Displaying publications 101 - 120 of 342 in total

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  1. Reza SM, Ahmad N, Choudhury IA, Ghazilla RA
    Sensors (Basel), 2014 Mar 04;14(3):4342-63.
    PMID: 24599193 DOI: 10.3390/s140304342
    Human motion is a daily and rhythmic activity. The exoskeleton concept is a very positive scientific approach for human rehabilitation in case of lower limb impairment. Although the exoskeleton shows potential, it is not yet applied extensively in clinical rehabilitation. In this research, a fuzzy based control algorithm is proposed for lower limb exoskeletons during sit-to-stand and stand-to-sit movements. Surface electromyograms (EMGs) are acquired from the vastus lateralis muscle using a wearable EMG sensor. The resultant acceleration angle along the z-axis is determined from a kinematics sensor. Twenty volunteers were chosen to perform the experiments. The whole experiment was accomplished in two phases. In the first phase, acceleration angles and EMG data were acquired from the volunteers during both sit-to-stand and stand-to-sit motions. During sit-to-stand movements, the average acceleration angle at activation was 11°-48° and the EMG varied from -0.19 mV to +0.19 mV. On the other hand, during stand-to-sit movements, the average acceleration angle was found to be 57.5°-108° at the activation point and the EMG varied from -0.32 mV to +0.32 mV. In the second phase, a fuzzy controller was designed from the experimental data. The controller was tested and validated with both offline and real time data using LabVIEW.
  2. Ord TJ, Diesmos A, Ahmad N, Das I
    Evolution, 2023 Mar 01;77(3):660-669.
    PMID: 36626820 DOI: 10.1093/evolut/qpac057
    We identified hypotheses for the cause and consequences of the loss of complexity in animal signals and tested these using a genus of visually communicating lizards, the Southeast Asian Draco lizards. Males of some species have lost the headbob component from their display, which is otherwise central to the communication of this genus. These males instead display a large, colorful dewlap to defend territories and attract mates. This dewlap initially evolved to augment the headbob component of the display, but has become the exclusive system of communication. We tested whether the loss of headbobs was caused by relaxed selection, habitat-dependent constraints, or size-specific energetic constraints on display movement. We then examined whether the consequences of this loss have been mitigated by increased signaling effort or complexity in the color of the dewlap. It appears the increased cost of display movement resulting from the evolution of large body size might have contributed to the loss of headbobs and has been somewhat compensated for by the evolution of greater complexity in dewlap color. However, this evolutionary shift is unlikely to have maintained the complexity previously present in the communication system, resulting in an apparent detrimental loss of information potential.
  3. Asadollahi A, Kaveh MH, Saberi LF, Karimi M, Ahmad N
    J Cross Cult Gerontol, 2023 Mar;38(1):97-109.
    PMID: 36792867 DOI: 10.1007/s10823-023-09470-w
    The CAGE questionnaire is an instrument, proved useful in helping to make a diagnosis of alcoholism. The questions focus on Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers. The questionnaire has been more pervasive simple tool than AUDIT and LAST scales to screen in busy medical settings where limited time is considered for adult patient interviews. The present study aimed to determine the reliability and validity of the CAGE questionnaire in Khuzistan province, Iran and evaluate its role in detecting alcohol-related problems. For this purpose, 382 men with mean age of 65 ± 5 were sampled by cluster-random sampling method in convenience model from the medical centers in eight counties of Khuzistan province during 2019 and they responded to the CAGE questionnaire. The coefficients of Cronbach's alpha (α = 0.82), convergent validity (0.73), divergent validity (-0.06), and criterion validity (0.87) were estimated (ρ 
  4. Shaibdat NS, Ahmad N, Azmin S, Ibrahim NM
    Front Neurol, 2023;14:1136858.
    PMID: 36959822 DOI: 10.3389/fneur.2023.1136858
    INTRODUCTION: Patients with Parkinson's disease (PD) are at a higher risk of hospital admissions compared to the general population. We studied the causes and factors associated with admissions among patients with PD over 6 years.

