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  1. Fulltext Diagnosis delay of breast cancer and its associated factors in Malaysian women
    Norsa'adah B, Rampal KG, Rahmah MA, Naing NN, Biswal BM
    BMC Cancer, 2011;11:141.
    PMID: 21496310 DOI: 10.1186/1471-2407-11-141
    Breast cancer is the leading cause of cancer mortality among women in Malaysia. Delayed diagnosis is preventable and has major effects on patients' prognosis and survival. The objectives of our study were to identify the magnitude of delayed diagnosis and its associated factors in women with breast cancer in Malaysia.
    Matched MeSH terms: Cross-Sectional Studies
  2. Fulltext Do the majority of Malaysian women have dense breasts on mammogram?
    Zulfiqar M, Rohazly I, Rahmah M
    Biomed Imaging Interv J, 2011 Apr;7(2):e14.
    PMID: 22291859 MyJurnal DOI: 10.2349/biij.7.2.e14
    PURPOSE: TO DETERMINE: (i) the mammographic parenchymal patterns in Malaysian women and whether the breasts are dense on mammogram; (ii) the effect of age on breast density; (iii) the effect of parity on breast density; (iv) the difference in breast parenchymal patterns among the major races of women in Malaysia.
    METHODS: This was a descriptive cross-sectional study of 1,784 patients (981 Malays, 571 Chinese, 214 Indians and 18 others) who had undergone mammography during the 1-year study period. Majority of women (41.7%) were aged between 51 and 60 years and majority (43%) had 3-4 children. The Tabar classification (Pattern I - V) was used to evaluate breast parenchymal patterns on mammogram. Tabar Pattern I was further divided into 3 sub-groups (Pattern IA, IB, and IC). The different patterns were then grouped into dense (IB, IC, IV, V) and not dense (IA, II, III) breasts. The SPSS package was used for statistical analysis.
    RESULTS: Majority (59%) of Malaysian women had dense breasts (Pattern IB 29%, IC 20%, IV 5%, and V 5%) and 41% did not have dense breasts (Pattern IA 28%, II 6%, and III 7%). Age and parity were inversely related to breast density (p < 0.0001). Chinese women (65.7%) had the highest percentage of dense breasts (p = 0.69, odds ratio = 1.22), followed by the Indians (57.2%) and the Malays (50.5%).
    CONCLUSION: Majority of women had dense breasts but Pattern IV, which has been associated with increased risk of breast cancer, was seen in only 5% of the women. The breast density reduced steadily with increasing age and parity. There was no statistically significant difference in breast density in the three main races.
    KEYWORDS: Mammography; breast density; breast parenchymal patterns
    Matched MeSH terms: Cross-Sectional Studies
  3. Availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in emergency departments in Malaysia
    Awang R, Al-Sohaim SI, Zyoud SH, Khan HR, Hashim S
    Intern Emerg Med, 2011 Oct;6(5):441-8.
    PMID: 21750875 DOI: 10.1007/s11739-011-0662-z
    Acute poisoning is a common medical emergency in Malaysia. Life can be saved if the patient is diagnosed properly and receives the appropriate treatment such as gastrointestinal decontamination techniques and resources to increase poison elimination according to clinical guidelines at a reasonable time. The aims of this study were to determine the availability of decontamination, elimination enhancement, and stabilization resources for the management of acute toxic exposures and poisonings in accident and emergency departments in Malaysia, and to compare the availability of such facilities among various types of hospitals. A comparative, descriptive cross-sectional study was conducted using a structured questionnaire. Seventy-four (58.3%) out of the targeted 127 hospitals replied and completed the questionnaire. The availabilities of most items related to stabilization resources were far better in general hospitals compared to district hospitals with specialists and district hospitals without specialists. These items were mechanical ventilators (p = 0.011), non-invasive positive pressure ventilators (0.024), pacemakers (p = 0.019), and transcutaneous cardiac pacing (p < 0.001). The availability of decontamination resources varied substantially with hospital type. Nevertheless, these differences did not reach statistical significance in any of the cases, whereas sodium sulphate, sorbitol, and polyethylene glycol were almost never available. The availabilities of most items related to elimination enhancement resources were far better in general hospitals and district hospitals with specialists compared to district hospitals without specialists. These items were haemodialysis (p = 0.046), haemoperfusion (p = 0.002), haemofiltration (p = 0.002), acid diuresis (p = 0.04), peritoneal dialysis (p < 0.001), and exchange transfusion (p < 0.001). Most Malaysian hospitals have certain important immediate interventions such as gastrointestinal decontamination techniques and resources to increase poison elimination. The availabilities of most facilities were far better in the general hospitals. Coordination between the National Poison Centre in Malaysia and hospitals should be established regarding the emergency facilities for effective management of poisoning cases in each hospital in order to direct the poisoned patients to the hospital where the appropriate management resources is available.
