S. Rampal - Academia.edu (original) (raw)

Papers by S. Rampal

Research paper thumbnail of The epidemiology of COVID-19 in ten Southeast Asian countries

The Medical journal of Malaysia, Nov 1, 2021

Periodic benchmarking of the epidemiology of COVID-19 in the Association of Southeast Asian Natio... more Periodic benchmarking of the epidemiology of COVID-19 in the Association of Southeast Asian Nations (ASEAN) countries is critical for the continuous understanding of the transmission and control of COVID-19 in the region. The incidence, mortality, testing and vaccination rates within the ASEAN region from 1 January 2020 to 15 October 2021 is analysed in this paper. COVID-19 data on cases, deaths, testing, and vaccinations were extracted from the Our World in Data (OWID) COVID-19 data repository for all the ten ASEAN countries. Comparative time-trends of the epidemiology of COVID-19 using the incidence rate, cumulative case fatality rate (CFR), delay-adjusted case fatality rate, cumulative mortality rate (MR), test positivity rate (TPR), cumulative testing rate (TR) and vaccination rate was carried out. Over the study period, a total of 12,720,661 cases and 271,475 deaths was reported within the ASEAN region. Trends of daily per capita cases were observed to peak between July and September 2021 for the ASEAN region. The cumulative case fatality rate (CFR) in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, was of 0.9% (N=68), 2.2% (N=2,610), 3.5% (N=142,889), 0.1% (N=36), 1.2% (N=27,700), 4.0% (N=18,297), 1.6% (N=40,424), 0.1% (N=215), 1.7% (N=18,123), and 2.6% (N=21,043), respectively. CFR was consistently highest between January-June 2020. The cumulative mortality rate (MR) was 9.5, 13.7, 51.4, 0.2, 80.3, 32.4, 34.5, 1.6, 23.9 and 19.7 per 100,000 population, respectively. The cumulative test positivity rate (TPR) was 8.4%, 16.9%, 4.6%, 7.5%, 11.1%, 12.9%, 0.5%, 11.7%, and 3.6%, with the cumulative testing rate (TR) at 25.0, 90.1, 27.4, 917.7, 75.8, 177.8, 3303.3, 195.2, and 224.9 tests per 1,000 population in Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, respectively. The percentage of population that completed vaccinations (VR) was 44.5%, 65.3%, 18.5%, 28.2%, 61.8%, 6.8%, 19.2%, 76.8%, 22.7%, and 10% in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, respectively. In 2020, most countries in ASEAN had higher case fatality rates but lower mortalities per population when compared to the third quarter of 2021 where higher mortalities per population were observed. Low testing rates have been one of the factors leading to high test positivity rates. Slow initiation of vaccination programs was found to be the key factor leading to high incidence and case fatality rate in most countries in ASEAN. Effective public health measures were able to interrupt the transmission of this novel virus to some extent. Increasing preparedness capacity within the ASEAN region is critical to ensure that any future similar outbreaks can be dealt with collectively.

Research paper thumbnail of predisposition to obesity in Malaysian Malays

Genetic association of SNPs in the FTO gene and

Research paper thumbnail of Clinical and Pathologic Differences Between BRCA1-, BRCA2-, and Non-BRCA-Associated Breast Cancers in a Multiracial Developing Country

World Journal of Surgery, 2009

Background Mutations in BRCA1 and BRCA2 confer an increased risk to breast and other cancers, but... more Background Mutations in BRCA1 and BRCA2 confer an increased risk to breast and other cancers, but to date there have only been limited numbers of studies of BRCA1-and BRCA2-associated cancers among Asians. Malaysia is a multiracial country with three main races: Malays, Chinese, Indians. We determined whether tumor pathologic features and clinical features differ in patients with and without BRCA mutations in this Asian population. Methods We conducted a retrospective review of the medical records of 152 women with breast cancer who underwent genetic testing for BRCA mutations. The patients self-reported ethnicity, age at onset, and clinical stage at diagnosis and tumor pathology were reviewed. Results A total of 31 patients carried germline deleterious mutations (16 BRCA1, 15 BRCA2). We found that tumors in BRCA1 carriers were more likely to be estrogen receptor (ER)negative and progesterone receptor (PR)-negative. HER2 was more likely to be negative in both BRCA1 and BRCA2 subjects compared with non-BRCA subjects. We found a strong association between triple-negative status and BRCA1 carriers. In addition, tumors in BRCA1 carriers were more likely to be higher grade than those in BRCA2 and non-BRCA carriers; but the difference was not statistically significant. Conclusions These results suggest that tumors associated with BRCA1 mutations are distinct from those of BRCA2associated and non-BRCA-associated breast cancers, and that the tumors associated with BRCA2 mutations are similar to the non-BRCA-associated breast cancers. Further studies are required to determine if the prognosis is different in each of these groups and the best management strategy for each group.

