METHODS: This cross-sectional study included adolescents aged 15-17 years from five randomly selected secondary schools in the Hulu Langat district of Selangor state, Malaysia. Waist circumference (WC) was measured at the midpoint between the lower margin of the last palpable rib and the top of the iliac crest. Information on sociodemographic data, dietary habits, physical activity levels and duration of sleep was obtained via interviewer-administered questionnaires. Participants' habitual food intake was determined using a 73-item Food Frequency Questionnaire.
RESULTS: Among 832 participants, 56.0% were girls; 48.4% were Malay, 40.5% Chinese, 10.2% Indian and 0.8% of other ethnic groups. Median age and WC were 16 (interquartile range [IQR] 15-16) years and 67.9 (IQR 63.0-74.6) cm, respectively. Overall prevalence of AO (> 90th percentile on the WC chart) was 11.3%. A higher proportion (22.4%) of Indian adolescents were found to have AO compared with Malay and Chinese adolescents. Logistic regression analysis showed that female gender (adjusted odds ratio [OR] 7.064, 95% confidence interval [CI] 2.087-23.913; p = 0.002), Indian ethnicity (adjusted OR 10.164, 95% CI 2.182-47.346; p = 0.003), irregular meals (adjusted OR 3.193, 95% CI 1.043-9.774; p = 0.042) and increasing body mass index (BMI) (adjusted OR 2.867, 95% CI 2.216-3.710; p < 0.001) were significantly associated with AO.
CONCLUSION: AO was common among Malaysian adolescents. Female gender, Indian ethnicity, irregular meals and increasing BMI were significant risk factors.
METHODS: An open-label study was conducted to evaluate the effectiveness of the addition of 1.5 mcg/kg intranasal fentanyl to 2 mg/kg intravenous tramadol (fentanyl + tramadol arm, n = 10) as compared to the administration of 2 mg/kg intravenous tramadol alone (tramadol-only arm, n = 10) in adult patients with moderate to severe pain due to acute musculoskeletal injuries.
RESULTS: When analysed using the independent t-test, the difference between the mean visual analogue scale scores pre-intervention and ten minutes post-intervention was 29.8 ± 8.4 mm in the fentanyl + tramadol arm and 19.6 ± 9.7 mm in the tramadol-only arm (t[18] = 2.515, p = 0.022, 95% confidence interval 1.68-18.72 mm). A statistically significant, albeit transient, reduction in the ten-minute post-intervention mean arterial pressure was noted in the fentanyl + tramadol arm as compared to the tramadol-only arm (13.35 mmHg vs. 7.65 mmHg; using Mann-Whitney U test with U-value 21.5, p = 0.029, r = 0.48). There was a higher incidence of transient dizziness ten minutes after intervention among the patients in the fentanyl + tramadol arm.
CONCLUSION: Although effective, intranasal fentanyl may not be appropriate for routine use in adult patients, as it could result in a significant reduction in blood pressure.
METHODS: This retrospective study included all patients with CML, in chronic or accelerated phase, who were treated with imatinib at University of Malaya Medical Centre, Malaysia.
RESULTS: A total of 70 patients were analysed. The median follow-up duration was 74 months, and the cumulative percentages of patients with CCyR and MMR were 80.0% and 65.7%, respectively. Overall survival (OS) and event-free survival (EFS) at ten years were 94.3% and 92.9%, respectively. Patients who achieved CCyR and MMR had significantly better OS and EFS than those who did not. At six months, patients who had a BCR-ABL level ≤ 10% had significantly better OS and EFS than those who had a BCR-ABL level > 10%. The target milestone of CCyR at 12 months and MMR at 18 months showed no survival advantage in our patients.
CONCLUSION: Our data showed that imatinib is still useful as first-line therapy. However, vigilant monitoring of patients who have a BCR-ABL level > 10% at six months of treatment should be implemented so that prompt action can be taken to provide the best outcome for these patients.
METHODS: This was a comparative cross-sectional study. We recruited children aged 8-11 years from eight primary schools in Kota Bharu, Kelantan, Malaysia. The children were divided into two groups: those with LBW (< 2,500 g) and those with normal birth weight (≥ 2,500 g). Parents of the enrolled children were asked to complete a translated version of the International Study of Asthma and Allergies in Childhood questionnaire. Lung function tests, done using a MicroLoop Spirometer, were performed for the children in both groups by a single investigator who was blinded to the children's birth weight.
RESULTS: The prevalence of 'ever wheezed' among the children with LBW was 12.9%. This value was significantly higher than that of the children with normal birth weight (7.8%). Forced vital capacity (FVC), forced expiratory volume in one second, and forced expiratory flow when 50% and 75% of the FVC had been exhaled were significantly lower among the children with LBW as compared to the children with normal birth weight.
