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Epstein-Barr virus infection in B-cell Non-Hodgkin's Lymphomas of the oral and maxillofacial region: Is there any evidence?

Abdelrahim LM, Peh SC, Kallarakkal TG

Malays J Pathol, 2018 Apr;40(1):49-56.
PMID: 29704384

INTRODUCTION: Epstein-Barr virus (EBV) might be an aetiological agent involved in the pathogenesis of certain Non-Hodgkin's Lymphomas (NHLs). EBV infection has been diagnosed by serologic testing within the tumour biopsies of patients with NHL. However, the association between EBV and NHL is inconsistent with a preference for certain anatomic sites, histologic subtypes and immunosuppressed patients. The objective of this study was to characterise the B-cell NHLs of the oral cavity and maxillofacial region using histological and immunophenotypical techniques and to determine its association with EBV infection.
MATERIALS AND METHODS: This was a descriptive cross-sectional study that included 14 cases of B-cell NHLs of the oral cavity and maxillofacial region. The haematopoietic and lymphoid tissue tumours classification of WHO was used to categorize the cases. In-situ hybridisation for EBV-encoded RNA was performed to confirm the EBV infection.
RESULTS: The average age of the patients included in the study was found to be 48.8 ± 23 years with a higher female to male ratio (1.3:1). Our study suggested that diffuse large B-cell lymphomas (DLBCLs) and Burkitt's lymphomas (BLs) constitute the predominant subtypes of lymphomas affecting the oral cavity and maxillofacial regions.
CONCLUSION: The findings from our study support the view that at least a relatively smaller proportion of B-cell NHLs that occur in the oral cavity and maxillofacial region do not have a pathogenic association with EBV.

Matched MeSH terms: Adult
Malignant peripheral nerve sheath tumour with perineurial differentiation and hyaline eosinophilic globules (thanatosomes): A rare tumour

Abdelzaher E, Elwany A, Amr SA

Malays J Pathol, 2018 Dec;40(3):355-358.
PMID: 30580369

Malignant peripheral nerve sheath tumour (MPNST) with perineurial differentiation is a rare variant of MPNST. The pathological features and clinical significance of this variant remain to be characterised. We reported the clinicoradiological and pathological features of a case of recurrent right arm mass related to the ulnar nerve in a 42-year-old female patient. On pathological examination, the tumour showed dual features of conventional and perineurial MPNST which was proven by positive immunostaining for S-100 and EMA. The pathological diagnosis was MPNST with perineurial differentiation. In addition, a peculiar and rare finding of intracytoplasmic eosinophilic hyaline globules (thanatosomes) within tumour cells is reported. We document a rare tumour with hybrid features between conventional and perineurial MPNSTs. Further studies are needed to establish its biological behaviour.

Matched MeSH terms: Adult
Sedentary behaviour and social anxiety in obese individuals: the mediating role of body esteem

Abdollahi A, Abu Talib M

Psychol Health Med, 2015;20(2):205-9.
PMID: 24922119 DOI: 10.1080/13548506.2014.913799

Given that the prevalence of social anxiety in obese individuals is high, it is necessary that we increase our knowledge about the related factors that cause social anxiety in obese individuals. The present study sought to examine the role of body esteem as a mediator between sedentary behaviour and social anxiety. The participants were 207 overweight and obese individuals who completed the self-report measures. The structural equation modelling displayed that obese individuals with sedentary behaviour and poor body esteem were more likely to show social anxiety. Body esteem partially mediated between sedentary behaviour and social anxiety. Our results highlight the role of sedentary behaviour and body esteem as promising avenues for reducing social anxiety in obese individuals.

