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Design Of A Fuzzy-Based Decision Support System For Coronary Heart Disease Diagnosis, Awang Bulgiba Jan 2012

Design Of A Fuzzy-Based Decision Support System For Coronary Heart Disease Diagnosis, Awang Bulgiba

Awang Bulgiba Awang Mahmud

In the present paper, a fuzzy rule-based system (FRBS) is designed to serve as a decision support system for Coronary heart disease (CHD) diagnosis that not only considers the decision accuracy of the rules but also their transparency at the same time. To achieve the two above mentioned objectives, we apply a multi-objective genetic algorithm to optimize both the accuracy and transparency of the FRBS. In addition and to help assess the certainty and the importance of each rule by the physician, an extended format of fuzzy rules that incorporates the degree of decision certainty and importance or support of …


High Prevalence Of Vitamin D Insufficiency And Its Association With Obesity And Metabolic Syndrome Among Malay Adults In Kuala Lumpur, Malaysia, Awang Bulgiba Awang Mahmud Aug 2011

High Prevalence Of Vitamin D Insufficiency And Its Association With Obesity And Metabolic Syndrome Among Malay Adults In Kuala Lumpur, Malaysia, Awang Bulgiba Awang Mahmud

Awang Bulgiba Awang Mahmud

Background: Vitamin D status, as indicated by 25-hydroxyvitamin D is inversely associated with adiposity, glucose homeostasis, lipid profiles, and blood pressure along with its classic role in calcium homeostasis and bone metabolism. It is also shown to be inversely associated with metabolic syndrome and cardiovascular diseases in western populations. However, evidence from the Asian population is limited. Therefore, we aim to study the prevalence of vitamin D insufficiency (< 50 nmol/L) and the association of 25-hydroxyvitamin D with metabolic risk factors among an existing Malay cohort in Kuala Lumpur. Methods: This is an analytical cross sectional study. A total of 380 subjects were sampled and their vitamins D status (25-hydroxyvitamin D), fasting blood glucose, full lipid profile were assessed using venous blood. Systolic and diastolic blood pressure, weight, height and waist circumference were measured following standard protocols. Socio-demographic data such as sex, age, smoking status etc were also collected. Data was analysed using t-test, chi-square test, General Linear Model and multiple logistic regression. Results: Females made up 58% of the sample. The mean age of respondents was 48.5 (SD 5.2) years. Females had significantly lower mean Vitamin D levels (36.2; 95% CI: 34.5, 38.0 nmol/L) compared to males (56.2; 95% CI: 53.2, 59.2 nmol/L). Approximately 41% and 87% of males and females respectively had insufficient (< 50 nmol/L) levels of 25-hydroxyvitamin D (p < 0.001). The prevalence of Metabolic Syndrome for the whole sample was 38.4 (95% CI: 33.5, 43.3)%. In the multivariate model (adjusted for age, sex, abdominal obesity, HDL-cholesterol, diastolic blood pressure), insufficient Vitamin D status was significantly associated with 1-year age increments (OR: 0.93; 95% CI: 0.88, 0.98), being female (OR: 8.68; 95% CI: 5.08, 14.83) and abdominal obesity (OR: 2.57; 95% CI: 1.51, 4.39). Respondents with insufficient vitamin D were found to have higher odds of having Metabolic Syndrome (OR: 1.73; 95% CI: 1.02, 2.92) after adjusting for age and sex. Conclusions: Our results highlight the high prevalence of vitamin D insufficiency among Malay adults in Kuala Lumpur. Vitamin D insufficiency is independently associated with younger age, female sex and greater abdominal obesity. Vitamin D insufficiency is also associated with Metabolic Syndrome.


