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  1. Cheah YK, Meltzer D
    J Gen Intern Med, 2020 09;35(9):2680-2686.
    PMID: 32185659 DOI: 10.1007/s11606-020-05766-6
    BACKGROUND: There were ethnic differences in the prevalence of non-communicable diseases among the elderly in Malaysia.

    OBJECTIVE: To examine ethnic differences in participation in medical check-ups among the elderly.

    DESIGN: A nationally representative data set was employed. Multiple logistic regressions were utilised to examine the relationship between ethnicity and the likelihood of undergoing medical check-ups. The regressions were stratified by age, income, marital status, gender, household location, insurance access and health status. These variables were also controlled for in the regressions (including stratified regressions).

    PARTICIPANTS: The respondents were required to be residents of Malaysia and not be institutionalised. Overall, 30,806 individuals were selected to be interviewed, but only 28,650 were actually interviewed, equivalent to a 93% response rate. Of those, only 2248 were used in the analyses, because 26,402 were others or below aged 60.

    MAIN MEASURES: The dependent variable was participation in a medical check-up. The main independent variables were the three major ethnic groups in Malaysia (Malay, Chinese, Indian).

    KEY RESULTS: Among the elderly aged 70-79 years, Chinese (aOR 1.89; 95% CI 1.28, 2.81) and Indians (aOR 2.39; 95% CI 1.20, 4.74) were more likely to undergo medical check-ups than Malays. Among the elderly with monthly incomes of ≤ RM999, Chinese (aOR 1.44; 95% CI 1.12, 1.85) and Indians (aOR 1.50; 95% CI 0.99, 2.28) were more likely to undergo medical check-ups than Malays. Indian males were more likely to undergo medical check-ups than Malay males (aOR 2.32; 95% CI 1.15, 4.67). Chinese with hypercholesterolaemia (aOR 1.45; 95% CI 1.07, 1.98) and hypertension (aOR 1.32; 95% CI 1.02, 1.72) were more likely to undergo medical check-ups than Malays.

    CONCLUSIONS: There were ethnic differences in participation in medical check-ups among the elderly. These ethnic differences varied across age, income, marital status, gender, household location, insurance access and health status.

    Matched MeSH terms: Malaysia/epidemiology
  2. Abdul Aziz NA, Toh TH, Goh KJ, Loh EC, Capelle DP, Abdul Latif L, et al.
    PMID: 33084408 DOI: 10.1080/21678421.2020.1832121
    OBJECTIVE: Studies from multiethnic populations are rarely reported but do indicate differences in phenotypic presentation and survival in amyotrophic lateral sclerosis (ALS). In this study, we aimed to investigate the natural history of a cohort of ALS patients from a multiethnic population. Methods: Data from ALS patients presenting to our multidisciplinary ALS clinic were prospectively collected from January 2015 to June 2020 as part of an ongoing hospital-based patient registry. Kaplan-Meier and Cox regression model were performed to identify potential prognostic factors. Results: A total of 144 ALS patients were recruited. We estimated the crude ALS incidence as 0.53 per 100,000 for 2019 but rises to 2 per 100,000 in patients aged 60-74 years. The majority of patients were of Chinese ethnicity (59.7%), followed by Malay (24.3%), Indian (11.1%), and others (4.9%). Malaysian Indians had a significantly steeper ALSFRS-R slope at diagnosis (p = 0.040). We found a worse prognosis in patients with bulbar-onset (HR = 1.915, p = 0.019), older age (HR = 1.052, p = 0.000), and who were fast-progressors (HR = 1.274, p = 0.000). In contrast, a higher body mass index (HR = 0.921, p = 0.007) and a longer time to diagnosis (HR = 0.967, p = 0.006), noninvasive ventilation (HR = 0.820, p = 0.000) and percutaneous endoscopic gastrostomy insertion (HR = 0.823, p = 0.000) were associated with better survival. On multivariate analysis, diagnostic delay and slow disease progression were associated with better survival. Conclusions: In our cohort, diagnostic delay and a slow disease progression were significantly associated with better survival in ALS. We also found ethnic variation with Chinese preponderance and more rapid disease progression in patients of Indian descent.
    Matched MeSH terms: Malaysia/epidemiology
  3. Tan AG, Tham YC, Chee ML, Mitchell P, Cumming RG, Sabanayagam C, et al.
    Clin Exp Ophthalmol, 2020 07;48(5):580-592.
    PMID: 32255547 DOI: 10.1111/ceo.13757
    IMPORTANCE: Long-term data on age-related cataract, a leading cause of blindness and visual impairment, is scarce in Asian populations.

