MyMedR

Displaying all 13 publications

Abstract:

Sort:

Fulltext Dengue in Malaysia – A Commentary

Abu Hassan Shaari, Mohamed Sapian Mohamed, Jamalludin Ab Rahman

International Medical Journal Malaysia, 2015;14(1):3-44.
MyJurnal

The incidence of dengue in Malaysia has increased from 15.2 per 100,000 in 1973 to 361.0 per 100,000 population by the year 2014. The same trend was seen in case fatality rates that went up from 0.16% to 0.62% between 2000 to 2013.1,2 More than 60% of the cases were from the Klang Valley region. In Pahang the dengue incidence rates from 2004 to 2014 showed a similar increase from 40.9 to 193.8 per 100,000 population and an increase in case fatality rates from 0.07% to 0.3% too was observed between 2000-2014. Fortunately these figures were below the national average.3
Fulltext Food security status and childhood obesity in Kuantan Pahang

Roselawati Mat Ya, Wan Azdie Mohd Abu Bakar, Aflah Afandi, Jamalludin Ab Rahman, Zalilah Mohd Shariff

International Journal of Allied Health Sciences, 2017;1(2):56-71.
MyJurnal

Food insecurity has become one of the concerning issues in public health. The purpose of this study was to investigate household food security status and its relationship with childhood obesity in Kuantan, Pahang. This comparative cross sectional study was conducted in Kuantan, Pahang among 128 mothers aged 18 to 55 years with the children aged 7 and 13 years. Data on food security status was collected using Radimer/Cornell hunger and food insecurity instrument through telephone survey while children's height and weight as well as socio-demographic data were measured and obtained during schools visits. A total of 23% of the respondents were food secure. However, 77% experienced food insecurity where 52% were household food insecure, 9% women were individual food insecure and 16% fell into the child hunger category. Income (p=0.04), income per capita (p=0.033), household size (p=0.032) and area of living (p=0.001) were the significant risk factors for household food insecurity. The prevalence of overweight and obesity among children were 60.6% in food insecure households which was higher compared to food-secure households (38.4%). However, there were no significant association between childhood obesity and food security status. This study demonstrates that the prevalence of food insecurity and childhood obesity in Kuantan, Pahang is a major concern. The results warrant the need
for further investigation to identify complex interaction between food insecurity and
childhood obesity.
Fulltext Liver Sinusoidal Endothelial Cell (LSEC) isolation following a liver profusion technique

Shahida Saharudin, Norlelawati A. Talib, Nor Zamzila Abdullah, Jamalludin Ab. Rahman, Zunariah Buyong

International Medical Journal Malaysia, 2017;16(11):27-27.
MyJurnal

Liver perfusion has been the standard method to digest and isolate liver
cells including liver sinusoidal endothelial cells (LSEC). Poor cannulating skills through
portal vein results in a waste of animal resource. Familiarization of both liver perfusion
technique and adhering strictly to aseptic technique during cell handling ensure high
cell yield, minimum morphology disruption and cell contamination. We aimed to present
a method of liver perfusion procedure followed by the isolation of LSEC. (Copied from article).
Fulltext Prevalence of undernutrition and its associated factors among under-five Orang Asli children in a selected Orang Asli settlement in Kuantan, Pahang

Karimah Hanim Abd. Aziz, Hafizah Pasi, Jamalludin Ab. Rahman, Razman Mohd. Rus, Hashima R. Nasreen, Farhan Rusl, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):84-84.
MyJurnal