Research paper thumbnail of Genome-Wide Analysis of Copy Number Variation Identifies Candidate Gene Loci Associated with the Progression of Non-Alcoholic Fatty Liver Disease

PLoS ONE, 2014

Between 10 and 25% of individuals with non-alcoholic fatty liver disease (NAFLD) develop hepatic ... more Between 10 and 25% of individuals with non-alcoholic fatty liver disease (NAFLD) develop hepatic fibrosis leading to cirrhosis and hepatocellular carcinoma (HCC). To investigate the molecular basis of disease progression, we performed a genome-wide analysis of copy number variation (CNV) in a total of 49 patients with NAFLD [10 simple steatosis and 39 nonalcoholic steatohepatitis (NASH)] and 49 matched controls using high-density comparative genomic hybridization (CGH) microarrays. A total of 11 CNVs were found to be unique to individuals with simple steatosis, whilst 22 were common between simple steatosis and NASH, and 224 were unique to NASH. We postulated that these CNVs could be involved in the pathogenesis of NAFLD progression. After stringent filtering, we identified four rare and/or novel CNVs that may influence the pathogenesis of NASH. Two of these CNVs, located at 13q12.11 and 12q13.2 respectively, harbour the exportin 4 (XPO4) and phosphodiesterase 1B (PDE1B) genes which are already known to be involved in the etiology of liver cirrhosis and HCC. Cross-comparison of the genes located at these four CNV loci with genes already known to be associated with NAFLD yielded a set of genes associated with shared biological processes including cell death, the key process involved in 'second hit' hepatic injury. To our knowledge, this pilot study is the first to provide CNV information of potential relevance to the NAFLD spectrum. These data could prove invaluable in predicting patients at risk of developing NAFLD and more importantly, those who will subsequently progress to NASH.

Research paper thumbnail of Association of glucokinase regulatory gene polymorphisms with risk and severity of non-alcoholic fatty liver disease: an interaction study with adiponutrin gene

Journal of Gastroenterology, 2013

Background Recent genome-wide association studies demonstrated an association between single nucl... more Background Recent genome-wide association studies demonstrated an association between single nucleotide polymorphisms (SNPs) on the glucokinase regulatory gene (GCKR) with hepatic steatosis. This study attempted to investigate the association of GCKR rs780094 and rs1260326 with susceptibility to non-alcoholic fatty liver disease (NAFLD) and its severity. Methods The genotypes were assessed on 144 histologically confirmed NAFLD patients and 198 controls using a Sequenom MassARRAY platform. Results The GCKR rs1260326 and rs780094 allele T were associated with susceptibility to NAFLD (OR 1.49, 95 % CI 1.09-2.05, p = 0.012; and OR 1.51, 95 % CI H.-L. Tan and S. M. Zain contributed equally to this project and should be considered co-first authors.

Research paper thumbnail of Maternal Acceptance of Human Papillomavirus Vaccine in Malaysia

Journal of Adolescent Health, 2009

Acceptability rates of human papillomavirus (HPV) vaccination by 362 Malaysian mothers were 65.7%... more Acceptability rates of human papillomavirus (HPV) vaccination by 362 Malaysian mothers were 65.7% and 55.8% for daughters and sons, respectively. Younger mothers, and those who knew someone with cancer, were more willing to vaccinate their daughters. If the vaccine was routine and cost free, acceptability rate was 97.8%.

Research paper thumbnail of The Prevalence of Colorectal Adenomas in Asymptomatic Korean Men and Women

Cancer Epidemiology, Biomarkers & Prevention, 2014

Background: Colorectal cancer incidence is rapidly rising in many Asian countries, with rates app... more Background: Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans. Methods: Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009. Results: Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significan...

Research paper thumbnail of A National study on the prevalence and factors associated with smoking among 17,246 Malaysians aged 18 years and above

Objective: Determine the prevalence of smoking among the community aged 18 years and above and de... more Objective: Determine the prevalence of smoking among the community aged 18 years and above and determine the association between smoking and age, sex, educational level, family and peer influence. Methods: A cross sectional study was conducted in Malaysia. ...

