Displaying publications 61 - 80 of 142 in total

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  1. Comparative analysis between multilevel sectioning with conventional haematoxylin and eosin staining and immunohistochemistry for detecting nodal micrometastases with stage I and II colorectal cancers
    Wong YP, Shah SA, Shaari N, Mohamad Esa MS, Sagap I, Isa NM
    Asian Pac J Cancer Prev, 2014;15(4):1725-30.
    PMID: 24641399
    Management of patients with stage II colorectal carcinomas remains challenging as 20 - 30% of them will develop recurrence. It is postulated that these patients may harbour nodal micrometastases which are imperceptible by routine histopathological evaluation. The aims of our study were to evaluate (1) the feasibility of multilevel sectioning method utilizing haematoxylin and eosin stain and immunohistochemistry technique with cytokeratin AE1/AE3, in detecting micrometastases in histologically-negative lymph nodes, and (2) correlation between nodal micrometastases with clinicopathological parameters. Sixty two stage I and II cases with a total of 635 lymph nodes were reviewed. Five-level haematoxylin and eosin staining and one-level cytokeratin AE1/AE3 immunostaining were performed on all lymph nodes retrieved. The findings were correlated with clinicopathological parameters. Two (3.2%) lymph nodes in two patients (one in each) were found to harbour micrometastases detected by both methods. With cytokeratin AE1/AE3, we successfully identified four (6.5%) patients with isolated tumour cells, but none through the multilevel sectioning method. Nodal micrometastases detected by both multilevel sectioning and immunohistochemistry methods were not associated with larger tumour size, higher depth of invasion, poorer tumour grade, disease recurrence or distant metastasis. We conclude that there is no difference between the two methods in detecting nodal micrometastases. Therefore it is opined that multilevel sectioning is a feasible and yet inexpensive method that may be incorporated into routine practice to detect nodal micrometastases in centres with limited resources.
  2. Spatial analysis of colorectal cancer cases in Kuala Lumpur
    Shah SA, Neoh HM, Rahim SS, Azhar ZI, Hassan MR, Safian N, et al.
    Asian Pac J Cancer Prev, 2014;15(3):1149-54.
    PMID: 24606433
    BACKGROUND: In Malaysia, data from the Malaysian Health Ministry showed colorectal cancer (CRC) to be the second most common type of cancer in 2007-2009, after breast cancer. The same was apparent after looking at males and females cases separately. In the present study, the Geographic Information System (GIS) was employed to describe the distribution of CRC cases in Kuala Lumpur (KL), Malaysia, according to socio-demographic factors (age, gender, ethnicity and district).

    MATERIALS AND METHODS: This retrospective review concerned data for patients diagnosed with colorectal cancer in the years 1995 to 2011 collected from the Wilayah Persekutuan Health Office, taken from the cancer notification form (NCR-2), and patient medical records from the Surgical Department, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A total of 146 cases were analyzed. All the data collected were analysed using ArcGIS version 10.0 and SPSS version 19.0.

    RESULTS: Patients aged 60 to 69 years accounted for the highest proportion of cases (34.2%) and males slightly predominated 76 (52.1%), Chinese had the highest number of registered cases at 108 (74.0%) and staging revealed most cases in the 3rd and 4th stages. Kernel density analysis showed more cases are concentrated up in the northern area of Petaling and Kuala Lumpur subdistricts. Spatial global pattern analysis by average nearest neighbour resulted in nearest neighbour ratio of 0.75, with Z-score of -5.59, p value of <0.01 and the z-score of -5.59. Spatial autocorrelation (Moran's I) showed clustering significant with p<0.01, Z score 3.14 and Moran's Index of 0.007. When mapping clusters with hotspot analysis (Getis-Ord Gi), hot and cold spots were identified. Hot spot areas fell on the northeast side of KL.

    CONCLUSIONS: This study demonstrated significant spatial patterns of cancer incidence in KL. Knowledge about these spatial patterns can provide useful information to policymakers in the planning of screening of CRC in the targeted population and improvement of healthcare facilities to provide better treatment for CRC patients.