    METHODS: We included all PD admissions between 1 January 2016 and 31 December 2021. Other causes of parkinsonism were excluded. Causes of admissions were divided into PD-related (direct or indirect) or non-PD-related. The type of admission was categorized into emergency or elective.

    RESULTS: We identified 605 hospital admissions (259 patients with PD); 345 (57.0%) were PD-related and 260 (43%) were non-PD-related. Emergency PD admissions contributed to 50.4% of all admissions, most commonly from respiratory infection (23%). PD admissions in comparison to non-PD admissions were associated with worse disease severity (HY ≥ 3; p < 0.001), longer disease duration [8.71 (SD 6.23) vs. 6.60 (SD 5.39) years; p < 0.001], and longer hospital stay [7.70 (SD 5.89) vs. 6.42 (SD 7.63) days; p = 0.020]. Non-PD admissions were associated with more comorbidities (97.3%; p = 0.013). There were 124 (20.5%) complications and 31 deaths (5.1%). A total of 29 deaths were due to respiratory infection and 3 deaths were due to COVID-19 pneumonia. Emergency admission (PD- and non-PD-related; p = 0.001) and respiratory-related causes (p < 0.001) were predictors of unfavorable hospital admission outcomes (death and complications).

    CONCLUSION: Respiratory infection was the leading cause of hospital admission and a significant independent predictor of unfavorable hospital admission outcomes (death and complications). PD-related admissions were associated with disease severity and led to more complications and longer hospital stays. Non-PD-related admissions were associated with comorbidities.

  5. Mawazi SM, Kumar M, Ahmad N, Ge Y, Mahmood S
    Polymers (Basel), 2024 May 10;16(10).
    PMID: 38794545 DOI: 10.3390/polym16101351
    Chitosan, a versatile biopolymer derived from chitin, has garnered significant attention in various biomedical applications due to its unique properties, such as biocompatibility, biodegradability, and mucoadhesiveness. This review provides an overview of the diverse applications of chitosan and its derivatives in the antibacterial, anticancer, wound healing, and tissue engineering fields. In antibacterial applications, chitosan exhibits potent antimicrobial properties by disrupting microbial membranes and DNA, making it a promising natural preservative and agent against bacterial infections. Its role in cancer therapy involves the development of chitosan-based nanocarriers for targeted drug delivery, enhancing therapeutic efficacy while minimising side effects. Chitosan also plays a crucial role in wound healing by promoting cell proliferation, angiogenesis, and regulating inflammatory responses. Additionally, chitosan serves as a multifunctional scaffold in tissue engineering, facilitating the regeneration of diverse tissues such as cartilage, bone, and neural tissue by promoting cell adhesion and proliferation. The extensive range of applications for chitosan in pharmaceutical and biomedical sciences is not only highlighted by the comprehensive scope of this review, but it also establishes it as a fundamental component for forthcoming research in biomedicine.
  6. Mansor E, Ahmad N, Mohd Zulkefli NA, Lim PY
    PLoS One, 2024;19(7):e0306387.
    PMID: 38995940 DOI: 10.1371/journal.pone.0306387
    BACKGROUND AND OBJECTIVE: Pregnant mothers are at risk of many adverse pregnancy outcomes, including infants with low birth weight (LBW). The World Health Organization aimed to achieve a 30% reduction in the number of LBW infants by the year 2025. In this study, we aimed to determine the incidence and determinants of LBW infants among pregnant mothers attending government health clinics in Peninsular Malaysia.

