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@#Introduction: Type 2 diabetes mellitus is a chronic disease which is highly prevalent in Malaysia. In managing diabetes, the American Diabetes Association (ADA) and the International Diabetes Federation (IDF) have advocated self-management to be the basic component of diabetes care. However, an ongoing discussion, education and assessment of the patient’s diabetic knowledge should be implemented in the patient’s empowerment process. There are various assessment tools available worldwide but very few are available in the Malay language. This study is aimed to perform the Malay translation of the Simplified Diabetes Knowledge Test (DKT) questionnaire and validate it. Methods: Forward-backward translation procedure was used to translate the simplified version of the DKT questionnaire. A total of 120 respondents with type 2 diabetes mellitus from a selected government health clinic were recruited to answer the questionnaire which consists of socio-demographic, diabetes characteristics and the 20-item Malay version of simplified DKT questionnaire. Reliability and construct validity were tested with Cronbach’s alpha coefficient and Exploratory Factor Analysis. Results: Factor analysis with Varimax rotation identified five meaningful domains for the final 18 items. The Cronbach’s alpha for the overall scale of the translated questionnaire was 0.573 with values of each five significant domain’s Cronbach’s alpha ranged from 0.370 to 0.564. Conclusion: The Malay version of simplified DKT is valid and reliable to be used as a brief assessment of knowledge among Malaysian diabetic patients.
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@#Speech and language skills are among the crucial components in determining cochlear implant habilitation outcomes. The purpose of this study was to investigate speech and language skills of Malay cochlear implant children using a developmental scale questionnaire and to identify the demographic factors that contribute to their performance. This study involved 26 children recruited from the National Cochlear Implant Program under the Malaysian Ministry of Health with chronological ages between 33 to 99 months (mean=72, SD=18.9), implant ages between 18 to 71 months (mean=40, SD=13.5) and hearing ages between 13 to 48 months (mean=30, SD=10.5). The instrument used was The Integrated Scale of Development-Malay version 2 (ISD-Mv2). The questionnaires were given to the parents or caregivers followed with by a phone call interview later. Results from the study showed that only 9 subjects (35%) were able score on the ISD-Mv2 equally or higher than their hearing age. From the six components in the ISD-Mv2, cognitive was scored the highest with 96.79% meanwhile expressive language was the lowest with 76.21%. Pearson correlation test revealed strong positive correlation between audition-receptive language (r=0.554, p<0.05) and cognitive–social communication/ pragmatic (r= 0.625, p<0.05). Speech and language performance of children with demographic factors did not show significant differences. The findings suggests that majority of the Malay cochlear implant children demonstrated delayed speech and language performance as compared to normal hearing children.
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@#Objective: This study is a preliminary work to develop a Malay version questionnaire named ‘Inventori Persepsi bagi Muslim yang Memiliki Masalah Pendengaran (IPM3P)’ to assess the perception on Islamic understanding and practice among Muslim adults with hearing impairment. Methods: The scale development involved three phases: i) generation of domains based on the literature, ii) generation of sub-domains based on literature review and Islamic panel survey, and iii) generation of items. Results: Preliminary version of IPM3P consists of 59 items was produced, representing three domains: Obligation (18 items), Practice (21 items), and Difficulty (20 items), and seven sub-domains (‘Ibadah’, ‘Aqidah’, ‘Muamalat’, ‘Tasawwuf’, ‘Akhlak’,‘Da’wah’, and ‘Sirah’). Conclusion: The preliminary version of IPM3P needs to be psychometrically tested. This pioneering study may become an impetus towards more research pertaining to understanding the effect of hearing loss towards religious life in the future in Malaysia.