    BACKGROUND: We report the 6-year incidence and progression of age-related cataract and associated risk factors in Malay adults living in Singapore.

    DESIGN: Population-based cohort study.

    PARTICIPANTS: A total of 3280 Malays aged 40+ years participated in baseline examinations of the Singapore Malay Eye Study (2004-2006). Six years later, 1901 (72.1% of eligible) baseline participants were re-examined.

    METHODS: Cataract was assessed using lens photos, taken during eye examinations, following the Wisconsin Cataract Grading System.

    MAIN OUTCOMES AND MEASURES: Incidence and progression of cortical, nuclear and posterior subcapsular (PSC) cataract. Poisson regression models and generalized estimating equations models (with Poisson link) were used to assess factors associated with cataract incidence and progression, respectively, adjusting for age, sex and other risk factors.

    RESULTS: Age-adjusted 6-year incidence of cortical, nuclear and PSC cataract was 14.1%, 13.6% and 8.7%, respectively, and was strongly age-related (P for trend

    Matched MeSH terms: Malaysia/epidemiology
  4. Mansor E, Ahmad N, Raj D, Mohd Zulkefli NA, Mohd Shariff Z
    J Med Internet Res, 2021 04 13;23(4):e25219.
    PMID: 33847590 DOI: 10.2196/25219
    BACKGROUND: Globally, there is an increasing prevalence of excessive screen time exposure among young children, including in Malaysia. Parents are advised to limit this exposure, but there are barriers for many of them to follow this recommendation. To date, there is a lack of research on the factors that cause these parental barriers.

    OBJECTIVE: This study aimed to determine the parental barrier toward the reduction of excessive child screen time and its predictors among parents of children aged younger than 5 years in the Petaling District, Selangor, Malaysia.

    METHODS: A cross-sectional study was conducted from April 2019 to June 2020 among 789 parent-child dyads attending child health clinics in the Petaling District. Validated self-administered questionnaires were used to capture information on sociodemographic, parental, child-related, and environmental factors and parental barriers. Stratified sampling with probability proportionate to size was employed. Data were analyzed using SPSS Statistics version 25 (IBM Corp). Descriptive analysis and bivariable analysis were performed before multiple linear regression was used to identify predictors of parental barriers.

    RESULTS: The overall mean score of parental barriers was 3.51 (SD 0.83), indicating that the average numbers of barriers experienced by parents were more than 3. The multivariable analysis showed that the predictors of parental barriers included monthly household income (adjusted β=-.03, 95% CI -0.05 to -0.02), parents who worked in public sectors (adjusted β=.18, 95% CI 0.06 to 0.29), positive parental attitude on screens (adjusted β=.68, 95% CI 0.58 to 0.79), low parent self-efficacy to influence child's physical activity (adjusted β=-.32, 95% CI -0.43 to -0.20), and child screen time (adjusted β=.04, 95% CI 0.02 to 0.06).

    CONCLUSIONS: The strongest predictor of parental barriers to reduce excessive child screen time was the positive parental attitude on screen time which could contribute to their abilities to limit child screen time. Thus, future intervention strategies should aim to foster correct parental attitudes toward screen time activities among young children.