    MATERIAL AND METHODS: A prospective cohort study "Relative Risk of Determinants of Adverse Pregnancy Outcomes Among Pregnant Mothers Attending Government Health Clinics, Peninsular Malaysia, PEN-MUM" was conducted from March 2022 until March 2023 at 20 government health clinics in Peninsular Malaysia that were randomly selected through a multistage sampling method. Malaysian pregnant mothers between 18 and 49 years old were recruited at 12-18 weeks of gestation and followed up at three time points: 1 (24-28 weeks of gestation), 2 (36-40 weeks of gestation), and 3 (post-delivery). Eight exposure factors of LBW were studied: gestational weight gain, dengue infection, urinary tract infection, COVID-19 infection, gestational hypertension, preeclampsia, maternal anemia, and gestational diabetes mellitus (GDM).

    RESULTS: Among 507 participants enrolled in the cohort, 40 were lost to follow-up. A total of 467 were included in the final analysis, giving an attrition rate of 7.9%. The incidence of LBW infants in Peninsular Malaysia was 14.3%. After adjusting for three covariates (ethnicity, employment status, and gestational age at birth), three determinants of LBW were identified. The risk of giving birth to LBW infants was higher among those with inadequate gestational weight gain (aRR = 2.86, 95% CI: 1.12, 7.37, p = 0.03), gestational hypertension (aRR = 4.12; 95% CI: 1.66, 10.43; p = 0.002), and GDM (aRR = 2.21; 95% CI: 1.18, 4.14; p = 0.013) during the second and third trimesters.

    CONCLUSIONS: The incidence of LBW infants in Peninsular Malaysia can be considered high. Having inadequate gestational weight gain, gestational hypertension, and GDM in the second and third trimesters increased the risk of LBW infants by threefold, fivefold, and twofold respectively. Thus, intervention strategies should target prevention, early detection, and treatment of gestational hypertension and GDM, as well as promoting adequate weight gain during antenatal care.

