Increasing number of motoring industries can contribute to air pollution which increase in turn the respiratory symptoms amongst schoolchildren. This study was done to explore the associations between respiratory symptoms and exposures to traffic related air pollution amongst schoolchildren. Cross-sectional study (schoolbased) of 10, 11 and 12 years old children would be done in two schools in Kota Bharu, Kelantan with reference to Sekolah Kebangsaan Langgar dan Sekolah Kebangsaan Demit. The total sample size in this study are 124 (n = 124). Sampling procedure employed was the probability sampling method of simple. Respondents were to answer questions by using the adaptation questionnaires from International Study of Asthma and Allergies in Childhood (ISAAC). Data were analysed by using Statistical Package For Social Sciences (SPSS). The finding shows that there are associations between respiratory symptoms and exposures to traffic-related air pollution amongst schoolchildren in two schools in Kota Bharu (p <0.05). The exposure to the traffic-related air pollution increased the respiratory symptoms amongst schoolchildren in studies area.

A cross-sectional study was carried out to evaluate the nutritional status of 51 subjects with leukemia aged 4 to 12 years from the Haematology & Oncology Paediatric Ward, Universiti Kebangsaan Malaysia Medical Centre (PPUKM) and the Paediatric Institute of Kuala Lumpur. Nutritional status was assessed using anthropometric measurements, biochemical and haematological parameters. Subjects comprised 32 (62.7%) males and 19 (27.3%) females. Most of the subjects (41.2%) were in the age group of 4 to 6 years. More than half of the children were Malays (70.6%) followed by Indians (15.7%) and Chinese (13.7%). The subjects were diagnosed as acute lymphoblastic leukemia (ALL) (84.3%) followed by acute myelogenous leukemia (AML) (13.7%) and chronic myelogenous leukemia (CML) (2.0%) respectively. Most of the children were in remission status (54.9%). Underweight (<-2 SD for weight-for-age) was observed in 37.3% of the children while 17.6% of them were stunted (<-2 SD for height-for-age), and sign(s) of malnutrition (<-2 SD) for mid upper arm circumference (MUAC)-for-age was observed in 15.7% of the subjects. Approximately 20.0% of the subjects were in the severe malnutrition category with respect to low serum albumin levels (<3.5g/dl). All subjects had hemoglobin levels of less than the normal range. While the results indicated no significant differences in the nutritional status of subjects with leukemia at different stages of treatment, it was observed that the prevalence of malnutrition was higher in children with newly diagnosed leukemia. Thus, the nutritional status of children with leukemia should be monitored closely as there is a likelihood of deterioration owing to the disease.

Background: The objective of this study was to determine the effectiveness of MMT program among injecting drug users (IDUs) in Kota Bharu , Kelantan. Methods: The study was a retrospective study based on the records of injecting drug users (IDUs) involved in the MMT program from November 2005 to 31st January 2008, registered at the Psychiatric Clinic of Hospital Raja Perempuan Zainab II. Opiate Treatment Index (OTI) was used as the research instrument. Repeated measures ANCOVA was used to compare the mean scores during the entry period and after completing twelve months of MMT program after adjusted for age, marital status and level of education. Results: A total of 117 file records were reviewed. There was significant reduction in the mean scores after 12 months of heroin Q score , HIV Risk-taking Behavior Scale and health scale after adjusted for age, marital status and level of education. For Heroin Q score, mean difference was 2.01 (95% CI: 1.45, 2.56), for HIV Risk-taking Behavior Scale, mean difference was 7.64 (95% CI: 6.03, 9.26); and for health scale, mean difference was 5.35(95% CI: 3.90, 6.79). Conclusion: This study supports the evidence that MMT program is effective in treating heroin and opiate dependence.

Interleukin 31 (IL-31)is one of the cytokines which appears to be an important regulator of Th2 responses. Previous study has been done to determine IL-31 serums levels in atopic dermatitis (AD). However, the serum levels of IL-31 in allergic rhinitis (AR) and atopic asthma (AA) is not many reported and still unclear. The objective of this cross sectional study is to determine an association between IL-31 and other predisposing factors with allergic diseases in HRPZ II (Hospital Raja PerempuanZainab II) and HUSM (Hospital UniversitiSains), Kelantan, Malaysia. This study involved 70 patients of AD, 70 patients of AR, 70 patients of AA and 70 healthy controls from staffs and people in HUSM.Five milliliters of blood were withdrawn and centrifuged for 5 minutes at 2000 rpm to obtain the serum and analyzed for IL-31 levels by using enzyme-linked immunosorbent (ELISA) kits (Human IL 31 Duoset, R&D System). Simple and multiple logistic regressions were used to analyze the association between IL-31 levels and predisposing factors among allergic diseases. The levels of IL-31 and other predisposing factors showed significant associations in smoking status, occupational exposure and area of living for AD and AR, however in AA, the significant association only found in smoking status and occupational exposure. In conclusion, we found that there were associations between IL-31 serum levels and other predisposing factors with AD, AR and AA. The findings can be the pilot study to determine IL-31 levels in allergic diseases in Malaysia.