Introduction: Undernutrition among under-five children is a very common issue in Malaysia, especially among the Orang Asli population. Therefore, identifying the prevalence and factors associated with undernutrition will assist in tackling the issue of undernutrition and reducing the morbidity and mortality rate associated with it. Methods: A total of 47 conveniently selected Orang Asli children aged 6 to 59 months from Kampung Paya Bungor, Gambang, Kuantan, Pahang participated in this cross-sectional study. A face-to-face interview was carried out by using the validated Questionnaire for the Study of Malnutrition in Rural Malaysia 2009. The weight and height of the children were measured and plotted on the growth chart. All the data were analyzed using IBM SPSS Statistics Version 24.0. Descriptive statistics was used to describe the background characteristics of the respondents and univariate analyses were used to identify suitable factors to be included in multivariate analysis. Binary logistic regression was done to determine independent factors associated with undernutrition. Results: The overall prevalence of undernutrition was 55.3%. The prevalence of underweight, stunting and wasting was 34.0%, 34.0% and 14.9% respectively. This research also revealed that gender (p=0.042) and family size (p=0.024) was shown to have a statistically significant association with undernutrition. However, there were no significant associations between undernutrition with other factors. Conclusion: The prevalence of undernutrition among under-five Orang Asli children was a concern. It was found that the factors associated with undernutrition were female children and children from small families. Prompt interventions aimed at the Orang Asli community should be done to overcome these problems.
Association Between Severity of Obstructive Sleep Apnea and Number and Sites of Upper Airway Operations With Surgery Complications

Asha'ari ZA, Rahman JA, Mohamed AH, Abdullah K, Leman WI

JAMA Otolaryngol Head Neck Surg, 2017 03 01;143(3):239-246.
PMID: 27893073 DOI: 10.1001/jamaoto.2016.3268

Importance: In patients with obstructive sleep apnea (OSA), operative risks depend on the severity of the underlying OSA and the invasiveness of the surgical procedure.
Objective: To investigate the nature of the associations between the severity of OSA and the number and anatomical sites of upper airway operations with operative complications.
Design, Setting, and Participants: This retrospective study included adult patients diagnosed with OSA (apnea-hypopnea index [AHI], >5) who underwent upper airway surgery at a single tertiary referral hospital between October 1, 2008, and October 1, 2015.
Interventions: All patients underwent single or combination surgery on the nose, palatopharyngeal (tonsils, adenoids, and soft palate), and tongue base as a treatment of OSA.
Main Outcomes and Measures: Pulmonary, surgical, and cardiovascular complications within the first 30 postoperative days were analyzed according to OSA severity and types of upper airway surgery. Logistic regression was used to assess the multivariable association of OSA, age, sex, body mass index, medical comorbidities, and types of upper airway surgery with short-term operative complications.
Results: The study included 95 patients (87 males [91.6%]; 83 were Malay [87.4%]; mean [SD] age, 37.7 [1.6] years) with complete data and follow-up who underwent upper airway surgery to treat OSA. Patients with more severe OSA had greater body mass index (Cohen d, 0.27; 95% CI, -0.28 to 0.82), longer surgical time (Cohen d, 1.57; 95% CI, 0.95-2.15), and older age (Cohen d, 3.06; 95% CI, 2.29-3.77). At least 1 operative complication occurred in 48 of 95 patients (51%). In a multivariable model, the overall complication rate was increased with age and body mass index. Complication rates were not associated with AHI severity, type of procedure performed, and whether the surgery was single or combination surgery. Lowest oxygen desaturation (odds ratio, 1.03; 95% CI, 0.96-1.45; P = .04) and longest apnea duration (odds ratio, 1.03; 95% CI, 0.99-1.08; P = .02) were polysomnographic variables that predict the short-term operative complications.
Conclusions and Relevance: In patients with OSA undergoing upper airway surgery, the severity of OSA as assessed by AHI, and the sites and numbers of concurrent operations performed were not associated with the rate of short-term operative complications.
Fulltext Quality of life of diabetes amputees following major and minor lower limb amputations

Nazri MY, Aminudin CA, Ahmad FS, Mohd Jazlan MA, Jamalludin Ab R, Ramli M

Med J Malaysia, 2019 02;74(1):25-29.
PMID: 30846658

INTRODUCTION: Minor amputation was performed as a salvage procedure because most of the patients were not able to ambulate and become dependent following major amputation. Minor amputation is defined as amputation at the level of ankle joint and below while major amputation is defines by amputation above the ankle joint. The aim of this study was to compare the quality of life among diabetes patients following major and minor amputations.

