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  1. Fulltext Enhancing Moringa nutritive value for impoverished populations and healthy wellbeing through proper nutrient enrichment
    Rufai, S., Hanafi, M.M., Rafii, M.Y., Mohidin, H., Kankara, S.S., Hussaini, M.A., et al.
    International Food Research Journal, 2018;25(4):1606-1615.
    MyJurnal
    Taking into account the many cases of malnutrition related deaths in especially sub-Saharan Africa, the current research effort was conceived with the objective of appraising the nutritive potential of Moringa oleifera L. plant through the evaluation of proper agronomic practice that will enhance its nutritive potential. Measured quantity of dried roots, stem, and leaves portions of 5 months old Moringa oleifera L. seedlings, grown under various applied phosphorus (P) and potassium (K) rates were analysed for essential and non-essential amino acids content, total antioxidants, secondary metabolites (phenolics and flavonoids), and mineral nutrient elements. The high-performance liquid chromatography (HPLC) analysis revealed the presence of 9 essential and 7 non-essential amino acids, with a range of 4.24 to 10.04 gkg-1 recorded for leucine, threonine, histidine, glutamic acid, aspartic acid, and glycine. The 2,2ꞌ- diphenyl-1- picrylhydrazyl (DPPH) and the ferric reducing antioxidant power (FRAP) assay revealed strong antioxidants presence (up to 68% DPPH scavenging activity and a high level FRAP potential of 2500 mg ascorbic acid equivalent (AAE) / 100g dry weight (DW). Folin-Ciocalteu’s and aluminium chloride calorimetric assay revealed high levels of secondary metabolites (ranging from 1000 to 1350 mg gallic acid equivalent (GAE)/100g DW total phenolics and up to 2400 mg quercetin equivalent (QE)/1mg DW total flavonoids), and the nitric acid wet digestion procedure revealed a lot of mineral nutrient elements (with significant values of up to 19.13 g kg-1 maximum content acquired from calcium (Ca) and up to 9.90 g kg-1 recorded for iron (Fe). These nutritive components are noted to be highest in the leaves portion, followed by the roots, and then the stem parts. Based on its recognised rich base nutritive content, Moringa oleifera L. is a tree plant of nutraceuticals importance for impoverished communities.
  2. Growth conditions of graphene grown in chemical vapour deposition (CVD)
    Mohamad Shukri Sirat, Edhuan Ismail, Hadi Purwanto, Mohd Hanafi Ani, Mohd Asyadi Azam Mohd Abid
    Sains Malaysiana, 2017;46:1033-1038.
    The fabrication of high quality graphene has become the main interest in current chemical vapour deposition (CVD) method due to the scalability for mass production of graphene-based electronic devices. The quality of graphene is determined by defect density, number of layers and properties changed such as electron mobility, transparency and conductivity as compared to the pristine graphene. Here, we did a study on the effects of reaction conditions such as methane, CH4 concentration and deposition time towards the quality of graphene produced. We found that by lowering both CH4 concentration down to 20% and deposition time to 5 min, a better quality graphene was produced with higher I2D/IG ratio of 0.82 compared to other reaction condition. Through the analysis, we concluded that there are two important parameters to be controlled to obtain high quality graphene.
  3. Fulltext VESSEL LIFE JACKET COMPATIBILITY MOBILE APPS FOR SAFETY ASSESSMENT
    MUHAMMAD SYUKRI HANAFI BASRI, MOHAMMAD AIZAT BASIR, AHMAD FAIZAL AHMAD FUAD
    UMT Journal of Undergraduate Research, 2020;2(2):83-92.