Matched MeSH terms: Adult; Young Adult
Hardiness as a mediator between perceived stress and happiness in nurses

Abdollahi A, Abu Talib M, Yaacob SN, Ismail Z

J Psychiatr Ment Health Nurs, 2014;21(9):789-96.
PMID: 24661763 DOI: 10.1111/jpm.12142

The relevance of the study of happiness and stress in nurses has been emphasized. In this sense, the intelligent use of hardiness is enable nurses to cope better with stress and contribute to being happier. This study aimed to examine the relationship among hardiness, perceived stress, and happiness in nurses. Moreover, we examined the mediator role of hardiness on the relationship between perceived stress and happiness in nurses. Our study revealed that hardi-attitude nurses evaluate situations as less stressful which results in a higher happiness. This study showed hardiness as being a protective factor against perceived stress and a facilitating factor for happiness in nurses. The findings could be important in training future nurses so that hardiness can be imparted, thereby giving them the ability to control their stress. Nursing is a stressful occupation with high levels of stress within the health professions. Given that hardiness is an important construct to enable nurses to cope better with stress and contribute to being happier; therefore, it is necessary we advance our knowledge about the aetiology of happiness, especially the role of hardiness in decreasing stress levels and increasing happiness. The present study sought to investigate the role of hardiness as a mediator between perceived stress and happiness. The participants, comprising 252 nurses from six private hospitals in Tehran, completed the Personal Views Survey, the Perceived Stress Scale, and the Oxford Happiness Inventory. Structural Equation Modelling (SEM) was used to analyse the data and answer the research hypotheses. As expected, hardiness partially mediated between perceived stress and happiness among nurses, and nurses with low levels of perceived stress were more likely to report greater hardiness and happiness. In addition, nurses with high levels of hardiness were more likely to report happiness. This study showed hardiness as being a protective factor against perceived stress and a facilitating factor for happiness in nurses. The findings could be important in training future nurses so that hardiness can be imparted, thereby giving them the ability to control their stress.

Matched MeSH terms: Adult; Young Adult
Problem-solving skills and hardiness as protective factors against stress in Iranian nurses

Abdollahi A, Talib MA, Yaacob SN, Ismail Z

Issues Ment Health Nurs, 2014 Feb;35(2):100-7.
PMID: 24502467 DOI: 10.3109/01612840.2013.843621

Nursing is a stressful occupation, even when compared with other health professions; therefore, it is necessary to advance our knowledge about the protective factors that can help reduce stress among nurses. The present study sought to investigate the associations among problem-solving skills and hardiness with perceived stress in nurses. The participants, 252 nurses from six private hospitals in Tehran, completed the Personal Views Survey, the Perceived Stress Scale, and the Problem-Solving Inventory. Structural Equation Modeling (SEM) was used to analyse the data and answer the research hypotheses. As expected, greater hardiness was associated with low levels of perceived stress, and nurses low in perceived stress were more likely to be considered approachable, have a style that relied on their own sense of internal personal control, and demonstrate effective problem-solving confidence. These findings reinforce the importance of hardiness and problem-solving skills as protective factors against perceived stress among nurses, and could be important in training future nurses so that hardiness ability and problem-solving skills can be imparted, allowing nurses to have more ability to control their perceived stress.

Matched MeSH terms: Adult; Young Adult
Fulltext Problem-solving skills appraisal mediates hardiness and suicidal ideation among malaysian undergraduate students

Abdollahi A, Talib MA, Yaacob SN, Ismail Z

PLoS One, 2015;10(4):e0122222.
PMID: 25830229 DOI: 10.1371/journal.pone.0122222

Recent evidence suggests that suicidal ideation is increased among university students, it is essential to increase our knowledge concerning the etiology of suicidal ideation among university students. This study was conducted to examine the relationships between problem-solving skills appraisal, hardiness, and suicidal ideation among university students. In addition, this study was conducted to examine problem-solving skills appraisal (including the three components of problem-solving confidence, approach-avoidance style, and personal control of emotion) as a potential mediator between hardiness and suicidal ideation.