METHODS: A total of 94 diabetes patients were reviewed six months following amputation. Their walking ability, dependency status and quality of life were evaluated, using the Malay translated version of the Short Form Health Survey 36 (SF-36) questionnaire.

RESULTS: During the follow up only three patients (8.3%) following major amputation were dependant compared to 30 patients (51.7%) following minor amputation. Forty-nine (84.5%) of minor amputation and only 15 (41.7%) of major amputation patients were ambulating independently. Patients with minor amputation have significantly better Physical functioning, Role - physical, General health, Role - emotional, and Mental health score (p<0.001). However, they have worse BP and SF score than those following major amputation (p<0.001). The VT score of both groups were not significantly different.

CONCLUSION: Patients with minor amputation are more independent, ambulatory and had better quality of life than those with major amputation. Despite the risk of persistent infection and amputation stump complication, minor amputation should be attempted in diabetes patients.
Fulltext Predictors of major lower limb amputation among type II diabetic patients admitted for diabetic foot problems

Yusof NM, Rahman JA, Zulkifly AH, Che-Ahmad A, Khalid KA, Sulong AF, et al.

Singapore Med J, 2015 Nov;56(11):626-31.
PMID: 26668408 DOI: 10.11622/smedj.2015172

Introduction: Diabetes mellitus (DM) is the most common cause of amputations in Malaysia. This study aimed to identify the predictive factors for major lower limb amputation among patients with type 2 DM (T2DM) who were admitted to a hospital, in order to reduce its likelihood.
Methods: This cross-sectional study involved 218 patients with T2DM who were admitted to Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, for diabetic foot problems from June 2011 to July 2012. A form was developed to document the patients' profiles, comorbidities, complications, investigations, treatment and clinical outcomes. The predictors for major lower limb amputations were determined using univariate and stepwise logistic regression analysis.
Results: A total of 31 patients underwent major lower limb amputations (25 transtibial, 6 transfemoral). The following factors were found to be associated with the incidence of major lower limb amputations: T2DM duration ≥ 10 years, diabetic neuropathy, diabetic nephropathy, presentation with gangrene, diabetic foot conditions of Wagner grade 4 or 5, and necrotising fasciitis. Patients who underwent major amputations had significantly lower haemoglobin and albumin levels, and higher total white blood cell counts, erythrocyte sedimentation rates, and C-reactive protein, urea and creatinine levels. However, only T2DM duration ≥ 10 years, positive bacterial culture and albumin levels were significant on stepwise logistic regression analysis.
Conclusion: T2DM duration ≥ 10 years, positive bacterial culture and low albumin levels were found to be significant predictive factors for major lower limb amputation among patients with T2DM admitted for diabetic foot problems.
Keywords: amputation; diabetes mellitus; diabetic foot; lower limb; type II.
Impact of parental perinatal depressive and anxiety symptoms trajectories on early parent-infant impaired bonding: a cohort study in east and west coasts of Malaysia

Nasreen HE, Pasi HB, Aris MAM, Rahman JA, Rus RM, Edhborg M

Arch Womens Ment Health, 2022 Apr;25(2):377-387.
PMID: 34313824 DOI: 10.1007/s00737-021-01165-w

