Publications by authors named "Najib Majdi Yaacob"

28 Publications

  • Page 1 of 1

Survival and Characteristics of Bladder Cancer: Analysis of the Malaysian National Cancer Registry.

Int J Environ Res Public Health 2021 05 14;18(10). Epub 2021 May 14.

Malaysian National Cancer Registry Department, National Cancer Institute, Ministry of Health Malaysia, Putrajaya 62250, Malaysia.

Background: Bladder cancer ranked ninth of principal male cancer in Malaysia. This study aimed to evaluate the clinical characteristics and survival of bladder cancer patients in Malaysia.

Methods: A retrospective cohort study was conducted by obtaining records in the Malaysian National Cancer Registry. Patients aged 15 years old and above with diagnosis date between 2007 and 2011 were included. Death was updated until 31 December 2016. Five-year observed survival and median survival time were determined by the life table method and Kaplan-Meier estimate method.

Results: Among 1828 cases, the mean (SD) age of diagnosis was 64.9 (12.5) years. The patients were predominantly men (78.7%), Malay ethnicity (49.4%) and transitional cell carcinoma (78.2%). Only 14.8% of patients were at stage I. The overall five-year observed survival and median survival time was 36.9% (95% CI: 34.6, 39.1) and 27.3 months (95% CI: 23.6, 31.0). The highest five-year observed survival recorded at stage I (67.6%, 95% CI: 62.0, 73.3) and markedly worsen at stage II (34.3%, 95% CI: 27.9, 40.8), III (25.7%, 95% CI: 18.7, 32.6) and IV (12.2%, 95% CI: 8.1, 16.3).

Conclusions: Survival of bladder cancer patients in Malaysia was lower with advancing stage. The cancer control programme should be enhanced to improve survival.
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http://dx.doi.org/10.3390/ijerph18105237DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8156894PMC
May 2021

Net survival differences of breast cancer between stages at diagnosis and age groups in the east coast region of West Malaysia: a retrospective cohort study.

BMJ Open 2021 05 18;11(5):e043642. Epub 2021 May 18.

Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia - Kampus Kesihatan, Kubang Kerian, Malaysia.

Objective: Estimation of the net survival of breast cancer helps in assessing breast cancer burden at a population level. Thus, this study aims to estimate the net survival of breast cancer at different cancer staging and age at diagnosis in the east coast region of West Malaysia.

Setting: Kelantan, Malaysia.

Participants: All breast cancer cases diagnosed in 2007 and 2011 identified from Kelantan Cancer Registry.

Design: This retrospective cohort study used a relative survival approach to estimate the net survival of patients with breast cancer. Thus, two data were needed; breast cancer data from Kelantan Cancer Registry and general population mortality data for Kelantan population.

Primary And Secondary Outcome Measures: Net survival according to stage and age group at diagnosis at 1, 3 and 5 years following diagnosis.

Results: The highest net survival was observed among stage I and II breast cancer cases, while the lowest net survival was observed among stage IV breast cancer cases. In term of age at diagnosis, breast cancer cases aged 65 and older had the best net survival compared with the other age groups.

Conclusion: The age at diagnosis had a minimal impact on the net survival compared with the stage at diagnosis. The finding of this study is applicable to other populations with similar breast cancer profile.
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http://dx.doi.org/10.1136/bmjopen-2020-043642DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130742PMC
May 2021

A Randomized Controlled Trial Comparing Two Doses of Caffeine for Apnoea in Prematurity.

Int J Environ Res Public Health 2021 04 23;18(9). Epub 2021 Apr 23.

Department of Paediatrics, Health Campus, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.

Caffeine is the most commonly used methyl xanthine for the prevention of apnoea in prematurity, but the ideal dose was uncertain, until now. This study compared two doses of caffeine for the prevention of apnoea in prematurity. A clinical trial was conducted on 78 preterm infants ≤32 weeks in Neonatal Intensive Care Unit. They were randomly allocated to receive the intervention (loading 40 mg/kg/day and maintenance of 20 mg/kg/day) or the control (loading 20 mg/kg/day and maintenance of 10 mg/kg/day) dose of caffeine. The primary outcome of the study was the frequency and total days of apnoea per duration of treatment for both groups. The frequency of apnoea ranged from zero to fourteen in the intervention group and zero to twelve in the control group. There was no statistically significant difference between the groups, with a -value of 0.839. The number of days of apnoea was also similar between both groups, with a -value of 0.928. There was also no significant difference in adverse events between both regimens. This study did not support the use of higher doses of caffeine as a prevention for apnoea in prematurity.
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http://dx.doi.org/10.3390/ijerph18094509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8123071PMC
April 2021

Perceived quality of care among people with type 2 diabetes mellitus in the north east region of peninsular Malaysia.

BMC Public Health 2021 02 2;21(1):268. Epub 2021 Feb 2.

Kota Bharu Health Clinic, Jalan Hospital, Bandar Kota Bharu, 15000, Kota Bharu, Kelantan, Malaysia.

Background: People with type 2 diabetes mellitus (T2DM) are best managed by a chronic care model that is associated with enhanced quality of care and improved patient outcome. Assessing patients' perceived quality of care is crucial in improving the healthcare delivery system. Hence, this study determined the perceived quality of care among people with T2DM and explored its associations with (i) sociodemographic and clinical characteristics and (ii) types of healthcare clinics to guide future planning.

Methods: A cross-sectional study involving 20 primary healthcare clinics in the North East Region of Peninsular Malaysia and people with T2DM as the sampling unit was conducted from February to May 2019. The pro forma checklist, interview-guided Skala Kepuasan Interaksi Perubatan-11, and Patient Assessment of Chronic Illness Care (Malay version; PACIC-M) questionnaire were used for data collection. Univariate analysis and linear regression were used to determine the status of perceived quality of care and the factors associated with the perceived quality of care, respectively.