Matched MeSH terms: Young Adult
Problem-solving skills and perceived stress among undergraduate students: The moderating role of hardiness

Abdollahi A, Abu Talib M, Carlbring P, Harvey R, Yaacob SN, Ismail Z

J Health Psychol, 2018 09;23(10):1321-1331.
PMID: 27352885 DOI: 10.1177/1359105316653265

This study was designed to examine the relationships between problem-solving skills, hardiness, and perceived stress and to test the moderating role of hardiness in the relationship between problem-solving skills and perceived stress among 500 undergraduates from Malaysian public universities. The analyses showed that undergraduates with poor problem-solving confidence, external personal control of emotion, and approach-avoidance style were more likely to report perceived stress. Hardiness moderated the relationships between problem-solving skills and perceived stress. These findings reinforce the importance of moderating role of hardiness as an influencing factor that explains how problem-solving skills affect perceived stress among undergraduates.

Matched MeSH terms: Young Adult
The Association of Rumination and Perfectionism to Social Anxiety

Abdollahi A

Psychiatry, 2019;82(4):345-353.
PMID: 31112491 DOI: 10.1080/00332747.2019.1608783

Objective: Evaluative concerns perfectionism is related to both rumination and social anxiety. However, the mediating role of rumination between two types of perfectionism-namely, evaluative concerns perfectionism and personal standards perfectionism-and social anxiety has yet to be studied. Therefore, the objective of this study was to examine the mediating role of rumination on the association between perfectionism and social anxiety. Methods: A cross-sectional study was conducted among 450 Malaysian undergraduate students using self-report questionnaires. Results: Structural equation modeling (SEM) revealed that evaluative concerns perfectionism and rumination were significant positive predictors of social anxiety. Multimodel analysis revealed that rumination partially mediated the association between evaluative concerns perfectionism and social anxiety. Conclusions: The results suggested that evaluative concerns perfectionists were more likely to engage in rumination and were consequently more likely to experience social anxiety.

Matched MeSH terms: Young Adult
Coping Styles Mediate Perfectionism Associations with Depression Among Undergraduate Students

Abdollahi A, Hosseinian S, Asmundson GJG

J Gen Psychol, 2018 01 18;145(1):93-105.
PMID: 29345535 DOI: 10.1080/00221309.2017.1421137

To better understand depression among adolescent university students, this study was designed to examine coping style as a potential mediator between perfectionism and depression. Participants comprised 510 undergraduate students from Malaysia. Structural Equation Modelling demonstrated that personal standards perfectionism and task-focused coping style were negatively associated with depression, while emotion-focused coping style, avoidant coping style, and evaluative concerns perfectionism were positively associated with depression. Multiple mediator modelling provided evidence that coping styles partially mediated the relationship between perfectionism and depression. These findings advance current knowledge by suggesting how perfectionism may contribute to depression and may inform the development of more effective prevention and intervention programs for depression.

Matched MeSH terms: Young Adult
Stability of depressive symptoms over 3 months post-partum

Abdollahi F, Zarghami M, Sazlina SG, Lye MS

Early intervention in psychiatry, 2017 Feb;11(1):57-62.
PMID: 25582677 DOI: 10.1111/eip.12215

AIM: Prolonged depression during the post-partum period is associated with maternal and infant mortality and morbidity. Less attention has been given to factors that predict the persistence of depression beyond the first 3 months post-partum.
METHODS: From a longitudinal cohort of 2279 women who attended Mazandaran's primary health centres in 2009, 478 women with an Edinburgh Postnatal Depression Scale (EPDS) score of 12 or greater in the third trimester of pregnancy were recruited. Persistently depressed women (depressed at all three occasions: during pregnancy, and at 2 and 12 weeks post-partum) were compared with those without depression to determine demographic, cultural, obstetric and biopsychosocial predictors for persistence of depression. Data were analysed using chi-square test, t-test and logistic regression models.
RESULTS: The stability of depression was found in 193 (46.2 %) of 418 depressed cases who were followed up over the study period. Of those mothers who scored more than the threshold of 12 during the third trimester of pregnancy, 277 (66.3%) and 221 (52.9%) had high EPDS at 2 and 12 weeks post-partum. Psychological distress (based upon the General Health Questionnaire), low maternal parental self-efficacy (based upon the Parental Expectation Survey) and perceived social isolation (based upon the Network Orientation Scale) were independent predictors of persistent depression.
CONCLUSION: Fewer depressed mothers in this study were found to recover during the first 3 months after giving birth. Psychosocial factors predicted sustained depression from pregnancy to 3 months post-partum. The findings highlight the significance of support in enhancing maternal mental health.

