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Physical Activity Measurement by Accelerometry Among Older Malay Adults Living in Semi-Rural Areas-A Feasibility Study

Zainol Abidin N, Brown WJ, Clark B, Muhamed AM, Singh R

J Aging Phys Act, 2016 10;24(4):533-539.
PMID: 26964887

We evaluated feasibility of physical activity measurement by accelerometry among older Malay adults living in semi-rural areas in Malaysia. Results showed that 95% of 146 participants (aged [SD] 67.6 [6.4] years) were compliant in wearing the accelerometer for at least five days. Fifteen participants were asked for re-wear the accelerometer because they did not have enough valid days during the first assessment. Participants wore the accelerometer an average of 15.3 hr in a 24-hr day, with 6.5 (1.2) valid wear days. No significant difference in valid wear day and time was found between men and women. Participants who are single provide more valid wear days compared with married participants (p < .05), and participants with higher levels of education provide longer periods of accelerometer wearing hours (p < .01). Eighty-seven percent of participants reported 'no issues' with wearing the meter. This study suggests that accelerometry is a feasible method to assess the physical activity level among older Malay adults living in semi-rural areas.
Patterns of oviposition and development of Chrysomya megacephala (Fabricius) (Diptera: Calliphoridae) and Chrysomya rufifacies (Macquart) (Diptera: Calliphoridae) on burned rabbit carcasses

Mahat NA, Zainol-Abidin NL, Nordin NH, Abdul-Wahab R, Jayaprakash PT

Forensic Sci Int, 2016 Mar;260:9-13.
PMID: 26779962 DOI: 10.1016/j.forsciint.2015.12.047

Considering that crimes against animals such as illegal killing and cruelty have been alarmingly increasing and since burning is one of the common ways for disposing cadavers, ability to estimate minimum postmortem interval (PMI) using entomological data merits consideration. Chrysomya megacephala and Chrysomya rufifacies are common necrophagous species recovered from cadavers in many countries including Malaysia. Specific studies focusing on the oviposition and developmental patterns of both species on cadavers manifesting different levels of burn as described by the Crow-Glassman Scale (CGS) remain scarce. In four replicates, rabbit carcasses were burned to CGS levels #1, #2 and #3 by varying the amount of petrol used and duration of burning. Oviposition by C. megacephala and C. rufifacies was delayed by one day in the case of carcasses burned to the CGS level #3 (p<0.05) when compared with that of controls. Such delay in oviposition was not observed in the CGS level #1 and #2 carcasses. No significant differences (p>0.05) in the duration of development were found between control and burned carcasses. These findings deserve consideration while estimating minimum PMI since burning as a mean for disposing animal and human cadavers is gaining popularity.
Fulltext Determinants of Foreign Direct Investment in ASEAN+3 Countries: The Role of Environmental Degradation

Shaari MS, Asbullah MH, Zainol Abidin N, Karim ZA, Nangle B

Int J Environ Res Public Health, 2023 Jan 17;20(3).
PMID: 36767086 DOI: 10.3390/ijerph20031720

Foreign direct investment (FDI) can boost economic growth and provide job opportunities. FDI inflows in ASEAN+3 countries have dropped markedly, which may affect economic development in the region. Many previous studies have investigated a multitude of factors that can influence FDI, such as market size, inflation, trade openness, corruption, and inflation. Previous studies did not, however, consider environmental degradation as a potential factor. Besides corruption and inflation, imposing stringent environmental regulations, such as carbon pricing and taxes to reduce environmental degradation, might deter foreign investors from the country. This is due to heightened costs for foreign investors, which may cause FDI inflows to drop. To shed some light on the reality of this situation, this study examines whether environmental degradation can significantly affect foreign direct investment in the region. This study includes environmental degradation as a potential factor and employs the panel ARDL approach to analyse data from 1995 to 2019. Results show that environmental degradation, infrastructure, and corruption can affect the inflow of FDI in the long run. In the short run, inflation can affect FDI. The findings of this study can be utilized by policymakers in formulating the right policies to attract more investors. An increase in infrastructure facilities should be considered to attract more foreign investment. It is also vital for governments to reduce corruption and inflation to attract more FDI inflows. Environmental incentives should also be introduced to ensure that attempts to reduce environmental degradation do not affect FDI inflows.
Fulltext A Malaysian ex-smoker with cough, breathlessness and nonresolving bronchospasm

Lim JA, Caruppaiya N, Zainol Abidin N, Khor BT, Palanivelu T, Hukam Gopal Chand SD, et al.

