Displaying publications 21 - 40 of 82 in total

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  1. Rampal L, Liew BS
    Med J Malaysia, 2021 01;76(1):1-4.
    PMID: 33510100
    The first case of COVID-19 was reported in Malaysia on the 25 January 2020. By the 20 January 2021, the cumulative numbers reported confirmed cases of COVID-19 had reached 169,379 including 630 deaths. Malaysia has been hit by three waves of COVID-19. This article reports on the three waves, the current situation and some of the possible factors associated. It outlines the need to reassess the overall situation, re-strategize the approach in order to contain the spread. The first COVID-19 wave lasted from 25 January to 16 February 2020, the second wave occurred between the 27 February 2020 and the 30 June 2020. The current third wave began on 8th September 2020.The sudden surge of cases in the third wave was mainly due to the two largest contributors, namely the Benteng Lahad Datu cluster in Sabah state and Kedah's Tembok cluster. The current situation is critical. The daily confirmed cases of COVID-19 continue to soar. The challengers faced by healthcare workers and other front liners is tremendous. Non-communicable diseases such as cardiovascular diseases, diabetes and cancer are the leading cause of death in Malaysia. A paradigm shift in the approach is required to ensure the sustainability of the normal healthcare services provided by the government especially for the lower income groups. There is also a need to expedite the tabling of Tobacco Control Bill in coming parliament session which is long overdue. H.E. the King of Malaysia has called on all Malaysians to put aside political, racial and religious differences and show the spirit of loyalty, humanitarianism and steadfastness in fighting the COVID-19 pandemic.
  2. Liew BS, Rampal L
    Med J Malaysia, 2023 Sep;78(5):551-558.
    PMID: 37775478
    No abstract available.
  3. Sherina MS, Rampal L, Mustaqim A
    Asia Pac J Public Health, 2004;16(2):109-14.
    PMID: 15624788 DOI: 10.1177/101053950401600206
    Chronic illness is one of the major causes of mortality and morbidity among the elderly. To determine the prevalence and factors associated with chronic illness among the elderly in a rural community setting. A cross sectional study design was used. Stratified proportionate cluster sampling method was used to select respondents in Mukim Sepang, Sepang, Selangor, Malaysia. Out of 263 elderly residents (6.2% of the total population), 223 agreed to participate in the study giving a response rate of 84.8%. The prevalence of chronic illness among the elderly in Mukim Sepang was 60.1%. Out of 223 respondents, 134 were diagnosed as having chronic illness such as hypertension, diabetes mellitus, ischaemic heart disease, bronchial asthma or gout. Chronic illness was found to be significantly associated with functional dependence among the elderly (chi2=6.863, df=1, p<0.05). The prevalence of chronic illness among the elderly in the rural community is very high. Problems facing this age-group should be addressed comprehensively in order to formulate appropriate programmes for the health care of the elderly.
  4. Sherina MS, Rampal L, Mustaqim A
    Med J Malaysia, 2004 Jun;59(2):252-7.
    PMID: 15559177 MyJurnal
    Cognitive impairment is common in late life and may be due to the normal process of ageing or associated with physical or mental disorders. The aim of this study was to determine the prevalence of cognitive impairment among the elderly in a rural community setting. A cross sectional study design using stratified proportionate cluster sampling method was used in this study. A questionnaire similar to the Elderly Cognitive Assessment Questionnaire (ECAQ) was used as a screening instrument for cognitive impairment. The prevalence of cognitive impairment was 22.4% (50/223) among the elderly respondents. Cognitive impairment among the elderly was significantly associated with age, gender, ethnicity, marital status and level of education.