    MyJurnal
    Life jacket is one of the safety appliances that can be found on the ship that provide buoyancy and prevention against drowning. Before the ship can sail, every element of safety of the vessel should be confirmed. Despite the establishment of standards for life jacket, both local and international, there have been cases of drowning associated with the usage of life jackets by the passengers of passenger boat/vessels for open-deck situation. Moreover, deficiency of information on safety instruction is reason the passengers are lack of personal safety information during on board. Thus, the evaluation on safety standard of life jackets and passenger vessel are vital for assessing the provision of the life jacket on board passenger vessel with respect to compatibility between life jacket and passenger vessel. In this paper, A Vessel Life Jacket Compatibility Mobile Apps (VELIT) was developed using software development methodology called Rational Unified Process (RUP) to automate the safety assessment process based on model called LCI (Life Jacket Compatibility Index). VELIT apps synchronized the safety assessment aspect and which allow user to compute the element in the model and produce the result of the safety assessment in real time. The VELIT apps are expected to be used in maritime area especially for ship safety assessment process.
  4. Fulltext Neuropsychiatric Systemic Lupus Erythematosus (NPSLE) – Masquerade Diagnosis: A Case Report
    Mohd Sharil Iman Mohd Hanafi, Mohammad Che’ Man, Shahidah Che Alhadi
    IIUM Medical Journal Malaysia, 2019;18(102):16-0.
    MyJurnal
    Diagnostic challenge is seen in Systemic Lupus Erythematosus (SLE) due to insidious onset, unpredictable course, broad spectrum of clinical presentation that mimic other diseases manifestation and possibility not fulfilling the classification criteria at the earlier course of the disease. Case report: We highlighted a case of a man, lived with diagnosis of Schizophrenia for almost 15 years subsequently revealed him suffered from neuropsychiatric lupus as he fulfilled the SLE classification criteria. His initial presentation was altered sensorium treated as acute psychosis-the tip of an iceberg to the underlying disease. His multiple admissions to psychiatric ward were believed contributed by episode of lupus flare. Necessary investigation is important to exclude another medical condition before make a diagnosis of Schizophrenia using DSM-V criteria. The misdiagnosis has significantly impaired his social life and untreated disease had leads to morbidity and severe organ damage. This case emphasizes on the crucial aspect of assessing patient as a whole, follow-up the progression and re-evaluates patient’s condition for a new hint. Even though there is no cure yet for SLE, correct and early diagnosis is able to guide for individualized treatment and thus helping in good disease control that warrant better outcome.
  5. Fulltext Reflective diaries: an impactful learning strategy in the undergraduate palliative care learning
    Fahisham Taib, Mohd Shahril Iman Mohd Hanafi, Nik Mohd Rizal Mohd Fakri, Zarawi Mat Nor
    Education in Medicine Journal, 2016;8(2):41-48.
    MyJurnal
    Reflection is a process of reviewing an experience of practice in order to describe, analyse and evaluate information. This leads to critical reflection which one can view and focus on self-experience within the context of his/her own life. Objective: The study aims to understand palliative care values with the use of reflective diary following home visit to patients who require palliative care.
    Method: Interview was performed during the house visit by the undergraduate medical students. This outreach house visits were supervised under community palliative care nurse. The students were required to develop a learning activity, using assessment of palliative care patients’ needs, through qualitative questionnaire. This was recorded in the reflective diary upon return of such activity. The questions asked covered explorative learning and holistic medical tasks such as the impact of patient’s life from emotional, psychosocial, medical and spiritual perspective. Guided questioning was done to avoid
    unnecessary communication issues that may aggravate emotional distress. Students were asked to probe using vetted and agreed questions, and explore multidimensional issues in relation to culturally naïve Kelantanese population.
    Result: Enjoyful learning experience was recorded. The reality of thisdealing with patients with chronic disease has put forth a positive intention to perform better as future doctors.
    Conclusion: Reflective diary is an effective tool in community palliative care learning. It documents patients’ plight and students’ sense of responsibility to community. This has invaluable and indirect learning impact as part of the students’ soft skills development.
