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5. Benchmarking Diet Quality to Assess Nutritional Risk in Hemodialysis Patients: Applying Adequacy and Moderation Metrics of the Hemodialysis-Healthy Eating Index

Author

Cheak, Bee Boon, Ahmad, Ghazali, Bak Leong, Goh, Soo Kun, Lim, Visvanathan, Ravindran, Yahya, Rosnawati, Bavanandan, Sunita, Morad, Zaki, Sualeheen, Ayesha, Khor, Ban-Hock, Balasubramanian, Gaiyal Villy, Sahathevan, Sharmela, Chinna, Karuthan, Mat Daud, Zulfitri Azuan, Khosla, Pramod, Abdul Gafor, Abdul Halim, and Karupaiah, Tilakavati

Published
2022
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6. Feasibility of supported self-management with a pictorial action plan to improve asthma control

Author

Sazlina, Shariff Ghazali, Lee, Ping Yein, Cheong, Ai Theng, Hussein, Norita, Pinnock, Hilary, Salim, Hani, Liew, Su May, Hanafi, Nik Sherina, Abu Bakar, Ahmad Ihsan, Ng, Chiu-Wan, Ramli, Rizawati, Mohd Ahad, Azainorsuzila, Ho, Bee Kiau, Mohamed Isa, Salbiah, Parker, Richard A., Stoddart, Andrew, Pang, Yong Kek, Chinna, Karuthan, Sheikh, Aziz, and Khoo, Ee Ming

Published
2022
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8. Seizure Incidence among Children Hospitalized with COVID-19 during the Omicron Wave.

Author

Eow, Sze Pei, Chua, Ker Yang, Chinna, Karuthan, Mohamed, Sitti Sulhoon, and Mohamed, Ahmad Rithauddin

Subjects
CORONAVIRUS diseases, SARS-CoV-2 Omicron variant, HOSPITAL admission & discharge, INTENSIVE care units
Abstract

Purpose: Since late 2019, coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. Some children with COVID-19 present with seizures; in particular, studies have reported an increase in seizure episodes during the Omicron wave of the pandemic. This study was performed to describe the clinical characteristics of seizures among children hospitalized with COVID-19 before and during the Omicron wave. Methods: A retrospective cross-sectional study was conducted on all pediatric admissions for COVID-19 at Hospital Tunku Azizah from June 2021 to May 2022. Results: During this period, 1,586 children were admitted with COVID-19, of whom 111 (7.0%) experienced seizures. Patients with seizures were more likely to have a history of seizure (odds ratio [OR], 71.4; 95% confidence interval [CI], 23.7 to 215.2; P<0.001) and prior antiseizure medication use (OR, 55.1; 95% CI, 6.1 to 497.4; P<0.001). Most seizures (55.0%) occurred on the first day of illness, with 86.5% lasting less than 5 minutes. None of the children required intubation or admission to the pediatric intensive care unit, and all were discharged without complications. Between June 2021 and January 2022, the seizure rate varied from 1.3% to 3.4%; however, it increased to 18% in April 2022, coinciding with the period of Omicron variant predominance in Malaysia. Children admitted during the Omicron wave had significantly higher odds of experiencing seizures (OR, 7.89; 95% CI, 2.07 to 13.07; P<0.001) than children hospitalized prior to this wave. Conclusion: In conclusion, the study revealed a marked increase in seizures associated with pediatric COVID-19 cases during the Omicron wave. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Habitual Dietary Patterns of Patients on Hemodialysis Indicate Nutritional Risk

Author

Cheak, Bee Boon, Ahmad, Ghazali, Goh, Bak Leong, Lim, Soo Kun, Visvanathan, Ravindran, Yahya, Rosnawati, Bavanandan, Sunita, Morad, Zaki, Sualeheen, Ayesha, Khor, Ban-Hock, Balasubramanian, Gaiyal V., Sahathevan, Sharmela, Ali, Mohammad Syafiq M., Narayanan, Sreelakshmi S., Chinna, Karuthan, Daud, Zulfitri Azuan M., Khosla, Pramod, Gafor, Abdul Halim A., and Karupaiah, Tilakavati