    Matched MeSH terms: Malaysia/epidemiology
  5. Shamsuddin N, Poh BK, Syed Zakaria SZ, Noor MI, Jamal R
    Int J Public Health Res, 2015;5(2):643-653.
    MyJurnal
    Introduction: Validation of instruments is essential when assessing physical activity (PA). The aim of this study was to validate a Malay language version of the International Physical Activity Questionnaire (IPAQ-M) against Actical accelerometer and to determine its reliability and validity.
    Methods: A total of 90 Malay adults aged 35-65 years old participating in The Malaysian Cohort project were recruited for this study. The IPAQ-M is comprised of 12 items, covering vigorous, moderate, walking, sitting and sleeping activities, and was administered on two occasions (Day 1 and Day 9) by interviewing the participants. Participants wore the Actical accelerometer for seven consecutive days between the two interview sessions. Results Validity tests showed that time spent in moderate-vigorous physical activity (MVPA) (min/wk) from IPAQ-M was significantly correlated with MVPA from accelerometer (rho=0.32, p<0.01). Time spent in vigorous activity (rho=0.44) and total activity (rho=0.36) from IPAQ-M were significantly correlated (p<0.01) with that measured by accelerometer, but no correlation was observed for sedentary behaviour. Reliability tests revealed significant correlations between the two interview sessions for all intensities of PA (rho=0.55 to 0.71, p<0.01). Bland-Altman plots showed that time spent in MVPA for IPAQ-M was significantly different from that measured by accelerometer (mean difference: 98.02 min/wk; 95% limits of agreement: -785.33 to 1317.83 min/wk; p<0.01). When classifying people into meeting PA recommendation, the agreement between the two instruments was fair (κ=0.22).
    Conclusions The IPAQ-M has acceptable validity for MVPA, vigorous and total physical activity, and was reliable for assessing the physical activity of Malay adults.
    Keywords Health care workers - Knowledge - Practice - Universal precaution - Health center.
    Study name: The Malaysian Cohort (TMC) Project
    Matched MeSH terms: Malaysia; Malaysia/ethnology
  6. Zamzuri Z, Goh KL, Aminuddin CA, Mohamed Azril MA, Shukrimi A
    MyJurnal
    A 15-year–old Malay male with congenital insensitivity to pain presented with recurrent septic arthritis of the left knee complicated by osteomylitis. Repeated arthrotomy and wound debridement was done, however, the condition was not resolved. Amputation was suggested as the best method of treatment to eradicate the infection.
    Matched MeSH terms: Malaysia; Malaysia/ethnology
  7. Lim KG
    Med J Malaysia, 2016 06;71(Suppl 1):1-19.
    PMID: 27801384 MyJurnal
    A literature search of articles as detailed in the paper Bibliography of clinical research in Malaysia: methods and brief results, using the MESH terms Obesity; Obesity, Abdominal; and Overweight; covering the years 2000 till 2015 was undertaken and 265 articles were identified. Serial population studies showed that the prevalence of obesity increased rapidly in Malaysia in the last decade of the twentieth century. This follows the rising availability of food per capita which had been begun two to three decades previously. Almost every birth cohort, even up to those in their seventh decade increased in prevalence of overweight and obesity between 1996 and 2006. However, the rise in prevalence in obesity appears to have plateaued after the first decade of the twentieth century. Women are more obese than men and Malays and Indians are more obese than Chinese. The Orang Asli (Aborigines) are the least obese ethnic group in Malaysia but that may change with socioeconomic development. Neither living in rural areas nor having low income protects against obesity. On the contrary, a tertiary education and an income over RM4,000/month is associated with less obesity. Malaysians are generally not physically active enough, in the modes of transportation they use and how they use their leisure time. Other criteria and measures of obesity have been investigated, such as the relevance of abdominal obesity, and the Asian criteria or Body Mass Index (BMI) cut-offs value of 23.0 kg/m2 for overweight and 27.0 kg/m2 for obesity, with the view that the risk of diabetes and other chronic diseases start to increase at lower values in Asians compared to Europeans. Nevertheless the standard World Health Organization (WHO) guidelines for obesity are still most widely used and hence is the best common reference. Guidelines for the management of obesity have been published and projects to combat obesity are being run. However, more effort needs to be invested. Studies on intervention programmes showed that weight loss is not easy to achieve nor maintain. Laboratory research worldwide has uncovered several genetic and biochemical markers associated with obesity. Similar studies in Malaysia have found some biomarkers with an association to obesity in the local population but none of great significance.
