Metabolic syndrome is a highly prevalent health problem within the adult population in developing countries. We aimed to study the association of physical activity levels and metabolic risk factors among Malay adults in Malaysia.
MeSH terms: Adult; Aged; Blood Glucose/metabolism; Blood Preservation; Cross-Sectional Studies; Developing Countries/statistics & numerical data*; Energy Metabolism/physiology; Female; Humans; Cholesterol, HDL/blood; Malaysia/epidemiology; Male; Middle Aged; Motor Activity/physiology*; Surveys and Questionnaires; Triglycerides/blood; Body Mass Index; Prevalence; Metabolic Syndrome X/epidemiology*; Metabolic Syndrome X/physiopathology; Waist Circumference; Obesity, Abdominal/epidemiology
The study aimed to determine the rates of functional remission and employment as well as the factors associated with functional remission among patients with Schizophrenia, receiving community psychiatric service in an urban setting in Malaysia.
MeSH terms: Adult; Community Mental Health Services; Cross-Sectional Studies; Employment/statistics & numerical data*; Female; Home Care Services*; Hospitalization/statistics & numerical data; Humans; Malaysia; Male; Random Allocation; Remission Induction; Schizophrenia/rehabilitation*; Severity of Illness Index; Social Support*; Time Factors; Recovery of Function*; Medication Adherence/psychology
Although the general pharmacokinetics of cephalexin is quite established up-to-date, however, no population-based study on Cephalexin pharmacokinetics profile in Malay population has been reported yet in the literature.
MeSH terms: Adult; Capsules/pharmacokinetics; Cephalexin/pharmacokinetics*; Humans; Malaysia; Male; Tablets/pharmacokinetics; Therapeutic Equivalency; Cross-Over Studies; Area Under Curve; Young Adult
In New Zealand, pharmacists are funded to provide adherence support to their patients via a service called "Medicines Use Review" (MUR). The service is based on the assumption that the medication regimen is clinically appropriate and therefore does not include a clinical review. However, whether or not pharmacists make clinical recommendations to patients during MUR is unclear.
MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Community Pharmacy Services/economics; Community Pharmacy Services/organization & administration*; Community Pharmacy Services/standards; Counseling; Female; Humans; Male; Middle Aged; New Zealand; Pharmacists/economics; Pharmacists/organization & administration*; Pharmacists/standards; Retrospective Studies; Professional Role; Medication Therapy Management/economics; Medication Therapy Management/organization & administration*; Medication Adherence*; Young Adult; Health Literacy
A secondary analysis of 2 qualitative studies was conducted to explore the experiences of suffering caused by interactions with health care providers in the hospital setting. Interview transcripts from 20 palliative care patients and 15 palliative care informal caregivers in University Malaya Medical Centre were thematically analyzed. The results of health care interactional suffering were associated with themes of attention, understanding, communication, competence, and limitation. These 5 themes may serve as a framework for the improvement in interaction skills of health care providers in palliative care.
The period of the cancer patients undergoing treatment is also the most stressful time for their family caregivers. This study aimed to determine the rates of major depressive disorder and dysthymia; and their associated factors in the caregivers during this time.
Study site: Oncology centre, Pusat Perubatan Universiti Kebangsaan Malaysia
A rapid dot immunogold filtration assay (DIGFA) was adopted for specific immunodiagnosis of human cerebral angiostrongyliasis, using purified 31-kDa glycoprotein specific to Angiostrongylus cantonensis as diagnostic antigen and protein A colloidal gold conjugate as antigen-antibody detector. A total of 59 serum samples were assayed - 11 samples from clinically diagnosed patients with detectable A. cantonensis-specific antibody in immunoblotting; 23 samples from patients with other related parasitic diseases, i.e. gnathostomiasis (n= 8), cysticercosis (n= 5), toxocariasis (n= 2), filariasis (n= 4), paragonimiasis (n= 2) and malaria (n= 2); and 25 samples from normal healthy subjects. The sensitivity and specificity of DIGFA to detect anti-A. cantonensis specific antibodies in serologically confirmed angiostrongyliasis cases, were both 100%. No positive DIGFA was observed in cases with other parasitic diseases, and the healthy control subjects. The 3-min DIGFA is as sensitive and specific as the 3-h immunoblot test in angiostrongyliasis confirmed cases that revealed a 31-kDa reactive band. The gold-based DIGFA is more rapid and easier to perform than the traditional enzyme-linked immunosorbent assay (ELISA). The test utilizing purified A. cantonensis antigen is reliable and reproducible for specific immunodiagnosis of human infection with A. cantonensis - thus can be applied as an additional routine test for clinical diagnostic support. Large-scale sero-epidemiological studies in endemic communities in north-east Thailand are under way to evaluate its usefulness under field conditions.