  3. Why do young adolescents bully? Experience in Malaysian schools
    Wan Ismail WS, Nik Jaafar NR, Sidi H, Midin M, Shah SA
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S114-20.
    PMID: 23763872 DOI: 10.1016/j.comppsych.2013.05.002
    INTRODUCTION: To determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia.
    METHODS: This is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively.
    RESULTS: Only male gender (OR=7.071, p=0.01*, CI=1.642-30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR=2.285, p=0.00*, CI=1.507-3.467) and inattentive ADHD symptoms reported by teachers (OR=1.829, p=0.03*, CI=1.060-3.154) and parents (OR=1.709, p=0.03*, CI=1.046-2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR=0.729, p=0.01*, CI=0.580-0.915) and teachers (OR=0.643, p=0.02*, CI=0.440-0.938) were protective against bullying behavior despite the influence of conduct behavior (OR=3.160, p=0.00*, CI=1.600-6.241). Internalizing behavior, that is, withdrawn (OR=0.653, p=0.04*, CI=0.436-0.977) and somatic complaints (OR=0.619, p=0.01*, CI=0.430-0.889) significantly protect against bullying behavior.
    DISCUSSIONS: Recognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.
  4. Fulltext The negative impact of living environment on intelligence quotient of primary school children in Baghdad City, Iraq: a cross-sectional study
    Ghazi HF, Isa ZM, Aljunid S, Shah SA, Tamil AM, Abdalqader MA
    BMC Public Health, 2012;12:562.
    PMID: 22839101 DOI: 10.1186/1471-2458-12-562
    Environmental factors play a very important role in the child development process, especially in a situation like that of Iraq. Thirteen years of economic sanctions followed by the 2003 war and 8 years of unstable security have affected the daily life of Iraqi families and children. The objective of this study was to assess the associations between living environment domains and child intelligence quotient (IQ) score.
  5. Fulltext Knowledge of colorectal cancer among patients presenting with rectal bleeding and its association with delay in seeking medical advice
    Mohd Hashim S, Tong SF, Omar K, Abdul Rashid MR, Shah SA, Sagap I
    Asian Pac J Cancer Prev, 2011;12(8):2007-11.
    PMID: 22292642
    BACKGROUND: Knowledge is believed to be a driving factor for patients' early presentation for healthcare. This study was conducted to assess knowledge of colorectal cancer among subjects presenting with rectal bleeding and to determine its association with late presentation.

    METHODS: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The research instruments used in this study was a self-administered questionnaire including data on duration of rectal bleeding, first medical consultation and knowledge of colorectal cancer.

    RESULTS: Sixty percent of subjects with rectal bleeding delayed seeking medical advice. Subjects were more aware of symptoms of non-colorectal cancers compared to symptoms of colorectal cancer. The majority of subjects (63.8%) correctly identified rectal bleeding as a symptom but were not aware of the best screening method to detect colorectal cancer. Half of the subjects knew increasing age and genetic background to be risk factors for colorectal carcinoma. However, knowledge of colorectal cancer was not found to be significantly associated with delay in seeking help.

    CONCLUSION: Findings indicate poor awareness of colorectal cancer among the subjects. Although public education of colorectal cancer is important for early presentation on rectal bleeding, further studies are advocated to evaluate other factors influencing patients' help seeking behavior other than knowledge.
  6. Fulltext Factors influencing late consultation among patients with rectal bleeding in University Kebangsaan Malaysia Medical Centre
    Hashim SM, Omar K, Fah TS, Rashid RA, Daud TI, Shah SA, et al.
    Asian Pac J Cancer Prev, 2010;11(5):1335-9.
    PMID: 21198288
    BACKGROUND: Patients' delay in the presentation with rectal bleeding had been identified as a factor for late diagnosis of colorectal cancer. This study was conducted to determine the prevalence of delay in consulting a medical practitioner and identifying associated factors.

    MATERIALS AND METHODS: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The self-administered questionnaire included data on sociodemographic, concern of rectal bleeding, whether patients sought initial advice, any self treatment prior to medical consultation and patients' opinion on causes of their own rectal bleeding.

