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Fulltext Racial differences in the fasting lipid profile of healthy Malaysians

Zaraihan S, Azman AB, Tariq AR

Med J Malaysia, 1994 Dec;49(4):355-63.
PMID: 7674971

The fasting lipid profile of a sample of Malays, Chinese and Indians in Peninsular Malaysia was studied to see whether these might explain differences in the rate of coronary heart disease mortality amongst the three ethnic groups. Fifty healthy subjects were studied from each of the three groups. They were matched for age, body mass index, gender and smoking habits, if any. The total cholesterol/HDL-cholesterol ratio and LDL-cholesterol/HDL-cholesterol ratio were found to be statistically higher in the Indians than in the Malays and the Chinese. The differences between the Indians and the Chinese were statistically more significant than the differences between the Indians and the Malays. Our findings may partially explain the higher predisposition of the Indian community in Malaysia to CHD mortality and are consistent with those of other studies performed on Indian communities living outside the Indian subcontinent.
Fulltext Health-related quality of life in patients with knee osteoarthritis attending two primary care clinics in Malaysia: a cross-sectional study

Zakaria ZF, Bakar AA, Hasmoni HM, Rani FA, Kadir SA

Asia Pac Fam Med, 2009 Dec 31;8(1):10.
PMID: 20084190 DOI: 10.1186/1447-056X-8-10

BACKGROUND: Measurement of health-related quality of life (HRQOL) among patients with osteoarthritis (OA) helps the health care provider to understand the impact of the disease in the patients' own perspective and make health services more patient-centered. The main aim of this study was to measure the quality of life among patients with symptomatic knee OA attending primary care clinic. We also aimed to ascertain the association between socio-demographic and medical status of patients with knee OA and their quality of life.
METHODS: A clinic based, cross sectional study using the Short Form-36 (SF-36) questionnaire was conducted in two primary care health clinics in Hulu Langat, Selangor, Malaysia over a period of 8 months. The nurses and medical assistants were involved in recruiting the patients while the family physicians conducted the interview.
RESULTS: A total 151 respondents were recruited. The mean age was 65.6 +/- 10.8 years with females constituted 119 (78.8%) of the patients. The mean duration of knee pain was 4.07 +/- 2.96 years. Half of the patients were overweight and majority, 138 (91.4%), had at least one co-morbidity, the commonest being hypertension. The physical health status showed lower score as compared to mental health component. The domain concerning mental health components showed positive correlation with age. There was a significant negative correlation between age and physical functioning (p < 0.0005) which indicated the deterioration of this domain as patients became older. Male respondents had better scores in most of the QOL dimensions especially in the physical functioning domain (p = 0.03). There was no significant association between QOL with different education levels, employment status and marital status. Patients with higher body mass index (BMI) and existence co-morbidities scored lower in most of the QOL domains.
CONCLUSIONS: This study has shown that patients with knee OA attending primary care clinics have relatively poor quality of life pertaining to the physical health components but less impact was seen on the patients' mental health.
Fulltext A Qualitative Analysis of the Coping Strategies of Female Victimisation After Separation

Yusof MM, Azman A, Singh PSJ, Yahaya M

J Hum Rights Soc Work, 2021 Oct 25.
PMID: 34722858 DOI: 10.1007/s41134-021-00199-5

Victims of high-risk domestic violence in Malaysia return to their husbands if they lack the necessary support to face life challenges, especially after separation. Violence against women is part of the violation of human rights. Therefore, several action strategies are essential to counteract the various pressures of the social injustice they have endured. This qualitative study identifies how victims of domestic violence use coping strategies to face various challenges and pressures after deciding to break up with their spouse. In-depth interviews using purposive sampling and snowball techniques were conducted on 15 female respondents in Penang, Malaysia. Actions including filling in time, positive thinking, seeking formal services assistance, religious approaches, and sharing problems with informal systems successfully reduced the stress and concerns of victims of domestic violence. Enhancing and empowering domestic violence victims about their rights is vital for them to exit the abusive cycle. It is hoped that by understanding their rights as a person, they will be able to resort to better social support systems to overcome their current challenges to better social functioning. Hence, social workers must continuously provide the source of support, including empowering/allowing victims to continuously aware of their rights, which are the most fundamental elements of professional social work practice.
EtOH-LN cryoembedding workflow to minimize freezing artifact in frozen tissues: A pilot study in preparing tissues compatible with mass spectrometry-based spatial proteomics application

Tan YC, Mustangin M, Rosli N, Wan Ahmad Kammal WSE, Md Isa N, Low TY, et al.

