Displaying publications 1 - 20 of 39 in total

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  1. Wan Munirah, W.M., Tahir, A., Azmirul, A.
    MyJurnal
    The transformation method (TM) of fuzzy arithmetic is aimed at simulation and analysis of a system. The aim of this paper is to use fuzzy arithmetic based on the TM on a state space of a steam turbine system. The model is then used to identify the degree of influence of each parameter on the system. Simulation and analysis of the system are presented in this paper.
  2. Nora, M.S., Tahir, A., Nuraimy, A., Hamzah, A.G.
    MyJurnal
    This is a cross sectional study to assess the performance of Putrajaya Health Clinic in meeting the client's expectation among 403 clients who came to seek medical treatment through a systematic random sampling in the month of July 2006. Our aim is not only to reduce dissatisfaction among clients but also try to meet their expectations; we have adopted SERVQUAL method which defined satisfaction as the difference between perceptions and expectations. We would also like to refer this dissatisfaction as not able to meet clients' expectations. It was found that there were only 6.9% of clients dissatisfied in Putrajaya Health Clinic, but they had not been able to meet 81.5% of clients' expectation. As for demographic characteristics, there appeared to be a significant association between client's satisfaction and age, gender, ethnicity and educational level. For outpatient's, the greatest dissatisfaction is in the dimension of Reliability. Clients were not happy with the waiting time at the clinic. Apart from recruiting more staff, management should develop a comfortable waiting environment to reduce the agony of waiting.
  3. Fadhli, Y., Azaadi, O., Noor Ani, A., Balkish, M.N., Ahmad Jessree, K., Tahir, A.
    MyJurnal
    The National Health and Morbidity Survey 2011 was a nationally representative household survey of non-institutionalized Malaysian population who were residing in Malaysia for at least 2 weeks prior to data collection. The aim of the survey was to provide health related community–based data and information to support Ministry of Health, Malaysia, in reviewing health priorities, programme strategies and activities, and planning for allocation of resources. There were twelve research scopes included in the survey. The sample size was calculated based on the requirement for each scope. A two-stage stratified sampling was adopted in the survey. The methods for data collection were via the questionnaire, clinical examination, and biochemical analysis. Quality controls were also instituted to ensure collection of high quality data. The National Health and Morbidity Survey 2011 (NHMS 2011) adopted an appropriate methodology for a population survey and all the necessary steps were taken to ensure valid and reliable findings.
    Study name: National Health and Morbidity Survey (NHMS-2011)
  4. Noriah, B., Roslan Johari, M.G., Teng, Seng Chong, Tahir, A., Nadhirah, R.
    MyJurnal
    The purpose of this study was to determine the quality of counter service at the Ministry of Health hospitals as perceived by patients. This was a cross sectional study using selfadrninistered questionnaires distributed to patients at the outpatient departments in all Ministry of Health Hospitals. By the end ofthe data collection period, 118 of 121 hospitals (total number of MOH Hospitals) participated with 93.2% response rate., The hospitals were divided into four categories, for the purpose of this study 1000 sample size were needed in each category, the number of sample size were obtained using Epi Info Program based on assumption that 30% Of patients were dissatisyded with the services provided and with a precision of 10%. In this study the quality were based on clarity and provision of services based on Client Charten deliverance of clear infomation by the healthcare personnel, priority treatment given to urgency of the cases, cleanliness of the facilities and teamwork among the staff This study revealed about 64% of patients perceived that the hospitals had provided quality services at the counter: Only about 11% of patients were not happy with the quality of the services given at the counter. The proportion of happy patients increased from the smaller to the bigger hospitals. In terms of delivering services according to the Client Charter; only about 15% said that service was not provided by the counter staff according to the Client’s Charter On the aspect of priority on the urgent cases, about 64% of the patients perceived that urgent cases were not seen immediately. About 64% of the respondents felt that the hospitah do provide quality services. Strategies should focus on the bigger hospitals because non conformance to quality occurs more frequently there. The post of Counter Supervisor should be created to ensure that quality services are delivered.

