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  1. Rusmadi SZ, Syed Ismail SN, Praveena SM
    J Environ Public Health, 2015;2015:591790.
    PMID: 26693230 DOI: 10.1155/2015/591790
    Many cases of dermatologic complication were reported with the use of skin lightening products. This study assessed the skin lightening practice and health symptoms among female students. Self-administered questionnaire was distributed to 104 female students (56 undergraduates and 48 postgraduates) aged 24 ± 2 years in Universiti Putra Malaysia. A total of 60.6% (N = 63) of the female students used skin lightening products (61.9% of undergraduates and 38.1% of postgraduates). Reasonable price (N = 35, 55.6%) and ingredients (N = 29, 46%) were considered the most important factors in the product selection. Most respondents purchased the product from drugstores (N = 39, 61.9%). Twenty-two respondents (34.9%) in this study experienced skin problem from the products they used. Skin peeling (N = 13, 12.5%) and acne (N = 9, 8.7%) were the most frequent symptoms experienced. Most of the respondents have the perception that lighter skin provides high self-esteem (N = 56, 53.8%) and looks beautiful and healthier (N = 54, 51.9%). The use of skin lightening products is common among female students in this study and some of these products can cause skin problems such as skin peeling, acne, and itching.
  2. Yien Fang T, Praveena SM, Aris AZ, Syed Ismail SN, Rasdi I
    Chemosphere, 2019 Jan;215:153-162.
    PMID: 30316157 DOI: 10.1016/j.chemosphere.2018.10.032
    Steroid estrogens, such as 17β-estradiol (E2) and 17α-ethynylestradiol (EE2) are potent and were categorized as "Watch List" in Directive 2013/39/EU because of their potential risks to aquatic environment. Commercialized enzyme-linked immunosorbent assay (ELISA) kits have been used to quantify steroid estrogens in wastewater samples due to their simplicity, rapid, cost-effectiveness, and validated assays. Hence, this study aims to determine the occurrence and removal of steroid hormones in Malaysian wastewater treatment plants (WWTPs) by ELISA, to identify the association of removal efficiency (E2 and EE2) with respect to WWTPs operating conditions, and to assess the potential risks of steroid estrogens to aquatic environment and human. Results showed E2 concentration ranged from 88.2 ± 7.0 ng/L to 93.9 ± 6.9 ng/L in influent and 35.1 ± 17.3 ng/L to 85.2 ± 7.6 ng/L in effluent, with removal of 6.4%-63.0%. The EE2 concentration ranged from 0.2 ± 0.2 ng/L to 4.9 ± 6.3 ng/L in influent and 0.02 ± 0.03 ng/L to 1.0 ± 0.8 ng/L in effluent, with removal of 28.3-99.3%. There is a correlation between EE2 removal with total suspended solid (TSS) and oxidation reduction potential (ORP), and was statistically significant. Despite the calculated estrogenic activity for E2 and EE2 was relatively high, dilution effects could lower estrogenic response to aquatic environment. Besides, these six selected WWTPs have cumulative RQ values below the allowable limit, except WWTP 1. Relatively high precipitation (129-218 mm) could further dilute estrogens concentration in the receiving river. These outputs can be used as quantitative information for evaluating the occurrence and removal of steroid estrogens in Malaysian WWTPs.
  3. Ab Hamid J, Juni MH, Rosliza AM, Syed Ismail SN, Lim PY
    Med J Malaysia, 2023 Jan;78(1):109-117.
    PMID: 36715200
    INTRODUCTION: The floating catchment area (FCA) method has emerged as the most comprehensive and accurate method for quantifying the spatial accessibility of health care services. There were variants of the FCA-based method that was continuously improvised by the researchers to suit specific local contexts and the different nature of healthcare service delivery. This scoping review identifies factors associated with the spatial accessibility of healthcare services that were specifically measured using the FCAbased method.

    MATERIALS AND METHODS: This scoping review was performed through electronic databases (PubMed and ScienceDirect) using keywords: 'spatial accessibility', 'floating catchment area' and 'factors'. Google Scholar and Mendeley Network were also used as additional sources to obtain relevant studies.

