooth movement genes, that is, FCRL1, HSPG2, and LAMB2 were detected at upper first premolar (with appliance) dental pulp tissue by using GeneFishing technique as compared to lower first premolar (without appliance). These three differentially expressed genes have the potential as molecular markers during orthodontic tooth movement by looking at molecular changes of pulp tissue.
  15. Ahmad NA, Mancini MV, Ant TH, Martinez J, Kamarul GMR, Nazni WA, et al.
    Philos Trans R Soc Lond B Biol Sci, 2021 02 15;376(1818):20190809.
    PMID: 33357050 DOI: 10.1098/rstb.2019.0809
    Aedes aegypti mosquitoes carrying the wAlbB Wolbachia strain show a reduced capacity to transmit dengue virus. wAlbB has been introduced into wild Ae. aegypti populations in several field sites in Kuala Lumpur, Malaysia, where it has persisted at high frequency for more than 2 years and significantly reduced dengue incidence. Although these encouraging results indicate that wAlbB releases can be an effective dengue control strategy, the long-term success depends on wAlbB maintaining high population frequencies and virus transmission inhibition, and both could be compromised by Wolbachia-host coevolution in the field. Here, wAlbB-carrying Ae. aegypti collected from the field 20 months after the cessation of releases showed no reduction in Wolbachia density or tissue distribution changes compared to a wAlbB laboratory colony. The wAlbB strain continued to induce complete unidirectional cytoplasmic incompatibility, showed perfect maternal transmission under laboratory conditions, and retained its capacity to inhibit dengue. Additionally, a field-collected wAlbB line was challenged with Malaysian dengue patient blood, and showed significant blocking of virus dissemination to the salivary glands. These results indicate that wAlbB continues to inhibit currently circulating strains of dengue in field populations of Ae. aegypti, and provides additional support for the continued scale-up of Wolbachia wAlbB releases for dengue control. This article is part of the theme issue 'Novel control strategies for mosquito-borne diseases'.
  16. Hoffmann AA, Ahmad NW, Keong WM, Ling CY, Ahmad NA, Golding N, et al.
    iScience, 2024 Feb 16;27(2):108942.
    PMID: 38327789 DOI: 10.1016/j.isci.2024.108942
    Partial replacement of resident Aedes aegypti mosquitoes with introduced mosquitoes carrying certain strains of inherited Wolbachia symbionts can result in transmission blocking of dengue and other viruses of public health importance. Wolbachia strain wAlbB is an effective transmission blocker and stable at high temperatures, making it particularly suitable for hot tropical climates. Following trial field releases in Malaysia, releases using wAlbB Ae. aegypti have become operationalized by the Malaysian health authorities. We report here on an average reduction in dengue fever of 62.4% (confidence intervals 50-71%) in 20 releases sites when compared to 76 control sites in high-rise residential areas. Importantly the level of dengue reduction increased with Wolbachia frequency, with 75.8% reduction (61-87%) estimated at 100% Wolbachia frequency. These findings indicate large impacts of wAlbB Wolbachia invasions on dengue fever incidence in an operational setting, with incidence expected to further decrease as wider areas are invaded.
  17. Abd Razak MA, Ahmad NA, Abd Aziz FA, Jamaluddin R, Sidik SM, Awaluddin SM, et al.
    Asia Pac J Public Health, 2019 11;31(8_suppl):30S-37S.
    PMID: 31402682 DOI: 10.1177/1010539519867796
    Limited evidence on the association of being bullied with depression among adolescents was found in Malaysia. This study aimed to determine the association of being bullied and depression among Malaysian school-going adolescents. Data from the National Health and Morbidity Survey 2017, a cross-sectional study conducted from March to May 2017, was analyzed using descriptive and multiple logistic regression analysis. A validated tool, the Depression, Anxiety, and Stress Scale-21 was used to categorize those with moderate or higher levels of depressive symptoms as having depression. A total of 27 399 school-going adolescents participated and 18.3% were found depressed. Adolescents of Indian ethnicity (adjusted odds ratio [aOR] = 2.02, P < .001), those with parents living apart (aOR = 1.41, P < .001), and those who were being bullied (aOR = 2.98, P < .001) were more likely to have depression. This study demonstrated the association between being bullied and having depression. Comprehensive preventive strategies should be implemented taking into consideration the findings from this study.
  18. Liew SH, Razak MAA, Kassim MSA, Ahmad NA, Tan L
    BMC Public Health, 2023 Nov 06;23(1):2165.
    PMID: 37932717 DOI: 10.1186/s12889-023-17019-2
    BACKGROUND: According to World Health Organization (WHO), the fourth leading cause of death among adolescents aged 15 -19 years is suicide. The National Health and Morbidity Survey (NHMS) 2017 reported that suicidal attempts among school adolescents increased from 6.8%-6.9% as compared to NHMS 2012. Suicide attempts can cause significant negative impacts on health, social and economic status. Bullying is one of the factors for adolescent suicide attempts, and its relationship to suicidality in adolescents has been shown in numerous research.