    Study site: outpatient departments in all Ministry of Health Hospitals
  5. Roslinah, A., Roslan, J.M.G., Aravalzi, K., Nuriza, Z., Hong, L.C., Tahir, A.
    MyJurnal
    Caring practice is one of the three core values of Corporate Culture of Ministry of Health Malaysia, initiated in 1991. A cross sectional study was conducted to determine the extent of hospital healthcare personnel practicing the element of caring. Self-administered questionnaires were mailed to all staff working in public hospitals followed by reminder letters and telephone calls. A total of 37,267 responded out of 69,385 personnel working in the hospitals with a response rate of 53.7%. Results showed that about half of the respondents perceived that they practice caring value of the corporate culture (49.5%) and only 33.3% perceived that their colleagues practiced it. The practice of caring value was highest among clinical specialists (65.4%) and lowest among the clerks (22.1%). Nurses perceived that 40.4% of their colleagues practiced caring values while the clerks perceived only 17.0% of their colleagues practice it. In conclusion, caring value is not being well practiced by healthcare staff especially among the support staff. There is a need for further research to study the reasons for poor caring practice by healthcare personnel and develop strategies to improve the situation.
  6. Nur Azmiah Z, Zulkarnain AK, Tahir A
    MyJurnal
    Introduction: Insulin has been viewed as a treatment option of last resort in type 2 diabetes management. The decision to start insulin therapy is often diffi cult. Patients are usually reluctant to begin insulin and many cases delay the initiation of insulin therapy. The aim of this study is to determine the magnitude of insulin refusal or recognize as psychological insulin resistance (PIR) and to identify its predictors. Materials and Methods: This is a cross-sectional study and data was collected from two primary public health clinics in Kuala Lumpur and Putrajaya. The study sample consisted of 404 insulin naive patients with type 2 diabetes. A self-administered questionnaire was used to obtain demographic and clinical information. Results: Fifty-one percent of patients with type 2 diabetes were found to be unwilling to take insulin. Regression analysis revealed that females were 2.7 times more likely to resist insulin treatment compared to males and those with uncontrolled diabetes were 1.8 times more likely to resist insulin treatment compared to controlled diabetics. Patients will refuse insulin if they perceived their diabetes worsen with insulin use. After controlling for other attitudinal belief factors in the model, an increase in one unit of perceived disease severity will increase the likelihood of PIR around 2 times. Conclusion: Several misconceptions regarding insulin therapy were identified and specifi c education intervention is recommended for successful transition to insulin therapy.
  7. Roslan Johari, M.G., Teng, S.C., Rosidah, S.S., Haliza, A.M., Tahir, A., Nadhirah, R., et al.
    MyJurnal
    A cross sectional study was conducted to determine the perception of Hospital Directors in performing clinical duties. This was done through a postal survey which was conducted covering all public hospitals in Malaysia. The majority of Hospital Directors had read the circular at the time of the study and agreed to do clinical work besides managerial duties. Before the issuance of the directive, the majority of those directors were already doing some clinical work. However they disagreed that by doing clinical work they could help overcome the problem of shortage of doctors. They agreed that the duration of 10 hours per week is suitable to do clinical duties. In term of confidence in giving curative treatment, the Hospital Directors especially those from district hospitals without specialists were confident in giving curative care to individuals. As for the clinicians, the majority felt that the implementation of the directive for Hospital Directors to do clinical work will not disrupt the clinicians' routine duties.
    Study site: University Malaya, Universiti Kebangsaan Malaysia; Hospital Kuala Lumpur, Malaysia
  8. Rafiza S, Rampal KG, Tahir A
    BMC Infect Dis, 2011;11:19.
    PMID: 21244645 DOI: 10.1186/1471-2334-11-19
    BACKGROUND: Health care workers are exposed to patients with tuberculosis and are at risk of nosocomial infection. The aim of this study was to determine the prevalence and factors associated with latent tuberculosis infection among health care workers in Malaysia and also to evaluate the agreement between Quantiferon TB Gold in tube test with Tuberculin Skin Test.
    METHODS: A cross sectional study was conducted at four randomly selected hospitals in the Klang Valley from December 2008 to May 2009. Self administered questionnaire was used to obtain information on health care workers and possible risk factors. The response rate for this study was 90.8% with 954 respondents completed the questionnaire and were tested with Quantiferon TB Gold in tube for latent tuberculosis infection. Agreement between Quantiferon TB Gold in tube and Tuberculin Skin Test was assessed among 95 health care workers who consented to undergo both tests.