Interleukin 31 (IL-31)is one of the cytokines which appears to be an important regulator of Th2 responses. Previous study has been done to determine IL-31 serums levels in atopic dermatitis (AD). However, the serum levels of IL-31 in allergic rhinitis (AR) and atopic asthma (AA) is not many reported and still unclear. The objective of this cross sectional study is to determine an association between IL-31 and other predisposing factors with allergic diseases in HRPZ II (Hospital Raja PerempuanZainab II) and HUSM (Hospital UniversitiSains), Kelantan, Malaysia. This study involved 70 patients of AD, 70 patients of AR, 70 patients of AA and 70 healthy controls from staffs and people in HUSM.Five milliliters of blood were withdrawn and centrifuged for 5 minutes at 2000 rpm to obtain the serum and analyzed for IL-31 levels by using enzymelinked immunosorbent (ELISA) kits (Human IL 31 Duoset, R&D System). Simple and multiple logistic regressions were used to analyze the association between IL-31 levels and predisposing factors among allergic diseases. The levels of IL-31 and other predisposing factors showed significant associations in smoking status, occupational exposure and area of living for AD and AR, however in AA, the significant association only found in smoking status and occupational exposure. In conclusion, we found that there were associations between IL-31 serum levels and other predisposing factors with AD, AR and AA. The findings can be the pilot study to determine IL-31 levels in allergic diseases in Malaysia.
IL-31 ; serum levels ; predisposing factors ; allergic diseases ; Kelantan

Haemolytic disease of the foetus and newborn (HDFN) is caused by maternal red blood cells (RBC) alloimmunisation resulted from incompatibility of maternal and foetal RBCs. However, only a few HDFN attributed to anti-M were reported, varying from asymptomatic to severe anaemia with hydrops foetalis and even intrauterine death. A case of severe HDFN due to anti-M alloantibody from an alloimmunized grandmultiparous Malay woman with recurrent pregnancy loss is reported here. The newborn was delivered with severe and prolonged anaemia which required frequent RBC transfusions, intensive phototherapy and intravenous immunoglobulin administration. Although anti-M is rarely known to cause severe HDFN, a careful serological work-up and close assessment of foetal well-being is important, similar to the management of RhD HDFN. Alloimmunisation with anti-M type can lead to severe HDFN and even foetal loss.

Background: Mortality and morbidity associated with intracerebral HemorrhageICH is still high. Up to now, there are no evidence-based effective treatments for acute ICH. This study is to assess the effect of tranexamic acid (TXA) on hematoma growth of patients with spontaneous ICH compared to a placebo. Methods: We performed a single-blinded, randomised placebo-controlled trial of TXA (intravenous 1g bolus, followed by infusion TXA 1 g/hour for 8 hours) in acute (< 8 hours) primary ICH. Strict blood pressure control (target SBP 140-160 mmHg). A repeat Computed Tomography brain was done after 24 hours to reassess hematoma growth. The primary objective is to test the effect of TXA on hematoma growth. Other objective was to test the feasibility, tolerability, and adverse events of TXA in primary ICH. Results: Statistical analysis showed significant hematoma growth in control group after 24 hours compared to baseline (14.3300 vs 17.9940, P = 0.001) whereas the treatment group there is no significant hematoma size expansion between baseline and after 24 hours (P = 0.313). Conclusions: This study showed a significant hematoma volume expansion in the control group compared to the treatment group.