Matched MeSH terms: Adult; Young Adult
Postnatal depression and its associated factors in women from different cultures

Abdollahi F, Lye MS, Md Zain A, Shariff Ghazali S, Zarghami M

Iran J Psychiatry Behav Sci, 2011;5(2):5-11.
PMID: 24644441

OBJECTIVE: Postpartum depression (PPD) is a common health problem which affects women in the postpartum period. This is a brief note on its associated factors in women from different cultures.
METHODS: A literature review was performed in MEDLINE and Pubmed from 1991 to 2008 and Magiran from 1991 to 2009. Additional articles and book chapters were referenced from these sources.
RESULTS: The prevalence of postpartum depression has been reported to be from 0.5% to 60% globally, and from 3.5% to 63.3% in Asian countries, in which Malaysia and Pakistan had respectively the lowest and highest rates. One of the factors contributing to PPD in Asian societies can be that women may not have the empowerment to reject traditional rituals that are imposed on them by their caregivers. Unsatisfactory pre-existing relationships between the mothers and their caregivers resulting in mothers experiencing difficulties during their confinement period may be another factor. Thirdly, some features of these traditional rituals may be the cause of tension, stress and emotional distress. Emotional conflicts caused by insistence on practice of traditional rituals during the postpartum period may lead to mental breakdown.
CONCLUSION: Health care professionals should be aware that the phenomenon in Asian cultures is as prevalent as European cultures. Moreover, further research needs to be conducted on the global prevalence of the experiences of childbearing women with depressive symptoms.
KEYWORDS: Cultures; Postpartum depression; Risk factors

Matched MeSH terms: Adult
Fulltext Postpartum mental health in relation to sociocultural practices

Abdollahi F, Etemadinezhad S, Lye MS

Taiwan J Obstet Gynecol, 2016 Feb;55(1):76-80.
PMID: 26927254 DOI: 10.1016/j.tjog.2015.12.008

OBJECTIVES: Cultural practices have been found to positively impact the mothering experience. This study sought to identify the relationship between sociocultural practices and postpartum depression (PPD) in a cohort of Iranian women for the first time.
MATERIALS AND METHODS: In a longitudinal cohort design, 2279 pregnant women attending primary health centers of Mazandaran province in Iran were recruited using stratified random sampling method. Data were collected using the Edinburgh Postnatal Depression Scale and researchers developed validated cultural practices questionnaire at 3 months after delivery. Data were analyzed using Chi-square test and multiple logistic regression models.
RESULTS: The prevalence of PPD was 19% among 1910 women who were followed postdelivery in this study. Cultural practices were not associated with lower odds of PPD in multiple logistic regression model after adjustment for all sociodemographic factors. The results of this study do not also provide any evidence to support that sex of baby is associated with the greater risk of PPD.
CONCLUSIONS: Cultural practices could not be perceived as protective mechanisms that protect women from PPD in this traditional society. However, health professionals should be familiar with postpartum beliefs and practices that could support mothers in the postpartum period.
KEYWORDS: culture; depression; postpartum; practices

Matched MeSH terms: Adult
Midwives' perceptions of Complementary and Alternative Medicines' during pregnancy

