Displaying publications 21 - 40 of 69 in total

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  1. Rashiden I, Ahmad Tajuddin NAN, Yee A, Amer Nordin AS
    Environ Sci Pollut Res Int, 2021 Aug;28(32):44557-44564.
    PMID: 33855660 DOI: 10.1007/s11356-021-13883-w
    This research sought to develop and validate the "Workplace Second-hand Smoke: Perception on the SHS Knowledge, Attitude, and Practice" (WSHS: PAP) instrument, which targets non-smoking employees. A cross-sectional study was conducted between April and June 2018 to validate WSHS: PAP among non-smoking employees at Universiti Malaya Medical Centre (UMMC). Experts were invited to validate the instrument. Then, for exploratory factor analysis, a cross-sectional study was conducted among 336 UMMC non-smoking employees who were recruited by convenience sampling. A total of 28 items on KAP, rated on five-point Likert scales, underwent exploratory factor analysis and were tested for internal consistency (Cronbach's alpha). Participants were approached after 2 weeks for the assessment of test-retest reliability. Cronbach's alpha was 0.828, 0.743 and 0.837, respectively, for the domains of perception of the knowledge, attitude and practice, indicating acceptable internal consistency (above 0.7). Exploratory factor analysis identified a one-factor solution for each of the KAP domains. Therefore, the Malay version of the WSHS: PAP instrument demonstrated satisfactory psychometric properties for the assessment of non-smoking employees in workplaces with a smoking ban.
  2. Al-Haddad A, Arsheed NAA, Yee A, Kohli S
    Saudi Dent J, 2024 Jan;36(1):11-19.
    PMID: 38375394 DOI: 10.1016/j.sdentj.2023.10.004
    PURPOSE: This systematic review is aimed to evaluate in fixed prosthodontics treated teeth, the effect of the BOPT on periodontal health compared to the horizontal preparation technique using a chamfer finishing line or to the baseline.

    METHODS: The electronic databases Cochrane Central Library, PubMed, Scopus, and ScienceDirect were searched based on specific MeSH keywords. The Randomized controlled clinical trials (RCTs) and prospective clinical trials on BOPT printed in English up to July 2022 were selected. Screening, selection, and data extraction were done. The studies were assessed for risk of bias, and descriptive and meta-analyses were performed.

    RESULTS: Eight studies were included in the systematic review and only three RCTs were involved in the meta-analysis. Two RCTs were assessed as low risk while one has some concerns. were grouped as good, fair, and poor based on NOS. Three of the prospective studies were considered to be of good quality and one study was fair. The meta-analysis revealed no statistically significant difference in the effect of BOPT and chamfer preparation on periodontal health status and success rate (P > 0.05).

    CONCLUSIONS: Considering the limitation of this review, the BOPT is comparable to chamfer preparation and it resulted in an acceptable effect to maintain periodontal health with a high success rate. However, more evidence is required to support these findings.

  3. Loh HH, Lim LL, Loh HS, Yee A
    J Diabetes Investig, 2019 Nov;10(6):1490-1501.
    PMID: 30938074 DOI: 10.1111/jdi.13054
    AIMS/INTRODUCTION: Although patients with type 1 diabetes are medically exempt, many insist on fasting during Ramadan. Multiple daily insulin injections (MDI), premixed insulin and continuous subcutaneous insulin infusion (CSII) are commonly used. To date, little is known about the safety of Ramadan fasting in these patients.

    MATERIALS AND METHODS: We pooled data from 17 observational studies involving 1,699 patients treated with either CSII or non-CSII (including premixed and MDI) regimen. The study outcomes were the frequencies of hypoglycemia, hyperglycemia and/or ketosis. Given the lack of patient-level data, separate analyses for premixed and MDI regimen were not carried out.