The association between maternal depressive and anxiety symptoms and impaired bonding with infants were widely studied, but not in fathers and none in Malaysia. We investigated the impact of different trajectories of perinatal depressive and anxiety symptoms on parent-infant impaired bonding during 2-3 months postpartum in both mothers and fathers in two areas of Malaysia. This study originated from a psychiatric morbidity cohort study carried out in health clinics in east and west Malaysia. Edinburgh Postnatal Depression Scale and anxiety subscale of Depression, Anxiety, and Stress Scale at late pregnancy and 2-3 months postpartum and Postpartum Bonding Questionnaire were completed by 566 mothers and 457 fathers. About 11.7% mothers and 16.1% fathers reported depressive symptoms during pregnancy, 6.5% mothers and 10.5% fathers during 2-3 months postpartum, and 3-4% mothers and fathers both depressive and anxiety symptoms 2-3 months postpartum. The mean impaired bonding score was highest in mothers and fathers who had both depressive and anxiety symptoms 2-3 months postpartum. Impaired bonding is associated with higher EPDS and DASS (anxiety subscale) scores 2-3 months postpartum in both parents. Physical partner violence and deteriorated marital relationship were associated with increased risk of impaired bonding in mothers. The association between depressive, anxiety, and comorbidity of depressive and anxiety symptoms in both mothers and fathers and parent-infant impaired bonding during 2-3 months postpartum urges for screening and treatment of depressive and anxiety symptoms in both parents during early parenthood.
Fulltext Impact of maternal antepartum depressive and anxiety symptoms on birth outcomes and mode of delivery: a prospective cohort study in east and west coasts of Malaysia

Nasreen HE, Pasi HB, Rifin SM, Aris MAM, Rahman JA, Rus RM, et al.

BMC Pregnancy Childbirth, 2019 Jun 14;19(1):201.
PMID: 31200677 DOI: 10.1186/s12884-019-2349-9

BACKGROUND: Antepartum depressive and anxiety symptoms (ADS and AAS) are prevalent in Malaysia. Prior evidence linking maternal ADS and AAS with adverse birth outcomes and caesarean section (CS) or instrumental delivery is conflicting. There is no research in Malaysia on the association between maternal mental disorders and adverse birth outcomes and mode of delivery. This study aims to investigate the independent effect of maternal ADS and AAS on low birth weight (LBW), preterm birth (PTB) and CS or instrumental delivery among women in east and west coasts of Malaysia.
METHODS: We used data from a prospective cohort study of 799 pregnant women from health clinics of two states in east and west coasts of Malaysia. Baseline data were measured at the third trimester of pregnancy on ADS, AAS, socioeconomic condition, anthropometric status, reproductive history and intimate partner violence. Birth outcomes and mode of delivery were determined at the time of delivery. Univariate and multiple Cox's regressions were applied to assess the association between ADS and AAS and LBW, PTB and CS or instrumental delivery.
RESULTS: ADS was significantly associated with an increased risk of giving birth to LBW babies in both east coast (RR = 3.64; 95% CI 1.79-7.40) and west coast (RR = 3.82; 95% CI 1.86-7.84), but not with PTB. AAS was associated with increased risk of both LBW (RR = 2.47; 95% CI 1.39-4.38) and PTB (RR = 2.49; 95% CI 1.16-5.36) in the east coast, but not in west coast. The risk of CS or instrumental delivery was evident among women with ADS (RR = 2.44; 95% CI 1.48-4.03) in west coast only.
CONCLUSION: ADS predicts LBW in both coasts, AAS predicts LBW and PTB in east coast, and ADS predicts CS or instrumental delivery in west coast. Policies aimed at detection and management of ADS and AAS during antenatal check-up in health clinics may help improve birth outcomes and reduce obstetric interventions.
Fulltext Prevalence and determinants of antepartum depressive and anxiety symptoms in expectant mothers and fathers: results from a perinatal psychiatric morbidity cohort study in the east and west coasts of Malaysia

Nasreen HE, Rahman JA, Rus RM, Kartiwi M, Sutan R, Edhborg M

BMC Psychiatry, 2018 06 15;18(1):195.
PMID: 29902985 DOI: 10.1186/s12888-018-1781-0

BACKGROUND: Research on antepartum psychiatric morbidities investigating depressive and anxiety symptoms in expectant mothers and fathers is lacking in low- and middle-income countries. This study aimed to estimate the prevalence of antepartum depressive, anxiety and co-occurring significant symptoms and explore the associated factors in a cross-section of Malaysian expectant mothers and fathers.

