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The role of complementary indigenous Malay therapies: perspectives from palliative care patients

Lua PL

J Complement Integr Med, 2011 Jan;8.
PMID: 22754943 DOI: 10.2202/1553-3840.1369

Although the popularity of complementary indigenous Malay therapies (CIMT) in general healthcare is undeniable in the Malaysian context today, their usage within the palliative care scenarios remains unexplored. Our study was specifically embarked to determine CIMT’s usage pattern, reasons, attitudes, beliefs, perceptions and health-related quality of life (HRQoL) differences (users vs. non-users) in a sample of hospice-based palliative patients in Selangor, Malaysia. From the 39 consenting patients (mean age = 56 years; female = 56.4 percent; Malay = 53.8 percent), 38.5 percent were users of CIMT. Dried medicinal roots, herbs and sea cucumber products were the most preferred types of CIMT (53.3 percent). The most common reason cited for usage was because these were "easier and simpler to be administered" (46.7 percent). Although users' attitudes, beliefs and perceptions were more favourable than the non-users, between 30.0-73.3 percent of users remained unsure or had no knowledge regarding CIMT. They also exhibited significantly poorer Physical Symptoms than the non-users (p=0.006), a probable motive for seeking CIMT in the first place. Despite the small sample size, the findings provided some insight into the role of CIMT especially with regard to usage trends and overall well-being among the terminally-ill, of which healthcare professionals should constantly be vigilant of amidst their routine care responsibilities.
The interactive animated epilepsy education programme (IAEEP): how feasible, acceptable and practical is the technology to children?

Lua PL, Neni WS, Lee JK, Abd Aziz Z

Technol Health Care, 2013;21(6):547-56.
PMID: 24284547 DOI: 10.3233/THC-130758

Being well-informed and knowledgeable about their illnesses would be a great advantage to children with epilepsy (CWE). Subsequently, an effective education programme which could secure interest and simultaneously improve their awareness, knowledge and attitudes (AKA) is essential in enhancing well-being and health outcomes.
Fulltext The impact of nutrition education interventions on the dietary habits of college students in developed nations: a brief review

Lua PL, Wan Putri Elena WD

Malays J Med Sci, 2012 Jan;19(1):4-14.
PMID: 22977369 MyJurnal

The purpose of this review is to provide a summary of studies on the effectiveness nutrition education interventions used by college students. Electronic databases such as Medline, Science Direct, CINAHL (EBSCOhost), and Google Scholar were explored for articles that involved nutrition education interventions for college students and that were published between 1990 and 2011. Fourteen studies, which involved a total of 1668 college students as respondents, were identified and met the inclusion criteria. The results showed that there were 3 major forms of nutrition education interventions: web-based education, lectures, and supplement provisions. Dietary intake measures were used in almost all studies and were primarily collected with food records, recall, food frequency questionnaires, and dietary habit questionnaires. The outcome measures varied among the studies, with indicators such as consumption of food, nutrition knowledge, dietary habits, physical activity, and quality of life. Methodological issues were also identified. In general, college students experienced significant changes in their dietary habits after the interventions were employed. The highlighted methodological issues should be considered to improve the quality of similar research in future.
The feasibility, reliability and validity of the McGill Quality of Life Questionnaire-Cardiff Short Form (MQOL-CSF) in palliative care population

Lua PL, Salek S, Finlay I, Lloyd-Richards C

Qual Life Res, 2005 Sep;14(7):1669-81.
PMID: 16119179 DOI: 10.1007/s11136-005-2817-8

