Displaying all 10 publications

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  1. Abdul Kadir A, Nordin R, Ismail SB, Yaacob MJ, Wan Mahmud WMR
    Objective: To determine the prevalence of postnatal depression (PND), and associated risk factors among women in Kota Bharu District, Kelantan. Design: A cohort study Methods: A study involving four hundred and twenty one pregnant women attending primary health care facilities in Kota Bharu between February and September 2000 were screened for depression at 36-42 weeks of pregnancy, 1 week postpartum and 4-6 weeks postpartum using validated Malay version of Edinburgh Postnatal Depression Scale (EPDS). Results: Three hundred and seventy seven women successfully completed the EPDS (response rate = 89.8%). The prevalence of PND at 4-6 weeks postpartum, based on an EPDS score of 12 and above, was 20.7%. Depressive symptoms at the end of pregnancy (p<0.05) and one week postnatal (p<0.05) were significantly associated with PND. Conclusions: PND among women in Kota Bharu was 20.7%, which was higher than previously reported studies. Onset of depressive symptoms towards the end of pregnancy and early postnatal period independently predicted postnatal depression. © 2005 Japan International Cultural Exchange Foundation.
  2. Abdul Kadir A, Mohammad Daud MN, Yaacob MJ, Nik Hussain NH
    Objective: To determine the prevalence of depressive symptomatology in early postnatal period and its relationship with obstetric risk factors. Material and Methodology: This is a cross sectional study involving 293 women from postnatal ward Hospital Universiti Sains Malaysia (HUSM), Malaysia. They were screened for depression at day 1 to day 5 postpartum and 4 to 6 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). At the first visit, the women completed questionnaires on socio-demography and obstetric risk factors and Brief Patient Health Questionnaire (BPHQ-9). At the second visit which is 4-6 weeks postpartum, they only completed EPDS. Results: Two hundred and ninety-three women successfully completed the study (100% response rates). The prevalence of PND at 4-6 weeks postpartum using the EPDS score of 12 or more was 27.3%. Women with the history of abortion (p < 0.05) and early postnatal depression (p < 0.05) was significantly associated with PND. Conclusion: Postnatal depression among women in Hospital USM was more common compared to previously reported series in Malaysia. Women with the history of abortion and early postnatal depression were significantly associated with PND. © 2009 Japan International Cultural Exchange Foundation.
  3. Bhaskar Raj N, Saha S, Saha S, Hashim HA, Mohd Zahir NEB, Huda F
    Background: This study was done to identify the problems associated with physical dysfunction in relation to proprioception in osteoarthrosis (OA) of knee. OA is a degenerative joint disorder, which commonly occurs in knee of middle aged and elderly patients, with a high prevalence rate amongst individuals with higher body-mass index. As the Community Orientated Program for Control of Rheumatic Diseases (COPCORD) reported that, 23% of Malaysians aging more than 55 yrs. and 39% of those aged more than 65 yrs. complained of sharp increase in knee pain.
    Materials and Methods: From a pool of six-hundred ninety-seven elderly individuals suffering from pain in knee, four-hundred forty-four individuals (two hundred fifty-three females and one-hundred ninety-one male patients) aging between fifty-six to sixty-five years were selected on the basis of Kellgren's (Grade - II) criteria of deficit in proprioception. Participants were subjected to assessment of body-composition analyses using the BOD-POD analyser. Extent of proprioception was evaluated by the Isokinetic device and problems associated with stiffness were evaluated by the 3D motion tracking system.
    Results: Following WOMAC assessment protocol, extent of difficulties associated with knee pain was evaluated. Regression analyses reports however revealed that, taller old individuals, if had higher BMI & higher extent of stiffness, were evident as having most difficulty in proprioception.
    Conclusion: Significance of perceived stiffness was evident, which in association with different metabolic indices emerged as significant predictor of deficient proprioception and related knee osteoarthrosis. © 2017 Japan Health Sciences University & Japan International Cultural Exchange Foundation.
  4. Azizah MR, Ainol SS, Kong NCT, Normaznah Y, Rahim MN
    Objective: SLE is an autoimmune disease which affects multiple organ system. Clinical and immunological expression of the disease have been widely studied and variations occur in different ethnic groups. Here in this study, we have analyzed the clinical manifestations and immunological features of Malaysian patients with Systemic lupus erythematosus (SLE) and compared them with SLE population from some of the Asian countries. Study design: A total of 134 Malaysian patients attending the SLE Clinic of The National University Hospital of Malaysia, Kuala Lumpur and who satisfy the revised ACR (American College of Rheumatology) criteria for the classification of SLE were enrolled into the study. Data on the demography, clinical and immunological features were obtained from medical records. Materials and Methods: The female to male ratio in the study cohort was 10:1 and consisted of the Malay, Chinese and Indian races. Past clinical and immunological features were entered into a prepared questionnaire. At study entry patients were seen by a rheumatologist for assessment of present clinical condition and blood obtained for immunological tests (Antinuclear, antids DNA, antiSm, antiU1RNP, antiSSA(Ro), antiSSB(La), anticardiolipin (IgG and IgM) antibodies and complements C3 and C4). Chi-square, Fisher's exact test and Mann Whitney U Test were used to analyze data. Results: Clinical features expressed at disease presentation in order of frequency was mucocutaneous (72%), followed by musculoskeletal (58%) and renal involvement (45%) which was also similar during the course of the disease (90%, 72% and 64% respectively). A high prevalence of antiSSB (La) antibodies was found (48%). Conclusion: This study provides the literature on the clinical and immunological features of Malaysian SLE patients and further shows the different spectrum of disease profile when compared to other ethnic groups. The roles of racial and genetic factors are suggested.
