Mohd Rizal Abdul Manaf

Serum IL‐6 and IL‐1‐ra with sequential organ failure assessment scores in septic patients receiving high‐volume haemofiltration and continuous venovenous haemofiltration

Aim:  Sepsis is characterized by an uncontrolled release of pro‐inflammatory and anti‐inflammatory mediators leading to immunoparalysis, cellular and humoral dysfunction, multiorgan dysfunction and death. This study evaluated the efficacy of high‐volume haemofiltration (HVHF) compared with continuous venovenous haemofiltration (CVVH) in removing these inflammatory mediators. Clinical responses were assessed with the sequential organ failure assessment (SOFA) score.

Risk factors for depression and anxiety among pregnant women in Hospital Tuanku Bainun, Ipoh, Malaysia

Anxiety and depression are prevalent during pregnancy. Estimates of the prevalence of anxiety and depression during pregnancy vary according to the criteria used, variable methodologies and population characteristics.

Helicobacter pylori cagA gene variants in Malaysians of different ethnicity.

We have defined DNA repeat variability in the 3′-terminus of the cagA gene of Helicobacter pylori strains from Malaysian patients of different ethnicities. We identified different alleles based on the EPIYA repeats. cagA types A-B-D and A-B-B-D are more similar to the sequence of Japanese strains, whereas cagA types A-B-C, A-B-C-C, A-B and A-C displayed similarity to strain 26695 sequences. A significant association was found between cagA genotypes and patients’ ethnicity, with cagA type A-B-D being predominantly isolated from Chinese patients and cagA type A-B-C from Malays and Indians. Our data further corroborate the possibility that variant biological activity of CagA may affect the host specificity and/or pathogenicity of H. pylori.

Cost analysis of colorectal cancer (CRC) management in UKM Medical Centre using clinical pathway

Background Cost analysis has become a huge concern in today’s healthcare due to the rising healthcare cost and the pressure for policy makers to make appropriate resource allocations. One of the approaches to cost calculation is by activity based costing using clinical pathway. Colorectal cancer (CRC) is fast becoming a threat to an industrialising country like Malaysia due to its rapidly rising incidence trend. Therefore, this study aims to develop a clinical pathway in managing CRC in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and to determine the cost of managing CRC according to disease stages.

Pre-marital sex and its predicting factors among Malaysian youths.

INTRODUCTION This study aimed to examine the prevalence of pre-marital sex and its predicting factors among youth trainees undergoing a national skill training programme in the state of Malaysia. METHODS Participants filled up health screening surveys at the beginning of their training period. A total of 1328 out of 1377 trainees were included in the study. Logistic regression was done to determine the potential predicting factors of pre-marital sex among the trainees. RESULTS Most trainees were 18 years old (97.1%) and 56% were female and 44% were male. The prevalence of pre-marital sex among trainees of these youths was 4.6%. A total of 6.2% of the female trainees as compared to 2.6% of their male counterpart had had pre-marital sex. Analysis using multiple logistic regression revealed only six significant predictor variables which were religion, race, lover, reading or watching porn, masturbation and bullying. CONCLUSION The prevalence of pre-marital sex amongst Malaysian youths is low as compared to those in developed countries. However, as pre-marital sex and pregnancy outside wedlock are largely socially unacceptable in Malaysia and may be kept hidden from others, the complications and social problems that may follow from this behaviour should be taken into consideration. Measures such as sex education and awareness programmes are needed among youth to curb this phenomenon from becoming a social as well as a public health concern.

Quality of life among Jordanian patients on haemodialysis and their caregivers

Results One hundred thirty-eight patients and forty-nine caregivers were involved in the study. Patients’ QOL score was less than their caregiver and both have poorer QOL compared to the general population. Patients’ and caregivers’ Physical Component Summary (PCS) were negatively correlated with their age (patients r=-0.38, P=0.001; caregivers r=-0.37, P=0.008). Moreover, caregivers’ Mental Component Summary (MCS) was negatively correlated with their age (r=-0.29, P=0.04). Single patients have higher PCS than married and widowed. Working patients have higher PCS than not working and retired. However, there was no correlation between patients’ and caregivers’ QOL (PCS P=0.32; MCS p=0.13).

Orgasmic dysfunction among Malay diabetic women in Malaysia.

OBJECTIVES The present study aimed to determine the prevalence and associated factors of orgasmic dysfunction among Malay women with type 2 diabetes mellitus in Malaysia. METHODS This cross-sectional study involved 347 women (174 non diabetic and 173 diabetic subjects) who attended the diabetic clinic in a university hospital. Orgasmic dysfunction was assessed using the orgasmic subscale of Malay Version of the Female Sexual Function Index (MVFSFI). Sociodemographic information of the subjects was collected with a pre-designed questionnaire. RESULTS Prevalence of orgasmic dysfunction among Malay women was 13.3% and 10.3% in type 2 diabetes mellitus and control group, respectively. However, the difference was not statistically significant. Multivariate logistic regression analysis showed that unemployment (Adjusted Odds Ratio, AOR=2.69, 95% CI=1.22, 5.97) and lower academic status (AOR=0.35, 95% CI=0.17, 0.72) were significantly associated with sexual orgasmic dysfunction in diabetic women. CONCLUSION Orgasmic dysfunction was highly prevalent among the Malay women regardless of the diabetic state. It is recommended that orgasmic dysfunction in women with diabetes should be assessed during routine clinical health visit to the hospital for early treatment.