  7. Shemu PL, Ahmad N, Lim PY, Suchi PM
    Afr J Reprod Health, 2022 Apr;26(4):32-41.
    PMID: 37584982 DOI: 10.29063/ajrh2022/v26i4.4
    This study aimed at determining the factors that influence family planning practice among rural women of Pankshin district in Plateau state, Nigeria. A cross-sectional study using a simple random sampling method was conducted from October to December 2019. A self-administered questionnaire was used for data collection among 302 respondents. Among respondents, 48.3% had practised family planning and the most popular family planning method ever practised was injectables (57.5%). The determinants of family planning practice were age group 29-39 and 40-49 years old (AOR=4.373, p <0.001; AOR=5.862, p <0.001), discussion with partner (AOR=9.192, p <0.001) and partner's approval (AOR=2.791, p=0.007). Findings showed an encouraging family planning prevalence with the main determinants involving male partners. Further efforts need to be made to promote family planning practice among male partners and to empower women of all reproductive age groups by providing them with relevant information that is needed for them to make informed decisions.
  8. Mohd Nordin UU, Ahmad N, Salim N, Mohd Yusof NS
    RSC Adv, 2021 Aug 23;11(46):29080-29101.
    PMID: 35478537 DOI: 10.1039/d1ra06087b
    Psoriasis is a lingering inflammatory skin disease that attacks the immune system. The abnormal interactions between T cells, immune cells, and inflammatory cytokines causing the epidermal thickening. International guidelines have recommended topical treatments for mild to moderate psoriasis whilst systemic and phototherapy treatments for moderate to severe psoriasis. However, current therapeutic approaches have a wider extent to treat moderate to severe type of psoriasis especially since the emergence of diverse biologic agents. In the meantime, topical delivery of conventional treatments has prompted many unsatisfactory effects to penetrate through the skin (stratum corneum). By understanding the physiology of stratum corneum barrier functions, scientists have developed different types of lipid-based nanoparticles like solid lipid nanoparticles, nanostructured lipid carriers, nanovesicles, and nanoemulsions. These novel drug delivery systems help the poorly solubilised active pharmaceutical ingredient reaches the targeted site seamlessly because of the bioavailability feature of the nanosized molecules. Lipid-based nanoparticles for psoriasis treatments create a paradigm for topical drug delivery due to their lipids' amphiphilic feature to efficiently encapsulate both lipophilic and hydrophilic drugs. This review highlights different types of lipid-based nanoparticles and their recent works of nano formulated psoriasis treatments. The encapsulation of psoriasis drugs through lipid nanocarriers unfold numerous research opportunities in pharmaceutical applications but also draw challenges for the future development of nano drugs.
  9. Dinshaw IJ, Ahmad N, Salim N, Leo BF
    Pharmaceutics, 2021 Jul 06;13(7).
    PMID: 34371716 DOI: 10.3390/pharmaceutics13071024
    Psoriasis is a skin disease that is not lethal and does not spread through bodily contact. However, this seemingly harmless condition can lead to a loss of confidence and social stigmatization due to a persons' flawed appearance. The conventional methods of psoriasis treatment include taking in systemic drugs to inhibit immunoresponses within the body or applying topical drugs onto the surface of the skin to inhibit cell proliferation. Topical methods are favored as they pose lesser side effects compared to the systemic methods. However, the side effects from systemic drugs and low bioavailability of topical drugs are the limitations to the treatment. The use of nanotechnology in this field has enhanced drug loading capacity and reduced dosage size. In this review, biosurfactants were introduced as a 'greener' alternative to their synthetic counterparts. Glycolipid biosurfactants are specifically suited for anti-psoriatic application due to their characteristic skin-enhancing qualities. The selection of a suitable oil phase can also contribute to the anti-psoriatic effect as some oils have skin-healing properties. The review covers the pathogenic pathway of psoriasis, conventional treatments, and prospective ingredients to be used as components in the nanoemulsion formulation. Furthermore, an insight into the state-of-the-art methods used in formulating nanoemulsions and their progression to low-energy methods are also elaborated in detail.
  10. Kadir Shahar H, Jafri F, Mohd Zulkefli NA, Ahmad N
    BMC Public Health, 2020 Oct 15;20(1):1550.
    PMID: 33059657 DOI: 10.1186/s12889-020-09587-4
    BACKGROUND: Intimate partner violence (IPV) is any behaviour within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship. IPV is an important public health problem with substantial consequences on physical, mental, sexual, and reproductive health. Data on the systematic review of IPV are vital as basis for policy and program recommendations. The purpose of this systematic review was to ascertain the prevalence of IPV and its associated factors in Malaysia.

    MATERIALS AND METHODS: A systematic review was conducted on published research studies from four databases which included Scopus, Medline, Sage and Google Scholar using keywords of intimate partner violence OR IPV AND associated factors OR risk factors OR protective factors AND Malaysia. Articles included were either cross-sectional, cohort or case-control studies which were published between the year 2005 till present. Excluded articles were the non-Malaysian origin, irrelevant topics being studied and articles not written in English.

    RESULTS AND DISCUSSION: Out of 1983 records identified and screened, five were included for the analysis and interpretation of the data. All of the included studies were of cross-sectional design in which one of the studies was secondary data. IPV prevalence in Malaysia has a wide range between 4.94 and 35.9%. Two studies reported emotional or psychological abuse as the most common form of IPV (13% out of 22%) and (29.8%; CI = [0.27, 0.32]). Significant factors associated with IPV were lower education background, lower socio-economic status, history/ current substance abuse, exposure to prior abuse or violence, violence-condoning attitude; husbands or partners controlling behaviour, substance abuse and involvement in fights and lack of social support.

    CONCLUSION: Specific IPV intervention should focus on lower socio-economic groups, high-risk institutionalised groups, the involvement of partners or husband and addressing issues of substance abuse.

  11. Manan NA, Nawi AM, Ahmad N, Hassan MR
    Int J Pediatr Adolesc Med, 2020 Jun;7(2):78-82.
    PMID: 32642541 DOI: 10.1016/j.ijpam.2019.08.001
    BACKGROUND & OBJECTIVE: In the local setting, the prevalence of smoking among adolescents varies, as it is based only on self-reporting without biomarker validation. The objective of the present study was to determine the accuracy of self-reported smoking among adolescents as compared to that of the urine cotinine strip test.