The aims of the study were (i) to determine the knowledge and perceptions of colorectal cancer (CRC), (ii) to explore the willingness of the study population to take a screening test for CRC, and (iii) to identify factors affecting the willingness to take a screening test for CRC. A cross-sectional survey was carried out in a semiurban town in Malaysia using a pretested structured questionnaire. Descriptive statistics were determined for all important variables. A binary logistic regression model was introduced to identify independent predictors of the willingness to take a screening test. Factors influencing willingness were explored according to the constructs of the health belief model. Of the 256 respondents who had heard about CRC, the majority were aware of altered bowel habits (67.3%) or the presence of blood in stool or rectal bleeding (63.4%) as the warning symptoms. Although 38% of the respondents knew of colonoscopy as the screening test, 22% were not aware of any screening test for CRC. A majority (77.4%) showed willingness to take a screening test for CRC. In the multivariate analysis, 'having family or friends with history of CRC' and 'self-perceived risk' were the two significant variables for predicting the acceptance of CRC screening among the study population. Findings suggested that the respondents' knowledge of the CRC screening test was inadequate, albeit a high proportion expressed their intention to take screening tests. Health education on the CRC addressing available screening tests and the benefits of early screening for CRC should be scaled up.
MeSH terms: Adult; Attitude to Health*; Cross-Sectional Studies; Data Collection; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Surveys and Questionnaires; Residence Characteristics; Volition; Colorectal Neoplasms/diagnosis*; Early Detection of Cancer/psychology*; Early Detection of Cancer/statistics & numerical data
This study was aimed at identifying behavioural, normative and control belief influencing intention to practise exclusive breastfeeding among pregnant women in Malaysia. An interviewer-guided questionnaire assessing behavioural, normative and control belief was developed based on the findings elicited from focus group discussions. Intention referred to the respondent's intended duration of exclusive breastfeeding, which was measured in weeks. Bivariate correlational analysis, linear regression analysis and independent t test comparing intenders and non-intenders were conducted to identify the composite belief measures and individual beliefs significantly influencing intention. Composite measures of all the beliefs were significantly correlated with intention, but injunctive normative belief and behavioural belief were the only significant factors identified from linear regression analysis. The respondents agreed to comply with four referents of their mother, husband, nurses and mother-in-law. Non-intenders believed that those referents would oppose them practising exclusive breastfeeding for six months. The behavioural belief concerning difficulty to leave the infant significantly differentiated intenders from non-intenders. Exclusive breastfeeding promotion should include the woman's mother, husband and mother-in-law. Nurses should provide accurate and complete information related to breastfeeding practise. Providing support for women to continue the practise even though separated from their infants may improve their intention and practise of exclusive breastfeeding.
