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Awareness of Breast Cancer among Surgical Patients in a Tertiary Hospital in Malaysia

Kirubakaran R, Chee Jia T, Mahamad Aris N

Asian Pac J Cancer Prev, 2017 01 01;18(1):115-120.
PMID: 28240018

Background: Breast cancer is the commonest cancer among women worldwide. About one in nineteen women in
Malaysia are at risk, compared to one in eight in Europe and the United States. The objectives of this study were: (1) to
assess patients’ knowledge on risk factors, symptoms and methods of screening of breast cancer; and (2) to determine
their perceptions towards the disease treatment outcomes. Methods: A cross-sectional survey using a validated selfadministered
questionnaire was conducted among 119 consecutive surgical female patients admitted from 1st of
September to 8th of October 2015 in Hospital Sultan Abdul Halim, Kedah. Data were analyzed using General linear
regression and Spearman’s correlation with Statistical Package for Social Science (SPSS) version 20. Results: Mean (SD)
age was 40.6 (15.1) years and majority of the patients were Malay (106, 89.1%). Mean scores for general knowledge,
risk factors and symptoms of breast cancer were 50.2 (24.0%), 43.0 (22.9%) and 64.4 (28.4%) respectively. Mean
total knowledge score was 52.1(19.7%). 80 (67.2%) and 55 (46.2%) patients were aware of breast self-examination
and clinical breast examination recommendations, respectively. Generally, patients had positive perceptions towards
breast cancer treatment outcomes. However, majority (59.7%) considered that it would be a long and painful process.
Knowledge was significantly better among married women with spouses (p=0.046), those with personal history of
breast cancer (p=0.022) and with monthly personal income (p=0.001) with the coefficient of determination, R2=0.16.
Spearman’s correlation test showed a significant positive relationship between monthly personal income and breast
cancer awareness (r = 0.343, p <0.001). Conclusion: Awareness on breast cancer among our patients was average. Thus,
there is a need for more awareness programs to educate women about breast cancer and promote its early detection.
Fulltext Relationship of anaemia with cognitive and functional status of elderly in Rembau, Negeri Sembilan. [Hubungan anemia dengan status kognitif dan kefungsian warga tua di Rembau, Negeri Sembilan]

Aris N, Abdul Rahman S, Shahidan N

Sains Malaysiana, 2009;38(6):953–958.

The prevalence of anaemia and nutritional status was evaluated among 88 Malay elderly (20 men and 68 women) aged 60 to 85 years (mean age 69.8 ± 6.0 years) from four villages in Rembau district, Negeri Sembilan. In addition, the relationship between hemoglobin with nutrient intake, cognitive and functional status of the elderly were also investigated. Subjects were interviewed to obtain information on demographic and nutrient intake. Cognitive status was assessed using Elderly Cognitive Assessment Questionnaire (ECAQ) while functional status was measured using Instrumental Activity Daily Living (IADL) and hand grip measurement. Hemoglobin level was determined using HemoCue method. The findings indicated that the prevalence of anaemia was 22.7%. Prevalence of anaemia for male subject was 30.0% with mean of hemoglobin as 11.7 ± 1.0 g/dL while 20.6% of female subject was anaemic with mean of hemoglobin was 11.2 ± 0.5 g/dL. As much as 21.6% of the subjects have cognitive impairment with the prevalence is high in old-old age group (57.9%) compared to the young-old age group (11.6%). Results from functional assessment showed that mean for IADL score as 11 ± 3. The IADL score was lower in old-old age group (9 ± 4) compared to the young-old age group (12 ± 2). For hand grip measurement, overall mean was 16.8 ± 8.7 kg (14.2 ± 8.4 kg for old-old age group and 17.6 ± 8.7 kg for young-old age group). Nutrient analysis showed that the mean calorie intake for men (1310 ± 448 kcal/day) and women (1180 ± 300 kcal) were lower than the RNI. However, only intakes of iron, niacin and vitamin A achieved the Malaysian Recommended Nutrient Intake (RNI). Correlation between hemoglobin and nutrients was only showed with calorie intake (r=0.486, p=0.048) and not with other nutrients. Besides that, there was no correlation between hemoglobin with ECAQ and IADL scores but hemoglobin was correlated with hand grip strength (r=0.265, p=0.013). As a conclusion, 22.7% case of anaemia was reported in this study. However, correlations were only formed between hemoglobin with calorie intake and hemoglobin with hand grip. Anaemia in elderly increases the inability of the elderly to live independently.
Keywords: Anemia; cognitive status; elderly; functional status
Fulltext Application of occupational health surveillance program among responder’s during chemical incident at Pasir Gudang, Johor

Salvaraji L., Haidar R.T., Mohd Aris N., Ayob Q. A., Nordin N., Abdul Latif N., et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):29-29.
MyJurnal

