Displaying publications 1 - 20 of 30 in total

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  1. Mohamed K, Tin TS, Jalaludin MY, Al-Sadat N, Majid HA
    Asia Pac J Clin Nutr, 2018 7 27;27(4):898-907.
    PMID: 30045437 DOI: 10.6133/apjcn.022018.03
    BACKGROUND AND OBJECTIVES: The food frequency questionnaire (FFQ) is a dietary tool used to assess the habitual intake of the population. The goal of this study is to examine the reproducibility and validity of the FFQ that was developed for a multi-ethnic population in Malaysia.

    METHODS AND STUDY DESIGN: Collective food data from MyHeARTs 2012 database were used to construct the MyUM Adolescent FFQ. Seventy-eight participants between 13 and 15 years old in 2014 were selected through convenient sampling for test-retest study. They completed the MyUM Adolescent FFQ twice, with an interval period of one week. One hundred and fifty-six MyHeARTs study participants who were 15 years old in 2014 were randomly selected for this comparative valid-ity study. They completed a 7-day diet history (7DDH) and subsequently completed the self-administered MyUM Adolescent FFQ.

    RESULTS: Pearson's correlations between the FFQ and 7DDH for all macronutrients were statistically significant. Energy-adjusted correlations for protein, carbohydrate, and fat were 0.54, 0.63 and 0.49 respectively. Most of the micronutrients and minerals, were statistically correlated ranging from 0.31 to 0.49 after energy adjustment. Cross-classification analyses revealed that more than 70 percent of adolescents were classified into either the same or adjacent quartile of nutrient intake when comparing data of 7DDH and FFQ. No serious systematic bias was evident in the Bland-Altman plots.

    CONCLUSION: The 200-item FFQ developed for Malaysian adolescents has moderate to good comparative validity for assessment of macronutrient and micronutrient intake.

  2. Al-Sadat N, Misau AY, Zarihah Z, Maznah D, Tin Tin Su
    Asia Pac J Public Health, 2010 Jul;22(3 Suppl):175S-180S.
    PMID: 20566551 DOI: 10.1177/1010539510372835
    The use of tobacco by adolescents is a major public health concern worldwide. There are 1.2 billion smokers globally, of which more than 50% are young people. The Southeast Asian countries have about 600 million tobacco smokers within the global burden of tobacco users. Most smokers begin at early stage of life and persist through adulthood. Malaysia alone has about 5 million smokers, 20% of whom are younger than 18 years old. Many factors are implicated in the continuous rising trend of tobacco use among adolescents in Southeast Asia. A triad of family, environmental, and individual factors synergistically acts to motivate adolescents toward smoking. This article discusses the current trends of tobacco use and implications of increasing rise in adolescent smoking in the Southeast Asia region.
  3. Al-Sadat N, Binns CW
    Asia Pac J Public Health, 2008 Oct;20 Suppl:6-14.
    PMID: 19533855
    The fast increase in the rate of uptake of smoking amongst adolescent girls in Malaysia is a public health concern. The objective of this study was to investigate factors that influenced the initiation of smoking and the effects of advertisement on consolidating the smoking habit among teenage girls in the urban city of Kuala Lumpur. Qualitative research was conducted using both interviews and focus group discussions with groups of adolescent girls. Data collected was analysed using grounded thematic theory methodology and validated using methodological triangulation. The reasons for initiating smoking elicited from the study can be grouped into 4 general themes; influence by peers, influence of seeing parents smoking, misguided belief that it could alleviate stress and finally that it would impress others. Smoking imageries in media and advertisements were not primary influencing factors in the initiation of smoking but it encouraged them to progress to become regulars. Ways should be sought to empower girls to feel more confident about resisting pressures to initiate smoking. This could be done through activities such as positive peer sports, education on how to alleviate stress and curbing of smoking imageries in the media.
  4. Marzuki N, Ismail S, Al-Sadat N, Ehsan FZ, Chan CK, Ng CW
    Asia Pac J Public Health, 2015 Nov;27(8 Suppl):86S-93S.
    PMID: 26085477 DOI: 10.1177/1010539515590180
    Despite the high costs involved and the lack of definitive evidence of sustained effectiveness, many low- and middle-income countries had begun to strengthen their health information system using information and communication technology in the past few decades. Following this international trend, the Malaysian Ministry of Health had been incorporating Telehealth (National Telehealth initiatives) into national health policies since the 1990s. Employing qualitative approaches, including key informant interviews and document review, this study examines the agenda-setting processes of the Telehealth policy using Kingdon's framework. The findings suggested that Telehealth policies emerged through actions of policy entrepreneurs within the Ministry of Health, who took advantage of several simultaneously occurring opportunities--official recognition of problems within the existing health information system, availability of information and communication technology to strengthen health information system and political interests surrounding the national Multimedia Super Corridor initiative being developed at the time. The last was achieved by the inclusion of Telehealth as a component of the Multimedia Super Corridor.
  5. Jeganathan PD, Hairi NN, Al Sadat N, Chinna K
    Asian Pac J Cancer Prev, 2013;14(6):3483-9.
    PMID: 23886133
    BACKGROUND: To identify the prevalence of different stages of smoking and differences in associated risk factors.