MeSH terms: Adult; Breast Feeding*; Female; Humans; Infant; Health Knowledge, Attitudes, Practice*; Malaysia; Pregnancy; Cohort Studies; Health Behavior; Intention*; Young Adult
In response to an absence of studies among refugees and host communities accessing highly active antiretroviral therapy (HAART) in urban settings, our objective was to compare adherence and virological outcomes among clients attending a public clinic in Kuala Lumpur, Malaysia. A cross-sectional survey was conducted among adult clients (≥18 years). Data sources included a structured questionnaire that measured self-reported adherence, a pharmacy-based measure of HAART prescription refills over the previous 24 months, and HIV viral loads. The primary outcome was unsuppressed viral load (≥40 copies/mL). Among a sample of 153 refugees and 148 host community clients, refugees were younger (median age 35 [interquartile range, IQR 31, 39] vs 40 years [IQR 35, 48], p
MeSH terms: Female; Humans; Lymphoma/pathology; Lymphoma/physiopathology*; Magnetic Resonance Imaging; Middle Aged; Central Nervous System Neoplasms/pathology; Central Nervous System Neoplasms/physiopathology*; Tuberculosis, Central Nervous System/physiopathology*
CYP2D6 polymorphisms show large geographical and interethnic differences. Variations in CYP2D6 activity may impact upon a patient's pain level and may contribute to interindividual variations in the response to opioids. This paper reviews the evidence on how CYP2D6 polymorphisms might influence pain sensitivity and clinical response to codeine and tramadol. For example, it is shown that (1) CYP2D6 poor metabolizers (PMs) may be less efficient at synthesizing endogenous morphine compared with other metabolizers. In contrast, ultra-rapid metabolizers (UMs) may be more efficient than other metabolizers at synthesizing endogenous morphine, thus strengthening endogenous pain modulation. Additionally, for codeine and tramadol that are bioactivated by CYP2D6, PMs may undergo no metabolite formation, leading to inadequate analgesia. Conversely, UMs may experience quicker analgesic effects but be prone to higher mu-opioid-related toxicity. The literature suggested the potential usefulness of the determination of CYP2D6 polymorphisms in elucidating serious adverse events and in preventing subsequent inappropriate selection or doses of codeine and tramadol. Notably, even though many studies investigated a possible role of the CYP2D6 polymorphisms on pain sensitivity, pharmacokinetics and pharmacodynamics of these drugs, the results of analgesia and adverse effects are conflicting. More studies are required to demonstrate genetically determined unresponsiveness and risk of developing serious adverse events for patients with pain and these should involve larger numbers of patients in different population types.
INTRODUCTION: To determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia.
METHODS: This is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively.
RESULTS: Only male gender (OR=7.071, p=0.01*, CI=1.642-30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR=2.285, p=0.00*, CI=1.507-3.467) and inattentive ADHD symptoms reported by teachers (OR=1.829, p=0.03*, CI=1.060-3.154) and parents (OR=1.709, p=0.03*, CI=1.046-2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR=0.729, p=0.01*, CI=0.580-0.915) and teachers (OR=0.643, p=0.02*, CI=0.440-0.938) were protective against bullying behavior despite the influence of conduct behavior (OR=3.160, p=0.00*, CI=1.600-6.241). Internalizing behavior, that is, withdrawn (OR=0.653, p=0.04*, CI=0.436-0.977) and somatic complaints (OR=0.619, p=0.01*, CI=0.430-0.889) significantly protect against bullying behavior.
DISCUSSIONS: Recognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.
MeSH terms: Adolescent; Child; Cross-Sectional Studies; Female; Humans; Malaysia; Malaysia/ethnology; Male; Random Allocation; Risk Factors; Schools/statistics & numerical data; Sex Factors; Students/psychology*; Conduct Disorder/ethnology; Conduct Disorder/psychology*; Attention Deficit and Disruptive Behavior Disorders/ethnology; Attention Deficit and Disruptive Behavior Disorders/psychology*; Bullying*
This work presents the structural and adsorption properties of the CaCO3(-)-rich Corbicula fluminea shell as a natural and economic adsorbent to remove Cd ions from aqueous solutions under batch studies. Experiments were conducted with different contact times, various initial concentrations, initial solution pH and serial biosorbent dosage to examine the dynamic characterization of the adsorption and its influence on Cd uptake capacity. The characterization of the C. fluminea shell using SEM/EDX revealed that the adsorbent surface is mostly impregnated by small particles of potentially calcium salts. The dominant Cd adsorption mechanism is strongly pH and concentration dependent. A maximum Cd removal efficiency of 96.20% was obtained at pH 7 while the optimum adsorbent dosage was observed as 5 g/L. The Langmuir isotherm was discovered to be more suitable to represent the experimental equilibrium isotherm results with higher correlation coefficients (R(2) > 0.98) than Freundlich (R(2)
MeSH terms: Adsorption; Animals; Cadmium/analysis; Cadmium/chemistry*; Calcium Carbonate/chemistry*; Cations, Divalent/chemistry; Hydrogen-Ion Concentration; Solutions/chemistry; Waste Disposal, Fluid; Water Pollutants, Chemical/analysis; Water Pollutants, Chemical/chemistry*; Corbicula/chemistry*; Environmental Restoration and Remediation/methods*; Animal Shells/chemistry*
This study investigated the survival of encapsulated potential probiotic Lactobacillus plantarum which isolated from fermented cocoa beans. κ-Carrageenan was used to encapsulate the probiotic. Encapsulation techniques such as emulsification, freeze-drying or extrusion were adopted to encapsulate the probiotic. Freeze-drying and extrusion methods showed higher (p
Maxillofacial injuries comprising hard tissue as well as soft tissue injuries can be associated with traumatic brain injuries due to the impact of forces transmitted through the head and neck. To date, the role of maxillofacial injury on brain injury has not been properly documented with some saying it has a protective function on the brain while others opposing this idea.
