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Fulltext Easy way to learn standardization : direct and indirect methods

Naing NN

Malays J Med Sci, 2000 Jan;7(1):10-5.
PMID: 22844209

In direct age-adjustment, a common age-structured population is used as standard. This population may actually exist (e.g., United States population, 1999) or may be fictitious (e.g., two populations may be combined to create a standard). In indirect age-adjustment, a common set of age-specific rates is applied to the populations whose rates are to be standardized. The simplest and most useful form of indirect adjustment is the standardized mortality ratio (SMR) (5).
Fulltext Determination of sample size

Naing NN

Malays J Med Sci, 2003 Jul;10(2):84-6.
PMID: 23386802 MyJurnal

There is a particular importance of determining a basic minimum required 'n' size of the sample to recognize a particular measurement of a particular population. This article has highlighted the determination of an appropriate size to estimate population parameters.
Fulltext Factors related to smoking habits of male secondary school teachers

Naing NN, Ahmad Z

Southeast Asian J. Trop. Med. Public Health, 2001 Jun;32(2):434-9.
PMID: 11556602

A cross-sectional study was conducted to identify the factors related to smoking habits of secondary school teachers in Kelantan, Malaysia. A total of 180 male teachers and trainee teachers from four secondary schools in Kelantan and a Teachers' Training College were interviewed by using a structured questionnaire. Cluster sampling was applied. The significant findings found were current smokers were found as high as 40.56%. Mean duration of smoking was 6.8 years and mean initiation age was 16.5 years. Trainee teachers had a significantly higher proportion of current smokers. There was a significant association between smoking status of teachers and their fathers' and perception of the hazards of smoking on health. Peer influence was found to be the major reason for smoking among smokers. Religious belief and care for health attitude prevented non-smokers from smoking. About 3/5 of smokers thought of quitting smoking and of these 1/4 had tried at least once. There was a significant difference of proportion of attempted quitting between regular and occasional smokers. Mass media was the best source of information on knowledge about smoking hazards. Anti-smoking campaigns should start as early as possible in schools. Lectures and talks on smoking should be included in the curriculum of teachers' training courses.
Characteristics of HIV-infected tuberculosis patients in Kota Bharu Hospital, Kelantan from 1998 to 2001

Mohammad Z, Naing NN

Southeast Asian J. Trop. Med. Public Health, 2004 Mar;35(1):140-3.
PMID: 15272757

To characterize the demographic profiles, clinical features, radiological patterns and outcomes of treatment of HIV-infected TB patients, a descriptive study was carried out on 149 HIV-infected TB cases diagnosed from 1998 through 2001 at Kota Bharu Hospital, Kelantan, Malaysia. The majority of the patients were males (94.6%), single (45.0%), ethnic Malay (94.0%) with a mean age of 34 years (standard deviation 7.8, range 18-76). The most common HIV transmission category was through injecting drug use (73.8%) and being the inmates or former inhabitants of drug rehabilitation centers and prisons were the commonest high-risk groups. One hundred and seventeen patients were diagnosed as having pulmonary TB, while about 20% were extra-pulmonary in type with 9 cases of milliary TB. The majority (45%) presented with cough symptoms while only 51% had a positive sputum smear. Fifty-five percent were found to have pulmonary lesions on chest x-ray, such as localized, milliary or diffuse pulmonary infiltrates, or opacities. Eight (5.4%) had pleural lesions while another 8 cases had hilar or mediastinal lymph node lesions. Overall, fifty-eight (38.9%) patients had died by the completion of data collection. The median weeks or survival from the time of starting TB treatment was 13.5 (range 1-56) and the majority of them (74%) died without completing the 6-month regime of treatment.
Hydrocephalic children presenting to a Malaysian community-based university hospital over an 8-year period

Abdullah J, Naing NN

Pediatr Neurosurg, 2001 Jan;34(1):13-9.
PMID: 11275782

There are few local statistics on the incidence of hydrocephalus and the outcome of hydrocephalic shunts in the South East Asian region. We report a retrospective study on 285 hydrocephalic patients who underwent shunting procedures between 1990 and 1998 at the University Hospital Science Malaysia, a regional referral center. Multiple logistic regression analysis was applied to predict determinants of outcome in relation to the timing of diagnosis, other congenital abnormalities associated with the hydrocephalus, timing of surgery and cortical thickness from CT scan. The relationship of shunt infection was correlated to the age of the patient and surgical procedure. The predictors for developmental outcome reported by this study were age at diagnosis, type of brain abnormalities and gender. Time of operation and cortical thickness did not contribute to the outcome.
Fulltext Prevalence and ethnic distribution of helicobacter pylori infection among endoscoped patients in north eastern peninsular malaysia