CONCLUSION: LBW is associated with an increased prevalence of asthma-like symptoms and impaired lung function indices later in life. Children born with LBW may need additional follow-up so that future respiratory problems can be detected early.
METHODS: Phylogenetic analysis of locally acquired P. knowlesi infections, based on circumsporozoite, small subunit ribosomal ribonucleic acid (SSU rRNA), merozoite surface protein 1 and COX1 gene targets, was performed. The results were compared with the published sequences of regional isolates from Malaysia and Thailand.
RESULTS: Phylogenetic analysis of the circumsporozoite, SSU rRNA and merozoite surface protein 1 gene sequences for regional P. knowlesi isolates showed no obvious differentiation that could be attributed to their geographical origin. However, COX1 gene analysis showed that it was possible to differentiate between Singapore-acquired P. knowlesi infections and P. knowlesi infections from Peninsular Malaysia and Sarawak, Borneo, Malaysia.
CONCLUSION: The ability to differentiate between locally acquired P. knowlesi infections and imported P. knowlesi infections has important utility for the monitoring of P. knowlesi malaria control programmes in Singapore.
METHODS: Two groups of final-year medical students from Universiti Sains Malaysia, Malaysia, were recruited to participate in this quasi-experimental study. The intervention group (n = 21) received educational intervention that introduced the TWED checklist, while the control group (n = 19) received a tutorial on basic electrocardiography. Post-intervention, both groups received a similar assessment on clinical decision-making based on five case scenarios.
RESULTS: The mean score of the intervention group was significantly higher than that of the control group (18.50 ± 4.45 marks vs. 12.50 ± 2.84 marks, p < 0.001). In three of the five case scenarios, students in the intervention group obtained higher scores than those in the control group.
CONCLUSION: The results of this study support the use of the TWED checklist to facilitate metacognition in clinical decision-making.
METHODS: Healthy participants aged ≥ 60 years with no neurological conditions were recruited from rural and urban locations in Malaysia. HGS and KPS were measured using hand grip and key pinch dynamometers. Basic demographic data, anthropometric measures, modified Barthel Index scores and results of the Functional Reach Test (FRT), Timed Up and Go (TUG) test and Jebsen-Taylor Hand Function Test (JTHFT) were recorded.
RESULTS: 362 subjects aged 60-93 years were recruited. The men were significantly stronger than the women in both HGS and KPS (p < 0.001). The hand strength of the study cohort was lower than that of elderly Western populations. Significant correlations were observed between hand strength, and residential area (p < 0.001), FRT (r = 0.236, p = 0.028), TUG (r = -0.227, p = 0.009) and JTHFT (r = -0.927, p < 0.001).
CONCLUSION: This study established reference ranges for the HGS and KPS of rural and urban elderly Malaysian subpopulations. These will aid the use of hand strength as a screening tool for frailty among elderly persons in Malaysia. Future studies are required to determine the modifiable factors for poor hand strength.
METHODS: This was a retrospective study of data from 37 NICUs in the Malaysian National Neonatal Registry in 2012. All newborns with gestational age ≥ 36 weeks, without major congenital malformations and fulfilling the criteria of HIE were included.
RESULTS: There were 285,454 live births in these hospitals. HIE was reported in 919 newborns and 768 of them were inborn, with a HIE incidence of 2.59 per 1,000 live births/hospital (95% confidence interval [CI] 2.03, 3.14). A total of 144 (15.7%) affected newborns died. Logistic regression analysis showed that the significant predictors of death were: chest compression at birth (adjusted odds ratio [OR] 2.27, 95% CI 1.27, 4.05; p = 0.003), being outborn (adjusted OR 2.65, 95% CI 1.36, 5.13; p = 0.004), meconium aspiration syndrome (MAS) (adjusted OR 2.16, 95% CI 1.05, 4.47; p = 0.038), persistent pulmonary hypertension of the newborn (PPHN) (adjusted OR 4.39, 95% CI 1.85, 10.43; p = 0.001), sepsis (adjusted OR 4.46, 95% CI 1.38, 14.40; p = 0.013), pneumothorax (adjusted OR 4.77, 95% CI 1.76, 12.95; p = 0.002) and severe HIE (adjusted OR 42.41, 95% CI 18.55, 96.96; p < 0.0001).
CONCLUSION: The incidence of HIE in Malaysian NICUs was similar to that reported in developed countries. Affected newborns with severe grade of HIE, chest compression at birth, MAS, PPHN, sepsis or pneumothorax, and those who were outborn were more likely to die before discharge.