Results: Overall, data from 772 participants were analyzed. The majority was from the Malay ethnic group (95.6%) with a mean (standard deviation [SD]) glycated hemoglobin A1c (HbA1c) level of 8.91% (2.30). The median (interquartile range [IQR]) of the number of medical officers available at each clinic was 6 (7), with Family Doctor Concept (FDC) clinics having a higher number of medical officers than non-FDC clinics (p = 0.001). The overall mean (SD) PACIC-M score was 2.65 (0.54) with no significant difference between scores of patients treated in the two clinic types (p = 0.806). Higher perceived quality of care was associated with lower number of medical officers (adjusted regression coefficient [Adj.β], - 0.021; p-value [p], 0.001), and greater doctor-patient interaction in all domains: distress relief (Adj.β, 0.033; p, < 0.001), rapport (Adj.β, 0.056; p, < 0.001), and interaction outcome (Adj.β, 0.022; p, 0.003).

Conclusion: Although there was no significant difference found between clinic type, this study reflects that patients are comfortable when managed by the same doctor, which may support a better doctor-patient interaction. A larger specialized primary care workforce could improve diabetes care in Malaysia.
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http://dx.doi.org/10.1186/s12889-021-10320-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7874640PMC
February 2021

Association between Vitamin D Receptor Polymorphisms (BsmI and FokI) and Glycemic Control among Patients with Type 2 Diabetes.

Int J Environ Res Public Health 2021 02 8;18(4). Epub 2021 Feb 8.

Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kota Bharu 16150, Malaysia.

(1) Several studies have suggested that the vitamin D receptor (VDR) gene plays a role in type 2 diabetes mellitus (T2DM) susceptibility. Nonetheless, the association between T2DM and VDR polymorphisms remains inconclusive. We determined the genotype of VDR rs1544410 (BsmI) and rs2228570 (FokI) polymorphisms among Malaysian patients with T2DM and their association with glycemic control factors (vitamin D levels, calcium, magnesium, and phosphate). (2) A total of 189 participants comprising 126 patients with T2DM (63 with good glycemic control and 63 with poor glycemic control) and 63 healthy controls were enrolled in this case-control study. All biochemical assays were measured using spectrophotometric analysis. VDR gene FokI and BsmI polymorphisms were analyzed using polymerase chain reaction and endonuclease digestion. (3) Our findings revealed no significant differences in VDR FokI and BsmI genotypes between participants with T2DM and healthy controls. Moreover, no significant association was observed between both single nucleotide polymorphisms and glycemic control factors. Participants with poor glycemic control had significantly lower serum magnesium levels and significantly higher HOMA-IR compared to the other groups. (4) The present study revealed that VDR gene BsmI and FokI polymorphisms were not significantly associated with T2DM.
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http://dx.doi.org/10.3390/ijerph18041595DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914454PMC
February 2021

Comparison of Vitamin D Levels, Bone Metabolic Marker Levels, and Bone Mineral Density among Patients with Thyroid Disease: A Cross-Sectional Study.

Diagnostics (Basel) 2020 Dec 11;10(12). Epub 2020 Dec 11.

Endocrine Unit, Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian 16150, Kelantan, Malaysia.

Thyroid hormones have a catabolic effect on bone homeostasis. Hence, this study aimed to evaluate serum vitamin D, calcium, and phosphate and bone marker levels and bone mineral density (BMD) among patients with different thyroid diseases. This cross-sectional study included patients with underlying thyroid diseases ( = 64, hyperthyroid; = 53 euthyroid; = 18, hypothyroid) and healthy controls ( = 64). BMD was assessed using z-score and left hip and lumbar bone density (g/cm). The results showed that the mean serum vitamin D Levels of all groups was low (<50 nmol/L). Thyroid patients had higher serum vitamin D levels than healthy controls. All groups had normal serum calcium and phosphate levels. The carboxy terminal collagen crosslink and procollagen type I N-terminal propeptide levels were high in hyperthyroid patients and low in hypothyroid patients. The z-score for hip and spine did not significantly differ between thyroid patients and control groups. The hip bone density was remarkably low in the hyperthyroid group. In conclusion, this study showed no correlation between serum 25(OH)D levels and thyroid diseases. The bone markers showed a difference between thyroid groups with no significant difference in BMD.
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http://dx.doi.org/10.3390/diagnostics10121075DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763871PMC
December 2020

Global Prevalence of Macroprolactinemia among Patients with Hyperprolactinemia: A Systematic Review and Meta-Analysis.

Int J Environ Res Public Health 2020 11 6;17(21). Epub 2020 Nov 6.

Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia.

Hyperprolactinemia (hPRL) often poses a diagnostic dilemma due to the presence of macroprolactin. Understanding the prevalence of macroprolactinemia (mPRL) has an important implication in managing patients with hPRL. The primary aim of this study was to determine the prevalence of mPRL globally and to explore selected factors influencing the prevalence estimate. Studies with original data related to the prevalence of mPRL among patients with hPRL from inception to March 2020 were identified, and a random effects meta-analysis was performed. Of the 3770 records identified, 67 eligible studies from 27 countries were included. The overall global prevalence estimate was 18.9% (95% CI: 15.8%, 22.1%) with a substantial statistical heterogeneity (I = 95.7%). The highest random effects pooled prevalence was observed in the African region (30.3%), followed by Region of the Americas (29.1%), European (17.5%), Eastern Mediterranean (13.9%), South-East Asian (12.7%), and Western Pacific Region (12.6%). Lower prevalence was observed in studies involving both sexes as compared to studies involving only female participants (17.1% vs. 25.4%) and in more recent studies (16.4%, 20.4%, and 26.5% in studies conducted after 2009, between 2000 and 2009, and before 2000, respectively). The prevalence estimate does not vary according to the age group of study participants, sample size, and types of polyethylene glycol (PEG) used for detection of macroprolactin (PEG 6000 or PEG 8000). With macroprolactin causing nearly one-fifth of hPRL cases, screening for mPRL should be made a routine before an investigation of other causes of hPRL.
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http://dx.doi.org/10.3390/ijerph17218199DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664288PMC
November 2020

Relapsed/Progressive Disease and Its Prognostic Factors among Multiple Myeloma Patients Receiving Novel Agent Treatment in North East Peninsular Malaysia: A Single Centre Experience.

Malays J Med Sci 2020 Oct 27;27(5):62-77. Epub 2020 Oct 27.

Haematopoietic Stem Cell Transplant Unit, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Background: Some multiple myeloma (MM) patients still relapse/progress despite novel agent therapy and relapse/progression in MM is therefore a vital area of ongoing research in the novel treatment era. This retrospective cohort study aimed to evaluate the time to relapse/progression (TTP) among MM patients who received novel agents and to determine the associated prognostic factors.