    RESULTS: A total of 32 articles were included in this review. Factors identified can be distinguished into two broad categories, which are spatial and non-spatial factors. Spatial factors were remoteness or distance from the urban centre, areas in close proximity to main roads, and some specific geographical characteristics such as mountainous and deltaic regions, whereas non-spatial factors were the degree of urbanisation, population density and various demographic profiles of the population such as socioeconomic status, health need, and minority ethnic composition.

    CONCLUSION: This study adds to the body of literature pertinent to the factors associated with spatial accessibility to healthcare services. These findings could give insight for researchers to consider and incorporate those additional variables to further improve the FCA-based method calculations.

  4. Ab Hamid J, Juni MH, Abdul Manaf R, Syed Ismail SN, Lim PY
    PMID: 36833838 DOI: 10.3390/ijerph20043147
    Disparities in access to health services in rural areas represent a global health issue. Various external factors contribute to these disparities and each root requires specific remedial action to alleviate the issue. This study elucidates an approach to assessing the spatial accessibility of primary care, considering Malaysia's dual public-private system specifically in rural areas, and identifies its associated ecological factors. Spatial accessibility was calculated using the Enhance 2-Step Floating Catchment Area (E2SFCA) method, modified as per local context. Data were secondary sourced from Population and Housing Census data and administrative datasets pertaining to health facilities and road network. The spatial pattern of the E2SFCA scores were depicted using Hot spot Analysis. Hierarchical multiple linear regression and geographical weight regression were performed to identify factors that affect E2SFCA scores. Hot spot areas revolved near the urban agglomeration, largely contributed by the private sector. Distance to urban areas, road density, population density dependency ratios and ethnic composition were among the associated factors. Accurate conceptualization and comprehensive assessment of accessibility are crucial for evidence-based decision making by the policymakers and health authorities in identifying areas that need attention for a more specific and localized planning and development.
  5. Shamsuddin AS, Mohd Abu Bakar WA, Syed Ismail SN, Jaafar NH, Mohd Yassin W, Norhizat M
    Malays J Med Sci, 2022 Oct;29(5):24-38.
    PMID: 36474532 DOI: 10.21315/mjms2022.29.5.4
    Approximately 230 million children under 5 years old of age suffer from malnutrition and over half of the children below 5 years old deaths are due to malnutrition nowadays. To gain a better understanding of this problem, the application of spatial analysis has risen exponentially in recent years. In this review, the present state of information on the use of spatial analysis in childhood malnutrition studies was evaluated using four databases of digital scientific journals: ScienceDirect, Scopus, PubMed and CINAHL. We chose 2,278 articles from the search results and a total of 27 articles met our criteria for review. The following information was extracted from each article: objective of study, study area, types of malnutrition, subject, data sources, computer software packages, spatial analysis and factors associated with childhood malnutrition. A total of 10 spatial analysis methods were reported in the reviewed articles and the Bayesian geoadditive regression model was the most common method applied in childhood malnutrition studies. This review highlights the importance of the application of spatial analysis in determining the geographic distribution of malnutrition cases, hotspot areas and risk factors correlated with childhood malnutrition. It also provides implications for strategic initiatives to eradicate all forms of malnutrition.
  6. Zulkifli A, Abidin NZ, Abidin EZ, Hashim Z, Rahman AA, Rasdi I, et al.
    Asian Pac J Cancer Prev, 2014;15(12):4815-21.
    PMID: 24998546
    BACKGROUND: This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation.

    MATERIALS AND METHODS: A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire.

    RESULTS: The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8).

    CONCLUSIONS: Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.

