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Fulltext Colonization of Methicillin-Resistant Staphylococcus aureus (MRSA) among Medical Students in Tertiary Institution in Central Malaysia

Rampal S, Zainuddin NH, Elias NA, Tengku Jamaluddin TZM, Maniam S, Teh SW, et al.

Antibiotics (Basel), 2020 Jul 06;9(7).
PMID: 32640588 DOI: 10.3390/antibiotics9070382

Methicillin-resistant Staphylococcus aureus or MRSA infection is virulent and presents with a broad spectrum of severity. Limited regional reports that specifically outlined the potential risk of medical students being part of the dissemination of MRSA in healthcare settings were noted. This study aims to assess the prevalence and contributory factors of colonization of MRSA on neckties, headscarves, and ID badges among medical students in a local medical university in Malaysia. A cross-sectional study was conducted involving 256 medical students. A validated questionnaire was used to collect the data, and sample swabs were collected between July and August 2013 by swabbing neckties, headscarves, or identification badges. The swabs were then streaked onto mannitol salt agar (MSA) and incubated at 37 °C overnight. Out of 433 samples taken, 40 swabs (9.24%) were positive for Staphylococcus aureus. Out of the 40 swabs, five (12.5%) isolates were MRSA (one culture was isolated from the headscarf of a preclinical student, one culture was isolated from the necktie of clinical students, while the remaining three were isolated from identification badges of clinical students. There was no significant association between age, gender, ethnicity, and phase of medical students with the colonization of MRSA (p > 0.05). There was a significant association between knowledge score on hand hygiene practice and phase of medical students. MRSA colonies were present on neckties, headscarves, and identification badges of medical students of all phases. The findings from this study suggest the need for improvement of hand hygiene knowledge and discontinuity of mandatory use of physical ID badges and neckties among medical students.
Sensitive Leptospira DNA detection using tapered optical fiber sensor

Zainuddin NH, Chee HY, Ahmad MZ, Mahdi MA, Abu Bakar MH, Yaacob MH

J Biophotonics, 2018 08;11(8):e201700363.
PMID: 29570957 DOI: 10.1002/jbio.201700363

This paper presents the development of tapered optical fiber sensor to detect a specific Leptospira bacteria DNA. The bacteria causes Leptospirosis, a deadly disease but with common early flu-like symptoms. Optical single mode fiber (SMF) of 125 μm diameter is tapered to produce 12 μm waist diameter and 15 cm length. The novel DNA-based optical fiber sensor is functionalized by incubating the tapered region with sodium hydroxide (NaOH), (3-Aminopropyl) triethoxysilane and glutaraldehyde. Probe DNA is immobilized onto the tapered region and subsequently hybridized by its complementary DNA (cDNA). The transmission spectra of the DNA-based optical fiber sensor are measured in the 1500 to 1600 nm wavelength range. It is discovered that the shift of the wavelength in the SMF sensor is linearly proportional with the increase in the cDNA concentrations from 0.1 to 1.0 nM. The sensitivity of the sensor toward DNA is measured to be 1.2862 nm/nM and able to detect as low as 0.1 fM. The sensor indicates high specificity when only minimal shift is detected for non-cDNA testing. The developed sensor is able to distinguish between actual DNA of Leptospira serovars (Canicola and Copenhageni) against Clostridium difficile (control sample) at very low (femtomolar) target concentrations.
Lifestyles and Sexual Behaviour Among School-Going Adolescents: A Mediational Role of Mental Health

Cheah YK, Zainuddin NH, Kee CC, Lim KH, Omar MA, Cheong YL

Clin Child Psychol Psychiatry, 2023 Oct;28(4):1341-1357.
PMID: 36428238 DOI: 10.1177/13591045221142497

Sexual behaviour and mental health among adolescents are major public health issues. This study examines how lifestyles affect sexual behaviour among school-going adolescents in Malaysia, and the potential mediational role of mental health. It is the first to our knowledge to explore the mediating effect of mental health on sexual behaviour with a focus on a fast-growing developing country. Data were obtained from the National Health and Morbidity Survey 2017 (n = 27,497). Structural equation modelling was utilized to examine depression and anxiety as mediators of the relationships between sexual behaviour and smoking, alcohol drinking and illicit drug use, controlling for sociodemographic factors. Results showed that adolescents who smoked, consumed alcohol, used illicit drugs, and had depression and anxiety were more likely to engage in sexual behaviour than others. Depression and anxiety partially mediated the relationships between sexual behaviour and smoking, and illicit drug use. The association between alcohol drinking and sexual behaviour was fully mediated by depression and anxiety. In conclusion, lifestyles may affect sexual behaviour through mediation of mental health. Therefore, policymakers should take mental health factors into consideration when designing adolescent sexual behaviour preventative interventions.
Is There An Optimal Time for Performing Cranioplasties? Results from a Prospective Multinational Study

Quah BL, Low HL, Wilson MH, Bimpis A, Nga VDW, Lwin S, et al.