    RESULTS: The overall prevalence of latent tuberculosis infection among health care workers was 10.6% (CI: 8.6%; 12.6%). Factors significantly associated with latent tuberculosis infection were aged 35 years and older [9.49 (CI: 2.22; 40.50)], history of living in the same house with close family members or friends who had active tuberculosis [8.69 (CI: 3.00; 25.18)], worked as a nurse [4.65 (CI: 1.10; 19.65)] and being male [3.70 (CI: 1.36; 10.02)]. Agreement between Quantiferon TB Gold in tube test and tuberculin skin test at cut-off points of 10 mm and 15 mm was 50.5% and 82.1% respectively. However, Kappa-agreement was poor for both cut-off points.
    CONCLUSION: The prevalence of latent tuberculosis infection in Malaysia was relatively low for an intermediate TB burden country. We could not comment on the occupational risk of latent tuberculosis infection among health care worker compared to the general population as there were no prevalence data available for latent tuberculosis infection in the general population. Kappa agreement between Quantiferon TB gold in-tube and tuberculin skin test was poor.
  9. Haliza, A.M., Roslan Johari, M.G., Badrulnizam, M., Rosidah, S.S., Teng, S.C., Saiful Safuan, M.S., et al.
    MyJurnal
    Diabetes mellitus is a chronic disorder with many vascular complications, leading to significant morbidity and mortality. The prevalence of Type 2 diabetes mellitus in Malaysia has risen dramatically from 6.3% (NHMS 1 in 1986); to 8.3% (NHMS 2 in 1996); and to 14.9% (NHMS 3 in 2006). An audit was conducted on patient's medical records from selected MOH health facilities to assess the control of diabetes using HbA1c. The response rate was 69.6% and the control of diabetes was poor. Only 18.4% of patients with valid HbA1c had value less than 6.5%. This is notably worst amongst patients from younger age groups. Many recommended investigations such as fundoscopy and urine microalbumin had not been done regularly. Efforts to look for various vascular complications were under-reported. About 45% of patients had been treated with 2 oral antidiabetic agents; mainly the sulphonylureas and the biguanides. Only 13.3% of patients were on insulin despite having poorly controlled disease. There is an urgent need to improve the management of diabetes mellitus in these areas:- (i) improving the glycemic control status (particularly among younger diabetic patients) with early and optimal use of oral diabetic drugs and insulin; (ii) stringent monitoring of glycemic control with adequate funds for regular performance of HbA1c (at least every 6 monthly for all diabetic patients) (iii) organizing regular updates or interactive programme for diabetes healthcare providers from primary, secondary and tertiary care; (iv) ensuring regular and prompt review of diabetic complications so that the complications can be dealt with early; (v) producing more diabetes educators to strengthen and standardize the diabetes education programme; and promote patients adherence to non-pharmacological and pharmacological interventions.
  10. Mahmud SZ, Joanita S, Khairun Nisa J, Balkish MN, Tahir A
    Med J Malaysia, 2013 Apr;68(2):125-8.
    PMID: 23629557 MyJurnal
    Extensive literature reviews showed that pacifier usage is associated with early cessation of breast feeding, as well as respiratory infection. This cross sectional study was a part of the bigger study of The Third National Health Morbidity Survey conducted throughout Malaysia in 2006. Survival and pearson cox regression was done to find association between pacifier user and breast feeding duration. Logistic Regression was done to find association between variables of interest. The prevalence of pacifier use was 32.9%. Chinese children reported significantly higher usage of pacifier (95% CI; 47.5, 58.7) as well as those resided in urban area (95% CI;32.5,37.7). One third of pacifier user had stopped breastfeeding at 6 months of age. Those with pacifier users were significantly shorter in breast feeding duration and significantly associated with non exclusivity in breastfeeding. Those without pacifier user were significantly associated with ever breast fed.(p value=0.001). There was no significant association between pacifier use with acute respiratory infection. Factors such as ethnicity and residential are non modifiable whereas modifiable factor such as pacifier use is certainly needed to be addressed at maternal and child health care level.
    Study name: National Health and Morbidity Survey (NHMS-2006)
  11. Abdullah J, Zamzuri I, Awang S, Sayuthi S, Ghani A, Tahir A, et al.
    Acta Neurochir. Suppl., 2005;95:311-4.
    PMID: 16463872
    The monitoring of craniospinal compliance is uncommonly used clinically despite it's value. The Spiegelberg compliance monitor calculates intracranial compliance (C = deltaV/deltaP) from a moving average of small ICP perturbations (deltaP) resulting from a sequence of up to 200 pulses of added volume (deltaV = 0.1 ml, total V = 0.2 ml) made into a double lumen intraventricular balloon catheter. The objective of this study was thus to determine the effectiveness of the decompressive craniectomy done on the worst brain site with regard to compliance (Cl), pressure volume index (PVI), jugular oximetry (SjVo2), autoregulation abnormalties, brain tissue oxygen (TiO2) and cerebral blood flow (CBF). This is a prospective cohort study of 17 patients who were enrolled after consent and approval of the ethics committee between the beginning of the year 2001 and end of the year 2002. For pre and post assessment on compliance and PVI, all 12 patients who survived were reported to become normal after decompressive craniectomy. There is no significant association between pre and post craniectomy assessment in jugular oxymetry (p > 0.05), autoregulation (p > 0.05), intracranial brain oxymetry (p = 0.125) and cerebral blood flow (p = 0.375). Compliance and PVI improved dramatically in all alive patients who received decompressive craniectomy. Compliance and PVI monitoring may be crucial in improving the outcome of severe head injured patients after decompressive craniectomy.