Abdollahi F, Yazdani Charati J, Lye MS

Complement Ther Med, 2020 Mar;49:102323.
PMID: 32147049 DOI: 10.1016/j.ctim.2020.102323

Using Complementary and Alternative Medicine (CAMs) is growing worldwide. This study determined the midwives' attitude toward CAMs in general and their view on its safety and efficacy during pregnancy. Via a random sampling method, 344 midwives working in Mazandaran primary health centers (PHC) were recruited from March to November 2017. The data were analyzed using descriptive statistics. The majority of the midwives had positive view on the usefulness of CAMs in general (74.3 %) and thought they should have more knowledge about it (76.7 %). While 50-83 % of the midwives considered some CAM-therapies safe and beneficial, a small number of them referred the patients for CAM-therapy during pregnancy (1.2-5.4 %). A minority of the midwives stated that CAM may be a threat to public health (12.7 %). The midwives' perception toward the usefulness of CAM in general was positive; although, they approved the benefit of few CAMs during pregnancy. A small minority of the midwives considered CAMs as a threat to public health, and few of them advised the patients to use CAMs during pregnancy. As most midwives are interested in learning in this field, it is recommended to run some training programs on the benefit and side effects of CAMs.

Matched MeSH terms: Adult
Fulltext Association of Vitamin D receptor gene polymorphisms and clinical/severe outcomes of COVID-19 patients

Abdollahzadeh R, Shushizadeh MH, Barazandehrokh M, Choopani S, Azarnezhad A, Paknahad S, et al.

Infect Genet Evol, 2021 Dec;96:105098.
PMID: 34610433 DOI: 10.1016/j.meegid.2021.105098

INTRODUCTION: Growing evidence documented the critical impacts of vitamin D (VD) in the prognosis of COVID-19 patients. The functions of VD are dependent on the vitamin D receptor (VDR) in the VD/VDR signaling pathway. Therefore, we aimed to assess the association of VDR gene polymorphisms with COVID-19 outcomes.
METHODS: In the present study, eight VDR single nucleotide polymorphisms (SNPs) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 500 COVID-19 patients in Iran, including 160 asymptomatic, 250 mild/moderate, and 90 severe/critical cases. The association of these polymorphisms with severity, clinical outcomes, and comorbidities were evaluated through the calculation of the Odds ratio (OR).
RESULTS: Interestingly, significant associations were disclosed for some of the SNP-related alleles and/or genotypes in one or more genetic models with different clinical data in COVID-19 patients. Significant association of VDR-SNPs with signs, symptoms, and comorbidities was as follows: ApaI with shortness of breath (P ˂ 0.001) and asthma (P = 0.034) in severe/critical patients (group III); BsmI with chronic renal disease (P = 0.010) in mild/moderate patients (group II); Tru9I with vomiting (P = 0.031), shortness of breath (P = 0.04), and hypertension (P = 0.030); FokI with fever and hypertension (P = 0.027) in severe/critical patients (group III); CDX2 with shortness of breath (P = 0.022), hypertension (P = 0.036), and diabetes (P = 0.042) in severe/critical patients (group III); EcoRV with diabetes (P ˂ 0.001 and P = 0.045 in mild/moderate patients (group II) and severe/critical patients (group III), respectively). However, the association of VDR TaqI and BglI polymorphisms with clinical symptoms and comorbidities in COVID-19 patients was not significant.
CONCLUSION: VDR gene polymorphisms might play critical roles in the vulnerability to infection and severity of COVID-19, probably by altering the risk of comorbidities. However, these results require further validation in larger studies with different ethnicities and geographical regions.

