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Snoring and breathing pauses during sleep in the Malaysian population

Kamil MA, Teng CL, Hassan SA

Respirology, 2007 May;12(3):375-80.
PMID: 17539841 DOI: 10.1111/j.1440-1843.2007.01030.x

OBJECTIVE: The aim of this study was to determine the prevalence of snoring and breathing pauses during sleep, and to assess associated factors, including morbidity and the impact on daytime functioning, in an adult Malaysian population.
METHODS: A cross-sectional survey of community-dwelling adults aged 30-70 years was conducted. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. Physical examinations were limited to measurements of body habitus and blood pressure.
RESULTS: The sample consisted of 1611 adults (52.9% male). The prevalence of habitual snoring, breathing pauses and excessive daytime sleepiness were 47.3%, 15.2% and 14.8%, respectively. Seven per cent of respondents (8.8% male, 5.1% female) were clinically suspected to have obstructive sleep apnoea syndrome (OSAS). The independent predictors of habitual snoring were older age, Chinese or Indian ethnicity (compared with Malays), smoking, obesity and use of sedatives. Clinically suspected OSAS and habitual snoring were significantly associated with difficulty in getting up in the morning, morning headache, driving and workplace accidents, hypertension, and ischaemic heart disease.
CONCLUSIONS: The prevalence of habitual snoring is high in the Malaysian population. Sleep-related breathing disorders in Malaysian adults are associated with significant morbidity.
Fulltext Hidradenitis Suppurativa in Kuala Lumpur, Malaysia: A 7-Year Retrospective Review

Ahmad Kamil MA, Mohd Affandi A

Dermatol Res Pract, 2018;2018:2017959.
PMID: 29951091 DOI: 10.1155/2018/2017959

Introduction: Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition characterized by inflamed nodules, abscesses, sinus tracts, and scarring, which can occur in any skin containing folliculopilosebaceous units. We aim to identify the demographic and clinical characteristics and treatment modalities in patients with HS.
Methods: A retrospective analysis involving records of patients diagnosed with HS in Hospital Kuala Lumpur from July 2009 to June 2016.
Results: Sixty-two patients were identified, with equal cases involving males and females. Majority of patients were Malays (41.9%), followed by Indians (35.5%), Chinese (17.7%), and other ethnicities (4.8%). Median age at diagnosis was 25 (IQR: 14) years. There is a delay in diagnosis with a median of 24 (IQR: 52) months. Most of the patients had lesions on the axilla (85.5%), followed by groin (33.9%) and gluteal region (29%). Gluteal lesions were more common in males. Nodules (67.7%), sinuses (56.5%), and abscesses (33.9%) were the main clinical features, with 43.5% classified under Hurley stage 2. There was no difference in terms of symptoms and types of lesions among different ethnicities and genders. Majority received systemic antibiotics, more than half had retinoid, and third of the patients had surgical intervention.
Conclusions: A prompt recognition of HS is imperative, to screen for comorbidities and to initiate early treatment to reduce physical and psychological complications.
Fulltext Pain morbidity in primary care - preliminary observations from two different primary care settings

Zailinawati AH, Teng CL, Kamil MA, Achike FI, Koh CN

Med J Malaysia, 2006 Jun;61(2):162-7.
PMID: 16898306 MyJurnal

The prevalence of pain complaints as a reason for patient-doctor encounters in the local primary care setting is unknown. We performed a cross-sectional survey of such encounters in one public primary care clinic (KK) and 17 general practice clinics (GP), from the city of Seremban, Negeri Sembilan, Malaysia. Reasons for visits were recorded by doctors in KK and medical students in GP using a structured questionnaire. Morbidity data was coded using the International Classification of Primary Care (ICPC-2). A total of 2234 encounters were recorded (80.9% from KK, 19.1% from GP). The overall prevalence of pain complaints was 31.9% with a significant difference between the two cohorts (KK 28.7% and GP 45.2%, p<0.001). Musculoskeletal pain complaints were more common in KK than GP (40.9% versus 29.7%, p<0.05). Of the 3 main ethnic groups in Malaysia (Malay, Chinese and Indian) the Indian patients at KK had the highest prevalence of pain complaints and the Chinese at the GP had the lowest. Thus pain was a common complaint in the two different primary care settings studied. Some of the differences observed are probably due to the differences in the healthcare seeking behaviour of patients consulting at these two settings as well as differences in the payment systems.
Fulltext Are Indians and females less tolerant to pain? An observational study using a laboratory pain model

Das Gupta E, Zailinawati AH, Lim AW, Chan JB, Yap SH, Hla YY, et al.

Med J Malaysia, 2009 Jun;64(2):111-3.
PMID: 20058568 MyJurnal

In Malaysia, it is a common belief among health care workers that females and Indians have lower pain threshold. This experience, although based on anecdotal experience in the healthcare setting, does not allow differentiation between pain tolerance, and pain expression. To determine whether there is a difference in the tolerance to pain between the three main ethnic groups, namely the Malays, Chinese and Indians as well as between males and females. This was a prospective study, using a laboratory pain model (ischaemic pain tolerance) to determine the pain tolerance of 152 IMU medical students. The mean age of the students was 21.8 years (range 18-29 years). All of them were unmarried. The median of ischaemic pain tolerance for Malays, Chinese and Indians were 639s, 695s and 613s respectively (p = 0.779). However, statistically significant difference in ischaemic pain tolerance for males and females Indian students were observed. Possible ethnic difference in pain tolerance in casual observation is not verified by this laboratory pain model. Difference in pain tolerance between genders is shown only for Indians.