  7. Mhd Noor MT, Kadir Shahar H, Baharudin MR, Syed Ismail SN, Abdul Manaf R, Md Said S, et al.
    PLoS One, 2022;17(11):e0271258.
    PMID: 36441735 DOI: 10.1371/journal.pone.0271258
    Floods occur when a body of water overflows and submerges normally dry terrain. Tropical cyclones or tsunamis cause flooding. Health and safety are jeopardized during a flood. As a result, proactive flood mitigation measures are required. This study aimed to increase flood disaster preparedness among Selangor communities in Malaysia by implementing a Health Belief Model-Based Intervention (HEBI). Selangor's six districts were involved in a single-blinded cluster randomized controlled trial Community-wide implementation of a Health Belief Model-Based Intervention (HEBI). A self-administered questionnaire was used. The intervention group received a HEBI module, while the control group received a health talk on non-communicable disease. The baseline variables were compared. Immediate and six-month post-intervention impacts on outcome indicators were assessed. 284 responses with a 100% response rate. At the baseline, there were no significant differences in ethnicity, monthly household income, or past disaster experience between groups (p>0.05). There were significant differences between-group for intervention on knowledge, skills, preparedness (p<0.001), Perceived Benefit Score (p = 0.02), Perceived Barrier Score (p = 0.03), and Cues to Action (p = 0.04). GEE analysis showed receiving the HEBI module had effectively improved knowledge, skills, preparedness, Perceived Benefit Score, Perceived Barrier Score, and Cues to Action in the intervention group after controlling the covariate. Finally, community flood preparedness ensured that every crisis decision had the least impact on humans. The HEBI module improved community flood preparedness by increasing knowledge, skill, preparedness, perceived benefit, perceived barrier, and action cues. As a result, the community should be aware of this module. Clinical trial registration: The trial registry name is Thai Clinical Trials Registry, trial number TCTR20200202002.
  8. Shamsuddin AS, Syed Ismail SN, Othman NMI, Zakaria NH, Abd Manan TS, Ibrahim MA, et al.
    Environ Geochem Health, 2023 Nov;45(11):7741-7757.
    PMID: 37428425 DOI: 10.1007/s10653-023-01671-z
    Excessive nitrate intake via ingestion pathway and dermal absorption exposures has adverse health impacts on human health. This study evaluated groundwater (GW) nitrate concentrations and health risks which focused on ingestion and dermal exposures to residents in Bachok District, Kelantan, Malaysia. Three hundred (300) samples of private wells were collected and it is found that the nitrate concentrations ranging between 0.11 and 64.01 mg/L NO3-N with a mean value of 10.45 ± 12.67 mg/L NO3-N. The possible health hazards of nitrate by ingestion and dermal contact were assessed using USEPA human health risk assessment model for adult males and females. It is observed that the mean Hazard Quotient (HQ) values of adult males and females were 0.305 ± 0.364 and 0.261 ± 0.330, respectively. About 7.3% (n = 10) and 4.9% (n = 8) of adult males and females had HQ values more than 1, respectively. It was also observed that the mean of HQderm was lesser than HQoral for males and females. The spatial distribution of HQ by interpolation method showed high nitrate concentrations (> 10 mg/L NO3-N) were distributed from the centre to the southern part of the study location, which identified as an agricultural area, indicating the used of nitrogenous fertilizers as the main source of GW nitrate contamination in this area. The findings of this study are valuable for establishing private well water protection measures to stop further deterioration of GW quality caused by nitrate.
  9. Zainol Abidin N, Abidin EZ, Zulkifli A, Syed Ismail SN, Karuppiah K, Amer Nordin AS, et al.
    Asian Pac J Cancer Prev, 2018 Feb 26;19(2):457-462.
    PMID: 29480664
    Background: Consistency and accuracy of results in assessing health risks due to vaping or e-cigarette use are difficult to achieve without established consumption data. The present report covers baseline data on vaping topography and reasons for use among local users in Klang Valley, Malaysia.
    Methods: An 80-item survey regarding socio-demographic characteristics, smoking topography and reasons for e-cigarette use was employed to assess e-cigarette users recruited from several public universities and private organisations. The survey questionnaire was self-administered. Data were analysed using statistical software.
    Results: Eighty-six current e-cigarette users participated with more than half (51.2%) of them aged ≥ 25 years old. Significant proportions of the sample were single (51.2%), had a tertiary education level (63.5%) and a household income of less than USD1000 per month (65.2%). Median duration of e-cigarette use was less than a year; users drew approximately 50 puffs per day and refilled twice a day. The majority (74%) used e-liquids containing nicotine with a concentration of 6 μg/mL. Daily users spent USD18-23 per month. Reasons for using the e-cigarette included enjoyment of the products (85.9%), perception of lower toxicity than tobacco (87%), and the fact that it was a cheaper smoking alternative (61%).
    Conclusion: The data on e-cigarette smoking topography obtained in this study are novel. The reasons of usage were mainly users’ enjoyment of e-cigarettes, preparation for quitting smoking, perception of low toxicity and a healthier smoking substitute and cheapness in the long run. The results establish basic knowledge for the local vaping topography and reference material for future e-cigarette-related research.
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