Displaying publications 1 - 20 of 23 in total

  1. Nanchappan NS, Chopra S, Samuel A, Therumurtei L, Ganapathy SS
    Malays Orthop J, 2021 Jul;15(2):136-142.
    PMID: 34429834 DOI: 10.5704/MOJ.2107.020
    Introduction: Mortality following traumatic femoral neck fractures in the elderly (age >60 years) is influenced by many factors. Addressing some of them may reduce the mortality rate thus improving patient survival and quality of life.

    Materials and methods: This study was a retrospective research using data collected from Hospital Sultanah Bahiyah, Kedah between the years 2008-2018. We measured outcomes such as age, gender, hospital stay, default rate, ambulation post-surgery, American Society of Anaesthesiologists score (ASA) and surgical timing in correlation with mortality rate and 10-year survival of elderly patients treated with Total Hip Arthroplasty for femoral neck fractures in this centre.

    Results: A total of 291 traumatic femoral neck fractures aged above 60 years post total hip arthroplasty performed were included. There was higher number of female (n =233) compared to male (n=53) Estimated 10 years survival from Kaplan Meier was 42.88% (95% CI: 33.15, 52.54). One year mortality rate in our study was found to be 18.9%. The average time to event was 7.1 years (95% CI:33.15, 52.24) with a mean age group of 75.

    Discussion: Total hip arthroplasty patients not ambulating after surgery had a 4.2 times higher hazard ratio compared to ambulators. Those with pre-existing systemic disease (ASA III and IV) were found to have the highest hazard ratio, almost five times that of healthy patients, after adjusting for confounding factors. Delay of more than seven days to surgery was found to be a significant factor in 10-year survival with a hazard ratio of 3.8, compared to surgery performed earlier.

    Conclusion: Delay of more than 7 days to surgery in 10 years survival was significant with high hazard ratio. It is a predictor factor for survival in 10 years. A larger sample size with a prospective design is required to confirm our findings regarding "unacceptable surgical timing" for femoral neck fractures in patients above 60 years of age.

  2. Wong WK, Chan WK, Ganapathy SS, Lim SK
    Semin Dial, 2023 Mar;36(2):107-116.
    PMID: 35821201 DOI: 10.1111/sdi.13117
    BACKGROUND: Metabolic-dysfunction-associated fatty liver disease (MAFLD) and end stage kidney disease (ESKD) are complications of the metabolic syndrome. Our aim is to study the prevalence of MAFLD and advanced liver fibrosis and the associated factors among hemodialysis patients in a multiracial urban population in Malaysia.

    METHODS: A cross-sectional study of hemodialysis patients from 10 hemodialysis centers was used. FibroTouch examination was performed on all patients. Fatty liver was diagnosed based on ultrasound attenuation parameter ≥248 dB/m while advanced liver fibrosis was diagnosed based on liver stiffness measurement ≥10 kPa.

    RESULTS: This study included 447 hemodialysis patients (median age 59 [50-67], male 55%, Chinese 61%, Malay 20%, Indian 18%). Dialysis vintage was 49 (22-93) months. The prevalence of MAFLD was 43.4%. Independent factors associated with MAFLD were elevated waist circumference (aOR = 10.1, 95% CI = 5.3-19.4, p 

  3. Letchumanan M, Anour AA, Ganapathy SS, Harry S, Nik Lah NSH, Arsad N, et al.
    Med J Malaysia, 2021 03;76(2):131-137.
    PMID: 33742618
    OBJECTIVES: To recognize the radiographic patterns of coronavirus disease 2019 (COVID-19) in Malaysia.

    MATERIALS AND METHODS: Chest radiographs of patients confirmed with COVID-19 in Hospital Tawau, Sabah, Malaysia were retrospectively analyzed by two radiologists. The radiographic pattern, distribution among subgroups and evolution of the disease over time were determined.