    MATERIALS AND METHODS: Thos longitudinal study started in February 2011 and the subjects were 2552 form one students aged between twelve to thirteen years of from 15 government secondary schools of Kinta, Perak. Data on demographic, parental, school and peer factors were collected using a self-administered questionnaire. We examined the effects of peer, school and parental factors on the five stages of smoking; never smokers, susceptible never smokers, experimenters, current smokers and ex-smokers, at baseline.

    RESULTS: In the sample, 19.3% were susceptible never smokers, 5.5% were current smokers 6% were experimenters and 3.1% were ex-smokers. Gender, ethnicity, best friends' smoking status, high peer pressure, higher number of relatives who smoked and parental monitoring were found to be associated with smoking stages. Presence of parent-teen conflict was only associated with susceptible never smokers and experimenters whereas absence of home discussion on smoking hazards was associated with susceptible never smokers and current smokers.

    CONCLUSIONS: We identified variations in the factors associated with the different stages of smoking. Our results highlight that anti-smoking strategies should be tailored according to the different smoking stages.

  6. Su TT, Sallehuddin BA, Murniati HH, Swinder J, Al Sadat N, Saimy I
    Asian Pac J Cancer Prev, 2012;13(1):175-9.
    PMID: 22502663
    The objective of the study is to investigate the success rate of quit attempts and identify factors associated with success or failure of quit attempts in a quit smoking clinic. A cohort study was conducted with 495 smokers who enrolled in a quit smoking clinic from 2005 to 2008. The factors leading to quit smoking successfully were "being Malay", "having high blood pressure" "type of Nicotine Replacement Therapy" and "duration of follow up". In contrast, clerical staff had negative association to quit smoking. People who started smoking in their teenage years had a high risk of relapse. Integration of active follow up and tailor-made support programmes for quitters appear necessary in order to maintain their non-smoking status and encourage them to be permanent quitters. Integration of quit smoking clinics and primary care clinics could be another potential step for the success of quit smoking programmes.
  7. Ibrahim NI, Dahlui M, Aina EN, Al-Sadat N
    Asian Pac J Cancer Prev, 2012;13(5):2213-8.
    PMID: 22901196
    INTRODUCTION: Worldwide, breast cancer is the commonest cause of cancer death in women. However, the survival rate varies across regions at averages of 73%and 57% in the developed and developing countries, respectively.

    OBJECTIVE: This study aimed to determine the survival rate of breast cancer among the women of Malaysia and characteristics of the survivors.

    METHOD: A retrospective cohort study was conducted on secondary data obtained from the Breast Cancer Registry and medical records of breast cancer patients admitted to Hospital Kuala Lumpur from 2005 to 2009. Survival data were validated with National Birth and Death Registry. Statistical analysis applied logistic regression, the Cox proportional hazard model, the Kaplan-Meier method and log rank test.

    RESULTS: A total of 868 women were diagnosed with breast cancer between January 2005 and December 2009, comprising 58%, 25% and 17% Malays, Chinese and Indians, respectively. The overall survival rate was 43.5% (CI 0.573-0.597), with Chinese, Indians and Malays having 5 year survival rates of 48.2% (CI 0.444-0.520), 47.2% (CI 0.432-0.512) and 39.7% (CI 0.373-0.421), respectively (p<0.05). The survival rate was lower as the stages increased, with the late stages were mostly seen among the Malays (46%), followed by Chinese (36%) and Indians (34%). Size of tumor>3.0cm; lymph node involvement, ERPR, and HER 2 status, delayed presentation and involvement of both breasts were among other factors that were associated with poor survival.

