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Fulltext Self-perceived anxiety symptoms and its associated factors among type 2 diabetic patients in rural communities of Malaysia

Nikmat AW, Fadzil MA, Idris S

Journal of Clinical and Health Sciences, 2016;1(2):11-17.

Introduction: Little is known about anxiety symptoms among diabetic patients, especially among those who are living in rural areas in Malaysia. Thus, the aim of this paper is to investigate the prevalence of anxiety among diabetic patients and factors associated with anxiety in rural communities in Malaysia.
Methods: A cross-sectional study involving 464 diabetes mellitus patients in rural health districts and outpatient clinics in Malaysia was conducted. Each participant was interviewed using the Hospital Anxiety and Depression Scale.
Results: Respondents consisted of 193 (41.6%) males and 271 (58.4%) females. The mean age of participants was 59.65 ± 10.16 years and the mean duration of diabetes mellitus was 6.9 ± 6.3 years. Results indicate that 15% of the participants have anxiety symptoms. Multiple logistic regression analysis revealed that patients with history of ischemic heart disease and depression and those who were underweight have higher anxiety scores with adjusted OR 5.06 (95% CI 1.79 to 14.27), 27.71 (95% CI 14.23 to 53.98) and 14.6 (95% CI 2.49 to 84.82), respectively.
Conclusions: This study suggests that although the prevalence of anxiety among diabetics is low, primary care physician should be trained to identify high risk patients and to manage their condition in order to improve the clinical outcome.
Fulltext Investigative Analysis of Automatic Mode Detection for a Lubricant Base Oil Production Plant Using PCA and Machine-Learning Models

Mohd Fadzil MA, Razali AA, Zabiri H, Che Hussin AH

ACS Omega, 2024 Jan 23;9(3):3525-3540.
PMID: 38284063 DOI: 10.1021/acsomega.3c07331

Lubricants are important fluids and are commonly used to suppress friction between two metallic surfaces and as a medium for heat transportation. In an industrial plant considered in this study, the base oil mode changes can only be detected based on the kinematic viscosity values obtained using lab analysis. Since the lab analysis data are only available every 8 h, detecting the change in the production modes for 4, 6, and 10 cSt and the transitions among them are significantly delayed, causing unnecessary off-spec products that have to be directed to the slopping tank. In this paper, the innovativeness of the work comes from the idea of trying to unravel the underlying pattern of the plant data that correlate to the changes in the base oil modes and using that to classify hourly the kinematic viscosity values. Hence, a novel industrial application is presented to predict the class of base oil mode change on an hourly basis that can significantly reduce the losses in terms of off spec products and sloping tank wastes. The modes are segregated into three classes based on the values of kinematic viscosity. The classes are C-1 (4 cSt), C-2 (6 cSt), and C-3 (10 cSt). Anything in between the stipulated thresholds is called transition [T-12 (C-1 to C-2), T-21(C-2 to C-1), T-23 (C-2 to C-3), T-31 (C-3 to C-1), and T-32 (C-3 to C-2)]. To unravel the pattern, principal component analysis (PCA) is utilized on 42,000 operating plant data. After a thorough analysis, the third principal component provides the highest correlation to the eight classes of the base oil mode changes [C-1 (4 cSt), C-2 (6 cSt), and C-3 (10 cSt) and the transitions T-12 (C-1 to C-2), T-21(C-2 to C-1), T-23 (C-2 to C-3), T-31 (C-3 to C-1), and T-32 (C-3 to C-2)]. This third principal component is then utilized together with plant process variable values as inputs to four machine learning models, namely, XGBOOST, Random Forest, and CatBoost algorithms to predict the mode of the base oil hourly. The overall comparison analysis shows that utilizing the XGBoost algorithm for the prediction of the eight classes of the base oil modes at a faster hourly rate results in the most consistent classification accuracy of 92.96% for the test set and 89.22% in the deployment set. This capability to predict the mode change in the hourly basis can significantly reduce the losses in terms of off spec products in the production line.
Factors associated with anxiety among elderly hypertensive in primary care setting

Ismail Z, Mohamad M, Isa MR, Fadzil MA, Yassin SM, Ma KT, et al.