    RESULTS: Among the 82 patients studied, 65 (79.3%) were males. Mean age of our cohorts was 37 ± 15 years. Baseline chest radiographs were abnormal in 37 patients (45.1%). Over half (52.9%) of the symptomatic patients had abnormal baseline radiograph. Among the children, patients with comorbidities, and patients 60 years of age and above, the abnormal radiographs were 14.3%, 71.4% and 69.3% respectively. Ground glass opacities were the commonest abnormal radiographic feature (35.4%), were peripherally located (35.4%) with predilection for the lower zones (29.3%). Most radiographic abnormalities were multifocal (20.7%) and frequently located in the left lung (19.5%). Radiographic recovery was observed in 15 of 18 patients (83%). Computed tomography (CT) scan demonstrated greater extent of the disease than observed in radiographs of the same patient.

    CONCLUSIONS: COVID-19 pneumonia presented with a specific radiographic pattern in our cohort of patients, comprising of ground glass opacities in peripheral and basilar distribution, affecting a single lung field and was observed in both symptomatic and asymptomatic patients. Chest radiograph is a useful adjunct screening tool, and in combination with clinical and epidemiological assessment may facilitate in early diagnosis of COVID-19 pneumonia.

  4. Sooryanarayana R, Ganapathy SS, Wong NI, Rosman A, Choo WY, Hairi NN
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:85-91.
    PMID: 33370859 DOI: 10.1111/ggi.13989
    AIM: Elder abuse is a significant public health problem. This study aims to estimate its prevalence and associated factors, using representative national Malaysian data.

    METHODS: A nationwide population-based survey involving 3977 community-dwelling older persons aged ≥60 years was conducted via face-to-face interview, of whom 3466 older persons were eligible for screening using a locally validated tool. Elder abuse was defined as any one occurrence of neglect, financial, psychological, physical or sexual abuse perpetrated by someone in a position of trust that was experienced in the past 12 months.

    RESULTS: About 9.0% of older persons in Malaysia have experienced elder abuse in the past 12 months, with neglect being the commonest type experienced (7.5%; 95% confidence interval [CI]: 5.54, 10.07). There is no significant difference by age group and geographical location. Males (adjusted odds ratio [aOR] 1.7; 95% CI: 1.06, 2.60), poorer social support (aOR 5.0; 95% CI: 2.25, 11.22), dependency in activities of daily living (aOR 2.1; 95% CI: 1.23, 3.44) and a previous history of abuse (aOR 10.1; 95% CI: 4.50, 22.86) show higher odds of experiencing elder abuse. Almost 5% of abused older persons reported experiencing multiple types of abuse. Reporting is low at 19.3% with none reporting to healthcare personnel.

    CONCLUSIONS: The prevalence of elder abuse in this study is lower than global estimates, but similar to local studies. Preventive measures and programs are crucial to overcoming elder abuse and need to be carried out at multiple levels - the individual, community, healthcare and other stakeholders. Geriatr Gerontol Int 2020; 20: 85-91.

  5. Cheong SM, Ambak R, Othman F, He FJ, Salleh R, Mohd Sallehudin S, et al.
    J Health Popul Nutr, 2021 05 31;40(Suppl 1):5.
    PMID: 34059162 DOI: 10.1186/s41043-021-00231-4
    BACKGROUND: Excessive intake of sodium is a major public health concern. Information on knowledge, perception, and practice (KPP) related to sodium intake in Malaysia is important for the development of an effective salt reduction strategy. This study aimed to investigate the KPP related to sodium intake among Malaysian adults and to determine associations between KPP and dietary sodium intake.

    METHODS: Data were obtained from Malaysian Community Salt Survey (MyCoSS) which is a nationally representative survey with proportionate stratified cluster sampling design. A pre-tested face-to-face questionnaire was used to collect information on socio-demographic background, and questions from the World Health Organization/Pan American Health Organization were adapted to assess the KPP related to sodium intake. Dietary sodium intake was determined using single 24-h urinary sodium excretion. Respondents were categorized into two categories: normal dietary sodium intake (< 2000 mg) and excessive dietary sodium intake (≥ 2000 mg). Out of 1440 respondents that were selected to participate, 1047 respondents completed the questionnaire and 798 of them provided valid urine samples. Factors associated with excessive dietary sodium intake were analyzed using complex sample logistic regression analysis.

    RESULTS: Majority of the respondents knew that excessive sodium intake could cause health problems (86.2%) and more than half of them (61.8%) perceived that they consume just the right amount of sodium. Overall, complex sample logistic regression analysis revealed that excessive dietary sodium intake was not significantly associated with KPP related to sodium intake among respondents (P > 0.05).

