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The prevalence of Dysphagia among head and neck cancer patients in tertiary public hospitals in Malaysia

Husmeela H, Kartini A, Zakinah Y, Sharifa Ezat WP, Hasherah MI

Med J Malaysia, 2021 Nov;76(6):837-844.
PMID: 34806670

INTRODUCTION: Dysphagia is the most common problem among head and neck cancer patients. It can occur before, during, and/or after cancer treatment due to cancer growth or side effects from cancer treatment. To date, the data on the prevalence of dysphagia in Malaysia is very limited. Therefore, the present study aimed to examine the prevalence and contributing factors of dysphagia.
MATERIALS AND METHODS: A total of 240 patients (mean age 53.1, 167 males and 73 females) from Hospital Kuala Lumpur and the National Cancer Institute were enrolled in this research. All patients were interviewed individually in which they completed a thorough case history and swallowing screening test, including the water swallow test.
RESULTS: The results revealed that 43.3% of patients had dysphagia. In multivariate logistic regression, occupation of the patients was found to be associated with dysphagia, i.e., working in service and sales sector (adjusted Odds Ratio, aOR=0.36, 95% Confidence Interval, 95%CI: 0.13, 0.99). Compared to patients without treatment, those who had chemoradiotherapy (aOR=4.45; 95%CI: 1.10, 17.99) were at an increased odd of developing dysphagia.
DISCUSSION: This study showed that occupation, cancer stage, and type of treatment received by the head and neck cancer patients were crucial factors associated with the development of dysphagia. These findings guide the clinicians in identifying head and neck cancer patients who are at greater risks of developing dysphagia.
Respiratory sequelae and quality of life in children one-year after being admitted with a lower respiratory tract infection: A prospective cohort study from a developing country

Nathan AM, Teh CSJ, Eg KP, Jabar KA, Zaki R, Hng SY, et al.

Pediatr Pulmonol, 2020 02;55(2):407-417.
PMID: 31846223 DOI: 10.1002/ppul.24598

INTRODUCTION: Respiratory tract infections in children can result in respiratory sequelae. We aimed to determine the prevalence of, and factors associated with persistent respiratory sequelae 1 year after admission for a lower respiratory tract infection (LRTI).
METHODOLOGY: This prospective cohort study involved children 1 month to 5-years-old admitted with an LRTI. Children with asthma were excluded. Patients were reviewed at 1-, 6-, and 12-months post-hospital discharge. The parent cough-specific quality of life, the depression, anxiety, and stress scale questionnaire and cough diary for 1 month, were administered. Outcomes reviewed were number of unscheduled healthcare visits, respiratory symptoms and final respiratory diagnosis at 6 and/or 12 month-review by pediatric pulmonologists.
RESULTS: Three hundred patients with a mean ± SD age of 14 ± 15 months old were recruited. After 1 month, 239 (79.7%) returned: 28.5% (n = 68/239) had sought medical advice and 18% (n = 43/239) had cough at clinic review. Children who received antibiotics in hospital had significantly lower total cough scores (P = .005) as per the cough diary. After 1 year, 26% (n = 78/300) had a respiratory problem, predominantly preschool wheezing phenotype (n = 64/78, 82.1%). Three children had bronchiectasis or bronchiolitis obliterans. The parent cough-specific quality of life (PCQOL) was significantly lower in children with respiratory sequelae (P
Fulltext Disrupted-in-Schizophrenia-1 SNPs and Susceptibility to Schizophrenia: Evidence from Malaysia

Norlelawati AT, Kartini A, Norsidah K, Ramli M, Tariq AR, Wan Rohani WT

Psychiatry Investig, 2015 Jan;12(1):103-11.
PMID: 25670952 DOI: 10.4306/pi.2015.12.1.103

Even though the role of the DICS1 gene as a risk factor for schizophrenia is still unclear, there is substantial evidence from functional and cell biology studies that supports the connection of the gene with schizophrenia. The studies associating the DISC1 gene with schizophrenia in Asian populations are limited to East-Asian populations. Our study examined several DISC1 markers of schizophrenia that were identified in the Caucasian and East-Asian populations in Malaysia and assessed the role of rs2509382, which is located at 11q14.3, the mutual translocation region of the famous DISC1 translocation [t (1; 11) (p42.1; q14.3)].
Relationship of psychological symptoms, antipsychotics and social data with psychosocial function in schizophrenia patients in Malaysia