Methods: This study included 89 MM patients treated at Hospital Universiti Sains Malaysia. We analysed the TTP and the type of relapse/progression (biochemical versus clinical), and a Cox proportional hazard model was used to identify the significant prognostic factors.

Results: Sixty-four percent of patients had biochemical relapse/progression. The overall median TTP among MM patients who received the novel agent(s) was 29.33 months (95% CI: 21.36-37.29). The type of paraprotein at diagnosis ( = 0.026, 0.228), International Staging System (ISS) score ( = 0.036, = 0.067) and autologous stem cell transplant (ASCT) ( 0.002) were prognostic factors for relapse/progression by simple Cox regression, but ASCT was the only significant predictor detected by multiple Cox regression ( = 0.003).

Conclusion: Our study reflects the importance of paraprotein monitoring to detect early features of relapse/progression. ASCT is the most prognostic factor that may lengthen the TTP.
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http://dx.doi.org/10.21315/mjms2020.27.5.7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605841PMC
October 2020

Interactive Low Back Pain Intervention Module Based on the Back School Program: A Cluster-Randomized Experimental Study Evaluating Its Effectiveness among Nurses in Public Hospitals.

Int J Environ Res Public Health 2020 08 14;17(16). Epub 2020 Aug 14.

Units of Biostatistics and Research Methodology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia.

The prevalence of low back pain (LBP) among nurses is high. The main aim of this study was to evaluate the effectiveness of an interactive LBP module based on the Back School Program in improving Oswestry Disability Scores (ODSs) among nurses in government hospitals in Penang, Malaysia. A cluster-randomized experimental study was conducted within four public hospitals. These hospitals were randomized to intervention and control groups. A total of 284 nurses from the selected hospitals were randomly selected (142 in each group). An interactive LBP intervention module based on the Back School Program was designed and prescribed. Both the intervention and control groups were assessed using the Oswestry Disability Questionnaire at baseline and at the end of the third and sixth weeks. Out of 284 participants, 281 completed this study. A between-group comparison revealed that ODSs were significantly lower in the intervention group than in the control group at the ends of the third ( = 0.006) and sixth weeks ( < 0.001). Within-group changes revealed a significant reduction in ODSs within the intervention group from baseline to the third ( < 0.001) and sixth weeks ( < 0.001) of the intervention. This simple interactive LBP module was effective in reducing symptoms of LBP among nurses as early as three weeks, and this effect was sustained until the sixth week of the intervention.
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http://dx.doi.org/10.3390/ijerph17165916DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7460316PMC
August 2020

Serum Anti-Müllerian Hormone in Polycystic Ovary Syndrome and its Relationship with Insulin Resistance, Lipid Profile and Adiponectin.

Indian J Endocrinol Metab 2020 Mar-Apr;24(2):191-195. Epub 2020 Apr 30.

Unit of Biostatistic and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Objectives: This study was done to estimate serum anti-Müllerian hormone (AMH) level in polycystic ovary syndrome (PCOS) patients and to correlate serum AMH level with insulin resistance, lipid profile, and adiponectin levels.

Materials And Methods: A cross-sectional study was conducted at Hospital Universiti Sains Malaysia (Hospital USM), Health Campus, Kubang Kerian, Kelantan, Malaysia. Thirty newly diagnosed patients with PCOS attending gynecology clinic between July 2016 and April 2017 were recruited. Fasting venous blood samples were collected from the subjects. Serum AMH, insulin, adiponectin, triglycerides, high-density lipoprotein cholesterol (HDL-C), and plasma glucose levels were measured, and insulin resistance was calculated based on homeostasis model of assessment-insulin resistance (HOMA-IR). The serum AMH level was estimated, and the correlation of serum AMH level with the metabolic parameters was analyzed.

Results: The median of serum AMH levels in women with PCOS was 6.8 ng/mL (interquartile range: 7.38 ng/mL). There was a significant negative correlation between serum AMH and HOMA-IR or triglyceride levels ( = -0.49, = 0.006 and = -0.55, = 0.002, respectively). A significant positive correlation was observed between serum AMH and serum HDL-C or serum adiponectin levels ( = 0.56, = 0.001 and = 0.44, = 0.014, respectively) in all study subjects.

Conclusion: The serum AMH level is associated with HOMA-IR, triglycerides, HDL-C, and adiponectin levels, and hence it may be used as a potential cardiometabolic risk marker in women with PCOS.
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http://dx.doi.org/10.4103/ijem.IJEM_305_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333742PMC
April 2020

Effects of FamilyDoctor Concept and Doctor-Patient Interaction Satisfaction on Glycaemic Control among Type 2 Diabetes Mellitus Patients in the Northeast Region of Peninsular Malaysia.

Int J Environ Res Public Health 2020 03 9;17(5). Epub 2020 Mar 9.

Kota Bharu Health Clinic, Kota Bharu District Health Office, Kelantan State Health Department, Kelantan 15586, Malaysia.

The implementation of Family Doctor Concept (FDC) to restructure the primary healthcare systems in Malaysia were expected to enhance patient's satisfaction on doctor-patient interaction and subsequently improved glycaemic control among Type 2 Diabetes Mellitus (T2DM) patients. Thus, this study aims to determine the difference in doctor-patient interaction satisfaction between T2DM patients attended FDC-implemented clinic vs non-FDC clinics, and to determine the association between FDC-implemented clinic and doctor-patient interaction satisfaction towards glycaemic control. A cross-sectional study was conducted throughout 10 districts in Kelantan from February until May 2019 using interview-guided (SKIP-11) and proforma checklist. Data were analyzed using SPSS ver.24. Chi-square statistic used to determine the difference in doctor-patient interaction satisfaction between both clinics type. Multiple logistic regression used to examine the association between FDC-implemented clinic and doctor-patient interaction satisfaction towards glycaemic control. Twenty primary health clinics involved, and 772 T2DM patients recruited. FDC clinics attendees has higher proportion of satisfaction (40.1%) compared to non-FDC attendees (33.7%) ( = 0.070). Multiple logistic regression confirmed the association of FDC-implemented health clinics (Adj. OR 1.63, = 0.021), and doctor-patients interaction satisfaction (Adj. OR 1.77, = 0.005) towards glycaemic control. Hence, strengthening of FDC in primary healthcare and improve the doctor-patient interaction satisfaction were essential to escalate good glycaemic control.
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http://dx.doi.org/10.3390/ijerph17051765DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084261PMC
March 2020

Effectiveness of the ColorApp Mobile App for Health Education and Promotion for Colorectal Cancer: Quasi-Experimental Study.