  5. Reddy SC, Rampal L, Nurulaini O
    Med J Malaysia, 2004 Jun;59(2):212-7.
    PMID: 15559172 MyJurnal
    A community based cross-sectional study was carried out to determine the prevalence and causes of visual impairment and blindness in residents aged forty years and above in kampung Jenderam Hilir of Sepang district, Selangor state. A total of 311 out of 341 (91.3%) respondents participated in this study. The prevalence of visual impairment and blindness observed was 18.9% and 2.9% respectively. The prevalence of visual impairment and blindness increased significantly with age. Amongst the 159 respondents who agreed for eye checkup, refractive errors (56%), cataract (20.1%), glaucoma (4.4%) and diabetic retinopathy (1.3%) were found to be causing visual impairment and blindness.
  6. Sherina MS, Rampal L, Kaneson N
    Med J Malaysia, 2004 Jun;59(2):207-11.
    PMID: 15559171 MyJurnal
    The aim of this study was to determine the prevalence of psychological stress among medical students and to identify its symptoms and association with depression. A cross-sectional study design was used. Three-hundred and ninety-six medical students at a university in Malaysia were included in the study. Tools similar to the General Health Questionnaire (GHQ-12) and Beck Depression Inventory (BDI) were used to screen for psychological stress and depression, respectively. 41.9% of the medical students were found to have psychological stress, which was significantly associated with depression (chi2=4.636, df=1, p<0.05). Psychological stress is common among medical students and is associated with depression.
  7. Sherina MS, Rampal L, Mustaqim A
    Med J Malaysia, 2004 Mar;59(1):45-9.
    PMID: 15535335 MyJurnal
    Objective: To determine the prevalence of depression among the elderly and to identify its associated factors.
    Methods: A cross sectional study design was used. Stratified proportionate cluster sampling method was used to select the respondents. A 30 item Geriatric Depression Scale questionnaire was used as a screening instrument.
    Results: 7.6% of the elderly were found to have depression. Only employment status was found to be significantly associated with depression.
    Discussion: The prevalence of depression in the elderly was 7.6%. Primary Care providers need to be vigilant when treating elderly patients as depression is commonly found in this age group .
    Study site: Nine villages in Mukim Sepang, Sepang District, Selangor, Malaysia
    Device, Questionnaire & Scale: Geriatric Depression Scale (GDS-30)
  8. Rampal L, Jegathesan M, Lim YS
    Med J Malaysia, 1984 Jun;39(2):116-22.
    PMID: 6439984
    A food poisoning outbreak affected 114 female Malay students staying in a religious secondary school hostel in Klang. The students developed an illness mainly characterized by abdominal pain, nausea, vomiting and giddiness. The median incubation period in this outbreak was 2.5 hours. Laboratory examination of suspected food revealed 2.3 X10^6 Bacillus cereus organisms per gram of fried noodles. B. cereus was determined as the probable cause of this outbreak and the fried. noodles the most likely vehicle for the organism. An outbreak of B. cereus food poisoning is being reported in Malaysia for the first time.
  9. Jegathesan M, Rampal L, Lim YS
    Med J Malaysia, 1983 Dec;38(4):308-10.
    PMID: 6599988
    A survey on the incidence of Salmonellae in soil was conducted on 12 kindergartens in the Klang District, The organism. was isolated from five (three urban and two rural) kindergartens from one or more soil samples tested. Ten isolates comprising six serotypes, namely, Salmonella bareilly, S. haifa, S. abony, S. weltevreden, S. agona and S. stanley, were encountered. The possible role that these soil isolates may play in the transmission. of salmonellae is discussed. The need to use more than one media in the detection of salmonellae is emphasised.