Matched MeSH terms: Adult
Fulltext Genetic Association of CYP1B1 4326 C>G Polymorphism with Disease-Free Survival in TNBC Patients Undergoing TAC Chemotherapy Regimen

Abdul Aziz AA, Md Salleh MS, Yahya MM, Zakaria AD, Ankathil R

Asian Pac J Cancer Prev, 2021 Apr 01;22(4):1319-1324.
PMID: 33906328 DOI: 10.31557/APJCP.2021.22.4.1319

BACKGROUND: Triple negative breast cancer (TNBC) which is treated with taxane, adriamycin and cyclophosphamide (TAC) chemotherapy regimen show variation in treatment response. CYP1B1 4326 C>G polymorphism has been implicated in contributing to the differences in treatment response in various types of cancers.
AIM: The objective of the present study was to investigate whether this polymorphism modulate the risk of disease recurrence in TNBC patients undergoing TAC chemotherapy regimen.
METHODS: Blood samples of 76 immunohistochemistry confirmed TNBC patients were recruited. The genotyping of CYP1B1 4326 C>G polymorphism was carried out using PCR-RFLP technique. The genotype patterns were categorized into homozygous wildtype, heterozygous and homozygous variant. Kaplan-Meier analysis followed by Cox proportional hazard regression model were performed to evaluate the TNBC patients' recurrence risk.
RESULTS: Out of 76 TNBC patients, 25 (33.0%) showed disease recurrence after one-year evaluation. Kaplan Meier analysis showed that TNBC patients who are carriers of CYP1B1 4326 GG variant genotypes (37.0%) had a significantly lower probability of disease-free rates as compared to TNBC patients who are carriers of CYP1B1 4326 CC/CG genotypes (71.0%). Univariate and multivariate Cox analysis demonstrated that TNBC patients who carried CYP1B1 4326 GG variant genotype had a significantly higher risk of recurrence with HR: 2.50 and HR: 4.18 respectively, even after adjustment as compared to TNBC patients who were carriers of CYP1B1 4326 CC and CG genotypes.
CONCLUSION: Our results demonstrate the potential use of CYP1B1 4325 GG variant genotype as a candidate biomarker in predicting risk of recurrence in TNBC patients undergoing TAC chemotherapy regimen.

Matched MeSH terms: Adult
Fulltext Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists

Abdul Aziz AF, Mohd Nordin NA, Abd Aziz N, Abdullah S, Sulong S, Aljunid SM

BMC Fam Pract, 2014;15:40.
PMID: 24580779 DOI: 10.1186/1471-2296-15-40

BACKGROUND: Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services.
METHODS: A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached.
RESULTS: Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on 'as needed' basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS' perceived 4 important 'needs' in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support.
CONCLUSIONS: Post discharge stroke care guidelines and access to rehabilitation services at primary care is needed for post stroke patients residing at home in the community.

Matched MeSH terms: Adult
Fulltext Profile and outcome of post stroke patients managed at selected public primary care health centres in Peninsular Malaysia: A retrospective observational study

Abdul Aziz AF, Ali MF, Yusof MF, Che' Man Z, Sulong S, Aljunid SM

Sci Rep, 2018 12 19;8(1):17965.
PMID: 30568180 DOI: 10.1038/s41598-018-36154-0

Data on post stroke outcomes in developing countries are scarce due to uncoordinated healthcare delivery systems. In Malaysia, the national stroke clinical practice guideline does not address transfer of care and longer term post stroke care beyond tertiary care. Hence, post stroke care delivery may be delivered at either tertiary or primary care facilities. This study aimed at describing patients' characteristics and outcomes of post stroke care delivered by the primary care teams at public primary care healthcentres across Peninsular Malaysia. Multi staged sampling was done to select public primary care health centres to recruit post stroke patients. At each health centre, convenience sampling was done to recruit adult patients (≥18 years) who received post stroke care between July-December 2012. Baseline measurements were recorded at recruitment and retrospective medical record review was done simultaneously, for details on medical and / or rehabilitation treatment at health centre. Changes in the measurements for post stroke care were compared using paired t-tests and Wilcoxon Rank test where appropriate. Total of 151 patients were recruited from ten public primary care healthcentres. The mean age at stroke presentation was 55.8 ± 9.8 years. Median duration of follow up was 2.3 (IQR 5.1) years. Majority co-resided with a relative (80.8%), and a family member was primary caregiver (75.%). Eleven percent were current smokers. Almost 71.0% of patients achieved BP ≤ 140/90 mmHg. Only 68.9% of the patients had been referred for neurorehabilitation. Percentage of recorded data was highest for blood pressure (88.1%) while lowest was HbA1c (43.0%). For clinical outcomes, systolic and diastolic blood pressure, triglyceride level and calculated GFR (eGFR) showed statistically significant changes during follow up (p

