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Fulltext Prevalence and reasons for smoking among upper secondary schoolboys in Hulu Langat, Malaysia

Khairani, O., Norazua, R., Zaiton, A.

Medicine & Health, 2007;2(1):80-85.
MyJurnal

Smoking in adolescence is a great health concern as it is related to many chronic diseases and mortality in later life. It is also associated with other high-risk behaviours among adolescents. The objective of this study was to determine the prevalence and reasons for smoking among upper secondary schoolboys. This was a cross-sectional study conducted among Form 4 and Form 5 students. Three schools in the District of Hulu Langat were identified and students from these schools were selected randomly. The students were given a self-administered questionnaire. A total of 343 students were included in the study. The prevalence of smoking among the schoolboys was 37%. Although the majority of them initiated smoking between 13-15 years old (67%), 21% of them began smoking below 12 years of age (primary school). There was a significant association between adolescent smoking and smoking among family members (p<0.05). The common reasons reported for
initiating smoking were curiosity (69%) and peer pressure (51%). However, the common reasons for continuing smoking were stress (70%) and addiction (49%). Schoolwork was reported as the most important factor which contributed to their stress. Smoking prevention programmes should begin early in primary schools. Adolescents should be educated on effective coping strategies in managing stress and learning to be assertive.
Keywords: smoking, adolescents, secondary school, reasons.
Fulltext Prevalence of Falls among Older People attending a Primary Care Clinic in Kuala Lumpur, Malaysia

Sazlina, S.G., Krishnan, R., Shamsul, A.S., Zaiton, A., Visvanathan, R.

Malaysian Journal of Community Health, 2008;14(1):11-0.
MyJurnal

Introduction : The aim of this study was to determine the prevalence and the pattern of falls in community dwelling older people attending a primary care clinic in Kuala Lumpur, Malaysia.
Methods : A cross sectional study was conducted in an urban primary care clinic. Participants aged 60 years and older were included in the study. A structured questionnaire, assessing socio-demographic variables, medical and falls history was administered by one investigator over a 3-month period in 2004.
Results : A total of 151 respondents participated in this study with a response rate of 72%. The prevalence of falls was 47.0% over the previous 12-months period. Fifty-seven percent reported experiencing recurrent falls. Majority (61%) of falls occurred in the home and the two most common places were the bathroom (27%) and stairs (27%). Sixty-one percent of older people who fell, sustained an injury and most sought medical attention.
Conclusion : In conclusion, falls are common amongst older people attending this primary care clinic. It occurred commonly in the home in the bathroom and near stairs. However, a larger local community study is warranted to determine the prevalence and risk factors for falls in Malaysia.

Study site: primary care clinic in Kuala Lumpur, Malaysia
Fulltext Cushing’s syndrome secondary to adulterated complementary and alternative medicine

Sazlina SG, Zaiton A

Malays Fam Physician, 2009;4(2):94-97.
PMID: 25606172 MyJurnal

This is a case of a 65 year old lady who presented with Cushing’s syndrome secondary to ingestion of a complementary and alternative medicine that has been adulterated with exogenous glucocorticoids. In a clinical consultation, it is important to include assessment of complementary and alternative medicine use for a comprehensive care.
Fulltext Reactive arthritis in tuberculosis: A case of Poncet's disease

Irmi Z, Zaiton A, Faezah H

Malays Fam Physician, 2013;8(1):24-7.
PMID: 25606264 MyJurnal

Reactive arthritis and erythema are uncommon presentations of tuberculosis (TB). Reactive arthritis in tuberculosis (TB) is known as Poncet's disease, a rare aseptic form of arthritis observed in patients with active TB. We report a case of Poncet's disease in a 20-year old man whose reactive arthritis overshadowed other clinical symptoms of TB resulting in delayed diagnosis and treatment. Although a conclusive diagnosis of Poncet's disease is not possible, reactive immunologic reactions such as reactive arthritis and erythema nodosum even without respiratory symptoms should raise suspicion on possible TB. Thus, taking a thorough medical history as well as performing relevant examinations and investigations for possible TB will help expedite the diagnostic process.
Fulltext A clinical audit on diabetes care in two urban public primary care clinics in Malaysia