    CONCLUSIONS: The overall survival rate of Malaysian women with breast cancer was lower than the western figures with Malays having the lowest because they presented at late stage, after a long duration of symptoms, had larger tumor size, and had more lymph nodes affected. There is an urgent need to conduct studies on why there is delay in diagnosis and treatment of breast cancer women in Malaysia.

  8. Abdullah NN, Aziz NA, Rampal S, Al-Sadat N
    Asian Pac J Cancer Prev, 2011;12(10):2643-7.
    PMID: 22320967
    BACKGROUND: Breast cancer is the most common cancer among women in Malaysia. Of the total cancer cases registered in the National Cancer Registry for 2006, 3,525 were female breast cancer cases. The overall age standardized rate was 39.3 per 100,000 population in 2006. An estimated 30%-40% were diagnosed in the late stages and this had resulted in poor survival rates. The purpose of the study was to determine the factors and barriers related to mammography screening uptake among hospital personnel.

    METHODS: This mixed method explanatory study was carried out on a universal sampling of 707 female personnel aged 40 and above, from June 2007 until November 2007. The study was conducted at University Malaya Medical Centre, a tertiary hospital in Kuala Lumpur. Pre-tested self-administered questionnaires were mailed to eligible personnel.

    RESULTS: The prevalence of mammography screening uptake was 80.3% (95%CI: 76.8%,83.5%) among 534 respondents. Personnel who had physician recommendation had significantly higher odds of mammography screening uptake compared to those who did not have recommendation, adjusted odds ratio of 21.25 (95%CI:12.71,36.56). Reported barriers can be grouped into several themes; negative perception of the procedure like embarrassment due to the presence of male technicians/radiographers; low confidence with radiologist/radiographers in detecting abnormality; lack of coping skills in dealing with expected results and pain during procedure.

    CONCLUSIONS: The findings of this study highlighted that 20% of personnel did not undertake mammography screening although there is no cost incurred and the procedure is fully accessible to them. Opportunistic recommendation by physician and concerns on the procedure should be addressed.
  9. Dahlui M, Ng C, Al-Sadat N, Ismail S, Bulgiba A
    Asian Pac J Cancer Prev, 2011;12(2):369-72.
    PMID: 21545196
    OBJECTIVES: This study aimed to determine the rate of breast self examination (BSE) among the female staff of University of Malaya and to determine the role of BSE in detecting breast abnormalities.

    METHODS: A total of 1598 questionnaires were posted to all female staff, aged 35 years and above. Their knowledge on breast cancer, practice of BSE and detection rate of breast abnormality as confirmed by CBE was determined.

    RESULTS: The response rate for this study was 45 percent (714 respondents). The rate of respondents having awareness on breast cancer was 98.7 percent. Eighty four percent (598) of the respondents had performed BSE in their lifetime. However, in only 41% was it regular at the recommended time. Forty seven percent (334) had undergone CBE at least once in a lifetime but only 26% (185) had CBE at least once in the past 3 years, while 23% (165) had had a mammogram. There was a significant relationship between CBE and BSE whereby those who had CBE were twice more likely to do BSE. Nineteen percent (84 respondents) of those who did BSE claimed they had detected a breast lump. Of these, 87% (73) had gone for CBE and all were confirmed as such.

    CONCLUSION: BSE is still relevant as a screening tool of breast cancer since those who detect breast lump by BSE will most probably go for further check up. CBE should be done to all women, especially those at highest risk of breast cancer, to encourage and train for BSE.

