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Fulltext The assessment of the quality of life questionnaires

Kamarul Imran, M., Ismail, A.A., Naing, L., Wan Moharnad, W.B.

Malaysian Journal of Public Health Medicine, 2005;5(1):51-55.
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Health traditionally has been compared using mortality and morbidity and in recent years health related instruments have been utilized along to complement those measures. Health related quality oflife instruments are important because they provide patient's opinion and decision of management and for monitoring and evaluating health status. The quality of life instruments such as health related quality of life questionnaires are increasingly being used and these questionnaires are classified into disease specific and generic questionnaires. They require proper assessment using psychometric analysis of reliability and validity, For reliability, the two common analyses are the test-retest and internal consistency and for validity, it requires the assessment of content validity and analyses of construct validity and criterion validity. Reliable and valid quality of lhfe questionnaires provide consistent and accurate information. The purpose of this paper is to provide crucial assessment and analyses of the reliability and validity of health related quality of life questionnaires.
Fulltext Fat content and EPA and DHA levels of selected marine, freshwater fish and shellfish species from the east coast of Peninsular Malaysia

Wan Rosli W. I., Rohana, A. J., Gan, S. H., Noor Fadzlina, H., Rosliza, H., Helmy, H., et al.

International Food Research Journal, 2012;19(3):815-821.
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The total lipid contents and the concentration of eicosapentaenoic (EPA) and docosahexaenoic
(DHA) fatty acid of fourteen selected marine, three freshwater fish species, four shellfish species and two selected canned fish species of East Coast of Peninsular Malaysia were determined. The fat content of all samples ranged from 1.01 % to 15.83 % with silver catfish reported to have the highest value. Most of the fish had fat amounts lower than 10% of their total weight. In general, DHA concentrations (50.50-165.21 µg/g) were significantly higher than EPA (11.12-55.38 µg/g) in all of the fish species analyzed. Among all marine fish species, the sixbar grouper recorded the highest concentration of DHA (165.21 µg/g) while barramundi had the highest concentration of EPA (55.38 µg/g). In conclusion, all fish and shellfish species are considered a good source of EPA and DHA, representing a very valuable essential nutrient for maintenance of human health.
Fulltext Type 2 diabetes mellitus patients with poor glycaemic control have lower quality of life scores as measured by the Short Form-36

Kamarul Imran M, Ismail AA, Naing L, Wan Mohamad WB

Singapore Med J, 2010 Feb;51(2):157-62.
PMID: 20358156

INTRODUCTION: This study aimed to compare the quality of life based on the Short Form-36 (SF-36) between two different groups of type 2 diabetes mellitus patients with glycaemic control: those with a glycosylated haemoglobin (HbA1c) level at or below 7.5 percent and those above 7.5 percent.
METHODS: In this cross-sectional study, a generic SF-36 questionnaire was self-administered to patients with type 2 diabetes mellitus. Based on the HbA1c level, the mean SF-36 scale scores were compared. The analysis of covariance was used to obtain the adjusted mean scores of the SF-36 scales while controlling for age and duration of type 2 diabetes mellitus.
RESULTS: 150 patients with type 2 diabetes mellitus were analysed. There were 63 (42 percent) women and 87 (58 percent) men, and their mean HbA1c level was 8.9 percent (SD 2.4 percent). When comparing the two groups of patients with different HbA1c levels, the adjusted means of four scales: physical health functioning, general health, social functioning and mental health, differed significantly between the two. The SF-36 scale scores in type 2 diabetes mellitus patients were also lower than those of the SF-36 norms for the Malaysian population.
CONCLUSION: Type 2 diabetes mellitus patients with poor glycaemic control had lower mean SF-36 scores in physical functioning, general health, social functioning and mental health, and the SF-36 scores in these patients were also lower than the SF-36 norms of the Malaysian population.
Fulltext Prevalence and risk factors of anti-tuberculosis drug-induced hepatitis in Malaysia