    CONCLUSION: The absence of significant associations between KPP and excessive dietary sodium intake suggests that salt reduction strategies should focus on sodium reduction education includes measuring actual dietary sodium intake and educating the public about the source of sodium. In addition, the relationship between the authority and food industry in food reformulation needs to be strengthened for effective dietary sodium reduction in Malaysia.

  6. Chong CT, Lai WK, Zainuddin AA, Pardi M, Mohd Sallehuddin S, Ganapathy SS
    Asia Pac J Public Health, 2022 Nov;34(8):786-792.
    PMID: 36196901 DOI: 10.1177/10105395221129113
    In 2016, World Health Organization (WHO) estimated more than 650 million obese adults, resulting in a country's health burden. This study aims to determine the prevalence of obesity and its associated factors among Malaysian adults. A total of 5820 respondents, aged 18 to 59 years, from the National Health and Morbidity Survey 2019, were included for the data analysis. The prevalence of obesity was described and multivariate analyses were conducted to determine the factors associated with obesity. The prevalence of obesity among Malaysian adults was 20.1%, based on the findings from this study. Multivariate analyses showed that women, being Malays, Indians, and other Bumiputeras, were significantly associated with a higher risk of obesity. Besides, those diagnosed with diabetes mellitus and hypertension were also significantly associated with greater risk of obesity. This information is crucial for policy makers in formulating effective strategies or targeted programs in preventing obesity among Malaysian adults.
  7. Lau WP, Ng KP, Ganapathy SS, Tah PC, Ismail R, Jalalonmuhali M, et al.
    Transplant Proc, 2022 Feb 03.
    PMID: 35125235 DOI: 10.1016/j.transproceed.2021.12.019
    BACKGROUND: Proteinuria and metabolic acidosis adversely affect long term renal allograft outcome and are highly prevalent in reported studies. The role of dietary intake in influencing proteinuria and metabolic acidosis remained uncertain. This study aims to determine the prevalence rate of proteinuria and metabolic acidosis among kidney transplant recipients (KTRs) and to study their relationship with dietary intake.

    METHODS: We performed a cross-sectional study on KTRs with functioning renal allograft and at least 3 months post transplant. Dietary protein, salt, and dietary acid load were estimated using 24-hour urine collection. Demographic characteristics, concomitant medications, medical history, and laboratory results were obtained from electronic medical records.

    RESULTS: A total of 204 KTRs were recruited with median age of 48 years (interquartile range [IQR], 18 years); male to female ratio was 61:39. A total of 79.9% (n = 163) were living related kidney transplants. The median duration after transplant was 71 months (IQR, 131 months), and median eGFR was 65 mL/min/1.73 m2 (IQR, 25 mL/min/1.73 m2). The prevalence rates of proteinuria (defined as ≥ 0.5 g/d) and metabolic acidosis (defined as at least 2 readings of serum bicarbonate ≤ 22 mmol/L in the past 6 months) were 17.7 % and 6.2%, respectively. High dietary protein of > 1.2 g/kg ideal body weight (adjusted odds ratio, 3.13; 95% CI, 1.35-7.28; P = .008) was significantly associated with proteinuria. Dietary protein, salt, and acid load did not correlate with chronic metabolic acidosis.

    CONCLUSIONS: The prevalence rate of proteinuria is consistent with published literature, but metabolic acidosis rate is extremely low in our cohort. High protein intake (> 1.2 g/kg ideal body weight) is a risk factor of proteinuria and may have negative impact on KTR outcome.

  8. Ganapathy SS, Yi Yi K, Omar MA, Anuar MFM, Jeevananthan C, Rao C
    BMC Public Health, 2017 08 11;17(1):653.
    PMID: 28800758 DOI: 10.1186/s12889-017-4668-y
    BACKGROUND: Mortality statistics by age, sex and cause are the foundation of basic health data required for health status assessment, epidemiological research and formation of health policy. Close to half the deaths in Malaysia occur outside a health facility, are not attended by medical personnel, and are given a lay opinion as to the cause of death, leading to poor quality of data from vital registration. Verbal autopsy (VA) is a very useful tool in diagnosing broad causes of deaths for events that occur outside health facilities. This article reports the development of the VA methods and our principal finding from a validation study.