    Matched MeSH terms: Cross-Sectional Studies
  4. Negative social reaction to strabismus in school children ages 8-12 years
    Lukman H, Kiat JE, Ganesan A, Chua WL, Khor KL, Choong YF
    J AAPOS, 2011 Jun;15(3):238-40.
    PMID: 21683635 DOI: 10.1016/j.jaapos.2011.01.158
    To investigate children's willingness to sit next to a child with noticeable exotropia as a measure of social alienation.
    Matched MeSH terms: Cross-Sectional Studies
  5. Asymptomatic bacteriuria in pregnant mothers: a valid and cost-effective screening test in Bangladesh
    Ullah A, Barman A, Ahmed I, Salam A
    J Obstet Gynaecol, 2012 Jan;32(1):37-41.
    PMID: 22185534 DOI: 10.3109/01443615.2011.601697
    In Bangladesh, a number of screening tests for asymptomatic bacteriuria in pregnancy are in practice. The objective of this study was to assess the validity and cost-effectiveness of these screening tests. A total of 600 apparently healthy pregnant mothers were included in this study. The validity of the screening tests was calculated against the urine culture as 'gold standard'. Incremental cost-effective ratio between the screening test methods and the least costly method (microscopic urine analysis) was calculated. Bacterial count/oil-immersion field in Gram-stained smear of urine was the most sensitive (91.7%) and specific (97.2%). Incremental cost per additional positive cases of bacterial count, leukocyte esterase and combination of leukocyte esterase and nitrite were US$3, US$25 and US$23, respectively. Gram staining may be the alternative approach to traditional routine urinalysis for the screening of asymptomatic bacteriuria during pregnancy in clinical practice in Bangladesh, as well as other developing countries.
    Matched MeSH terms: Cross-Sectional Studies
  6. Fulltext Interpreting systematic reviews: are we ready to make our own conclusions? A cross-sectional study
    Lai NM, Teng CL, Lee ML
    BMC Med, 2011;9:30.
    PMID: 21450083 DOI: 10.1186/1741-7015-9-30
    BACKGROUND: Independent evaluation of clinical evidence is advocated in evidence-based medicine (EBM). However, authors' conclusions are often appealing for readers who look for quick messages. We assessed how well a group of Malaysian hospital practitioners and medical students derived their own conclusions from systematic reviews (SRs) and to what extent these were influenced by their prior beliefs and the direction of the study results.
    METHODS: We conducted two cross-sectional studies: one with hospital practitioners (n = 150) attending an EBM course in June 2008 in a tertiary hospital and one with final-year medical students (n = 35) in November 2008. We showed our participants four Cochrane SR abstracts without the authors' conclusions. For each article, the participants chose a conclusion from among six options comprising different combinations of the direction of effect and the strength of the evidence. We predetermined the single option that best reflected the actual authors' conclusions and labelled this as our best conclusion. We compared the participants' choices with our predetermined best conclusions. Two chosen reviews demonstrated that the intervention was beneficial ("positive"), and two others did not ("negative"). We also asked the participants their prior beliefs about the intervention.