Research paper thumbnail of 1285 Association of psychological distress and work-related factors and multisite musculoskeletal pain among teachers in malaysia

Musculoskeletal Disorders

departments associated to heavier and less autonomous patient handling activity, were most affect... more departments associated to heavier and less autonomous patient handling activity, were most affected by back MSD. Discussion Our investigation identifies biomechanical risk factor of MSD among nurses and suggests the necessity of preventive actions according to exposure leve.

Research paper thumbnail of Construction and Validation of a Malay Version of the Overactive Bladder Screener for Assessing Urinary Tract Symptoms in a Malaysian Population

Journal of Health and Translational Medicine

The aim of this study was to validate the translation of the Overactive Bladder (OAB) Screener (O... more The aim of this study was to validate the translation of the Overactive Bladder (OAB) Screener (OAB V8) to the Malay language. It was to assess the reliability of the screener in the context of a Malaysian population. The original screener consists of eight symptoms indicative of OAB that has been proven to be highly sensitive and reliable. Translation was done with a modification of the Brislin Method using back translation and a panel of experts as a final review panel. The pilot study had two groups; a symptomatic (n=19 patients) and an asymptomatic group (n=18 patients). All patients performed the test twice at two week intervals once at the clinic and subsequently at home. Test-retest method was used for reliability and Cronbach's alpha for internal consistency. The translated questionnaire demonstrated good internal consistency in both groups of patients for all eight items individually and for the total score. Cronbach's alphas ranged from 0.972 to 0.981 for the symptomatic group and from 0.750 to 0.976 for the asymptomatic group. Testretest correlation for all items was highly significant. Intraclass correlation (ICC) was high for both the asymptomatic (ICC ranging from 0.600 to 0.953) and the symptomatic group (ranging from 0.944 to 0.989).The Malay OAB V8 showed itself to be suitable for use, reliable in distinguishing symptomatic and asymptomatic patients and a valid instrument.

Research paper thumbnail of Superior Somatic Pain Relief and Improved Visceral Pain Control is Achieved Using Pre-Emptive Analgesia for Laparoscopic Cholecystectomy: A Randomized Controlled Trial

Journal of Health and Translational Medicine

BACKGROUND: Laparoscopic cholecystectomy, although is less invasive than open surgery, is not com... more BACKGROUND: Laparoscopic cholecystectomy, although is less invasive than open surgery, is not completely pain free. The use of local anaesthesia to relieve pain following this procedure is a common practice. However, it remains debatable whether a pre-or post-operative drug administration is more effective. Here, we investigated the role of preemptive local anaesthetic infiltration given pre-or post-incisional, in relieving the pain during laparoscopic surgery. METHODOLOGY: A randomized controlled trial was conducted with 96 patients receiving 0.5% Bupivacaine 100mg. Group A (n=48) received post-incisional skin infiltration whilst Group B (n=48) received pre-incisional infiltration. Incisional (somatic) and intra-abdominal (visceral) pain was assessed using Visual Analog Scale (VAS) at day 0, day 1 and day 7 post-operative days. RESULT: Baseline characteristics between the two groups were similar. Incisional pain was lower in Group B as compared to Group A at day 0 (P=0.03) and day 1 (P<0.01). Intra-abdominal pain was also lower in Group B at day 0 and day 1 (P= 0.04). VAS score was similar at day 7 although analgesia requirement is higher in Group A (P>0.05). CONCLUSION: Administration of pre-incisional local anaesthesia offers better pre-emptive pain relief measure than postincisional administration by reducing somatic and visceral pain in laparoscopic gall bladder surgery.

Research paper thumbnail of Quantifying tuberculosis burden and underrepresentation in Malaysia, 1990-2014

International Journal of Infectious Diseases, 2016

Research paper thumbnail of High tumour stage and margin clearance are still important prognostic factors for post-mastectomy locoregional recurrence in Malaysia

Asian Pacific journal of cancer prevention : APJCP, 2010

Locoregional recurrence after mastectomy for breast cancer may predict distant recurrence and mor... more Locoregional recurrence after mastectomy for breast cancer may predict distant recurrence and mortality. This study examined the pattern and rates of post-mastectomy locoregional recurrence (PMLRR), survival outcome and prognostic factors for isolated PMLRR (ILR) in a breast cancer cohort in University of Malaya Medical Center (UMMC). We studied 522 patients who underwent mastectomy between 1998 and 2002 and followed them up until 2008. We defined PMLRR as recurrence to the axilla, supraclavicular nodes and or chest wall. ILR was defined as PMLRR occurring as an isolated event. Prognostic factors for locoregional recurrence were determined using the Cox proportional hazards regression model. The overall PMLRR rate was 16.4%. ILR developed in 42 of 522 patients (8.0%). Within this subgroup, 25 (59.5%) remained disease free after treatment while 17 (40.5%) suffered disease progression. Univariate analyses identified race, age, size, stage, margin involvement, lymph node involvement, g...