    METHODS: We performed a cross-sectional study of 314 adolescents aged 16 years from February 2015 to April 2015 in Putrajaya, Malaysia. The accuracy of self-reporting was assessed using a data collection sheet and was validated by the urine cotinine strip test. Three schools were chosen by the simple random method, where all Form 4 students constituted the sample unit. The kappa statistic was used for determining agreement between self-reporting and urine cotinine strip testing.

    RESULTS: There was a substantial agreement between self-reporting and the urine cotinine strip test (kappa = 0.757, 95% confidence interval [CI]: 0.63, 0.88); there was 95.86% overall agreement. The prevalence of self-reported smoking was 8% (95% CI: 7.47, 8.53) and that of urine cotinine strip testing was 10.8% (95% CI: 10.20, 11.41). There was a discrepancy with the results of the urine cotinine strip test in 8% of self-reported smokers and 3.8% of self-reported nonsmokers. Self-reporting had 67.6% sensitivity and 99.3% specificity as compared to those of urine cotinine strip testing and had 92% positive predictive value and 96.2% negative predictive value.

    CONCLUSION: Self-reporting can be used to assess smoking status but should be used with care among adolescents. Urine cotinine strip test validation of self-reporting enables the measurement of the true prevalence of smoking among adolescents.

  12. Anuar HM, Fadzil F, Ahmad N, Abd Ghani N
    J Altern Complement Med, 2012 Jan;18(1):61-4.
    PMID: 22236030 DOI: 10.1089/acm.2010.0797
    BACKGROUND: Urut Melayu, the traditional Malay massage, had been introduced into three pioneer hospitals in Malaysia, as part of the integrated hospital program. It was introduced primarily for the rehabilitation of poststroke patients. After almost 3 years since it was first implemented, there are currently plans to extend it to other hospitals in the country. Information from this study will contribute toward a better future implementation plan.

    OBJECTIVES: This study was conducted to gain an insight into the experiences and views of poststroke patients and their urut Melayu practitioners.

    METHODS: A qualitative study design was adopted. A total of 17 semistructured in-depth interviews were carried out with poststroke patients who were undergoing urut Melayu treatment at one of the three integrated hospitals. Information was solicited from their accompanying caregivers whenever necessary. The 2 urut Melayu practitioners at the hospital were also interviewed. All the interviews were carried out in Malay by the authors, at the Traditional and Complementary Medicine unit of the relevant hospital. The interviews were audiotaped, transcribed, and coded into categories through a constant-comparison method of data analysis. Illustrative quotations were identified to supplement the narrative descriptions of the themes.

    RESULTS: It was found that urut Melayu was sought by patients who had experienced stroke brought about by hypertension and postdelivery complications. They reported the unique characteristics of urut Melayu and their positive experiences with it.

    CONCLUSIONS: Urut Melayu has potential as a complementary therapy for poststroke patients. It is recommended that the number of practitioners at the Traditional and Complementary Medicine unit be increased to provide the optimum care for poststroke patients.