  6. Fulltext Hybrid composites: study on un-treated kenaf/glass fibre properties
    Abdul Malek Ya’acob, Azhar Abu Bakar, Hanafi Ismail, Khairul Zaman Dahlan
    Pertanika Journal of Science & Technology, 2011;19(2):373-381.
    MyJurnal
    A hybrid composite consisting of untreated kenaf fibre and glass fibre was investigated by varying the fibre glass weight ratios and using interply fabrication method. The expected results were to have better composite performance in terms of its toughness and impact strength as a comparison between the hybrid (kenaf/E-glass fibre composites) and E-GF composites alone. For the purpose of this study, all the samples were prepared using typical sample preparation. Results show that the incorporation of E–glass fibre resulted in brittle failure and a higher amount of E-Glass fibre with low percentage of kenaf fibre causing high strength, low ductile, and low toughness behaviours.
  7. Fulltext Sediment quality index in mangrove forest
    Ahmad Mustapha, Gandaseca, Seca, Ahmad Hanafi, Siti Nurhidayu, Mohammad Roslan, Khan, Waseem, et al.
    The Pertanika Journal of Scholarly Research Reviews, 2017;3(3):41-50.
    MyJurnal
    The objectives of this review are to determine the types of indices to use, to assess the current sediment quality index (SQI) of a mangrove forest and to select the appropriate index to describe the mangrove sediment quality index. Amongst the many indices considered in this review are the enrichment factors (EFs), the geo-accumulation index (Igeo), the pollution load index (PLI), the marine sediment pollution index (MSPI) and sediment quality index (SQI). The different indices give diverse perspectives of the status of mangrove sediment quality. This review also highlights the appropriate parameters that need to be used in assessing sediment quality, such as the physical, chemical and biological properties. As the comparison review, the sediment quality can be utilized for Mangrove quality index (MQI) development like to assess the heavy metal, complete laboratory parameters and a classification following the Interim Sediment Quality Guidelines ISQG, PCA and HACA. For the heavy metal content of sediment, the suggested parameters are Pb, Zn, Cu, Co and Mn. Lastly, for the indices, the enrichment factor (EFs), geo-accumulation index (Igeo), pollution load index (PLI) and marine sediment pollution index (MPSI) are used in develop SQI on mangrove forest.
  8. Fulltext Suppression subtractive hybridization technique in wheat for the identification of disease resistance differentially expressed genes
    Aktar-Uz-Zamana, Md., Tuhina-Khatun, Mst., Mohamed Hanafi Musa, Sahebi, Mahbod
    The Pertanika Journal of Scholarly Research Reviews, 2015;2(1):49-62.
    MyJurnal
    A resistant variety with high yielding potential is key for increasing crop production to
    fulfill the food requirement of the ever increasing world populations. Consequently, the aim of plant
    breeders is to develop high yielding varieties or cultivars that are resistant or tolerant to specific
    diseases or insects. For developing a resistant variety, it is enormously indispensable to incorporate or
    introgress the specific resistant genes of that particular disease into the recipient. Suppression
    subtractive hybridization (SSH) is a powerful technique for the identification of disease specific
    differentially expressed genes that are expressed in a resistant or susceptible variety. This paper
    presents a brief review on the SSH technique with examples focusing on the identification of the
    wheat disease specific differentially expressed genes and their defense mechanisms against fungal
    pathogens in global wheat cultivars. This review is helpful for wheat researchers for the updated
    information on the SSH technique for the identification of differentially expressed genes in the global
    wheat cultivars and varieties. Eventually, the identified genes could be used to develop the disease
    resistance variety through marker-assisted backcrossing programme or conventional breeding.
  9. An analysis of the electron trajectory in the vicinity of GaAs quantum dot
    Hanafi Ithnin, Khalid Kasmin M, Radzi Mat Isa A, Shaari A, Armed R
    Sains Malaysiana, 2014;43:819-825.