World Neurosurg, 2016 Oct;94:13-17.
PMID: 27368511 DOI: 10.1016/j.wneu.2016.06.081

BACKGROUND: The optimal timing of cranioplasty remains uncertain.
OBJECTIVE: We hypothesized that the risk of infections after primary cranioplasty in adult patients who underwent craniectomies for non-infection-related indications are no different when performed early or delayed. We tested this hypothesis in a prospective, multicenter, cohort study.
METHODS: Data were collected prospectively from 5 neurosurgical centers in the United Kingdom, Malaysia, Singapore, and Bangladesh. Only patients older than 16 years from the time of the non-infection-related craniectomy were included. The recruitment period was over 17 months, and postoperative follow-up was at least 6 months. Patient baseline characteristics, rate of infections, and incidence of hydrocephalus were collected.
RESULTS: Seventy patients were included in this study. There were 25 patients in the early cranioplasty cohort (cranioplasty performed before 12 weeks) and 45 patients in the late cranioplasty cohort (cranioplasty performed after 12 weeks). The follow-up period ranged between 16 and 34 months (mean, 23 months). Baseline characteristics were largely similar but differed only in prophylactic antibiotics received (P = 0.28), and primary surgeon performing cranioplasty (P = 0.15). There were no infections in the early cranioplasty cohort, whereas 3 infections were recorded in the late cohort. This did not reach statistical significance (P = 0.55).
CONCLUSIONS: Early cranioplasty in non-infection-related craniectomy is relatively safe. There does not appear to be an added advantage to delaying cranioplasties more than 12 weeks after the initial craniectomy in terms of infection reduction. There was no significant difference in infection rates or risk of hydrocephalus between the early and late cohorts.
Fulltext Prevalence and factors associated with multimorbidity among older adults in Malaysia: a population-based cross-sectional study

Shariff Ghazali S, Seman Z, Zainuddin NH, Omar MA, Sooryanarayana R, Ariaratnam S, et al.

BMJ Open, 2021 10 20;11(10):e052126.
PMID: 34670764 DOI: 10.1136/bmjopen-2021-052126

OBJECTIVES: To determine the prevalence and factors associated with multimorbidity among community-dwelling older adults in Malaysia.
DESIGN: A population-based cross-sectional study.
SETTING: 13 states and 3 Federal Territories in Malaysia.
PARTICIPANTS: A total of 3966 adults aged 60 years and above were extracted from the nationwide National Health and Morbidity Survey (NHMS) 2018 data set.
PRIMARY OUTCOME MEASURES: Multimorbidity was defined as co-occurrence of at least two known chronic non-communicable diseases in the same individual. The chronic diseases included hypertension, type 2 diabetes mellitus, dyslipidaemia and cancer.
RESULTS: The prevalence of multimorbidity among Malaysian older adults was 40.6% (95% CI: 37.9 to 43.3). The factors associated with multimorbidity were those aged 70-79 years (adjusted OR (AOR)=1.30; 95% CI=1.04 to 1.63; p=0.019), of Indian (AOR=1.69; 95% CI=1.14 to 2.52; p=0.010) and Bumiputera Sarawak ethnicities (AOR=1.81; 95% CI=1.14 to 2.89; p=0.013), unemployed (AOR=1.53; 95% CI=1.20 to 1.95; p=0.001), with functional limitation from activities of daily livings (AOR=1.66; 95% CI=1.17 to 2.37; p=0.005), physically inactive (AOR=1.28; 95% CI=1.03 to 1.60; p=0.026), being overweight (AOR=1.62; 95% CI=1.11 to 2.36; p=0.014), obese (AOR=1.88; 95% CI=1.27 to 2.77; p=0.002) and with abdominal obesity (AOR=1.52; 95% CI=1.11 to 2.07; p=0.009).
CONCLUSION: This study highlighted that multimorbidity was prevalent among older adults in the community. Thus, there is a need for future studies to evaluate preventive strategies to prevent or delay multimorbidity among older adults in order to promote healthy and productive ageing.
Prevalence study of epilepsy in Malaysia

Fong SL, Lim KS, Tan L, Zainuddin NH, Ho JH, Chia ZJ, et al.

