Search

Age-related macular degeneration (AMD) is the most widely recognised cause of irreversible vision loss and previous studies have suggested that the advancement of wet AMD is influenced by both modifiable and non-modifiable elements. Single nucleotide polymorphism (SNPs) and copy number of variations (CNVs) have been associated with AMD in various populations, however the results are conflicting. Our aim is to determine the CNVs of Complement Factor H-Related genes among Malaysian subjects with wet AMD. 130 patients with wet AMD and 120 healthy controls were included in this research. DNA was extracted from all subjects and CNVs of CFH, CFHR1 and CFHR3 genes; determined using quantitative real-time PCR and were compared between the two groups. A consistent association was observed between CFH gene and wet AMD susceptibility (P

Introduction: Non-adherence to antihypertensive medications is a leading cause of uncontrolled hypertension and its complications. However, data on the factors associated with non-adherence to antihypertensive medications in the communities of Sarawak, Malaysia, are limited. This study aimed to examine the prevalence and determinants of medication non-adherence among patients with uncontrolled hypertension. Methods: A cross-sectional study was conducted using the systematic sampling method in four government primary healthcare clinics in Sarawak. A self-administered questionnaire was used to obtain socio-demographic data and evaluate non-adherence. Blood pressure was measured, and relevant clinical variables were collected from medical records. Multivariate logistic regression was used to determine the determinants of medication non-adherence. Results: A total of 488 patients with uncontrolled hypertension were enrolled in this study. The prevalence of medication non-adherence was 39.3%. There were four predictors of medication non-adherence among the patients with uncontrolled hypertension: tertiary educational level (odds ratio [OR]=4.21, 95% confidence interval [CI]=1.67--10.61, P=0.010), complementary alternative medication (OR=2.03, 95% CI=1.12--3.69, P=0.020), non-usage of calcium channel blockers (OR=1.57, 95% CI=1.02--2.41, P=0.039) and 1 mmHg increase in the systolic blood pressure (OR=1.03, 95% CI=1.00--1.05, P=0.006). Conclusion: Because of the high prevalence of medication non-adherence among patients with uncontrolled hypertension, primary care physicians should be more vigilant in identifying those at risk of being non-adherent. Early intervention should be conducted to address non-adherence for blood pressure control. [ABSTRACT FROM AUTHOR]

Background: Internet addiction (IA) among adolescents has become an important health problem due to its association with many negative consequences if not prevented early. However, there were no data on IA among adolescents in Malaysia. Aim: The objective of this study was to determine the prevalence and factors associated with IA among adolescents aged 10 to 19 years of age in Malaysia. Methods: A cross-sectional study was done in 15 primary care clinics throughout Malaysia using the validated Malay version of the Internet Addiction Test. A standardized, selfadministered questionnaire on socio-demographic data and questions assessing IA were given to the participants. Data analyses were done using Statistical Package for Social Sciences (SPSS) 21. The findings were described in terms of frequencies, percentages, means, and standard deviations. The association between socio-demographic factors and IA was determined by using univariate analysis. Multivariate logistic regressions were used to identify predictors of IA. Results: A total of 921 participants were included in this study. The male population was 49.5% (n=456), with a mean age of 16.38±2.38 years. The prevalence of internet addiction was 56.4% (n=519). The significant predictors of internet addiction were age, mother's high education level, and having a smartphone. Conclusion: This study showed that there is a high prevalence of internet addiction among adolescents in Malaysia. [ABSTRACT FROM AUTHOR]

Introduction: Facebook has emerged as one of the top social networking sites (SNSs) among university students but at the cost of leading to negative implications on psychosocial wellbeing. Psychological factors such as depression, anxiety and stress have been implicated in the development of addictions; however studies that evaluate this are scarce among the Malaysian population. Our objective was to identify problematic Facebook use among undergraduate students in Universiti Putra Malaysia (UPM) and to correlate the psychological factors that influence problematic Facebook use. Methods: A cross sectional study was conducted among 1060 students from various faculties in UPM. Validated Facebook Addiction Test (FAT) and DASS-21 questionnaires were used to collect data. Descriptive analysis was done for demographic data. Pearson correlation and regression analysis were used in the analytical part. Results: Problematic Facebook use was detected among 16.6% of the undergraduate students. Problematic Facebook use was significantly related to the level of depression, anxiety and stress (p<0.05). Multiple regression analysis indicated that younger age, male gender and depression were significant predictors of problematic Facebook use (p<0.05). Conclusion: Problematic Facebook use is significantly related to the level of depression, anxiety and stress. Young male university students are more prone to problematic Facebook use than females. Depression plays an important role in the development of problematic Facebook usage, thus requires careful monitoring of young students for early detection and prevention. [ABSTRACT FROM AUTHOR]

