1.Prevalence of Urban Poor and Its Health Related Factors in the State of Selangor, Malaysia
MS Sherina ; L Rampal ; AR Hejar ; A Rozali ; A Mohd Yunus
Malaysian Journal of Medicine and Health Sciences 2011;7(1):17-26
The objectives of this study were to determine the prevalence of the urban poor and its health related
factors in Selangor. This cross-sectional study was conducted in the community of Selangor. Data
was collected from January 2006 to June 2006. Three out of nine districts were selected to be involved
in the study, which were Klang, Kuala Langat and Petaling. A Multistage Stratified Proportionate
Systematic Random Sampling was used for this study. The sampling was carried out by the Statistics
Department of Malaysia. The survey frame was based on the information gathered from the Population
and Housing Census in year 2000. The respondents were interviewed by trained research assistants
using a structured pre-tested standardized questionnaire prepared in Malay and English languages.
A monthly income of RM706 and less was used to define urban poor based on the guidelines given
by the Economy Planning Unit of Malaysia (2004). SPSS 16.0 version was used to analyze the data.
Out of 2535 respondents interviewed in this study, 2491 respondents answered the questionnaire
completely (response rate 98.3%). Out of 2491 respondents, 202 (8.1%) had a monthly income of
RM706 and less. Analysis of the urban poor respondents found that majority were aged between 18 to
40 years old (55.9%), and 29.7% had diagnosed medical illnesses, where hypertension, diabetes and
asthma were the most common illnesses at 12.4%, 10.9% and 5.0% respectively. About 10% of the
urban poor respondents had physical disabilities such as blurring of vision (7.9%), hearing problems
(1.0%) and other disabilities (1.0%).
2.Prevalence of Metabolic Syndrome Among Staff in a Malaysian Public University Based on Harmonised, International Diabetes Federation and National Cholesterol Education Program Definitions
Heng KS ; Hejar AR ; Rushdan AZ ; Loh SP
Malaysian Journal of Nutrition 2013;19(1):77-86
Introduction: Metabolic syndrome (MetSyn) as defined by the latest Harmonised
definition and the agreement between the Harmonised definition and other
definitions is poorly studied among Malaysians. This study was conducted to
determine and compare the prevalence of MetSyn according to the Harmonised,
International Diabetes Federation (IDF) and National Cholesterol Education
Program (NCEP ATPIII) definitions among Malay staff of Universiti Putra
Malaysia (UPM). Methods: Subjects aged between 20 to 65 years were recruited
by convenient sampling. Waist circumference, blood pressure, lipid profiles and
fasting plasma glucose levels were assessed. The agreement between the
Harmonised and other definitions was determined by Kappa statistics. Results:
A total of 227 subjects with a mean ± SD age of 37.9±9.6 years participated in the
study. The overall prevalence of MetSyn was 38.3%, 38.8% and 33.5% according
to Harmonised, IDF and NCEP ATP III definitions, respectively. Generally, men
had higher prevalence of MetSyn than women. The prevalence increased with
age in both genders with a more progressive trend in women. Men in the age
group of 20-39 years had a high prevalence of metabolic syndrome. A strong
agreement was found between the Harmonised and the IDF definitions (Kappa
index=0.991), and between the Harmonised and the NCEP ATP III definitions
(Kappa index=0.857). Conclusion: Regardless of definitions used, the prevalence
of metabolic syndrome in the study, especially in young men, was high and
warrants further investigation. The Harmonised definition is suitable for
diagnosing metabolic syndrome in any population with similar sociodemographic
characteristics.
3.Breastfeeding Practices and Nutritional Status of Orang Asli Children (Temuan and Mah Meri) in Sepang District and Carey Island, Selangor
WN Wan Norlida ; MS Zalilah ; GL Khor ; WC Ng ; K Mirnalini ; AG Nawalyah ; AR Hejar
Malaysian Journal of Medicine and Health Sciences 2007;3(2):1-15
Objectives: There is a lack of current published information on health and nutritional status of Orang Asli children. A study was conducted to assess breastfeeding practices, dietary intake and growth status of Orang Asli children in Sepang and Carey Island, Selangor.Methods: A total of 173 children(88 Temuan and 85 Mah Meri) from 137 households were measured for body weight and height. Information on breastfeeding practices and dietary intake was obtained from their mothers. Results:Most of the mothers (98.9%) breastfed their infants with a high proportion (86.8%) initiating breastfeeding within one hour after delivery.About 53% of the mothers reported discarding colostrum due to various reasons including the perception that colostrum in undesirable and can produce ill-health. Although many of these mothers (58.3%) discarded colostrum on their own initiative, about 25% of them reported that they were advised by health professionals. Among mothers who had stopped breastfeeding at the time of the study (n=48), the mean duration of breastfeeding was 12.1 ± 8.9 months. About 33% of the mothers stopped breastfeeding before their infants were 6 months old and only 31% breastfed their children for more than 1 year. The percentages of significantly underweight, stunted and wasted were 48.9%, 5.2.2% and 4.3% respectively for children aged 1-3 years, whereas among children aged 4-6 years old, 35.8%, 50.6% and 1.3% were underweight, stunted and wasted, respectively. A higher proportion of Mah Meri than Temuan children in both age groups were significantly underweight, stunted and wasted. Despite the adequate intake of energy and most nutrients,the Orang Asli children had insufficient mean number of servings for all food groups-grain and cereals, fruits, vegetables, meat and fish, and milk and dairy products. Conclusion: In this study, undernutrition is a major health and nutrition problem among the Orang Asli children. The problem could be due to many factors that include poor infant and child feeding practices. Concerted efforts by various government and non government agencies are essential to improve the health and nutrition of Orang Asli.