    RESULTS: The CSII-treated group (n = 203) was older (22.9 ± 6.9 vs 17.8 ± 4.0 years), and had longer diabetes duration (116.7 ± 66.5 vs 74.8 ± 59.2 months) and lower glycated hemoglobin (7.8 ± 1.1% vs 9.1 ± 2.0%) at baseline than the non-CSII-treated group (n = 1,496). The non-CSII-treated group had less non-severe hypoglycemia than the CSII-treated group (22%, 95% CI 13-34 vs 35%, 95% CI 17-55). Of the non-CSII-treated group, 7.1% (95% CI 5.8-8.5) developed severe hypoglycemia, but none from the CSII-treated group did. The non-CSII-treated group was more likely to develop hyperglycemia (12%, 95% CI 3-25 vs 8.8%, 95% CI 0-31) and ketosis (2.5%, 95% CI 1.0-4.6 vs 1.6%, 95% CI 0.1-4.7), and discontinue fasting (55%, 95% CI 34-76 vs 31%, 95% CI 9-60) than the CSII-treated group.

    CONCLUSIONS: The CSII regimen had lower rates of severe hypoglycemia and hyperglycemia/ketosis, but a higher rate of non-severe hyperglycemia than premixed/MDI regimens. These suggest that appropriate patient selection with regular, supervised fine-tuning of the basal insulin rate with intensive glucose monitoring might mitigate the residual hypoglycemia risk during Ramadan.

  4. Low ET, Alias H, Boon SH, Shariff EM, Tan CY, Ooi LC, et al.
    BMC Plant Biol, 2008 May 29;8:62.
    PMID: 18507865 DOI: 10.1186/1471-2229-8-62
    BACKGROUND: Oil palm (Elaeis guineensis Jacq.) is one of the most important oil bearing crops in the world. However, genetic improvement of oil palm through conventional breeding is extremely slow and costly, as the breeding cycle can take up to 10 years. This has brought about interest in vegetative propagation of oil palm. Since the introduction of oil palm tissue culture in the 1970s, clonal propagation has proven to be useful, not only in producing uniform planting materials, but also in the development of the genetic engineering programme. Despite considerable progress in improving the tissue culture techniques, the callusing and embryogenesis rates from proliferating callus cultures remain very low. Thus, understanding the gene diversity and expression profiles in oil palm tissue culture is critical in increasing the efficiency of these processes.

    RESULTS: A total of 12 standard cDNA libraries, representing three main developmental stages in oil palm tissue culture, were generated in this study. Random sequencing of clones from these cDNA libraries generated 17,599 expressed sequence tags (ESTs). The ESTs were analysed, annotated and assembled to generate 9,584 putative unigenes distributed in 3,268 consensi and 6,316 singletons. These unigenes were assigned putative functions based on similarity and gene ontology annotations. Cluster analysis, which surveyed the relatedness of each library based on the abundance of ESTs in each consensus, revealed that lipid transfer proteins were highly expressed in embryogenic tissues. A glutathione S-transferase was found to be highly expressed in non-embryogenic callus. Further analysis of the unigenes identified 648 non-redundant simple sequence repeats and 211 putative full-length open reading frames.

    CONCLUSION: This study has provided an overview of genes expressed during oil palm tissue culture. Candidate genes with expression that are modulated during tissue culture were identified. However, in order to confirm whether these genes are suitable as early markers for embryogenesis, the genes need to be tested on earlier stages of tissue culture and a wider range of genotypes. This collection of ESTs is an important resource for genetic and genome analyses of the oil palm, particularly during tissue culture development.