J Ment Health, 2015 Feb;24(1):29-32.
PMID: 25358109 DOI: 10.3109/09638237.2014.971148

BACKGROUND: There is increasing evidence showing that anxiety is associated with morbidity in the older age group. Factors contributing to anxiety may vary among different diseases and settings.
AIMS: The aim of this study was to determine the factors associated with anxiety symptoms among elderly hypertensive at the primary care level.
METHODS: A cross-sectional study and face-to-face interviews using Hospital Anxiety and Depression Scale (HADS) were conducted among elderly hypertensive.
RESULTS: The mean (SD) age of subjects was 68.8 (6.76) years and comprised of 49.5% and 50.5% of males and females, respectively. The majority of respondents were Malays (76.1%), followed by Chinese (14.3%), and Indians (9.5%). The mean (SD) duration of hypertension was 8.44 (7.29) years and the prevalence of anxiety symptoms was 13.3% (95% CI: 9.9, 16.7). Multiple logistic regression analysis showed that elderly hypertensive with a past history of stroke (adjusted OR: 4.472; 95% CI: 1.754, 11.405; p = 0.002) and depression (adjusted OR: 3.715; 95% CI: 2.009, 6.872; p
Socio-demographic and psychosocial correlates of erectile dysfunction among hypertensive patients

Fadzil MA, Sidi H, Ismail Z, Hassan MR, Thuzar K, Midin M, et al.

Compr Psychiatry, 2014 Jan;55 Suppl 1:S23-8.
PMID: 23453753 DOI: 10.1016/j.comppsych.2012.12.024

OBJECTIVE:
The main aim of the study was to estimate the prevalence of ED and the associated socio-demographic and psychological correlates among hypertensive patients from a rural multiethnic community in Malaysia.

METHODS:
A cross-sectional study was conducted among hypertensive patients attending rural primary care clinics. The socio-demographic, health characteristics, erectile function and levels of depression, anxiety and stress were recorded and analysed. The International Index of ErectileFunction-5 (IIEF-5) questionnaire and the Depression, Anxiety and Stress Scale (DASS-21) were used to assess erectile function and the levels of depression, anxiety and stress, respectively.

RESULTS:
A total of 253 hypertensive patients comprising 178 (70.4%) Malays, 56 (22.1%) Chinese and 18 (7.5%) Indians participated. The mean age of participants was 59.8 ± 10.62 years. Overall, the prevalence rate of ED was 62%: 90 (35%) with moderate and 69 (27%) with severe ED. The prevalence rate of ED among those aged 65 years or older (83.1%) was significantly higher than those less than 65 years (51.8%), (p<0.001). Higher prevalence rates were also noted among the Chinese (78.6%) compared to Malays (59.6%) and Indians (50%) (p=0.021); lower education level (69.1%) (p=0.026), among hypertensive patients with concomitant diabetes mellitus (70.6%) (p=0.026) and WHR ≥ 0.9 (31.3%) (p=0.021). However, no significant association was found between depression, anxiety and stress scores with IIEF-5 score.

CONCLUSION:
The prevalence rate of ED among Malaysian hypertensive patients is high. The rate increases significantly with age, Chinese ethnicity, concomitant diabetes mellitus, lower education level, WHR and the number of pack years of smoking. ED should be properly recognized and managed in hypertensive patients.
Support for a Campus Tobacco-Free Policy among Non- Smokers: Findings from a Developing Country

Yasin SM, Isa MR, Fadzil MA, Zamhuri MI, Selamat MI, Mat Ruzlin AN, et al.