  10. Sivalingam N, Lim RBL, Rampal L
    Med J Malaysia, 2021 05;76(3):279-283.
    PMID: 34031323
    No abstract provided.
  11. Rampal L, Azhar MZ, Sanjay R
    Introduction: A cross-sectioned study was carried out on 1016 drug addicts from Johor state to better understand their profile.
    Method: A structured questionnaire prepared in three languages was used to collect the data which was analyzed using the Statistical Package for Social Sciences.
    Result & Discussion: The overall mean age of the respondents was 33.8 (95% CI= 33.3 - 34.4) years and ranged from 16 to 61 years. ANOVA post hoc multiple comparison tests showed that there was a significant difference in the mean age between Malays and Chinese (p<0.05). The majority of the respondents were Malay (79.6%) and had secondary education (72.1%) or primary education (21.7%). The majority (79%) was either semi-skilled or unskilled. More than 70% had mores than five siblings. About 36% of the respondents had past a history of discipline problem at school. The majority (99.6%) of the drugs addicts had smoked before and more than 90% were currently smoking. More than 80% had consumed alcoholic beverages. The majority did not use condom when they had sex. Only 24% stated that they did use a needle or syringe that had previously been used by someone else. Less than 4% had either bleached or boiled the needle or syringe that had previously been used by someone else. About 17% were tested positive for HIV. The mean age at which the respondents first started injecting drugs was 21.5 (95% CI= 20.7 - 22.2) years. ANOVA post hoc multiple comparison tests showed that there was no significant difference in the mean age of the different ethnic groups at which the respondents first started injecting drugs. The majority (84.2%) of the drug addicts started injecting drugs between 10 and 20 years of age. Friends introduced 80% of the drug addicts to drugs. The common reasons given for first taking drugs was " I was curious about the feeling of taking drugs (43.6%), "my friends asked me to try" (23.4%), "to release tension" (15.6%) and 5% stated "to try for fun", and 3% that they were "depressed". The majority (64.2%) of the drug addicts spend RM 500 or more per month on drugs and more than 10% of them spend as much as RM 1000 or more per month.
    Conclusion: These results indicate an urgent need for a more comprehensive prevention program involving family, schools, commmunities and the media and aimed at reducing drug abuse. Keywords: Profile, drug addicts, Malaysia
  12. Sherina MS, Rampal L, Kaneson N
    Objective: This study was conducted to determine the prevalence of anxiety among medical students at a local university in Malaysia and to identify its associated factors.
    Methods: Across-sectional study design was used. Three-hundred and ninety-six medical students at a local university in Malaysia were included in the study. A pre-tested, modified, self-administered Beck Anxiety Inventory (BAI) was used to screen for anxiety.
    Results: Three-hundred-and-ninety-six out of 414 medical students participated (response rate 95.7%).38.4% of the medical students were found to have anxiety.
    Conclusion: The overall prevalence of anxiety among medical students was high (38.4%). Factors found to be significantly associated with anxiety were gender, perceived level of pressure, year of study in medical school, ethnicity and depression(p<0.05).
    Keywords: Anxiety, depression, medical students, prevalence
  13. Alagappan M, Rampal L, Zalilah MS
    Med J Malaysia, 2019 12;74(6):513-520.
    PMID: 31929478
    INTRODUCTION: This cross-sectional study aimed to determine the prevalence of overweight and obesity and factors associated among secondary school students in Batang Padang District, Perak, Malaysia.