Cryobiology, 2024 Mar;114:104843.
PMID: 38158171 DOI: 10.1016/j.cryobiol.2023.104843

Coolant-assisted liquid nitrogen (LN) flash freezing of frozen tissues has been widely adopted to preserve tissue morphology for histopathological annotations in mass spectrometry-based spatial proteomics techniques. However, existing coolants pose health risks upon inhalation and are expensive. To overcome this challenge, we present our pilot study by introducing the EtOH-LN workflow, which demonstrates the feasibility of using 95 % ethanol as a safer and easily accessible alternative to existing coolants for LN-based cryoembedding of frozen tissues. Our study reveals that both the EtOH-LN and LN-only cryoembedding workflows exhibit significantly reduced freezing artifacts compared to cryoembedding in cryostat (p
Fulltext Ocular involvement in acute lymphoblastic leukaemia

Tan AK, Azman A, Hoe TS, Rohana T

Med J Malaysia, 1994 Dec;49(4):409-11.
PMID: 7674978

A six-year-old boy, a known case of acute lymphoblastic leukaemia (ALL) on remission since 1991 presented with leukocoria and poor vision of the left eye for two days' duration. Examination revealed endophthalmitis in the left eye with raised intraocular pressure. Anterior chamber paracentesis with vitreous biopsy confirmed a diagnosis of ocular involvement. Further investigation revealed that he also had bone marrow and central nervous system relapse. Clinical manifestation and treatment modalities of ocular involvement in leukaemia are discussed.
Fulltext Development of an indoor air quality checklist for risk assessment of indoor air pollutants by semiquantitative score in nonindustrial workplaces

Syazwan A, Rafee BM, Hafizan J, Azman A, Nizar A, Izwyn Z, et al.

Risk Manag Healthc Policy, 2012;5:17-23.
PMID: 22570579 DOI: 10.2147/RMHP.S26567

To meet the current diversified health needs in workplaces, especially in nonindustrial workplaces in developing countries, an indoor air quality (IAQ) component of a participatory occupational safety and health survey should be included.
Fulltext Analysis of indoor air pollutants checklist using environmetric technique for health risk assessment of sick building complaint in nonindustrial workplace

Syazwan A, Rafee BM, Juahir H, Azman A, Nizar A, Izwyn Z, et al.

Drug Healthc Patient Saf, 2012;4:107-26.
PMID: 23055779 DOI: 10.2147/DHPS.S33400

To analyze and characterize a multidisciplinary, integrated indoor air quality checklist for evaluating the health risk of building occupants in a nonindustrial workplace setting.
Fulltext Lime juice as a dietary alternative to mist potassium citrate for urine alkalinisation: A prospective, cross-over clinical trial

Sivananthan K, Nagappan P, Md Mansor M, Abdullah U, Azman A

Malays Fam Physician, 2023;18:5.
PMID: 36992952 DOI: 10.51866/oa.216

INTRODUCTION: Urinary citrate is a potent inhibitor of urinary crystallization that is freely filtered in the proximal tubule of the kidney. We aimed to investigate the effect of citrate supplementation with fresh lime juice on the urinary pH and calcium excretion level among healthy individuals compared with that of mist potassium citrate.
METHOD: In this prospective, cross-over single-centre study, 50 healthy medical student volunteers were randomly allocated to two treatment arms. One arm was prescribed with potassium citrate, while the other arm received citrate supplementation with a home preparation of fresh lime juice. The urinary pH and calcium-to-creatinine ratio (uCa/uCr) were measured at baseline and after 7 days of treatment. This was followed by a washout period of 2 weeks, after which each participant crossed over to the other treatment arm, and the urinary measurements were repeated.
RESULTS: Potassium citrate significantly increased the urinary pH among all participants, while fresh lime juice did not. Both fresh lime juice and potassium citrate reduced the uCa/uCr, although this effect was not significant.
CONCLUSION: Fresh lime juice is not as effective as potassium citrate in improving the urinary pH and calcium excretion level of healthy individuals. Therefore, it should be used as an adjunct rather than an alternative to potassium citrate.
Use of traditional and complementary medicine in Malaysia: a baseline study

Siti ZM, Tahir A, Farah AI, Fazlin SM, Sondi S, Azman AH, et al.