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@#Introduction: Food insecurity has a complex and multifaceted concept and definition, thus assessing it has been an ongoing challenge for researchers, health practitioners, and policy makers. Previous studies reported inconsistent findings on the prevalence and severity of food insecurity, depending on the measuring tools used. To overcome this limitation, this study aimed to translate and validate the Food Insecurity Experience Scale (FIES) for Malaysians, which has been used as a standard measurement by Food and Agriculture Organization (FAO). Methods: Two forward and backward translations involving experts in food insecurity studies and experts in language were done, as well as the pre-test and cognitive interview stipulated in World Health Organization (WHO) translation guidelines. Content and face validity were conducted as part of the validation process. Content Validity Index (CVI) was done to analyse content validity. Results: The harmonised Malay version of FIES was produced with 1.0 CVI, which was above the 0.8 criteria. Face validity showed good understandability and clarity of FIES. Conclusion: The translated Malay version of FIES had good acceptability, as well as good face validity when tested among the target audience. Thus, a full validation study of the Malay version FIES should be done before it is widely used to measure food insecurity in the population, specifically the Malaysian population.
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@#Sickle cell disease in Malay ethnicity is uncommon, with few cases been reported only in Malaysian Indians. Detecting sickle haemoglobin in patients with osteoarticular manifestation is not as simple as those with haemolysis crisis, due to its extremely low incidence in this country. We hereby report a case of a 19-year-old Malay female who presented with a long-standing history of disabling movement of both hip joints, intermittent painful swollen right elbow, and chronic back pain. Imaging investigations revealed features of chronic osteomyelitis and avascular necrosis while blood investigations demonstrated features of mild normochromic normocytic anaemia and extravascular haemolysis. Further blood smear and haemoglobin analysis eventually confirmed the presence of homozygous sickle haemoglobin manifesting as sickle cell anaemia. Our case has highlighted the importance of prompt identification and thorough evaluation of the cause of anaemia in a patient with disabling chronic osteoarticular problem.
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@#Introduction: Fear of cancer progression may lead to worsening of psychological complications of cancer and affects the quality of life of cancer patients. Hence, fear of cancer progression needs to be monitored. This study translated the original English version of the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) into the Malay language and investigated the reliability and validity of the Malay version of the FoP-Q-SF (FoP-Q-SF-M) among Malaysian cancer patients. Methods: Concurrent translation and back translation of the English version of the FoP-Q-SF to the FoP-Q-SF-M was performed, and the FoP-Q-SF-M and the Malay version of the Cancer Therapy Satisfaction Questionnaire (CTSQ-M) (as a comparison to assess the discriminant validity of the FoP-Q-SF-M) were administered to 200 cancer patients with different sites, stages, and duration of cancer diagnosis. Results: The CTSQ-M exhibited excellent internal consistency (Cronbach’s α= 0.927) as well as demonstrated good convergent and discriminant validity. Exploratory factor analysis of the FoP-Q-SF-M extracted one factor with twelfth items, thereby this supports the single-factor model reported by the English version of the FoP-Q-SF. Conclusion: The FoP-Q-SF-M exhibited acceptable psychometric properties and valid for use to assess fear of cancer progression in the Malaysian cancer population.
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@#Lip print is useful in forensic investigations for individual identification. The present study aimed to discriminate sex based on lip print patterns in Malaysian Malay population in Klang Valley using a scanning technique. Lip prints of 360 subjects (180 males and 180 females) were taken using the lipstick-cellophane tape technique, pasted onto A4 papers. These papers were then scanned using Brother DCP-J100 printer (300dpi resolution). The images were analysed using a software based on Suzuki and Tsuchihashi’s classification. The lip print images were divided into six sections which are upper left, upper middle, upper right, lower right, lower middle and lower left. The Pearson chi-square test showed that there are significant differences (p < 0.05) between sexes in each section except for the upper middle section. In males, type V (irregular pattern) was the dominant pattern for upper left, upper right, lower right and lower left sections (ranging from 71.1% to 86.7%) while type IV (reticular pattern) was dominant at upper and middle sections (ranging from 57.2% to 66.1%). Type IV (48.3%) was dominant in upper middle section for female, while for the rest of the sections, type V was the dominant lip print pattern (ranging from 40% to 82.8%). These results showed that sex differentiation between males and females in Malaysian Malay population, Klang Valley can be suggested to be used for identification in forensic investigation.