Epilepsy Res, 2021 02;170:106551.
PMID: 33440303 DOI: 10.1016/j.eplepsyres.2021.106551

INTRODUCTION: The lifetime prevalence of epilepsy varies greatly from 1.5-14.0 per 1000 persons among the Asian countries. We aim to study the prevalence of epilepsy in Malaysia to have a better insight into the burden of disease in the country.
METHODS: A population-based door-to-door survey was carried out throughout the country, using questionnaire for brief screening in ascertainment of epilepsy, using a questionnaire and its validated multilingual versions. Respondents who were screened positive underwent second-stage diagnostic phone interview by neurologists/ research assistants.
RESULTS: A total 16, 686 respondents participated in the survey and 646 (3.8 %) respondents were screened positive during the first stage interview. A total of 185 consented for second stage diagnostic interview and 118 (63.8 %) respondents were contacted successfully for the second stage diagnostic phone interview, of which 17 (14.4 %) respondents were diagnosed to have epilepsy. An additional 68 (57.6 %) respondents had febrile seizures only. After applying a weighting factor to each respondent to adjust for non-response and for the varying probabilities of selection, the adjusted lifetime epilepsy prevalence was 7.8 in 1000 population, and the adjusted prevalence for active epilepsy was 4.2 in 1000 population in Malaysia.
CONCLUSION: The prevalence of lifetime epilepsy in Malaysia is 7.8 per 1000 persons.
Fulltext Developing forecasting model for future pandemic applications based on COVID-19 data 2020-2022

Wan Mohamad Nawi WIA, K Abdul Hamid AA, Lola MS, Zakaria S, Aruchunan E, Gobithaasan RU, et al.

PLoS One, 2023;18(5):e0285407.
PMID: 37172040 DOI: 10.1371/journal.pone.0285407

Improving forecasting particularly time series forecasting accuracy, efficiency and precisely become crucial for the authorities to forecast, monitor, and prevent the COVID-19 cases so that its spread can be controlled more effectively. However, the results obtained from prediction models are inaccurate, imprecise as well as inefficient due to linear and non-linear patterns exist in the data set, respectively. Therefore, to produce more accurate and efficient COVID-19 prediction value that is closer to the true COVID-19 value, a hybrid approach has been implemented. Thus, aims of this study is (1) to propose a hybrid ARIMA-SVM model to produce better forecasting results. (2) to investigate in terms of the performance of the proposed models and percentage improvement against ARIMA and SVM models. statistical measurements such as MSE, RMSE, MAE, and MAPE then conducted to verify that the proposed models are better than ARIMA and SVM models. Empirical results with three real datasets of well-known cases of COVID-19 in Malaysia show that, compared to the ARIMA and SVM models, the proposed model generates the smallest MSE, RMSE, MAE and MAPE values for the training and testing datasets, means that the predicted value from the proposed model is closer to the actual value. These results prove that the proposed model can generate estimated values more accurately and efficiently. As compared to ARIMA and SVM, our proposed models perform much better in terms of error reduction percentages for all datasets. This is demonstrated by the maximum scores of 73.12%, 74.6%, 90.38%, and 68.99% in the MAE, MAPE, MSE, and RMSE, respectively. Therefore, the proposed model can be the best and effective way to improve prediction performance with a higher level of accuracy and efficiency in predicting cases of COVID-19.
Fulltext Assessing the sustainability of the homestay industry for the East Coast of Malaysia using the Delphi approach

Zamzuki FA, Lola MS, Aruchunan E, Muthuvalu MS, Jubilee RVW, Zainuddin NH, et al.

Heliyon, 2023 Nov;9(11):e21433.
PMID: 38027815 DOI: 10.1016/j.heliyon.2023.e21433

Homestay ecotourism in Malaysia has been extensively examined in terms of its concepts, approaches, activities, and community engagement. However, a comprehensive assessment of the sustainability factors pertaining to host families remains a critical area awaiting exploration. This is paramount for ensuring the long-term viability of homestays and fostering economic benefits within rural communities. The present study seeks to establish direct subjective measurements for evaluating the interplay between local communities, tourism, and resources in safeguarding sustainable homestays. Utilizing the Delphi approach, this research conducted interviews with 51 experts who were actively involved in six homestays located on the East Coast of Peninsular Malaysia. The objective was to identify key evaluation indicators pertinent to the homestay industry. The findings underscored the pivotal roles played by community resources and tourism in the sustainability of homestays. Additionally, environmental, economic, and social factors emerged as crucial components for maintaining the industry's sustainability. This innovative assessment methodology offers a valuable instrument for enhancing the sustainability of the homestay sector, especially in the wake of the COVID-19 pandemic. By embracing this approach, homestay operators can fortify their sustainable management practices and prepare themselves for future pandemics. This study represents a significant contribution to the field of homestay ecotourism, emphasizing the imperative for continued research in this dynamic domain.