  5. Beng TS, Chin LE, Guan NC, Yee A, Wu C, Jane LE, et al.
    Am J Hosp Palliat Care, 2015 Mar;32(2):144-60.
    PMID: 24142593 DOI: 10.1177/1049909113508640
    To develop a mindfulness-based palliative psychotherapy to address psychoexistential suffering in palliative care.
  6. Ching SM, Yee A, Ramachandran V, Sazlly Lim SM, Wan Sulaiman WA, Foo YL, et al.
    PLoS One, 2015;10(10):e0139337.
    PMID: 26431511 DOI: 10.1371/journal.pone.0139337
    This study was initiated to determine the psychometric properties of the Smart Phone Addiction Scale (SAS) by translating and validating this scale into the Malay language (SAS-M), which is the main language spoken in Malaysia. This study can distinguish smart phone and internet addiction among multi-ethnic Malaysian medical students. In addition, the reliability and validity of the SAS was also demonstrated.
  7. Yee A, Yassim AR, Loh HS, Ng CG, Tan KA
    BMC Psychiatry, 2015;15:200.
    PMID: 26286597 DOI: 10.1186/s12888-015-0587-6
    BACKGROUND: This study examines the psychometric properties of the Malay version of the Montgomery-Ǻsberg Depression Rating Scale (MADRS-BM).
    METHODS: A total of 150 participants with (n = 50) and without depression (n = 100) completed the self-rated version of the Montgomery-Ǻsberg Depression Rating Scale (MADRS-S), the Malay versions of the MADRS-BM, the Beck Depression Inventory-II (BDI-II-M), the General Health Questionnaire-12 (GHQ-12), and the Snaith-Hamilton Pleasure Scale (SHAPS-M).
    RESULTS: With respect to dimensionality of the MADRS-BM, we obtained one factor solution. With respect to reliability, we found that internal consistency was satisfactory. The scale demonstrated excellent parallel form reliability. The one-week test-retest reliability was good. With respect to validity, positive correlations between the MADRS-BM, BDI-II-M, and the GHQ and negative correlation between the MADRS-BM and SHAPS-M provide initial evidence of MADRS-BM's concurrent validity. After adjusting for age, gender, ethnicity, educational level, and marital status, individuals with depression significantly reported higher MADRS-BM scores than did individuals without depression. Hence, there is additional evidence for concurrent validity of the MADRS-BM. Cut-off score of 4 distinguished individuals with depression from individuals without depression with a sensitivity of 78 % and a specificity of 86 %.
    CONCLUSIONS: The MADRS-BM demonstrated promising psychometric properties in terms of dimensionality, reliability, and validity that generally justifies its use in routine clinical practice in Malaysia.
  8. Wong HY, Subramaniyan M, Bullen C, Amer Siddiq AN, Danaee M, Yee A
    Tob Induc Dis, 2019;17:65.
    PMID: 31582954 DOI: 10.18332/tid/111355
    INTRODUCTION: The mobile-phone-based Bedfont iCOTM Smokerlyzer® is of unknown validity and reproducibility compared to the widely-used piCO+ Smokerlyzer®. We aimed to compare the validity and reproducibility of the iCOTM Smokerlyzer® with the piCO+ Smokerlyzer® among patients reducing or quitting tobacco smoking.

    METHODS: Methadone-maintained therapy (MMT) users from three centers in Malaysia had their exhaled carbon monoxide (eCO) levels recorded via the piCO+ and iCOTM Smokerlyzers®, their nicotine dependence assessed with the Malay version of the Fagerström Test for Nicotine Dependence (FTND-M), and daily tobacco intake measured via the Opiate Treatment Index (OTI) Tobacco Q-score. Pearson partial correlations were used to compare the eCO results of both devices, as well as the corresponding FTND-M scores.

    RESULTS: Among the 146 participants (mean age 47.9 years, 92.5% male, and 73.3% Malay ethnic group) most (55.5%) were moderate smokers (6-19 cigarettes/day). Mean eCO categories were significantly correlated between both devices (r=0.861, p<0.001), and the first and second readings were significantly correlated for each device (r=0.94 for the piCO+ Smokerlyzer®, p<0.001; r=0.91 for the iCOTM Smokerlyzer®, p<0.001). Exhaled CO correlated positively with FTND-M scores for both devices. The post hoc analysis revealed a significantly lower iCOTM Smokerlyzer® reading of 0.82 (95% CI: 0.69-0.94, p<0.001) compared to that of the piCO+ Smokerlyzer®, and a significant intercept of -0.34 (95% CI: -0.61 - -0.07, p=0.016) on linear regression analysis, suggesting that there may be a calibration error in one or more of the iCOTM Smokerlyzer® devices.