In terminally-ill patients, effective measurement of health-related quality of life (HRQoL) needs to be done while imposing minimal burden. In an attempt to ensure that routine HRQoL assessment is simple but capable of eliciting adequate information, the McGill Quality of Life Questionnaire-Cardiff Short Form (MQOL-CSF: 8 items) was developed from its original version, the McGill Quality of Life Questionnaire (MQOL: 17 items). Psychometric properties of the MQOL-CSF were then tested in palliative care patients consisting of 55 out-patients, 48 hospice patients and 86 in-patients: The MQOL-CSF had little respondent burden (mean completion time = 3.3 min) and was evaluated as 'very clear' or 'clear' (98.2%), comprehensive (74.5%) and acceptable (96.4%). The internal consistency reliability was moderate to high (Cronbach's alpha = 0.462-0.858) and test-retest reliability (Spearman's r(s)) ranged from 0.512-0.861. Correlation was moderate to strong (0.478-0.725) between items in the short form and their analogous domains in the MQOL. Most MQOL-CSF items showed strong associations with their own domain (r(s) > or = 0.40). Scores from MQOL-CSF significantly differentiated between patients with differing haemoglobin levels (p < 0.05). Construct validity was overall supported by principal component analysis. It is concluded that the MQOL-CSF is a feasible tool with favourable psychometric properties for routine HRQoL assessment in the palliative care population.
Study site: out-patient palliative care clinic; a hospice centre and hospital inpatient wards, United Kingdom
Fulltext The feasibility, reliability and validity of the Malay McGill Quality of Life Questionnaire--Cardiff Short Form (MMQOL-CSF) in Malaysian advanced cancer population

Lua PL, Salek MS, Finlay IG, Boay AGI, Rahimah MS

Med J Malaysia, 2005 Mar;60(1):28-40.
PMID: 16250277

Health-related quality of life (HRQoL) assessment is important in healthcare outcomes. This study aimed to determine the feasibility, reliability and validity of the Malay McGill Quality of Life Questionnaire--Cardiff Short Form (MMQOL-CSF) in advanced cancer population. Patients either completed the MMQOL-CSF alone or in addition to its long version. The study recruited 116 participants (average age = 44 years old). On average, MMQOL-CSF was completed in 5.4 minutes. Most domains showed evidence of reliability (Cronbach's alpha = 0.76-0.92). Correlation with its long version was moderate to strong (r(s) = 0.54-0.87). The MMQOL-CSF was a feasible, reliable and valid HRQoL instrument in this population.
The feasibility and acceptability of hypnotherapy among overweight and obese individuals in a Malaysia's public university

Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Lua PL

J Complement Integr Med, 2021 Apr 02;18(3):561-568.
PMID: 33794082 DOI: 10.1515/jcim-2020-0177

OBJECTIVES: The global epidemic of overweight and obesity presents a major challenge in the health status of the society. Their prevalence is at an alarming rate worldwide due to poor compliance with conventional treatment and high rates of relapse, thus increasing demand for an effective and safe alternative approach such as hypnotherapy. This study aimed to evaluate the feasibility and acceptability of hypnotherapy for weight loss and to compare these among selected socio-demographics.
METHODS: A cross-sectional study was conducted among 30 students and staff of a public university in Terengganu, Malaysia using convenience sampling. Data analysis was carried out using SPSS 23.0.
RESULTS: Among the respondents (age = 26.17 ± 8.23 years; female = 66.7%; students = 63.3%), 40.0% were overweight and 60.0% were obese. Results indicated excellent feasibility as determined by participants' satisfaction towards the clarity of hypnotherapist's voice (93.3%), the suitability of content (86.7%) and time spent for the session (90.0%). Good overall acceptability (>60.0%) was also reported regarding hypnotherapist professionalism, the environment and perceived usefulness of hypnotherapy. Obese individuals were significantly more satisfied towards the hypnotherapist environment than overweight respondents (p=0.015). Additionally, no adverse effects were reported after the intervention.
CONCLUSIONS: This evidence signalled that hypnotherapy is a promising alternative tool in assisting overweight and obese individuals to lose weight. Extensive research is needed to substantiate its role in weight management programs for its full benefits.
Fulltext The effectiveness of auricular acupuncture for drug addiction: a review of research evidence from clinical trials