Research paper thumbnail of Prevalence of Overweight among Secondary School Students in Klang District, Selangor

Malaysian journal of nutrition, 2007

Overweight and obesity place children and adolescents at increased risk of significant health pro... more Overweight and obesity place children and adolescents at increased risk of significant health problems, both during their early life and adult life. A cross sectional study was carried out to determine the prevalence of overweight among secondary school students aged 13-17 years in the Klang district and to determine the association between overweight and age, sex, ethnicity, religion and blood pressure. Random cluster proportionate to size sampling technique was used to select the respondents. Weight was recorded using TANITA model HD-309 and height was measured using SECA Body meter Model 208. A mercury sphygmomanometer was used to measure blood pressure manually. Statistical analysis was carried out using SPSS version 13. Out of the 3,333 respondents, 11.4% were found to be at risk of overweight and 8.2% were overweight. The prevalence of overweight was significantly higher in the males (10.6%) as compared to females (6.0%). Prevalence of overweight was highest in Malays (10.7%) ...

Research paper thumbnail of Mammography screening uptake among hospital personnel in Kuala Lumpur tertiary hospital

Asian Pacific journal of cancer prevention : APJCP, 2011

Breast cancer is the most common cancer among women in Malaysia. Of the total cancer cases regist... more Breast cancer is the most common cancer among women in Malaysia. Of the total cancer cases registered in the National Cancer Registry for 2006, 3,525 were female breast cancer cases. The overall age standardized rate was 39.3 per 100,000 population in 2006. An estimated 30%-40% were diagnosed in the late stages and this had resulted in poor survival rates. The purpose of the study was to determine the factors and barriers related to mammography screening uptake among hospital personnel. This mixed method explanatory study was carried out on a universal sampling of 707 female personnel aged 40 and above, from June 2007 until November 2007. The study was conducted at University Malaya Medical Centre, a tertiary hospital in Kuala Lumpur. Pre-tested self-administered questionnaires were mailed to eligible personnel. The prevalence of mammography screening uptake was 80.3% (95%CI: 76.8%,83.5%) among 534 respondents. Personnel who had physician recommendation had significantly higher odds...

Research paper thumbnail of Poster 19

Research paper thumbnail of End Stage Renal Disease (Esrd) Secondary to Lupus Nephritis: Long Term Follow-Up of Malaysian Patients

Research paper thumbnail of Prevalence, awareness; treatment and control in Malaysia; 1996-2006: A nationwide survey

Research paper thumbnail of Prevalence, awareness., treatment and control of hypertension in Malaysia: A national study of 16,440 subjects

Research paper thumbnail of EGFR Mutation Testing in Patients with Advanced Non-Small Cell Lung Cancer: A Comprehensive Evaluation of Real-World Practice in an East Asian Tertiary Hospital

Plos One, 2013

Introduction: Guidelines for management of non-small cell lung cancer (NSCLC) strongly recommend ... more Introduction: Guidelines for management of non-small cell lung cancer (NSCLC) strongly recommend EGFR mutation testing. These recommendations are particularly relevant in Asians that have higher EGFR mutation prevalence. This study aims to explore current testing practices, logistics of testing, types of EGFR mutation, and prevalence of EGFR mutations in patients with advanced NSCLC in a large comprehensive cancer center in Korea. Methods: Our retrospective cohort included 1,503 NSCLC patients aged $18 years, with stage IIIB/IV disease, who attended the Samsung Medical Center in Seoul, Korea, from January 2007 through July 2010. Trained oncology nurses reviewed and abstracted data from electronic medical records. Results: This cohort had a mean age (SD) of 59.6 (11.1) years, 62.7% were males, and 52.9% never-smokers. The most common NSCLC histological types were adenocarcinoma (70.5%) and squamous cell carcinoma (18.0%). Overall, 39.5% of patients were tested for EGFR mutations.