    CONCLUSIONS: The iCOTM Smokerlyzer® readings are highly reproducible compared to those of the piCO+ Smokerlyzer®, but calibration guidelines are required for the mobile-phone-based device. Further research is required to assess interchangeability.

  9. Lim SH, Daghar L, Bullen C, Faiz HM, Akbar M, Amer Nordin AS, et al.
    Asia Pac J Public Health, 2020 11;32(8):414-417.
    PMID: 33084374 DOI: 10.1177/1010539520965370
    Previous studies documented the health disparities in smoking among sexual minority populations, including men who have sex with men (MSM). However, smoking behaviors have never been examined among Malaysian MSM, a sexual minority group in a predominantly Muslim country. A total of 622 Malaysian MSM completed an anonymous online survey in 2017. Data on the demographics, smoking and substance use behaviors, psychosocial factors, and attitudes toward smoking cessation were collected and analyzed. The mean age was 28 years and 67% of participants were of Malay ethnicity. The prevalence of current smoking was 23% (n = 143), while former smokers were 9% (n = 59). Current smoking status was associated with HIV-positive status and risk behaviors, such as suicidality, alcohol use, and illicit drug use (P = .001). Almost two thirds of current smokers had attempted to quit in the past year. Hence, comprehensive smoking cessation interventions addressing the psychosocial needs of MSM should be prioritized.
  10. Loh HH, Yee A, Loh HS, Kanagasundram S, Francis B, Lim LL
    Hormones (Athens), 2020 Sep;19(3):413-423.
    PMID: 32462512 DOI: 10.1007/s42000-020-00210-0
    PURPOSE: Polycystic ovarian syndrome (PCOS) is a common disorder characterized by clinical or biochemical hyperandrogenism and ovulary dysfunction. Female sexual dysfunction (FSD) adversely affects quality of life and interpersonal relationships. We aimed to compare the prevalence of FSD in women with and without PCOS.

    METHODS: We pooled data from 28 observational studies involving 6256 women. Apart from the total prevalence of FSD, subgroup analyses based on different PCOS diagnostic criteria and obesity status (body mass index [BMI] ≥ 25 kg/m2) were performed. The differences in total and subscale scores of the Female Sexual Function Index (FSFI) among women with and without PCOS were also compared.

    RESULTS: Women with PCOS were younger (mean ± SD 28.56 ± 3.0 vs 31.5 ± 3.2 years, p 

  11. Teoh JB, Yee A, Danaee M, Ng CG, Sulaiman AH
    J Addict Med, 2017 Jan-Feb 6;11(1):40-46.
    PMID: 27753719 DOI: 10.1097/ADM.0000000000000267
    OBJECTIVES: Erectile dysfunction (ED) is a problem commonly encountered by patients on methadone maintenance therapy (MMT). This study aimed to assess the prevalence of ED among this group of patients along with its risk factors and association with quality of life (QOL).
    METHODS: Male patients on MMT in a tertiary hospital in Malaysia were included in the study. A total of 134 patients with sexual partners were assessed for ED using the International Index of Erectile Function. Patients were assessed for substance use using Opiate Treatment Index (OTI) and depression using the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM). QOL was evaluated using World Health Organisation Quality of Life (WHOQOL)-BREF.
    RESULTS: The prevalence of ED among patients on MMT was 67%, with 26.1% having mild ED, 30.4% having mild-to-moderate ED, 7.0% having moderate ED, and 17.2% having severe ED. Patients with depression were 4 times more likely to have ED compared with patients without depression, whereas increasing age significantly correlated with the severity of ED. Having ED predicted a poorer QOL in the social relationships domain.
    CONCLUSION: Depression is highly associated with ED, which negatively influences the social aspect of QOL among patients on methadone maintenance therapy.
    Study site: outpatient addiction psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  12. Loh HH, Lim LL, Yee A, Loh HS, Vethakkan SR
    Minerva Endocrinol., 2019 Jun;44(2):221-231.
    PMID: 28294593 DOI: 10.23736/S0391-1977.17.02584-6
    INTRODUCTION: We conducted a meta-analysis to assess the effects of vitamin D replacement on biochemical and skeletal parameters in subjects with mild primary hyperparathyroidism (PHPT) and coexistent vitamin D deficiency.

