Displaying publications 1 - 20 of 29 in total

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  1. Lim KG, Cheah WK
    Med J Malaysia, 2016 06;71(Suppl 1):20-28.
    PMID: 27801385 MyJurnal
    Seventy-three articles related to metabolic syndrome were found in a search through databases dedicated to indexing all literature with original data involving the Malaysian population between years 2000 and 2015. Metabolic syndrome affects 25 to 40% of adult population of Malaysia with the risk increasing with age. Obese children are also at risk. Indian ethnicity has the highest rates, followed by Malay and chinese. It was found that socioeconomics determinants such as living in urban areas, unemployment, lower income, lower education level and shift workers had higher prevalence of metabolic syndrome. Metabolic syndrome is associated with other medical conditions like cardiovascular diseases, psychiatric disorders, erectile dysfunction, polycystic ovarian syndrome and colorectal cancer. Several biomarkers have been determined to be relevant to our local population but their usage in clinical setting needs further research. Literature into effectiveness of management of metabolic syndrome in Malaysia is lacking and the results were only modest. there are several diagnostic criteria available for metabolic syndrome internationally and their individual significant to our local population is not clear. It also makes it difficult to compare results between studies using different criteria. Finally, we could not identify any local study to look at the health economic burden of metabolic syndrome locally.
  2. Cheah W, Wan Abdul Manan W, Zabidi-Hussin Z, Chang C
    Rural Remote Health, 2009 Jul-Sep;9(3):1155.
    PMID: 19705956
    Historical data have shown that the factors contributing to and underlying malnutrition among children are diverse, multisectoral and include interrelated biological, social, cultural and economic factors. To determine the these factors in a given population an accurate and reliable questionnaire is essential. This article concerns the process of questionnaire development and validation.
  3. Cheah, W. L., Lee, P. Y., Kamarudin, K., Syed Alwi, S. A. R., Albela, H., Lau, E. H., et al.
    MyJurnal
    Introduction: Acute gastroenteritis (AGE) is one of the frequent causes of hospitalization in children under the age of five, particularly in a rural setting. This study was conducted to determine the epidemiology of acute gastroenteritis in indigenous children admitted to a rural district hospital in Sarawak. Methods: A retrospective review of indigenous paediatrics cases of acute gastroenteritis
    admitted to the ward of Serian District Hospital, a rural district hospital in Sarawak, between the years
    2006-2007. The data was collected from the patients’ case notes, obtained with permission from the
    hospital management. Data was entered and analyzed using SPSS version 16. Results: During the study period, 234 indigenous children with acute gastroenteritis were admitted with the highest prevalence in 2006 (53.4%). The findings showed higher prevalence was found in children aged 3 years and below (76.5%) and male (56.4%) The minimum duration of hospital stay is 1 day, and the maximum stay is 5 days. The clinical findings showed that the majority of the cases presented with vomiting, diarrhea, dry mouth and tongue, sunken eye, with the majority (76%) reported having mild dehydration. The most common treatment used is oral rehydration solutions (85.4%), followed by intravenous bolus or drip (82.3%), paracetamol (79%) and antibiotic (36.2%). Peak incidence of admissions was between November to January. About 38.5% of the AGE cases admitted were found to be underweight (weight for- age below -2SD). Conclusion: The findings indicated children aged 3 years and below are the most vulnerable to AGE and malnutrition could be one of the predisposing factors. The peak incidence during the raining season at the end of the year indicated a possible relationship between AGE and seasonal type of virus infection. Prevention in the form of proper hygiene at the household level probably will prove to be useful.
  4. Cheah WL, Majorie Ensayan J, Helmy H, Chang CT
    Malays Fam Physician, 2018;13(1):2-9.
    PMID: 29796204 MyJurnal
    Introduction: The present study aimed to determine the prevalence of hypertension and its association with nutritional status (body mass index, body fat percentage, and visceral fat) among students in a public university in Sarawak, Malaysia.

    Methods: This was a cross-sectional study among undergraduate students aged 18 years old and above. Anthropometric measurements, such as weight, height, body composition, and blood pressure measurements, were collected. Hypertension was defined as equal or more than 140/90 mmHg. Statistical analyses were done using IBM SPSS version 20.

    Results: A total of 354 respondents participated in the study. Mean age for the respondents was 21 years (SD 1.18 years). About 40% of the respondents were overweight or obese. Prevalence of hypertension was 8.2%. Mean systolic blood pressure was 119.1mmHg (SD14.36mmHg), and the mean diastolic blood pressure was 72.6mmHg (SD 9.73mmHg). There is a significant association between male gender (odds ratio =3.519, 95% CI is 1.886-6.566), body fat percentage (odds ratio = 1.944, 95% CI is 1.050-3.601), visceral fat (odds ratio = 2.830, 95% CI is 1.346-5.951), and family history of hypertension (odds ratio= 2.366, 95% CI is 1.334-4.194) and hypertension.