  10. Fadzlina AA, Harun F, Nurul Haniza MY, Al Sadat N, Murray L, Cantwell MM, et al.
    BMC Public Health, 2014;14 Suppl 3:S7.
    PMID: 25437226 DOI: 10.1186/1471-2458-14-S3-S7
    BACKGROUND: Obesity and metabolic syndrome is prevalent among Malaysian adolescents and has been associated with certain behavioural factors such as duration of sleep, screen time and physical activity. The aim of the study is to report the prevalence of overweight/obesity, metabolic syndrome and its risk factors among adolescents.
    METHODS: A multi-staged cluster sampling method was used to select participants from urban and rural schools in Selangor, Perak and Wilayah Persekutuan Kuala Lumpur. Participants underwent anthropometric measurement and physical examination including blood pressure measurement. Blood samples were taken for fasting glucose and lipids and participants answered a self-administered questionnaire. Overweight and obesity was defined using the extrapolated adult body mass index (BMI) cut-offs of >25 kg/m2 and >30 kg/m2, according to the International Obesity Task Force (IOTF) criteria. Metabolic syndrome was defined based on International Diabetes Federation (IDF) 2007 criteria.
    RESULTS: Data were collected from 1361 participants. After excluding incomplete data and missing values for the variables, we analysed a sample of 1014 participants. Prevalence of overweight and obesity in this population was 25.4% (N = 258). The prevalence of metabolic syndrome was 2.6% in the population and 10% among the overweight and obese adolescents. Participants who slept between 7 and 9 hours a day has a lower risk of developing metabolic syndrome OR 0.38(0.15-0.94).
    CONCLUSION: Our results provide the prevalence of metabolic syndrome in Malaysian adolescents. Adequate sleep between 7 and 9 hours per day reduces the risk of developing metabolic syndrome.
    MESH: screen time
  11. Hazreen MA, Su TT, Jalaludin MY, Dahlui M, Chinna K, Ismail M, et al.
    BMC Public Health, 2014;14 Suppl 3:S6.
    PMID: 25437068 DOI: 10.1186/1471-2458-14-S3-S6
    BACKGROUND: The National Health & Morbidity Survey (NHMS) IV (2011) observed that the prevalence of obese children aged less than 18 years in Malaysia is 6.1% compared to 5.4% overweight and obese in NHMS III (2006). As such, this observation is of public health importance as obesity is a forewarning risk factor for chronic diseases such as type-2 diabetes, cardiovascular diseases (CVD) and certain types of cancers. This MyHeART (Malaysian Health and Adolescents longitudinal Research Team) study aims to examine risk factors of non-communicable diseases (NCD) among adolescents.
    METHODS/DESIGN: The MyHeART study is longitudinal cohort study of 1361 schoolchildren (13-years old) attending 15 public secondary schools from the central (Kuala Lumpur and Selangor) and northern (Perak) regions of Peninsular Malaysia. The study used a stratified sampling design to select the study participants. Data collected at baseline included socio-economic, lifestyle (e.g. smoking, physical activity assessment, fitness assessment, seven-day diet history), and environmental information, anthropometric measurements, blood pressure, handgrip strength and bone mineral density. Blood samples for fasting blood glucose and lipid profiles, full blood count, renal profile, as well as bone profile and serum vitamin D were taken. This study cohort will be followed up again when participants turn 15, 17 and lastly, after a period of ten years (around the age of 27).
    RESULTS: Nine percent of the adolescents from this study were obese. More male participants smoked compared to female participants (15.4% vs. 4.7%). Adolescent males had higher fasting blood glucose but the female participants had lower high density lipoprotein (HDL-cholesterol) and higher low density lipoprotein (LDL-cholesterol). In addition, adolescents from the rural area had higher fasting blood glucose, diastolic blood pressure, total cholesterol and LDL-cholesterol.
    DISCUSSION: Our results demonstrated that adolescents from the rural area are at higher risk of NCDs compared to their urban counterpart. Tailor made public health interventions are highly recommended for adolescents as this may minimise the dreadful NCD burden in adulthood and health disparity between the rural and urban in the near future.
    Study name: Malaysian Health and Adolescents Longitudinal Research Team study (The MyHeART study)
  12. Hanifah RA, Majid HA, Jalaludin MY, Al-Sadat N, Murray LJ, Cantwell M, et al.
    BMC Public Health, 2014;14 Suppl 3:S5.
    PMID: 25436933 DOI: 10.1186/1471-2458-14-S3-S5
    The importance of fitness level on the well-being of children and adolescent has long been recognised. The aim of this study was to investigate the fitness level of school-going Malaysian adolescent, and its association with body composition indices.
  13. Farid ND, Rus SC, Dahlui M, Al-Sadat N, Aziz NA
    BMC Public Health, 2014;14 Suppl 3(Suppl 3):S9.
    PMID: 25437631 DOI: 10.1186/1471-2458-14-S3-S9
    BACKGROUND: In welfare institutions, it is essential to address the health-related needs of adolescent populations who often engage in sexual activities. This study examines the association between individual and interpersonal factors concerning sexual risk behaviour (SRB) among adolescents in welfare institutions in Malaysia.