    EVIDENCE ACQUISITION: A systematic search of all English-language medical literature published from 1980 till May 2016 using PubMed, Embase and Ovid was performed. Nine observational studies were evaluated after fulfilling the inclusion and exclusion criteria.

    EVIDENCE SYNTHESIS: A total of 547 patients were examined. All studies used vitamin D2/D3 or calcifediol (25-hydroxyvitamin D3), There was significant improvement of serum 25(OH)D with unchanged serum iPTH level after vitamin D replacement, with pooled d+: 3.10 (95% CI 2.25 to 3.95), P<0.01 and pooled d+: 0.82 (95% CI -0.35 to 1.98), P=0.16 respectively. There was neither worsening of the pre-existing hypercalcemia (pooled d+: -0.27 [95% CI -1.09 to 0.64, P=0.56]) nor hypercalciuria (pooled d+: 3.64 [95% CI -0.55 to 7.83, P=0.09]). Two studies assessed in this meta-analysis reported unchanged bone density with vitamin D replacement.

    CONCLUSIONS: Vitamin D replacement in subjects with mild PHPT and coexistent vitamin D deficiency improved serum 25(OH)D level without worsening of pre-existing hypercalcemia or hypercalciuria. Well-designed multicenter randomized controlled trials examining pre- and postoperative outcomes of vitamin D therapy in patients with different severities of PHPT and vitamin D inadequacy are warranted to elucidate the most appropriate vitamin D treatment protocol and determine the long-term safety concerns.

  13. Yee A, Loh HS, Loh HH, Riahi S, Ng CG, Sulaiman AHB
    Ann Gen Psychiatry, 2019;18:25.
    PMID: 31649742 DOI: 10.1186/s12991-019-0249-z
    Background: Methadone is an effective therapy for opiate dependence. However, one of the commonest side effects is sexual dysfunction among male patients. Buprenorphine is an alternative to methadone. This study aimed to compare sexual desire among opiate-dependent male patients on buprenorphine (BMT) and methadone maintenance therapy (MMT).

    Methods: This cross-sectional study involved 126 male opiate-dependent patient who were tested for total testosterone (TT) and prolactin levels, and were interviewed and completed the Sexual Desire Inventory-2 (SDI-2), Malay language of International Index of Erectile Function (Mal-IIEF-15) and the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM) questionnaires.

    Results: There were 95 (75.4%) patients on MMT and 31 (24.6%) on BMT. Patients on MMT scored significantly lower in the sexual desire domain (Mal-IIEF-15 scores) (p 