Introduction: Widespread use of the internet is a relatively recent phenomenon that is affecting different cultures worldwide in both positive and negative ways. This study aimed to determine the gender differences in the internet addiction among medical students in public university. Methods: 426 medical students from year one to four were invited to participate in the study. For data collection, we used a self-administered questionnaire consisting of socio-demographic and internet usage questions, the Internet Addiction Test (IAT) and the Depression Anxiety and Stress Scales 21 (DASS-21). Results: There were a total of 426 (270 female and 156 male) medical students included in this study. IA was high in both male and female students. There was a higher proportion of male students (44.9%) found to be addicted compared to female students (32.2%). There were positive correlations between the DASS- 21 and IAT scores for both male and female students. For female students, longer hours spent online daily (p-value = 0.02), as well as high anxiety (p-value < 0.001) and depression scores (p-value = 0.037) were found to be most strongly associated with IA. Among male students, factors associated with IA were the availability of internet access at home (p-value=0.02) and high anxiety scores (p<0.001). Conclusion: IA was high in both male and female medical students, with higher anxiety raising the risk in both groups. In female students, a higher depression score was also found to be associated with IA. [ABSTRACT FROM AUTHOR]

Background: Malaysia experienced an unprecedented dengue outbreak from the year 2014 to 2016 that resulted in an enormous increase in the number of cases and mortality as compared to previous years. The causes that attribute to a dengue outbreak can be multifactorial. Viral factors, such as dengue serotype and genotype, are the components of interest in this study. Although only a small number of studies investigated the association between the serotype of dengue virus and clinical manifestations, none of these studies included analyses on dengue genotypes. The present study aims to investigate dengue serotype and genotype-specific clinical characteristics among dengue fever and severe dengue cases from two Malaysian tertiary hospitals between 2014 and mid-2017. Methodology and principal findings: A total of 120 retrospective dengue serum specimens were subjected to serotyping and genotyping by Taqman Real-Time RT-PCR, sequencing and phylogenetic analysis. Subsequently, the dengue serotype and genotype data were statistically analyzed for 101 of 120 corresponding patients’ clinical manifestations to generate a descriptive relation between the genetic components and clinical outcomes of dengue infected patients. During the study period, predominant dengue serotype and genotype were found to be DENV 1 genotype I. Additionally, non-severe clinical manifestations were commonly observed in patients infected with DENV 1 and DENV 3. Meanwhile, patients with DENV 2 infection showed significant warning signs and developed severe dengue (p = 0.007). Cases infected with DENV 2 were also commonly presented with persistent vomiting (p = 0.010), epigastric pain (p = 0.018), plasma leakage (p = 0.004) and shock (p = 0.038). Moreover, myalgia and arthralgia were highly prevalent among DENV 3 infection (p = 0.015; p = 0.014). The comparison of genotype-specific clinical manifestations showed that DENV 2 Cosmopolitan was significantly common among severe dengue patients. An association was also found between genotype I of DENV 3 and myalgia. In a similar vein, genotype III of DENV 3 was significantly common among patients with arthralgia. Conclusion: The current data contended that different dengue serotype and genotype had caused distinct clinical characteristics in infected patients. [ABSTRACT FROM AUTHOR]