JMIR Hum Factors 2020 Feb 25;7(1):e15487. Epub 2020 Feb 25.

Clinical Research Centre, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.

Background: Lack of knowledge and poor attitude are barriers to colorectal cancer screening participation. Printed material, such as pamphlets and posters, have been the main approach in health education on disease prevention in Malaysia. Current information technology advancements have led to an increasing trend of the public reading from websites and mobile apps using their mobile phones. Thus, health information dissemination should also be diverted to websites and mobile apps. Increasing knowledge and awareness could increase screening participation and prevent late detection of diseases such as colorectal cancer.

Objective: This study aimed to assess the effectiveness of the ColorApp mobile app in improving the knowledge and attitude on colorectal cancer among users aged 50 years and older, who are the population at risk for the disease in Kedah.

Methods: A quasi-experimental study was conducted with 100 participants in Kedah, Malaysia. Participants from five randomly selected community empowerment programs in Kota Setar district were in the intervention group; Kuala Muda district was the control group. Participants were given a self-administered validated questionnaire on knowledge and attitudes toward colorectal cancer. A mobile app, ColorApp (Colorectal Cancer Application), was developed as a new educational tool for colorectal cancer prevention. The intervention group used the app for two weeks. The same questionnaire was redistributed to both groups after two weeks. The mean percentage scores for knowledge and attitude between groups were compared using repeated measure ANCOVA.

Results: There was no significant difference in age, sex, highest education level, current occupation, and diabetic status between the two groups. The number of smokers was significantly higher in the intervention group compared with the control group and was controlled for during analysis. The intervention group showed a significantly higher mean knowledge score compared with the control group with regards to time (Huynh-Feldt: F=19.81, P<.001). However, there was no significant difference in mean attitude scores between the intervention and control groups with regards to time (F=0.36, P=.55).

Conclusions: The ColorApp mobile app may be an adjunct approach in educating the public on colorectal cancer.
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http://dx.doi.org/10.2196/15487DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7064964PMC
February 2020

Modelling excess mortality among breast cancer patients in the North East Region of Peninsular Malaysia, 2007-2011: a population-based study.

BMC Public Health 2019 Dec 30;19(1):1754. Epub 2019 Dec 30.

Kelantan State Health Department, Aras 5, Wisma Persekutuan Kota Bharu, Jalan Bayam, 15590, Kota Bharu, Kelantan, Malaysia.

Background: Measurement of breast cancer burden and identification of its influencing factors help in the development of public health policy and strategy against the disease. This study aimed to examine the variability of the excess mortality of female breast cancer patients in the North East Region of Peninsular Malaysia.

Methods: This retrospective cohort study was conducted using breast cancer data from the Kelantan Cancer Registry between 2007 and 2011, and Kelantan general population mortality data. The breast cancer cases were followed up for 5 years until 2016. Out of 598 cases, 549 cases met the study criteria and were included in the analysis. Modelling of excess mortality was conducted using Poisson regression.

Results: Excess mortality of breast cancer varied according to age group (50 years old and below vs above 50 years old, Adj. EHR: 1.47; 95% CI: 1.31, 4.09; P = 0.004), ethnicity (Malay vs non-Malay, Adj. EHR: 2.31; 95% CI: 1.11, 1.96; P = 0.008), and stage (stage III and IV vs. stage I and II, Adj. EHR: 5.75; 95% CI: 4.24, 7.81; P < 0.001).

Conclusions: Public health policy and strategy aim to improve cancer survival should focus more on patients presented at age below 50 years old, Malay ethnicity, and at a later stage.
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http://dx.doi.org/10.1186/s12889-019-8113-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937984PMC
December 2019

Low Back Pain and Its Associated Factors among Nurses in Public Hospitals of Penang, Malaysia.

Int J Environ Res Public Health 2019 11 1;16(21). Epub 2019 Nov 1.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu 16150, Kelantan, Malaysia.

Objectives: To determine the prevalence of low back pain (LBP) and its associated factors among the nurses working in the public hospitals of Penang, Malaysia.

Methods: A cross-sectional study was conducted on nurses, aged 25-60 years, who had been working for at least three months at six public hospitals of Penang. A proportionate stratified random sampling method was applied to select 1292 respondents. The Malay-validated BACKS Tool questionnaire using a 5-point Likert scale was used to obtain data. Simple and multiple logistic regression analyses were performed.

Results: A total of 989 (76.5%) nurses suffered from LBP at a point of time. The factors significantly associated with LBP among the nurses included working more than seven hours [adjusted odds ratio (AOR) (95% confidence interval (CI)) 1.48 (1.06, 1.98)], twisting of the body while working [AOR (95% CI) 1.60 (1.13, 2.26)], manual handling of patients in wards [AOR (95% CI) 1.44 (1.08, 2.07)], and fatigue [AOR (95% CI) 2.63 (1.94, 3.58)].

Conclusion: The prevalence of LBP among the nurses in the public hospitals of Penang was relatively high. The factors predicting LBP included working more than seven hours a day, twisting of the body while working, manual handling, and fatigue. The findings from this study may better enable policymakers to devote resources to minimize low back pain among nurses. The nurses should be encouraged to comply with safe working procedures.
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http://dx.doi.org/10.3390/ijerph16214254DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861894PMC
November 2019

Effectiveness of Diabetes Community Sharp Disposal Education Module in Primary Care: An Experimental Study in North-East Peninsular Malaysia.

Int J Environ Res Public Health 2019 09 11;16(18). Epub 2019 Sep 11.

Kota Bharu District Health Office, Kelantan State Health Department, Kota Bharu, 15200 Kelantan, Malaysia.