    METHODS: Out of the 7247 students in the ten selected schools studied, a total of 6248 students (2928 males, 3320 females) took part. A validated self-administered questionnaire was used. Data was analysed using SPSS version 22. Multivariable logistic regression was used to determine the adjusted odd ratio.

    RESULTS: The prevalence of overweight and obesity was 16.0% and 11.5% respectively. Obesity/overweight was significantly (p<0.05) associated with gender, age, ethnicity, education level of father, education level of mother, physical activity, disordered eating, smoking status, body size perception and body part satisfaction. The multivariable analysis results showed that the odds of being overweight/obesity were higher in males compared to females (OR 1.56, 95%CI: 1.37, 1.77). The results also showed that the odds of being overweight/obesity were highest among those in age group 12 and 13 years and among Malay ethnicity. The odds of overweight/obesity were higher in those who was dissatisfied with their body parts, (OR 1.96, 95%CI: 1.71, 2.25), dissatisfied with their body size (OR: 4.25, 95%CI: 3.60, 5.02), low physical activity (OR 1.23, 95%CI: 1.06, 1.44), current smokers (OR 1.38, 95%CI: 1.07, 1.78) and at risk of having eating disorder (OR: 1.39, 95%CI 1.22, 1.59).

    CONCLUSION: The overall prevalence of overweight and obesity is high. The findings from this study can be used by policy makers to plan an integrated intervention program in schools.

  14. Jahanfar S, Lye MS, Rampal L
    Singapore Med J, 2009 Feb;50(2):173-80.
    PMID: 19296033
    INTRODUCTION: The aim of this study was to investigate the knowledge, attitudes and behaviour of university students regarding acquired immunodeficiency syndrome (AIDS) and the human immunodeficiency virus (HIV).
    METHODS: A randomised controlled trial of 530 university students was done using peer-adult facilitators. Participants completed a questionnaire before and after the intervention, which was a four-hour group session. A prevention programme was developed by local experts, health educators and peer facilitators. The peer-adult-led programme was designed to provide a conceptual model of HIV risk reduction through information, motivational and behavioural skills, a harm reduction module and health promotion theme.
    RESULTS: The main outcome measured was the level of knowledge, attitudes and behaviour scores. The results suggest that relative to the control group, participants in the intervention group had higher levels of knowledge (30.37 vs. 25.40; p-value is 0.001) and a better attitude (12.27 vs. 10.84; p-value is 0.001). However, there was no difference in the behavioural score (9.47 vs. 9.41; p-value is 0.530). The correlation between the level of knowledge and age and the level of education was found in the intervention group, but not in the control group (p-value is 0.01). Attitude and gender were found to be correlated in the intervention group only (p-value is 0.01).
    CONCLUSION: Our programme was successful in increasing knowledge and improving attitudes towards AIDS and HIV. However, it did not improve risk-taking behaviour. Peer-adult-led educational programmes for youth using various interactional activities, such as small group discussions, poster activity and empathy exercises, can be successful in changing the prevailing youth perceptions of AIDS and HIV.
  15. Rampal L, Rampal S, Azhar MZ, Rahman AR
    Public Health, 2008 Jan;122(1):11-8.
    PMID: 17981310 DOI: 10.1016/j.puhe.2007.05.008
    Study design: A cross-sectional study was conducted in all states of Malaysia to determine the prevalence, awareness, treatment and control of hypertension. A stratified two-stage cluster sampling design with proportional allocation was used.
    Methods: Trained nurses obtained two blood pressure measurements from each subject. Hypertension was defined as mean systolic blood pressure >140 mmHg, diastolic blood pressure >90 mmHg, or a self-reported diagnosis of hypertension and taking antihypertensive medication. All data were analysed using Stata 9.2 software and took the complex survey design into account. A two-sided P-value of <0.05 was considered to be statistically significant.
    Results: The overall prevalence of hypertension for subjects aged 15 years was 27.8% (95% confidence interval (CI) 26.9-28.8). The prevalence of hypertension was significantly higher in males (29.6%, 95% CI 28.3-31.0) compared with females (26.0%, 95% CI 25.0-27.1). Multivariate logistic regression showed that the odds of having hypertension increased with increasing age, in males, in subjects with a family history of hypertension, with increasing body mass index, in non-smokers and with decreasing levels of education. Only 34.6% of the subjects with hypertension were aware of their hypertensive status, and 32.4 were taking antihypertensive medication. Amongst the latter group, only 26.8% had their blood pressure under control. The prevalence of hypertension amongst those aged 30 years has increased from 32.9% in 1996 to 40.5% in 2004.
    Conclusion: In Malaysia, the prevalence of hypertension is high, but levels of awareness, treatment and control are low. There is an urgent need for a comprehensive integrated population-based intervention programme to ameliorate the growing problem of hypertension in Malaysians.
  16. Tan ST, Sherina MS, Rampal L, Normala I
    Med J Malaysia, 2015 Feb;70(1):1-5.
    PMID: 26032521 MyJurnal
    BACKGROUND: Undergraduate medical students have been the most distressed group among the student population. Depression and anxiety have been found to be more prevalent in this group of students compared to others.