Complement Ther Med, 2009 Oct-Dec;17(5-6):292-9.
PMID: 19942109 DOI: 10.1016/j.ctim.2009.04.002

The increasing popularity and use of traditional and complementary medicine (TCAM) in both developed and developing countries, including Malaysia, have raised significant public health policy issues. However, currently, there is a paucity of baseline data on such usage by the Malaysian community.
Barriers to enrolling in voluntary treatment programs in Malaysia: a study of women who use methamphetamine (WWUM)

Singh D, Anandan A, Narayanan S, Athirah Daud NA, Azman A, Vicknasingam B

J Ethn Subst Abuse, 2022 Nov 21.
PMID: 36409777 DOI: 10.1080/15332640.2022.2147116

Women with substance use disorders (SUDs) have been widely reported to face barriers in seeking treatment. We sought to identify barriers that prevented women who use methamphetamine (WWUM) from accessing the decade-old Voluntary Treatment Centers (VTCs) in Malaysia. A total of 153 WWUM who were undergoing rehabilitation for methamphetamine use at a compulsory drug detention center (CDDC) were recruited for this cross-sectional study. Data were collected by canvasing a structured questionnaire through face-to-face meetings. Of the total sample, 131 (86%) were Malays, with a mean age of 32.1 years. The commonly cited treatment barriers were the belief that methamphetamine use was not problematic (42%), not knowing how to seek treatment (38%), feeling embarrassed to seek treatment (33%), the lack of family support (24%), and the long waiting time for enrollment (23%). Logistic analyses indicated that a longer duration of use increased the odds of not acknowledging methamphetamine use as a problem while older participants had lower odds of holding a similar view. A longer duration of use also increased the odds of claiming treatment was not needed but lowered the odds of asserting a lack of confidence in treatment. Furthermore, Malays had higher odds of lacking family support in seeking treatment while being employed lowered the odds of not wanting treatment. Addressing these concerns will hopefully encourage higher participation of WWUM in voluntary treatment programs.
Assessment of knowledge, attitude and practice of food allergies among food handlers in the state of Penang, Malaysia

Shafie AA, Azman AW

Public Health, 2015 Sep;129(9):1278-84.
PMID: 25931434 DOI: 10.1016/j.puhe.2015.03.016

Food handler's knowledge, attitude and practice regarding food allergies are important to prevent debilitating and sometimes fatal reactions. This study aimed to assess their food allergy knowledge, attitude and practice, which could help to maintain the safety and hygiene of food consumed by the public.
Fulltext Tuberculosis Treatment Outcome in Patients with TB-HIV Coinfection in Kuala Lumpur, Malaysia

Selimin DS, Ismail A, Ahmad N, Ismail R, Mohd Azman NF, Azman A

J Trop Med, 2021;2021:9923378.
PMID: 34194511 DOI: 10.1155/2021/9923378

Background: Tuberculosis (TB) is a serious health threat to people living with human immunodeficiency virus (HIV). This study aimed to identify the characteristics, unsuccessful TB treatment rate, and determinants of unsuccessful TB treatment outcome among patients with TB-HIV coinfection in Kuala Lumpur.
Methods: This was a cross-sectional study. The data of all patients with TB-HIV in the federal territory of Kuala Lumpur from 2013 to 2017 were collected and reviewed. The data were retrieved from the national database (TB Information System) at the Kuala Lumpur Health Department from 1 March 2018 to 31 May 2018.
Results: Out of 235 randomly selected patients with TB-HIV, TB treatment outcome was successful in 57.9% (cured and completed treatment) and unsuccessful in 42.1% (died, failed, or lost to follow-up). Patients who did not receive DOTS (directly observed treatment, short course) (adjusted odds ratio: 21.71; 95% confidence interval: 5.36-87.94) and those who received shorter treatment duration of <6 months (aOR: 34.54; 95% CI: 5.97-199.93) had higher odds for unsuccessful TB treatment outcome.
Conclusions: Nearly half of the patients with TB-HIV had unsuccessful TB treatment outcome. Therefore, it is important to ensure that such patients receive DOTS and continuous TB treatment of >6 months. It is crucial to strengthen and widen the coverage of DOTS, especially among high-risk groups, in healthcare settings. Strict follow-up by healthcare providers is needed for patients with TB-HIV to gain treatment adherence and for better rates of successful TB treatment.
Fulltext Validity and reliability of the SF-36: the Malaysian context

Sararaks S, Azman AB, Low LL, Rugayah B, Aziah AM, Hooi LN, et al.