: Structured education is needed to cultivate safe sharp disposal behavior among diabetic patients. Thus, this study aimed to assess the effectiveness of the Diabetes Community Sharp Disposal Education Module in improving knowledge and sharp disposal practice among Malaysian Type 2 diabetic patients. : This quasi-experimental study was conducted at primary health clinics in two districts in Kelantan, a state in the North-East Region of Peninsular Malaysia. A total of 132 Type 2 diabetic patients on insulin therapy were involved, with 68 participants in each control and intervention group. The health education intervention was based on the validated Diabetes Community Sharp Disposal Education Module. The knowledge and practices were measured using a validated questionnaire at baseline, one month, and three months after the intervention. : There was a significant increment in the mean knowledge score for intervention group; from baseline to one month follow up and from baseline to three months follow up [Greenhouse-Geisser; F(1.5, 199.7) = 62.38, < 0.001; effect size (η) = 0.318]. Intervention group had significantly higher mean knowledge score as compared to control group; at one month and three months follow up [F(1, 134) = 17.38, < 0.001; effect size (η) = 0.115]. There was a statistically significant increment in the proportion of participants in the intervention group who practiced the proper community sharp disposal method over time, X(2) = 52.061, < 0.001. : The Diabetes Community Sharp Disposal Education Module was an effective health education tool to improve knowledge and encourage Malaysian diabetic patients to engage with proper sharp disposal practices.
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http://dx.doi.org/10.3390/ijerph16183356DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6765895PMC
September 2019

Survival Time and Prognostic Factors of Mortality among Patients with Acquired Immunodeficiency Syndrome in North-East Peninsular Malaysia.

Malays J Med Sci 2019 Jul 29;26(4):70-78. Epub 2019 Aug 29.

HIV/STI/Hep C Unit, Kelantan State Health Department, Ministry of Health Malaysia, Kelantan, Malaysia.

Background: Death resulting from the acquired immunodeficiency syndrome (AIDS) is a worldwide concern. This study is aimed at determining the overall median survival time, and the prognostic factors of mortality among AIDS-infected patients in North-East Peninsular Malaysia.

Methods: In 2018, a retrospective cohort study stretching from January to April was conducted. This study involved a review of data obtained from the National AIDS Registry. A total of 1,073 AIDS cases diagnosed from 1 January 2010 to 31 December 2014 were selected, and follow-up procedures were conducted until 31 March 2015 (a 3-month follow-up). The Kaplan-Meier plot and Cox's proportional hazard regression were used for data analyses.

Results: 564 (52.5%) patients died due to AIDS, while the remaining 509 (47.4%) were censored. The overall median survival time was 11 months. The probability of survival in 1-year, 2-year, 3-year, 4-year and 5-year periods were 49.1%, 47.8%, 47.3%, 47.0% and 46.7%, respectively. Multiple Cox regression revealed that the significant prognostic factors were age 30-49 years [adjusted hazard ratio (Adj. HR) 1.57; 95% CI: 1.14, 2.16; = 0.006], male (Adj. HR 1.39; 95% CI: 1.07, 1.79; = 0.012), unemployed (Adj. HR 1.40; 95% CI: 1.12, 1.75; = 0.003) and HIV-TB co-infection (Adj. HR 1.78; 95% CI: 1.37, 2.31; < 0.001).

Conclusion: The overall median survival time among AIDS patients in North-East Peninsular Malaysia was revealed to be short, in comparison to the other studies. The chances for survival can be improved with more emphasis on early detection (to ensure early treatment) and social support, particularly for HIV-TB co-infected patients, as well as for younger and unemployed patients.
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http://dx.doi.org/10.21315/mjms2019.26.4.8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719878PMC
July 2019

Procalcitonin as an Early Laboratory Marker of Sepsis in Neonates: Variation in Diagnostic Performance and Discrimination Value.

Malays J Med Sci 2019 Jul 29;26(4):61-69. Epub 2019 Aug 29.

Department of Chemical Pathology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Background: As an early recognition of neonatal sepsis is important for triggering the initiation of treatment, this study was thus designed to assess the diagnostic performance and discrimination value of procalcitonin (PCT) in neonatal sepsis cases.

Methods: This cross-sectional study, which was carried out at the Paediatric Intensive Care Unit of Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia, had involved 60 neonates admitted for suspected sepsis. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV) and the area under receiver operating characteristics curve (AUC) for PCT were determined at initial presentation (0 h) as well as 12 h and 24 h after presentation in comparison to blood culture as the gold standard.

Results: The study consisted of 27 (45.0%) male and 33 (55.0%) female neonates with a mean (SD) age of 76.8 (48.25) h. At cut-off PCT value of > 2 ng/mL, the sensitivity, specificity, PPV and NPV were 66.7%, 66.7%, 33.3% and 88.9% at 0 h. The respective parameters were 83.3%. 56.3%, 32.3% and 93.1% at 12 h and 83.3%, 52.1%, 30.3% and 92.6% at 24 h. AUC was 71.6%, 76.6% and 71.7% at 0 h, 12 h and 24 h.

Conclusions: Diagnostic performance and discrimination values of PCT for diagnosis of neonatal sepsis varied with time of obtaining the blood samples. The PCT result at 12 h demonstrates the most optimal diagnostic performance and discrimination values.
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http://dx.doi.org/10.21315/mjms2019.26.4.7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719890PMC
July 2019

Usage of Traditional and Complementary Medicine among Dengue Fever Patients in the Northeast Region of Peninsular Malaysia.

Malays J Med Sci 2019 May 28;26(3):90-101. Epub 2019 Jun 28.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Background: The recent epidemic of dengue fever (DF) in Malaysia was alarming. The treatment of DF remains supportive as there is no anti-viral agent or vaccine available as yet. Traditional and complementary medicine (T&CM) provides an alternative option for the treatment of DF but there is limited evidence with regard to its usage. The aim of this study was to determine the prevalence, types and predictor factors of T&CM usage among DF patients in the northeast region of Peninsular Malaysia.

Methodology: This was a cross-sectional study of DF patients in the northeast region of Peninsular Malaysia who had been admitted to a tertiary centre from January 2014 until December 2015. Serologically-confirmed DF patients aged 18 years and above were randomly selected. Phone interviews were conducted to obtain information regarding the use of T&CM during hospitalisation. Notes were made regarding the prevalence and type of T&CM used. Binary logistic regressions were used to identify the predictor factors of T&CM usage.