Kaur G, Naing NN

Malays J Med Sci, 2003 Jul;10(2):66-70.
PMID: 23386799 MyJurnal

The objective of this study was to determine the prevalence and ethnic distribution of Helicobacter pylori infection in an endoscoped population in North Eastern Peninsular Malaysia.
Sociodemographic characteristics of food handlers and their knowledge, attitude and practice towards food sanitation: a preliminary report

Zain MM, Naing NN

Southeast Asian J. Trop. Med. Public Health, 2002 Jun;33(2):410-7.
PMID: 12236444

Diseases spread through food still remain a common and persistent problems resulting in appreciable morbidity and occasional mortality. Food handlers play an important role in ensuring food safety throughout the chain of production, processing, storage and preparation. This study is to explore the pattern of sociodemographic distribution and to determine knowledge, attitude and practice of food handlers towards food-borne diseases and food safety. A total of 430 food handlers were randomly selected from Kota Bharu district and interviewed by using structured questionnaire. Distribution of food handlers was Malays (98.8%), females (69.5%), married (81.4%), working in food stalls (64.2%), involved in operational areas (49.3%), having no license (54.2%) and immunized with Ty2 (60.7%). The mean age was 41 +/- 12 years and the mean income was RM 465 +/- 243/month. The educational level was found as no formal education (10.5%), primary school (31.9%), secondary school (57.0%) and diploma/degree holders (0.7%). A significant number of food handlers (57.2%) had no certificate in food handlers training program and 61.9% had undergone routine medical examinations (RME). Almost half (48.4%) had poor knowledge. Multiple logistic regression showed type of premise [Odd ratio (OR) = 4.0, 95% Confidence interval (CI) =1.8-7.5, p = 0.0004], educational level (OR = 4.0, 95% CI = 1.8-7.4, p = 0.0003) and job status of food handlers (OR = 0.5, 95% CI = 0.3-0.8, p = 0.0031) significantly influenced the level score of knowledge. No significant difference of attitude and practice between trained and untrained food handlers. Findings of this preliminary study may help in planning health education intervention programs for food handlers in order to have improvement in knowledge, attitude and practice towards food-borne diseases and food safety. Furthermore, it will in turn reduce national morbidity and mortality of food-borne diseases.
Fulltext Ascariasis, trichuriasis, and growth of schoolchildren in Northeastern Peninsular Malaysia

Raj SM, Naing NN

Southeast Asian J. Trop. Med. Public Health, 1998 Dec;29(4):729-34.
PMID: 10772554

A study to determine the effect of antihelminthic treatment on growth and nutritional status was undertaken on 103 children in the second grade of primary school, 71 of whom were found to be infected with Ascaris lumbricoides or Trichuris trichiura. The median Ascaris and Trichuris intensities in the infected group were 19,600 (range; 0-488,000) and 2,800 (range; 0-84,600) eggs per gram of feces respectively. Forty-three children harbored both types of worm. Fourteen weeks after two 400 mg doses of albendazole were administered to infected children, the increases in weight, height, weight for age, height for age and weight for height were significantly higher among infected children than controls who were uninfected at baseline. The observed gains were independent of sex and socioeconomic status. Decrease in log transformed Trichuris intensity correlated with increases in weight (r=0.24; p=0.02) and weight for age (r=0.20; p=0.06) but decrease in Ascaris intensity did not correlate with increases in any of the anthropometric parameters. The results suggest that antihelminthic treatment has beneficial short-term effects on growth and nutritional status of a modest magnitude among early primary schoolchildren in the area.
Fulltext Lung function and cognitive performance of primary school children exposed to secondhand smoke at home in Kota Bharu, Kelantan