    METHODS: A cross sectional study on nationally representative sample deaths that occurred in Malaysia during 2013 was used. A VA questionnaire suitable for local use was developed. Trained field interviewers visited the family members of the deceased at their homes and conducted face to face interviews with the next of kin. Completed questionnaires were reviewed by trained physicians who assigned multiple and underlying causes. Reference diagnoses for validation were obtained from review of medical records (MR) available for a sample of the overall study deaths.

    RESULTS: Corresponding MR diagnosis with matched sample of the VA diagnosis were available in 2172 cases for the validation study. Sensitivity scores were good (>75%) for transport accidents and certain cancers. Moderate sensitivity (50% - 75%) was obtained for ischaemic heart disease (64%) and cerebrovascular disease (72%). The validation sample for deaths due to major causes such as ischaemic heart disease, pneumonia, breast cancer and transport accidents show low cause-specific mortality fraction (CSMF) changes. The scores obtained for the top 10 leading site-specific cancers ranged from average to good.

    CONCLUSION: We can conclude that VA is suitable for implementation for deaths outside the health facilities in Malaysia. This would reduce ill-defined mortality causes in vital registration data, and yield more accurate national mortality statistics.

  9. Tan L, Ganapathy SS, Sooryanarayana R, Hasim MH, Saminathan TA, Mohamad Anuar MF, et al.
    Asia Pac J Public Health, 2019 Nov;31(8_suppl):18S-29S.
    PMID: 31470742 DOI: 10.1177/1010539519870665
    This study aimed to assess the prevalence and factors associated with bullying victimization from a nationwide school-based survey among 27 458 students aged 13 to 17 years. The overall prevalence of having been bullied in the past 30 days was 16.2%; this decreased with age. Multivariate logistic regression analysis revealed that factors most strongly associated with bullying victimization were exposure to physical attacks (adjusted odds ratio [aOR] = 2.46, 95% confidence interval [CI] = 2.17-2.79), illicit drug use (aOR = 2.44, 95% CI = 1.78-3.34), involvement in physical fights (aOR = 1.97, 95% CI = 1.74-2.23), being younger than 14 years (aOR =1.95, 95% CI = 1.59-2.38), and having ever attempted suicide (aOR = 1.83, 95% CI = 1.51-2.21). Other significantly associated factors include loneliness, truancy, making suicidal plans, and symptoms of depression, anxiety, and stress. Exposure to bullying victimization can result in negative lifelong sequelae and important associated factors should be considered in planning effective school-based anti-bullying interventions.
  10. Omar A, Ganapathy SS, Anuar MFM, Khoo YY, Jeevananthan C, Maria Awaluddin S, et al.
    BMC Public Health, 2019 Jan 24;19(1):110.
    PMID: 30678685 DOI: 10.1186/s12889-018-6384-7
    BACKGROUND: Mortality indicators are essential for monitoring population health. Although Malaysia has a functional death registration system, the quality of information on causes of death still needs improvement, since approximately 30% of deaths are classified to poorly defined causes. This study was conducted to verify registered causes in a sample of deaths in 2013 and utilise the findings to estimate cause-specific mortality indicators for Malaysia in 2013.

    METHODS: This is a cross-sectional study involving a nationally representative sample of 14,497 deaths distributed across 19 districts. Registered causes of deaths were verified using standard medical record review protocols for hospital deaths, and locally adapted international standard verbal autopsy procedures for deaths outside hospitals. The findings were used to measure the validity and reliability of the registration data, as well as to establish plausible cause-specific mortality fractions for hospital and non-hospital deaths, which were subsequently used as the basis for estimating national cause-specific mortality indicators.

    RESULTS: The overall response rate for the study was 67%. Verified causes of 5041 hospital deaths and 3724 deaths outside hospitals were used to derive national mortality estimates for 2013 by age, sex and cause. The study was able to reclassify most of the ill-defined deaths to a specific cause. The leading causes of deaths for males were Ischaemic Heart Disease (15.4%), Cerebrovascular diseases (13.7%), Chronic Obstructive Pulmonary Disease (8.5%) and Road Traffic Accident (8.0%). Among females, the leading causes were Cerebrovascular diseases (18.3%), Ischaemic Heart Disease (12.7%), Lower Respiratory Infections (11.5%) and Diabetes Mellitus (7.2%).