Lua PL, Talib NS

ASEAN Journal of Psychiatry, 2012;13(1):55-68.
MyJurnal

Objectives: This review aims to compile and evaluate all available randomised controlled trials (RCTs) of auricular acupuncture (AA) treatment in drug addiction population with emphasis on the length of treatment course, needle-points, outcome measures, reported side-effects and overall outcomes.
Methods: Science Direct, Medline and EBSCOhost databases were searched. From the year 1990 until 2010, only full-length English articles incorporating RCTs related to AA studies (needle-based only) in drug addiction such as heroin, morphine, methamphetamine and cocaine were included. Studies involving the usage of various methods of electroacupuncture and investigations relating to cigarette-smoking or alcohol addiction were excluded.
Results: Eight RCTs met all inclusion criteria comprising of 1,594 respondents (age = 19 - 46 years; male = 57% - 76%). Most were involved in cocaine addiction. Overall, trials were designed with brief periods of treatment course and utilised three to five standard National Acupuncture Detoxification Association (NADA) points (Sympathetic, Lung, Liver, Kidney and Shen men), but inconsistent sham points. All trials included urine toxicology test as the main outcome measure while data on side-effects incidence was insufficient. Conclusions: Overall, four of the RCTs reported positive outcomes although at this point, AA’s effectiveness and safety could not be substantially confirmed. For the future, high-quality RCTs of AA are urgently required to provide a clearer understanding on the usefulness of this complementary therapy in drug addiction treatment.
Fulltext Safety culture perceptions of pharmacists in Malaysian hospitals and health clinics: a multicentre assessment using the Safety Attitudes Questionnaire

Samsuri SE, Lua PL, Fahrni ML

BMJ Open, 2015 Nov 26;5(11):e008889.
PMID: 26610761 DOI: 10.1136/bmjopen-2015-008889

OBJECTIVE: To assess the safety attitudes of pharmacists, provide a profile of their domains of safety attitude and correlate their attitudes with self-reported rates of medication errors.
DESIGN: A cross-sectional study utilising the Safety Attitudes Questionnaire (SAQ).
SETTING: 3 public hospitals and 27 health clinics.
PARTICIPANTS: 117 pharmacists.
MAIN OUTCOME MEASURES: Safety culture mean scores, variation in scores across working units and between hospitals versus health clinics, predictors of safety culture, and medication errors and their correlation.
RESULTS: Response rate was 83.6% (117 valid questionnaires returned). Stress recognition (73.0±20.4) and working condition (54.8±17.4) received the highest and lowest mean scores, respectively. Pharmacists exhibited positive attitudes towards: stress recognition (58.1%), job satisfaction (46.2%), teamwork climate (38.5%), safety climate (33.3%), perception of management (29.9%) and working condition (15.4%). With the exception of stress recognition, those who worked in health clinics scored higher than those in hospitals (p<0.05) and higher scores (overall score as well as score for each domain except for stress recognition) correlated negatively with reported number of medication errors. Conversely, those working in hospital (versus health clinic) were 8.9 times more likely (p<0.01) to report a medication error (OR 8.9, CI 3.08 to 25.7). As stress recognition increased, the number of medication errors reported increased (p=0.023). Years of work experience (p=0.017) influenced the number of medication errors reported. For every additional year of work experience, pharmacists were 0.87 times less likely to report a medication error (OR 0.87, CI 0.78 to 0.98).
CONCLUSIONS: A minority (20.5%) of the pharmacists working in hospitals and health clinics was in agreement with the overall SAQ questions and scales. Pharmacists in outpatient and ambulatory units and those in health clinics had better perceptions of safety culture. As perceptions improved, the number of medication errors reported decreased. Group-specific interventions that target specific domains are necessary to improve the safety culture.
Study site: Klinik kesihatan, hospitals, Malaysia
Fulltext Relationship of objectively measured physical activity and sedentary behaviour with health-related quality of life among breast cancer survivors

Nurnazahiah A, Shahril MR, Nor Syamimi Z, Ahmad A, Sulaiman S, Lua PL

Health Qual Life Outcomes, 2020 Jul 10;18(1):222.
PMID: 32650777 DOI: 10.1186/s12955-020-01478-x