    RESULTS: The prevalence of delay in the presentation of rectal bleeding was 60%. Patients who were less worried (OR 9.6; 95% CI 3.3-27.5), who did not seek anyoneandapos;s advice (OR 11.8; 95% CI 3.8-36.8) and took some treatment before seeking medical consultation (OR 5.0; 95% CI 1.0-24.1) were significantly more likely to delay. Multiple logistic regression revealed that less worry of rectal bleeding and not seeking anyoneandapos;s advice were important predictors (p<0.05). The majority of patients attributed their bleeding to benign causes.

    CONCLUSION: A high proportion of patients with rectal bleeding in the high risk group delayed in seeking medical advice. Public education needs to focus on interventions to reduce the delay in presenting and diagnosis of colorectal carcinoma.
  7. Fulltext Low back pain and association with whole body vibration among military armoured vehicle drivers in Malaysia
    Rozali A, Rampal KG, Shamsul Bahri MT, Mohd Sidik S, Shamsul Azhar S, Khairuddin H, et al.
    Med J Malaysia, 2009 Sep;64(3):197-204.
    PMID: 20527267 MyJurnal
    A cross sectional study was conducted among military armoured vehicle drivers in the two largest mechanized battalions with the objective to determine the prevalence of low back pain (LBP), and its association with whole body vibration (WBV) and other associated factors. A self-administered questionnaire and Human Vibration Meter were used in this study. A total of 159 respondents participated in this study and 102 (64.2%) of them were subjected to WBV measurement. One-hundred-and-seventeen respondents complained of LBP for the past 12 months giving a prevalence of 73.6%. The prevalence of LBP among tracked armoured vehicle drivers was higher (81.7%) as compared to wheeled armoured vehicle drivers (67.0%). The mean acceleration at Z-axis in tracked armoured vehicles (1.09 +/- 0.26 ms(-2)) and wheeled armoured vehicles (0.33 +/- 0.07 ms) were the dominant vibration directions. The mean estimated vibration dose value (eVDV) for eight-hour daily exposure at Z-axis (19.86 +/- 4.72 ms(-1.75)) in tracked armoured vehicles showed the highest estimation. Based on the European Vibration Directive (2002), the mean eVDV at Z-axis in tracked armoured vehicles exceeded exposure action value (EAV) (> 9.1 ms(-1.75), but did not exceed exposure limit value (ELV) (<21.0 ms(-1.75)). Logistic regression analysis revealed that only driving in forward bending sitting posture (OR = 3.63, 95% CI 1.06-12.42) and WBV exposure at X-axis (OR = 1.94, 95% CI 1.02-3.69) were significant risk factors to LBP. Preventive measures should be implemented to minimize risk of WBV and to improve ergonomic postures among drivers.
  8. Fulltext Work related determinants of breastfeeding discontinuation among employed mothers in Malaysia
    Amin RM, Said ZM, Sutan R, Shah SA, Darus A, Shamsuddin K
    Int Breastfeed J, 2011;6(1):4.
    PMID: 21342506 DOI: 10.1186/1746-4358-6-4
    This cross-sectional study assesses factors that contribute to discontinuing breastfeeding among employed mothers in Malaysia.
  9. A study of intima media thickness and their cardiovascular risk factors in patients with psoriatic arthritis
    Mazlan SA, bin Mohamed Said MS, Hussein H, binti Shamsuddin K, Shah SA, Basri H
    Acta Medica (Hradec Kralove), 2009;52(3):107-16.
    PMID: 20073422 DOI: 10.14712/18059694.2016.114
    INTRODUCTION: Psoriatic Arthritis (PsA) is an inflammatory arthritis associated with Psoriasis. Its recognition as an inflammatory disease distinct from Rheumatoid Arthritis has put forward for consideration several questions regarding its specific CVS mortality and morbidity (9, 11, 16, 26). Carotid intima media thickness is a useful surrogate and sensitive marker to determine atherosclerosis even in its subclinical stages (6, 14, 22, 27, 32).

    OBJECTIVE: Prevalence of carotid intima media thickness in patients with Psoriatic arthritis is unknown in Asian population. We aim to identify the presence of subclinical atherosclerosis in patients with psoriatic arthritis and disease activity association and its predictors in a series of patients with PsA attended to the rheumatology clinic, tertiary hospitals.