Sharina D, Zulkifli A, Naing NN

Malaysian Journal of Public Health Medicine, 2004;4(2):19-23.
MyJurnal

Exposure to secondhand smoke has consistently been linked to adverse health effects in children, including reduced lung function and various respiratory diseases. There is also increasing evidence that secondhand smoke exposure is associated with cognitive impairment and behavioral problems in children, This cross sectional study was done on 795 chiildren to determine the association between secondhand smoke exposure and peak expiratory flow rate (PEFR) and cognitive performance among the primary school children in Kota Bharu Kelantan. A questionnaire was used to obtain information on socio-demography and smoking status of the household. The PEER was measured using a child Mini Wright peak expiratory flow meter while cognitive performance was assessed by four subtests of Weschler Intelligence Scale For Children (WISC III). Data analysis was done using SPSS version 11. Children were classified as exposed to secondhand smoke when at least one househoH member smoked. There were 442 (55 .6%) children exposed to secondhand smoke at home. The mean (SD) PEFR for unexposed and exposed children were 266.18 (60.80) l/min and 266 .06 (57. 70) l/min respectively, The mean (SD) scores for Digit Span Forward, Digit Span Backward Coding and Arithmetic in unexposed chiMren were 6.84 (1.80), 4.Z7(1.68), 45.25 (9,99) and 8.04 (1.04) respectively. The mean (SD) scores for exposed children were 6.73 (1 .77). 4.07 (l .65), 45.1 I (1 I ,03) and 8.13 (1 .00) respectively. Multivariate analysis of variance showed no signincant dijference in the PEFR (p=O.816) and the cognitive scores between exposed and unexposed primary school children in Kota Bharu, Kelantan
Five-year survival and median survival time of nasopharyngeal carcinoma in Hospital Universiti Sains Malaysia

Siti-Azrin AH, Norsa'adah B, Naing NN

Asian Pac J Cancer Prev, 2014;15(15):6455-9.
PMID: 25124642

BACKGROUND: Nasopharyngeal carcinoma (NPC) is the fourth most common cancer in Malaysia. The objective of this study was to determine the five-year survival rate and median survival time of NPC patients in Hospital Universiti Sains Malaysia (USM).
METHODS: One hundred and thirty four NPC cases confirmed by histopathology in Hospital USM between 1st January 1998 and 31st December 2007 that fulfilled the inclusion and exclusion criteria were retrospectively reviewed. Survival time of NPC patients were estimated by Kaplan-Meier survival analysis. Log-rank tests were performed to compare survival of cases among presenting symptoms, WHO type, TNM classification and treatment modalities.
RESULTS: The overall five-year survival rate of NPC patients was 38.0% (95% confidence interval (CI): 29.1, 46.9). The overall median survival time of NPC patients was 31.30 months (95%CI: 23.76, 38.84). The significant factors that altered the survival rate and time were age (p=0.041), cranial nerve involvement (p=0.012), stage (p=0.002), metastases (p=0.008) and treatment (p<0.001).
CONCLUSION: The median survival of NPC patients is significantly longer for age≤50 years, no cranial nerve involvement, and early stage and is dependent on treatment modalities.
Fulltext Spectrum of thyroid lesions in hospital Universiti Sains Malaysia over 11years and a review of thyroid cancers in Malaysia

Othman NH, Omar E, Naing NN

Asian Pac J Cancer Prev, 2009;10(1):87-90.
PMID: 19469631

INTRODUCTION: Endemic goitre is a major concern in many nations including Malaysia. Seven states in the country have been identified by Ministry of Health of Malaysia to have high incidence of goitre and one of these is Kelantan.

METHODS: This is a retrospective study over an 11-year period from 1994 to 2004 on all thyroid specimens submitted to the Pathology Department, Hospital Universiti Sains Malaysia (HUSM), in Kelantan. Epidemiological data were retrieved from the patients' records and pathology findings from the pathology reports.

RESULTS: During this period, Department of Pathology HUSM received a total of 1,486 thyroid specimens. The female to male ratio was 6:1 and the median age was 40.0 years. The duration of goitre ranged from one to 15 years. Histopathological examination showed 71.9 percent were non-neoplastic and 28.1 percent neoplastic lesions. The hospital-based incidence of nodular hyperplasia was 9.9 per 100,000 admitted patients per year. The hospital-based incidence of all types of malignant thyroid cancers was 3.5 per 100,000. The most common malignancy was papillary carcinoma 76.6 percent. The majority of the cancers (59.5 percent) occurred in a background of nodular hyperplasia. Thyroid cancers made up 4.9 percent of all cancers seen in HUSM.

CONCLUSION: This study suggests that malignant thyroid lesions arising from multi-nodular goitre are high in a population living in an iodine-deficiency area.
Fulltext Helicobacter pylori infection in peptic ulcer disease: the importance of smoking and ethnicity

Pillay KV, Htun M, Naing NN, Norsa'adah B

Southeast Asian J. Trop. Med. Public Health, 2007 Nov;38(6):1102-10.
PMID: 18613553