Risk Of Metabolic Syndrome Among Children Living In Metropolitan Kuala Lumpur: A Case Control Study, Awang Bulgiba Awang Mahmud May 2011

Risk Of Metabolic Syndrome Among Children Living In Metropolitan Kuala Lumpur: A Case Control Study, Awang Bulgiba Awang Mahmud

Awang Bulgiba Awang Mahmud

Background: With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9 12 years in Kuala Lumpur and its metropolitan suburbs. Methods: A case control study was conducted among 402 children, comprising 193 normal-weight and 209 overweight/obese. Weight, height, waist circumference (WC) and body composition were measured, and WHO (2007) growth reference was used to categorise …


Breast Cancer In A Multi-Ethnic Asian Setting: Results From The Singapore-Malaysia Hospital-Based Breast Cancer Registry, Awang Bulgiba Feb 2011

Breast Cancer In A Multi-Ethnic Asian Setting: Results From The Singapore-Malaysia Hospital-Based Breast Cancer Registry, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Two hospital-based breast cancer databases (University Malaya Medical Center, Malaysia [n = 1513] and National University Hospital, Singapore [n = 2545]) were merged into a regional registry of breast cancer patients diagnosed between 1990 and 2007. A review of the data found 51% of patients diagnosed before the age of 50 years. and 72% percent of the women were Chinese followed by Malays (16%), Indians (8%), and other races (4%). Median tumor size at presentation was 26 mm and about 25% of patients presented with TNM stage III or IV disease. Most tumors were of ductal histology (87%). Fifty-seven percent …


Predictors Of 3-Month Abstinence In Smokers Attending Stop-Smoking Clinics In Malaysia, Awang Bulgiba Jan 2011

Predictors Of 3-Month Abstinence In Smokers Attending Stop-Smoking Clinics In Malaysia, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Introduction: Much is known about the predictors of success in quitting smoking. In particular, nicotine dependence, but not strength of motivation to stop, appears to predict abstinence. However, to date, studies have come almost exclusively from Western countries. More data are needed on the cross-cultural generalizability of these findings. Methods: One hundred and ninety-eight smokers attending 5 stop-smoking clinics in Malaysia completed a questionnaire prior to their target quit date and were followed up 3 months after this date. Predictors included sociodemographic variables, smoking patterns, past history of quitting, characteristics of current quit attempt, and smoking motives as well as …


Coffee And Tea Intake And Risk Of Breast Cancer, Awang Bulgiba Jun 2010

Coffee And Tea Intake And Risk Of Breast Cancer, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Known risk factors account for about 10-15% of breast cancer incidence suggesting that lifestyle exposures are crucial in its etiology. Previous epidemiological studies on the association between coffee and tea consumption and breast cancer risk have been inconsistent. We investigated the association of coffee and tea consumption with the risk of breast cancer among women in EPIC-NL cohort, a population-based prospective cohort in Netherlands with 27,323 participants. Exposure was measured by a validated food frequency questionnaire, and the outcome was verified by direct linkage with the Netherlands Cancer Registry. A total of 681 invasive primary breast cancers were diagnosed in …


Coffee And Tea Intake And Risk Of Breast Cancer, Awang Bulgiba Awang Mahmud Jun 2010

Coffee And Tea Intake And Risk Of Breast Cancer, Awang Bulgiba Awang Mahmud

Awang Bulgiba Awang Mahmud

Known risk factors account for about 10-15% of breast cancer incidence suggesting that lifestyle exposures are crucial in its etiology. Previous epidemiological studies on the association between coffee and tea consumption and breast cancer risk have been inconsistent. We investigated the association of coffee and tea consumption with the risk of breast cancer among women in EPIC-NL cohort, a population-based prospective cohort in Netherlands with 27,323 participants. Exposure was measured by a validated food frequency questionnaire, and the outcome was verified by direct linkage with the Netherlands Cancer Registry. A total of 681 invasive primary breast cancers were diagnosed in …


Job Strain Among Malaysian Office Workers Of A Multinational Company, Awang Bulgiba May 2010

Job Strain Among Malaysian Office Workers Of A Multinational Company, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Aims To investigate the prevalence and factors associated with high job strain among office workers of a multinational company in Malaysia. Methods A cross-sectional study was conducted in November 2007 among 470 eligible workers. Respondents self-administered the Job Content Questionnaire downloaded from the company's intranet. A median-split procedure was applied to create four groups according to the Job Demand-Control Model: active, passive, high and low job strain. Logistic regression models were used to investigate the associations between socio-demographic, occupational and psychosocial factors and high job strain. Results A total of 356 questionnaires were received (response rate 76%). Twenty-one per cent …