    METHODS: A total of 63 patients with PsA who fulfilled the CASPAR criteria were recruited from UKM Medical Centre and Hospital Putrajaya. Common carotid intima media thickness (IMT) was measured in both right and left carotid artery by using high resolution B-mode ultrasound. This was a cross sectional study first done in Malaysia for PsA patients.

    RESULTS: The positive IMT (IMT > 1.00 mm) among PsA was observed in 10 out of 63 patients (15.9 %) regardless of background cardiovascular risk. The mean +/- SD of IMT was 0.725 +/-0.260 mm for this study. Variables significantly associated with positive IMT (p < 0.05) included age at the time of study (p = 0.005), waist circumference (p = 0.001), Hypertension (p = 0.007), Diabetes (p = 0.002) and Metabolic syndrome (p = 0.001) and not associated with gender, ethnicity, duration of PsA disease, pattern of PsA, disease activity and severity. Above all, only age had positive IMT independent predictor (p = 0.032), with OR 1.116; 95 % CI (1.010-1.234).

    CONCLUSIONS: There was a significant association between CVS risk and positive Intima Media Thickness in Psoriatic Arthritis patients. Otherwise, there was no association in disease activity, disease severity and DMARDS therapy with positive Intima Media Thickness in Psoriatic Arthritis patients. The study was approved by Research and Ethics Committee of the faculty of medicine, Universiti Kebangsaan Malaysia with project code FF-114-2008 and by Community Research Center (CRC) of National Institutes of Health (NIH) for the case study in Hospital Putrajaya with the project code NMRR-08-970-2125.
  10. Intravenous calcitriol versus paricalcitol in haemodialysis patients with severe secondary hyperparathyroidism
    Abdul Gafor AH, Saidin R, Loo CY, Mohd R, Zainudin S, Shah SA, et al.
    Nephrology (Carlton), 2009 Aug;14(5):488-92.
    PMID: 19298641 DOI: 10.1111/j.1440-1797.2008.01058.x
    Secondary hyperparathyroidism (SHPT) is common among haemodialysis patients. Intensive treatment with calcitriol is often complicated by hypercalcaemia, hyperphosphataemia and elevated calcium phosphorus (Ca X PO(4)) product. Paricalcitol is a vitamin D analogue developed to overcome some of the limitations of calcitriol therapy. The study objectives were to compare the response of intact parathyroid hormone (iPTH) and the incidence of hypercalcaemia, hyperphosphataemia and elevated Ca X PO(4) product in patients with severe SHPT treated with either i.v. calcitriol or i.v. paricalcitol.
  11. Mammography screening: Female doctors'attitudes and practice in Sana'a, Yemen
    Al-Naggar RA, Isa ZM, Shah SA, Chen R, Kadir SY
    Asian Pac J Cancer Prev, 2009;10(5):743-6.
    PMID: 20104962
    A cross-sectional study was conducted at the main hospitals in Sana'a, Yemen to determine the attitude and practice of Yemen female doctors on mammography screening. Study subjects were all female doctors who were on duty during the questionnaire distribution. Those who agreed to participate were given the questionnaire to complete. Descriptive statistics were used to analyse socio-demographic variables and variables related to general health. Participants in this study were 105 female doctors with mean age of 32.1 years (SD = 7.17). Thirty-four respondents (36.6%) did not send asymptomatic women for mammography screening. The reasons were because of high cost (58.0%, n= 25), availability of other methods (23.3%, n= 10), instrument not available (11.6%, n= 5) and high risk of radiation (7.0%, n= 3). Twenty-five participants (26.9%) sent patients on regular basis if there was a family or personal history of breast cancer. Twenty-three participants (24.7%) sent the patients for mammogram screening every year regardless of the patients'history or symptoms. Although most doctors (36.5%) do not refer patients for mammography screening, seventy-seven (74.0%) indicated that they would refer patients for mammography screening on personal request by the patients. This study showed a low percentage of doctors who referred patients for routine mammography. The major reason given was the high cost of the procedure.
  12. Fulltext Colorectal cancer patients in a tertiary referral centre in Malaysia: a five year follow-up review
    Rashid MR, Aziz AF, Ahmad S, Shah SA, Sagap I
    Asian Pac J Cancer Prev, 2009;10(6):1163-6.
    PMID: 20192604
    BACKGROUND: Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC is fast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental and genetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC.