Marzuki OA, Fauzi AR, Ayoub S, Kamarul Imran M

Singapore Med J, 2008 Sep;49(9):688-93.
PMID: 18830542

Tuberculosis (TB) affects one-third of the world's population. Anti-TB drugs with isoniazid, rifampicin and pyrazinamide are very effective but they can cause hepatotoxicity. Many risk factors have been recognised. Data on prevalence of anti-TB drug-induced hepatitis as well as the contributing risk factors are scarce in Malaysia. This observational case control study was designed to look at the prevalence and the risk factors of drug-induced hepatitis in our population.
The reliability and validity of the Malay version of the 18-item audit of Diabetes Dependent Quality of Life (the Malay ADDQOL) questionnaire

Kamarul Imran M, Ismail AA, Naing L, Wan Mohamad WB

Southeast Asian J Trop Med Public Health, 2007 Mar;38(2):398-405.
PMID: 17539293

The objective of this study was to examine the reliability and validity of the Malay version of the 18-item Audit of Diabetes Dependent Quality of Life (the Malay ADDQOL). Patients with type 2 diabetes mellitus who fulfilled the inclusion criteria were systematically selected. The Malay ADDQOL linguistically validated from the 18-item English version ADDQOL was self-administered twice at a 1-week interval. Two hundred eighty-eight respondents were included in the study. Analysis involved checking the feasibility, floor and ceiling effects, internal consistency, test-retest reliability and factor analysis. Item means and standard deviations fulfilled the Likert scale assumptions. The Cronbach's alpha was 0.943 (lower bound of the 95% CI of 0.935) and the intraclass correlation coefficient was 0.81 (95% CI from 0.72 to 0.87). Exploratory one factor analysis showed factor loadings above 0.5 for all the 18 items. The Malay ADDQOL has acceptable linguistic validity. It is feasible, has excellent reliability, content, construct validity, and is recommended to be used among Malay-speaking diabetic patients.
Fulltext A study on the nutritional status of physically "active men in Kota Bharu"

Wan Nudri WD, Mohamed Rusli A, Wan Abdul Manan W, Mohd Rafi M, Naing L, Kamarul Imran M, et al.

Malays J Nutr, 2003 Sep;9(2):95-103.
PMID: 22691731

A cross-sectional comparative study was conducted to determine the nutritional status among physically active groups in Kota Bharu. The study population comprised 83 adult male athletes from 8 different types of sports (athlete group), 80 active men who exercised a minimum of 30 min per day for at least 3 times per week (exercise group), and 80 inactive men (sedentary group). All the respondents were aged between 18 to 44 years. Measurements taken from the respondents were anthropometric measurements, systolic (SBP) and diastolic (DBP) blood pressure, and serum total cholesterol (TC). The results showed that the combined prevalence of pre-obese (BMI 25.0-29.9) and obese (BMI ≥30.0) was 21.7% in athletes, 29.9% in exercise group, and 47.5% in sedentary group. The mean (± SD) percentage of body fat in athletes was 15.7 ± 5.4%, which was lower compared to the exercise (18.9 ± 5.5%) and sedentary (20.6 ± 5.8%) groups. The incidence of waist-to-hip ratio above 0.9 in athlete, exercise and sedentary groups was 9.6%, 18.7% and 31.3%, respectively. The incidence of hypertension (SBP ≥140 and/or DBP ≥90 mmHg) was 13.2% in athletes, 17.5% in exercise group and 42.5% in the sedentary group. The TC values showed that the prevalence of "high risk" individuals (TC ≥6.20 mmol/l) was also lower in athletes (20.5%), compared to the exercise (36.2%) and sedentary (47.5%) groups. The study revealed that individuals who are actively involved in physical activity, particularly in sport activities have better nutritional status compared to sedentary people. However, the nutritional status in the athlete and exercise groups was still unsatisfactory. The incidence of poor health status related to over nutrition in the active groups was rather high and needs attention from health professionals. Further studies are needed to determine nutritional practices among physically active groups.
Predictors of ischaemic heart disease in a Malaysian population with the metabolic syndrome

Yeow TP, Khir AS, Ismail AA, Ismail IS, Kamarul Imran M, Khalid BA, et al.