Sazlina SG, Zailinawati AH, Zaiton A, Ong I

Malaysian Journal of Medicine and Health Sciences, 2010;6(1):101-109.
MyJurnal

Introduction: The incidence of diabetes mellitus (DM) is increasing globally and it is associated with significant morbidity and mortality. The importance of a better quality of diabetes care is increasingly acknowledged. Objective: This clinical audit was conducted to assess the quality of care given to type 2 DM patients in public primary care clinics. Methods: A clinical audit was conducted in two selected urban public primary care clinics, between April and June of 2005. The indicators and criteria of quality care were based on the current Malaysian clinical practice guidelines for type 2 DM. A structured pro forma was used to collect data. Results: A total of 396 medical records of patients with type 2 DM were included in this audit. Most of the patients had measurements of fasting blood glucose and blood pressure recorded in more than 90% of the visits over the previous one year. Twenty-seven percent of the patients had glycosylated haemoglobin (HbA1c) done every 6 months with a mean of 8.3%. Only 15.6% had HbA1c values less than 6.5 %. Fifty percent had blood pressure controlled at 130/80 mmHg and below; and 13.0% had low density lipoprotein cholesterol values of 2.6 mmol/L or less. The majority of the patients were overweight or obese. Conclusions: The quality of diabetes care in this study was
found to be suboptimal. There is a gap between guidelines and clinical practice. Certain measures to improve the quality of diabetes care need to be implemented with more rigour.
Fulltext The nutritional status of 1081 elderly people residing in publicly funded shelter homes in Peninsular Malaysia

Visvanathan R, Zaiton A, Mohd Sidik S, Muhamad YA

Eur J Clin Nutr, 2005 Mar;59(3):318-24.
PMID: 15523487

OBJECTIVES: The aim of this study was to determine the: (1) prevalence of undernutrition as determined by the 'DETERMINE Your Nutritional Health Checklist' (NHC) and (2) factors independently associated with undernutrition among the older residents of these publicly funded shelter homes in Peninsular Malaysia.
DESIGN: A total of 1081 elderly people (59%M) over the age of 60 y were surveyed using questionnaires determining baseline demographics, nutritional and cognitive status, physical function and psychological well-being.
SETTING: Shelter homes, Peninsular Malaysia.
RESULTS: In all, 41.4% (n = 447) were nourished (score <3), 32.1% (n = 347) at moderate risk (score between 3 and 5) and 26.6% (n = 287) were at high risk of undernutrition (score>5) according to the NHC. A large proportion of subjects were underweight with 14.3% of subjects recording a low body mass index (BMI) <18.5 kg/m2 and a further 18.2% recording a BMI between 18.5 and 20 kg/m2. The residential geriatric depression score (GDS-12R) (relative risk (RR) = 1.03 (95% confidence interval (CI) 1.01-1.05); P = 0.002) and the number of illnesses (RR = 1.14 (95% CI 1.07-1.21); P < 0.001) were found to be independently associated with nutritional risk (NHC score > or = 3). Using a BMI < 18.5 kg/m2 as an objective marker for nutritional risk, the NHC was shown to have a sensitivity of 66.4% (95% CI 58.0-74.2%), specificity of 42.7% (95% CI 39.3-46.1%), positive predictive value of 16.2% (95% CI 13.3-19.5%) and a negative predictive value of 88.4% (95% CI 84.9-91.4%).
CONCLUSIONS: Many elderly people residing in publicly funded shelter homes in Malaysia may be at-risk of undernutrition, and were underweight. The NHC is better used as an awareness tool rather than as a screening tool.
Fulltext Nutritional composition of ready-to-eat cereals in the Malaysian market

Suraiami, M., Mohd Fairulnizal, M.N., Norhayati, M.K., Zaiton, A., Norliza, A.H., Wan Syuriahti, W.Z., et al.