Research paper thumbnail of The epidemiology of COVID-19 in ten Southeast Asian countries

The Medical journal of Malaysia, Nov 1, 2021

Periodic benchmarking of the epidemiology of COVID-19 in the Association of Southeast Asian Natio... more Periodic benchmarking of the epidemiology of COVID-19 in the Association of Southeast Asian Nations (ASEAN) countries is critical for the continuous understanding of the transmission and control of COVID-19 in the region. The incidence, mortality, testing and vaccination rates within the ASEAN region from 1 January 2020 to 15 October 2021 is analysed in this paper. COVID-19 data on cases, deaths, testing, and vaccinations were extracted from the Our World in Data (OWID) COVID-19 data repository for all the ten ASEAN countries. Comparative time-trends of the epidemiology of COVID-19 using the incidence rate, cumulative case fatality rate (CFR), delay-adjusted case fatality rate, cumulative mortality rate (MR), test positivity rate (TPR), cumulative testing rate (TR) and vaccination rate was carried out. Over the study period, a total of 12,720,661 cases and 271,475 deaths was reported within the ASEAN region. Trends of daily per capita cases were observed to peak between July and September 2021 for the ASEAN region. The cumulative case fatality rate (CFR) in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, was of 0.9% (N=68), 2.2% (N=2,610), 3.5% (N=142,889), 0.1% (N=36), 1.2% (N=27,700), 4.0% (N=18,297), 1.6% (N=40,424), 0.1% (N=215), 1.7% (N=18,123), and 2.6% (N=21,043), respectively. CFR was consistently highest between January-June 2020. The cumulative mortality rate (MR) was 9.5, 13.7, 51.4, 0.2, 80.3, 32.4, 34.5, 1.6, 23.9 and 19.7 per 100,000 population, respectively. The cumulative test positivity rate (TPR) was 8.4%, 16.9%, 4.6%, 7.5%, 11.1%, 12.9%, 0.5%, 11.7%, and 3.6%, with the cumulative testing rate (TR) at 25.0, 90.1, 27.4, 917.7, 75.8, 177.8, 3303.3, 195.2, and 224.9 tests per 1,000 population in Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, respectively. The percentage of population that completed vaccinations (VR) was 44.5%, 65.3%, 18.5%, 28.2%, 61.8%, 6.8%, 19.2%, 76.8%, 22.7%, and 10% in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam, respectively. In 2020, most countries in ASEAN had higher case fatality rates but lower mortalities per population when compared to the third quarter of 2021 where higher mortalities per population were observed. Low testing rates have been one of the factors leading to high test positivity rates. Slow initiation of vaccination programs was found to be the key factor leading to high incidence and case fatality rate in most countries in ASEAN. Effective public health measures were able to interrupt the transmission of this novel virus to some extent. Increasing preparedness capacity within the ASEAN region is critical to ensure that any future similar outbreaks can be dealt with collectively.

Research paper thumbnail of predisposition to obesity in Malaysian Malays

Genetic association of SNPs in the FTO gene and

Research paper thumbnail of Clinical and Pathologic Differences Between BRCA1-, BRCA2-, and Non-BRCA-Associated Breast Cancers in a Multiracial Developing Country

World Journal of Surgery, 2009

Background Mutations in BRCA1 and BRCA2 confer an increased risk to breast and other cancers, but... more Background Mutations in BRCA1 and BRCA2 confer an increased risk to breast and other cancers, but to date there have only been limited numbers of studies of BRCA1-and BRCA2-associated cancers among Asians. Malaysia is a multiracial country with three main races: Malays, Chinese, Indians. We determined whether tumor pathologic features and clinical features differ in patients with and without BRCA mutations in this Asian population. Methods We conducted a retrospective review of the medical records of 152 women with breast cancer who underwent genetic testing for BRCA mutations. The patients self-reported ethnicity, age at onset, and clinical stage at diagnosis and tumor pathology were reviewed. Results A total of 31 patients carried germline deleterious mutations (16 BRCA1, 15 BRCA2). We found that tumors in BRCA1 carriers were more likely to be estrogen receptor (ER)negative and progesterone receptor (PR)-negative. HER2 was more likely to be negative in both BRCA1 and BRCA2 subjects compared with non-BRCA subjects. We found a strong association between triple-negative status and BRCA1 carriers. In addition, tumors in BRCA1 carriers were more likely to be higher grade than those in BRCA2 and non-BRCA carriers; but the difference was not statistically significant. Conclusions These results suggest that tumors associated with BRCA1 mutations are distinct from those of BRCA2associated and non-BRCA-associated breast cancers, and that the tumors associated with BRCA2 mutations are similar to the non-BRCA-associated breast cancers. Further studies are required to determine if the prognosis is different in each of these groups and the best management strategy for each group.