    Matched MeSH terms: Malaysia; Malaysia/epidemiology
  8. Rosnani Zakaria, Muzaimi Mustapha, Tengku Alina Tengku Ismail, Bella Puvok, Kamarul Aryffin Baharuddin, Mohd Suhaimi Ab Wahab, et al.
    MyJurnal
    Myth, believe in powerful ‘being’ commonly known as jinn and usage of ‘bomoh’ as the medium is still widespread in our community in Kelantan especially among the Malay community. This believe and practice of usin ‘bomoh’ to cure and help with known and unknown disease believe to be caused by the jinn, occasionally poses a significant complication and threat to the management of patient in the hospital. Our case is just one of many cases that happen in our local hospital, and we hope by sharing this case will illustrate how ethical discussion occasionally surpassed the four common ethical pillars.
    Matched MeSH terms: Malaysia; Malaysia/ethnology
  9. Mahfudzah A, Nazihah MY, Wan Syamimee WG, Huay, Lin T, Wan Rohani WT
    MyJurnal
    Introduction: Solute carrier family 2, member 9 (SLC2A9) is thought to be an important urate transporter that influences the excretion and reabsorption of serum uric acid, thus has a strong effect on serum urate and risk of gout. SLC2A9 polymorphisms have been extensively studied in various populations in association with gout development. Our aim was to test for association of SLC2A9 SNPs with gout in Malay males.
    Methods: 78 gouty patients and 82 normal subjects were recruited and genotyped for rs3733591, rs5028843 and rs11942223 using PCR-RFLP technique. Single association and haplotype association analyses were conducted using SHEsis online software.
    Results: rs3733591 and rs5028843 showed association with gout with p value of 0.020 and 0.036, respectively, whilst rs11942223 yielded no association with p value of 0.08 with trend towards susceptibility projecting by OR=3.547, 3.667 and 2.732, respectively. It is noteworthy that haplotype 1/1/1 conferred protection in gout with p value 0.004 (OR=0.324 [0.147-0.716]).
    Conclusion: This study might suggest an evidence of association of SLC2A9 SNPs with gout among Malay males.
    KEYWORDS: Gout, SLC2A9, Malay males
    Study site: Medical Specialist Clinic at Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Malaysia; Malaysia/ethnology
  10. Lie-Injo LE, Chin J, Ti TS
    Ann. Hum. Genet., 1964 Nov;28:173-6.
    PMID: 14228004 DOI: 10.1111/j.1469-1809.1964.tb00472.x
    A total of 1008 healthy unrelated young adult male police and military recruits, 317 from Brunei, 398 from Sabah and 293 from Sarawak, were examined for G-6-PD deficiency. The frequency in the 317 Brunei recruits, who were all of Malay origin, was 6.3 %. In Sabah the frequencies for the four main ethnic groups were 12.1 % in 165 Kadazans, 4.1% in 73 Malays, 3.4 % in 68 Bajaus and 24.2 % in 33 Muruts. In Sarawak the frequency was 11.6 % in 95 recruits of Malay origin. Three among 56 Ibans and one among 80 Sea Dayaks were found to be enzyme-deficient, but the numbers examined of these groups were too small for estimation of the frequency. The overall frequency for the Malay group in Brunei, Sabah and Sarawak was 7.0% in 485 persons examined.
    Matched MeSH terms: Malaysia; Malaysia/ethnology
  11. Thiruchelvam L, Dass SC, Zaki R, Yahya A, Asirvadam VS
    Geospat Health, 2018 05 07;13(1):613.
    PMID: 29772882 DOI: 10.4081/gh.2018.613
    This study investigated the potential relationship between dengue cases and air quality - as measured by the Air Pollution Index (API) for five zones in the state of Selangor, Malaysia. Dengue case patterns can be learned using prediction models based on feedback (lagged terms). However, the question whether air quality affects dengue cases is still not thoroughly investigated based on such feedback models. This work developed dengue prediction models using the autoregressive integrated moving average (ARIMA) and ARIMA with an exogeneous variable (ARIMAX) time series methodologies with API as the exogeneous variable. The Box Jenkins approach based on maximum likelihood was used for analysis as it gives effective model estimates and prediction. Three stages of model comparison were carried out for each zone: first with ARIMA models without API, then ARIMAX models with API data from the API station for that zone and finally, ARIMAX models with API data from the zone and spatially neighbouring zones. Bayesian Information Criterion (BIC) gives goodness-of-fit versus parsimony comparisons between all elicited models. Our study found that ARIMA models, with the lowest BIC value, outperformed the rest in all five zones. The BIC values for the zone of Kuala Selangor were -800.66, -796.22, and -790.5229, respectively, for ARIMA only, ARIMAX with single API component and ARIMAX with API components from its zone and spatially neighbouring zones. Therefore, we concluded that API levels, either temporally for each zone or spatio- temporally based on neighbouring zones, do not have a significant effect on dengue cases.