    MATERIALS AND METHODS: Retrospective case review study done on CRC patients at University Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia. Patientsandapos; socio-demographic characteristics, modalities of treatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records.

    RESULTS: A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%). Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms including per rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was 13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presented with Dukes C stage (40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%. Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lower recurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinese patients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment (22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45).

    CONCLUSION: Socio-demographic profile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatment gives rise to poor overall survival and local recurrence rates.
  13. Fulltext Emergence of chikungunya seropositivity in healthy Malaysian adults residing in outbreak-free locations: chikungunya seroprevalence results from the Malaysian Cohort
    Azami NA, Salleh SA, Shah SA, Neoh HM, Othman Z, Zakaria SZ, et al.
    BMC Infect Dis, 2013;13:67.
    PMID: 23379541 DOI: 10.1186/1471-2334-13-67
    In 1998, Malaysia experienced its first chikungunya virus (CHIKV) outbreak in the suburban areas followed by another two in 2006 (rural areas) and 2008 (urban areas), respectively. Nevertheless, there is still a lack of documented data regarding the magnitude of CHIKV exposure in the Malaysian population. The aim of this study was to determine the extent of chikungunya virus infection in healthy Malaysian adults residing in outbreak-free locations.
  14. Anxiety and Depression among Breast Cancer Patients in an Urban Setting in Malaysia
    Hassan MR, Shah SA, Ghazi HF, Mohd Mujar NM, Samsuri MF, Baharom N
    Asian Pac J Cancer Prev, 2015;16(9):4031-5.
    PMID: 25987081
    BACKGROUND: Breast cancer is one of the most feared diseases among women and it could induce the development of psychological disorders like anxiety and depression. An assessment was here performed of the status and to determine contributory factors.

    MATERIALS AND METHODS: A cross-sectional study was conducted among breast cancer patients at University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur. A total of 205 patients who were diagnosed between 2007 until 2010 were interviewed using the questionnaires of Hospital Anxiety and Depression (HADS). The associated factors investigated concerned socio-demographics, socio economic background and the cancer status. Descriptive analysis, chi-squared tests and logistic regression were used for the statistical test analysis.

    RESULTS: The prevalence of anxiety was 31.7% (n=65 ) and of depression was 22.0% (n=45) among the breast cancer patients. Age group (p= 0.032), monthly income (p=0.015) and number of visits per month (p=0.007) were significantly associated with anxiety. For depression, marital status (p=0.012), accompanying person (p=0.041), financial support (p-0.007) and felt burden (p=0.038) were significantly associated. In binary logistic regression, those in the younger age group were low monthly income were 2 times more likely to be associated with anxiety. Having less financial support and being single were 3 and 4 times more likely to be associated with depression.

    CONCLUSIONS: In management of breast cancer patients, more care or support should be given to the young and low socio economic status as they are at high risk of anxiety and depression.