  5. Dollah R, Yaacob A, Ismail AH, Che Hussin CM
    Objective: The assay for anti-cyclic citrullinated peptide (anti-CCP) antibody is a recent test of interest due to low diagnostic specificity of rheumatoid factor in the diagnosis of rheumatoid arthritis. To determine the sensitivity and specificity of anti-CCP antibodies in rheumatoid arthritis patients using American College of Rheumatology (ACR) criteria as a gold standard.
    Design: A cross sectional study was conducted from January 2008 to December 2008 on 100 patients with rheumatoid arthritis and 153 patients with arthritis or arthralgia but not fulfilling ACR criteria for rheumatoid arthritis.
    Materials and Methods: Serum from each subject was tested for anti-CCP antibodies and IgM rheumatoid factor (IgM RF) by an enzyme linked immunosorbent assay (ELISA). Sensitivity and specificity of the tests were evaluated using the ACR criteria as the gold standard. Data was analyzed using SPSS version 12.0 software. The association between the two categorical variables were tested using chi-square test. The differences between the two groups were tested using independent t-test. Results: The sensitivity of anti-CCP antibodies was 71% with 94.8% of specificity. For rheumatoid factor the sensitivity was 85% and the specificity was 74.5%. Positive predictive value for anti-CCP antibodies was 89.9% whereas for rheumatoid factor it was 68.5%. The sensitivity of ACR criteria with inclusion of anti- CCP antibodies was 100% and specificity of 94.8% (95%CI: 91.3%, 98.2%).
    Conclusion: Anti-CCP antibody has a higher diagnostic accuracy compared to the RF. Anti-CCP antibody is a useful laboratory marker to support the diagnosis of rheumatoid arthritis and to differentiate patients with rheumatoid arthritis from rheumatoid arthritis-like symptoms. Therefore, it is suggested that anti-CCP antibodies should be included as another laboratory supportive criterium besides RF test in ACR criteria in the diagnosis of RA.
    Study site: family medicine clinic, rheumatology clinic and immunology laboratory of Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian, Kelantan, Malaysia
  6. Radzi AM, Hun KS, Kong N, Yahaya N
    Background: Systemic lupus erythematosus (SLE) is a complex autoimmune disease exhibiting extensive clinical heterogeneity. Genetic factors and immune dysregulation play important roles in its development. Apoptosis is a physiologic process that regulates normal homeostasis. It is likely to contribute to the pathogenesis of autoimmune diseases by impairing elimination of autoreactive T and B cells. Apo-1/Fas which is a transmembrane protein mediates apoptosis and is a member of the tumour necrosis factor/nerve growth factor receptor family. It transduces the apoptotic signal into susceptible target cells. Recent studies have focused on the apoptosis mediated by these proteins in the causation of several autoimmune disorders including SLE. Aim: To determine the frequency of Apo-1/Fas promoter gene polymorphism in patients with systemic lupus erythematosus and healthy controls and to investigate its role in the susceptibility of SLE in a cohort of Malaysian Chinese SLE patients Materials and methods: 107 Chinese patients and 60 matched controls were genotyped using polymerase chain reaction (PCR) amplification followed by MvaI restriction enzyme digestion. The MvaI RFLP is located at the -670 position from the transcription starting site and results from an A→G substitution which alters the MvaI restriction site. Results: G/G genotype was found in 25% of patients and controls while the A/A genotype in 23% and 31.6% of patients and controls respectively. Heterozygous form was noted in 43% of the normal population compared to 51% in SLE patients. There was also no significant difference in the allele frequencies of G and A in both groups studied. Conclusion: We suggest that polymorphism of the Apo-1/Fas promoter gene does not play a role in disease susceptibility in Chinese patients with SLE. © 2008 Japan International Cultural Exchange Foundation.
  7. Wan Mohamad WM, Mohd Ashari NS, Wan AbHamid WZ
    Objective: We presented a case report, systemic lupus erythematosus (SLE) in a Malay boy. Interestingly, this case occurs in a boy, which is not so common because autoimmune disease usually occurs in female. Design: Case report. Methods: We highlighted a case of a boy with SLE who presented with clinical symptoms suggestive of SLE and fulfilled the criteria for SLE diagnosis. Results: The patient was successfully managed with antihypertensive, intravenous cyclophosphamide and oral prednisolone and respond well to the therapy. Conclusion: Systemic lupus erythematosus is a chronic autoimmune disease which rarely occurs in male. However we reported one such case which fulfilled the criteria for SLE. © 2017 Japan Health Sciences University & Japan International Cultural Exchange Foundation.