    Conclusion: The prevalence of hypertension was less than 10% and is associated with male gender, body composition, and family history of hypertension.

  5. Ivan Vun JS, Cheah WL, Helmy H
    Malays Fam Physician, 2019;14(2):18-25.
    PMID: 31827731
    Introduction: Caregivers have a high risk of mental health disorders. The quality of patient care is inseparable from the mental health status of caregivers. The objective of this research was to study the mental health status among caregivers of psychiatric patients and its associated factors.

    Method: A cross-sectional study was conducted among 198 caregivers in Kuching from January till July 2014.   The respondents were recruited using systematic sampling and were required to provide information on sociodemographic and environmental factors as well as complete the Hospital Anxiety and Depression Scale (HADS) questionnaire. The data was analysed using the IBM SPSS Statistical Software Version 20.0.

    Results: The prevalence rates of anxiety and depression among caregivers were 32.8% and 27.8%, respectively.  The caregiver's age (OR=0.97, 95% CI = 0.953 - 0.996), the perception of caregiving as an economic burden (OR= 2.70, 95% CI= 1.256 - 5.803) and the dependence of the patient (OR= 2.27, 95% CI= 1.087 - 4.719) were associated with anxiety.  A caregiver who was male (OR= 2.21, 95% CI= 1.143 - 4.262), a caretaker who held the perception that a patient was dependent on them (OR=2.53, 95% CI= 1.203 - 5.337), and a caretaker who lacked stress-coping skills (OR=2.48, 95% CI= 1.030 - 5.973) were found to be significant factors in depression.

    Conclusion: A high prevalence of probable anxiety and depression among caregivers points to the need to screen caregivers. There is a vital need to train healthcare workers to be able to detect early anxiety and depression. Culturally sensitive research should be carried out for different ethnicity, and improving the support system for caregivers is necessary.

  6. Mabel HM, Othman NB, Cheah WK
    Med J Malaysia, 2022 May;77(3):403-405.
    PMID: 35638501
    Pontine infarct is a rare but clinically significant cause of an isolated facial nerve palsy. Prompt diagnosis with the use of magnetic resonance imaging (MRI) allows early initiation of treatment for such patients. We report a 62-year-old gentleman with diabetes, hypertension, and gout, presenting with lower motor neuron facial nerve palsy. This report highlights that isolated facial nerve palsy is not always associated with Bell's palsy, which remains the commonest cause of facial nerve paralysis. A thorough neurological examination and good clinical correlation with the patient's history and physical findings, coupled with the use of facial nerve anatomical knowledge and early employment of MRI, are imperative in clinching the diagnosis.
  7. Cheah WK, Ng KS, Marzilawati AR, Lum LC
    Med J Malaysia, 2014 Aug;69 Suppl A:59-67.
    PMID: 25417953 MyJurnal
    Dengue infection is a major cause of morbidity and mortality in Malaysia. To date, much research on dengue infection conducted in Malaysia have been published. One hundred and sixty six articles related to dengue in Malaysia were found from a search through a database dedicated to indexing all original data relevant to medicine published between the years 2000-2013. Ninety articles with clinical relevance and future research implications were selected and reviewed. These papers showed evidence of an exponential increase in the disease epidemic and a varying pattern of prevalent dengue serotypes at different times. The early febrile phase of dengue infection consist of an undifferentiated fever. Clinical suspicion and ability to identify patients at risk of severe dengue infection is important. Treatment of dengue infection involves judicious use of volume expander and supportive care. Potential future research areas are discussed to narrow our current knowledge gaps on dengue infection.
  8. Chow CH, Cheah W, Tai JH, Liu SF
    Sci Rep, 2019 10 29;9(1):15550.
    PMID: 31664110 DOI: 10.1038/s41598-019-51989-x
    In summer 2010, a massive bloom appeared in the middle (16-25°N, 160-200°E) of the North Pacific Subtropical Gyre (NPSG) creating a spectacular oasis in the middle of the largest oceanic desert on Earth. Peaked in June 2010 covering over two million km2 in space, this phytoplankton bloom is the largest ever recorded by ocean color satellites in the NPSG over the period from 1997 to 2013. The initiation and mechanisms sustaining the massive bloom were due to atmospheric and oceanic anomalies. Over the north (25-30°N) of the bloom, strong anticyclonic winds warmed sea surface temperature (SST) via Ekman convergence. Subsequently, anomalous westward ocean currents were generated by SST meridional gradients between 19°N and 25°N, producing strong velocity shear that caused large number of mesoscale (100-km in order) cyclonic eddies in the bloom region. The ratio of cyclonic to anticyclonic eddies of 2.7 in summer 2010 is the highest over the 16-year study period. As a result of the large eddy-number differences, eddy-eddy interactions were strong and induced submesoscale (smaller than 100 km) vertical pumping as observed in the in-situ ocean profiles. The signature of vertical pumping was also presented in the in-situ measurements of chlorophyll and nutrients, which show higher concentrations in 2010 than other years.
  9. Cheah WL, Edmund Shin CV, Ayu Akida AR
    Malays Fam Physician, 2019;14(1):2-9.
    PMID: 31289625
    Introduction: This study aimed to determine the blood pressure profile for preschool children in Kuching Sarawak and its relationship with sociodemographic characteristics, nutritional status and parental hypertension.