  13. Arsad FS, Hod R, Ahmad N, Baharom M, Ja'afar MH
    Environ Sci Pollut Res Int, 2023 Jun;30(29):73137-73149.
    PMID: 37211568 DOI: 10.1007/s11356-023-27089-9
    Thermal comfort is linked to our health, well-being, and productivity. The thermal environment is one of the main factors that influence thermal comfort and, consequently, the productivity of occupants inside buildings. Meanwhile, behavioural adaptation is well known to be the most critical contributor to the adaptive thermal comfort model. This systematic review aims to provide evidence regarding indoor thermal comfort temperature and related behavioural adaptation. Studies published between 2010 and 2022 examining indoor thermal comfort temperature and behavioural adaptations were considered. In this review, the indoor thermal comfort temperature ranges from 15.0 to 33.8 °C. The thermal comfort temperature range varied depending on several factors, such as climatic features, ventilation mode, type of buildings, and age of the study population. Elderly and younger children have distinctive thermal acceptability. Clothing adjustment, fan usage, AC usage, and open window were the most common adaptive behaviour performed. Evidence shows that behavioural adaptations were also influenced by climatic features, ventilation mode, type of buildings, and age of the study population. Building designs should incorporate all factors that affect the thermal comfort of the occupants. Awareness of practical behavioural adaptations is crucial to ensure occupants' optimal thermal comfort.
  14. Raj D, Ahmad N, Mohd Zulkefli NA, Lim PY
    J Med Internet Res, 2023 May 04;25:e40955.
    PMID: 37140970 DOI: 10.2196/40955
    BACKGROUND: High prevalence of excessive screen time among preschool children is attributable to certain parental factors such as lack of knowledge, false perception about screen time, and inadequate skills. Lack of strategies to implement screen time guidelines, in addition to multiple commitments that may hinder parents from face-to-face interventions, demands the need to develop a technology-based parent-friendly screen time reduction intervention.

    OBJECTIVE: This study aims to develop, implement, and evaluate the effectiveness of Stop and Play, a digital parental health education intervention to reduce excessive screen time among preschoolers from low socioeconomic families in Malaysia.

    METHODS: A single-blind, 2-arm cluster randomized controlled trial was conducted among 360 mother-child dyads attending government preschools in the Petaling district, who were randomly allocated into the intervention and waitlist control groups between March 2021 and December 2021. This 4-week intervention, developed using whiteboard animation videos, infographics, and a problem-solving session, was delivered via WhatsApp (WhatsApp Inc). Primary outcome was the child's screen time, whereas secondary outcomes included mother's screen time knowledge, perception about the influence of screen time on the child's well-being, self-efficacy to reduce the child's screen time and increase physical activity, mother's screen time, and presence of screen device in the child's bedroom. Validated self-administered questionnaires were administered at baseline, immediately after the intervention, and 3 months after the intervention. The intervention's effectiveness was evaluated using generalized linear mixed models.

    RESULTS: A total of 352 dyads completed the study, giving an attrition rate of 2.2% (8/360). At 3 months after the intervention, the intervention group showed significantly reduced child's screen time compared with the control group (β=-202.29, 95% CI -224.48 to -180.10; P