Matched MeSH terms: Adult
Fulltext Prevalence and associated factors of burnout among working adults in Southeast Asia: results from a public health assessment

Abdul Aziz AF, Ong T

Front Public Health, 2024;12:1326227.
PMID: 38550314 DOI: 10.3389/fpubh.2024.1326227

The COVID-19 pandemic has spotlighted the mental health crisis among employees worldwide. However, burnout research is often industry- or occupation-specific, and limited knowledge currently exists on the prevalence of burnout in the general working population of Southeast Asia. This study aims to examine the prevalence of employee burnout and its associated factors among working adults in Southeast Asia using secondary data. 4,338 full-time employees aged 18-65 years old living in Malaysia, Singapore, Philippines, and Indonesia were assessed for burnout, depression, anxiety, stress, and sociodemographic characteristics as part of an online public health assessment in October 2022. The prevalence of burnout in the region was 62.91%. Burnout was highest among employees in the Philippines (70.71%) and lowest in Malaysia (58.13%). Experiencing burnout was associated with severe or extremely severe depression (AOR = 6.48 [95% CI = 5.06-8.33]), anxiety (AOR = 2.22 [1.74-2.85]), and stress (AOR = 5.51 [4.13-7.39]). Working more than 50 hours a week (AOR = 1.38 [1.04-1.82]) and being very dissatisfied with the job led to higher odds of burnout (AOR = 16.46 [8.99-30.53]). Alarmingly, more than half of working adults in the region are reporting increased levels of burnout, and improving employee mental health and work conditions may be key to improving employee burnout in the region. Findings contribute to existing research on burnout prevalence in the region and provide more comprehensive insights into understanding the factors driving employee burnout in the working population of Southeast Asia 2 years after the onset of the pandemic.

Matched MeSH terms: Adult; Young Adult
Fulltext Drug Utilization in the Treatment of Diabetes Mellitus in the Ministry of Health Facilities

Abdul Aziz AM, Manan MM, Bahri S, Md Yusof FA, Kamarruddin Z, Said S, et al.

ISBN: 978-967-5570-45-2

Citation: Abdul Aziz AM, et al. Drug Utilization in the Treatment of Diabetes Mellitus in the Ministry of Health Facilities. Petaling Jaya: Pharmaceutical Services Division, Ministry of Health, Malaysia; 2013