  14. Subramaniam S, Yee A, Bin Amer Nordin AS, Bin Khalib AQ
    J Dual Diagn, 2020 12 12;17(1):4-12.
    PMID: 33308058 DOI: 10.1080/15504263.2020.1854410
    OBJECTIVE: The aim of this study was to determine the prevalence of alcohol or non-alcohol substance use dual diagnosis among inpatients with severe mental illness in a psychiatric institution in Malaysia. In addition, this study aimed to determine adverse outcomes between dual diagnosis versus single diagnosis. Methods: This was a cross-sectional study conducted in the inpatient ward using the Mini-International Neuropsychiatric Interview (MINI) to establish the diagnosis of severe mental illness and to screen for alcohol or non-alcohol substance use disorder comorbidity. Outcomes and severity of different domains among severe mental illness patients were assessed using the Addiction Severity Index (ASI). Results: Out of 152 patients who participated in this study, 51.3% (n = 78) had comorbid alcohol use disorder, and 29.6% (n = 45) had non-alcohol substance use disorder. Males with Kadazan ethnicity with severe mental illness and alcohol use disorder had a higher risk of having comorbid non-alcohol substance use disorder. Similarly, male Kadazan patients with severe mental illness and non-alcohol substance use disorder had a higher risk of having a comorbid alcohol use disorder. Dual diagnosis patients with alcohol and non-alcohol substance use disorder had higher rates of hospitalizations (p < .001 and p = .001). Family and social relationships were affected among the alcohol use disorder group as shown by the higher composite score for family status (FCOMP; p < .001). This group also showed more severe psychiatric status, as the composite score for psychiatric status (PCOMP) was high (p = .004). Suicidality was higher among patients with alcohol use disorder and severe mental illness (p < .001). Conclusions: The prevalence of severe mental illness dual diagnosis was high in this study with poorer outcomes, higher rates of admissions, and risk of suicidality. This highlights the importance of provisions for a more holistic treatment approach among patients with dual diagnosis.
  15. Loh HH, Francis B, Lim LL, Lim QH, Yee A, Loh HS
    Diabetes Metab Res Rev, 2021 Nov;37(8):e3458.
    PMID: 33891377 DOI: 10.1002/dmrr.3458
    AIMS: We aimed to examine if bariatric surgery was associated with a reduction in the prevalence of depressive and anxiety symptoms among people with obesity.

    MATERIALS AND METHODS: We pooled data from 49 studies involving 11,255 people with obesity who underwent bariatric surgery. The study outcomes were the prevalence of depressive and anxiety symptoms among these patients pre- and post-surgery.

    RESULTS: There was a significant reduction in body mass index (BMI) post-operatively (pooled d+: -13.3 kg/m2 [95% confidence interval [CI] 15.19, -11.47], p 