Summary Background This study aims to provide an analytical overview of the changing burden of colorectal cancer and highlight the implementable control measures that can help reduce the future burden of colorectal cancer in Malaysia. Methods We performed a MEDLINE search via OVID with the ​Medical Subject Headings (MeSH) terms “Colorectal Neoplasms”[Mesh] and “Malaysia”[Mesh], and PubMed with the key words “colorectal cancer” and “Malaysia” from 1990 to 2015 for studies reporting any clinical, societal, and economical findings associated with colorectal cancer in Malaysia. Incidence and mortality data were retrieved from population-based cancer registries/databases. Results In Malaysia, colorectal cancer is the second most common cancer in males and the third most common cancer in females. The economic burden of colorectal cancer is substantial and is likely to increase over time in Malaysia owing to the current trend in colorectal cancer incidence. In Malaysia, most patients with colorectal cancer have been diagnosed at a late stage, with the 5-year relative survival by stage being lower than that in developed Asian countries. Public awareness of the rising incidence of colorectal cancer and the participation rates for colorectal cancer screening are low. Conclusion The efficiency of different screening approaches must be assessed, and an organized national screening program should be developed in a phased manner. It is essential to maintain a balanced investment in awareness programs targeting general population and primary care providers, focused on increasing the knowledge on symptoms and risk factors of colorectal cancer, awareness on benefits of screening, and promotion of healthy life styles to prevent this important disease. [ABSTRACT FROM AUTHOR]

Objective: This study was aimed to determine the prevalence and predictors of mild cognitive impairments (MCIs) in Malaysia. Method: This is a cross-sectional community-based study among elderlies aged 60 years and above in the four states of Malaysia - Perak, Kelantan, Selangor and Johor. A multi-stage stratified random sampling method was used for the data collection. Mini Mental State Examination score ≥22 was used to diagnosed MCI and analyzed by using multivariate logistic regression. Results: A total of 2112 participants were recruited into this study. Mean age of the participants was 69.2±18.8 years, and 51.4% of them were females. The ethnic distribution was 63.4% Malaysian, 31.4% Chinese, 5.0% Indians, and 0.2% others. The overall prevalence of MCI was 68% (n=1436/2112). In multivariate logistic regression analysis, participant who were older (OR 1.02, 95% CI 1.00-1.04), did not receive formal education (OR 6.85, 95% CI 4.58-10.25), had primary education (OR 2.35 95% CI 1.84-3.00), were lonely (OR 1.18 95% CI 1.05-1.32), and had low level of life satisfaction (OR 1.68 95% CI 1.02-2.67), had significant positive correlations with MCI. Conclusion: MCI is present in seven out of ten elderly Malaysians. Aging population, presence of low education level, loneliness and low life satisfaction level seem to facilitate development of MCI. [ABSTRACT FROM AUTHOR]

Introduction: The National Clinical Practice Guideline in Tuberculosis (TB) was designed to improve the quality of tuberculosis care. However, it remains unknown whether primary care doctors adhere to it well. This audit aims to assess the quality of care in the process of TB contact tracing in a primary care setting. Methods: Data on TB contact tracing from 1st February 2013 to 15th February 2013 was obtained retrospectively from all medical records of diagnosed pulmonary TB in a public primary care clinic. All patients who fulfilled the inclusion and exclusion criteria were included in the study. Results: A total of 102 medical records of adult TB contacts were recruited. The median age of the TB contact was 34 (IQR=10) years and 65 % were male. Seventy two percent of the adult TB contact had a TBIS 10C3 form created, and 95% of the medical records were fully documented. History taking and physical examination were recorded on 97% and 99% of patients respectively during the first follow-up at the polyclinic. Eighty five percent and 100% of the patients had a chest-x-ray and sputum direct smear for acid-fast bacilli done respectively. The turn-up rate for the first, second, third and fourth visit was 100% to 32%, 10% and 2% respectively. Conclusion: The quality of care for adult TB contacts tracing in this clinical audit was found to be suboptimal. There is a difference between the current national guidelines and practice in the clinic. Certain measures to improve the quality of care for adult TB contact tracing are urgently needed. [ABSTRACT FROM AUTHOR]