    RESULTS: Overall, 60.3% correctly identified the direction of effect, and 30.1% chose the best conclusions, having identified both the direction of effect and the strength of evidence. More students (48.2%) than practitioners (22.2%) chose the best conclusions (P < 0.001). Fewer than one-half (47%) correctly identified the direction of effect against their prior beliefs. "Positive" SRs were more likely than "negative" SRs to change the participants' beliefs about the effect of the intervention (relative risk (RR) 1.8, 95% confidence interval 1.3 to 2.6) and "convert" those who were previously unsure by making them choose the appropriate direction of effect (RR 1.9, 95% confidence interval 1.3 to 2.8).
    CONCLUSIONS: The majority of our participants could not generate appropriate conclusions from SRs independently. Judicious direction from the authors' conclusions still appears crucial to guiding our health care practitioners in identifying appropriate messages from research. Authors, editors and reviewers should ensure that the conclusions of a paper accurately reflect the results. Similar studies should be conducted in other settings where awareness and application of EBM are different.
    Matched MeSH terms: Cross-Sectional Studies
  7. Off-pump Coronary artery bypass graft surgery in patients with left main stem disease
    Ishamuddin IM, Zamrin DM, Joanna OS, Ramzisham AR, Hairolfaizi H
    Clin Ter, 2011;162(6):527-31.
    PMID: 22262322
    The safety, feasibility and post-operative outcome are the main concern in Off-pump Coronary artery bypass graft (OPCAB) surgery as compared to conventional technique especially in multi-vessels coronary artery disease.
    Matched MeSH terms: Cross-Sectional Studies
  8. The quality of life among coronary heart disease patients at a teaching hospital
    Ho SE, Ting CK, Das S, Loo CY, Rohayu AB, Khor SY, et al.
    Clin Ter, 2011;162(3):217-22.
    PMID: 21717045
    Quality of life after acute coronary heart disease amongst patients is important outcome factor in deliberations of patient's care. The main aim of the study was to examine the quality of life amongst acute CHD patients.
    Matched MeSH terms: Cross-Sectional Studies
  9. The ideal measurement of the quality of life in post stroke patients: an urban study
    Samsiah M, Das S, Chee SY, Rashidah R, Siti H, Ruth P, et al.
    Clin Ter, 2011;162(3):209-15.
    PMID: 21717044
    There is paucity of literature on the measurement of the quality of life in post stroke patients in the developing countries. The main objective of this study was to determine the quality of life (QOL) of post stroke patients.
    Matched MeSH terms: Cross-Sectional Studies
  10. Anti-HCMV IgG positivity rate among renal transplant recipients in Baghdad
    Al-Alousy BM, Abdul-Razak SH, Al-Ajeeli KS, Al-Jashamy KA
    Saudi J Kidney Dis Transpl, 2011 Nov;22(6):1269-74.
    PMID: 22089802
    In developing countries, the majority of infection by human cytomegalovirus (HCMV) occurs during childhood and continues as a latent infection. By adulthood, almost all the population may show anti-HCMV IgG as positive. This study was undertaken to determine the correlation between the prevalence of HCMV antibodies and HCMV infection during post transplant period among renal transplant patients in Baghdad. 43 renal transplant patients attending three renal transplantation centers, and 40 healthy individuals who served as controls were enrolled in this study. 18 (41.9%) were transplanted recently and they were under post-operative follow-up and 25 (58.1%) were transplanted more than one year ago. Detection of anti-HCMV IgG was carried out using enzyme-linked immunosorbant assay (ELISA). The results revealed that anti-HCMV IgG was significantly higher among renal transplant recipients compared to healthy controls (97.7% vs 85%, P = 0.04). The anti-HCMV IgG positivity rate was not affected by patients' age, sex, and duration after transplantation or immunosuppressive therapy. We conclude that the high anti-HCMV IgG positivity rate among Iraqi renal transplant recipients make them prone to considerable risk of reactivation of HCMV infection.