Published
2020
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21. Mitigation of COVID-19 Risk Among Older Adults in Nursing Homes: A Public Survey

Author

Lee, Wang Ling., DeWitt, Dorothy, Chui, Ping Lei, Sahibudeen, Abdul Kadir Shah, Nurumal, Mohd Said, Chinna, Karuthan, and Chong, Mei Chan

Subjects
Nursing home patients -- Health aspects, Nursing homes -- Safety and security measures, Health, Seniors
Abstract

The current study examines the public's perception on the mitigation of COVID-19 risk and knowledge of disease symptoms among older adults in nursing homes, with the intention to address gaps in knowledge using mobile technologies. An online survey questionnaire was completed by 611 adults residing in Malaysia. The four domains, derived from factor analysis, affirmed the supportive perception among the public (score range = 4.42 to 4.64/5.0). However, among the gaps identified were the perception toward hand sanitizing and susceptibility of older adults to COVID-19. Public knowledge on symptoms of COVID-19 was limited (e.g., 41.4% to 53.4% incorrect responses to anosmia, diarrhea, confusion). Multivariate analysis of variance found that males and participants with less education had significantly lower supportive perceptions (p < 0.05). With >86% of participants having access to internet communication technology, mobile interventions tailored to gender and educational level are recommended to promote long-term pandemic preparedness among stakeholders and the public. [Journal of Gerontological Nursing, 47(3), 23–28.], The coronavirus disease, or COVID-19, poses an unprecedented challenge to public health, specifically among the 962 million older adults worldwide (United Nations, Department of Economic and Social Affairs, Population Division, [...]

Published
2021
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28. Asthma control and care among six public health clinic attenders in Malaysia:A cross-sectional study

Author

Hussein, Norita, Liew, Su May, Hanafi, Nik Sherina, Lee, Ping Yein, Cheong, Ai Theng, Shariff-Ghazali, Sazlina, Chinna, Karuthan, Pang, Yong-Kek, Kassim, Asiah, Parker, Richard A, Schwarze, Jürgen, Sheikh, Aziz, Pinnock, Hilary, and Khoo, Ee Ming

Subjects
primary care, risk factors, asthma, asthma control
Abstract

BACKGROUND AND AIMS: Asthma is common in Malaysia but neglected. Achieving optimal asthma control and care is a challenge in the primary care setting. In this study, we aimed to identify the risk factors for poor asthma control and pattern of care among adults and children (5-17 years old) with asthma attending six public health clinics in Klang District, Malaysia.METHODS: We conducted a cross-sectional study collecting patients' sociodemographic characteristics, asthma control, trigger factors, healthcare use, asthma treatment, and monitoring and use of asthma action plan. Descriptive statistics and stepwise logistic regression were used in data analysis.RESULTS: A total of 1280 patients were recruited; 85.3% adults and 14.7% children aged 5-17 years old. Only 34.1% of adults had well-controlled asthma, 36.5% had partly controlled asthma, and 29.4% had uncontrolled asthma. In children, 54.3% had well-controlled asthma, 31.9% had partly controlled, and 13.8% had uncontrolled asthma. More than half had experienced one or more exacerbations in the last 1 year, with a mean of six exacerbations in adults and three in children. Main triggers for poor control in adults were haze (odds ratio [OR] 1.51; 95% confidence interval [CI] 1.13-2.01); cold food (OR 1.54; 95% CI 1.15-2.07), extreme emotion (OR 1.90; 95% CI 1.26-2.89); air-conditioning (OR 1.63; 95% CI 1.20-2.22); and physical activity (OR 2.85; 95% CI 2.13-3.82). In children, hot weather (OR 3.14; 95% CI 1.22-8.11), and allergic rhinitis (OR 2.57; 95% CI 1.13-5.82) contributed to poor control. The majority (81.7% of adults and 64.4% of children) were prescribed controller medications, but only 42.4% and 29.8% of the respective groups were compliant with the treatment. The importance of an asthma action plan was reported less emphasized in asthma education.CONCLUSION: Asthma control remains suboptimal. Several triggers, compliance to controller medications, and asthma action plan use require attention during asthma reviews for better asthma outcomes.