Diabet Med, 2012 Nov;29(11):1378-84.
PMID: 22803824 DOI: 10.1111/j.1464-5491.2012.03741.x

AIMS: Cardiovascular disease is the foremost cause of mortality in Malaysia but little is known about the prevalence of the metabolic syndrome and its associations with other known cardiovascular risk markers. We undertook a population-based study to examine these.
METHODS: For the study, 4341 subjects were selected using a multistage stratified sampling method. Subjects were interviewed for personal and past medical history. Biomedical markers and anthropometric indices were measured. The metabolic syndrome was defined using the harmonized criteria. The associations between the metabolic syndrome and cardiovascular risk markers, including high-sensitivity C-reactive protein, microalbuminuria and HbA(1c) were examined.
RESULTS: The prevalence of the metabolic syndrome was 42.5%. Subjects with the metabolic syndrome are significantly more likely to have higher BMI (> 25 kg/m(2)), HbA(1c) [≥ 42 mmol/mol (6.0%)], LDL (≥ 2.6 mmol/l), elevated albumin:creatinine ratio (> 2.5 μg/mmol creatinine for men, 3.5 μg/mmol creatinine for women) and high-sensitivity C-reactive protein (> 3 mg/l); odds ratio 5.48, 6.14, 1.44, 3.68 and 1.84, respectively, P < 0.001. The presence of an elevated albumin:creatinine ratio and high-sensitivity C-reactive protein are strong predictors for the presence of a higher number of positive criteria of the metabolic syndrome. HbA(1c) > 48 mmol/mol (6.5%) is associated with increased relative risk of elevated albumin:creatinine ratio, high-sensitivity C-reactive protein and LDL (relative risk 3.10, 2.46 and 1.65 respectively, P < 0.001).
CONCLUSIONS: We confirmed the high prevalence of the metabolic syndrome in Malaysia. Our study revealed a strong relationship between risk markers of elevated BMI, HbA(1c), LDL, albumin:creatinine ratio and high-sensitivity C-reactive protein with the presence of the metabolic syndrome, putting them at a statistically high risk for cardiovascular mortality.
Prognostic factors and survival rate of osteosarcoma: A single-institution study

Faisham WI, Mat Saad AZ, Alsaigh LN, Nor Azman MZ, Kamarul Imran M, Biswal BM, et al.

Asia Pac J Clin Oncol, 2017 Apr;13(2):e104-e110.
PMID: 25870979 DOI: 10.1111/ajco.12346

AIM: Osteosarcoma is a highly malignant primary bone tumor. The study aim to evaluate the prognostic factors influencing the survival rate in our center.
METHODS: This was a retrospective cohort study of all patients treated between January 2005 and December 2010.
RESULTS: We included 163 patients with an age range of 6-59 years (median = 19). The median follow-up was 47 months (range 36-84). The overall survival in patients who completed chemotherapy and surgery (n = 117) was 72% at 2 years and 44% at 5 years. Histologically, 99 (85%) had osteoblastic, 6 (5%) had chondroblastic and 3 (2.5%) had telangiectatic osteosarcoma. Limb salvage surgery was performed in 80 (49%) and 41 (25%) underwent amputation. However, 46 patients (28%) underwent no surgical intervention and incomplete chemotherapy. In total, 38/79 patients had a good chemotherapy response. There was a significantly better survival rate for limb salvage versus amputation. Independent prognostic factors for survival are compliance to treatment and presence of lung metastasis.
CONCLUSION: The overall survival of osteosarcoma patients was influenced by the presence of pulmonary metastases and compliance to treatment. Histological subtype, different chemotherapy regimens and histological necrosis after chemotherapy did not significantly influence survival. The patients who did not complete treatment had significantly poorer survival.