Malays J Nutr, 2014;20(3):417-427.
MyJurnal

Introduction: This study aimed to determine the nutrient content of cornflakes and muesli, ready-to-eat cereal products available in the Malaysian market. Cornflakes and muesli were chosen due to their popularity as a breakfast meal especially in urban areas. Methods: A total of six brands each for cornflakes and muesli were purchased from supermarkets in the Klang Valley using stratified random sampling. All samples were analysed using AOAC official methods of analysis. The validity of the test data was monitored with the application of internal quality controls in line with the requirements of ISO 17025. Results: Proximate analysis revealed significantly higher mean levels of carbohydrate (86.94 ± 0.59 mg/lOOg), minerals such as iron (8.48±1.72 mg/lOOg) and sodium (674.83±102.99 g/lOOg), B3 as niacinamide (25.87 ± 6.14 g/lOOg) and sucrose (5.10 ± 0.90 mg/lOOg) in cornflakes than in muesli. However, muesli contained significantly more mean moisture (10.23 ± 0.72 mg/lOOg), protein (10.07 ± 0.79 mg/lOOg), total dietary fibre (12.49 ± 1.44 mg/lOOg), magnesium (113.22 ± 7.93 mg/lOOg), zinc (1.65 ± 0.16 mg/lOOg), copper (0.25 ± 0.02 mg/lOOg), total sugar (18.75 ± 2.05 mg/lOOg), glucose (7.70±1.77 mg/lOOg) and fructose (8.68±1.76 mg/lOOg) than cornflakes. Most of the fatty acids analysed were not detected or of low value in both the cereal products. Conclusion: The nutrient analysis of cornflakes and muesli suggests that both ready-to-eat cereals are nutritionally good choice as breakfast for consumers as it provides carbohydrate, minerals, fibre and vitamins. The data provides additional information to the Malaysian Food Composition Database.
Development and validation of a selective, sensitive and stability indicating UPLC-MS/MS method for rapid, simultaneous determination of six process related impurities in darunavir drug substance

A VBR, Yusop Z, Jaafar J, Aris AB, Majid ZA, Umar K, et al.

J Pharm Biomed Anal, 2016 Sep 05;128:141-148.
PMID: 27262107 DOI: 10.1016/j.jpba.2016.05.026

In this study a sensitive and selective gradient reverse phase UPLC-MS/MS method was developed for the simultaneous determination of six process related impurities viz., Imp-I, Imp-II, Imp-III, Imp-IV, Imp-V and Imp-VI in darunavir. The chromatographic separation was performed on Acquity UPLC BEH C18 (50 mm×2.1mm, 1.7μm) column using gradient elution of acetonitrile-methanol (80:20, v/v) and 5.0mM ammonium acetate containing 0.01% formic acid at a flow rate of 0.4mL/min. Both negative and positive electrospray ionization (ESI) modes were operated simultaneously using multiple reaction monitoring (MRM) for the quantification of all six impurities in darunavir. The developed method was fully validated following ICH guidelines with respect to specificity, linearity, limit of detection (LOD), limit of quantification (LOQ), accuracy, precision, robustness and sample solution stability. The method was able to quantitate Imp-I, Imp-IV, Imp-V at 0.3ppm and Imp-II, Imp-III, and Imp-VI at 0.2ppm with respect to 5.0mg/mL of darunavir. The calibration curves showed good linearity over the concentration range of LOQ to 250% for all six impurities. The correlation coefficient obtained was >0.9989 in all the cases. The accuracy of the method lies between 89.90% and 104.60% for all six impurities. Finally, the method has been successfully applied for three formulation batches of darunavir to determine the above mentioned impurities, however no impurity was found beyond the LOQ. This method is a good quality control tool for the trace level quantification of six process related impurities in darunavir during its synthesis.
Fulltext Cross-sectional study of older adults with type 2 diabetes mellitus in two rural public primary healthcare facilities in Malaysia