BACKGROUND: Lack of physical activity throughout one's lifetime has been associated with obesity and it is also an important risk factor of breast cancer. This study aimed to determine the relationship between objectively measured physical activity and sedentary behaviour with health-related quality of life (HRQoL) among breast cancer survivors in the East Coast region of Peninsular Malaysia.
METHODS: A cross-sectional study involving 83 breast cancer survivors was carried out in two main government referral hospitals in the region. Participants wore the ActivPAL3™ microdevice physical activity monitor for seven consecutive days. The validated European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30) and Breast Cancer Supplementary Measure (EORTC QLQ-BR23) were used to measure their HRQoL. Multiple linear regression analysis was conducted to determine the relationship between objectively measured physical activity and sedentary behaviour with HRQoL.
RESULTS: Longer time spent on moderate to vigorous physical activity (MVPA) was significantly associated with an improvement of HRQoL (p = 0.039) whereas longer time spent on sedentary behaviour significantly reduced the functioning score (p = 0.005). In addition, prolonged sedentary bouts were also significantly associated with better body image that led to improved HRQoL (p = 0.013).
CONCLUSIONS: The study findings suggest that an increase in the time spent on MVPA was associated with improved HRQoL while sedentary behaviour was associated with poorer HRQoL among breast cancer survivors. Thus, it is essential to displace sedentary behaviour with MVPA to improve the quality of life of breast cancer survivors.
Provision of sudden unexpected death in epilepsy (SUDEP) information among Malaysian parents of children with epilepsy

Fong CY, Lim WK, Kong AN, Lua PL, Ong LC

Epilepsy Behav, 2017 10;75:6-12.
PMID: 28806633 DOI: 10.1016/j.yebeh.2017.06.037

Sudden unexpected death in epilepsy (SUDEP) is an important cause of mortality in epilepsy. To date, there is only one published UK study evaluating information provision of SUDEP among parents of children with epilepsy (CWE), and there are no studies published from Asia. Although SUDEP information provision is recommended among parents of CWE, it is uncertain if these recommendations are applicable to Asian countries due to the different cultural attitude towards epilepsy. Our prospective cohort study consisted of multiethnic parents of children with epilepsy (CWE) seen in a tertiary hospital in Malaysia. Information on SUDEP was delivered to parents using an epilepsy educational software program. Participants completed a set of standardized questionnaire and Depression Anxiety Stress Scales-Short Form (DASS-21) immediately after and retested 3-6months after the SUDEP information provision. A total of 127 parents (84 mothers) participated in the study. The CWE consisted of 3 ethnic groups (38% Malay, 30% Chinese, 32% Indian) with a mean age of 9.6years. Majority (70.9%) felt positive after SUDEP information provision, 90.6% wanted SUDEP discussion for themselves with 70.1% wanted SUDEP discussion with their child, and a lower proportion (58.3%) would discuss SUDEP with their child. None of the participants reported increased symptoms of depression, stress or anxiety attributed to SUDEP information provision. Most parents took steps to reduce SUDEP risk, and most parents did not report an impact on their own functioning. However, there was an increase in parental report over time of impact on their child's functioning following SUDEP information (P<0.05). In conclusion, most Malaysian parents of CWE wanted SUDEP information. Following SUDEP information disclosure, majority did not report negative emotions; however, an increase in parents over time reported an impact on their child. Our findings reiterate that provision of SUDEP information should form part of care of CWE and parents should receive ongoing support as they undergo a period of parenting adjustment when dealing with the information provided.
Fulltext Prevalence of metabolic syndrome among breast cancer survivors in East Coast of Peninsular Malaysia

Shahril MR, Amirfaiz S, Lua PL, Nurnazahiah A, Zakarai NS, Kow VL, et al.

BMC Public Health, 2021 01 28;21(1):238.
PMID: 33509143 DOI: 10.1186/s12889-021-10288-9

BACKGROUND: To date, limited data are available on metabolic syndrome prevalence among breast cancer survivors in Malaysia. Therefore, this study was conducted to determine the prevalence of metabolic syndrome and abnormal metabolic syndrome components among breast cancer survivors in East Coast of Peninsular Malaysia.
METHODS: This cross-sectional study included 95 breast cancer survivors (age 53.7 ± 7.6 years) who have completed main cancer treatments for ≥6 months. Cancer survivors were recruited from two main government hospitals in Kelantan and Terengganu using a purposive sampling method.
RESULTS: According to the Harmonized criteria, the metabolic syndrome prevalence was 50.5%. Among those with metabolic syndrome, the most prevalent abnormal metabolic components were triglycerides (91.2%), fasting blood glucose (79.6%) and HDL-c level (78.4%). Except for total cholesterol and LDL-c, all other metabolic syndrome components were significantly different (p
Prevalence and usage of printed and electronic drug references and patient medication records in community pharmacies in Malaysia