    METHODS: Data were derived from a cross-sectional study of 1082 adolescents in 22 welfare institutions located across Peninsular Malaysia in 2009. Using supervised self-administered questionnaires, adolescents were asked to assess their self-esteem and to complete questions on pubertal onset, substance use, family structure, family connectedness, parental monitoring, and peer pressure. SRB was measured through scoring of five items: sexual initiation, age of sexual debut, number of sexual partners, condom use, and sex with high-risk partners. Multivariate logistic regression analysis was used to examine the various predictors of sexual risk behaviour.

    RESULTS: The study showed that 55.1% (95%CI = 52.0-58.2) of the total sample was observed to practice sexual risk behaviours. Smoking was the strongest predictor of SRB among male adolescents (OR = 10.3, 95%CI = 1.25-83.9). Among females, high family connectedness (OR = 3.13, 95%CI = 1.64-5.95) seemed to predict the behaviour.

    CONCLUSION: There were clear gender differences in predicting SRB. Thus, a gender-specific sexual and reproductive health intervention for institutionalised adolescents is recommended.

  14. Al-Sadat N, Majid HA, Sim PY, Su TT, Dahlui M, Abu Bakar MF, et al.
    BMJ Open, 2016 08 18;6(8):e010689.
    PMID: 27540095 DOI: 10.1136/bmjopen-2015-010689
    OBJECTIVE: To determine the prevalence of vitamin D deficiency (<37.5 nmol/L) among young adolescents in Malaysia and its association with demographic characteristics, anthropometric measures and physical activity.

    DESIGN: This is a cross-sectional study among Form 1 (year 7) students from 15 schools selected using a stratified random sampling design. Information regarding sociodemographic characteristics, clinical data and environmental factors was collected and blood samples were taken for total vitamin D. Descriptive and multivariable logistic regression was performed on the data.

    SETTING: National secondary schools in Peninsular Malaysia.

    PARTICIPANTS: 1361 students (mean age 12.9±0.3 years) (61.4% girls) completed the consent forms and participated in this study. Students with a chronic health condition and/or who could not understand the questionnaires due to lack of literacy were excluded.

    MAIN OUTCOME MEASURES: Vitamin D status was determined through measurement of sera 25-hydroxyvitamin D (25(OH)D). Body mass index (BMI) was classified according to International Obesity Task Force (IOTF) criteria. Self-reported physical activity levels were assessed using the validated Malay version of the Physical Activity Questionnaire for Older Children (PAQ-C).

    RESULTS: Deficiency in vitamin D was seen in 78.9% of the participants. The deficiency was significantly higher in girls (92.6%, p<0.001), Indian adolescents (88.6%, p<0.001) and urban-living adolescents (88.8%, p<0.001). Females (OR=8.98; 95% CI 6.48 to 12.45), adolescents with wider waist circumference (OR=2.64; 95% CI 1.65 to 4.25) and in urban areas had higher risks (OR=3.57; 95% CI 2.54 to 5.02) of being vitamin D deficient.

    CONCLUSIONS: The study shows a high prevalence of vitamin D deficiency among young adolescents. Main risk factors are gender, ethnicity, place of residence and obesity.