  15. Evaluation of auditory hallucinations in patients with schizophrenia: A validation study of the Malay version of Psychotic Symptom Rating Scales (PSYRATS)
    Wahab S, Zakaria MN, Sidek D, Abdul Rahman AH, Shah SA, Abdul Wahab NA
    Psychiatry Res, 2015 Aug 30;228(3):462-7.
    PMID: 26142835 DOI: 10.1016/j.psychres.2015.06.014
    The Psychotic Symptom Rating Scales (PSYRATS) is the most widely used validated scale to measure the specific symptoms of auditory hallucination and delusion. The aim of this study was to validate and to examine the psychometric properties of the auditory hallucination component of the Malay PSYRATS (MyPSYRATS). The research was done in the Universiti Kebangsaan Malaysia Medical Center (UKMMC) among 51 schizophrenia inpatients and outpatients who had experienced or reported verbal auditory hallucination. The psychometric properties of MyPSYRATS (auditory hallucination) were studied and a comparison was made between the psychometric properties obtained and the Positive and Negative Syndrome Scale (PANSS). The internal consistency of MyPSYRATS was good as revealed by Cronbach's alpha value. Factor analysis replicated three components (emotional, cognitive, and physical) similar to the factorial structure of the original auditory hallucination scale. However, two items were regrouped under the emotional component. Spearman's rank-order correlation showed a significant positive relationship between the total score of auditory hallucinations and PANSS auditory hallucinations item (P3). In conclusion, the auditory hallucination domain of MyPSYRATS is a reliable and valid assessment tool for further clinical applications.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  16. Improvement in binge eating in non-diabetic obese individuals after 3 months of treatment with liraglutide - A pilot study
    Robert SA, Rohana AG, Shah SA, Chinna K, Wan Mohamud WN, Kamaruddin NA
    Obes Res Clin Pract, 2015 May-Jun;9(3):301-4.
    PMID: 25870084 DOI: 10.1016/j.orcp.2015.03.005
    We examined the effects of liraglutide, a glucagon-like peptide-1 analogue on appetite and plasma ghrelin in non-diabetic obese participants with subclinical binge eating (BE). Forty-four obese BE participants (mean age: 34±9 years, BMI: 35.9±4.2kg/m(2)) were randomly assigned to intervention or control groups for 12 weeks. All participants received standard advice for diet and exercise. Binge eating score, ghrelin levels and other anthropometric variables were evaluated at baseline and at the end of the study. Participants who received liraglutide showed significant improvement in binge eating, accompanied by reduction in body weight, BMI, waist circumference, systolic blood pressure, fasting glucose and total cholesterol. Ghrelin levels were significantly increased which may potentially diminish the weight loss effects of liraglutide beyond the intervention.
  17. Knowledge of Acute Stroke Management Among Healthcare Professionals: Development and Validation of Acute Stroke Management Questionnaire (ASMaQ)
    Sim CY, Wan Zaidi WA, Shah SA, Wan Yahya WNN, Tan HJ
    J Stroke Cerebrovasc Dis, 2021 Jan;30(1):105421.
    PMID: 33160125 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105421
    BACKGROUND: Around 15.0% of all strokes occurred in hospitalised patients and studies showed significant delay in the stroke recognition and lack of awareness on thrombolytic therapy for acute ischaemic stroke (AIS) which lead to higher mortality for in-hospital stroke. We aimed to develop and validate a new instrument known as acute stroke management questionnaire (ASMaQ) to evaluate the awareness of healthcare professionals in managing acute ischaemic stroke cases.

    METHODS: This study consisted of 3 steps; the formulation of ASMaQ draft, content validation and construct validity. A total of 110 questions were drafted with 5-point Likert scale answers. From the list, 31 were selected and subsequently tested on 158 participants. The results were analysed and validated using exploratory factor analysis on SPSS. Components were extracted and questions with low factor loading were removed. The internal consistency was then measured with Cronbach's alpha.

    RESULTS: Following analysis, 3 components were extracted and named as general stroke knowledge, hyperacute stroke care and advanced stroke management. Two items were deleted leaving 29 out of 31 questions for the final validated ASMaQ. Internal consistency showed high reliability with Cronbach's alpha of 0.82. Our respondents scored a total cumulative mean of 113.62 marks or 66.6%. A sub analysis by occupation showed that medical assistants scored the lowest in the group with a score of 57% whilst specialists including neurologists scored the highest at 79.4%.

    CONCLUSION: The ASMaQ is a newly developed and validated questionnaire consisting of 29 questions testing the respondents' acute stroke management knowledge.