This study was conducted to determine the prevalence of Helicobacter pylori (H. pylori) and its associated factors among patients with peptic ulcer disease in Taiping Hospital. Consecutive peptic ulcer disease patients who had undergone esophagogastro-duodenoscopy were included. The H. pylori status was assessed by the rapid urease test. We excluded those who had active bleeding, a perforated peptic ulcer, severe vomiting, a history of gastric surgery, peptic ulcer disease or renal or liver diseases, carcinoma of the stomach, and recent use of antibiotics or proton pump inhibitors. Socio-demography, H. pylori status, medication history and other relevant clinical data were collected from case notes. A total of 416 subjects were selected, 49.7% were positive and 50.3% were negative for H. pylori infection. There were significant associations between H. pylori and age, ethnicity, smoking status and NSAID usage. However, there were no significant relationships between H. pylori status and gender or type of peptic ulcer. Multiple logistic regression showed that other ethnicities than Malays and smokers had a higher risk of H. pylori. Our prevalence rate was low and the identified risk factors were consistent with previous studies. Ethnic differences may be related to genetic and sociocultural behaviors. Quitting smoking may benefit peptic ulcer patients with H. pylori infection.
Perception of students about the problem-based learning sessions conducted for medical and dental schools' students of Universiti Sains Malaysia

Barman A, Jaafar R, Naing NN

Educ Health (Abingdon), 2006 Nov;19(3):363-8.
PMID: 17178518
Trichuriasis: localized inflammatory responses in the colon

Kaur G, Raj SM, Naing NN

Southeast Asian J. Trop. Med. Public Health, 2002 Jun;33(2):224-8.
PMID: 12236416

Most patients with trichuriasis have light worm burdens. Data regarding the inflammatory response to Trichuris worms in the colon of lightly infected persons are scant. Nine patients whose Trichuris infection was found by colonoscopy had biopsies taken from a site adjacent to visible worms and from a second site some 20 cm distally. The biopsies were studied by routine and immunohistochemical methods. None of the biopsies showed mucosal ulceration, significant congestion, fibrosis, gland distortion or goblet cell mucin depletion. There was no difference between worm and worm-free sites in terms of edema, lymphoid follicles or epithelial slough. Worm sites had higher numbers of eosinophils, neutrophils and total inflammatory cells and lower numbers of plasma cells. However there was no difference in lymphocyte, mast cell, and B- and T-cell counts between the two sites. This suggests that the T. trichiura worm incites a local inflammatory response involving eosinophils and neutrophils, even when the colon has only a light burden of worms.
Stereotactic neuroendoscopic management of hydrocephalus: a three-year follow-up and analysis of Malaysian children with aqueduct stenosis

Abdullah J, Ariff AR, Ghazaime G, Naing NN

Stereotact Funct Neurosurg, 2001;76(3-4):175-80.
PMID: 12378096

The beneficial effects of stereotactic third ventriculostomy versus ventriculoperitoneal shunt were evaluated in 62 paediatric patients and analysed in relation to age, sex, clinical history, presence of meningomyelocele, magnetic resonance imaging measurements of hydrocephalus and third ventricle floor size. The third ventriculostomy were done on 50 patients using the Richard-Wolf Caemaert Endoscope and the Leksell Stereotactic Frame Model G. These patients were operated using the 4-French Fogarty catheter to open the base of the third ventricle. During the same period of study 12 paediatric patients with aqueduct stenosis who were managed by ventriculoperitoneal shunt were included. Both surgical procedures were compared. Statistically univariate analysis revealed that those patient with an age group of more than six months undergoing ventriculostomy had good outcome. Multivariate analysis revealed that past history of haemorrhage and/or meningitis were predictors of poor outcome. Sex, size of lumbar meningocele at birth, abnormal ventricular anatomy or narrow third ventricular floor size were non predictors of bad outcome in these patients. There was no difference in outcome in both the shunt or ventriculostomy group.
Fulltext Prognostic factors of nasopharyngeal carcinoma patients in a tertiary referral hospital: a retrospective cohort study

Siti-Azrin AH, Norsa'adah B, Naing NN

BMC Res Notes, 2017 Dec 06;10(1):705.
PMID: 29212521 DOI: 10.1186/s13104-017-2990-1

BACKGROUND: Nasopharyngeal carcinoma (NPC) exhibits a distinctive racial and geographic distribution. Many studies have reported varied significant prognostic factors affect the survival of NPC patients. Hence, this current study aimed to identify the prognostic factors of NPC patients registered in a tertiary referral hospital.
METHODS: The records of one hundred and thirty-four NPC cases confirmed by histopathology in Hospital Universiti Sains Malaysia (USM) between 1st January 1998 and 31st December 2007 that fulfilled the inclusion and exclusion criteria were retrospectively reviewed. Simple and multiple Cox proportional hazard regression analyses were performed to determine the significant prognostic factors affect the survival of NPC patients.
RESULTS: The mean (SD) age of patients diagnosed with NPC was 48.12 (15.88) years with Malay was the largest ethnic group compared to other ethnicities. Most of patients had locally advanced stage IV (40.6%) and stage III (39.1%) of NPC. The overall median survival time of NPC patients was 31.30 months (95% CI 23.76, 38.84). The significant prognostic factors that influenced the survival of NPC patients were older age (HR 1.03, 95% CI 1.01, 1.04), metastases (HR 2.52, 95% CI 1.01, 6.28) and stage IV disease (HR 4.50, 95% CI 1.66, 9.88).
CONCLUSION: Older age, the presence of metastases and late stage are significant prognostic factors that influence the survival of NPC. Therefore, it is important to provide education to public and to raise awareness to diagnose NPC at an earlier stage and before the presence of metastases.
Fulltext Prognostic factors of differentiated thyroid cancer patients in Hospital Universiti Sains Malaysia