    Matched MeSH terms: Malaysia/epidemiology
  12. Sinniah D, Lin HP, Kwan PW, Somasundram K
    PMID: 7344086
    A review of 20 cases of neuroblastoma at the University Hospital, Kuala Lumpur from 1967 to 1980 reveals six infants aged 2 to 13 months with stage IV·S disease, associated with an unusually good prognosis. Four of the six patients presented with hepatomegaly, one had skin nodules and another paresis of the lower limbs. The primary tumour was located infra-diaphragmatically in all cases, four had disease in the bone marrow but none had radiological evidence of bone involvement. Although not systematic, with limited treatment of low dose radiation and mild chemotherapy, four patients are alive and well, one absconded and one died of septicaemia. It is important to define this special category as an unexpectedly good survival is possible with minimal therapy. Death is more likely to result from over-zealous treatment than from the disease itself.
    Matched MeSH terms: Malaysia; Malaysia/ethnology
  13. Panirselvam RR, Ramly SS, Harun NA
    MyJurnal
    Systemic lupus erythematosus (SLE) is a debilitating and chronic autoimmune disease which strikes insidiously. The disease currently has a prevalence of 43/ 100 000 individuals in Malaysia. The presentation of the disease is varied resulting in delay in diagnosis and onset of complications prior to management. The disease commonly presents as joint pain and cutaneous manifestations. Neuropsychiatric presentation accounts for 24% of symptoms during onset of illness. This case report highlights that we encountered a patient who presented with neuropsychiatric manifestations, whereby the patient was managed for the psychiatric symptoms prior to the organic diagnosis being made.
    Matched MeSH terms: Malaysia; Malaysia/ethnology
  14. Loo, J.L., Syed-Mohamad, S.N., Razali, R.
    MyJurnal
    Introduction: Grief may be complicated in patients with dementia, posing a challenge to caregivers and healthcare professionals. A case of major vascular neurocognitive disorder with pathological jealousy and major depressive disorder in grief is reported.
    Case: A 73 year-old Malay lady with diabetes mellitus, hypertension, dyslipidemia, and right cerebrovascular
    accident developed major vascular neurocognitive disorder with pathological jealousy and major depressive disorder. She presented with unmanageable agitation and depression after her late husband’s death. She also experienced
    a bizarre delusion of her husband’s resurrection and infidelity. Her psychotropic medications were optimised and her bizarre delusion was challenged daily using validation and distraction techniques. Combined pharmacotherapy and behavioural therapy managed to resolve her psychiatric symptoms and facilitate her grief process.
    Conclusion: Grief reaction in major vascular neurocognitive disorder patients is often atypical. Individualized treatment comprising both pharmacotherapy and behavioural therapy should be offered to treat atypical grief and the underlying disease.
    Matched MeSH terms: Malaysia/ethnology
  15. Rozanizam Zakaria, Asrenee Ab Razak
    ASEAN Journal of Psychiatry, 2017;18(1):20-30.
    MyJurnal
    Objective: The psychological impact of care giving responsibility for dementia patients is significant regardless of the cultural background. Most of the current advanced caregivers’ interventions, originating from developed western countries, do not necessarily apply to local settings. Hence, there is a need for an effective culturally competent psychological intervention for these caregivers. The aim of the study is to assess the effectiveness of the cultural-based support group for Malay caregivers of dementia patients in Kelantan towards their burden, anxiety and depression level, and quality of life.
    Methods: This was an experimental study, without control, investigating pre and post support group intervention effectiveness in reducing caregiver burden, anxiety and depression, and improving the quality of life. Sixteen caregivers completed the program, which involved seven fortnightly support group sessions with duration of 2 hours each, conducted over twelve weeks. Caregivers’ burden was assessed using Caregiver Strain Index (CSI) while their psychological well-being was objectively assessed using Hospital Anxiety and Depression Scale (HADS). WHO Quality of Life questionnaire (WHOQOL-BREF) was used to measure the quality of life. The validated Malay versions of the questionnaires were used.