The Modified Ncep Atp Iii Criteria Maybe Better Than The Idf Criteria In Diagnosing Metabolic Syndrome Among Malays In Kuala Lumpur, Awang Bulgiba Jan 2010

The Modified Ncep Atp Iii Criteria Maybe Better Than The Idf Criteria In Diagnosing Metabolic Syndrome Among Malays In Kuala Lumpur, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Background: Metabolic Syndrome is associated with increased risk for type 2 diabetes and cardiovascular diseases. However, different diagnostic criteria have been recommended by different expert groups. In Malaysia, there is a lack of research comparing these different diagnostic criteria. Therefore, it is our aim to study the concordance between the IDF and the modified NCEP ATP III definitions of Metabolic Syndrome among a Malay cohort in Kuala Lumpur; and to demonstrate if all participants have the same cardiometabolic risks. Methods: This was an analytical cross sectional study. Ethics approval was obtained and informed consent was given by all participants. Anthropometric …


Prevalence And Correlates Of Physical Disability And Functional Limitation Among Community Dwelling Older People In Rural Malaysia, A Middle Income Country, Awang Bulgiba Dec 2009

Prevalence And Correlates Of Physical Disability And Functional Limitation Among Community Dwelling Older People In Rural Malaysia, A Middle Income Country, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Background: The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries. Methods: A population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool). Data were also collected for self reported activities of daily living …


Tooth Mortality In Smokers And Nonsmokers In A Selected Population In Sana'a, Yemen, Awang Bulgiba Feb 2008

Tooth Mortality In Smokers And Nonsmokers In A Selected Population In Sana'a, Yemen, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Background and Objective: Tobacco smoking has been shown to be a major risk factor for tooth loss. The present study was designed to examine tooth mortality and the patterns of tooth loss in smokers and nonsmokers over a wide age range in a selected population from Sana'a, Yemen. Material and Methods: A total of 2506 persons between the ages of 15 and 64 years were examined, and every permanent tooth was assessed. Missing teeth included both extracted and missing teeth. Individuals currently smoking one or more boxes of cigarettes (20 cigarettes) a day for 5 years were considered as smokers, …


Translating The Research Diagnostic Criteria For Temporomandibular Disorders Into Malay: Evaluation Of Content And Process, Awang Bulgiba Jan 2008

Translating The Research Diagnostic Criteria For Temporomandibular Disorders Into Malay: Evaluation Of Content And Process, Awang Bulgiba

Awang Bulgiba Awang Mahmud

Aims: To develop a Malay-language version of the Axis II Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) through a formal translation/back-translation process and to summarize available data about the psychometric properties of the translated scales. Methods: To cross-culturally adapt the instrument, the RDC/TMD underwent translation using a forward-backward method. Subjects were recruited to test the congruency between translated and original versions of the RDC/TMD. The psychometric properties of 3 domains (Graded Chronic Pain Scale, Nonspecific Physical Symptoms, and Depression) of the RDC/TMD were examined, and the literature on this topic was reviewed. Results: All the items scored 93% to 100% …


How Well Can Signs And Symptoms Predict Ami In The Malaysian Population?, Awang Bulgiba Jun 2005

How Well Can Signs And Symptoms Predict Ami In The Malaysian Population?, Awang Bulgiba

Awang Bulgiba Awang Mahmud

The aim of the study was to use data from an electronic medical record system (EMR) to look for factors that would help us diagnose acute myocardial infarction (AMT) with the ultimate aim of using these factors in a decision support system for chest pain. We extracted 887 records from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. We cleaned the data, extracted 69 possible variables and performed univariate and multivariate analysis. From the univariate analysis we find that 22 variables are significantly associated with a diagnosis of AMT. However, multiple logistic regression reveals that only 9 of …