  8. Azizah MR, Ainol SS, Kuak SH, Kong NCT, Normaznah Y, Rahim MN
    Objective: The frequency of the HLA class II antigens (HLA DR, DQ and DP) were determined among Malay patients with systemic lupus erythematosus (SLE) to ascertain the role they play in disease susceptibility. Study design: Fifty-six Malay SLE patients on follow-up at the SLE Clinic of the National University of Malaysia Hospital, Kuala Lumpur were enrolled into the study. Controls were taken from healthy unrelated individuals, ethnically-matched. Materials and Methods: Five ml of anticoagulated blood was taken from each patient and control and DNA extracted. The HLADR, DQ and DP antigen/allele frequencies were determined by the technique of modified PCR-RFLP and statistical analysis done by Chi-square and Fischers exact test. Relative risk was determined by the odds ratio and significant p values were corrected for the number of antigens/alleles tested. Results: We found that the DR2 antigen was significantly increased among the patients (85.7%) as compared to controls (61%)(p corr=0.03, RR=3.83). As for HLA-DQA1, the allele most commonly found among the patients was *0102 (57 vs 49.2%). HLA-DQA1* 0601 was slightly decreased among the patients but this finding was insignificant. Both HLA-DQB1*0501 and 0601 were found to be increased among the patients even after correction of multiple comparisons made (p=0.0036, RR=4.56 and p=0.0048, RR=6.0, respectively). However, HLA-DQB1*0503 and 0301 was slightly decreased in the sle patients though not statistically significant. The frequency of HLA-DQB1*0201 was insignificantly increased among the patients. Limited studies on the DPB1 locus shows the uncertain role of this antigen in contributing to disease susceptibility. However, our analysis of the HLA-DPB1*0901 showed a slight increase among the patients as compared to controls but failed to remain significant after being corrected with number of comparisons made. All other HLA-DPB1 alleles exhibited similar frequencies between sle patients and controls. Conclusion: From this study we suggest that HLA DR2, DQB1*0501 and *0601 may be important genetic factors in conferring disease susceptibility in the Malay SLE population of Malaysia.
  9. Azizah MR, Kuak SH, Ainol SS, Kong NCT, Rahim MN, Normaznah Y
    Background: Systemic lupus erythematosus (SLE) is a chronic disease of autoimmune nature. Genetic pre-disposition has been known to play a role. With a number of genes already named, the IL-RA is no exception. Polymorphism in the human cytokine gene, an uncommon allele of a variable repeat polymorphism in intron 2 of the IL1-RA gene has been found to be associated with SLE. Objective: The aim of this present study was to study the polymorphism of the IL-1RA gene in Malay and Chinese SLE patients and to investigate the possible contribution of the IL-RA gene polymorphism in disease susceptibility. Materials and Methods: We thus investigated the allele frequencies of the IL-RA gene polymorphism in 87 Malay and 100 Chinese SLE population at the Hospital of National University of Malaysia, Kuala Lumpur by PCR and direct analysis by electrophoresis on agarose gel. Unrelated healthy ethnically-matched individuals were taken as controls. Results: Allelic frequencies of the IL1-RN*4 were most dominant in all groups (patients and controls) but there was no significant differences among them. We found an increased allelic frequency and carriage rate of the IL1-RN*2 repeat in both the Malay and Chinese SLE cases compared to controls. However they were not statistically significant. Conclusion: Thus from this finding we postulate that the polymorphism of the IL-1RA gene (both alleles 2 and 4) does not influence susceptibility to SLE.
  10. Yahya NK, Afzal N, Daud KM
    Objectives: To evaluate the frequency of HLA Class II antigens in Malays with SLE in order to determine their role in disease susceptibility and association with clinical manifestations.
    Design: Cross-sectional study
    Methods: Fifty-four SLE patients from Malay ethnic attending Physician Clinic at Hospital Universiti Sains Malaysia were enrolled into the study. Demographic and clinical findings were obtained from medical records. HLA typing of class II antigens were carried out using MicroSSP Class II generic (DRB/ DQB) from One Lambda Inc. Controls were from ethnically matched healthy individuals.
    Results: A univariate analysis confirmed the association between HLA-DR15 with SLE compared to healthy control group; and was maintained using multiple logistic regression model (P corr = 0.002, adjusted OR = 5.513). There was a weak decrease of HLA-DR4 which was not significant after corrections for multiple comparisons made. DR7 was found to be significantly increased in patients with malar rash. There was positive association of DR15 with arthritis in patients compare to those without.
    Conclusion: Our data support the role of HLA Class II genes in conferring SLE susceptibility.
    Study site: Physician Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
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