    CONCLUSIONS: Investigation of registered causes of death using verbal autopsy and medical record review yielded adequate information to enable estimation of cause-specific mortality indicators in Malaysia. Strengthening the national mortality statistics system must be made a priority as it is a core data source for policy and evaluation of the public health and healthcare sectors in Malaysia.
  11. Ramasamy P, Kumarasamy V, Singh ASM, Abu Bakar MZB, Narayanan P, Ganapathy SS, et al.
    Obes Surg, 2021 08;31(8):3749-3757.
    PMID: 34046825 DOI: 10.1007/s11695-021-05492-w
    PURPOSE: The effect of altered subsphincteric gastric volume and pressure after bariatric surgery on laryngopharyngeal reflux (LPR) remains largely unknown. This was a cross-sectional pilot study conducted between January 2018 and January 2019 to identify changes in LPR symptoms and signs in bariatric surgery patients presurgery and postsurgery.

    MATERIALS AND METHODS: Thirty-four patients listed for bariatric surgery in a single tertiary referral center were recruited, where 31 (77.4% female, mean age 46.3 ± 8.9 years) fulfilled the eligibility criteria. Of the eligible patients, 54.8% and 45.2% underwent sleeve gastrectomy (SG) and gastric bypass (GB), respectively. LPR symptoms were assessed using the self-reported reflux symptom index (RSI). Video-recorded endolaryngeal signs were scored using the reflux finding score (RFS) by two blinded otolaryngologists. Patients' presurgical and 3-month postsurgical body mass index (BMI), RSI, and RFS were determined. Patients were deemed as having LPR when RSI > 13 or RFS > 7.

    RESULTS: There was a significant correlation between the postsurgical RSI and RFS changes (Pearson's r = 0.474, p = 0.007). Of the 31 patients, 12.9% (RSI) and 6.4% (RFS) recovered from preexisting LPR, whereas 22.6% (RSI) and 3.2% (RFS) developed new de novo LPR postsurgery. The postsurgical mean RFS change improved significantly in the GB group compared with that of the SG group (p < 0.05).

    CONCLUSION: LPR is best assessed clinically using a multimodal approach (RSI and RFS). Bariatric surgery may worsen or lead to de novo LPR. Recognizing the LPR outcomes in these patients is paramount for optimal voice, speech, and swallowing functions.