4.Potential of Mixed Tocotrienol Supplementation to Reduce Cholesterol and Cytokines Level in Adults with Metabolic Syndrome
Heng KS ; Hejar AR ; Johnson Stanslas J ; Ooi CP ; Loh SPI
Malaysian Journal of Nutrition 2015;21(2):231-243
Introduction: Metabolic syndrome is associated with low-grade, chronic inflammation. Our study aimed to evaluate the effects of tocotrienols supplementation on cytokines and lipid profile in adults with metabolic syndrome.
Method: In a 16-week randomised, double-blind, placebo-controlled trial, 70 adults with metabolic syndrome aged 20-60 years were randomly assigned to a mixed tocotrienols group (n=35) that received 400mg/day of mixed tocotrienols or a placebo group (n=35) that received capsules containing soy bean oil. At baseline, week 8 and week 16, anthropometric, body composition and blood pressure measurements were conducted. At baseline and week 16 only, serum levels of total cholesterol (TC) and high density lipoprotein (HDL)-cholesterol, plasma levels of fasting plasma glucose (FPG), interleukin-6 (IL-6), tumouxr necrosis factor- a (TNF-a), leptin, adiponectin and high sensitivity C-reactive protein were also determined. Changes in dietary intake and physical activity level between baseline, week 8 and week 16 were also assessed.
Results:In the tocotrienols group, significant reductions from baseline were found in diastolic blood pressure (p=0.001), TC (p=0.008), LDL-cholesterol (p=0.022), HDL-cholesterol (p<0.001), IL-6 (p=0.024) and TNF-a (p=0.013) at week sixteen. However, the changes in the tocotrienols group were not significantly different from those of the placebo group.
Conclusion: The 16-week mixed tocotrienols supplementation exerted potential beneficial effects on cytokines and lipid profile in adults with metabolic syndrome. The results might have been confounded by the physiological effects produced by the soy bean oil in the placebo capsule.
5.Breast cancer screening: How knowledgeable are female staff of a public university?
Nor Afiah MZ ; Hejar AR ; Looi YK ; Lim SJ ; Ng CY ; Tong CY
The International Medical Journal Malaysia 2011;10(1):23-30
Breast cancer is the most common cancer among women worldwide and in Malaysia. It has better
cure rate if detected early. However, the practice of breast cancer screening in Malaysia is still low. The
objective of this study is to determine the knowledge and its associated factors as well as sources of information
on breast cancer and breast cancer screening among female staff in a public university in Malaysia.
Materials and Methods: This was a cross sectional study conducted in 2005 involving 394 female staff including
academic and non-academic staff, which was selected by cluster sampling. A self-administered questionnaire
on socioeconomic characteristics and family history of breast cancer was used for data collection. Chi-square
Test and Fisher’s Exact Test was used for testing an association using SPSS 12.0. Results: The response rate was
84.3%. Only 50.9% had high knowledge on breast cancer and breast cancer screening and this was significantly
associated with occupational status, monthly family income and educational level (p<0.05). The usual source
of information was mass media (92.2%) while the most preferred source is the health team (71.4%).
Conclusion: As mass media was a major source of information, all types of mass media could efficiently be utilized
to disseminate knowledge by presenting specific programmes associated with breast cancer and breast
cancer screening.
6.Pain Interference Level and its Effects on Patients’ Quality of Life and Depression: A Study on Breast Cancer Survivors in Hospital Kuala Lumpur, Malaysia
JO Zubaidah ; AR Hejar ; YW Lim ; KT Chin ; Z Muhd Aizuddin ; Z Muhd Hazeman ; I Normala ; MA Muhd Najib
Malaysian Journal of Medicine and Health Sciences 2013;9(1):45-54
Introduction: Cancer pain is a complex experience and is one of the most common and distressing
symptom of breast cancer which affects patients’ functioning in daily activities, their quality of life
(QOL), and mood. Yet, there is a great lack of data on breast cancer and pain in Malaysia. Methods:
A cross-sectional study using the Breast Cancer Patient Version of Quality of Life (QOL) Instrument
(translated into Malay) and Depression Anxiety and Stress Scale (DASS) were conducted on 87 female
breast cancer patients to investigate the impact of pain interference level on their quality of life and
depressive level. Results: The patients were divided into 4 groups based on their rating of how pain
and aches have been a problem to them (i.e not a problem [n=18 (20.7%)], mild[n=29 (33.3%)],
moderate [n=18 (20.7%)] and severe [n=22(25.3%). Pain and aches ware reported to be the most severe
interference problems in QOL physical domain by patients (mean=5.8, SD=2.8), followed by fatigue
(mean=6.0, SD=3.1) and sleep changes (mean=6.2, SD=3.5). Patients who reported that pain and aches
had severely affected them showed significantly lower score on many aspects of quality of life (Fs > 5, p
< 0.005; p < 0.0001) and patients reported pain was not a problem at all demonstrated highest score on
all aspects of QOL. Patients with most severe pain interference level showed highest depressive score
[F (3, 84) =3, p < 0.05]. Conclusion: The study underscores the impact of pain interference on patients’
quality of life and depressive level. The pain assessment deserves significant attention and therefore a
comprehensive biopsychosocial assessment of pain to rule out any related underlying issues is warranted
in the management of breast cancer to ensure appropriate intervention given to the patients.