Diabetes Mellitus (DM) is a costly disease to manage because of its chronic nature and severity of complications. Treatment of DM incurred high healthcare cost in both developed and developing countries. In Malaysia, treatment of DM is provided by all Ministry of Health (MOH) healthcare facilities and treatment may vary according to types of facilities. These differences may be associated with the utilization pattern and patient’s adherence to therapy and it is important to link actual medication therapy and the direct medical cost in the management of Malaysian DM patients. Thus, this study is to describe the utilization of medications in the treatment of DM in the MOH healthcare facilities and DM patient’s adherence towards their medication. This is a cross-sectional study in 94 MOH health facilities from November 2010 to December 2011. The healthcare facilities were categorized as National Referral Hospital, State Hospitals, Hospitals with Specialist, Hospitals without Specialist and Health Clinics. Patients were selected by the method of systematic random sampling and screened based on the inclusion and exclusion criteria. Face-to-face interview and retrospective data retrieval of patients’ medical record were conducted. The questionnaire and Morisky’s four questions adherence scale were utilized during the interview. A total of 2,509 (88.2%) patients were included in the study. The findings showed that variables for age, gender, race, marital status, household income, and occupation were essential components in examining its impact towards DM care. Most of the patients were between 45 to 55 years old and were burdened with co-morbidities. The observed trend in disease status showed that DM is closely related to co-morbidities such as hypertension, cardiovascular diseases, and hyperlipidaemia; more commonly in patients with more than 5 disease years. A total of 14.6% of DM patients have yet to be initiated with insulin while 84% and 78.9% of patients had poor control of HbA1c and fasting blood glucose. In terms of drug utilization and medication cost, there was no significant difference in the pattern of medication used for the first-line treatment of DM among type of facilities. Biguanides, sulphonamides, urea derivatives, and insulin are the top three DM medications. Insulin usage ranges from 25.6% at Hospitals without Specialist to 57.8% at State Hospitals and this corresponds to 2.5 to 7.0 times increment from National Health and Morbidity Survey (NHMS) III. Use of non-antidiabetic agents (ADA) corresponds with the top 10 co-morbidities. These include platelet aggregating inhibitors, ACE-inhibitors and statins. The pattern of treatment for co-morbidities showed significant differences among facilities and may be due to the degree of severity of DM patients. Also, the policies of categorizing A*/A/KK has led to these medications being less commonly prescribed in Hospitals without Specialist and Health Clinics. Adherence is an issue that DM patients need to improve. This study found that race, household income, and age were significant indicators for poor adherence. The odds ratio (OR) for age showed it contributed to almost one time lower in adherence. The OR for inter-racial differences found that both Chinese and Indian patients were about 0.7 times more likely to be non-adherence than Malays. Household income of less than RM1,000 per month similarly showed a 0.8 times less adherence compared to households earning between RM1,000 to RM3,000 per month. Pharmacists had been giving counselling to patients and the personalized approach by pharmacist had shown positive impact on Diabetic Medication Therapy Adherence Clinic (DMTAC) patients. The study findings, however, showed no improvement in adherence between those who attended DMTAC and those who have not. These findings might not be generalizable since most facilities had a very small percentage of DM patients and they are usually the problematic or difficult patients; this could have led to the rather uneventful findings. Finally, this study showed that there is no significant difference in the utilization of medication among health facilities in the treatment of DM. Adherence is still an area of concern and collaboration between healthcare professionals is vital for better treatment outcome.

Matched MeSH terms: Adult
Fulltext A dual genetic alteration (mitochondrial and nuclear DNA): first case in Malaysia detected in glioblastoma multiforme

Abdul Aziz Mohamed Yusoff, Wan Salihah Wan Abdullah, Alarmelu Nithya Ramanathan, Jafri Malin Abdullah, Zamzuri Idris

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):332-335.
MyJurnal

Although the precise etiology of Glioblastoma multiforme (GBM, WHO grade IV) remains unknown, its progression
is believed to be driven by the accumulation of multiple genetic alterations. Here, we report a case of a patient who
developed GBM, and associated with dual alterations, particularly 4977-bp deletion in mtDNA (mtDNA4977) and
p.Arg132His (R132H) mutation in IDH1. A 35-year old Malaysian woman patient who primary diagnosed with astrocytoma WHO grade I and subsequently after four years developed a GBM, was detected with a mtDNA4977. This
deletion appears to be a sporadic mutation. Additionally, analysis of patient’s tumor tissue also found to harbor a heterozygous IDH1 R132H mutation. This represents the first case report of coexisting mtDNA4977 together with IDH1
R132H mutation in a Malaysian patient of GBM. The findings of dual alterations could be of therapeutic benefit if
these alterations were justified to be contributing to GBM growth and aggressiveness.

Matched MeSH terms: Adult

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