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@#Introduction: Limited information is available on healthrelated quality of life (HRQoL) in children with strabismus in South East Asia. We aimed to evaluate the HRQoL and associated factors pre- and post-strabismus surgery in Malaysian children with infantile esotropia and their parents/guardians. Methods: A prospective study was conducted on children with infantile esotropia aged 8-17 years old and their parents/guardians who attended two tertiary hospitals with a paediatric ophthalmology service from 2017 to 2018. The patients and parents answered the Intermittent Exotropia Questionnaire (IXTQ), translated into Malay, at the time of enrolment and three months after the surgery. Results: Thirty-four children and one (each) of their parents/guardians were enrolled. Thirteen (38.2%) children had esotropia with angles of deviation of more than 50 prism dioptres. A total of 33 (97.1%) children achieved successful alignment correction three months after surgery. Surgery significantly improved the total mean scores of the children, which were 62.87 (17.05) preoperatively and 87.13 (13.26) postoperatively (p<0.001). There was statistically improvement in the total mean scores in the parent/guardian group, which was 37.07 (22.01) preoperatively and 75.39 (22.09) postoperatively (p<0.001). The parents/guardians functional, psychosocial and surgery subscales also had a significant increment in the score postoperatively (p<0.001). Older children and children with poorer visual acuity on presentation had a lower score preoperatively, while girls scored better postoperatively (p<0.05). Mothers scored significantly lower preoperatively and postoperatively (p<0.05). Conclusion: Surgery significantly improved the HRQoL score in Malaysian children with infantile esotropia and their parents/guardians. The score was significantly higher in female children after the surgery. Mothers exhibited poor scores before and after surgery
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@#The study evaluates the prevalence, knowledge, attitude, and practices of non-communicable diseases (NCDs) among adult Orang Asli and Malay ethnicity in Negeri Sembilan, Malaysia. This cross-sectional study involving 634 respondents aged 18 years and above of Orang Asli (51.3%) and Malays (48.7%) from the rural villages. Structured interview questionnaire for disease history and KAP level conducted. Weight, height, waist circumference, blood pressure, and blood glucose levels then measured. Prevalence of NCDs was higher among Malays compared to Orang Asli with hypertension (35.0% vs 14.8%), hypercholesterolemia (31.1% vs 5.2%), and diabetes mellitus (16.2% vs 4.3%), respectively. Malays also had a higher percentage of being abdominal obese (70.6% vs 59.7%) and increased blood pressure (54.4% vs 29.8%). Multivariate analysis indicates hypercholesterolemia [OR=6.035 (95%CI: 3.150,11.561)], abdominal obesity [aOR= 1.807 (95%CI: 1.065, 3.067)], and increased in blood pressure [aOR= 2.359 (95%C1: 1.619,3.437)] have a significant relation with Malay ethnicity. For Orang Asli, 51.7% had poor knowledge, 72.3% had a good attitude, and 16.0% had a good practice. Knowledge and attitude scores were significantly less among Orang Asli with no significant difference for practice compared to the Malays. The prevalence of NCDs among the Malays is alarmingly high, with an increasing trend among Orang Asli, which needs immediate attention. The NCDs and obesity were significant among Malays but also showed a worrying trend in the Orang Asli as the good practice on a healthy life-style was low in both ethnicities. Thus, proper education and promotion regarding NCDs needed for diseases screening and prevention.
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@#Introduction: Identification of remains recovered at advanced stages of decomposition can be problematic due to the lack of physical evidence. Nonetheless, human dentition is least susceptible to decomposition and as such carry a significant value in personal identification of decomposed remains. Demirjian’s method of age estimation was developed specifically for children with developing dentition. In this article, a method on adapting the Demirjian’s method for Malay ethnic-specific age estimation using the third molar development is presented. Methods: Orthopantomograms of Malay subjects aged 18 to 25 were obtained from UiTM Sungai Buloh. Total of 318 samples were taken, comprising of 123 and 195 images from male and female subjects. Development of right and left mandibular third molar was classified according to the eight stages of development as illustrated in Demirjian’s method. Data obtained were subjected to statistical analysis such as descriptive statistics and analysis of variance. The intra- and inter-gender variation between left and right mandibular third molar was evaluated using independent student t-test and analysis of variance, respectively. Results: Intra-gender comparison analysis revealed a significant difference in the female and male with a p-value of 0.000 and 0.003, respectively. Regression equation to estimate age based on third molar development were formulated according to dental age and maturity score. Conclusion: The Demirjian’s method was successfully adapted for age estimation of individuals of Malay ethnicity. These findings can help with victim identification in cases of poor skeletal framework recovery and highly decomposed remains.