Breathe (Sheff), 2019 Dec;15(4):324-329.
PMID: 31803267 DOI: 10.1183/20734735.0224-2019

Repeated noisy breathing may be a tricky feature of lung infection. Recognising classical features in radiographs and CT scans may help in the diagnosis of severe lung infection and the start of life-saving treatment. http://bit.ly/2lQwe5y.
Self-reported bone fracture among Malaysian adults: Baseline findings of PURE Malaysia cohort study

Zaleha MI, Noor Hassim I, Azmi MT, Hasni MJ, Rosnah I, Abdul-Hamid H, et al.

Med J Malaysia, 2023 Nov;78(6):787-792.
PMID: 38031222

INTRODUCTION: In Malaysia, studies on self-reported bone fractures are scarce. Due to the fact that bone fractures may serve as an indicator of osteoporosis in the community, this study aimed to identify the factors associated with their occurrence among adults in Malaysia.
MATERIALS AND METHODS: Epidemiological data for selfreported bone fractures were obtained through direct interviews using a validated questionnaire from the Prospective Urban and Rural Epidemiology (PURE) study.
RESULTS: Of 15,378 respondents, 6.63% (n=1019) reported bone fractures, with a higher proportion of men (65.8%, n=671) than women (34.2%, n=348). Higher odds of selfreporting bone fractures were seen in males (aOR, 2.12; 95%CI: 1.69, 2.65), those with a history of injury (aOR 5.01; 95%CI: 3.10, 6.32) and those who were obese (aOR: 1.46; 95% CI: 1.13, 1.89), highly active (aOR 1.25; 95%CI: 1.02, 1.53), smokers (aOR 1.35; 95%CI: 1.11, 1.65) and alcohol consumers (aOR 1.67; 95%CI: 1.20,2.32).
CONCLUSION: Adopting a healthier lifestyle that includes a balanced diet and moderate physical activity is critical for weight loss, increased muscle and bone mass and better stability, which reduces the likelihood of fractures following a fall.
Fulltext Vaping topography and reasons of use among adults in Klang Valley, Malaysia

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.
New insights of minimum requirement on legumes (Fabaceae sp.) daily intake in Malaysia

Jaafar MH, Ismail NH, Ismail R, Md Isa Z, Mohd Tamil A, Md Yasin M, et al.

BMC Nutr, 2023 Jan 09;9(1):6.
PMID: 36624521 DOI: 10.1186/s40795-022-00649-x

BACKGROUND: Despite their low energy density and high nutrient content, legumes may be under-recognised as a beneficial food for the prevention and management of obesity and related diseases, such as cardiovascular disease (CVD). This study aims to analyse the moderation effect of legume intake on the relationship between BMI and the prevalence of CVD among the Malaysian adult population.
METHODS: This study addressed communities of urban and rural Malaysia, including adults aged between 35 and 70 years old at the baseline recruitment. A series of standardised questionnaires were used to assess legume intake, history of comorbidities and socio-demographic information. Resting blood pressure measurements and physical examinations were performed to collect blood pressure and anthropometric data. Bivariate analysis was completed to determine the association between legume intake, socio-demographic characteristics and CVD prevalence. Moderation analysis was used to quantify the moderation effect of minimum daily legume intake on the relationship between BMI and CVD prevalence.
RESULTS: This study found that those who consume less than 3 servings of legumes per day benefit from protective effects against CVD risk (POR = 0.56, 95% CI = 0.37 - 0.85). Moderation analysis of a minimum of three servings/day for the relationship between BMI and CVD prevalence showed significant effects. The group that benefited the most from this effect was those with a BMI in the range of 26 to 34 kg/m2.
CONCLUSIONS: This study provides new insights into the recommendation for legume intake according to the relationship between BMI and the prevalence of CVD in Malaysian adults. This study recommends that those with a BMI of 26 to 34 kg/m2 should consume at least 3 servings of legumes per day to reduce the risk of CVD. Further prospective research is warranted to affirm these findings throughout the Malaysian population.
Normative reference values and predicting factors of handgrip strength for dominant and non-dominant hands among healthy Malay adults in Malaysia