    Quantum dots being an interesting class of nanostructures are considered potential prototype systems for novel nano-devices such as single electron transistor (sET). Here in this research, we present an analysis of the electron trajectory in the vicinity of gallium arsenide (GaAs) quantum dot. To perform this study, DFT based methodology is employed to optimize structure of quantum dot and determining the electrostatic potential around the dot. Under the influence of obtained electrostatic potential, trajectory of the moving electron towards the dot is investigated. The results showed that GaAs quantum dot have negative and positive potential surfaces that influence the electron interaction with the dot. These results motivate the development of SET electrode channel where the electron moves towards the dot on the surface with positive potential rather than negative potential surface.
  10. Morphological characteristics of Pinna bicolor Gmelin and Pinna deltodes Menke from the seagrass bed of Sungai Pulai, Johor, Peninsular Malaysia
    Mohd Hanafi Idris, Aziz Arshad, Japar Sidik Bujang, Mazlan Abd. Ghaffar, Siti Khalijah Daud
    Sains Malaysiana, 2009;38.
    Samples of Pinna bicolor Gmelin and Pinna deltodes Menke were collected from the seagrass bed of Sungai Pulai, covering Merambong shoal, Tanjung Adang shoal and Merambong Island off south western coast of Johor, Malaysia for morphological study from August 2005 to June 2006. It was observed that P. deltodes is associated with hard substratum and P. bicolor is associated with soft substratum in the study area. Physically there was no difference between P. bicolor and P. deltodes. The species were identified on the basis of nine internal and external characteristics of the valves. The two species were found to be morphologically different on the basis of width of sulcus, distance between posterior adductor muscle to posterior dorsal nacreous layer, dorsal posterior margin length and shell width.
  11. Fulltext Word Sequential Using Deep LSTM and Matrix Factorization to Handle Rating Sparse Data for E-Commerce Recommender System
    Hanafi, Mohd Aboobaider B
    Comput Intell Neurosci, 2021;2021:8751173.
    PMID: 34917141 DOI: 10.1155/2021/8751173
    Recommender systems are essential engines to deliver product recommendations for e-commerce businesses. Successful adoption of recommender systems could significantly influence the growth of marketing targets. Collaborative filtering is a type of recommender system model that uses customers' activities in the past, such as ratings. Unfortunately, the number of ratings collected from customers is sparse, amounting to less than 4%. The latent factor model is a kind of collaborative filtering that involves matrix factorization to generate rating predictions. However, using only matrix factorization would result in an inaccurate recommendation. Several models include product review documents to increase the effectiveness of their rating prediction. Most of them use methods such as TF-IDF and LDA to interpret product review documents. However, traditional models such as LDA and TF-IDF face some shortcomings, in that they show a less contextual understanding of the document. This research integrated matrix factorization and novel models to interpret and understand product review documents using LSTM and word embedding. According to the experiment report, this model significantly outperformed the traditional latent factor model by more than 16% on an average and achieved 1% on an average based on RMSE evaluation metrics, compared to the previous best performance. Contextual insight of the product review document is an important aspect to improve performance in a sparse rating matrix. In the future work, generating contextual insight using bidirectional word sequential is required to increase the performance of e-commerce recommender systems with sparse data issues.
  12. Preparation, characterisation and viability of encapsulated Trichoderma harzianum UPM40 in alginate-montmorillonite clay
    Adzmi F, Meon S, Musa MH, Yusuf NA
    J Microencapsul, 2012;29(3):205-10.