  16. Ali N, Aziz SA, Nordin S, Mi NC, Abdullah N, Paranthaman V, et al.
    Subst Use Misuse, 2018 01 28;53(2):239-248.
    PMID: 29116878 DOI: 10.1080/10826084.2017.1385630
    BACKGROUND: Opioid misuse and dependence is a global issue with a huge negative impact. In Malaysia, heroin is still the main illicit drug used, and methadone maintenance treatment (MMT) has been used since 2005.
    OBJECTIVE: To evaluate the effectiveness of MMT.
    METHODS: This was a cross-sectional study conducted in 103 treatment centers between October and December 2014 using a set of standard questionnaires. Data were analyzed using SPSS Statistics 20.
    RESULTS: There were 3254 respondents (93.6% response rate); of these 17.5% (n = 570) transferred to another treatment center, 8.6% (n = 280) died, 29.2% (n = 950) defaulted, and 7.6% (n = 247) were terminated for various reasons. Hence, 1233 (37%) respondents' baseline and follow-up data were further analyzed. Respondents had a mean age of 39.2 years old and were mainly male, Malay, Muslim, married (51.1%, n = 617), and currently employed. Few showed viral seroconversion after they started MMT (HIV: 0.5%, n = 6; Hepatitis B: 0.3%, n = 4; Hepatitis C: 2.7%, n = 29). There were significant reductions in opioid use, HIV risk-taking score (p < 0.01), social functioning (p < 0.01), crime (p < 0.01), and health (p < 0.01). However, there were significant improvements in quality of life in the physical, psychological, social, and environmental domains. Factors associated with change were being married, employed, consuming alcohol, and high criminality at baseline. Lower methadone dosage was significantly associated with improvements in the physical, psychological, and environmental domains.
    Conclusion/Importance: The MMT program was found to be successful; hence, it should be expanded.
  17. Yee A, Ng BS, Hashim HMH, Danaee M, Loh HH
    BMC Psychiatry, 2017 Dec 02;17(1):384.
    PMID: 29197359 DOI: 10.1186/s12888-017-1553-2
    BACKGROUND: This study evaluates the psychometric properties of the Malay version of the Brief Psychiatric Rating Scale (BPRS-M) among patients with schizophrenia in a psychiatric outpatient clinic.
    METHODS: Ninety-nine schizophrenia outpatients were administered the Malay version of the Brief Psychiatric Rating Scale (BPRS-M), Malay version of Positive and Negative Syndrome Scale (PANSS), Malay version of Calgary Depression Scale for Schizophrenia (CDSS) and Malay version of World Health Organization Quality of Life - Brief Version (WHOQOL-BREF).
    RESULTS: An exploratory factor analysis (EFA) of BPRS-M produced a seven-factor solution which accounted for 71.4% of the total variance. It exhibited fair internal consistency (Cronbach's alpha coefficient of 0.75). "Positive symptoms" and "Resistance" factors had association with unemployment and number of antipsychotics, positively correlated with PANSS but negatively correlated with WHOQOL-BREF. "Mood disturbance" factor correlated with lifetime history of suicide attempts, Malay version of CDSS and WHOQOL-BREF (psychological). Both "Negative symptoms" and "Activation" factors were associated with male, lower education, unemployment and positively correlated with Malay version of PANSS but negatively correlated with WHOQOL-BREF.
    CONCLUSIONS: The BPRS-M demonstrated promising psychometric properties in terms of dimensionality, reliability, and validity that generally justifies its use in routine clinical practice in Malaysia.
    Study site: psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
  18. Yee A, Loh HS, Danaee M, Riahi S, Ng CG, Sulaiman AH
    J Sex Med, 2018 02;15(2):159-166.
    PMID: 29275046 DOI: 10.1016/j.jsxm.2017.12.004
    BACKGROUND: Methadone has been recognized as an effective maintenance treatment for opioid dependence. However, its use is associated with several complications, including sexual dysfunction in men.

    AIM: To assess plasma testosterone and sexual function in Southeast Asian men on methadone maintenance treatment (MMT) or buprenorphine maintenance treatment (BMT).

    METHODS: 76 sexually active men on MMT (mean age = 43.30 ± 10.32 years) and 31 men on BMT (mean age = 41.87 ± 9.76 years) from a Southeast Asian community were evaluated using plasma total testosterone (TT) and prolactin levels, body mass index, social demographics, substance use measures, and depression severity scale.

    OUTCOMES: Prevalence and associated factors of TT level lower than the reference range in men on MMT or BMT.

    RESULTS: More than 1 third of men (40.8%, n = 31) on MMT had TT levels lower than the reference range, whereas 1 fourth of men (22.6%, n = 7) on BMT did. At univariate analysis, MMT vs BMT (β = 0.298, adjusted R2 = 0.08, P = .02) and body mass index (β = -0.23, adjusted R2 = 0.12, P = .02) were associated with changes in TT after stepwise regression. There were no significant associations with age; Opiate Treatment Index Q scores for alcohol, heroin, stimulant, tobacco, or cannabis use and social functioning domain; education levels; hepatitis C status; and severity of depression. Prolactin level did not differ between the MMT and BMT groups.

    CLINICAL IMPLICATIONS: The sex hormonal assay should be used regularly to check men on MMT.

    STRENGTHS AND LIMITATIONS: This is the first study conducted in the Southeast Asian community. Our study was limited by the lack of a healthy group as the reference for serum levels of testosterone and prolactin.

    CONCLUSIONS: The findings showed that plasma testosterone levels are lower in MMT than in BMT users. Hence, men who are receiving MMT should be screened for hypogonadism routinely in the clinical setting. Yee A, Loh HS, Danaee M, et al. Plasma Testosterone and Sexual Function in Southeast Asian Men Receiving Methadone and Buprenorphine Maintenance Treatment. J Sex Med 2018;15:159-166.