Jaafar MH, Ismail R, Ismail NH, Md Isa Z, Mohd Tamil A, Mat Nasir N, et al.

BMC Musculoskelet Disord, 2023 Jan 28;24(1):74.
PMID: 36709276 DOI: 10.1186/s12891-023-06181-8

INTRODUCTION: Handgrip strength (HGS) measures the maximum voluntary force of the hand, which has been used to assess individual health status indirectly. Although several factors related to HGS have been identified, studies among adults in Malaysia are lacking. This study aimed to provide the normative reference HGS values and determine its predictor factors among healthy adults of Malay ethnic in Malaysia.
METHODOLOGY: This study was a part of the Prospective Urban Rural Epidemiology (PURE) study carried out among adults aged between 35 to 70 years old residing in urban and rural Malaysian communities. A standardised questionnaire was used to assess the socio-demographic information and physical activity level of respondents who provided written informed consent to participate in this study. HGS was measured using Jamar's dynamometer. A total of 3,446 healthy adults of Malay ethnic were included in this study. Descriptive data were used to derive the normative reference values for HGS using means and standard deviations stratified by age and gender. The predictors of HGS were determined using a general linear model (GLM).
RESULTS: Mean HGS ranged from 38.48 (± 9.40) kg for the dominant hand of men aged 35-40 years to 16.53 (± 5.69) kg for the non-dominant hand of women aged 61-70 years. The ANOVA indicated that there was a significant descending trend of HGS as age increased for both genders (p
Fulltext A cross-sectional analysis of the PURE study on minerals intake among Malaysian adult population with hypertension

Mat Nasir N, Md Isa Z, Ismail NH, Ismail R, Mohd Tamil A, Jaafar MH, et al.

Sci Rep, 2024 Apr 13;14(1):8590.
PMID: 38615144 DOI: 10.1038/s41598-024-59206-0

Hypertension (HPT) is the leading modifiable risk factor for cardiovascular diseases and premature death worldwide. Currently, attention is given to various dietary approaches with a special focus on the role of micronutrient intake in the regulation of blood pressure. This study aims to measure the dietary intake of selected minerals among Malaysian adults and its association with HPT. This cross-sectional study involved 10,031 participants from the Prospective Urban and Rural Epidemiological study conducted in Malaysia. Participants were grouped into HPT if they reported having been diagnosed with high blood pressure [average systolic blood pressure (SBP)/average diastolic blood pressure (DBP) ≥ 140/90 mm Hg]. A validated food frequency questionnaire (FFQ) was used to measure participants' habitual dietary intake. The dietary mineral intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, sodium, and zinc was measured. The chi-square test was used to assess differences in socio-demographic factors between HPT and non-HPT groups, while the Mann-Whitney U test was used to assess differences in dietary mineral intake between the groups. The participants' average dietary intake of calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, sodium, and zinc was 591.0 mg/day, 3.8 mg/day, 27.1 mg/day, 32.4 mg/day, 0.4 mg/day, 1431.1 mg/day, 2.3 g/day, 27.1 µg/day, 4526.7 mg/day and 1.5 mg/day, respectively. The intake was significantly lower among those with HPT than those without HPT except for calcium and manganese. Continuous education and intervention should be focused on decreasing sodium intake and increasing potassium, magnesium, manganese, zinc, and calcium intake for the general Malaysian population, particularly for the HPT patients.
Fulltext Prevalence and Factors Associated with Prehypertension and Hypertension Among Adults: Baseline Findings of PURE Malaysia Cohort Study

Ismail R, Ismail NH, Md Isa Z, Mohd Tamil A, Ja'afar MH, Mat Nasir N, et al.