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@#Introduction: In Malaysia, herbal medicines are used for variety of reasons including health promotion and home remedies during pregnancy and postpartum with Manjakani (Quercus infectoria) as one of the most commonly consumed herbs. Herbal medicines consumption had been linked to heavy metals contamination and transfer from mother to infant and may affect infant’s growth and development. This study aims to (i) determine Manjakani consumption among postpartum mothers, (ii) quantify its heavy metals level, namely lead, cadmium, arsenic and chromium, and (iii) determine health risk associated with its consumption. Methods: A cross-sectional study involving 106 postpartum mothers was carried out in Kuala Lumpur. Six samples of Manjakani were sampled and extracted using microwave digester and analysed using Inductively coupled plasma mass spectrometry (ICP-MS). Non-carcinogenic health risks for herbal medicine consumption were calculated using Hazard Quotient (HQ). Results: Manjakani was consumed by 16% of mothers (n=17). Highest level of the metals was shown by chromium with mean concentration of 4210 ± 1910 ug/kg, followed by lead (170.8 ± 193.2), arsenic (39.3 ± 27.1) and cadmium (7.7 ± 0.76). There were no significant non-carcinogenic health risks with lead, arsenic, chromium and cadmium contamination (HQ < 1). Conclusion: Manjakani is consumed by mothers during confinement period. Heavy metals were quantified in Manjakani although no significant association was observed with socio-demographic characteristics and birth outcomes.
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@#Background: Mutations in glucocerebrosidase (GBA) have been associated with the risk of developing Parkinson’s disease (PD) in different ethnic populations. The prevalence of GBA mutations among Malay PD patients is unknown. Thus, the aim of this study was to determine the frequency of GBA mutations among Malay PD patients, focusing on early (EOPD) and late-onset (LOPD) patients. Methods:EOPD (n = 50) and LOPD (n = 50) patients along with 50 ethnically and age-matched control wererecruited. The GBA exons of these patients were sequenced using the Ion Torrent PGMTM System. Results: Five heterozygous mutations exclusive to EOPD patients were identified; c.-203A>G,p.S146L, p.R159Q, p.L483P and p.L483R+c.-145G>A. In LOPD patients, c.543C>T(p.(F181=)), c.28-10C>A and p.R202Q were identified in which this p.R202Q was also present in a control subject. In addition, c.259C>A(p.(R87=)) and c.-145G>A were identified in two control subjects. In summary, we observed GBA mutations in 8% and 6% of Malay PD cases and control subject, respectively. The prevalence of GBA mutations was higher in EOPD (10%) than LOPD (6%). However, these differences were not statistically significant; [PD vs. controls: OR = 1.36, 95%CI 0.35-5.38, p = 0.752] and [EOPD vs. LOPD: OR = 1.74, 95%CI 0.39-7.71, p = 0.715]. Conclusion: We identified five exclusive heterozygous GBA mutations in EOPD patients which might predict the increase susceptibility of Malays to develop PD at young age. These findings could add knowledge into the existing evidences linking genetic alterations in GBA and PD.
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@#Introduction: Colorectal cancer (CRC) is one of the leading cancers in Malaysia where new cases are increasing every year. The aim of this study was to test the reliability and validity of a newly developed questionnaire on knowledge, attitude and dietary practices (KAP) related to CRC for the Malay population. Methods: The respondents were conveniently selected among visitors attending an outpatient clinic in a tertiary hospital. We excluded those with any cancers, chronic diseases and those that were illiterate. The exploratory factor and reliability analyses were conducted. Results: A total of 108 respondents were recruited of which 67.7% were males and the mean age was 54.59 years (standard deviation 8.93). The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy values for KAP were 0.64, 0.66 and 0.67, respectively (P < 0.001). The 17 items of knowledge formed five domains with loading factors ranging from 0.54–0.89. The six items of attitude formed two domains with loading factors ranging from 0.64–0.80 and the 15 practices had four domains with loading factors ranging from 0.52–0.83. The total variances explained for each KAP were 61.02%, 56.41% and 53.12%, respectively. The internal consistency Cronbach alpha values on KAP were 0.61, 0.60 and 0.70, respectively. Conclusion: The final questionnaire is suitable for measuring KAP related to CRC among the Malay population.