Published
2023

32. Metering Self-Reported Adherence to Clinical Outcomes in Malaysian Patients with Hypertension: Applying the Stages of Change Model to Healthful Behaviors in the CORFIS Study

Author

Karupaiah, Tilakavati, Wong, Kimberly, Chinna, Karuthan, Arasu, Kanimolli, and Chee, Winnie Siew Swee

Abstract

The CORFIS ("Community-Based Cardiovascular Risk Factors Intervention Strategies") program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in CORFIS patients with hypertension. Based on submitted diet and exercise records (n = 209), adherence to sodium reduction, regular exercise, and increasing fruit and vegetable intake behaviors were quantified against weight, waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) changes. Patients were categorized at 6 months into nonadherent/N-A (Precontemplation, Contemplation, and Preparation), newly adherent/NA (Action) and totally adherent/TA (Maintenance) groups. Self-reported adherence records did not meet recommended targets for healthful behaviors, but clinical benefits were achieved by adherent groups as indicated by effect size (Cohen's d) comparisons. SBP reduction was associated with adherence to sodium reduction in NA (d = 0.60, p < 0.001) and TA (d = 0.45, p < 0.001) compared to N-A (d = 0.13, p > 0.05). Marginally increasing fruit and vegetable consumption (? = 0.41 servings) resulted in sizeable reductions in weight for NA (d = 0.81, p < 0.001) > TA (d = 0.54, p < 0.001) > N-A (d = 0.21, p > 0.05) and in WC for NA (d = 0.68, p < 0.00) > TA (d = 0.53, p < 0.001) > N-A (d = 0.52, p > 0.05). Exercise behavior was least successful as pedometer counting was below 10,000 steps but sizeable weight and WC reductions were largest for NA (d = 0.71 and 0.79, respectively) > TA (d = 0.60 and 0.53, respectively) > N-A (d = 0.33 and 0.35, respectively). Patients reporting a shift to positive stages of change behaviors enjoyed clinically beneficial reductions in SBP, DBP, weight, and WC.

Published
2015
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41. Statistical Significance, Effect Size and Confidence Intervals

Author

Chinna, Karuthan

Subjects
Confidence Intervals, Statistical Significance, Effect Size
Abstract

Article Type:Editorial Title: Statistical Significance, Effect Size and Confidence Intervals Year:2022;Volume:2;Issue:4;Page No:3–4 Author:Karuthan Chinna https://doi.org/10.55349/ijmsnr.20222434 Affiliation: Professor, Faculty of Business and Management, UCSI University, Malaysia.Email ID:karuthan@ucsiuniversity.edu.myPhone No:+60 12 3758255 Article Summary:Submitted:26-October-2022;Revised:14-November-2022;Accepted:02-December-2022;Published:31-December-2022

Published
2022

42. Lower Limb Lymphedema Successfully Treated with Flap Monitoring – A Case Report

Author

Krishnasamy, Karthikayini, Abdullah, Haleematus Saadiah, and Chinna, Karuthan

Subjects
flap care, vacuum assisted closure, Lymphedema
Abstract

Background: Lymphedema is a chronic, progressive pathologic condition of the lymphatic system with interstitial accumulation of protein-rich fluid and inflammation, adipose tissue hypertrophy and fibrosis. Protein-rich lymph initiates inflammatory response and increase susceptibility to infections, which can lead to disfigurement or dermal changes. Case Report: A 42-year-old lady was referred to a tertiary care hospital for chronic lymphedema of the left lower limb. She has been having this ailment for the past 20 years, she has a history of traumatic injury of left ankle and the swelling gradually increase in size over the years and developed pulmonary embolism a few years ago. Flap monitoring was done on this patient frequently. During the stay, vacuum assisted closure (VAC) dressing was applied after free muscle coverage of the lower extremity. The patient was given health education on skin care to improve hydration and lower the risk of infection by applying moisturizing emollient to soothe and support the skin. Keywords:Lymphedema, flap care, vacuum assisted closure