Am J Med Open, 2023 Dec;10:100049.
PMID: 39035240 DOI: 10.1016/j.ajmo.2023.100049

BACKGROUND: Although prehypertension and hypertension can be detected at the primary healthcare level and low-cost treatments can effectively control its complications, hypertension is still the world's leading preventable risk factor. Therefore, the present study aimed to determine its prevalence and its risk factors among Malaysian adults.
METHODS: A cross-sectional study involving 7585 adults was performed covering the rural and urban areas. Respondents with systolic blood pressure (SBP) of 120-139 mmHg and/or diastolic blood pressure (DBP) of 80-89 mmHg were categorized as prehypertensive, and hypertensive categorization was used for respondents with an SBP of ≥140 mmHg and/or DBP of ≥90 mmHg.
RESULTS: Respondents reported to have prehypertension and hypertension were 40.7% and 38.0%, respectively. Those residing in a rural area, older age, male, family history of hypertension, and overweight or obese were associated with higher odds of prehypertension and hypertension. Unique to hypertension, the factors included low educational level (AOR: 1.349; 95% CI: 1.146, 1.588), unemployment (1.350; 1.16, 1.572), comorbidity of diabetes (1.474; 1.178, 1.844), and inadequate fruit consumption (1.253; 1.094, 1.436).
CONCLUSIONS: As the prehypertensive state may affect the prevalence of hypertension, proactive strategies are needed to increase early detection of the disease among specific group of those residing in a rural area, older age, male, family history of hypertension, and overweight or obese.
Correction: Pattern of macronutrients intake among type-2 diabetes mellitus (T2DM) patients in Malaysia

Md Isa Z, Ismail NH, Mohd Tamil A, Jaafar MH, Ismail R, Mohamed Noor Khan NA, et al.

BMC Nutr, 2023 Feb 07;9(1):27.
PMID: 36750888 DOI: 10.1186/s40795-023-00687-z
Fulltext Depressive symptoms among adults: Baseline findings of PURE Malaysia cohort study

Mohd Tamil A, Ismail NH, Jaafar MH, Md Isa Z, Ismail R, Mat Nasir N, et al.

Heliyon, 2024 Jan 15;10(1):e23042.
PMID: 38192831 DOI: 10.1016/j.heliyon.2023.e23042

INTRODUCTION: In Malaysia, the prevalence of depression has increased from 1.8 % to 2.3 % within a decade. Thus, this study was performed to identify depressive symptoms and its associated factors among Malaysian adults.
METHODS: A cross-sectional study was conducted among the adult population aged 35-70 residing in rural and urban areas in Malaysia. Depressive symptoms were assessed using the short form Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Composite International Diagnostic Interview (CIDI) questionnaire. Logistic regression models were fitted to identify the associated factors related to depressive symptoms.
RESULTS: About 3.7 % (95 % CI: 2.33-4.83) of the respondents reported having depressive symptoms. Younger adults aged 35-40 years old (AOR: 3.087; 95 % CI: 2.021-4.717), females (AOR: 2.318; 95 % CI: 1.669-3.219), widows and divorcees (AOR: 2.294; 95 % CI: 1.085-4.848), smokers (AOR: 1.843; 95 % CI: 1.334-2.545) and alcohol consumers (AOR: 1.843; 95 % CI: 1.264-2.688) showed a higher odds compared to their other counterparts. Underweight individuals (AOR: 1.899; 95 % CI: 1.177-3.065) and those diagnosed either with hypertension (AOR: 1.442; 95 % CI: 1.11-1.873), diabetes (AOR: 1.554; 95 % CI: 1.133-2.13), angina (AOR: 2.73; 95 % CI: 1.596-4.67), COPD (AOR: 4.187; 95 % CI: 1.528-11.472) or asthma (AOR: 1.906; 95 % CI: 1.309-2.774) were more likely to have depressive symptoms. Additionally, individuals with difficulty trusting people (AOR: 1.477; 95 % CI: 1.024-2.13) and those reported to experience either home or work-related stress (AOR: 2.584; 95 % CI: 2.003-3.331) were more prone to have depressive symptoms.
CONCLUSION: In this broad population-based study, about 3.7 % (95 % CI: 2.33-4.83) of respondents reported having depressive symptoms. Timely and well targeted collaborative intervention on the identified risk factors by the relevant authorities, would mitigate their effect on the quality of life and retard the progression into depression, especially among younger adults.
Fulltext Exploring Prevalence and Sociodemographic Factors Associated With Smoking Among Malaysian Adults: A Cross- Sectional Study