  12. Fatimah S, Siti Saadiah HN, Tahir A, Hussain Imam MI, Ahmad Faudzi Y
    Malays J Nutr, 2010 Aug;16(2):195-206.
    PMID: 22691925 MyJurnal
    In Malaysia, the National Breastfeeding Policy recommends exclusive breastfeeding for the first six months of life and continued up to two years. Since the 1990s, several breastfeeding promotion programmes had been implemented in the country. This article reports the findings on the prevalence of breastfeeding practice from The Third National Health and Morbidity Survey (NHMS III) which was conducted in 2006. A total of 2167 mothers or carers of children below two years old were interviewed representing 804,480 of the estimated population of children aged below 2 years in Malaysia. Respondents were asked whether various types of liquid or solid food were given to the child at any time during the preceding 24-hour period. The overall prevalence of ever breastfed among children aged less than 12 months was 94.7% (CI: 93.0 - 95.9). The overall prevalence of exclusive breastfeeding below 6 months was 14.5% (CI: 11.7 - 17.9). Prevalence of timely initiation was 63.7% (CI: 61.4 - 65.9) and the continued prevalence of breastfeeding up to two years was 37.4% (CI: 32.9 - 42.2). The findings suggest that the programmes implemented in the last ten years were effective in improving the prevalence of ever breastfeeding, timely initiation of breastfeeding and continued breastfeeding up to two years. However, the challenge is to improve exclusive breastfeeding practice. Longterm community-based interventions need to be carried out in partnership with the existing health care system, focusing on discouraging the use of water and infant formula, especially in the first few months of life.
    Study name: National Health and Morbidity Survey (NHMS-2006)
  13. Rashidah, A., Yeo, P.S., Noor Ani, A., Muhammad Fadhli, M.Y., Tahir, A., Feisul Idzwan, M., et al.
    Malays J Nutr, 2014;20(3):317-326.
    MyJurnal
    Introduction: High sodium consumption over an extended period of time has been associated with hypertension, stroke, cardiovascular disease, renal damage, and other adverse health effects. This study aimed to determine urinary sodium excretion and consequently estimate dietary sodium consumption among normotensive health staff in Malaysia. Methods: A cross-sectional study was conducted to acquire data on sodium excretion among normotensive Ministry of Health staff aged 20 - 56 years (mean age 35.08, SD 9.78) in 14 states and a research institute. Respondents were recruited using quota sampling. Data collection was conducted from December 2011 to February 2012. A single urine sample was collected over 24 hours for sodium concentrations and calculated as 95.0% of total daily sodium intake. Results: Among the 471 enrolled respondents, 445 (94.0%) provided complete information on socio-demography and urine samples. Mean urine sodium excretion was 142.0 mmol/day (SD 71.7), which is equivalent to 3429 mg sodium/day or 8.7 gm of salt intake (1.75 teaspoon, which exceeds the Malaysian recommendation of 2000 mg sodium/day by 1.7 times. About 79.0% (n=353) of respondents (88.0% male and 73.0% female) had daily sodium consumption that was above the recommendation. Excretion was significantly higher among males at 161.7 mmol/day (SD 78.1) (3726 mg sodium/day) than females, 125.3 mmolfday (SD 61.1) (2875 mg/day). There was a positive, low correlation between BMl and sodium intake (r=0.216, p
  14. Roslan Johari, M.G., Muslha, D., Abdul Kadir, A.B., Safraz Manzoor, H., Sharifah Rohani, S.A.B., Tahir, A., et al.
    MyJurnal
    Tujuan menjalankan kajian ini adalah untuk mengetahui tahap kekerapan penyelidikan yang berkaitan dengan kesihatan mental yang dijalankan di fasiliti Kementerian Kesihatan Malaysia. Sebanyak 258 fasiliti Kementerian Kesihatan yang terlibat dalam kajian ini meliputi Hospital Mental, Hospital dengan perkhidmatan Pakar Psikiatri, Hospital tanpa perkhidmatan Pakar Psikiatri dan Pejabat Kesihatan Daerah. Borang kajiselidik telah dihantar melalui pos kepada Pengarah Hospital dan Pegawai Kesihatan Daerah dengan kadar maklumbalas 70.2%. Hasil kajian mendapati hanya 23(13.1%) fasiliti sahaja yang menjalankan kajian mengenai kesihatan mental. Sebanyak 37 kajian berkaitan kesihatan mental telah dijalankan bagi tahun 2003-2004. Penyebab utama penyelidikan kurang dijalankan disebabkan oieh peruntukan yang tidak mencukupi dan tiada kepakaran untuk menjalankan penyelidikan yang berkaitan dengan kesihatan mental. Antara penyebab lain adalah kekurangan anggota, NGO tidak berminat dan tiada latihan. Kesimpulannya menunjukkan tahap penyelidikan kesihatan mental di fasiliti Kementerian Kesihatan masih rendah.
  15. Teh CH, Rampal S, Lim KH, Azahadi O, Tahir A
    Nicotine Tob Res, 2023 Jun 09;25(7):1340-1347.
    PMID: 36879440 DOI: 10.1093/ntr/ntad035
    INTRODUCTION: Tobacco use is one of the major preventable risk factors for premature death and disability worldwide. Understanding the trend of tobacco use over time is important for informed policy making.