    PMID: 22309479 DOI: 10.3109/02652048.2012.659286
    Microencapsulation is a process by which tiny parcels of an active ingredient are packaged within a second material for the purpose of shielding the active ingredient from the surrounding environment. This study aims to determine the ability of the microencapsulation technique to improve the viability of Trichoderma harzianum UPM40 originally isolated from healthy groundnut roots as effective biological control agents (BCAs). Alginate was used as the carrier for controlled release, and montmorillonite clay (MMT) served as the filler. The encapsulated Ca-alginate-MMT beads were characterised using Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA) and scanning electron microscopy (SEM). The FTIR results showed the interaction between the functional groups of alginate and MMT in the Ca-alginate-MMT beads. Peaks at 1595, 1420 and 1020 cm(-1) characterised alginate, and peaks at 1028 and 453 cm(-1) characterised MMT; both sets of peaks appeared in the Ca-alginate-MMT FTIR spectrum. The TGA analysis showed an improvement in the thermal stability of the Ca-alginate-MMT beads compared with the alginate beads alone. SEM analysis revealed a homogeneous distribution of the MMT particles throughout the alginate matrix. T. harzianum UPM40 was successfully encapsulated in the Ca-alginate-MMT beads. Storage analysis of the encapsulated T. harzianum UPM40 showed that the low storage temperature of 5°C resulted in significantly (p 
  13. Fulltext Universal versus selective screening for detection of gestational diabetes mellitus in a malaysian population
    Nazimah I, Che Hatikah CH, Murizah MZ, Md Rushdan MN
    Malays Fam Physician, 2009;4(2-3):83-7.
    PMID: 25606169 MyJurnal
    To compare the efficacy of two screenings methods for gestational diabetes mellitus, namely the universal screening using 50g Glucose Challenge Test to that of selective screening based on risk factors.
  14. Hand-arm vibration disorder among grass-cutter workers in Malaysia
    Azmir NA, Ghazali MI, Yahya MN, Ali MH
    Int J Occup Saf Ergon, 2016 Apr 6.
    PMID: 27050159
    Prolonged exposure to hand-transmitted vibration from grass-cutting machines has been associated with increasing occurrences of symptoms and signs of occupational diseases related to hand-arm vibration syndrome (HAVS).
  15. Fulltext Birth prevalence and late diagnosis of critical congenital heart disease: A population-based study from a middle-income country
    Mat Bah MN, Sapian MH, Alias EY
    Ann Pediatr Cardiol, 2020 09 17;13(4):320-326.
    PMID: 33311920 DOI: 10.4103/apc.APC_35_20
    Aims: There are limited data regarding critical congenital heart disease (CCHD) from middle-income countries (MIC). This study aims to determine the birth prevalence, rate of late diagnosis, and influence of timing of diagnosis on the outcome of CCHD.

    Setting and Design: Retrospective observational cohort study in the State of Johor, Malaysia.

    Subjects and Methods: All infants born between January 2006 and December 2015 with a diagnosis of CCHD, defined as infants with duct-dependent lesions or cyanotic heart disease who may die without early intervention. The late diagnosis was defined as a diagnosis of CCHD after 3 days of age.

    Results: Congenital heart disease was diagnosed in 3557 of 531,904 live-born infants and were critical in 668 (18.7%). Of 668, 347 (52%) had duct-dependent pulmonary circulation. The birth prevalence of CCHD was 1.26 (95% confidence interval: 1.16-1.35) per 1000 live births, with no significant increase over time. The median age of diagnosis was 4 days (Q1 1, Q3 26), with 61 (9.1%) detected prenatally, and 342 (51.2%) detected late. The highest rate of late diagnosis was observed in coarctation of the aorta with a rate of 74%. Trend analysis shows a statistically significant reduction of late diagnosis and a significant increase in prenatal detection. However, Cox regression analysis shows the timing of diagnosis does not affect the outcome of CCHD.

    Conclusions: Due to limited resources in the MIC, the late diagnosis of CCHD is high but does not affect the outcome. Nevertheless, the timing of diagnosis has improved over time.

  16. Hydralazine administration activates sympathetic preganglionic neurons whose activity mobilizes glucose and increases cardiovascular function
    Parker LM, Damanhuri HA, Fletcher SP, Goodchild AK
    Brain Res, 2015 Apr 16;1604:25-34.