Med J Malaysia, 2005 Jun;60(2):163-79.
PMID: 16114157

Results of construct validity and reliability of the SF-36 are described, based on data from a multi-centre study on asthmatics and a population based survey. Questionnaire refinement was carried out between the two studies. Quality of data was good, with all items having less than 0.5% missing values. Floor and/or ceiling effects were observed for REE, REP, PF and SF. For scaling assumptions, correlations between each items and its hypothesized scale were all above 0.50, except for one item in PF. and for both items in SF. Item discriminant validity was an issue for items in VT, SF and MH scales. Cronbach's as for all scales exceeded the recommended 0.70 level, except for SF. Only one latent dimension was identified in principal component analysis, and only 52-53% of variance accounted for. As expected, PF shows high correlations with the physical component while MH was highly correlated with the mental component. Contrasting findings in the loadings of other scales were observed in the asthma data. Age, disease severity and presence of self-reported handicap/disability significantly affect PF, while MH demonstrates no obvious pattern with declining age. In essence, the Malay version of SF-36 could be used in Malaysia, with its generally acceptable internal consistency and validity. The caveat is in the call for additional domains of importance to Malaysians that is not covered by the instrument, and in the caution to be employed when using and construing the instrument.
Fulltext Quality of life--how do Malaysian asthmatics fare?

Sararaks S, Rugayah B, Azman AB, Karuthan C, Low LL

Med J Malaysia, 2001 Sep;56(3):350-8.
PMID: 11732082

Asthma can place considerable restrictions on the physical, emotional and social aspects of the lives of patients. The assessment of quality of life aims to provide a means of measuring the impact of this disease on patients' lives, from the patients' perspective. A cross sectional multi-centre study was conducted in six government hospitals throughout the country. Self-administered SF-36 was used, and clinical information obtained through interviews and examination. 1612 asthmatics responded. Females constituted 63% of the respondents; mean age was 40.9 years; Malays were the majority ethnic group, while 70.8% had secondary level education and 53.7% were employed. Half had suffered from asthma for at least 13 years, while 46.8% and 23.6% have moderate and severe disease respectively. Quality of life was affected by severity of disease. Asthmatics, had a significantly poorer quality of life than the general US population. Severe asthma disease was associated with a compromised quality of life, similar to that of COPD.
Fulltext Social assistance programs during the COVID-19 pandemic in Bangladesh: Does faith-based approach matters?

Salahuddin AFM, Hossain MI, Ali I, Azman A

Asian Soc Work Policy Rev, 2022 Jun 25.
PMID: 35942155 DOI: 10.1111/aswp.12261

This paper aimed to examine the role of faith-based organizations (FBOs) in the distribution of social assistance (SA) during the COVID-19 pandemic in Bangladesh. The paper adopts a qualitative case-study approach to explore the best practices in the distribution of SA by five (5) organizations including FBOs, governmental organizations (GOs), Non-governmental organizations (NGOs), political groups, and private voluntary groups. In this study, 14 beneficiaries of SA were selected by stratified proportionate random sampling method, and five (5) key personnel were selected purposively based on their experiences in the management of SA distribution. The study found that "no-move, no touch" approach followed by FBOs is more likely to establish human rights and social justice and reduce the transmission of diseases. In contrast to the modern idea, which undermines the faith-based charity, the study proved that faith-based charity is gaining attraction as an effective approach combating global pandemic. The findings of this paper will be useful for policymakers, voluntary service workers, GO, and NGO workers to ensure the distribution of SA in a more productive and disciplined way during and after an emergency like the COVID-19 pandemic.
Fulltext Multi-level basis selection of wavelet packet decomposition tree for heart sound classification

Safara F, Doraisamy S, Azman A, Jantan A, Abdullah Ramaiah AR

Comput Biol Med, 2013 Oct;43(10):1407-14.
PMID: 24034732 DOI: 10.1016/j.compbiomed.2013.06.016

Wavelet packet transform decomposes a signal into a set of orthonormal bases (nodes) and provides opportunities to select an appropriate set of these bases for feature extraction. In this paper, multi-level basis selection (MLBS) is proposed to preserve the most informative bases of a wavelet packet decomposition tree through removing less informative bases by applying three exclusion criteria: frequency range, noise frequency, and energy threshold. MLBS achieved an accuracy of 97.56% for classifying normal heart sound, aortic stenosis, mitral regurgitation, and aortic regurgitation. MLBS is a promising basis selection to be suggested for signals with a small range of frequencies.
Fulltext Wavelet packet entropy for heart murmurs classification