Objective: The involvement of families in assisting health professionals in providing care for their family members who suffer a stroke during hospitalization is common in Malaysia. Family caregivers are accountable in providing for the first-ever stroke survivor’s needs, including maintaining functional improvements gained in rehabilitation and the long-term well-being of the stroke survivors. The objective of this study was to determine the predictors of life satisfaction among family caregivers of hospitalized first-ever stroke patients. Methods: This was a cross-sectional community research design study with purposive sampling. It involved 102 family caregivers of hospitalized first-ever stroke patients of two tertiary hospitals in Kelantan. The Bakas Caregiving Outcomes Score (BCOS) was used to measure life satisfaction. Multiple linear regression was used to determine the predictors of life satisfaction. Results: Out of 102 respondents, 21 were males and 81 were females with age range of 16 to 76 years. Significant predictors of life satisfaction of caregivers while caring for their hospitalized first-ever stroke family members were caregivers’ health (β: -2.875, 95%CI: -5.725, -0.025, p = 0.048), patients’ age (β: - 4.251, 95% CI: - 6.379, -2.123, p<0.001) and educational status of patients (β: 3.176, 95% CI: 1.083, 5.269, p = 0.003). Conclusion: This study highlighted predictors of life satisfaction among caregivers while caring for their hospitalized family members with stroke. The results may provide a basis for developing a support program for the family caregivers of hospitalized stroke patients in preparation for their continuing caregiving role at their homes. ASEAN Journal of Psychiatry, Vol. 15 (2): July – December 2014: 164-175.

Malnutrition is common among pediatric oncology patients. Factors contributing to malnutrition include physiological abnormalities, response to the tumors and side effects of the treatment. A pilot study was carried out to determine the nutritional status of 17 pediatric oncology patients aged 4 to 12 years old in Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur. The nutritional status was assessed via anthropometric measurements and dietary intake through 3 days repeatitive 24 hours diet recall with subjects and their carers. Biochemical profiles (serum albumin and hemoglobin) were reviewed from the medical record. Through anthropometry measurements, weight and height were used to calculate Z-scores and further determine the percentile weight-for-age, height-for-age using NCHS percentile charts (WHO 1983). Frisancho’s standards (1981) were used to define malnutrition based on MUACfor- age. Underweight as determined using z scores below -2 for weight-for-age was observed in 70.6% of the subjects. Whilst, 76.5% of the subjects were classified as stunted (z score < –2) for height-for-age. Based on MUAC-for-age percentile, the sign of severe malnutrition category (<5 percentile) was observed in 35.3% of the subject and 23.6% of the subject were in the moderate malnutrition (>5 – <10 percentile). About 70.6% of the subject had low haemoglobin (< 11 g/dl) and 29.4% of the subject were hypoalbuminemia (< 35 g/dl) . Total macronutrient intake was assessed and compared with the individual requirement (Seashore 1984) for energy and protein intake were satisfactory, except for subjects in age group 10 – 12 years who achieved only 70% of the individuals requirements. As a conclusion, although food intake of the subjects was satisfactory but chronic malnutrition was prevalent. Early recognition of malnutrition is essential in order to plan for a nutritional intervention and further enhancing the quality of life.

Validation of instruments is essential when assessing physical activity (PA). The aim of this study was to validate a Malay language version of the International Physical Activity Questionnaire (IPAQ-M) against Actical accelerometer and to determine its reliability and validity. A total of 90 Malay adults aged 35-65 years old participating in The Malaysian Cohort project were recruited for this study. The IPAQ-M is comprised of 12 items, covering vigorous, moderate, walking, sitting and sleeping activities, and was administered on two occasions (Day 1 and Day 9) by interviewing the participants. Participants wore the Actical accelerometer for seven consecutive days between the two interview sessions. Validity tests showed that time spent in moderate-vigorous physical activity (MVPA) (min wk-1) from IPAQ-M was significantly correlated with MVPA from accelerometer (ρ=0.32, p<0.01). Time spent in vigorous activity (ρ=0.44) and total activity (ρ=0.36) from IPAQ-M were significantly correlated (p<0.01) with that measured by accelerometer, but no correlation was observed for sedentary behaviour. Reliability tests revealed significant correlations between the two interview sessions for all intensities of PA (=ρ0.55 to 0.71, p<0.01). Bland-Altman plots showed that time spent in MVPA for IPAQ-M was significantly different from that measured by accelerometer (mean difference: 98.02 min wk-1; 95% limits of agreement: -785.33 to 1317.83 min wk-1; p<0.01). When classifying people into meeting PA recommendation, the agreement between the two instruments was fair (κ=0.22). The IPAQ-M has acceptable validity for MVPA, vigorous and total physical activity, and was reliable for assessing the physical activity of Malay adults.​