Usir E, Lua PL, Majeed AB

J Pharm Pract, 2012 Jun;25(3):374-80.
PMID: 22551563 DOI: 10.1177/0897190012442218

This study aimed to determine the availability and usage of printed and electronic references and Patient Medication Record in community pharmacy. It was conducted for over 3 months from 15 January to 30 April 2007. Ninety-three pharmacies participated. Structured questionnaires were mailed to community pharmacies. Six weeks later a reminder was sent to all non responders, who were given another six weeks to return the completed questionnaire. Outcomes were analyzed using descriptive statistics and chi-square test of independence. Almost all the pharmacies (96.8%) have at least Monthly Index of Medical Specialties (MIMS) while 78.5% have at least MIMS ANNUAL in their stores. Only about a third (31.2%) of the pharmacies were equipped with online facilities of which the majority referred to medical websites (88.9%) with only a minority (11.1%) referring to electronic journals. More than half (59.1%) of the pharmacists kept Patient Medication Record profiles with 49.1% storing it in paper, 41.8% electronically and 9.1% in both printed and electronic versions. In general, prevalence and usage of electronic references in community pharmacies were rather low. Efforts should be increased to encourage wider usage of electronic references and Patient Medication Records in community pharmacies to facilitate pharmaceutical care.
Fulltext Prevalence and Predictors of Malnutrition Risk among Post-Stroke Patients in Outpatient Setting: A Cross-Sectional Study

Wong HJ, Harith S, Lua PL, Ibrahim KA

Malays J Med Sci, 2020 Jul;27(4):72-84.
PMID: 32863747 MyJurnal DOI: 10.21315/mjms2020.27.4.7

Background: The present study examined the prevalence and predictors of malnutrition risk among post-stroke patients.
Methods: Post-stroke patients who attended the outpatient clinics in three hospitals of Peninsular Malaysia were enrolled in the study. The risk of malnutrition was assessed using the Malnutrition Risk Screening Tool-Hospital. Data including demographic characteristics, clinical profiles, dietary nutrients intake, body mass index (BMI) and hand grip strength were collected during the survey. The crude odds ratio (OR) and adjusted odds ratio (AOR) were reported for univariate and multivariate logistic regression analyses, respectively.
Results: Among 398 patients included in the study, 40% were classified as high-risk for malnutrition. In the multivariable logistic regression, tube feeding (AOR: 13.16, 95% confidence interval [CI]: 3.22-53.77), loss of appetite (AOR: 8.15, 95% CI: 4.71-14.12), unemployment (AOR: 4.26, 95% CI: 1.64-11.12), wheelchair-bound (AOR: 2.23, 95% CI: 1.22-4.09) and BMI (AOR: 0.87, 95% CI: 0.82-0.93) were found to be significant predictors of malnutrition risk among stroke patients.
Conclusion: The risk of malnutrition is highly prevalent among post-stroke patients. Routine nutritional screening, identification of risk factors, and continuous monitoring of dietary intake and nutritional status are highly recommended even after the stroke patient is discharged.
Fulltext Nutritional status and health-related quality of life of breast cancer patients on chemotherapy

Lua PL, Salihah NZ, Mazlan N

Malays J Nutr, 2012 Aug;18(2):173-84.
PMID: 24575665 MyJurnal

Nutritional decline is typically accepted as a consequent of the course of treatment for cancer. This study aimed to (1) assess body weight status and dietary intake of breast cancer patients on chemotherapy and (2) to correlate Body Mass Index (BMI), energy and protein intake with health-related quality of life (HRQoL) profile.
Fulltext Nutrition quality of life among female-majority Malay undergraduate students of health sciences