Safara F, Doraisamy S, Azman A, Jantan A, Ranga S

Adv Bioinformatics, 2012;2012:327269.
PMID: 23227043 DOI: 10.1155/2012/327269

Heart murmurs are the first signs of cardiac valve disorders. Several studies have been conducted in recent years to automatically differentiate normal heart sounds, from heart sounds with murmurs using various types of audio features. Entropy was successfully used as a feature to distinguish different heart sounds. In this paper, new entropy was introduced to analyze heart sounds and the feasibility of using this entropy in classification of five types of heart sounds and murmurs was shown. The entropy was previously introduced to analyze mammograms. Four common murmurs were considered including aortic regurgitation, mitral regurgitation, aortic stenosis, and mitral stenosis. Wavelet packet transform was employed for heart sound analysis, and the entropy was calculated for deriving feature vectors. Five types of classification were performed to evaluate the discriminatory power of the generated features. The best results were achieved by BayesNet with 96.94% accuracy. The promising results substantiate the effectiveness of the proposed wavelet packet entropy for heart sounds classification.
Analysis of examinations in curriculum review

Rotem A, Barrand J, Azman A

Med Educ, 1982 Jan;16(1):3-6.
PMID: 7057721

This paper describes the analysis of the written professional examinations administered at the Medical School, Universiti Kebangsaan Malaysia (UKM), during the academic year 1979-80. It is a product of a collaborative activity involving medical teachers and two short-term consultants of the World Health Organization. The examination papers were analysed in order to identify content areas disproportionately emphasized in the examinations; to determine the quality and appropriateness of the examination items used; and to review the extent of continuity and integration across departments and courses. This paper is intended to introduce an approach to curriculum review which is based on analysis of the examination system. The procedures and sample outcomes are described and the implications for curriculum development and evaluation are discussed.
Fulltext Cost analysis of cataract surgery with intraocular lens implantation: a single blind randomised clinical trial comparing extracapsular cataract extraction and phacoemulsification

Rizal AM, Aljunid SM, Normalina M, Hanom AF, Chuah KL, Suzainah Y, et al.

Med J Malaysia, 2003 Aug;58(3):380-6.
PMID: 14750378

A randomised single blinded clinical trial to compare the cost of cataract surgery between extracapsular cataract extraction (ECCE) and phacoemulsification (PEA) was conducted at Hospital Universiti Kebangsaan Malaysia (HUKM) between March and December 2000. A total of 60 patients were included in this study. The cost of a cataract surgery incurred by hospital, patients and households up to two months after discharge were included. The costs of training, loss of patients' income after discharge and intangible costs were excluded. Results showed that the average cost for one ECCE operation is RM1,664.46 (RM1,233.04-RM2,377.64) and for PEA is RM1,978.00 (RM1,557.87-RM3,334.50). During this short period of follow up, it can be concluded that ECCE is significantly cheaper than PEA by an average difference of RM 313.54 per patient (p < 0.001). Cost of equipment and low frequency of PEA technique done in HUKM were the two main reasons for the high unit cost of PEA as compared to ECCE.
Violence and trauma encountered by Rohingya women fleeing to Malaysia: a qualitative study

Rajaratnam S, Azman A

Arch Womens Ment Health, 2023 Nov 25.
PMID: 38006427 DOI: 10.1007/s00737-023-01402-4

Rohingya women are doubly marginalized owing to their ethnicity and gender. Therefore, this study aims to describe the unique experiences of violence faced by Rohingya women who fled Myanmar and Bangladesh to seek asylum in Malaysia before, during, and after their transit. Primary data were collected from 33 participants comprising Rohingya women refugees and asylum seekers, medical social workers, medical officials, volunteer workers/activists, refugee organization officers, and a mental health care provider. Thematic analysis was used to identify the patterns in and relationships between the concepts in the collected data. Rohingya women were exposed to various forms of violence and trauma by various groups of men, including those from their own community, throughout their journey to and in Malaysia. The lack of recognition of refugees and asylum seekers in Malaysia prevents them from having mainstream or legal access to jobs, education, and healthcare, and this predicament compounds their suffering from violence, especially for women and girls. Rohingya women and girls in Malaysia need better access to healthcare, resources, and support to identify and address violence, which has a significant impact on their health.

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