    OBJECTIVE: This study was conducted to determine the prevalence and predictors of suicidality among undergraduate medical students in a public university.

    METHODS: This was an analytical cross-sectional study, conducted in a public university in Selangor, Malaysia. Data were collected using self-administered questionnaires from January to February 2013, and analysed using the Statistical Package for Social Sciences Software (version 21).

    RESULTS: Out of 625 undergraduate medical students, 537 (85.9%) participated in the study. The prevalence of the suicidality among undergraduate medical students was 7.0%. The significant predictors of suicidality based on multiple logistic regression were the respondent's lifetime suicide attempts (Adjusted Odds Ratio, AOR 10.4, 95% CI 2.7 to 40.9); depression (AOR 5.9, 95% CI 1.5 to 23.0); breaking off a steady love relationship (AOR 5.4, 95% CI 1.3 to 22.4); hopelessness (AOR 4.9, 95% CI 1.1 to 21.6); and something valued being lost or stolen (AOR 4.4, 95% CI 1.2 to 15.9).

    CONCLUSION: These findings indicate that mental health care services should be strengthened at university level. The results show a need for an intervention programme to reduce suicidality among the undergraduate medical students.
  17. Ummavathy P, Sherina MS, Rampal L, Siti Irma Fadhilah I
    Med J Malaysia, 2015 Jun;70(3):131-41.
    PMID: 26248774 MyJurnal
    INTRODUCTION: Chemotherapy is the most common form of treatment among cancer patients. It is also known to cause many physical and psychological side-effects.

    OBJECTIVE: This study developed, implemented and evaluated the outcome of a chemotherapy counseling module among oncology patients by pharmacists based on their psychological effects (depression, anxiety) and selfesteem.

    METHODS: A randomized, single blind, placebo controlled study was conducted among 162 patients undergoing chemotherapy in a government hospital in Malaysia.

    INTERVENTION: Counseling sessions were conducted using the 'Managing Patients on Chemotherapy' module for oncology patients undergoing chemotherapy at each treatment cycle.

    OUTCOME: The outcome of repetitive chemotherapy counseling using the module was determined at baseline, first follow-up, second follow-up and third follow-up.

    RESULTS: The findings revealed that there was significant improvement in the intervention group as compared to the control group with large effect size on depression (p = 0.001, partial η(2) = 0.394), anxiety (p = 0.001, partial η(2) = 0.232) and self-esteem (p = 0.001, partial η(2) = 0.541).

    CONCLUSION: Repetitive counseling using the 'Managing Patients on Chemotherapy' module was found to be effective in improving psychological effects and self-esteem among patients undergoing chemotherapy.

  18. Parwathi A, Sherina MS, Rampal L, Ismail SIF
    Med J Malaysia, 2021 05;76(3):332-339.
    PMID: 34031331
    INTRODUCTION: The prevalence of urinary incontinence among pregnant women is high in Malaysia. However, healthcare providers appear to pay little attention to it along with a limited local intervention that addresses the continence health during pregnancy. This study aims to develop and validate intervention with pelvic floor muscle exercise (PFME) for pregnant women.

    MATERIALS AND METHODS: The development of PFME intervention was guided by the Medical Research Council Framework for Developing and Evaluating Complex Intervention (MRC Framework). This involved four phases: identification of current research evidence, expert opinion, validation via focus group discussions with physiotherapists and pregnant women, and piloting the intervention using a single group pre-post design among 30 pregnant women at Maternity Hospital Kuala Lumpur to assess the feasibility of the intervention by evaluating changes in knowledge and attitude. The qualitative approach was used to analyse the first three phases, while non-parametric methods were used to analyse the pilot prepost test results.

    RESULTS: Based on research evidence and guidelines found during the literature review, a PFME intervention was developed using a new paradigm incorporating two theories, the Health Belief Model and Motivational Interviewing that have been shown to be important in continence promotion and exercise adherence. The contribution of the panel of experts in refining the intervention to meet the local context, endorses the achievement of the intervention's content validity. While, the focus group discussion with pregnant women and physiotherapists revealed the face-validity of the intervention. The findings of the pilot pre-testing showed that PFME knowledge (p<0.001) and attitude (p=0.011) improved significantly immediately following the intervention.