BACKGROUND: Effective communication between community pharmacists and patients, particularly with a patient-centered approach, is important to address patients' concerns relating to antidepressant medication use. However, few studies have investigated community pharmacists' communication behaviors in depression care.
OBJECTIVE: To characterize community pharmacist-patient interactions during consultations involving use of antidepressants.
METHODS: Twenty community pharmacists received 3 simulated patient visits involving issues related to the use of antidepressants: 1) patient receiving a first-time antidepressant prescription; 2) patient perceiving lack of efficacy of antidepressants after 2 weeks of treatment, and 3) patient intending to discontinue treatment prematurely. All 60 encounters were audio-recorded and analyzed using the Roter Interaction Analysis System (RIAS), a quantitative coding system that characterizes communication behaviors through discrete categories. A patient-centeredness score was calculated for each encounter.
RESULTS: The majority of pharmacist communication was biomedical in nature (50.7%), and focused on providing therapeutic information and advice on the antidepressant regimen. In contrast, only 5.4% of pharmacist communication was related to lifestyle/psychosocial exchanges. There were also few instances of emotional rapport-building behaviors (8.6%) or information gathering (6.6%). Patient-centered scores were highest in the scenario involving a first-time antidepressant user, as compared to other scenarios involving issues with continued therapy.
CONCLUSIONS: Community pharmacists appeared to adopt a "medication-centered" approach when counseling on antidepressant issues. There is scope for improvement in patient-centered communication behaviors, particularly lifestyle/psychosocial discussions, facilitating patient participation, and emotional rapport-building. The RIAS appears suited to characterize brief consultations in community pharmacies and can provide a framework in guiding communication training efforts. Further research is needed to assess the impact of pharmacist communication behaviors on patient care outcomes.
KEYWORDS: Antidepressant adherence; Patient-centeredness; Pharmacist–patient communication; Roter Interaction Analysis System
to explore community and health-care provider attitudes towards maltreatment during delivery in rural northern Ghana, and compare findings against The White Ribbon Alliance's seven fundamental rights of childbearing women.
MeSH terms: Attitude of Health Personnel*; Cross-Sectional Studies; Female; Ghana; Humans; Interviews as Topic; Pregnancy; Rural Population; Focus Groups; Perinatal Care*; Parturition/psychology*
Mesenchymal stem cells (MSCs) have captured the attention of researchers today due to their multipotent differentiation capacity. Also, they have been successfully applied clinically, in the treatment of various diseases of the heart and musculoskeletal systems, with encouraging results. Their supportive role in haematopoiesis and their anti-inflammatory and immunomodulatory properties have enhanced their contribution towards the improvement of engraftment and the treatment of graft-versus-host disease in patients receiving haematopoietic stem cell transplantation. However, there is a growing body of research that supports the involvement of MSCs in leukaemogenesis with several genetic and functional abnormalities having been detected in the MSCs of leukaemia patients. MSCs also exert leukaemia-enhancing effects and induce chemotherapy resistance in leukaemia cells. This paper addresses the key issues in the therapeutic value as well as the harmful effects of the MSCs in leukaemia with a sharp focus on the recent updates in the published literature.