  18. Glycaemic control status among type 2 diabetic patients and the role of their diabetes coping behaviours: a clinic-based study in Tripoli, Libya
    Ashur ST, Shah SA, Bosseri S, Fah TS, Shamsuddin K
    Libyan J Med, 2016 Jan;11(1):31086.
    PMID: 28349838 DOI: 10.3402/ljm.v11.31086
    Background Achieving good glycaemic control is important in diabetes management. However, poor glycaemic control is widely reported. This article assessed the prevalence of uncontrolled and poor glycaemic control among Libyans with type 2 diabetes and examined the relative contribution of diabetes coping behaviours to their glycaemic control status. Methods A cross-sectional study was undertaken in 2013 in a large diabetes centre in Tripoli. The study included 523 respondents. Diabetes coping behaviours were measured using the revised version of the Summary of Diabetes Self-Care Activities measure (SDSCA) and the eight-item Morisky Medication Adherence Scale (MMAS-8(©)), while glycaemic control status was based on the HbA1c level. Results Mean HbA1c was 8.9 (±2.1), and of the 523 patients, only 114 (21.8%) attained the glycaemic control target of HbAc1 of less than 7.0%. Females (OR=1.74, 95% CI=1.03-2.91), patients on insulin and oral hypoglycaemic agents (OR=1.92, 95% CI=1.05-3.54), patients on insulin (OR=3.14, 95% CI=1.66-6.03), and low-medication adherents (OR=2.25, 95% CI=1.36-3.73) were more likely to have uncontrolled and poor glycaemic control, while exercise contributed to glycaemic control status as a protective factor (OR=0.85, 95% CI=0.77-0.94). Conclusion The findings from this study showed the considerable burden of uncontrolled and poor glycaemic control in one of the largest diabetes care settings in Libya. Medication adherence as well as exercise promotion programs would help in reducing the magnitude of poor glycaemic control.
  19. Fulltext Reduction in Urinary Chemokine (C-C Motif) Ligand 2 (CCL2) After Surgery-Induced Weight Loss
    Said SB, Loo GH, Kosai NR, Rajan R, Mohd R, Wahab AA, et al.
    Sci Rep, 2020 01 21;10(1):790.
    PMID: 31964990 DOI: 10.1038/s41598-020-57763-8
    Kidney dysfunction, a deleterious effect of obesity, is now recognized as a relevant health risk. Chemokine (C-C Motif) Ligand 2 (CCL2) is one of the critical chemokines that play a vital role in the development of obesity-related metabolic disease. We aim to measure the changes in urinary CCL2 in our patients before and after their bariatric procedure and examine the correlation between CCL2 and renal function. A prospective cohort study was conducted at our teaching university hospital. Ethics approval was obtained from our institutional review board. Patients with a BMI of ≥37.5 kg/m2 with no history of renal disease were included. They underwent single anastomosis gastric bypass (SAGB), Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG), all performed via laparoscopic approach. Venous blood and urine samples were obtained preoperatively and six months after surgery. A total of 58 patients were recruited, with SG being performed in 74.1% of patients. At six-months follow-up, median (IQR) body weight reduced from 101.35 kgs (20.25) to 76.95 kg (24.62) p 
  20. Fulltext Pregnancy and COVID-19 Pandemic Perception in Malaysia: A Cross-Sectional Study
    Syed Anwar Aly SA, Abdul Rahman R, Sharip S, Shah SA, Abdullah Mahdy Z, Kalok A
    Int J Environ Res Public Health, 2021 May 27;18(11).
    PMID: 34072017 DOI: 10.3390/ijerph18115762
    Pregnant women are susceptible to COVID-19 complications due to gestation-related physiological changes. We aimed to evaluate the level of maternal knowledge, perception, and practice during the pandemic. A cross-sectional study was conducted during the Malaysian Movement Control Order (MCO) between April and June 2020. A self-administered electronic questionnaire that included the knowledge and practice domains was distributed. A newly designed set of questions was used to evaluate (1) women's perception of MCO and (2) maternal experience, which was subdivided into clinical care provision and maternal anxiety. The survey response rate was 93% with the final number for analysis of 415. The majority of women (95%) demonstrated an adequate level of knowledge on COVID-19, whilst 99% had a good practice. We found that tertiary education (p < 0.001), employment status (p = 0.03), higher household income (p < 0.001), and multiple sources of information (p < 0.001) were independent predictors of adequate maternal knowledge on COVID-19. Women with adequate knowledge also reported a more positive perception of MCO (p < 0.001) and better obstetric care experience (p = 0.037), as did those of Malay ethnicity. Younger (p < 0.001) and nulliparous (p = 0.01) women demonstrated greater anxiety levels. The majority of our women reported good practice and adequate knowledge, which contributed to a positive perception of MCO and better maternal obstetric experience. First-time mothers may benefit from extra support and reassurance during the pandemic to alleviate maternal anxiety.
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