    Results: There was a statistically significant reduction in the level of caregiver burden (p = or < 0.001). Measurement of both scores of anxiety and depression comparing pre and post intervention also showed improvement, but statistically were not significant. Assessment of caregivers’ quality of life showed statistically significant improvement in the domains of social, psychological and physical (all with the p-value <0.05). Discussion: Our cultural-based support group is an effective intervention to improve burden, psychological well-being and quality of life among local caregivers of dementia patients.
    Keyword: Dementia Caregivers, Support Group, Malay, Burden, Quality of Life
    Study site: Memory clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Malaysia; Malaysia/ethnology
  16. Hung LC, Nadia R
    Med J Malaysia, 2016 06;71(Suppl 1):79-86.
    PMID: 27801390 MyJurnal
    A total of 39 titles related to rheumatic fever or rheumatic heart disease in Malaysia were found with online literature search dating back to their inceptions and through 2014. Additional publications from conference journals were included. Nine papers were selected based on clinical relevance and future research implications. There were no population-based studies on the incidence or prevalence of ARF or RHD. In the 1980s, the incidence of admission due to ARF ranged from 2 to 21.1 per 100 000 paediatric admission per year. The burden of disease was significant in the adult population; 74.5% of patients with RHD were female, of which 77.1% were in the reproductive age group of 15-45 years old. Rheumatic mitral valve disease constituted almost half (46.7%) of all mitral valve repairs, ranging from 44.8 - 55.8 patients per year from 1997 - 2003. From 2010-2012, mitral valve interventions increased to 184 per year, of which 85.7% were mitral valve repair. In children with ARF, 25.4% - 41.7% had past history of rheumatic fever or RHD. In patients with rheumatic mitral valve disease undergoing surgical or medical interventions, only 6% reported history of ARF, none had history of GABHS pharyngitis or antibiotic prophylaxis. Only 44.7% of patients with RHD on follow-up were on intramuscular benzathine penicillin prophylaxis. Overall, there is scarcity of publications on ARF and RHD in Malaysia. Priority areas for research include determination of the incidence and prevalence of ARF and RHD, identification of high-risk populations, evaluation on the implementation and adherence of secondary preventive measures, identification of subclinical RHD especially amongst the high-risk population, and a surveillance system to monitor and evaluate preventive measures, disease progression and outcomes.
    Matched MeSH terms: Malaysia/epidemiology
  17. Fasal P
    DOI: 10.1001/archderm.1944.01510150012002
    Manifestations of vitamin deficiencies observed in 6,000 Tamil and 4,000 Malay children and young adults during a survey carried out by the Institute for Medical Research in the Federated Malay States included phrynoderma, Bitot spots
    and angular stomatitis. They were more frequent in Tamils than in Malays. Phrynoderma and Bitot spots responded rapidly to administration of vitamin A or carotene, though in some patients with phrynoderma improvement was not attained unless also the protein intake was increased and vitamin B complex added. Angular stomatitis was benefited by administration of riboflavin or vitamin B complex. The clinical and histologie observations of phrynoderma in Tamils and Malays in Malaya were identical with those previously reported in Chinese, Ceylonese and southern Indians. A supplementary food ration, composed of soy beans, skim milk powder, dal and red palm oil, given to Tamil children on rubber estates not only increased the general state of health but led to a rapid regression of the manifestations of vitamin deficiencies.
    Matched MeSH terms: Malaysia/ethnology
  18. Smith GH
    Lancet, 1841;37:291-292.
    DOI: 10.1016/S0140-6736(02)81752-4
    Matched MeSH terms: Malaysia/ethnology
  19. Loong YY, Fadzli A, Lim PH, Rakhi G
    We describe a patient who had fever and bilateral cortical blindness and was later found to have leaking intracerebral mycotic aneurysm secondary to Staphylococcus aureus endocarditis. He had a vegetation at the .tricuspid valve with evidence of systemic embolisation, however, chest radiograph did not reveal any evidence of pulmonary emboli.
    Keywords: Endocarditis, cortical blindness, mycotic aneurysm, Staphylococcus
    Matched MeSH terms: Malaysia; Malaysia/ethnology
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