Asian Pac J Cancer Prev, 2016;17(1):275-80.
PMID: 26838223

BACKGROUND: A tobacco-free workplace policy is identified as an effective means to reduce tobacco use and protect people from second-hand smoke; however, the number of tobacco-free policies (TFP) remains very low in workplaces in Malaysia. This study explored the factors affecting support for a tobacco-free policy on two healthcare campuses in Malaysia, prior to the implementation of TFP.
MATERIALS AND METHODS: This cross- sectional study was conducted among 286 non-smokers from two healthcare training centres and two nearby colleges in Malaysia from January 2015 to April 2015. A standardized questionnaire was administered via staff and student emails. The questionnaire collected information on sociodemographic characteristics, support for a tobacco-free policy and perceived respiratory and sensory symptoms due to tobacco exposure. Bivariate and multivariate logistic regression analyses were performed to estimate the independent effects of supporting a tobacco-free campus.
RESULTS: The percentage of individuals supporting completely tobacco-free facilities was 83.2% (N=238), as opposed to 16.7% (N=48) in support of partially tobacco-free facilities. Compared to the supporters of partially tobacco-free facilities, non-smokers who supported completely tobacco-free health facilities were more likely to be female, have higher education levels, to be very concerned about the effects of other people smoking on their health and to perceive a tobacco-free policy as very important. In addition, they perceived that tobacco smoke bothered them at work by causing headaches and coughs and, in the past 4 weeks, had experienced difficulty breathing. In the multivariate model, after adjusting for sociodemographic characteristics and other factors, only experiencing coughs and headaches increased the odds of supporting a completely tobacco-free campus, up to 2.5- and 1.9-fold, respectively.
CONCLUSIONS: Coughs and headaches due to other people smoking at work enhances support for a completely tobacco-free campus among non-smokers.
Fulltext Relationship between coping styles and lipid profile among public university staff

Ariaratnam S, Krishnapillai AD, Daher AM, Fadzil MA, Razali S, Omar SA, et al.

Lipids Health Dis, 2017 Feb 28;16(1):50.
PMID: 28245847 DOI: 10.1186/s12944-017-0438-1

BACKGROUND: The scarcity of data about coping styles with a biochemical marker namely lipid profile, potentially associated with cardiovascular risk factors is most striking among professionals working in public university. Hence, this research aimed to investigate the relationship between coping styles and lipid profile comprising total cholesterol (TC), triglyceride (TG), HDL-cholesterol (high density lipoprotein-cholesterol) and LDL-cholesterol (Low density lipoprotein-cholesterol) among this group of professionals.
METHODS: A cross sectional survey was conducted among staff from a tertiary education centre. Subjects were contacted to ascertain their medical history. A total of 320 subjects were interviewed and 195 subjects were eligible and subsequently recruited on a suitable date for taking blood and administration of the questionnaires. The subjects completed questionnaires pertaining to demographic details and coping styles. Pearson's correlation coefficient was used to measure the strength of association between lipid profile and coping styles.
RESULTS: Majority of the subjects were non-academic staff (60.0%), female (67.2%), Malay (91.8%), married (52.3%) and educated until Diploma level (34.9%). Academic staff scored significantly higher mean scores in task-oriented coping styles (Mean = 64.12). Non-academic staff scored significantly higher mean scores in emotion (Mean = 48.05) and avoidance-oriented coping styles (Mean = 57.61). Malay subjects had significantly higher mean scores in emotion (Mean = 47.14) and avoidance-oriented coping styles (Mean = 55.23). Non-malay subjects (Mean = 66.00) attained significantly higher mean scores in task-oriented coping styles. Single/divorced/widowed individuals scored significantly higher mean scores in emotion (Mean = 48.13) and avoidance-oriented coping styles (Mean = 56.86). There was a significant negative correlation between TC (r = -0.162) and LDL (r = -0.168) with avoidance-oriented coping styles (p = 0.023, p = 0.019 respectively).
CONCLUSION: Avoidance-oriented coping style was more likely to engender favourable lipid profile. Hence, assessment of coping styles would certainly assist health care practitioners in predicting subjects who would be at a greater risk of developing cardiovascular diseases.