Results: A total of 241 DF patients with a mean age of 36.62 (SD = 14.62) years were included. The estimated prevalence of T&CM usage was 84.6% (95%CI: 80.1%, 89.2%). The most common T&CM used were crab soup (85.3%), papaya leaf extract (64.2%) and isotonic drinks (61.8%). The significant predictors for T&CM usage were age [adjusted odds ratio (AOR) 0.97; 95%CI: 0.94, 0.99], tertiary education (AOR 3.86; 95%CI: 1.21, 12.32) and unemployment (AOR 2.55; 95%CI: 1.02, 6.42).

Conclusion: The prevalence of T&CM usage in our population is high. Age, tertiary education and unemployment influence the use of T&CM.
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http://dx.doi.org/10.21315/mjms2019.26.3.7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613470PMC
May 2019

Effect of MyMAFI-A Newly Developed Mobile App for Field Investigation of Food Poisoning Outbreak on the Timeliness in Reporting: A Randomized Crossover Trial.

Int J Environ Res Public Health 2019 07 10;16(14). Epub 2019 Jul 10.

Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan 16150, Malaysia.

Prompt investigation of food poisoning outbreak are essential, as it usually involves a short incubation period. Utilizing the advancement in mobile technology, a mobile application named MyMAFI (My Mobile Apps for Field Investigation) was developed with the aim to be an alternative and better tool for current practices of field investigation of food poisoning outbreak. A randomized cross-over trial with two arms and two treatment periods was conducted to assess the effectiveness of the newly developed mobile application as compared to the standard paper-based format approach. Thirty-six public health inspectors from all districts in Kelantan participated in this study and they were randomized into two equal sized groups. Group A started the trial as control group using the paper-format investigation form via simulated outbreaks and group B used the mobile application. After a one-month 'washout period', the group was crossed over. The primary outcome measured was the time taken to complete the outbreak investigation. The treatment effects, the period effects and the period-by-treatment interaction were analyzed using Pkcross command in Stata software. There was a significant treatment effect with mean square 21840.5 and its corresponding F statistic 4.47 (-value = 0.038), which indicated that the mobile application had significantly improve the reporting timeliness. The results also showed that there was a significant period effect (-value = 0.025); however, the treatment by period interaction was not significant (-value = 0.830). The newly developed mobile application-MyMAFI-can improve the timeliness in reporting for investigation of food poisoning outbreak.
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http://dx.doi.org/10.3390/ijerph16142453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678406PMC
July 2019

Factors Contributing to Sharp Waste Disposal at Health Care Facility Among Diabetic Patients in North-East Peninsular Malaysia.

Int J Environ Res Public Health 2019 06 26;16(13). Epub 2019 Jun 26.

Kota Bharu District Health Office, Kelantan State Health Department, Kota Bharu, Kelantan 15200, Malaysia.

Background: Type 2 diabetic patients are major users of medical sharps in the community. Proper sharp disposal practice among them, however, was reported to be low. The current study was aimed to determine the factors contributing to sharp waste disposal at a health care facility among Type 2 diabetic patients.

Methods: In this cross-sectional study, Type 2 diabetic patients who were on insulin therapy attending health clinics were randomly selected and interviewed using a validated questionnaire. Binary logistic regression analysis was applied.

Results: Out of 304 respondents, only 11.5% of them brought their used sharps to be disposed at health care facilities. Previous advice on sharp disposal from health care providers, knowledge score, and duration of diabetes were significant contributing factors for sharp waste disposal at health care facilities: (Adj. OR 6.31; 95% CI: 2.63, 15.12; < 0.001), (Adj. OR 1.05; 95% CI: 1.03, 1.08; < 0.001), and (Adj. OR 2.51; 95% CI: 1.06, 5.93; = 0.036), respectively.

Conclusion: Continuous education and a locally adapted safe sharp disposal option must be available to increase awareness and facilitate diabetic patients adopting proper sharp disposal behavior.
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http://dx.doi.org/10.3390/ijerph16132251DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651231PMC
June 2019

Psychometric Properties of the Malay Version of the Goal Content for Exercise Questionnaire among Undergraduate Students at the Health Campus, Universiti Sains Malaysia.

Malays J Med Sci 2019 Jan 28;26(1):115-124. Epub 2019 Feb 28.

Exercise and Sports Science, School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

Background: Understanding the individual aspirations of exercise participation is important for promoting physical activity. However, there is a lack of evidence to validate a measurement instrument for exercise-based goal content among Malaysian populations. The purpose of this study was to determine the validity and reliability of the Malay version of the Goal Content in Exercise Questionnaire (GCEQ) for a sample of Malaysian undergraduates.

Methods: The original English version of the GCEQ underwent forward and backward translation into the Malay language. A cross-sectional study was conducted. The finalised Malay version was administered to 674 undergraduate students at the Health Campus of the Universiti Sains Malaysia (USM) with a mean age of 20.27 years (SD = 1.35 years). Confirmatory factor analysis (CFA) was conducted for the psychometric evaluation.

Results: The measurement model consisted of 20 observed items and five latent factors. CFA demonstrated adequate fit to the data: comparative fit index = 0.929; standardised root mean square residual = 0.052; root mean square error of approximation = 0.061 (90% CI = 0.056, 0.067). The composite reliability coefficients for the five latent factors ranged from 0.777 to 0.851. All the correlations between the factors were less than 0.85, so discriminant validity was achieved.

Conclusion: The findings suggested that the Malay version of the GCEQ is valid and reliable for assessing goal content in the exercise context of undergraduates at the Health Campus, USM.
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http://dx.doi.org/10.21315/mjms2019.26.1.11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419867PMC
January 2019

Pre-Hospital Factors Influencing Time of Arrival at Emergency Departments for Patients with Acute ST-Elevation Myocardial Infarction.

Malays J Med Sci 2019 Jan 28;26(1):87-98. Epub 2019 Feb 28.

Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan.

Background: Pre-hospital delay is currently a major factor limiting early reperfusion among ST-elevation myocardial infarction (STEMI) patients worldwide. This study aims to determine pre-hospital factors affecting symptom-to-door time among STEMI patients in Malaysia.