Published
2022

46. Feasibility of supported self-management with a pictorial action plan to improve asthma control

Author

Shariff-Ghazali, Sazlina, Lee, Ping Yein, Cheong, Ai Theng, Hussein, Norita, Pinnock, Hilary, Salim, Hani, Su May, Liew, Nik Hanafi, Nik Sherina, Ihsan Abu Bakar, Ahmad, Ng, Chiu-wan, Ramli, Rizawati, Mohd Ahad, Azainorsuzila, Kiau Ho, Bee, Mohamed Isa, Salbiah, Parker, Richard A, Stoddart, Andrew, Pang, Yong-Kek, Chinna, Karuthan, and Ee Ming, Khoo

Abstract

Supported self-management reduces asthma-related morbidity and mortality. This paper is on a feasibility study, and observing the change in clinical and cost outcomes of pictorial action plan use is part of assessing feasibility as it will help us decide on outcome measures for a fully powered RCT. We conducted a pre-post feasibility study among adults with physician-diagnosed asthma on inhaled corticosteroids at a public primary care clinic in Malaysia. We adapted an existing pictorial asthma action plan. The primary outcome was asthma control, assessed at 1, 3, and 6 months. Secondary outcomes included reliever use, controller medication adherence, asthma exacerbations, emergency visits, hospitalisations, days lost from work/daily activities and action plan use. We estimated potential cost savings on asthma related care following plan use. About 84% (n=59/70) completed the 6-months follow-up. The proportion achieving good asthma control increased from 18 (30.4%) at baseline to 38 (64.4%) at 6-month follow-up. The proportion of at least one acute exacerbation (3-months:%difference-19.7; 95%CI-34.7 to -3.1; 6-months:%difference-20.3; 95%CI-5.8 to -3.2), one or more emergency visit (1-month:%difference -28.6; 95%CI-41.2 to -15.5; 3-months:%difference-18.0; 95%CI-32.2 to -3.0;6-months:%difference-20.3; 95%CI-34.9 to -4.6), and one or more asthma admission (1-month:%difference-14.3; 95%CI-25.2 to -5.3; 6-months:% difference-11.9; 95%CI-23.2 to -1.8) improved over time. Estimated savings for the 59 patients at 6 months follow-up and each patient over the 6 months were RM15,866.22 (USD3,755.36) and RM268.92 (USD63.65), respectively. Supported self-management with a pictorial asthma action plan was associated with an improvement in asthma control and potential cost savings in Malaysian primary care patients.

Published
2022

47. Teacher Reporting Attitudes Scale (TRAS): Confirmatory and Exploratory Factor Analyses with a Malaysian Sample

Author

Choo, Wan Yuen, Walsh, Kerryann, Chinna, Karuthan, and Tey, Nai Peng

Abstract

The Teacher Reporting Attitude Scale (TRAS) is a newly developed tool to assess teachers' attitudes toward reporting child abuse and neglect. This article reports on an investigation of the factor structure and psychometric properties of the short form Malay version of the TRAS. A self-report cross-sectional survey was conducted with 667 teachers in 14 randomly selected schools in Selangor state, Malaysia. Analyses were conducted in a 3-stage process using both confirmatory (stages 1 and 3) and exploratory factor analyses (stage 2) to test, modify, and confirm the underlying factor structure of the TRAS in a non-Western teacher sample. Confirmatory factor analysis did not support a 3-factor model previously reported in the original TRAS study. Exploratory factor analysis revealed an 8-item, 4-factor structure. Further confirmatory factor analysis demonstrated appropriateness of the 4-factor structure. Reliability estimates for the four factors--commitment, value, concern, and confidence--were moderate. The modified short form TRAS (Malay version) has potential to be used as a simple tool for relatively quick assessment of teachers' attitudes toward reporting child abuse and neglect. Cross-cultural differences in attitudes toward reporting may exist and the transferability of newly developed instruments to other populations should be evaluated.

Published
2013
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48. Pulmonary dysfunction in overweight and obese children with obstructive sleep apnoea.