Research paper thumbnail of Genome-Wide Analysis of Copy Number Variation Identifies Candidate Gene Loci Associated with the Progression of Non-Alcoholic Fatty Liver Disease

PLoS ONE, 2014

Between 10 and 25% of individuals with non-alcoholic fatty liver disease (NAFLD) develop hepatic ... more Between 10 and 25% of individuals with non-alcoholic fatty liver disease (NAFLD) develop hepatic fibrosis leading to cirrhosis and hepatocellular carcinoma (HCC). To investigate the molecular basis of disease progression, we performed a genome-wide analysis of copy number variation (CNV) in a total of 49 patients with NAFLD [10 simple steatosis and 39 nonalcoholic steatohepatitis (NASH)] and 49 matched controls using high-density comparative genomic hybridization (CGH) microarrays. A total of 11 CNVs were found to be unique to individuals with simple steatosis, whilst 22 were common between simple steatosis and NASH, and 224 were unique to NASH. We postulated that these CNVs could be involved in the pathogenesis of NAFLD progression. After stringent filtering, we identified four rare and/or novel CNVs that may influence the pathogenesis of NASH. Two of these CNVs, located at 13q12.11 and 12q13.2 respectively, harbour the exportin 4 (XPO4) and phosphodiesterase 1B (PDE1B) genes which are already known to be involved in the etiology of liver cirrhosis and HCC. Cross-comparison of the genes located at these four CNV loci with genes already known to be associated with NAFLD yielded a set of genes associated with shared biological processes including cell death, the key process involved in 'second hit' hepatic injury. To our knowledge, this pilot study is the first to provide CNV information of potential relevance to the NAFLD spectrum. These data could prove invaluable in predicting patients at risk of developing NAFLD and more importantly, those who will subsequently progress to NASH.

Research paper thumbnail of Association of glucokinase regulatory gene polymorphisms with risk and severity of non-alcoholic fatty liver disease: an interaction study with adiponutrin gene

Journal of Gastroenterology, 2013

Background Recent genome-wide association studies demonstrated an association between single nucl... more Background Recent genome-wide association studies demonstrated an association between single nucleotide polymorphisms (SNPs) on the glucokinase regulatory gene (GCKR) with hepatic steatosis. This study attempted to investigate the association of GCKR rs780094 and rs1260326 with susceptibility to non-alcoholic fatty liver disease (NAFLD) and its severity. Methods The genotypes were assessed on 144 histologically confirmed NAFLD patients and 198 controls using a Sequenom MassARRAY platform. Results The GCKR rs1260326 and rs780094 allele T were associated with susceptibility to NAFLD (OR 1.49, 95 % CI 1.09-2.05, p = 0.012; and OR 1.51, 95 % CI H.-L. Tan and S. M. Zain contributed equally to this project and should be considered co-first authors.

Research paper thumbnail of Maternal Acceptance of Human Papillomavirus Vaccine in Malaysia

Journal of Adolescent Health, 2009

Acceptability rates of human papillomavirus (HPV) vaccination by 362 Malaysian mothers were 65.7%... more Acceptability rates of human papillomavirus (HPV) vaccination by 362 Malaysian mothers were 65.7% and 55.8% for daughters and sons, respectively. Younger mothers, and those who knew someone with cancer, were more willing to vaccinate their daughters. If the vaccine was routine and cost free, acceptability rate was 97.8%.

Research paper thumbnail of The Prevalence of Colorectal Adenomas in Asymptomatic Korean Men and Women

Cancer Epidemiology, Biomarkers & Prevention, 2014

Background: Colorectal cancer incidence is rapidly rising in many Asian countries, with rates app... more Background: Colorectal cancer incidence is rapidly rising in many Asian countries, with rates approaching those of Western countries. This study aimed to evaluate the prevalence and trends of colorectal adenomas by age, sex, and risk strata in asymptomatic Koreans. Methods: Cross-sectional study of 19,372 consecutive participants aged 20 to 79 years undergoing screening colonoscopy at the Center for Health Promotion of the Samsung Medical Center in Korea from January 2006 to June 2009. Results: Among participants at average risk, those without a history of colorectal polyps or a family history of colorectal cancer, the prevalence of colorectal adenomas and advanced adenomas were 34.5% and 3.1%, respectively, in men and 20.0% and 1.6%, respectively, in women. The prevalence of adenomas increased with age in both men and women, with a more marked increase for advanced adenoma. Participants with a family history of colorectal cancer or with a history of colorectal polyps had significan...