  19. Ching SM, Hamidin A, Vasudevan R, Sazlyna MS, Wan Aliaa WS, Foo YL, et al.
    Med J Malaysia, 2017 02;72(1):7-11.
    PMID: 28255133 MyJurnal
    INTRODUCTION: Internet is important to university students, especially for medical students who use it to search for literature and relevant information. However, some of the users are experiencing a gradual loss of the ability to reduce the duration and frequency of their internet activities, despite the negative consequences. The literature on internet usage among Malaysian medical students is limited. This study aims to determine the prevalence and factors associated with internet usage among medical students in a public university in Malaysia.

    METHODS: This cross-sectional study was performed among all the medical students (Year 1-5). Students were assessed on their internet activities using the internet addiction questionnaires (IAT). A Multiple Logistic Regression was used for data analysis.

    RESULTS: The study was conducted among 426 students. The study population consisted of 156 males (36.6%) and 270 females (63.4%). The mean age was 21.6 ±1.5 years. Ethnicity distribution among the students was: Malays (55.6%), Chinese (34.7%), Indians (7.3%) and others (2.3%). According to the IAT, 36.9% of the study sample was addicted to the internet. Using the multivariate logistic regression analysis, we have found that the use of internet access for entertainment purposes (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.05-12.00), male students (OR 1.8, 95% CI 1.01-3.21) and increasing frequency of internet usage were associated with internet addiction (OR 1.4, 95% CI 1.09- 1.67).

    CONCLUSION: Internet addiction is a relatively frequent phenomenon among medical students. The predictors of internet addiction were male students using it for surfing and entertainment purposes.

  20. Ong JY, Yee A, Amer Nordin AS, Danaee M, Azwa RI
    Int J STD AIDS, 2022 Sep;33(10):880-889.
    PMID: 35801969 DOI: 10.1177/09564624221106528
    BACKGROUND: This study estimates prevalence of depression and anxiety among adults living with Human Immunodeficiency Virus (HIV) in University Malaya Medical Centre (UMMC) and determines its associated factors.

    METHODS: This cross-sectional study was conducted between August 2020 and January 2021, in the Infectious Disease clinic and ward. One hundred ninety-one patients were recruited via convenience sampling. Patients' sociodemographic were obtained, followed by Depression, Anxiety, Stress Scale -21 (DASS-21), Multidimensional Scale of Perceived Social Support (MSPSS), and M.I.N.I. international neuropsychiatric interview (M.I.N.I.) The cut off DASS-21 point for depression is ≥5, for anxiety, ≥ 4. Mann-Whitney U and Chi square test were used to analyse the association between variables, and logistic regression to find predictability.

    RESULTS: Of the 191 participants, 89.5% outpatient, mean age 40 years (SD 0.742), 91.1% male, 65.4% single, 71.2% working, 46.1% Malaysian Chinese, 59.8% non- heterosexual, mean 6 years of being HIV positive; mean CD4 count 449/μL; mean viral load 116,690 (median = 20). 85.9% were taking antiretroviral therapy. The prevalence of depression was 35.1% (n = 67); anxiety was 42.9% (n = 82). Regression analysis revealed anxiety and stress increased odds of depression by 3.8 times (p = .001) and 12 times (p < .001) respectively. Those 40 years old and younger had 2.3 times odds of anxiety (p = .048). Increased social support from friends increased odds of anxiety by 1.7 times (p = .018). Depression and stress increased odds of anxiety by 4.4 times (p = .001) and 3.7 times (p = .008) respectively.

    CONCLUSIONS: Depression and anxiety among people with HIV is often under-recognised. Early identification and treatment of the mental illness is warranted. Screening with DASS-21 is useful to detect depression in patients with HIV.

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