DEVELOPMENT AND EVALUATION OF 'NECK PAIN AND FUNCTIONAL LIMITATION SCALE': A VALIDATION STUDY IN THE ASIAN CONTEXT

BACKGROUND There is a paucity of literature on validated outcome measurement tools for evaluation of neck pain and related disability in the Asian context. AIM The main aim of the present study was to design a new tool called neck pain functional limitation scale (NPFLS) for measuring disability related to neck pain and observe its reliability, concurrent validity and criterion validity. SETTING AND DESIGN This study was performed at the institutional hospital. MATERIALS AND METHODS A total of 157 subjects (neck pain group) and 25 control subjects (control group) without neck pain were recruited for this study. NPFLS was framed as a new tool for this study, which consisted of 5 domains - pain intensity, activities of daily living, social activities, functional activities and psychological factors. Neck Bournemouth questionnaire (NBQ) was used as a gold standard to measure the concurrent validity and criterion validity of the NPFLS. STATISTICAL ANALYSIS Criterion validity and concurrent validity between the neck Bournemouth questionnaire (NBQ) and NPFLS scores were tested statistically using Mann-Whitney U test and Spearman correlation test. The reliability was tested by examining the internal consistency to calculate the Cronbachs alpha value for each item in NPFLS. RESULTS No significant difference between NPFLS and NBQ was observed using Mann-Whitney U Test, with P value greater than 0.05 (P= 0.557). Besides that, NPFLS had a high concurrent validity (r= 0.916) and good internal consistency with high Cronbachs alpha value of (r= 0.948), which demonstrated strong correlation between the items of NPFLS and NBQ. CONCLUSION NPFLS demonstrated good reliability, high concurrent validity and criterion validity in this study. NPFLS can be used to assess neck pain and disability among patients with neck pain.

Seropositivity and serointensity of Toxoplasma gondii antibodies and DNA among patients with schizophrenia.

The aim of this cross sectional case control study was to examine the serofrequency and serointensity of Toxoplasma gondii (Tg) IgG, IgM, and DNA among patients with schizophrenia. A total of 101 patients with schizophrenia and 55 healthy controls from Sungai Buloh Hospital, Selangor, Malaysia and University Malaya Medical Center (UMMC) were included in this study. The diagnosis of schizophrenia was made based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The presence of Tg infection was examined using both indirect (ELISA) and direct (quantitative real-time PCR) detection methods by measuring Tg IgG and IgM and DNA, respectively. The serofrequency of Tg IgG antibodies (51.5%, 52/101) and DNA (32.67%, 33/101) among patients with schizophrenia was significantly higher than IgG (18.2%, 10/55) and DNA (3.64%, 2/55) of the controls (IgG, P=0.000, OD=4.8, CI=2.2-10.5; DNA, P=0.000, OD=12.9, CI=2.17-10.51). However, the Tg IgM antibody between patients with schizophrenia and controls was not significant (P>0.005). There was no significant difference (P>0.005) in both serointensity of Tg IgG and DNA between patients with schizophrenia and controls. These findings have further demonstrated the strong association between the active Tg infection and schizophrenia.

Effects of Lifestyle Intervention towards Obesity and Blood Pressure among Housewives in Klang Valley: A Quasi-Experimental Study

Background The obesity rate in Malaysia is the highest in Asia. Half its population is obese or overweight. The present study aims to determine the effects of lifestyle intervention on weight loss and blood pressure among Malaysian overweight and obese housewives in Klang Valley. Methods A quasi-experimental study with 328 obese and overweight low socio- economic status housewives aged 18-59 years old who met the screening criteria participated in the study. They were recruited into an intervention group (N = 169) or control group (N = 159). The intervention group received a lifestyle intervention consisting of a diet, physical activity and self-monitoring behavior package. The control group (delayed intervention group) received a womens health seminar package. Both groups were followed up for six months. Weight, body mass index (BMI), and blood pressure were evaluated both pre- and post-intervention. Results A total of 124 participants from the intervention group and 93 participants from the control group completed the study. Mean weight loss was 1.13 ± 2.70 kg (P < 0.05) in the intervention group and 0.97 ± 2.60 kg (P < 0.05) in the control group. Systolic blood pressure (SBP) reductions in the intervention group were 5.84 ± 18.10 mmHg (P < 0.05). The control group showed reduction in SBP 6.04 ± 14.52 mmHg (P < 0.05). Both group had non-significant DBP reduction. Multivariate analysis via General Linear Model Repeated Measures observed no significant differences in terms of parameter changes with time in both groups for all parameters. Conclusions The results indicate that the lifestyle interventions in this study resulted in modest weight loss and thus decreased BMI and blood pressure (SBP) within six months of intervention.