Research paper thumbnail of A National study on the prevalence and factors associated with smoking among 17,246 Malaysians aged 18 years and above

Objective: Determine the prevalence of smoking among the community aged 18 years and above and de... more Objective: Determine the prevalence of smoking among the community aged 18 years and above and determine the association between smoking and age, sex, educational level, family and peer influence. Methods: A cross sectional study was conducted in Malaysia. ...

Research paper thumbnail of 1285 Association of psychological distress and work-related factors and multisite musculoskeletal pain among teachers in malaysia

Musculoskeletal Disorders

departments associated to heavier and less autonomous patient handling activity, were most affect... more departments associated to heavier and less autonomous patient handling activity, were most affected by back MSD. Discussion Our investigation identifies biomechanical risk factor of MSD among nurses and suggests the necessity of preventive actions according to exposure leve.

Research paper thumbnail of Construction and Validation of a Malay Version of the Overactive Bladder Screener for Assessing Urinary Tract Symptoms in a Malaysian Population

Journal of Health and Translational Medicine

The aim of this study was to validate the translation of the Overactive Bladder (OAB) Screener (O... more The aim of this study was to validate the translation of the Overactive Bladder (OAB) Screener (OAB V8) to the Malay language. It was to assess the reliability of the screener in the context of a Malaysian population. The original screener consists of eight symptoms indicative of OAB that has been proven to be highly sensitive and reliable. Translation was done with a modification of the Brislin Method using back translation and a panel of experts as a final review panel. The pilot study had two groups; a symptomatic (n=19 patients) and an asymptomatic group (n=18 patients). All patients performed the test twice at two week intervals once at the clinic and subsequently at home. Test-retest method was used for reliability and Cronbach's alpha for internal consistency. The translated questionnaire demonstrated good internal consistency in both groups of patients for all eight items individually and for the total score. Cronbach's alphas ranged from 0.972 to 0.981 for the symptomatic group and from 0.750 to 0.976 for the asymptomatic group. Testretest correlation for all items was highly significant. Intraclass correlation (ICC) was high for both the asymptomatic (ICC ranging from 0.600 to 0.953) and the symptomatic group (ranging from 0.944 to 0.989).The Malay OAB V8 showed itself to be suitable for use, reliable in distinguishing symptomatic and asymptomatic patients and a valid instrument.

Research paper thumbnail of Superior Somatic Pain Relief and Improved Visceral Pain Control is Achieved Using Pre-Emptive Analgesia for Laparoscopic Cholecystectomy: A Randomized Controlled Trial

Journal of Health and Translational Medicine

BACKGROUND: Laparoscopic cholecystectomy, although is less invasive than open surgery, is not com... more BACKGROUND: Laparoscopic cholecystectomy, although is less invasive than open surgery, is not completely pain free. The use of local anaesthesia to relieve pain following this procedure is a common practice. However, it remains debatable whether a pre-or post-operative drug administration is more effective. Here, we investigated the role of preemptive local anaesthetic infiltration given pre-or post-incisional, in relieving the pain during laparoscopic surgery. METHODOLOGY: A randomized controlled trial was conducted with 96 patients receiving 0.5% Bupivacaine 100mg. Group A (n=48) received post-incisional skin infiltration whilst Group B (n=48) received pre-incisional infiltration. Incisional (somatic) and intra-abdominal (visceral) pain was assessed using Visual Analog Scale (VAS) at day 0, day 1 and day 7 post-operative days. RESULT: Baseline characteristics between the two groups were similar. Incisional pain was lower in Group B as compared to Group A at day 0 (P=0.03) and day 1 (P<0.01). Intra-abdominal pain was also lower in Group B at day 0 and day 1 (P= 0.04). VAS score was similar at day 7 although analgesia requirement is higher in Group A (P>0.05). CONCLUSION: Administration of pre-incisional local anaesthesia offers better pre-emptive pain relief measure than postincisional administration by reducing somatic and visceral pain in laparoscopic gall bladder surgery.

Research paper thumbnail of Quantifying tuberculosis burden and underrepresentation in Malaysia, 1990-2014

International Journal of Infectious Diseases, 2016

Research paper thumbnail of High tumour stage and margin clearance are still important prognostic factors for post-mastectomy locoregional recurrence in Malaysia