METHODS: We used cross-sectional data from a prospective cohort study of 911 expectant mothers and 587 expectant fathers during their third trimester of pregnancy, from health clinics of two states in the east and west coasts of Malaysia. The validated Malay version of Edinburgh Postnatal Depression Scale and the anxiety sub-scale of Depression, Anxiety and Stress Scale were used to measure the depressive and anxiety symptoms. Multiple logistic regression analyses identified the determinants of antepartum depressive and anxiety symptoms (ADS and AAS).

RESULTS: Prevalence of ADS was 12.2% in expectant mothers and 8.4% in expectant fathers, while AAS was 28.8% in expectant mothers and 13.3% in expectant fathers, and co-occurring significant symptoms was 8.0% in expectant mothers and 4.0% in expectant fathers. Expectant mothers and fathers having perceived social/family support were less likely to suffer from ADS. Intimate partner violence, poor relationship with husbands, depression in earlier pregnancy and husband's depression in current pregnancy in expectant mothers, and living in rented house, sex preference for the unborn child, stressful life events and wife's depression in current pregnancy in expectant fathers were associated with a greater likelihood of ADS. The determinants for AAS were living in rented house and with parents/in-laws, poor relationship with husbands, restrictions during pregnancy and stressful life events for expectant mothers, and stressful life events and being unsupportive towards wives in household chores for expectant fathers.

CONCLUSION: Both ADS and AAS are prevalent in expectant mothers and fathers, and largely an undetected problem in Malaysia. Administration of couple-based screening and referral program during antenatal check-up should be universal practices to identify and treat the psychiatric morbidities.
Fulltext Leucocytic DNA Methylation of Interleukin-6 Promoter Reduction in Pre-Hypertensive Young Adults

Omar WFNW, Abdullah A, Talib NA, Shah ASM, Rahman JA

Malays J Med Sci, 2019 Nov;26(6):46-54.
PMID: 31908586 MyJurnal DOI: 10.21315/mjms2019.26.6.5

Background: Pre-hypertension is associated with increased risk of cardiovascular disease. Chronic inflammation plays an important role in the pathophysiology of essential hypertension, with epigenetic dysregulation involvement. Nevertheless, the role of DNA methylation in prehypertensive state is unknown. The aim of this study was to investigate the association between DNA methylation level of interleukin-6 (IL-6) promoter in pre-hypertensive (PreHT) and normotensive (NT) young adults.
Methods: A total of 80 NT and 80 PreHT healthy subjects aged between 18-45 years were recruited in Kuantan, Pahang, Malaysia using an observational cross-sectional study approach. DNA methylation level of IL-6 promoter in peripheral leukocytes were measured using bisulphite conversion and MethyLight assay.
Results: There was no significant difference in age between NT and PreHT (P = 0.655). The mean blood pressure was 110(8)/73(5) mmHg in NT and 125(7)/82(5) mmHg in PreHT subjects. The IL-6 promoter methylation level was significantly lower in PreHT compared to NT subjects (P < 0.001).
Conclusion: The current study demonstrates that hypomethylation of IL-6 promoter was associated with pre-hypertension in young adults. Thus, IL-6 methylation could be used as an early indicator for predicting hypertension and related risk of cardiovascular diseases in prehypertensive subjects. Gene expression and longitudinal studies are warranted to examine the methylation effect on IL-6 expression over time.
Randomized clinical trial comparing helmet continuous positive airway pressure (hCPAP) to facemask continuous positive airway pressure (fCPAP) for the treatment of acute respiratory failure in the emergency department

Adi O, Via G, Salleh SH, Chuan TW, Rahman JA, Muhammad NAN, et al.