Introduction: Responder’s action during mass environmental chemical incident involves collaboration of multiple agency. They clean the exposure site, control public safety and safe lives. The health of the responder is also as valuable as the public and always been neglected. Hence, this study is to highlights the method used and challenges during the incidents. Methods: A modified Occupational Health Surveillance Programme designed by Baker and Matte (Thirteen Steps in designing and implementing an Occupational Health Surveillance Programme) was imple-mented. These method full fill the criteria of impossible further reduce exposure to known hazards and uncertain health effect of the offending chemicals. Two core workplace namely the source of chemical contamination locale and victims’ evacuation centre were identified. The exposed responder is identified and categorised according to their expected exposure. Offending chemicals identified were known hazardous to health. An electronic survey form was developed and the surveillance were conducted during the event and post-exposures of one, third and sixth months. Laboratory tests were performed as a grab sample randomly and strategically to represent responder exposure. Results: During the event, 1338 responders were surveyed and twenty percent had symptoms of cough, headache, sore throat, nausea and skin irritation. After one-month post-exposure, three percent of responder noted to have continue symptoms. Laboratory tests were performed randomly due to the sheer numbers of responders in action. Only sixty-one samples were collected and sixteen percent had positive metabolites for urine cyanide. Re-sponders with abnormal laboratory result (FBC/LFT/RP/Urine) were interviewed and a repeat sample were performed. Conclusion: The health surveillance of the responder in mass environmental chemical incident is a great challenge when the exposure level is unsure and involve more than one chemicals. Likewise, reliability and validity adopting statistical test for health surveillance instruments is unattainable due to urgency. However, a proper method of occu-pational surveillance need to be devised and implemented to ensure the protection of worker’s health is guaranteed.
Fulltext Counting Footsteps with a Pedometer to Improve HMW Adiponectin and Metabolic Syndrome among Young Female Adults in the United Arab Emirates

Hasan H, Attlee A, Jan Bin Jan Mohamed H, Aris N, Bin Wan Muda WAM

J Obes, 2018;2018:1597840.
PMID: 30631594 DOI: 10.1155/2018/1597840

INTRODUCTION: Physical activity (PA) may improve cardiometabolic fitness and increase high-molecular-weight adiponectin (HMW-Adip). The pedometer is an effective, user-friendly device to monitor PA with the aim of improving health. This study examined how counting footsteps, using a pedometer, might affect HMW-Adip and MetS components among young females.
METHODS: Fifty-two females (21.43 ± 4.8 years) were divided into "normal" (BMI = 18-24.9 kg/m2) and "high" (BMI ≥ 25 kg/m2) BMI groups. Participants wore pedometers throughout the day for nine weeks. Pre-post intervention tests performed on anthropometric, biochemical, and nutrient intake variables were tested at p ≤ 0.05.
RESULTS: Participants walked 7056 ± 1570 footsteps/day without a significant difference between normal (7488.49 ± 1098) and high (6739.18 ± 1793) BMI groups. After week 9, the normal BMI group improved significantly in BMI, body fat mass (BFM), and waist-hip ratio (WHR). Additionally, percent body fat, waist circumference (WC), and visceral fat area also reduced significantly in the high BMI group. A significant decrease in triglycerides (TG) (71.62 ± 29.22 vs. 62.50 ± 29.16 mg/dl, p=0.003) and insulin (21.7 ± 8.33 µU/l vs. 18.64 ± 8.25 µU/l, p=0.046) and increase in HMW-Adip (3.77 ± 0.46 vs. 3.80 ± 0.44 μg/ml, p=0.034) were recorded in the high BMI group. All participants exhibited significant inverse correlations between daily footsteps and BMI (r=-0.33, p=0.017), BFM (r=-0.29, p=0.037), WHR (r=-0.401, p=0.003), and MetS score (r=-0.49, p < 0.001) and positive correlation with HMW-Adip (r=0.331, p=0.017). A positive correlation with systolic (r=0.46, p=0.011) and diastolic (r=0.39, p=0.031) blood pressures and inverse correlation with the MetS score (r=-0.5, p=0.005) were evident in the high BMI group.
CONCLUSION: Counting footsteps using a pedometer is effective in improving MetS components (obesity, TG) and increasing HMW-Adip levels.
Fulltext Association of birth weight with risk of diabetes mellitus in adolescence and early adulthood: analysis of the Indonesian Family Life Survey

Sartika RAD, Sigit FS, Purwanto E, Aris N, Marjan AQ, Putra WKY, et al.

Ann Pediatr Endocrinol Metab, 2023 Dec;28(4):267-274.
PMID: 38173382 DOI: 10.6065/apem.2346146.073

PURPOSE: We aimed to investigate the association of birth weight with the risk of diabetes mellitus in adolescence and early adulthood in the Indonesian population.
METHODS: This study analyzed data from the Indonesian Family Life Survey, a longitudinal study of the Indonesian population with repeated measurements at 3 time points (1997, 2007, and 2014). The subjects observed were children aged 0-59 months in 1997, who were 10-15 years old in 2007, and 17-22 years in 2014. We performed a generalized linear model to investigate the association between birth weight at baseline and the level of hemoglobin A1c (HbA1c) at the 2 follow-up periods. We adjusted the association for the characteristics of the children, parents, and household.
RESULTS: The mean±standard deviation level of HbA1c was 7.35%±0.95% in 2007 and decreased to 5.30%±0.85% in 2014. The crude β (95% confidence interval [CI]) of the association between birth weight and HbA1c was 0.150 (-0.076, 0.377) in 2007 and 0.146 (-0.060, 0.351) in 2014. After adjustment for the sociodemographic characteristics of the children, parents, and confounding factors, the adjusted β (95% CI) was 1.12 (0.40-1.85) in 2007 and 0.92 (0.35-1.48) in 2014. The HbA1c of the parents, father's employment status, percentage of food expenditure, and underweight were the covariates that had significant associations with HbA1c.
CONCLUSION: HbA1c level was higher in adolescence than in early adulthood. Birth weight was associated with HbA1c level in both periods. The HbA1c of the parents, father's employment, percentage of food expenditure, and underweight partly explained the association between birth weight and the HbA1c level.