    Matched MeSH terms: Cross-Sectional Studies
  11. Fulltext Older Age Group in Pregnancy is Associated with Increased Arterial Stiffness
    Salmi AA, Nor Aliza AG, Nik Zaki NM, Wong AR, Aida HR
    Med J Malaysia, 2010 Jun;65(2):115-8.
    PMID: 23756794 MyJurnal
    Arterial stiffness is an index of vascular health; normal pregnancy is associated with reduced arterial stiffness. This cross sectional study compared arterial stiffness in older (≥35 years) and the younger (≤34 years) age groups of pregnant women. Arterial stiffness was assessed noninvasively in 66 pregnant women between 23 - 32 weeks gestation (41 women ≤ 34 years, 25 women ≥ 35 years) using the parameters pulse wave analysis and pulse wave velocity. Blood pressure (BP), body mass index (BMI), serum total cholesterol (TC) and fasting blood glucose (FBS) were also recorded. Mean ages of the younger and older age groups were 27.6±0.62 and 39.3±0.58 years; no significant difference was seen between the groups in their BMI, TC, FBS, SBP, DBP and gestational age. The older age group of women have increased arterial stiffness (augmentation index 19.4±1.9% vs 13.2±1.6%, p=0.015) and aortic stiffness (pulse wave velocity 8.7±0.3 vs 7.7±0.2 m/s, p=0.004) compared to the younger women. Linear regression analysis showed a positive significant correlation between age and augmentation index (R=0.278, p=0.026), and pulse wave velocity (R=0.350, p=0.004). We conclude that older pregnant women has increased arterial stiffness compared to a younger age group of pregnant women suggesting that vascular changes due to ageing occurs in pregnancy despite cardiovascular adaptations occurring in pregnancy.
    Matched MeSH terms: Cross-Sectional Studies
  12. Fulltext Analysis of factors in response to rotavirus vaccination counselling in a private paediatric clinic
    Kannan Kutty P, Pathmanathan G, Salleh NM
    Med J Malaysia, 2010 Jun;65(2):127-32.
    PMID: 23756797 MyJurnal
    Rotavirus vaccine is available as an optional vaccine in Malaysia. The counselling of optional vaccines is considered an integral part of the health services offered in a private paediatric clinic. While ensuring that all babies are up-todate with their compulsory immunization, counselling of optional vaccines like the rotavirus vaccine could give parents the choice to make an informed decision on the acceptance of this vaccine. Over a period of two years, we counselled the parents regarding diarrhoea caused by rotavirus disease and the rotavirus vaccine. In this study, the factors that were significantly associated with the acceptance of the rotavirus vaccine were the gender of the baby, the mother's age, the mother's occupation, the mode of payment for the vaccine, the number of previous visits to the clinic by the parents, the number of counselling sessions given to the parents and the pre-counselling awareness or knowledge of rotavirus disease and rotavirus vaccine. It is hoped that these findings may assist busy clinicians in their continuous efforts to provide health education and vaccination counselling to the parents of their patients.
    Matched MeSH terms: Cross-Sectional Studies
  13. Fulltext Enhancing active learning in microbiology through case based learning: experiences from an Indian medical school
    Ciraj AM, Vinod P, Ramnarayan K
    Indian J Pathol Microbiol, 2010 Oct-Dec;53(4):729-33.
    PMID: 21045402 DOI: 10.4103/0377-4929.72058
    Case-based learning (CBL) is an interactive student-centered exploration of real life situations. This paper describes the use of CBL as an educational strategy for promoting active learning in microbiology.
    Matched MeSH terms: Cross-Sectional Studies
  14. Fulltext Assessment of factors influencing morale in the elderly
    Loke SC, Abdullah SS, Chai ST, Hamid TA, Yahaya N
    PLoS One, 2011;6(1):e16490.
