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Fulltext The prevalence of goitre in remote inland versus coastal areas

Osman A, Zaleha MI, Letchumen R, Khalid BA

Med J Malaysia, 1995 Sep;50(3):256-62.
PMID: 8926905

The study was conducted to compare the prevalence of goitre among Malays and Aborigines in remote inland rural areas to those in coastal areas. All subjects were examined thoroughly by an experienced endocrinologist for the presence of goitre. The overall goitre prevalence in coastal areas was 6.3%; 6.0% (4/67) of Aborigines and 6.7% (4/60) of Malays were affected. However, in remote inland areas, the prevalence of goitre was almost 5 times higher compared to coastal areas. The prevalence of goitre was 30.7% in Baling; 30.2% (19/63) Aborigines and 30.8% (92/299) Malays were affected. Iodine deficiency is the most likely cause for the high prevalence of goitre in the remote inland areas.
Prevalence, risk factors, and complications of violence against pregnant women in a hospital in Peninsular Malaysia

Khaironisak H, Zaridah S, Hasanain FG, Zaleha MI

Women Health, 2017 09;57(8):919-941.
PMID: 27636717 DOI: 10.1080/03630242.2016.1222329

Violence against women is a worldwide public health problem and becomes more crucial when it involves pregnant women. The primary aim of this study was to determine the prevalence of violence against pregnant women (VAPW), while the secondary aim was to identify the factors associated with violence and complications of violence during pregnancy. This was a cross-sectional study conducted in 1,200 postnatal women from March 1, 2015 through August 31, 2015 using a validated Malay Version of the WHO Women's Health and Life Experiences Questionnaire. Data on pregnancy complications were obtained from antenatal records and discharge summaries. The prevalence of any form of VAPW was 35.9%, consisting of: any psychological (29.8%); any physical (12.9%); and any sexual (9.8%) violence. VAPW was significantly associated with: (1) women's use of drugs, having had exposure to violence during childhood, having a violence-supporting attitude, having two or more children; and (2) having partners who were smokers, alcohol drinkers, or had controlling behavior. VAPW was significantly associated with anemia, urinary tract infection, premature rupture of membranes, antepartum hemorrhage, poor weight gain during pregnancy, low birth weight, and prematurity. In conclusion, the high prevalence of violence requires further research on preventive strategies for VAPW.
Fulltext Micronutrients and its correlation with mental performance among schoolchildren in Bario, Sarawak: a preliminary study

Zaleha MI, Noor Hayaati AR, Mohd Rizam AR, Jamaludin M, Osman A

Med J Malaysia, 2003 Aug;58(3):309-19.
PMID: 14750369

Children who are born in a community with insufficient micronutrients, particularly iodine in remote rural areas are associated with low intellectual functions and mental retardation. The aim of this cross-sectional study is to determine the mental performance of the schoolchildren in Bario, a highland settlement of the Kelabit people in the district of Baram, Sarawak and to determine its correlation with the availability of iodine in the environment, as well as other micronutrients such as selenium, copper and manganese. A total of 25 schoolchildren in Bario age ranging from 7 to 12 years old participated in the study. Mental performance of the schoolchildren were tested using TONI-2 (Test of Nonverbal Intelligence--second edition), a cognitive ability measures with a response format which eliminates language and reduces motoric and cultural factors. The iodine levels from several wells, soils and salt found in Bario were determined using HPLC (software version 3.05.01) whilst serum levels of selenium, copper and manganese were measured using Graphite Furnace Atomic Absorption Spectrophotometer (GFAAS). The results showed that the median and mode scores of intelligence quotient for Bario were 82 and 75, respectively, whilst median and mode scores of intelligence percentile were 11.0 and 5.0, respectively. The maximum score achieved were at the average level with the quotient score between 90-110. It was found that salt produced from one of the wells in Bario contained high quantity of iodine. Based on standards established by the Trace Elements Laboratory, Roben Institute, University of Surrey, United Kingdom, schoolchildren in Bario are having sufficient blood levels of copper and a high selenium and manganese levels. Despite the remoteness of the study area, the schoolchildren in Bario, Sarawak showed higher mental performance compared to other isolated areas. This is probably correlated with the high micronutrients availability, particularly iodine, found naturally in Bario.
Fulltext Patient satisfaction on waiting time and duration of consultation at Orthopedic Clinic, Universiti Kebangsaan Malaysia Medical Centre

Raja Lexshimi RG, Zaleha MI, Shamsul AS, Suriawati G

Medicine & Health, 2009;4(1):35-49.
MyJurnal

Patients are increasingly dissatisfied with the “waiting time” and “duration of consultation” at outpatient clinics. A cross sectional study was carried out to measure waiting time and duration of consultation and to examine patients’ level of satisfaction towards waiting time and duration of consultation at the Orthopedic Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This study also examined patient’s satisfaction towards the overall clinic services. Data was collected using a self-administered questionnaire. A total of 81 patients participated in this study with a response rate of 100 percent. Findings indicated a significant difference in the mean between expected waiting time level II (from the time the patient is given the calling number till the time patient is called into the doctor’s room) and the actual waiting time level II experienced. A significant difference in the mean between the expected duration of consultation and the actual duration of consultation experienced was also noted. However, no significant difference was found between the mean of expected waiting time level I (the time patient register at the counter till the patient is given the calling number) and the actual waiting time (p>0.05). Overall, patient satisfaction towards waiting time was low (29.6%) and duration of consultation was of moderate level (41.9%). The overall satisfaction towards the clinic services were of average level (56.8%). Findings also indicated that patient satisfaction was not influenced by socio-demographic factors of respondents such as age, ethnic, education level, occupation and income level. Important findings from this study may help staff managing the clinic in addressing patients’ complaint on waiting time and improve patients’ satisfaction on the overall services of the Orthopedic clinic in UKMMC.
Study site: Orthopedic clinc, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Fulltext Estimation of glomerular filtration rate using serum cystatin C in overweight and obese subjects