  15. Mohammad AH, Al-Sadat N, Siew Yim L, Chinna K
    Biomed Res Int, 2014;2014:302097.
    PMID: 25276774 DOI: 10.1155/2014/302097
    This study aims to test the translated Hausa version of the stroke impact scale SIS (3.0) and further evaluate its psychometric properties. The SIS 3.0 was translated from English into Hausa and was tested for its reliability and validity on a stratified random sample adult stroke survivors attending rehabilitation services at stroke referral hospitals in Kano, Nigeria. Psychometric analysis of the Hausa-SIS 3.0 involved face, content, criterion, and construct validity tests as well as internal and test-retest reliability. In reliability analyses, the Cronbach's alpha values for the items in Strength, Hand function, Mobility, ADL/IADL, Memory and thinking, Communication, Emotion, and Social participation domains were 0.80, 0.92, 0.90, 0.78, 0.84, 0.89, 0.58, and 0.74, respectively. There are 8 domains in stroke impact scale 3.0 in confirmatory factory analysis; some of the items in the Hausa-SIS questionnaire have to be dropped due to lack of discriminate validity. In the final analysis, a parsimonious model was obtained with two items per construct for the 8 constructs (Chi-square/df < 3, TLI and CFI > 0.9, and RMSEA < 0.08). Cross validation with 1000 bootstrap samples gave a satisfactory result (P = 0.011). In conclusion, the shorter 16-item Hausa-SIS seems to measure adequately the QOL outcomes in the 8 domains.
  16. Hamza AM, Al-Sadat N, Loh SY, Jahan NK
    Biomed Res Int, 2014;2014:350281.
    PMID: 24982864 DOI: 10.1155/2014/350281
    This study aims to identify the predictors in the different aspects of the health-related quality of life (HRQoL) and to measure the changes of functional status over time in a cohort of Nigerian stroke survivors. A prospective observational study was conducted in three hospitals of Kano state of Nigeria where stroke survivors receive rehabilitation. The linguistic-validated Hausa versions of the stroke impact scale 3.0, modified Rankin scale, Barthel index and Beck depression inventory scales were used. Paired samples t-test was used to calculate the amount of changes that occur over time and the forward stepwise linear regression model was used to identify the predictors. A total of 233 stroke survivors were surveyed at 6 months, and 93% (217/233) were followed at 1 year after stroke. Functional disabilities were significantly reduced during the recovery phase. Motor impairment, disability, and level of depression were independent predictors of HRQoL in the multivariate regression analysis. The involvement of family members as caregivers is the key factor for those survivors with improved functional status. Thus, to enhance the quality of poststroke life, it is proposed that a holistic stroke rehabilitation service and an active involvement of family members are established at every possible level.
  17. Thangiah N, Chinna K, Su TT, Jalaludin MY, Al-Sadat N, Majid HA
    PMID: 32257989 DOI: 10.3389/fpubh.2020.00069
    Background: Cardiovascular disease (CVD) risk factors tend to cluster and progress from adolescence to young adulthood. Reliable and meaningful clustering of CVD risk factors is essential to circumvent loss of information. Tracking adverse and high-risk profiles of adolescents is hoped to curb CVD progression later in life. The study aims to investigate the clustering of biological CVD risk factor among adolescents in Malaysia and the transitions between clusters over time. Method: The Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs) examined school students aged 13 in 2012 and re-examined them in 2014 and 2016. In a two-stage stratified cluster sampling, 1,361 students were recruited, of which, 1,320 had complete data. In the follow-up, there were 881 and 637 students in 2014 and in 2016, respectively. Pearson's correlation coefficients were used to identify and remove highly correlated CVD risk factors. All risk factors were standardized into z-scores. The hierarchical and non-hierarchical (k-means) cluster analyses were used to classify students into high, medium and low risk clusters in each screening year. The tracking and stability of cluster transitions through cross-classification were enumerated with Pearson's inter-age correlations and percentages. Results: Three significant clusters of high, medium and low risk groups were derived from the clustering of eight biological CVD risk factors. The transitions between risk clusters from one screening year to the other were categorized as either stagnant, improved or adverse. The number of students who had adverse transitions increased from 15.5% (13-15 year) to 19.5% (15-17 year), 13.8 to 18.2% among the girls and 19.9 to 22.8% among the boys. For girls, the number of them who remained at high risk over the two transition periods were about the same (13.6 vs. 13.8%) whereas for boys, the percentage reduced from 14.6 to 12.3%. Conclusion: Over time, more than 12% of adolescents remained in the high risk cluster. There were sizable adverse transitions over time as more adolescents appear to be shifting toward an increased risk of having CVD. Collaborative and constant measures should be taken by parents, school, health promotion boards and policy makers to curb the multiplicative effect of clustering CVD risk factors among adolescents.
  18. Zulkipli AF, Islam T, Mohd Taib NA, Dahlui M, Bhoo-Pathy N, Al-Sadat N, et al.
    Integr Cancer Ther, 2018 06;17(2):312-321.
    PMID: 29218996 DOI: 10.1177/1534735417745248
    BACKGROUND: The use of complementary and alternative medicine (CAM) has increased and little is known on CAM use during the initial period. Therefore, the aim was to determine prevalence of CAM use among newly diagnosed breast cancer patients prior to seeking conventional treatment.