    PMID: 21283551 DOI: 10.1371/journal.pone.0016490
    We examined the relationship between morale measured by the Philadelphia Geriatric Morale Scale (PGC) and disability, social support, religiosity, and personality traits. Instruments predicting morale were then tested against PGC domains.
    Matched MeSH terms: Cross-Sectional Studies
  15. Fulltext Sleep position and infant care practices in an urban community in Kuala Lumpur
    Lope RJ, Kong WK, Lee VW, Tiew WT, Wong SY
    Med J Malaysia, 2010 Mar;65(1):45-8.
    PMID: 21265248 MyJurnal
    Several modifiable risk factors for sudden infant death syndrome (SIDS) have been identified such as sleeping prone or on the side, sleeping on a soft surface, bed-sharing, no prenatal care and maternal ante-natal smoking. A cross-sectional survey of infant sleep and care practices was conducted among parents of babies aged below 8 months to determine the prevalence and predictors of non-supine sleep position and the prevalence of other high-risk infant care practices for SIDS. Of 263 infants, 24.7% were placed to sleep in the non-supine position and age of infants was a factor positively associated with this (adjusted odds ratio 1.275, 95% CI=1.085, 1.499). The most common modifiable risk factor was the presence of soft toys or bedding in the infants' bed or cot (89.4%). Results from this study indicate that although the predominant sleep position of Malaysian infants in this population is supine, the majority of infants were exposed to other care practices which have been shown to be associated with SIDS.
    Matched MeSH terms: Cross-Sectional Studies
  16. Fulltext Knowledge and attitude of university students in health sciences on the prevention of cervical cancer
    Tan YY, Hesham R, Qodriyah HM
    Med J Malaysia, 2010 Mar;65(1):53-7.
    PMID: 21265250 MyJurnal
    Cervical cancer is the second most common female cancer after breast cancer both in Malaysia and worldwide although it can be mostly prevented. The objective of this study was to assess the knowledge level and attitude of University Kebangsaan Malaysia female students in the Faculties of Pharmacy and Allied Health Sciences on the prevention of cervical cancer. A total of 675 respondents were recruited for this cross-sectional study involving pre-tested questionnaires. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 15.0. There was significant association between grade and mean score of knowledge with different faculties and year of education (p<0.05). However, significant association was shown only between grade of knowledge with different programs in the Faculty of Allied Health Sciences. For mean score of knowledge, significant difference only existed among different races (p<0.05). Mass media was the most common source of information. In conclusion, the knowledge level of respondents on cervical cancer and its prevention was not satisfactory despite their positive attitude on prevention. Thus, more awareness programs should be conducted in University campuses to provide students with knowledge on prevention of cervical cancer.
    Matched MeSH terms: Cross-Sectional Studies
  17. Fulltext Auditory functionality and early use of speech in a group of pediatric cochlear implant users
    Umat C, Siti Hufaidah K, Azlizawati AR
    Med J Malaysia, 2010 Mar;65(1):7-13.
    PMID: 21265239 MyJurnal
    This study examined auditory functionality and early use of speech in a group of paediatric cochlear implant users. Parents of 33 implanted children from the Universiti Kebangsaan Malaysia Cochlear Implant Program were interviewed using the Meaningful Auditory Integration Scale (MAIS) and the Meaningful Use of Speech Scale (MUSS). In general, higher MAIS scores post-implantation were significantly associated with higher MUSS scores suggesting that those with better functional hearing with the implant were also better in using spontaneous speech to communicate. Multiple regression analyses showed that several time factors significantly correlated with the MAIS scores post-implantation but not with the MUSS.
    Matched MeSH terms: Cross-Sectional Studies
  18. Fulltext A comparison of morbidity patterns in public and private primary care clinics in malaysia
    Mimi O, Tong SF, Nordin S, Teng CL, Khoo EM, Abdul-Rahman A, et al.