    AIMS AND METHODS: The present study aimed to examine the changes in mean daily cigarette consumption among random samples of the Malaysian current smoker population over 20 years using an age-period-cohort (APC) approach. We conducted APC analysis using a multilevel hierarchical age-period-cohort model and data from four nationally representative, repeated cross-sectional surveys (National Health and Morbidity Survey) conducted in 1996, 2006, 2011, and 2015 among individuals aged 18 to 80 years. Analyses were also stratified by gender and ethnicity.

    RESULTS: Overall, mean daily cigarette consumption (smoking intensity) among current smokers increased with age until 60, after which a drop was observed. There were increases in daily cigarette consumption across birth cohorts. Age and cohort trends did not vary by gender but by ethnicity. The decreasing cigarette consumption after age 60 among the current smoker population was consistent with those observed among the Chinese and Indians, a trend that was not observed in Malays and other aborigines. In contrast, the increasing cohort trend was consistent with those observed among the Malays and other bumiputras.

    CONCLUSIONS: The present study highlighted important ethnic-specific trends for mean daily cigarette consumption among the current smoker population in Malaysia. These findings are essential in guiding the formulation of interventional strategies or implementation of national tobacco control policies and help achieve the Ministry of Health Malaysia's 2025 and 2045 targets for smoking prevalence.

    IMPLICATIONS: This is the first APC study on smoking intensity among current smokers in a multiracial, middle-income nation. Very few studies had performed gender- and ethnic-stratified APC analyses. The ethnic-stratified APC analyses provide useful insights into the overall age and cohort trends observed among the current smoker population in Malaysia. Therefore, the present study could add evidence to the existing literature on the APC trends of smoking intensity. The APC trends are also important in guiding the government to develop, implement, and evaluate antismoking strategies.

  16. Teh CH, Rampal S, Kee CC, Azahadi O, Tahir A
    Int J Obes (Lond), 2023 Dec;47(12):1302-1308.
    PMID: 37833560 DOI: 10.1038/s41366-023-01391-5
    OBJECTIVE: The global obesity epidemic remains a significant threat to public health and the economy. Age-period-cohort (APC) analysis is one method to model the trajectory of obesity. However, there is scarce published evidence of such analyses among the South East Asian population. This study aims to explore the sex and ethnic variations of BMI and waist circumference trajectories over time among non-institutionalized Malaysian adults aged 18 to 80 years.