Norlelawati AT, Kartini A, Norsidah K, Ramli M, Wan Azizi WS, Tariq AR

Asia Pac Psychiatry, 2015 Mar;7(1):45-53.
PMID: 23857669 DOI: 10.1111/appy.12089

INTRODUCTION: The present study investigated the relationship between psychological symptoms and psychosocial function and the role of relevant sociodemographic data and antipsychotic use in the prediction of psychosocial function among multiracial schizophrenia outpatients in Malaysia.
METHODS: A total of 223 participants were recruited in this cross-sectional study conducted from December 2010 to April 2011. Psychological symptoms were assessed using the Positive and Negative Syndrome Scale whilst the psychosocial function was assessed using the Personal and Social Performance scale. Sociodemographic and treatment variables were gathered through interview or review of the medical records.
RESULTS: All dimensions of psychosocial functions were inversely correlated with Positive and Negative Syndrome Scale sub-domains. Only the disorganization sub-domain significantly predicts all dimensions of psychosocial function. For social data, body mass index and employment status were significant predictors of all dimensions of psychosocial functions. Typical antipsychotics significantly predict social function negatively as compared to sulpiride (β = -0.152, P = 0.028).
DISCUSSION: We found that the relationship between psychological symptoms and psychosocial functions were relatively consistent with the findings from the Caucasian population. Additionally, disorganization was the only significant predictor of all dimensions of psychosocial functions. This further emphasized the importance of cognition in psychosocial function. The roles of sulpiride, body mass index and employment status as predictors of psychosocial function were also discussed.
KEYWORDS: antipsychotics; psychosocial function; schizophrenia; symptoms
Study site: Psychiatric clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
Fulltext Obesity in multiracial schizophrenia patients receiving outpatient treatment in a regional tertiary hospital in malaysia

Norlelawati AT, Kartini A, Ramli M, Norsidah K, Wan Azizi WS, Tariq AR

East Asian Arch Psychiatry, 2012 Jun;22(2):49-56.
PMID: 22714874

OBJECTIVES. Obesity is an issue of concern among patients with schizophrenia as it is a co-morbid condition that is closely related to metabolic syndrome. The present study assessed the correlation of body mass index with antipsychotic use among multiracial schizophrenia outpatients. The study also compared the patients' body mass index with Malaysian Adult Nutrition Survey (MANS) data.
METHODS. A total of 216 participants were recruited into a cross-sectional study conducted over 5 months, from December 2010 to April 2011. Body weight and height were measured using the standard methods. Demographic data and treatment variables were gathered through interview or review of the medical records.
RESULTS. There were differences in mean body mass index between men and women (p = 0.02) and between Malay, Chinese and Indian races (p = 0.04). Stratified by sex, age, and race, the body mass index distributions of the patients were significantly different to those of the reference MANS population. The prevalence of obesity among patients was more than 2-fold greater than among the reference population in all variables. Although body mass index distribution was related to antipsychotic drugs (χ(2) = 33.42; p = 0.04), obesity could not be attributed to any specific drug.
CONCLUSION. The prevalence of obesity among patients with schizophrenia was significantly greater than that in the healthy Malaysian population, and affects the 3 main races in Malaysia.
Study site: Psychiatry Clinic, Tengku Ampuan Afzan Hospital, Kuantan, Pahang, Malaysia.
DNA methylation of membrane-bound catechol-O-methyltransferase in Malaysian schizophrenia patients

Nour El Huda AR, Norsidah KZ, Nabil Fikri MR, Hanisah MN, Kartini A, Norlelawati AT

Psychiatry Clin Neurosci, 2018 Apr;72(4):266-279.
PMID: 29160620 DOI: 10.1111/pcn.12622

AIM: This study examined catechol-O-methyltransferase (COMT) DNA methylation in the peripheral blood of schizophrenia patients and also in healthy controls to investigate its potential use as a peripheral biomarker of schizophrenia and its relations with the clinical variables of schizophrenia patients.
METHODS: We examined the DNA methylation levels of COMT using genomic DNA from the peripheral blood of schizophrenia patients (n = 138) and healthy control participants (n = 132); all were Malaysian Malays. The extracted DNA was bisulfite converted, and the percentage methylation ratio value was calculated based on the results following a MethyLight protocol analysis.
RESULTS: The percentage methylation ratio of COMT was lower in schizophrenia than it was in the healthy controls (P
Reelin (RELN) DNA methylation in the peripheral blood of schizophrenia

Nabil Fikri RM, Norlelawati AT, Nour El-Huda AR, Hanisah MN, Kartini A, Norsidah K, et al.

J Psychiatr Res, 2017 05;88:28-37.
PMID: 28086126 DOI: 10.1016/j.jpsychires.2016.12.020

The epigenetic changes of RELN that are involved in the development of dopaminergic neurons may fit the developmental theory of schizophrenia. However, evidence regarding the association of RELN DNA methylation with schizophrenia is far from sufficient, as studies have only been conducted on a few limited brain samples. As DNA methylation in the peripheral blood may mirror the changes taking place in the brain, the use of peripheral blood for a DNA methylation study in schizophrenia is feasible due to the scarcity of brain samples. Therefore, the aim of our study was to examine the relationship of DNA methylation levels of RELN promoters with schizophrenia using genomic DNA derived from the peripheral blood of patients with the disorder. The case control studies consisted of 110 schizophrenia participants and 122 healthy controls who had been recruited from the same district. After bisufhite conversion, the methylation levels of the DNA samples were calculated based on their differences of the Cq values assayed using the highly sensitive real-time MethyLight TaqMan® procedure. A significantly higher level of methylation of the RELN promoter was found in patients with schizophrenia compared to controls (p = 0.005) and also in males compared with females (p = 0.004). Subsequently, the RELN expression of the methylated group was 25 fold less than that of the non-methylated group. Based upon the assumption of parallel methylation changes in the brain and peripheral blood, we concluded that RELN DNA methylation might contribute to the pathogenesis of schizophrenia. However, the definite effects of methylation on RELN function during development and also in adult life still require further elaboration.