    OBJECTIVES: This study examined the relationship between suicide attempts and bullying among school adolescents in Malaysia.

    METHODS: Data from the Malaysia NHMS 2017, a nationwide study that adopted a two-stage cluster sampling design, were analysed. The survey used a self-administered questionnaire in bilingual language adapted from GSHS developed by WHO. Participants were secondary school students aged 13 -17 in all states. Descriptive and multiple logistic regression analyses were performed using IBM SPSS version 28.

    RESULTS: A total of 27,497 school adolescents participated in the study. Results showed that 6.9% of school adolescents had attempted suicide. There was 16.2% of adolescents being bullied. Multiple logistic regression revealed that students who were bullied were more likely to have suicide attempts (aOR 4.827, 95% CI: 4.143, 5.624) P 

  19. Yusof M, Awaluddin SM, Omar M, Ahmad NA, Abdul Aziz FA, Jamaluddin R, et al.
    J Environ Public Health, 2018;2018:1803025.
    PMID: 29853924 DOI: 10.1155/2018/1803025
    Introduction: Anaemia is common among the elderly, yet it remains an underresearched clinical condition. This study investigates ethnic differences in prevalence of anaemia and identifies potential factors associated with anaemia in the elderly.
    Methods: Data from the National Health & Morbidity Survey (NHMS) 2015 conducted by Ministry of Health was analyzed. Haemoglobin levels were measured using point-of-care testing, HemoCue® Hb 201+ System©, from consenting individuals. Demographic information and other clinical information were obtained through a structured questionnaire. Descriptive and multivariate analyses were conducted and significant results were presented as adjusted odds ratio.
    Results: A total of 3794 participants aged 60 years and older responded to the anaemia module with a response rate of 93.7%. 64.0% of respondents were of Malay ethnicity, 21.6% were Chinese, 6.1% were Indians, and 8.3% were of other ethnicities. The overall prevalence of anaemia among older people was 35.3%. The highest prevalence of anaemia was found among respondents of Indian ethnicity (45.5%). The Indian (aOR: 1.72; 95% CI 1.26-2.34) and Malay (aOR: 1.25; 95% CI 1.04-1.49) ethnic groups were more likely to be anaemic in comparison to those of Chinese ethnicity. Anaemia in older people was also associated with increasing age, history of hospital admission, and the presence of diabetes mellitus.
    Conclusion: Anaemia in the elderly is associated with Indian and Malay ethnicities, increasing age, hospitalization, and diabetes. Our study has identified important information on a common condition which will guide and assist future studies in reducing the burden of anaemia.
    Study name: National Health and Morbidity Survey (NHMS-2015)
  20. Alareqe NA, Roslan S, Nordin MS, Ahmad NA, Taresh SM
    Front Psychol, 2021;12:562619.
    PMID: 34566736 DOI: 10.3389/fpsyg.2021.562619
    Millon Clinical Multiaxial Inventory MCMI-III is a multidimensional measure of psychopathology with excellent construct validity, test-retest reliability as well as internal consistency. Factor analysis of the MCMI-III has produced mixed results, extracting parsimonious three-factor solutions, or replicating the original four-factor solution in psychiatric samples from Western countries. However, little work has been done on the psychometric properties of the MCMI-III, using non-Western psychiatric samples. Outpatients (N = 212) completed the MCMI-III during a semi-structured interview. Eight exploratory factor analysis (EFA) methods were used to explore the underlying structure of MCMI-III. Skewness, kurtosis, and descriptive statistics confirmed that scales of MCMI-III were normally distributed. High-internal consistency was found. The eight EFA methods applied to the 24 clinical scales identified a consensual three-factor solution: factor I (internalizing psychopathology; 18 scales), factor II (externalizing psychopathology; 4 scales) and factor III (psychological disturbance; 2 scales), accounting for a total of 72% of the common variance. Regarding the cross-cultural equivalence of the MCMI-III structure, Tucker's congruence coefficient (Φ) was used and confirmed that internalizing (F1) and externalizing psychopathology (F2) factors obtained in this study are similar to high vs. low psychopathology and emotional constraint factors provided by American study of Haddy et al. (2005) (Φ was 0.86 and 0.97). These two factors are also similar to the general adjustment and antisocial acting out factors provided by the American study of Craig and Bivens (1998) (Φ was 0.82 and 0.96). The first two factors in this study also reflect high similarity with the factor solutions obtained with the Italian and Dutch versions of MCMI-III (Rossi et al., 2007; Pignolo et al., 2017). Despite using a psychiatric sample from a non-Western culture, the two factors identified for this MCMI-III Arabic version were similar to those reported on studies with MCMI-III, using primarily Western samples (Craig and Bivens, 1998; Rossi et al., 2007).
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