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@#Prostate cancer is forth most common diagnosed tumors in Malaysian male. The use of a self-reported, quality of life assessment is important for clinical practice, care taker and researcher to evaluate the level of quality of life. The aim of this study was to measure the internal consistency of the translated Malay Language EORTC QLQ-C30 and EORTC PR-25 questionnaires among prostate cancer patient at National University of Malaysia hospital in Kuala Lumpur, Malaysia. Methods This was a cross sectional study conducted between July 2017 and Dec 2017. The respondent comprised of 110 Malaysian prostate cancer patients who were under follow up at Urology and Oncology Clinic. Sets of translated Malay language EORTC QLQ C30 and EORTC PR-25 consisted of functional, symptom and global health status domains were administered to assess their quality of life. Results The translated questionnaires were acceptable by 110 respondents. Cronbach`s α coefficient result were 0.913 (EORTC QLQ-C30) and 0.829 (EORTC PR25) respectively suggested that this instrument had good internal consistency. Conclusions Our study confirmed that translated Malay language EORTC QLQ-C30 and QLQ-PR25 questionnaires are acceptable, reliable and valid instrument to be used among Malaysian prostate cancer patients.
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@#Autoimmune blistering diseases (AIBD) represent a group of rare and chronic disorders with significant impact on quality of life (QoL). The aim of this study was to assess the validity and reliability of the Malay translation of the autoimmune bullous disease quality of life (ABQOL) questionnaire.
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Background: Having an autistic child and living together may not be easy for the affected families. The families may experience and face various effects when caring for their autistic children, both physically and psychologically. This study aimed to describe the impacts of having children with autism experienced by Malay family in West Kalimantan Indonesia.Methods: This ethnography study employed participant observations, focus group discussions, and in-depth interviews to gather the data from 20 Malay families who have autistic children who were selected using a purposive sampling technique. The families served as the key informants comprising fathers, mothers, siblings, grandmothers, and grandfathers. The data collected through the three techniques were then analyzed using thematic analysis.Results: The findings of this study generated five impacts categorized into themes consisting of (1) stress on main caregivers; (2) financial problem; (3) impact on employment; (4) impact on family or marital relationship; and (5) positive impact of having autistic children.Conclusions: Families with autistic children have a high risk of experiencing physical, psychological, and social problems. Thus, to improve the quality of family health, nurses, and health workers need to teach the family how to manage stress properly. They may also need to provide counseling to primary caregivers by making a deep hearing of their concerns
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@#Ulam is fresh traditional Malaysian vegetables which normally consumed in raw form or after a short blanching process. It contains high antioxidants and polyphenols. However, there is limited study about the relationship between ulam consumption and cognitive status. Thus, a cross sectional study was conducted to determine the relation with cognitive function among 132 middle-aged Malays adults (45-59 years old), recruited by convenient sampling from low income residences in Klang Valley. Respondents were interviewed to obtain data on sociodemography, dietary intake and total ulam intake and also measured for anthropometric parameters at respective community centres. Cognitive status was measured using Digit Span (attention and working memory), Rey auditory verbal learning test (RAVLT) (verbal memory) and comprehensive trail making test (CTMT) (cognitive flexibility). The average ulam intake by the respondents was 15.1 ± 8.2g/day and the top five highest consumed ulam were petai (68.1%), pucuk paku (62.9%), ulam raja (56.8%), pegaga (54.6%) and kesum (44.7%).There was a significant correlation between ulam intake with Digit Span (r = 0.265, p = 0.006), total immediate recall of RAVLT (r = 0.427, p < 0.001) and CTMT (r = 0.257, p = 0.007). Analysis of multiple regression indicated that total ulam intake was a significant predictor for Digit Span (R2 = 0.152, p < 0.05), RAVLT (R2 = 0.335, p = 0.001) and CTMT (R2 = 0.310, p < 0.001). In conclusion, this study showed that ulam has the potential to protect against cognitive decline, however, randomized control trials should be conducted to determine the efficacy of the ulam as neuroprotective agent.