    Methods: This was a cross sectional study conducted in a government preschool in Kuching district from January to June 2017. Data were collected using questionnaire as well as anthropometric and blood pressure measurements. Data were entered into and analyzed using SPSS Version 22.

    Results: A total of 229 preschool children participated in this study (response rate of 81%). About 9.7% of the respondents were at risk for hypertension. The mean systolic blood pressure was 95.6 mmHg (SD=8.36), and the mean diastolic blood pressure was 59.9 mmHg (SD=6.09). Ten percent of the children were overweight and 7.4% were obese. Binary logistics regression analysis indicated that gender (Male: OR = 3.085, p< 0.05), parent's education level (comparing primary education and below with secondary education: OR = 4.88, p<0.05; comparing primary education and below tertiary education: OR = 7.63, p<0.05) and ethnicity (comparing Malay with Chinese: OR = 0.10, p< 0.01) were significantly associated with being at risk for hypertension.

    Conclusion: The study showed that 9.7% of the children were at risk for hypertension and that 17.4% had abnormal body weights. Identifying and tackling the factors leading to these issues will help to improve and ensure a better quality of non-communicable disease programs offered in primary health clinics and school health programs.

  10. Lai YKI, Ting SL, Cheah WL, Sunder R, Jamalia R
    Med J Malaysia, 2019 08;74(4):266-269.
    PMID: 31424031
    OBJECTIVE: To determine the socio-demographic and clinical profile of exotropia surgery outcomes amongst paediatric patients.

    METHODS: This is a descriptive, retrospective, clinical study of surgeries performed between 2014 and 2016 at the Sarawak Heart Centre, Malaysia. Medical records of patients with primary and secondary exotropia were reviewed. The following factors that affected the surgical outcomes were collected: onset age of squint, age at the time of surgery, the interval between diagnosis and surgery, the type of exotropia, visual acuity, presence of amblyopia, previous patching, anisometropia, refractive error, type of surgery, preoperative and postoperative deviation, pre-existing ocular comorbidity and systemic illness.

    RESULT: A total of 15 patients were studied with more than two thirds being females. Seven patients had primary exotropia while eight patients had secondary exotropia. Average interval between diagnosis and surgery was 1.3 years (±0.82) for primary exotropia and 1.2 years (±0.84) for secondary exotropia. Average pre-operative angle for primary exotropia was 50.57PD (±10.83) whereas secondary exotropia was 39.38PD (±8.63). Seven patients had successful surgical outcomes of within 10 prism dioptres, five for primary exotropia and two for secondary exotropia. The response to surgery was 3.0PD/mm (±0.59) for primary exotropia and 2.2PD/mm (±0.74) for secondary exotropia.

    CONCLUSION: In our study, primary exotropia had larger preoperative angle than secondary exotropia. The response to surgery was positively correlated with the preoperative angle of deviation. Primary exotropia showed better surgical outcome.