    PMID: 25662772 DOI: 10.1016/j.brainres.2015.01.049
    Hypotensive drugs have been used to identify central neurons that mediate compensatory baroreceptor reflex responses. Such drugs also increase blood glucose. Our aim was to identify the neurochemical phenotypes of sympathetic preganglionic neurons (SPN) and adrenal chromaffin cells activated following hydralazine (HDZ; 10mg/kg) administration in rats, and utilize this and SPN target organ destination to ascribe their function as cardiovascular or glucose regulating. Blood glucose was measured and adrenal chromaffin cell activation was assessed using c-Fos immunoreactivity (-ir) and phosphorylation of tyrosine hydroxylase, respectively. The activation and neurochemical phenotype of SPN innervating the adrenal glands and celiac ganglia were determined using the retrograde tracer cholera toxin B subunit, in combination with in situ hybridization and immunohistochemistry. Blood glucose was elevated at multiple time points following HDZ administration but little evidence of chromaffin cell activation was seen suggesting non-adrenal mechanisms contribute to the sustained hyperglycemia. 16±0.1% of T4-T11 SPN contained c-Fos and of these: 24.3±1.4% projected to adrenal glands and 29±5.5% projected to celiac ganglia with the rest innervating other targets. 62.8±1.4% of SPN innervating adrenal glands were activated and 29.9±3.3% expressed PPE mRNA whereas 53.2±8.6% of SPN innervating celiac ganglia were activated and 31.2±8.8% expressed PPE mRNA. CART-ir SPN innervating each target were also activated and did not co-express PPE mRNA. Neurochemical coding reveals that HDZ administration activates both PPE+SPN, whose activity increase glucose mobilization causing hyperglycemia, as well as CART+SPN whose activity drive vasomotor responses mediated by baroreceptor unloading to raise vascular tone and heart rate.
  17. Fulltext Reproductive Cycle of Hard Clam, Meretrix lyrata Sowerby, 1851 (Bivalvia: Veneridae) from Sarawak, Malaysia
    Hamli H, Idris MH, Rajaee AH, Kamal AH
    Trop Life Sci Res, 2015 Dec;26(2):59-72.
    PMID: 26868710 MyJurnal
    A study of the reproductive cycle of the hard clam, Meretrix lyrata, was documented based on histological observation and Gonad Index (GI). Samples were taken from estuarine waters of the Buntal River in Sarawak, Malaysia. The gonad of M. lyrata started to develop in September 2013. Gametogenesis continued to develop until the maturation and spawning stage from February to April 2014. The GI pattern for a one-year cycle showed a significant correlation with chlorophyll a. The corresponding GI with chlorophyll a suggested that the development of the reproductive cycle of M. lyrata required a high amount of food to increase gametogenesis.
  18. Fulltext Conchology Variations in Species Identification of Pachychilidae (Mollusca, Gastropoda, Cerithiodea) through Multivariate Analysis
    Hamli H, Hamed NA, Azmai SHS, Idris MH
    Trop Life Sci Res, 2020 Jul;31(2):145-158.
    PMID: 32922672 DOI: 10.21315/tlsr2020.31.2.7
    Pachychilidae is one of the freshwater gastropod family which was previously known under the Potamididae and Thiaridae families. Studies on freshwater gastropods especially on conchcology examinantions are still inadequate compared to marine gastropods. Morphological and morphometric studies of gastropods are practically used to identify and differentiate between species and necessary to complement molecular studies due to its low cost and tolerable resolving power of discrimination. The aim of the current study is to provide information on morphological and morphometric characteristics of Pachychilidae in Bintulu, Sarawak stream. A total of 20 individuals from each species of Sulcospira testudinaria, Sulcospira schmidti, Brotia siamensis, and Tylomelania sp. from Pachychilidae familiy were collected at three different sites from a small stream within the Bintulu area. Fourteen measurement of shell morphometrics were converted into proportioned ratios and analysed for univariate and multivariate analysis. Three shell morphometric (Aperture width, AW; Whorl width, WW2; and, Interior anterior length, AINL) of Pachychilidae indicated significant differences (P < 0.05) between species. However, multivariate analysis revealed that these shell morphometrics are pre-eminent factors to discriminate genus Sulcospira, Brotia and Tylomelania, as well as between Sulcospira species. This current study also suggests that these three characteristics are unique to Sulcospira species due to strong distinction among species. Findings on these three characteristics are significant for Sulcospira spp. as this study is the first shell morphometric report on the Pachychilidae species in Sarawak.