  15. Hii SYF, Ali NA, Ahmad N, Amran F
    J Med Microbiol, 2017 Nov;66(11):1623-1627.
    PMID: 29048275 DOI: 10.1099/jmm.0.000611
    Melioidosis is an endemic infectious disease in Southeast Asia and northern Australia, caused by Burkholderia pseudomallei. However, the incidence rate in Malaysia is not well documented. The high mortality rate and broad range of clinical presentations require rapid and accurate diagnosis for appropriate treatment. This study compared the efficacy of in-house IgM and IgG ELISA methods using a local B. pseudomallei strain. The diagnostic accuracy of the in-house IgG ELISA was better than that of the IgM ELISA: sensitivity (IgG: 84.71 %, IgM: 76.14 %) and specificity (IgG: 93.64 %, IgM: 90.17 %); positive predictive value (IgG: 86.75 %, IgM: 79.76 %) and negative predictive value (IgG: 92.57 %, IgM: 89.66 %); likelihood ratio (LR) [IgG: 13.32, IgM: 7.75 (LR+); IgG: 0.16, IgM: 0.26 (LR-)], and was supported by the observation of the absorbance value in comparisons between culture and serology sampling. In-house IgG ELISA was shown to be useful as an early diagnostic tool for melioidosis.
  16. Anwar NA, Aizuddin AN, Ahmad N, Aziz A
    Cureus, 2024 Jul;16(7):e65468.
    PMID: 39071073 DOI: 10.7759/cureus.65468
    This review aims to identify the associated attributes of willingness to pay (WTP) for overweight and obesity interventions. A narrative review was conducted by partially adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. A non-exhaustive search using a pre-defined strategy and keywords was done on three selected literature databases: Pubmed, Scopus, and Web of Science. The inclusion criteria for the review were original studies written in English, published between 2000 and 2022, and focused on WTP for overweight and obesity interventions in adults. The extracted studies were manually screened for their eligibility through three cascading tiers: the title, the abstract, and the full article. Only nine original studies were eligible for review based on the screening procedure of 40 screened articles. There was heterogeneity in the study designs, methods, target populations, study duration, and perspectives across the studies. The majority of the studies showed that higher WTP was associated with younger age, having higher income, being female, having higher body mass index (BMI), having the perception of being overweight, habits, and attitudes. WTP is also attributed to the associated percentage of weight loss, long-term health risk reduction, time to noticeable weight loss, delivery mode, side effects, lifestyle modification, and costs of interventions. The identification of common attributes of the WTP for overweight and obesity intervention can assist in the formulation and implementation of effective evidence-based policies. Specific sub-groups with low WTP could be targeted via unique initiatives to improve their participation in weight-loss interventions.
  17. Azahar ZA, Ab Rahim MF, Ahmad N, Ramli R
    BMJ Case Rep, 2024 May 14;17(5).
    PMID: 38749515 DOI: 10.1136/bcr-2023-257698
    Achalasia is characterised by incomplete relaxation of the lower oesophageal sphincter and aberrant oesophageal peristaltic activity resulting in impaired oesophageal emptying. This rare condition in pregnancy is unique as both the disease and its treatment are associated with fetomaternal risks and complications. A woman in her early 30s, gravida 3 para 2 at 35 weeks' pregnancy with suspected oesophageal achalasia, presented with shortness of breath, cough and fever following frequent bouts of vomiting and fluid regurgitation. She was diagnosed with aspiration pneumonia complicated by severe metabolic acidosis, malnutrition syndrome and fetal growth restriction. Following stabilisation of the acute clinical problems, delivery was expedited via caesarean section. Postpartum endoscopy confirmed the diagnosis of achalasia as per initial suspicion. Definitive surgery was performed several months later after optimisation of the patient's nutritional status. This case illustrates the life-threatening complications of achalasia in pregnancy.
  18. Syed Shamsuddin SM, Ahmad N, Radi MFM, Ibrahim R
    PLoS One, 2024;19(11):e0311427.
    PMID: 39514466 DOI: 10.1371/journal.pone.0311427
    BACKGROUND: The global mortality caused by non-communicable diseases is on the rise. Health-promoting lifestyles are among the most effective approaches, yet the physical activity domain consistently scores the lowest. Physical activity is linked to individual behaviour and influenced by numerous factors. Illness has been identified as a key factor in behavioural change. Therefore, the primary purpose of this review was to investigate the role of illness perception in the physical activity domain among patients with non-communicable disease.

    METHOD: This systematic review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A literature search was conducted across three scientific databases (Scopus, PubMed, and Web of Science), targeting original articles published in English between 2014 and 2024. The quality of the eligible articles was assessed using the Joanna Briggs Institute Critical Appraisal tools. The findings were synthesised through content analysis.

    RESULTS: A total of 17 studies were included, identifying both the direct and indirect effects of illness perception variables as a whole or in their respective dimensions. The illness perception variable has demonstrated a significant positive and negative relationships with the physical activity domain.

    LIMITATION: The majority of the included studies had a cross-sectional design. Therefore, the evidence quality was relatively low and exhibited a high risk of bias. Furthermore, there was language bias as only English-language publications were selected.