Ja'afar MH, Ismail R, Md Isa Z, Mohd Tamil A, Ismail NH, Mat Nasir N, et al.

Health Sci Rep, 2025 Jan;8(1):e70310.
PMID: 39741747 DOI: 10.1002/hsr2.70310

BACKGROUND AND AIMS: The Malaysian government has implemented various antismoking measures to reduce the incidence of unhealthy lifestyles within the population. This study analyzes the baseline data of the Prospective Urban Rural Epidemiology (PURE) study to establish the prevalence of sociodemographic factors that are associated with smoking habits among Malaysian adults.
METHODS: This study was carried out in urban and rural communities with adults aged between 35 and 70 years using purposive sampling. Standardized questionnaires were used to assess the smoking status and sociodemographic data of the participants. Bivariate analysis and multiple logistic regression were done to determine the association between smoking status and demographic characteristics among Malaysian adults.
RESULTS: The prevalence of smoking among adults is 23.2%. The sociodemographic factors significantly associated with active smoking status were being a younger adult (adjusted odds ratio [AOR] = 1.26, 95% CI: 1.06-1.50), being male (AOR = 24.16, 95% CI: 20.58-28.36), being Malay (AOR = 1.72, 95% CI: 1.49-1.98), being a blue-collar worker (AOR = 1.75, 95% CI: 1.48-2.06), having no formal education (AOR = 1.99, 95% CI: 1.56-2.53), being unmarried (AOR = 1.22, 95% CI: 1.02-1.48) and being of low socioeconomic status (AOR = 1.45, 95% CI: 1.14-1.84).
CONCLUSION: Public health policies and actions on smoking reduction should emphasize those identified as high-risk sub-populations, particularly younger adults, males and those who are not yet married, have no formal education and are of low socioeconomic status.
The rate of blood culture contamination and common organisms isolated in Malaysian public hospitals

Mokhtar NA, Ting SY, Zainol Abidin NZ, Abdul Hameed A, Mohamed Z, Mustapa NI, et al.

Malays J Pathol, 2024 Aug;46(2):307-314.
PMID: 39207008

INTRODUCTION: Blood culture contamination remains a dilemma issue in the diagnosis of bloodstream infection. However, to date, there is no national data on blood culture contamination and the common organism isolated in Malaysia. This is a pioneer multi-centre study involving public hospitals with medical microbiologists in Malaysia to determine the blood culture contamination rate and the common organism isolated.
MATERIALS AND METHODS: This retrospective cross-sectional study involved record review of all blood culture results over 9 months period from 1st January 2018 until 30th September 2018 in 27 government hospitals in Malaysia. For each positive culture result, the type of isolated organism was classified to represent true bacteraemia or contamination.
RESULTS: We analysed 448,109 blood culture records from the participating hospitals. The blood culture positivity rate was 12.5% (57395 of 448109) and 25.0% (14367 of 57395) of the positive blood culture represents contamination. The national blood culture contamination rate in Malaysia was 3.2%. The contamination rate in the adult population was significantly higher than the paediatric population (3.6% vs. 2.6%; p<0.001). The blood contamination rate by institution ranged from 1.5% to 6.8%. The most frequently isolated microorganisms in the contaminated cultures were coagulase-negative staphylococci (71.0%).
CONCLUSION: Blood culture contamination is a major issue that warrants priority in recognition, and interventions should be implemented to reduce the blood contamination rate in Malaysia.

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