Marwyne MN, Loo CY, Halim AG, Norella K, Sulaiman T, Zaleha MI

Med J Malaysia, 2011 Oct;66(4):313-7.
PMID: 22299549 MyJurnal

Obesity and overweight are strong independent risk factors for chronic kidney disease (CKD). Using serum creatinine-based estimated glomerular filtration rate (eGFR) equations in these subjects may be inaccurate. On the other hand, cystatin C-based eGFR equations may overestimate CKD prevalence as recent findings suggest an association of cystatin C with obesity. The objective of this study was to assess the accuracy of a cystatin C-based eGFR equation compared to two creatinine -based eGFR equations in overweight and obese subjects.
Levels of thyroxine, TSH, thyroid volume and mental performance among Orang Asli in selected settlements in Malaysia

Osman A, Zaleha MI, Iskandar ZA, Tan TT, Ali MM, Roslan I, et al.

East Afr Med J, 1996 Apr;73(4):259-63.
PMID: 8706612

A significant difference in the levels of thyroxine (T4), thyroid stimulating hormone (TSH) and thyroid volume among settlements at various selected Orang Asli locations is reported. The levels improved according to the level of socio-economic development. No significant difference was found in mental performance by location.
The supplementation of levothyroxine among indigenous people in endemic goitre areas: The impact of therapy

Zaleha MI, Osman A, Iskandar ZA, Sazali S, Ali MM, Roslan I, et al.

Asia Pac J Clin Nutr, 1998 Jun;7(2):138-50.
PMID: 24393641

In order to study the effect of levothyroxine in the treatment of endemic goitre, a longitudinal study was conducted among the Aborigines in Lanai Post and Sinderut Post, situated in an iodine-deficient area located in the district of Kuala Lipis, Pahang. All subjects in the treatment group (Lanai Post) were given 100 µg of levothyroxine per day and were followed for 1 1/2 years. A total of 311 subjects were examined at baseline, 323 on the first, 256 on the second, 239 on the third and 184 on the fourth visit following levothyroxine supplementation. Goitre prevalence, thyroid hormones, thyroid volume, nutritional status, urinary iodine levels, arterial blood pressure and mental performance were determined. Following the intervention, goitre prevalence was significantly reduced in the treatment group (baseline 42.8% vs final visit 13.0%, p<0.0001); however, no significant difference was noted in the control group. Total T4 levels were increased in the treatment group (p<0.0001), while a significant reduction was noted in the control group (p<0.0001). Thyroid-stimulating hormone levels increased significantly in the treatment group following 1 year of intervention, while no significant changes were observed in the control group. As for the thyroid volume, both groups showed a significant increment following the intervention (p<0.0001). With respect to the nutritional status, the treatment group showed a significant increase in body weight following the intervention (p<0.05). In addition, the mid-arm circumference and body mass index also increased after 1 year of intervention. However, the control group showed a reduction in the waist-hip ratio (p<0.0001). Although there was no statistical difference in the waist-hip ratio in the treatment group, there has been a significant reduction observed after 1 year of intervention. At 1 year, a reduction in skinfold thickness was noted in the treatment group while only the triceps and subscapular were increased in the control group. The body fat was decreased in the treatment group following 1 year of intervention (p<0.0001). No particular trend was noted in the urinary iodine excretion in the treatment group, but surprisingly, the levels were increased in the control group (p<0.0001). A significant increase in both systolic and diastolic blood pressures was observed in the treatment group following 1 year of intervention, but the controls showed a reduction in the systolic blood pressure (p<0.0001). Both groups showed a remarkable increase in mental performance, with a more pronounced effect in the treatment group (p<0.05). The correction of iodine deficiency by levothyroxine supplementation has a short-term beneficial effect in reducing the prevalence of goitre and improving the mental ability among the Aborigines in endemic areas; however, proper monitoring and close supervision are needed to maintain compliance.
Self-reported bone fracture among Malaysian adults: Baseline findings of PURE Malaysia cohort study

Zaleha MI, Noor Hassim I, Azmi MT, Hasni MJ, Rosnah I, Abdul-Hamid H, et al.

Med J Malaysia, 2023 Nov;78(6):787-792.
PMID: 38031222

INTRODUCTION: In Malaysia, studies on self-reported bone fractures are scarce. Due to the fact that bone fractures may serve as an indicator of osteoporosis in the community, this study aimed to identify the factors associated with their occurrence among adults in Malaysia.
MATERIALS AND METHODS: Epidemiological data for selfreported bone fractures were obtained through direct interviews using a validated questionnaire from the Prospective Urban and Rural Epidemiology (PURE) study.
RESULTS: Of 15,378 respondents, 6.63% (n=1019) reported bone fractures, with a higher proportion of men (65.8%, n=671) than women (34.2%, n=348). Higher odds of selfreporting bone fractures were seen in males (aOR, 2.12; 95%CI: 1.69, 2.65), those with a history of injury (aOR 5.01; 95%CI: 3.10, 6.32) and those who were obese (aOR: 1.46; 95% CI: 1.13, 1.89), highly active (aOR 1.25; 95%CI: 1.02, 1.53), smokers (aOR 1.35; 95%CI: 1.11, 1.65) and alcohol consumers (aOR 1.67; 95%CI: 1.20,2.32).
CONCLUSION: Adopting a healthier lifestyle that includes a balanced diet and moderate physical activity is critical for weight loss, increased muscle and bone mass and better stability, which reduces the likelihood of fractures following a fall.