Am J Emerg Med, 2021 Nov;49:385-392.
PMID: 34271286 DOI: 10.1016/j.ajem.2021.06.031

STUDY OBJECTIVE: To determine whether non-invasive ventilation (NIV) delivered by helmet continuous positive airway pressure (hCPAP) is non-inferior to facemask continuous positive airway pressure (fCPAP) in patients with acute respiratory failure in the emergency department (ED).
METHODS: Non-inferiority randomized, clinical trial involving patients presenting with acute respiratory failure conducted in the ED of a local hospital. Participants were randomly allocated to receive either hCPAP or fCPAP as per the trial protocol. The primary endpoint was respiratory rate reduction. Secondary endpoints included discomfort, improvement in Dyspnea and Likert scales, heart rate reduction, arterial blood oxygenation, partial pressure of carbon dioxide (PaCO2), dryness of mucosa and intubation rate.
RESULTS: 224 patients were included and randomized (113 patients to hCPAP, 111 to fCPAP). Both techniques reduced respiratory rate (hCPAP: from 33.56 ± 3.07 to 25.43 ± 3.11 bpm and fCPAP: from 33.46 ± 3.35 to 27.01 ± 3.19 bpm), heart rate (hCPAP: from 114.76 ± 15.5 to 96.17 ± 16.50 bpm and fCPAP: from 115.07 ± 14.13 to 101.19 ± 16.92 bpm), and improved dyspnea measured by both the Visual Analogue Scale (hCPAP: from 16.36 ± 12.13 to 83.72 ± 12.91 and fCPAP: from 16.01 ± 11.76 to 76.62 ± 13.91) and the Likert scale. Both CPAP techniques improved arterial oxygenation (PaO2 from 67.72 ± 8.06 mmHg to 166.38 ± 30.17 mmHg in hCPAP and 68.99 ± 7.68 mmHg to 184.49 ± 36.38 mmHg in fCPAP) and the PaO2:FiO2 (Partial pressure of arterial oxygen: Fraction of inspired oxygen) ratio from 113.6 ± 13.4 to 273.4 ± 49.5 in hCPAP and 115.0 ± 12.9 to 307.7 ± 60.9 in fCPAP. The intubation rate was lower with hCPAP (4.4% for hCPAP versus 18% for fCPAP, absolute difference -13.6%, p = 0.003). Discomfort and dryness of mucosa were also lower with hCPAP.
CONCLUSION: In patients presenting to the ED with acute cardiogenic pulmonary edema or decompensated COPD, hCPAP was non-inferior to fCPAP and resulted in greater comfort levels and lower intubation rate.
Fulltext Nutritional status of children below five years in Malaysia: Anthropometric analyses from the Third National Health and Morbidity Survey III (NHMS, 2006)

Khor GL, Noor Safiza MN, Jamalludin AB, Jamaiyah H, Geeta A, Kee CC, et al.

Malays J Nutr, 2009 Sep;15(2):121-36.
PMID: 22691811 MyJurnal

The Third National Health and Morbidity Survey (NHMS III) was conducted in 2006 on a nationally representative sample of population in Malaysia. Over 21,000 children aged 0-17.9 years were measured for body weight and stature according to the protocol of the World Health Organization. This article describes the nutritional status of children aged 0-59.9 months. Mean z score for weightfor-age (WAZ), height-for-age (HAZ) and BMI-for-age were compared with the z-scores tables of the WHO standards. The overall prevalence of underweight and stunting of the children were 12.9% and 17.2% respectively. These levels included 2.4% severe underweight and 6.0% severe stunting. In terms of z scores, the age group of 0-5.9 months showed the best nutritional status with mean WAZ of -0.33 (95%CI: -0.52, 0.15) and -0.40 (-0.57, 0.24) for boys and girls respectively, while mean HAZ was 0.64 (0.38, 0.89) for boys and 0.76 (0.54, 0.98) for girls. Mean HAZ and WAZ status was least satisfactory after about 6 months, suggesting a faltering in growth rate at an age that coincides with dependence on complementary feeding. Prevalence of overweight based on BMI-for-age for the sexes combined was 6.4%, while that based on WAZ was 3.4%. The NHMS III results indicate that Malaysian children have better nutritional status compared to children under 5 years in neighbouring countries. In order to meet the targets set in the National Plan of Nutrition (2006-2015), more effective intervention programmes are needed to accelerate the reduction of underweight and stunting, and to arrest the rise of overweight in young children.
Study name: National Health and Morbidity Survey (NHMS-2006)

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links