    METHODS: This is a cross-sectional study involved interviewing newly diagnosed breast cancer patients in the University Malaya Medical Centre (UMMC) using a structured questionnaire. Eligible respondents were interviewedduring a routine clinical visit.

    RESULTS: A total of 400 patients were interviewed, of whom 139 (34.8%) were CAM users. Dietary supplementation (n = 107, 77.0%) was the most frequently used type of CAM, followed by spiritual healing (n = 40, 28.8%) and traditional Chinese medicine (n = 32, 23.0%). Malay ethnic group (n = 61, 43.9%) was the largest group of CAM users, followed by Chinese (n = 57, 41.0%) and Indian (n = 20, 14.4%). Majority of these CAM users (n = 87, 73.1%) did not disclose the use of CAM to their doctors. Most of them used remedies based on the recommendation of family and friends. Malay ethnicity and patients with 3 or more comorbidities were more likely to use CAM.

    CONCLUSION: There is substantial use of CAM among breast cancer patients in UMMC prior to seeking hospital treatment, and the most popular CAM modality is dietary supplements. Since, the majority of CAM users do not disclose the use of CAM to their physicians, therefore health care providers should ensure that those patients who are likely to use CAM are appropriately counseled and advised.

  19. Tahir NM, Al-Sadat N
    Int J Nurs Stud, 2013 Jan;50(1):16-25.
    PMID: 23084438 DOI: 10.1016/j.ijnurstu.2012.09.006
    Exclusive breastfeeding rates in Malaysia remains low despite the implementation of the Baby Friendly Hospital Initiative (BFHI) policy in government hospitals. It has been suggested that any form of postnatal lactation support will lead to an increase in exclusive breastfeeding rates.
  20. Mohammad AH, Al Sadat N, Loh SY, Chinna K
    Iran Red Crescent Med J, 2015 Feb;17(2):e18776.
    PMID: 25838933 DOI: 10.5812/ircmj.18776
    BACKGROUND: Social support has been identified as one of the key factors for enhancing the quality of life after stroke. However, a scientific tool that is valid for evaluating social support among stroke survivors in Nigeria has not been developed so far.

    OBJECTIVES: The objective of this study was to examine the psychometric properties of the Hausa translated versions of the Multidimensional Scale of Perceived Social Support (MSPSS) and to validate it for future use in clinical research in Nigeria.

    PATIENTS AND METHODS: This cross-sectional study was conducted on a sample of 140 adult stroke survivors attending rehabilitation services at stroke referral centers in Kano, Nigeria. The psychometric analysis of the Hausa-MSPSS involved face, content, criterion and construct validity tests, as well as internal and test-retest reliability. Confirmatory factor analysis was performed to assess validity of the three-factor (Family, Friends and Significant others) model for the Hausa-MSPSS.

    RESULTS: Based on expert panel, clinicians' review and patients' feedback, the 12 item Hausa-MSPSS had sufficient face, content and criterion validity. In reliability analysis, the Cronbach's alpha was 0.781. In test-retest reliability analysis, the minimum kappa value was 0.673. In Confirmatory factor analysis, the three-factor model was not acceptable. An alternative two-factor model with Family and Friends, as the two domain was found to be acceptable (Chi-square/df < 3, TLI, CFI > 0.9, RMSEA < 0.08). The average variances extracted for the two constructs were 0.5 and 0.7, respectively. The R-squared value between the two constructs was 0.397. Cross validity tested using 1000 bootstrap resamples gave satisfactory results (P = 0.079).

    CONCLUSIONS: The 11 item Hausa-MSPSS index is valid for the assessment of perceived social support among stroke survivors in Nigeria.

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