    Malays Fam Physician, 2011;6(1):19-25.
    PMID: 25606215 MyJurnal
    OBJECTIVES: To compare the morbidity patterns in public and private primary care clinics; determine patients' reasons for encounter (RFE) and diagnoses using the ICPC-2, and compare ten commonest diagnoses and RFEs.
    METHODS: A cross-sectional study on randomly selected clinics was conducted nationwide. Doctors completed the Patient Encounter Record (PER) for systematically selected encounters for a week.
    RESULTS: Response rate was 82.0% (public clinic) and 33% (private clinic) with 4262 encounters and 7280 RFE. Overall, the three commonest disease categories encountered were respiratory (37.2%), general and unspecified (29.5%), and cardiovascular diseases (22.2%). Public and private clinics handled 27% versus 50% acute cases and 20.0% versus 3.1% chronic cases i.e. 33.7 and 5.6 chronic diseases per 100 RFE respectively.
    CONCLUSION: Doctors in public clinics saw more chronic and complex diseases as well as pregnancy related complaints and follow-up cases while in private clinics more acute and minor illnesses were seen. Health services should be integrated and support given to co-manage chronic diseases in both sectors.
    KEYWORDS: Malaysia; Primary practice; delivery of health care; morbidity pattern; reasons for encounter
    Matched MeSH terms: Cross-Sectional Studies
  19. A cross-sectional validation study of EQ-5D among the Malaysian adult population
    Shafie AA, Hassali MA, Liau SY
    Qual Life Res, 2011 May;20(4):593-600.
    PMID: 21046257 DOI: 10.1007/s11136-010-9774-6
    PURPOSE: The objective of this study was to assess the construct validity of the EQ-5D instrument among the Malaysian population.

    METHODS: This was a cross-sectional study conducted among Malaysian adults in three northern states of Malaysia. A pre-developed questionnaire consisting of both the EQ-5D and SF-12 items was used for data collection. Concurrent, convergent, and known group validity of EQ-5D were assessed against SF-12 and several known relationships with participants' demographic and illness characteristics.

    RESULTS: A total of 596 Malaysians participated in the study. The mean EQ-5D score was 0.93 (SD = 0.13), while the mean physical component score (PCS-12) and mental component score (MCS-12) scores were 48.9 (SD = 7.4) and 49.1 (SD = 8.0), respectively. Participants with a current medical problem had lower PCS-12 and MCS-12 scores and reported more problems with all of the EQ-5D dimensions; they also had lower EQ-5D and EQ-VAS scores (P < 0.05). Convergent validity was supported by a moderately positive correlation between EQ-5D and EQ-VAS with MCS-12 and PCS-12 scores; moreover, the stronger effect sizes between PCS-12 and the physical dimensions of EQ-5D as well as between MCS-12 with anxiety/depression scores further supported the convergent validity of EQ-5D. Responses to the EQ-5D dimensions only supported two of the four known group validity hypotheses of higher quality of life among individuals who are better educated and no medical problem. No association was found between income and gender with EQ-5D score.

    CONCLUSION: This study has demonstrated acceptable construct validity of the EQ-5D among the Malaysian population.

    Matched MeSH terms: Cross-Sectional Studies
  20. Loss of muscle strength, mass (sarcopenia), and quality (specific force) and its relationship with functional limitation and physical disability: the Concord Health and Ageing in Men Project
    Hairi NN, Cumming RG, Naganathan V, Handelsman DJ, Le Couteur DG, Creasey H, et al.
    J Am Geriatr Soc, 2010 Nov;58(11):2055-62.
    PMID: 21054284 DOI: 10.1111/j.1532-5415.2010.03145.x
    To determine the association between loss of muscle strength, mass, and quality and functional limitation and physical disability in older men.
    Matched MeSH terms: Cross-Sectional Studies
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