  11. Lee PY, Cheah Wl, Chang CT, Siti Raudzah G
    Malays J Nutr, 2012 Aug;18(2):207-19.
    PMID: 24575667 MyJurnal
    There is limited data on childhood obesity and its impact on children from diverse cultural backgrounds. This study is aimed at determining the association between obesity, self-esteem and health-related quality of life (HRQOL) among Malaysian urban primary school children of different ethnicity.
  12. Liat LB, Wah LT, Cheah W, Cheah W, Fong YL, Fong YL
    PMID: 1030843
    A survey of Angiostrongylus malaysiensis among wild rodent and molluscan hosts was made in the Tuaran Central Agricultural Research Station and within the vicinity of Tuaran, Sabah. Three of 19 Rattus rattus diardii, one of 2 R. exulans and one R. argentiventer were found naturally infected with the parasite. In this survey 56 of 382 molluscs comprising of Pila scutata, Achatina fulica and two species of land slugs, Laevicaulis alte and Microparmarion malayanus, were found naturally infected with the parasite. Samples of larvae from each of these molluscs were experimentally transferred to laboratory albino rats and adult worms consistent with A. malaysiensis were recovered. Comparison of the rat hosts and the molluscan intermediate hosts of the parasite in Peninsular Malaysia, Sarawak and Sabah was made, and the finding of A. malaysiensis in Tuaran is the first report of the parasite from Sabah. The distribution of the parasite throughout Malaysia is discussed. Observation on the human consumption of the freshwater snail, P. scutata, was made. Although the infection rate of this snail is low compared with other molluscan hosts examined. The importance of this mollusc as a potential source of human infection should not be overlooked. Hospital records for 1974 and 1975 were examined and clinical human angiostrongyliasis was rarely recorded in Sabah.
  13. Cheah WC, Cheong WH, Mahadevan S, Lai KP, Sivanandam S
    Med J Malaysia, 1977 Dec;32(2):103-10.
    PMID: 614475
  14. Cheah WK, Hor CP, Abdul Aziz Z, Looi I
    Med J Malaysia, 2016 Jun;71(Suppl 1):58-69.
    PMID: 27801388
    Over 100 articles related to stroke were found in a search through a database dedicated to indexing all literature with original data involving the Malaysian population between years 2000 and 2014. Stroke is emerging as a major public health problem. The development of the National Stroke Registry in the year 2009 aims to coordinate and improve stroke care, as well as to generate more data on various aspects of stroke in the country. Studies on predictors of survival after strokes have shown potential to improve the overall management of stroke, both during acute event and long term care. Stroke units were shown to be effective locally in stroke outcomes and prevention of stroke-related complications. The limited data looking at direct cost of stroke management suggests that the health economic burden in stroke management may be even higher. Innovative rehabilitation programmes including braincomputer interface technology were studied with encouraging results. Studies in traditional complementary medicine for strokes such as acupuncture, Urut Melayu and herbal medicine were still limited.
  15. Cheah WL, Chang CT, Helmy H, Wan Manan WM
    Malays Fam Physician, 2019;14(3):46-54.
    PMID: 32175040
    Introduction: Physical inactivity is the one of the leading causes of major non-communicable diseases in the world. The aim of this study is to assess the feasibility of an intervention program based on the stages of change, physical activity levels and health profiles of selected overweight and obese adults in Sarawak.

    Methods: This intervention study was carried out using selected overweight and obese adults in Sarawak. A total of 75 participants were placed in the intervention group, and 80 respondents were placed in the control group participated. Respondent-determined weekly aerobic exercise sessions were conducted for six months. The Malay version of the long-form International Physical Activity Questionnaire (IPAQ) and Transtheoretical model of change (TTM) questionnaire were used, together with anthropometric measurements and the collection of venous fasting blood profiles. Data was entered and analyzed using SPSS Version 20.

    Results: The intervention group had significant better stage transitions compared to the control group (p<0.01). They also had significantly lower total cholesterol, although both groups showed significant results (difference= 0.53, p<0.01; difference= 0.38, p=0.01). The respondent-determined intervention program was effective in improving stage transition; however, an intervention of longer duration could provide more conclusive health outcomes.

    Conclusion: Physical activity plays a role in assisting overweight and obese adults to be more active and healthier.

