1.Factors associated with ultrasound diagnosed neurogenic bladder complications following spinal cord injury
Akmal Hafizah Zamli ; Nadia Mohd Mustafah ; Nadiah Sa&rsquo ; at ; Sumayya Shaharom
The Medical Journal of Malaysia 2020;75(6):642-648
secondary medical impairment following spinal cord injury(SCI). Ultrasound (US) of the kidneys, ureters and bladder(KUB) has been recommended as a useful, non-invasivesurveillance method with good diagnostic sensitivity. Thisstudy aims to understand US diagnosed NB complicationsand identify its associated factors.Methods: We enrolled all patients referred for SCIrehabilitation from 2012 to 2015 that fulfilled our studycriteria. Data that were retrospectively reviewed includeddemographic and clinical characteristic data; and US KUBsurveillance studies.Results: Out of 136 electronic medical records reviewed, 110fulfilled the study criteria. The prevalence of NB in our studypopulation was 80.9%. We found 22(20%) of the patientsshowed evidence of US diagnosed NB complications withthe mean detection of 9.61±7.91 months following initial SCI.The reported NB complications were specific morphologicalchanges in the bladder wall 8(36.4%); followed byunilateral/bilateral hydronephrosis 7(31.8%); bladder and/orrenal calculi 5(22.7%); and mixed complication 2(9.1%)respectively. Half of the patients with NB complications hadurodynamic diagnosis of neurogenic detrusor overactivitywith/without evidence of detrusor sphincter dyssynergia.We found co-existing neurogenic bowel, presence ofspasticity and mode of bladder management weresignificantly associated factors with US diagnosed NBcomplications (p<0.05), while spasticity was its predictorwith adjusted Odds Ratio value of 3.93 (1.14, 13.56).Conclusion: NB is a common secondary medical impairmentin our SCI population. A proportion of them had USdiagnosed NB complications. Co-existing neurogenic bowel,presence of spasticity and mode of bladder managementwere its associated factors; while spasticity was itspredictor.
2.Maternal Obesity and Its Associated Factors and Outcomes in Klang Valley, Malaysia: Finding from National Obstetric Registry
Rohana Abdul Jalil ; Nurul Farehah Shahrir ; J. Ravichandran R Jeganathan ; Shamala Devi Karalasingam ; Noraihan Mohd Nordin ; Mohamad Farouk Abdullah ; Nadiah Sa&rsquo ; at
Malaysian Family Physician 2021;16(3):56-67
Introduction: Maternal obesity presents significant health risks to mothers and their fetuses. This study aimed to determine the proportion, associated factors and outcomes of maternal obesity among pregnant women in Klang Valley, Malaysia.
Methods: A retrospective cross-sectional study was conducted between January 2018 and March 2018 using secondary data from the Malaysian National Obstetric Registry (NOR) for the year 2015. All pregnant women with first-trimester booking at 12 weeks and below that were registered with the NOR and met the inclusion and exclusion criteria were included in the study. Descriptive statistics and multiple logistic regression analysis were used. Data were analysed using SPSS version 22.0. A total of 2113 respondents were included in this study to determine the proportion, associated factors and outcomes of maternal obesity. Regarding the univariate and multivariate analyses, respondents were classified into two groups: normal and obese. The obese group comprised overweight and obese mothers. The underweight group was excluded in the subsequent analysis.
Results: Out of the 2113 respondents, 7.1% were underweight, 41.7% were of normal weight, 28.6% were overweight, 15.9% were in obese class I, 4.6% were in obese class II, and 2.1% were in obese class III according to the WHO (1995) reference. However, when the MOH (2003) cutoff point was used, there was a marked increase in the proportion of respondents in the overweight categories by 2.7% and obesity class I by 12.8%. The Indian (AdjOR 2.06, 95% CI: 1.11, 3.83, p=0.021) and Malay (AdjOR 1.75, 95% CI: 1.02, 3.00, p=0.040) ethnicities, as well as both multiparity (AdjOR 1.46, 95% CI: 1.23, 1.73, p <0.001) and grand multiparity (AdjOR 2.41, 95% CI: 1.78, 3.26, p <0.001), were significantly associated with maternal obesity. There were significant association between maternal obesity with hypertensive disorder in pregnancy (p=0.025), caesarean section delivery (p=0.002) and macrosomic infant (p <0.001).
Conclusion: The identification of risk factors for maternal obesity is important to facilitate intervention programmes focused on improving the pregnancy outcomes for a high-risk group of women.