Voralu K, Norsa'adah B, Naing NN, Biswal BM

Singapore Med J, 2006 Aug;47(8):688-92.
PMID: 16865209

The aim of this study was to identify the prognostic factors that influence the survival of differentiated thyroid cancer patients treated at Hospital Universiti Sains Malaysia (HUSM).
Fulltext Angioarchitecture of brain arteriovenous malformations and the risk of bleeding: an analysis of patients in northeastern malaysia

Kandai S, Abdullah MS, Naing NN

Malays J Med Sci, 2010 Jan;17(1):44-8.
PMID: 22135525

Central nervous system arteriovenous malformation (AVM) is a vascular malformation of the brain and involves entanglement of veins and arteries without an intervening capillary bed. Affecting predominantly young male patients, AVM presents with different clinical manifestations namely headache, seizures, neurological deficit and intracranial haemorrhage. The patients who present acutely with intracranial bleeding have a significant morbidity and mortality. The aim is to study the angioarchitecture of brain AVM (BAVM) and determine the risk factors for intracranial bleeding. Ultimately, the goal of the study is to look for the association between volume of haematoma and architecture of BAVM.
Survival and prognostic factors in Malaysian acute myeloid leukemia patients after allogeneic haematopoietic stem cell transplantation

Mangantig E, Naing NN, Norsa'adah B, Azlan H

Int J Hematol, 2013 Aug;98(2):197-205.
PMID: 23719676 DOI: 10.1007/s12185-013-1373-1

Studies of survival outcomes in acute myeloid leukemia (AML) patients treated with allogeneic haematopoietic stem cell transplantation (HSCT) are essential for planning patient care. The objectives of the present study were to determine overall survival (OS) and disease-free survival (DFS) in AML patients treated with allogeneic HSCT, and to identify prognostic factors associated with poor outcome. This study was conducted retrospectively, using data from the Blood and Bone Marrow Transplant, National Transplant Registry, Malaysia. All cases of AML treated with allogeneic HSCT registered at the registry between 1st January 1987 and 31st December 2010 were included in the study. A total of 300 patients were included for final analysis. The Kaplan-Meier method and Cox proportional hazard regression were used for statistical analysis. The overall 10-year OS and DFS for Malaysian AML patients after allogeneic HSCT were 63 and 67 %, respectively. Donor gender, marrow status, and conditioning intensity were identified as important prognostic factors for overall survival, whereas the significant prognostic factors for disease-free survival were ethnic group, donor gender, marrow status, and conditioning intensity. In conclusion, the survival outcomes for Malaysian AML patients treated with allogeneic HSCT were good, and this treatment should be considered the standard therapeutic approach for suitable candidates.
Oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia, Kelantan

Razak AA, Saddki N, Naing NN, Abdullah N

Asian Pac J Cancer Prev, 2010;11(1):187-91.
PMID: 20593955

AIMS: This study was performed to determine oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia (HUSM), Kelantan.
METHODS: The medical records of 118 Malay patients with oral cancer admitted in HUSM from 1st January 1986 to 31st December 2005 were reviewed. Data collected include socio-demographic background, high-risk habits practiced, clinical and histological characteristics, and treatment profile of the patients. Survival status and duration were determined by active validation until 31st December 2006. Data entry and analysis were accomplished using SPSS version 12.0. The Kaplan-Meier method was used to perform survival estimates while the log-rank test and the Cox proportional hazards regression model were employed to perform univariate analysis and multivariable analysis of the variables, respectively.
RESULTS: The overall five-year survival rate of Malay patients with oral cancer was 18.0%, with a median survival time of 9 months. Significant factors that influenced survival of the patients were age, sex, tumour site, TNM stage, histological type, and treatment received.
CONCLUSION: Survival of oral cancer patients in HUSM was very low. Being elderly, male, presenting with an advanced stage at diagnosis, and not having treatment all contributed to poor survival.

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