  16. Mallika PS, Aziz S, Goh PP, Lee PY, Cheah WL, Chong MS, et al.
    Med J Malaysia, 2012 Aug;67(4):369-74.
    PMID: 23082443
    This study aims to determine the risk factors associated with diabetic retinopathy (DR) among natives and non-natives Sarawakians who were seen at 3 public hospitals and one health clinic in Sarawak. It is a cross sectional study where data on patients with DM were collected by staff at these healthcare facilities and entered into the web-based Diabetic Eye Registry. Univariate and multivariate analysis was used to determine the association factors for DR. DR was significantly less associated with natives (24.4%) compared to non-native Sarawakians (34.1%) (p < 0.001). The odds of getting DR was higher in patients whose duration of DM was more than 20 years (OR = 2.6), who have renal impairment (OR = 1.7) and non-natives (OR = 1.4).
  17. Chang CJ, Hsu HH, Cheah W, Tseng WL, Jiang LC
    Sci Rep, 2019 04 01;9(1):5421.
    PMID: 30931981 DOI: 10.1038/s41598-019-41889-5
    In addition to monsoon-driven rainfall, the Maritime Continent (MC) is subject to heavy precipitation caused by the Madden-Julian Oscillation (MJO), a tropical convection-coupled circulation that propagates eastward from the Indian to the Pacific Ocean. This study shows that riverine runoff from MJO-driven rainfall in the western MC significantly enhances phytoplankton biomass not only in the coastal regions but as far as the nutrient-poor Banda Sea, located 1,000 km downstream of the riverine source. We present observational estimates of the chlorophyll-a concentration in the Banda Sea increasing by 20% over the winter average within an MJO life cycle. The enhancement of phytoplankton in the central Banda Sea is attributed to two coinciding MJO-triggered mechanisms: enhanced sediment loading and eastward advection of waters with high sediment and chlorophyll concentrations. Our results highlight an unexpected effect of MJO-driven rainfall on the downstream oceanic region. This finding has significant implications for the marine food chain and biogeochemical processes in the MC, given the increasing deforestation rate and projections that global warming will intensify both the frequency and strength of MJO-driven rainfall in the MC.
  18. Chew SH, Looi I, Neoh KK, Ooi J, Cheah WK, Zariah AA
    Med J Malaysia, 2021 Jan;76(1):12-16.
    PMID: 33510102
    BACKGROUND: Thrombolytic therapy with intravenous alteplase is a well-established treatment for acute ischaemic stroke (AIS). However, in Malaysia, treatment prescription is often limited by the availability of neurologists. The objective was to compare the outcomes of acute stroke thrombolysis therapy prescribed by neurologists in the Seberang Jaya Hospital (SJH) and non-neurologists in the Taiping Hospital (TH).

    METHODS: In this cross-sectional study, all AIS patients who received thrombolytic therapy in SJH and TH between January 2012 and September 2019 were included. Clinical data was extracted from admission records. The outcomes assessed were the percentage of patients who achieved excellent functional outcome at 3 months (modified Rankin scale of 0 to 1), rates of symptomatic intracranial haemorrhage (SICH), and mortality.

    RESULTS: A total of 63 AIS patients who received thrombolytic therapy were included, of which 37 patients (58.7%) were treated in SJH. The median NIHSS on admission was 12 in SJH and 11.5 in TH. In all 21.6% of patients from SJH and 30.7% of patients from TH achieved favourable functional outcome at 3 months (p=0.412). There were no significant differences between the two centres in terms of the rates of SICH (10.8% in SJH and 3.8% in TH, p=0.314) and 3-month mortality (24.3% versus 12.5%, p=0.203).

    CONCLUSION: The 3-month functional outcomes and complication rates of stroke thrombolysis in hospitals with or without neurologists are not significantly different. Thus non-neurologist hospitals may be able to provide thrombolysis service to AIS patients safely and effectively.

  19. Tan KC, Chang CT, Cheah WK, Vinayak CR, Chan HK
    Med J Malaysia, 2019 Jun;74(3):215-218.
    PMID: 31256176
    INTRODUCTION: This study was designed to determine the influence of bariatric surgery on changes in the body mass index (BMI), and the control of diabetes, hypertension and dyslipidaemia among obese patients in Malaysia.

    MATERIALS AND METHODS: This was a retrospective cohort study undertaken at a public tertiary care centre in the state of Perak, Malaysia. Information of obese patients who underwent bariatric surgery was obtained from their medical records. The changes in the BMI, HbA1C, systolic and diastolic blood pressure (SBP and DBP), and lipid levels between three months before and after the surgery were assessed.

    RESULTS: The patients (n=106) were mostly Malay (66.0%), had at least one comorbidity (61.3%), and had a mean age of 40.38±11.75 years. Following surgery, the BMI of the patients was found to reduce by 9.78±5.82kg/m2. For the patients who had diabetes (n=24) and hypertension (n=47), their mean HbA1C, SBP and DBP were also shown to reduce significantly by 2.02±2.13%, 17.19±16.97mmHg, and 11.45±12.63mmHg, respectively. Meanwhile, the mean total cholesterol, triglyceride and low-density lipoprotein levels of those who had dyslipidaemia (n=21) were, respectively, lowered by 0.91±1.18mmol/L, 0.69±1.11mmol/L and 0.47±0.52mmol/L.

    CONCLUSION: The findings suggest that in addition to weight reduction, bariatric surgery is helpful in improving the diabetes, hypertension and dyslipidaemia control among obese patients. However, a large-scale trial with a control group is required to verify our findings.

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