Methods: This cross-sectional study included 222 STEMI patients admitted to two tertiary hospitals in Malaysia. By determining symptom-to-door time, the study population was categorised into two definitive treatment seeking groups: early (≤ 3 h) and delayed (> 3 h). Data was collected focusing on socio-demographical data, risk factors and comorbidities, clinical presentation, situational factors and action taken by patients.

Results: The mean age of our patients was 58.0 (SD = 11.9) years old, and the population consisted of 186 (83.8%) males and 36 (16.2%) females. Our study found that the median symptom-to-door time was 130.5 (IQR 240) min, with 64% of subjects arriving early and 36% arriving late. Pre-hospital delays were found to be significant among females (adj OR = 2.42; 95% CI: 1.02, 5.76; = 0.046), patients with recurrence of similar clinical presentations (adj OR = 2.74; 95% CI: 1.37, 5.46; = 0.004), patients experiencing atypical symptoms (adj OR = 2.64; 95% CI: 1.11, 6.31; = 0.029) and patients who chose to have their first medical contact (FMC) for their symptoms with a general practitioner (adj OR = 2.80; 95% CI: 1.20, 6.56; = 0.018). However, patients with hyperlipidaemia (adj OR = 0.46; 95% CI: 0.23, 0.93; = 0.030), self-perceived cardiac symptoms (adj OR = 0.36; 95% CI: 0.17, 0.73; = 0.005) and symptoms that began in public places (adj OR = 0.21; 95% CI: 0.06, 0.69; = 0.010) tended to seek treatment earlier.

Conclusion: The symptom-to-door time among the Malaysian population is shorter in comparison to other developing countries. Nevertheless, identified, modifiable pre-hospital factors can be addressed to further shorten symptom-to-door time among STEMI patients.
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http://dx.doi.org/10.21315/mjms2019.26.1.8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419865PMC
January 2019

Validation of Malay Version of Body Self- Image Questionnaire-Short Form among Malaysian Young Adults.

Malays J Med Sci 2018 Jul 30;25(4):131-141. Epub 2018 Aug 30.

Clinical Research Centre, Sarawak General Hospital, Ministry of Health, Malaysia.

Background: Body self-image questionnaire-short form (BSIQ-SF) is developed to measure body image perceptions. Due to the cultural, language and environmental differences between western and eastern population, the validity and reliability need to be established. The aim of this study was to determine validity and reliability of Malay version BSIQ-SF.

Methods: A cross-sectional study involved web-based survey was employed. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was performed using SPSS version 22 and Mplus 7.3.

Results: There were 688 young adults in Malaysia with mean age of 23.67 (SD = 0.188) and mean body mass index (BMI) of 23.34 (SD = 0.27) participated in the study. Exploratory factor analysis performed and the number domains reduced from nine to four, namely 'Negative Affect', 'Attractiveness Evaluation', 'Physical Functionality Awareness' and 'Height Dissatisfaction'. CFA further confirmed the structure of the model with adequate goodness-of-fit values [CFI = 0.927, TLI = 0.913, SRMR = 0.075, RMSEA = 0.053 (95% CI: 0.047, 0.060)].

Conclusion: The revised 21-item of the Malay version BSIQ-SF was a valid and reliable instrument to measure body image perceptions among Malaysian young adults.
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http://dx.doi.org/10.21315/mjms2018.25.4.13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422542PMC
July 2018

Factors associated with the severity of hypertension among Malaysian adults.

PLoS One 2019 3;14(1):e0207472. Epub 2019 Jan 3.

Institute for Public Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia.

High blood pressure is a worldwide problem and major global health burden. Whether alone or combined with other metabolic diseases, high blood pressure increases the risk of cardiovascular disease. This study is a secondary data analysis from the National Health and Morbidity Survey 2015, a population-based study that was conducted nationwide in Malaysia using a multi-stage stratified cluster sampling design. A total of 15,738 adults ≥18-years-old were recruited into the study, which reports the prevalence of hypertension stages among adults in Malaysia using the JNC7 criteria and determinants of its severity. The overall prevalence of raised blood pressure was 66.8%, with 45.8% having prehypertension, 15.1% having Stage 1 hypertension, and 5.9% having Stage 2 hypertension. In the multivariate analysis, a higher likelihood of having prehypertension was observed among respondents with advancing age, males (OR = 2.74, 95% CI: 2.41-3.12), Malay ethnicity (OR = 1.21, 95% CI: 1.02-1.44), lower socioeconomic status, and excessive weight. The factors associated with clinical hypertension (Stages 1 and 2) were older age, rural residency (Stage 1 OR = 1.22, Stage 2 OR = 1.28), Malay ethnicity (Stage 2 OR = 1.64), diabetes (Stage 2 OR = 1.47), hypercholesterolemia (Stage 1 OR = 1.34, Stage 2 OR = 1.82), being overweight (Stage 1 OR = 2.86, Stage 2 OR = 3.44), obesity (Stage 1 OR = 9.01, Stage 2 OR = 13.72), and lower socioeconomic status. Almost 70% of Malaysian adults are at a risk of elevated blood pressure. The highest prevalence was in the prehypertension group, which clearly predicts a future incurable burden of the disease. Public health awareness, campaigns through mass and social media, and intervention in the work place should be a priority to control this epidemic.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0207472PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6317782PMC
September 2019

Translation, Cross-Cultural Adaptation, and Validation of the Malay Version of the System Usability Scale Questionnaire for the Assessment of Mobile Apps.

JMIR Hum Factors 2018 May 14;5(2):e10308. Epub 2018 May 14.

Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.

Background: A mobile app is a programmed system designed to be used by a target user on a mobile device. The usability of such a system refers not only to the extent to which product can be used to achieve the task that it was designed for, but also its effectiveness and efficiency, as well as user satisfaction. The System Usability Scale is one of the most commonly used questionnaires used to assess the usability of a system. The original 10-item version of System Usability Scale was developed in English and thus needs to be adapted into local languages to assess the usability of a mobile apps developed in other languages.

Objective: The aim of this study is to translate and validate (with cross-cultural adaptation) the English System Usability Scale questionnaire into Malay, the main language spoken in Malaysia. The development of a translated version will allow the usability of mobile apps to be assessed in Malay.