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@#The Quality of Life-Alzheimer’s Disease (QOL-AD) questionnaire is a reliable, valid and popular outcome measure in dementia related studies. However, to date there is no published report on adopted version of QOL-AD in Malay language. Thus this preliminary study aimed to evaluate the reliability and validity of the QOL-AD in Malay language for patients with dementia and to examine the level of agreement between patient-caregiver as a proxy reports on patient’s quality of life. A total of 65 patients with mild to moderate dementia and their caregivers were recruited from the psycho-geriatric clinic, Universiti Kebangsaan Malaysia Medical Centre using a cross sectional study design. The QOL-AD was translated into Malay language using the standard guidelines for cross-cultural adaptation of measure. The patient-caregiver dyads completed the QOL-AD in Malay language separately. Test-retest and internal consistency was evaluated for reliability and construct validity was tested with principal component factor analysis. The reliability of QOL-AD in Malay language was good with Cronbach alpha coefficients of 0.82 and 0.79 and intraclass correlation coefficients of 0.77 and 0.89 for patients and caregivers report respectively. Meanwhile a positive moderate agreement was achieved between patient and caregiver rating (r=0.60, p<0.01). The principal component factor analysis extracted 4 factors for both patient and caregiver reports which explained 66.02% (patients’ report) and 64.24% (caregivers’ report) of the total variance of the scale. As a conclusion, the QOL-AD in Malay language is a reliable and valid tool to measure the quality of life of people with mild to moderate dementia.
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@#Introduction: Depression and anxiety are common complications associated with traumatic brain injury (TBI) patients but screening tools which are validated to assess these complications in the TBI population are scarce. This study investigated the validity of the Malay version of Hospital Anxiety and Depression Scale (HADS) to screen for depression and anxiety among Malaysian TBI patients. Materials and Methods: This cross -sectional study recruited 101 TBI patients in which they were administered the Malay version of HADS and the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorder 4th Edition (DSM-IV) for Axis I Disorders (SCID-I) (as comparison tool). Internal consistency (Cronbach’s α) and concurrent validity (using receiver operating characteristics) of the Malay version of HADS were evaluated. Results: The total Malay version of HADS score and its anxiety subscale exhibited good internal consistency of 0.80 and 0.78 respectively, but the internal consistency of its depressive subscale was low at 0.57. The depressive subscale of the Malay version of HADS exhibited high area under the curve (AUC) of 0.86, specificity of 82%, sensitivity of 76% and negative predictive value of 91% but its positive predictive value was 58%, at cut-off point of 8/9. While the anxiety subscale also demonstrated high AUC of 0.88, specificity of 71%, sensitivity of 93% and negative predictive value of 98% its positive predictive value was only 34%. Conclusion: The Malay version of HADS is a valid screening tool for depression and anxiety among Malaysian TBI population.
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@#Introduction: The transtheoretical model (TTM) is an integrative model of intentional change consisting of stages of change, processes of change, decisional balance and self-efficacy. This study aimed at validating the TTM questionnaires on physical activity for Malaysian children using confirmatory factor analysis. Methods: The participants were 381 Malay students (188 male; 193 female), aged 10–12 years old, with a mean age of 10.94 (SD = 0.81). The original version of the TTM was translated into the Malay language using forward and backward translation. Certain phrases were adapted based on the local culture and vocabulary suitable for primary school students. Results: The final measurement models and their fit indices were: processes of change (CFI = 0.939, TLI = 0.925, SRMR = 0.040, RMSEA = 0.030); decisional balance (CFI = 0.897, TLI = 0.864, SRMR = 0.045, RMSEA = 0.038); and self-efficacy (CFI = 0.934, TLI = 0.915, SRMR = 0.042, RMSEA = 0.032). Conclusion: Care must be taken when using the TTM with children, as it has been prevalently validated with adults. The final version of the TTM questionnaire for Malay primary school children had 24 items for process of changes, 13 items for self-efficacy and 10 items for decisional balance.