  12. Ganapathy SS, Tan L, Sooryanarayana R, Hashim MH, Saminathan TA, Ahmad FH, et al.
    Asia Pac J Public Health, 2019 11;31(8_suppl):38S-47S.
    PMID: 31617372 DOI: 10.1177/1010539519879339
    Body weight is a factor, with body weight perception a mediator, toward being a victim of bullying. This study aimed to explore the association between body weight, body weight perception, and bullying among students 13 to 17 years of age in Malaysia. Data were collected using a self-administered questionnaire. A 2-stage stratified cluster sampling design was used, and 212 schools across Malaysia were selected for this survey. Body weight was measured and body weight perception was the student's reflection of their body weight. The prevalence of being bullied among adolescents in Malaysia was 16.2%. Being too thin or being obese increased the probability of being bullied. Students with a normal body mass index, but with a misperception of their body weight, also had increased odds of being bullied. Obesity prevention, together with instilling positive body weight perception, should be part of all programs directed toward tackling the problem of bullying.
  13. Awaluddin SM, Shahein NA, Che Abdul Rahim N, Mohd Zaki NA, Nasaruddin NH, Saminathan TA, et al.
    PMID: 34682667 DOI: 10.3390/ijerph182010922
    This study aimed to determine the prevalence of anemia and factors associated with anemia among men in Malaysia. The researchers used data from the 2019 National Health and Morbidity Survey (NHMS). The hemoglobin levels of men aged 15 years and above who gave their consent was measured using the HemoCue® Hb 201+ System©. The majority of them (87.2%) were men aged 15-59 years, referred to as the younger age group in this study. The prevalence of anemia among men was 12.6% (95% confidence interval (CI): 10.9, 14.5). The prevalence was higher among older men (30.7%; 95% CI: 26.6, 35.1) than younger men (10.0%; 95% CI: 8.2, 12.2). Anemia among men was associated with older age (adjusted odds ratios (aOR) = 3.1; 95% CI: 2.1, 4.4) and those with diabetes (aOR = 1.5; 95% CI: 1.2, 2.1) via a logistic regression analysis. In conclusion, older men were more affected by anemia than younger men in this study. Anemia among older men in Malaysia is at the level of moderate to severe public health significance. The likelihood of developing anemia is increased among older men with diabetes compared to older men without diabetes. These often-overlooked issues among men need to be detected and treated early in order to prevent complications and improve their quality of life.
  14. Khaw WF, Nasaruddin NH, Alias N, Chan YM, Tan L, Cheong SM, et al.
    Sci Rep, 2022 Oct 04;12(1):16569.
    PMID: 36195767 DOI: 10.1038/s41598-022-20511-1
    This study aimed to investigate the association between socio-demographic factors and designated healthy lifestyle behaviours in a nationally-representative sample of Malaysian adults aged 18 years and above. Secondary data involving 7388 participants aged 18-96 years from the National Health and Morbidity Survey 2019, a national cross-sectional survey, was used in this study. A healthy lifestyle score (0-5 points) was calculated based on five modifiable lifestyle factors: non-smoker, body mass index 
  15. Rodzlan Hasani WS, Robert Lourdes TG, Ganapathy SS, Ab Majid NL, Abd Hamid HA, Mohd Yusoff MF
    PLoS One, 2023;18(1):e0264593.
    PMID: 36649298 DOI: 10.1371/journal.pone.0264593
    INTRODUCTION: Polysubstance use is the use of more than one non-prescribed licit or illicit substance at one time. This is a common phenomenon, but little is known about the severity and the various substances used by adults in Malaysia.

    OBJECTIVE: To determine the pattern of polysubstance use and its associated factors among general adults in Malaysia.

    METHODOLOGY: This was a secondary data analysis from the National Health and Morbidity Survey (NHMS) 2019), a cross-sectional population survey with a two-stage stratified random sampling design. A total of 10,472 Malaysians aged 18 years and above participated in this survey. Polysubstance use was defined as concurrent use of more than one substance, either alcohol, tobacco, or drugs (opioids, marijuana, amphetamine/ methamphetamine or kratom). A latent class analysis (LCA) was used to identify the membership of polysubstance groups. The association of class membership with demographic profiles was examined using Multinomial Logistic Regression analysis.

    RESULTS: Fit indices (AIC = 16458.9, BIC = 16443.6) from LCA supported 3 classes solution: Class 1; "moderate-drug" group primarily combination used of tobacco and alcohol (2.4%), Class 2; "high-drug" group using multiple substance including kratom (0.3%) and Class 3; "low-drug" group reporting minimal alcohol and tobacco use or non-user (97.3%). The multinomial model showed young adults (18-40 years) had a higher likelihood of being polysubstance users both for moderate-drug class (OR = 4.1) and high-drug class (OR = 3.9) compared to older age (≥60 years). Chinese (OR = 18.9), Indian (OR = 23.3), Indigenous Sabah & Sarawak (OR = 34.6) and others ethnicity (OR = 8.9) showed higher odds of being moderate-drug users than Malays. The greater odds of moderate-drug use for males (OR = 35.5), working groups (OR = 1.5) and low education level group (OR = 3.2).

    CONCLUSION: Our study highlights patterns and demographics related to the use of polysubstances among adults in Malaysia. These results would help formulate specific prevention programmes for these high-risk groups.

  16. Ganapathy SS, Sooryanarayana R, Ahmad NA, Jamaluddin R, Abd Razak MA, Tan MP, et al.
    Geriatr Gerontol Int, 2020 Dec;20 Suppl 2:16-20.
    PMID: 33370858 DOI: 10.1111/ggi.14031
    AIM: Dementia is the major cause of disability among older persons and leading physical and psychological sequelae for both the person living with dementia (PLwD) and their caregivers. The aim of this study was to determine the prevalence of dementia in Malaysia and identify the factors influencing quality of life (QoL) of caregivers of PLwD.