Methods: Forward and backward translation of the questionnaire was conducted by groups of Malay native speakers who spoke English as their second language. The final version was obtained after reconciliation and cross-cultural adaptation. The content of the Malay System Usability Scale questionnaire for mobile apps was validated by 10 experts in mobile app development. The efficacy of the questionnaire was further probed by testing the face validity on 10 mobile phone users, followed by reliability testing involving 54 mobile phone users.

Results: The content validity index was determined to be 0.91, indicating good relevancy of the 10 items used to assess the usability of a mobile app. Calculation of the face validity index resulted in a value of 0.94, therefore indicating that the questionnaire was easily understood by the users. Reliability testing showed a Cronbach alpha value of .85 (95% CI 0.79-0.91) indicating that the translated System Usability Scale questionnaire is a reliable tool for the assessment of usability of a mobile app.

Conclusions: The Malay System Usability Scale questionnaire is a valid and reliable tool to assess the usability of mobile app in Malaysia.
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http://dx.doi.org/10.2196/10308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972216PMC
May 2018

Survival Time and Prognostic Factors for Breast Cancer among Women in North-East Peninsular Malaysia

Asian Pac J Cancer Prev 2018 Feb 26;19(2):497-502. Epub 2018 Feb 26.

Department of Community Medicine, School of Medical Sciences, Universiti Sains, Malaysia. Email:

Background: Breast cancer is the most common malignant disease and the leading cause of cancer death among women globally. This study aimed to determine the median survival time and prognostic factors for breast cancer patients in a North-East State of Malaysia. Methods: This retrospective cohort study was conducted from January till April 2017 using secondary data obtained from the state’s cancer registry. All 549 cases of breast cancer diagnosed from 1st January 2007 until 31st December 2011 were selected and retrospectively followed-up until 31st December 2016. Sociodemographic and clinical information was collected to determine prognostic factors. Results: The average (SD) age at diagnosis was 50.4 (11.2) years, the majority of patients having Malay ethnicity (85.8%) and a histology of ductal carcinoma (81.5%). Median survival times for those presenting at stages III and IV were 50.8 (95% CI: 25.34, 76.19) and 6.9 (95% CI: 3.21, 10.61) months, respectively. Ethnicity (Adj. HR for Malay vs non-Malay ethnicity=2.52; 95% CI: 1.54, 4.13; p<0.001), stage at presentation (Adj. HR for Stage III vs Stage I=2.31; 95% CI: 1.57, 3.39; p<0.001 and Adj. HR for Stage IV vs Stage I=6.20; 95% CI: 4.45, 8.65; p<0.001), and history of surgical treatment (Adj. HR for patients with no surgical intervention=1.95; 95% CI: 1.52, 2.52; p<0.001) were observed to be the statistically significant prognostic factors associated with death caused by breast cancer. Conclusion: The median survival time among breast cancer patients in North-East State of Malaysia was short as compared to other studies. Primary and secondary prevention aimed at early diagnosis and surgical management of breast cancer, particularly among the Malay ethnic group, could improve treatment outcome.
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http://dx.doi.org/10.22034/APJCP.2018.19.2.497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5980940PMC
February 2018

Increased circulating oxidised low-density lipoprotein and antibodies to oxidised low-density lipoprotein in preeclampsia.

J Obstet Gynaecol 2017 Jul 30;37(5):580-584. Epub 2017 Mar 30.

c Unit of Biostatistics and Research Methodology , School of Medical Sciences, Universiti Sains Malaysia, Health Campus , Kubang Kerian , Malaysia.

Enhanced oxidative stress is involved in the pathogenesis of endothelial dysfunction in preeclampsia (PE). Circulating oxidised LDL (oxLDL) and antibodies to oxLDL (Ab-oxLDL) have been found to be associated with atherosclerosis. The objectives of this study were to investigate the association of oxLDL and Ab-oxLDL with PE and to assess the association between oxLDL and Ab-oxLDL. The levels of oxLDL and Ab-oxLDL were measured by enzyme-linked immunoassay in 78 women with preeclampsia (PE group) and 78 women with normal pregnancy (control group). The PE group had higher oxLDL and Ab-oxLDL levels than the control group (485.1vs.145.9 ng/ml, p < .001) and (578.7 vs 216.2 mU/ml, p < .001), respectively. However, Ab-oxLDL levels were not associated with the levels of oxLDL, age, BMI, gestational age, systolic blood pressure (SBP) and diastolic blood pressure (DBP) in both the groups. In conclusion, our study showed that PE was associated with increased oxLDL and Ab-oxLDL, which may reflect the enhanced oxidative stress in PE. Impact Statement Preeclampsia (PE) is a potentially life-threatening condition and both maternal and foetal complications can develop if it is not monitored appropriately. The pathogenesis of endothelial dysfunction in PE is related to the enhanced oxidative stress and oxidation of LDL. However, more studies were required as previous studies had not shown a consistent association of oxLDL and Ab-oxLDL with PE. Our study showed significant association of oxLDL and Ab-oxLDL with PE, indicating that their levels may be reliable indicators of oxidation stress and of the risk of PE. Levels of oxidative stress markers may have implications for clinical practice, such as their association with intrauterine growth restriction (IUGR), HELLP syndrome or eclampsia, foetal birth weight and premature delivery. Further research is still needed, ideally as a prospective cohort study to investigate the association of oxLDL and Ab-oxLDL with such outcome parameters.
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http://dx.doi.org/10.1080/01443615.2016.1269227DOI Listing
July 2017

Reporting Statistical Results in Medical Journals.

Malays J Med Sci 2016 Sep 5;23(5):1-7. Epub 2016 Oct 5.

Statistical Editors, Malaysian Journal of Medical Sciences, Penerbit Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia; PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Gadong BE 1410, Brunei.

Statistical editors of the Malaysian Journal of Medical Sciences (MJMS) must go through many submitted manuscripts, focusing on the statistical aspect of the manuscripts. However, the editors notice myriad styles of reporting the statistical results, which are not standardised among the authors. This could be due to the lack of clear written instructions on reporting statistics in the guidelines for authors. The aim of this editorial is to briefly outline reporting methods for several important and common statistical results. It will also address a number of common mistakes made by the authors. The editorial will serve as a guideline for authors aiming to publish in the MJMS as well as in other medical journals.
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http://dx.doi.org/10.21315/mjms2016.23.5.1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5101968PMC
September 2016