Ooi CP, Loke SC, Zaiton A, Tengku-Aizan H, Zaitun Y

Med J Malaysia, 2011 Jun;66(2):108-12.
PMID: 22106688 MyJurnal

Knowledge of the characteristics of older adults with type 2 diabetes mellitus (T2DM) is indispensible for improvement of their care. A cross-sectional study in two rural public primary healthcare centres in Malaysia identified 170 actively engaged older patients with T2DM, with suboptimal glycaemic control and frequent hypoglycaemia. The prevalence of multiple co-morbidities, complications of T2DM, high cardiovascular risk, neurological, musculoskeletal and visual deficits suggested high risk of disabilities and dependency but not yet disabled. This short window for interventions presents as an opportunity for development of a more comprehensive approach extending beyond glycaemia control to risk management, preventing functional loss and continuity of social participation.
Study site: Klinik Kesihatan, Selangor, Malaysia
Fulltext Nutrient content in selected commercial rice in Malaysia: An update of Malaysian food composition database

Mohd Fairulnizal, M.N., Norhayati, M.K., Zaiton, A., Norliza, A.H., Rusidah, S., Aswir, A.R., et al.

International Food Research Journal, 2015;22(2):768-776.
MyJurnal

There is an increase need and demand to update Malaysian Food Composition Database (FCD) which was last updated in 1997. The current FCD program was designed to expand the quantity and improve the quality of the existing database. The present work was aimed to determine the nutrient content of commercial rice products from three rice varieties classified as raw and processed foods, namely Basmati, Siam, and Fragrant rice. A total of six brands from each type of rice were sampled from a local supermarket within Klang Valley. Analyses were carried out for 27 nutrients that include proximate (Energy, Water, Protein, Fat, Carbohydrate, Total Dietary Fibre, and Ash), minerals (Magnesium, Calcium, Sodium, Iron, Zinc, and Copper), water soluble vitamins (C, B1, B2, B3, B6 and B9), fat soluble vitamins (A and E), total sugar, fatty acids (total saturated fat, total monounsaturated fat and total polyunsaturated), trans fatty acids, and cholesterol. The three rice varieties were found to contain comparable nutrient levels except for vitamin C, B1, A, E and total sugar which were not detected in all samples. The fatty acid (total saturated, total monounsaturated, and total polyunsaturated) as well as trans- fatty acid were detected at very low levels. Cholesterol was not detected in all samples. These findings can be utilised in raising public awareness and assistance to better estimate nutrient contents and intake depending on the varieties of rice.
Predictors of health related quality of life in older people with non-communicable diseases attending three primary care clinics in Malaysia

Sazlina SG, Zaiton A, Nor Afiah MZ, Hayati KS

J Nutr Health Aging, 2012 May;16(5):498-502.
PMID: 22555798

OBJECTIVES: To determine the health related quality of life and its predictive factors among older people with non-communicable diseases attending primary care clinics.
DESIGN: Cross-sectional study.
SETTING: Three public primary care clinics in a district in Selangor, Malaysia.
PARTICIPANTS: Registered patients aged 55 years and above.
MEASUREMENTS: A face-to-face interview was conducted using a validated questionnaire of Medical Outcome Study 36-item short form health survey (SF-36). The outcome measure was the health related quality of life (HRQoL) and other factors measured were socio demography, physical activity, social support (Duke-UNC Functional Social Support Questionnaire), and presence of non-communicable diseases.
RESULTS: A total of 347 participants had non-communicable diseases which included hypertension (41.8%), type 2 diabetes (33.7%), asthma (4.8%), hyperlipidaemia (1.7%), coronary heart disease (1.2%), and osteoarthritis (0.2%). Age ≥ 65 years old (OR =2.23; 95%CI=1.42, 3.50), single (OR=1.75; 95%CI=1.06,2.90), presence of co-morbid condition (OR=1.66; 95%CI=1.06, 2.61), and poorer social support (OR=2.11; 95%CI=1.27, 3.51; p=0.002) were significant predictors of poorer physical component of HRQoL . In predicting lower mental health component of HRQoL, the significant predictors were women (OR=2.28; 95%CI=1.44, 3.62), Indian ethnicity (OR=1.86; 95%CI=1.08, 3.21) and poorer social support (OR=2.71; 95%CI=1.63, 4.51). No interactions existed between these predictors.
CONCLUSION: Older people with non-communicable diseases were susceptible to lower health related quality of life. Increasing age, single, presence of co-morbid conditions, and poorer social support were predictors of lower physical health component of HRQoL. While the older women, Indian ethnicity and poorer social support reported lower mental health component of HRQoL.
Fulltext Ethnic differences in glycaemic control and complications: the adult diabetes control and management (ADCM), Malaysia