    METHODS: A nationwide survey was conducted among individuals aged ≥60 years. Cognition was assessed with the Identification and Intervention for Dementia in Elderly Africans (IDEA) tool. QoL of older caregivers was assessed using the Control, Autonomy, Self-Realization and Pleasure (CASP-19) questionnaire.

    RESULTS: The prevalence of dementia among older adults aged ≥60 years in Malaysia was found to be 8.5%. The prevalence was found to be higher among females, those with no formal education and those in rural areas in Malaysia. The mean QoL of family caregivers of PLwD was significantly lower than the caregivers of older adults without dementia were (P 

  17. Lim KH, Lim HL, Teh CH, Kee CC, Khoo YY, Ganapathy SS, et al.
    Tob Induc Dis, 2017;15:9.
    PMID: 28163668 DOI: 10.1186/s12971-016-0108-5
    BACKGROUND: A multitude of studies have revealed that smoking is a learned behaviour during adolescence and efforts to reduce the incidence of smoking has been identified as long-term measures to curb the smoking menace. The objective of this study was to determine the prevalence as well as the intra and inter-personal factors associated with smoking among upper secondary school students in selected schools in Peninsular Malaysia.

    METHODS: A study was carried out in 2013, which involved a total of 40 secondary schools. They were randomly selected using a two-stage clustering sampling method. Subsequently, all upper secondary school students (aged 16 to 17 years) from each selected school were recruited into the study. Data was collected using a validated standardised questionnaire.

    RESULTS: This study revealed that the prevalence of smoking was 14.6% (95% CI:13.3-15.9), and it was significantly higher among males compared to females (27.9% vs 2.4%, p 

  18. Awaluddin SM, Ahmad FH, Jeevananthan C, Ganapathy SS, Sooryanarayana R, Mohamad Anuar MF, et al.
    Asia Pac J Public Health, 2019 Nov;31(8_suppl):65S-72S.
    PMID: 31522523 DOI: 10.1177/1010539519872662
    Serious injury due to motor vehicle accidents (MVAs) significantly contributes to the adolescents' health status. The objective of this study was to estimate the prevalence of nonfatal injury due to MVAs and its associated factors among Malaysian school-going adolescents. Nationally representative samples were selected via 2-stage stratified cluster sampling. Data was collected using a validated self-administered questionnaire. Logistic regression analysis was conducted to examine the associations between the variables. A total of 1088 out of 27 497 adolescents reported that they had sustained serious injury due to MVAs with a prevalence of 4.1% (95% confidence interval [CI] = 3.7-4.5). Serious injury due to MVAs among adolescents was positively associated with being current cigarette smokers (adjusted odds ratio [aOR] = 2.5; 95% CI = 2.2-2.9), followed by Malay ethnicity (aOR = 2.4; 95% CI = 1.9-3.0), current drug users (aOR = 2.3; 95% CI = 1.9-3.0), boys (aOR = 2.1; 95% CI = 1.8-2.4), Indian ethnicity (aOR = 1.8; 95% CI = 1.2-2.5), and those who were in upper secondary school (aOR = 1.3; 95% CI = 1.2-1.5). Targeted intervention and curbing substance use among boys may reduce the morbidities from MVAs and its resulting complications.
  19. Saminathan TA, Ganapathy SS, Sooryanarayana R, Hasim MHB, Mohd Anuar MF, Ahmad FH, et al.
    Asia Pac J Public Health, 2019 11;31(8_suppl):88S-96S.
    PMID: 31680535 DOI: 10.1177/1010539519883139
    We assessed the current situation of physical abuse among adolescents at home in Malaysia. A total of 27 497 school-going adolescents answered a self-administered questionnaire during the Malaysian National Health and Morbidity Survey 2017. A complex sampling analysis was applied to identify factors associated with physical abuse among adolescents using multivariate logistic regression analysis. The prevalence of physical abuse at home among students was 11.8%. Our result shows that adolescents aged 13 years had significantly higher odds of such abuse, with odds decreasing as the adolescents age. Girls and adolescents from Indian ethnicity (minority ethnic group) had higher odds of such abuse. Other associated factors were mental health problems, substance abuse, and problems at school. Physical abuse among adolescents at home should be countered with appropriate measures.
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