Asian Pacific journal of cancer prevention : APJCP, 2010

Locoregional recurrence after mastectomy for breast cancer may predict distant recurrence and mor... more Locoregional recurrence after mastectomy for breast cancer may predict distant recurrence and mortality. This study examined the pattern and rates of post-mastectomy locoregional recurrence (PMLRR), survival outcome and prognostic factors for isolated PMLRR (ILR) in a breast cancer cohort in University of Malaya Medical Center (UMMC). We studied 522 patients who underwent mastectomy between 1998 and 2002 and followed them up until 2008. We defined PMLRR as recurrence to the axilla, supraclavicular nodes and or chest wall. ILR was defined as PMLRR occurring as an isolated event. Prognostic factors for locoregional recurrence were determined using the Cox proportional hazards regression model. The overall PMLRR rate was 16.4%. ILR developed in 42 of 522 patients (8.0%). Within this subgroup, 25 (59.5%) remained disease free after treatment while 17 (40.5%) suffered disease progression. Univariate analyses identified race, age, size, stage, margin involvement, lymph node involvement, g...

Research paper thumbnail of Prevalence of Overweight among Secondary School Students in Klang District, Selangor

Malaysian journal of nutrition, 2007

Overweight and obesity place children and adolescents at increased risk of significant health pro... more Overweight and obesity place children and adolescents at increased risk of significant health problems, both during their early life and adult life. A cross sectional study was carried out to determine the prevalence of overweight among secondary school students aged 13-17 years in the Klang district and to determine the association between overweight and age, sex, ethnicity, religion and blood pressure. Random cluster proportionate to size sampling technique was used to select the respondents. Weight was recorded using TANITA model HD-309 and height was measured using SECA Body meter Model 208. A mercury sphygmomanometer was used to measure blood pressure manually. Statistical analysis was carried out using SPSS version 13. Out of the 3,333 respondents, 11.4% were found to be at risk of overweight and 8.2% were overweight. The prevalence of overweight was significantly higher in the males (10.6%) as compared to females (6.0%). Prevalence of overweight was highest in Malays (10.7%) ...

Research paper thumbnail of Mammography screening uptake among hospital personnel in Kuala Lumpur tertiary hospital

Asian Pacific journal of cancer prevention : APJCP, 2011

Breast cancer is the most common cancer among women in Malaysia. Of the total cancer cases regist... more Breast cancer is the most common cancer among women in Malaysia. Of the total cancer cases registered in the National Cancer Registry for 2006, 3,525 were female breast cancer cases. The overall age standardized rate was 39.3 per 100,000 population in 2006. An estimated 30%-40% were diagnosed in the late stages and this had resulted in poor survival rates. The purpose of the study was to determine the factors and barriers related to mammography screening uptake among hospital personnel. This mixed method explanatory study was carried out on a universal sampling of 707 female personnel aged 40 and above, from June 2007 until November 2007. The study was conducted at University Malaya Medical Centre, a tertiary hospital in Kuala Lumpur. Pre-tested self-administered questionnaires were mailed to eligible personnel. The prevalence of mammography screening uptake was 80.3% (95%CI: 76.8%,83.5%) among 534 respondents. Personnel who had physician recommendation had significantly higher odds...

Research paper thumbnail of Poster 19

Research paper thumbnail of End Stage Renal Disease (Esrd) Secondary to Lupus Nephritis: Long Term Follow-Up of Malaysian Patients

Research paper thumbnail of Prevalence, awareness; treatment and control in Malaysia; 1996-2006: A nationwide survey

Research paper thumbnail of Prevalence, awareness., treatment and control of hypertension in Malaysia: A national study of 16,440 subjects

Research paper thumbnail of EGFR Mutation Testing in Patients with Advanced Non-Small Cell Lung Cancer: A Comprehensive Evaluation of Real-World Practice in an East Asian Tertiary Hospital

Plos One, 2013

Introduction: Guidelines for management of non-small cell lung cancer (NSCLC) strongly recommend ... more Introduction: Guidelines for management of non-small cell lung cancer (NSCLC) strongly recommend EGFR mutation testing. These recommendations are particularly relevant in Asians that have higher EGFR mutation prevalence. This study aims to explore current testing practices, logistics of testing, types of EGFR mutation, and prevalence of EGFR mutations in patients with advanced NSCLC in a large comprehensive cancer center in Korea. Methods: Our retrospective cohort included 1,503 NSCLC patients aged $18 years, with stage IIIB/IV disease, who attended the Samsung Medical Center in Seoul, Korea, from January 2007 through July 2010. Trained oncology nurses reviewed and abstracted data from electronic medical records. Results: This cohort had a mean age (SD) of 59.6 (11.1) years, 62.7% were males, and 52.9% never-smokers. The most common NSCLC histological types were adenocarcinoma (70.5%) and squamous cell carcinoma (18.0%). Overall, 39.5% of patients were tested for EGFR mutations.