Chew BH, Mastura I, Lee PY, Wahyu TS, Cheong AT, Zaiton A

Med J Malaysia, 2011 Aug;66(3):244-8.
PMID: 22111449 MyJurnal

Ethnicity is an important factor in diabetes care. The understanding of its effect in this country may help to improve diabetes care, glycaemic control and diabetic complication rates. This study was to determine the diabetes control profile in relation to complication rates between the three main ethnics group in Malaysia.
Fulltext Gycaemic control and treatment profile amongst 20646 adult type 2 diabetes mellitus: a descriptive report

Chew BH, Lee PY, Mastura I, Cheong AT, Sri Wahyu T, Zaiton A

Pertanika Journal of Science & Technology, 2014;22(1):95-103.
MyJurnal

An audit of Diabetes Control and Management-Diabetes Registry Malaysia (ADCM-DRM) was started to monitor the provision of diabetes care in the country. A total of 20,646 patients were registered in the registry until 31st December 2008. This report set out to determine the Type 2 diabetes controls and treatment profiles of these cohorts of patients. This was a registry-based observational study conducted from May to December, 2008. An online standard case record form was available for site data providers to register their diabetic patients aged 18 years old and above annually. Demographic data, diabetes duration, treatment modalities, as well as various risk factors and diabetes complications were reported. Data were analyzed using Data Analysis and Statistical Software (Stata) version 9. A total of 81 centres, 6 of which were hospitals, participated in this registry until 31st December 2008, contributing a total of 20646 patients. A majority of them (99.2%) had Type 2 diabetes mellitus. The mean HbA1c was 8.0% (SD 2.10), with 30.1% and 17.9% of the patients who attained HbA1c < 7% and HbA1c < 6.5%, respectively. Metformin was prescribed more than sulfonylurea while only 11% had insulin. A review of the diabetic care policy and strategies in the primary health care clinics is needed to implement a more effective treatment of diabetes in this country.
Does ethnicity contribute to the control of cardiovascular risk factors among patients with type 2 diabetes?

Lee PY, Cheong AT, Zaiton A, Mastura I, Chew BH, Sazlina SG, et al.

Asia Pac J Public Health, 2013 Jul;25(4):316-25.
PMID: 22186400 DOI: 10.1177/1010539511430521

This study aimed to examine the control of cardiovascular risk factors among the ethnic groups with type 2 diabetes in Malaysia. The authors analyzed the data of 70 092 adults from the Malaysian diabetes registry database. Malays had the worst achievement of target for most of the risk factors. Indians had poor achievement of control for waist circumference (odds ratio [OR] = 0.6, 95% confidence interval [CI] = 0.6-0.7) and high-density lipoprotein cholesterol (OR = 0.5, 95% CI = 0.4-0.5). As compared with the Malays, the Chinese had a better achievement of target control for the risk factors, including the following: body mass index (OR = 1.3, 95% CI = 1.2-1.4), blood pressure (OR = 1.3, 95% CI = 1.3-1.4), total cholesterol (OR = 1.7, 95% CI = 1.6-1.8), low-density lipoprotein cholesterol (OR = 1.7, 95% CI = 1.6-1.8), glycated hemoglobin A1c (OR = 1.4, 95% CI = 1.3-1.4) and fasting blood glucose (OR = 1.4, 95% CI = 1.3-1.5). Ethnicity, sociocultural factors, and psychobehavioral factors should be addressed in designing and management strategies for the control of cardiovascular risk factors among type 2 diabetes patients.

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