    CONCLUSION: The findings of this review will serve as a guide for healthcare providers in enhancing physical activity adherence among patients with non-communicable diseases through an illness perception approach. This approach can be integrated into clinic consultations and intervention programmes. Future studies are warranted to evaluate the effectiveness of the illness perception approach in promoting physical activity adherence.

  19. Jane Ling MY, Ahmad N, Noor Aizuddin A, Ja'afar MH
    PLoS One, 2024;19(7):e0308152.
    PMID: 39078862 DOI: 10.1371/journal.pone.0308152
    BACKGROUND: Risk perception plays important role in motivating preventive health behaviours. The objective of this systematic review was to explore the level of diabetes risk perception among individuals with and without apparent risk for diabetes, and to consider the effect of environmental factors on the level of diabetes risk perception.

    METHODS: This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The literature search was carried out through PubMed, Web of Science, and Scopus. Original articles written in English and published between 2013 and 2023 were considered. Study quality was appraised using the Mixed Methods Appraisal Tool. Narrative synthesis was undertaken due to methodological heterogeneity in the included studies.

    RESULTS: A total of 13 cross-sectional studies, two randomized controlled trials, two cohort studies, two mixed methods studies and one quasi-experiment with a control group were included. An overall low level of diabetes risk perception was reported particularly in those without apparent risk for diabetes. The 20 included studies reported widely varied measures for calculating diabetes risk perception. The influence of environmental factors on the risk perception of diabetes was highlighted.

    LIMITATIONS: The use of study-specific and non-validated measures in the included studies weakens the authors' ability to compare across studies. The role of language and publication bias within this systematic review should be acknowledged as we included only English-language studies published in peer-reviewed journals. Another limitation is the exclusion of dimensions of risk perception such as optimistic bias as search terms.

    CONCLUSION: The overall low risk perception of diabetes calls for urgent need of public health interventions to increase the risk perception of diabetes. In the future, researchers should ensure the validity and reliability of the measures being used. The influence of environmental factors on the diabetes risk perception indicates that diabetes preventive interventions targeting environmental factors may be effective in increasing the risk perception of diabetes.

  20. Balqis-Ali NZ, Ahmad N, Minhat HS, Fattah Azman AZ
    BMC Geriatr, 2024 Aug 14;24(1):685.
    PMID: 39143517 DOI: 10.1186/s12877-024-05211-x
    BACKGROUND: Although significant and disabling consequences are presented due to geriatric population-related depression, an insufficient comprehension of various biological, psychological, and social factors affecting this issue has been observed. Notably, these factors can contribute to geriatric population-related depression with low social support. This study aimed to identify factors associated with depression among the community-dwelling geriatric population with low social support in Malaysia.

    METHODS: This study used secondary data from a population-based health survey in Malaysia, namely the National Health Morbidity Survey (NHMS) 2018: Elderly Health. The analysis included 926 community-dwelling geriatric population aged 60 and above with low social support. The primary data collection was from August to October 2018, using face-to-face interviews. This paper reported the analysis of depression as the dependent variable, while various biological, psychological and social factors, guided by established biopsychosocial models, were the independent variables. Multiple logistic regression was applied to identify the factors. Analysis was performed using the complex sampling module in the IBM SPSS version 29.

    RESULTS: The weighted prevalence of depression among the community-dwelling geriatric population aged 60 and above with low social support was 22.5% (95% CI: 17.3-28.7). This was significantly higher than depression among the general geriatric Malaysian population. The factors associated with depression were being single, as compared to those married (aOR 2.010, 95% CI: 1.063-3.803, p: 0.031), having dementia, as opposed to the absence of the disease (aOR 3.717, 95% CI: 1.544-8.888, p: 0.003), and having a visual disability, as compared to regular visions (aOR 3.462, 95% CI: 1.504-7.972, p: 0.004). The analysis also revealed that a one-unit increase in control in life and self-realisation scores were associated with a 32.6% (aOR: 0.674, 95% CI: 0.599-0.759, p 

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