  19. Graphene/transition metal dichalcogenides hybrid supercapacitor electrode: status, challenges, and perspectives
    Seman RNAR, Azam MA, Ani MH
    Nanotechnology, 2018 Dec 14;29(50):502001.
    PMID: 30248022 DOI: 10.1088/1361-6528/aae3da
    Supercapacitors, based on fast ion transportation, are among the most promising energy storage solutions that can deliver fast charging-discharging within seconds and exhibit excellent cycling stability. The development of a good electrode material is one of the key factors in enhancing supercapacitor performance. Graphene (G), an allotrope of carbon that consists of a single layer of carbon atoms arranged in a hexagonal lattice, elicits research attention among scientists in the field of energy storage due to its remarkable properties, such as outstanding electrical conductivity, good chemical stability, and excellent mechanical behavior. Furthermore, numerous studies focus on 2D materials that are analogous to graphene as electrode supercapacitors, including transition metal dichalcogenides (TMDs). Recently, scientists and researchers are exploring TMDs because of the distinct features that make 2D TMDs highly attractive for capacitive energy storage. This study provides an overview of the structure, properties, synthesis methods, and electrochemical performance of G/TMD supercapacitors. Furthermore, the combination of G and TMDs to develop a hybrid structure may increase their energy density by introducing an asymmetric supercapacitor system. We will also discuss the future prospect of this system in the energy field.
  20. Delayed diagnosis of Kawasaki disease in Malaysia: Who is at risk and what is the outcome
    Mat Bah MN, Alias EY, Sapian MH, Abdullah N
    Pediatr Int, 2022 Jan;64(1):e15162.
    PMID: 35789141 DOI: 10.1111/ped.15162
    BACKGROUND: Data on the delayed diagnosis of (KD) is limited. This study aimed to determine the prevalence and trend of delayed diagnosis over time and identify the associated risk factors in Malaysia.

    METHODS: This retrospective, observational, population-based study involved all children with KD registered in Johor Kawasaki Clinical Registry over 10 years (January 2010 and December 2019). The prevalence of delayed diagnosis and its trend over time was calculated. Multivariable binary logistic regression was used to identify the independent risk factors for delayed diagnosis.

    RESULTS: There were 556 cases of KD, with 28% having incomplete criteria, 11% atypical presentation, while 10% developed a coronary aneurysm. The overall prevalence of delayed diagnosis was 9.9% (95% confidence interval (CI): 7.6-12.7%). There was a statistically significant decrease in delayed diagnosis over time (P = 0.008), with the latest rate of 4.6%. The majority of delayed diagnoses were due to failure to diagnose the disease during the initial consultation. Independent risk factors for delayed diagnosis were children older than 1 year, diagnosis before 2015, atypical presentation, and incomplete KD, with adjusted odds ratios (ORs) of 2.7, 2.3, 4.3, and 3.6, respectively. Compared to early diagnosis of KD, delayed diagnosis was significantly associated with coronary aneurysms (27.3% vs. 8.2%, P < 0.001, OR 4.2, [95% CI: 2.1-8.3]).

    CONCLUSIONS: One-tenth of cases of KD were diagnosed late, but it has improved over time. Children > 1 year, presenting with atypical presentation, and incomplete criteria are associated with late diagnosis.

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