    CONCLUSIONS: Evidently, this is a pioneer study that illustrates the development of a Malaysian context-adapting PFME intervention on the basis of recommended steps using the MRC Framework. Incorporating a theory-based and rigorous validation approach into the development of the PFME intervention brought novel perspectives to the intervention. Given the promising preliminary results of the pre-testing pilot study, the PFME intervention could be implemented in the planned randomised control trial to validate the robustness of the results.

  19. Rampal L, Aziz SI, Razin A, Sanjay R
    MyJurnal
    A cross sectional study was conducted in Kelantan state with the objectives to determine the prevalence of smoking in 2004 and to determine the relationship between smoking and age, sex, educational level, family and peer influence. All residents aged 15 years and above from all the selected households were included in this study. A standardized pre-tested structured questionnaire was used in this study. Out of 1025 respondents interviewed the prevalence of ever and current smokers was 34% and 25.1% respectively.The prevalence of ever smokers and current smokers was significantly higher In males as compared to females (p.<0.001). The mean initiation age for the males current smokers was 10.4 (95% CI = 19.4, 21.5) years with a range from 7 to 66 years. For the females the mean initiation age was 31 (95% Cl =26.8, 35.2) years with a range from 15 to 64 years. The difference between the mean initiation age between male and female smokers was statistically significant (p<0.0001). The overall mean duration of smoking was 23.9 years with a median of 23 years. It ranged from less than 1 year to 66 years. There was no significant difference between the mean duration of smoking between male and females current smokers (p =0.59). There was a significant association between current smoking status and education level (p<0.01 ) and between smoking and peer influence (p<0.01). There was no significant difference in smokers whose parents were smokers as compared to non-smokers whose parents were smokers. In conclusion the prevalence of smoking in Kelantan state in 2004 is lower than the reported prevalence in 1996. However, it is still very high especially in the males.
    Key words: Smoking, peer influence, Kelantan
  20. Lye MS, Tohit NF, Rampal L
    Med J Malaysia, 2017 02;72(1):12-17.
    PMID: 28255134 MyJurnal
    INTRODUCTION: Pediculosis capitis infestation is endemic in both developing and developed countries leading to various physical, economical and psychological consequences. Our main objective was to determine the prevalence and predictors of pediculosis capitis among primary school children in Hulu Langat District, Malaysia.

    METHODS: An analytic cross-sectional study using cluster random sampling method was carried out in Hulu Langat District, Malaysia. Self-administered pretested questionnaires were used to collect the data. Hair and scalp examination was also carried out. Multivariate logistic regression was used to control for potential confounding and determine the predictors.

    RESULTS: The overall mean age of the 1,336 respondents was 9.3 years. Majority were males (52.8%), Malays (79.5%) and 81.3% of the fathers had secondary or tertiary education as compared to 77.3% for the mothers. The overall prevalence of pediculosis capitis was 15.3%. The prevalence of pediculosis was significantly higher among females (28.4%) than males (3.7%, p=0.001). Multivariate logistic regression analysis showed that age 10 years or more (Odds Ratio (OR) = 2.34, 95% Confidence Interval (CI) = 1.673 to 3.272), female gender (OR = 10.26, 95% CI = 6.620 to 15.903), history of contact with an infested person (OR = 2.11, 95% CI = 1.506 to 2.960), Indian compared to Chinese (OR = 3.55, 95% CI = 1.282 to 9.860), Malay to Chinese (OR = 2.59, 95% CI = .994 to 6.774) were associated with pediculosis capitis.

    CONCLUSIONS: Prevalence of pediculosis capitis among children aged 7 - 12 years in Hulu Langat District was high. There is a need for screening and treatment of pediculosis capitis in primary schools.

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