Author

Kasim, Aina Salwa, Golbabapour, Shahram, Zaini, Azriyanti Anuar, Peng, Eg Kah, Jalaludin, Muhammad Yazid, Nathan, Anna Marie, Chinna, Karuthan, and Thavagnanam, Surendran

Subjects
SLEEP apnea syndromes, OVERWEIGHT children, VITAL capacity (Respiration), BODY mass index, OXYGEN saturation, CHILDHOOD obesity, PHYSICAL fitness
Abstract

Introduction: Overweight and obese children are at risk of obstructive sleep apnoea (OSA) and abnormal pulmonary function (PF). Aim: Investigate the relationship between body mass index (BMI), OSA on PF in children. Materials & Method: Seventy‐four children were recruited. Mixed obstructive apnoea‐hypopnea index (MOAHI), BMI, oxygen saturation (SpO2), forced expiratory volume one second (FEV1), forced vital capacity (FVC) and fractionated exhaled nitric oxide (FeNO) were measured. Results: Twenty‐four and thirty children had mild OSA and moderate‐to‐severe OSA respectively. BMI correlated negatively with SpO2 nadir (r = −.363, p =.001). FVC, FEV1 and nadir SpO2 values decreased with OSA severity (p <.001). The odds of a child with OSA having an abnormal spirometry was 3.16 (95% CI: 1.08, 9.22). There was significant association between FeNO and AHI (r =.497, <.001). Discussion: Overweight and obese children with OSA have significant abnormalities in pulmonary function independent of BMI. OSA severity and elevated FeNO also correlated with diminishing lung function. [ABSTRACT FROM AUTHOR]

Published
2023
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49. Asthma control and care among six public health clinic attenders in Malaysia: A cross‐sectional study.

Author

Hussein, Norita, Liew, Su May, Hanafi, Nik Sherina, Lee, Ping Yein, Cheong, Ai Theng, Ghazali, Sazlina Shariff, Chinna, Karuthan, Pang, Yong Kek, Kassim, Asiah, Parker, Richard A., Schwarze, Jürgen, Sheikh, Aziz, Pinnock, Hilary, and Khoo, Ee Ming

Abstract

Background and Aims: Asthma is common in Malaysia but neglected. Achieving optimal asthma control and care is a challenge in the primary care setting. In this study, we aimed to identify the risk factors for poor asthma control and pattern of care among adults and children (5–17 years old) with asthma attending six public health clinics in Klang District, Malaysia. Methods: We conducted a cross‐sectional study collecting patients' sociodemographic characteristics, asthma control, trigger factors, healthcare use, asthma treatment, and monitoring and use of asthma action plan. Descriptive statistics and stepwise logistic regression were used in data analysis. Results: A total of 1280 patients were recruited; 85.3% adults and 14.7% children aged 5–17 years old. Only 34.1% of adults had well‐controlled asthma, 36.5% had partly controlled asthma, and 29.4% had uncontrolled asthma. In children, 54.3% had well‐controlled asthma, 31.9% had partly controlled, and 13.8% had uncontrolled asthma. More than half had experienced one or more exacerbations in the last 1 year, with a mean of six exacerbations in adults and three in children. Main triggers for poor control in adults were haze (odds ratio [OR] 1.51; 95% confidence interval [CI] 1.13–2.01); cold food (OR 1.54; 95% CI 1.15–2.07), extreme emotion (OR 1.90; 95% CI 1.26–2.89); air‐conditioning (OR 1.63; 95% CI 1.20–2.22); and physical activity (OR 2.85; 95% CI 2.13–3.82). In children, hot weather (OR 3.14; 95% CI 1.22–8.11), and allergic rhinitis (OR 2.57; 95% CI 1.13–5.82) contributed to poor control. The majority (81.7% of adults and 64.4% of children) were prescribed controller medications, but only 42.4% and 29.8% of the respective groups were compliant with the treatment. The importance of an asthma action plan was reported less emphasized in asthma education. Conclusion: Asthma control remains suboptimal. Several triggers, compliance to controller medications, and asthma action plan use require attention during asthma reviews for better asthma outcomes. [ABSTRACT FROM AUTHOR]

Published
2023
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