Background and objective Early diagnosis of chronic obstructive pulmonary disease ( COPD) in primary care settings is difficult to achieve chiefly due to lack of availability of spirometry. This study estimated the prevalence of airflow limitation among chronic smokers using a handheld spirometer in this setting. Methods This is a cross-sectional study performed on consecutive patients who were ≥40 years old with ≥10 pack-years smoking history. Face-to-face interviews were carried out to obtain demographic data and relevant information. Handheld spirometry was performed according to a standard protocol using the COPd-6 device ( Model 4000, Vitalograph, Ennis, Ireland) in addition to standard spirometry. Airflow limitation was defined as ratio of forced expiratory volume in 1 s ( FEV1)/forced expiratory volume in 6 s <0.75 ( COPd-6) or FEV1/forced vital capacity <0.7. Multiple logistic regression analyses were used to determine predictors of airflow limitation. Results A total of 416 patients were recruited with mean age of 53 years old. The prevalence of airflow limitation was 10.6% ( n = 44) with COPd-6 versus 6% as gauged using standard spirometry. Risk factors for airflow limitation were age >65 years (odds ratio ( OR) 3.732 95% confidence interval ( CI): 1.100-1.280), a history of 'bad health' ( OR 2.524, 95% CI: 1.037-6.142) and low to normal body mass index ( OR 2.914, 95% CI: 1.191-7.190). Conclusions In a primary care setting, handheld spirometry ( COPd-6) found a prevalence of airflow limitation of ∼10% in smokers. Patients were older, not overweight and had an ill-defined history of health problems. [ABSTRACT FROM AUTHOR]

Background: Neurophobia is defined as the fear of neural sciences and clinical neurology. Our study aims to determine the prevalence and factors associated with neurophobia among family medicine specialist trainees in Malaysia. Methods: A cross-sectional study was conducted among family medicine specialist trainees. Multiple logistic regression analysis was used to determine the factors associated with neurophobia. Results: A total of 415 subjects were enrolled into this study. The prevalence of neurophobia was 66% (n=274/415). In multivariate logistic regression analysis, having poor knowledge in neurology (odds ratio [OR] 3.85, 95% confidence interval [CI] 1.87-7.94), those with self-declared phobia toward neurology or neuroscience subject (OR 2.56 95% CI 1.30-5.03); those whose practice were in government sector (OR 1.78, 95% CI 1.09-2.88); those who perceived basic neuroscience (OR 1.95, 95% CI 1.03-3.67) and the complex clinical examination were important (OR 2.10, 95% CI 1.19-3.72); and those who perceived textbooks were not a useful method of learning (OR 1.78, 95% CI 1.05-3.02) were more prone to have neurophobia. Conclusion: Two-thirds of family medicine specialist trainees in Malaysia found neurology a difficult subject. Among the factors associated with neurophobia were those with poor knowledge in neurology, and those who self-declared to have phobia toward neurology or neuroscience subject. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension contributes to major cardiovascular morbidities and mortalities worldwide and medication compliance is crucial in achieving target blood pressure control. This study aimed to determine the prevalence and factors associated with non-compliance towards anti-hypertensive medication in Malaysia. Methods: This is a cross-sectional study among hypertensive patients who were attending the medical outpatient department, Hospital Serdang from March until May 2018. Systematic random sampling was used to recruit patients and a structured self-administered questionnaire was used to collect information. Non-compliance is defined as attaining a score of 26 and below from the Medication Compliance Scale. Data analysis was done using SPSS v. 23. Multiple logistic regression was used to determine the predictors of medication non-compliance among hypertensive patients. Results: A total of 120 respondents were recruited into this study with a response rate of 60.9%. Mean age of the study respondents was 60.82 ± 11.25 years old. They were predominantly female (60.8%), Malay (58.3%) and attained at least secondary educational level (75.0%). The prevalence of non-compliance towards anti-hypertensive medication was 25%. Multiple logistic regression showed that side effects of medication (OR=5.59; 95% CI=1.29-24.21, p=0.021), traditional medications usage (OR=19.19; 95% CI=3.90-94.45, p=<0.001), health advice counsellors (OR=35.31; 95% CI=2.03-35.31, p=0.003) and duration of hypertension (OR=3.38; 95% CI=1.05-10.91, p=0.042) were predictors of non-compliance to anti-hypertensive medications among hypertensive patients Conclusion: Our study reported that those with longer duration of hypertension, suffered from side effect of medication and have experience in usage of traditional medicine are the predictors of medication non-compliance. [ABSTRACT FROM AUTHOR]