    METHODS: Data from four population-based National Health and Morbidity Surveys conducted in 1996, 2006, 2010, and 2015 were pooled. Hierarchical Age-Period-Cohort (HAPC) analysis explored the trajectories of BMI and waist circumference across the life course and birth cohorts by sex and ethnicity. These models assumed no period effect.

    RESULTS: Generally, BMI and waist circumference trajectories increased across age and birth cohorts. These trajectories varied by sex and ethnicity. Females have more profound increasing BMI and waist circumference trajectories than their male counterparts as they age and as cohort recency increases. Chinese have less profound BMI and waist circumference increases across the life course and birth cohorts than other ethnic groups.

    CONCLUSIONS: The profound increasing cohort trajectories of obesity, regardless of sex and ethnicity, are alarming. Future studies should focus on identifying factors associated with the less profound cohort effect among the Chinese to reduce the magnitude of trajectories in obesity, particularly among future generations.

  17. Ali Tahir A, Ullah H, Sudhagar P, Asri Mat Teridi M, Devadoss A, Sundaram S
    Chem Rec, 2016 06;16(3):1591-634.
    PMID: 27230414 DOI: 10.1002/tcr.201500279
    Graphene (GR) and its derivatives are promising materials on the horizon of nanotechnology and material science and have attracted a tremendous amount of research interest in recent years. The unique atom-thick 2D structure with sp(2) hybridization and large specific surface area, high thermal conductivity, superior electron mobility, and chemical stability have made GR and its derivatives extremely attractive components for composite materials for solar energy conversion, energy storage, environmental purification, and biosensor applications. This review gives a brief introduction of GR's unique structure, band structure engineering, physical and chemical properties, and recent energy-related progress of GR-based materials in the fields of energy conversion (e.g., photocatalysis, photoelectrochemical water splitting, CO2 reduction, dye-sensitized and organic solar cells, and photosensitizers in photovoltaic devices) and energy storage (batteries, fuel cells, and supercapacitors). The vast coverage of advancements in environmental applications of GR-based materials for photocatalytic degradation of organic pollutants, gas sensing, and removal of heavy-metal ions is presented. Additionally, the use of graphene composites in the biosensing field is discussed. We conclude the review with remarks on the challenges, prospects, and further development of GR-based materials in the exciting fields of energy, environment, and bioscience.
  18. Lim TO, Ding LM, Zaki M, Suleiman AB, Fatimah S, Siti S, et al.
    Med J Malaysia, 2000 Mar;55(1):108-28.
    PMID: 11072496 MyJurnal
    We describe the distribution of body weight, height and body mass index (BMI) by age, sex and ethnicity in Malaysian adults. A national sample of 28,737 individuals aged 20 or older had usable data. They were selected by stratified 2-stage cluster sampling. Percentile tables and curves by age, sex and ethnicity are presented. The body weight and BMI distributions were right skewed, while that of height was symmetrical. BMI distribution showed the expected increase with age, while that of height decrease with age. Differences in BMI between the 2 sexes and among the 4 ethnic groups were observed. Indian had the highest BMI, followed by Malay, Chinese and other indigenous ethnic group.
    Study name: National Health and Morbidity Survey (NHMS-1996)
  19. Meah FA, Abdullah T, Jasmi AY, Hisham AN, Tan TT, Khalid BA, et al.
    Ann Acad Med Singap, 1996 Mar;25(2):251-4.
    PMID: 8799016
    Between January 1978 to December 1993, 130 cases of adrenal diseases were diagnosed and surgically treated at the National University of Malaysia. They were 58 cases (44.6%) of Conn's syndrome, 40 cases (30.7%) of Cushing's syndrome, 20 cases (15.3%) of phaeochromocytoma and 12 cases (9.2%) of adrenocortical carcinoma (ACC). The commonest cause of Conn's syndrome was an adenoma (96.5%) which affected the left gland four times more than the right gland. Cushing's syndrome was caused by adrenocortical adenoma (32.5%), diffuse bilateral adrenal hyperplasia (40.0%), pigmented macronodular hyperplasia (20.0%) and adrenal carcinoma (7.5%). Twenty-five percent of the phaeochromocytomas were extraadrenal in origin arising mainly from the abdominal sympathetic chain. More than 50% of ACCs were non-functioning tumours. Fifty percent of the patients with ACC had inoperable tumours. The prognosis was poor even with adjuvant chemoradiotherapy. The main surgical approach was the anterior transabdominal route. There was no operative mortality or morbidity in all operated cases.
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