Lua PL, Wan Putri Elena WD, Mohd Razif S

Malays J Med Sci, 2012 Oct;19(4):37-49.
PMID: 23785251 MyJurnal

BACKGROUND: University students generally tend to engage in problematic eating behaviours, including unhealthy dieting, skipping meals, and high intake of fast food, although they are aware of the negative consequences. Eating behaviours have been shown to be interestingly related to quality of life (QoL). Our study aimed to 1) assess general nutrition quality of life (NQoL) status and 2) compare NQoL status based on gender, financial resources, study courses, year of study, and body mass index (BMI) profiles.
METHODS: This study was conducted among undergraduates of health sciences in a local public university in Terengganu. Students completed the Malay version of NQoL (6 domains; 50 items; Likert-type responses 1-5). Data analysis was carried out by using SPSS 16.0, utilising descriptive and parametric statistics.
RESULTS: A total of 241 students were enrolled [age = 19.7 (0.1) years; female (83.0%); Malay (96.7%)]. Social/Interpersonal Factors [3.84 (0.43)] emerged as the best component, while Food Impact [3.10 (0.40)] was the worst. Across all variables, only gender and study courses showed significantly different NQoL. Females scored better than males in Self-Efficacy (confidence in food selection ability) (P < 0.05). Nursing students also experienced significantly greater NQoL (mean = 3.58, 95% CI = 3.47, 3.68) than radiography students in Self-Efficacy (p < 0.05). Medical laboratory technology students had a significantly more favourable NQoL rating (mean = 3.62, 95% CI = 3.47, 3.76) than nursing students in Self-Image (p < 0.05). Study courses significantly influenced the NQoL status of students with Good NQoL, while those with Poor NQoL were mostly influenced by gender and financial resources (p < 0.05).
CONCLUSION: These outcomes indicate that specific demographic characteristics seemed to make a difference in the NQoL of undergraduate students.
KEYWORDS: health sciences; nutrition; quality of life; undergraduates
Study site: public university, Terengganu, Malaysia
Scales & Questionnaires: Nutrition Quality of Life instrument (NQoL)
Methadone maintenance treatment versus methadone maintenance treatment plus auricular acupuncture: impacts on patient satisfaction and coping mechanism

Lua PL, Talib NS, Ismail Z

J Pharm Pract, 2013 Dec;26(6):541-50.
PMID: 23764566 DOI: 10.1177/0897190013489574

This study intended to (1) describe the baseline patient satisfaction level and preferred coping strategies and (2) assess patient satisfaction and coping mechanisms pre- and postintervention. Patients on methadone maintenance treatment (MMT) in Terengganu, Malaysia, were randomized into either MMT or MMT plus auricular acupuncture (MMT + AA) groups. All received the standard MMT, while participants on MMT + AA underwent concurrent AA session thrice weekly for 2 months (each session = 30 minutes). Data analysis was carried out using SPSS 16.0, employing descriptive and nonparametric statistics. Participations were received from 97 eligible male patients (median age = 36.0 years; Malay = 97.9%). After screening for dropouts, only 69 patients were considered for subsequent analysis (MMT = 40; MMT + AA = 29). At preintervention, both groups did not differ significantly in the parameters investigated. During postintervention, no significant difference was detected for satisfaction level but coping-wise, substance use was significantly and frequently adopted by MMT + AA patients compared to MMT respondents (P < .05). On separate analysis, those who received MMT alone adopted active coping, venting, and self-blame significantly more frequently postintervention (P < .05). Nevertheless, no significant difference for coping styles of MMT + AA patients was exhibited over time (P >.05). The addition of AA therapy into the standard MMT treatment did not seem to influence patient satisfaction and their coping ways.
Lipid profiles and lifestyle habits of stroke survivors in the east coast region of peninsular Malaysia: Preliminary findings

Wong HJ, Harith S, Lua PL, Ibrahim KA

Nutr Health, 2023 Dec;29(4):695-705.
PMID: 35763460 DOI: 10.1177/02601060221097459

Background: Stroke survivors are at high risk for recurrent cardiovascular events if no prevention strategies are undertaken. Aim: This study aimed to investigate the fasting serum lipid profiles and lifestyle habits in stroke survivors, and the factors associated with suboptimal lipid profiles. Methods: A cross-sectional retrospective study was conducted in three public hospitals in Malaysia. Stroke survivors' data regarding the socio-demographic characteristics, clinical profiles, fasting serum lipid profiles, dietary adherence, and physical activity levels were acquired. Binary logistic regression was used to examine the factors associated with suboptimal lipid goals. Results: A total of 104 stroke survivors were recruited from patients attending the neurology and rehabilitation departments. Only 22% of the stroke survivors attained the targeted low-density lipoprotein cholesterol level (LDL-C < 1.8 mmol/L). Meanwhile, more than two thirds of patients achieved the targeted total cholesterol, triglyceride, and high-density lipoprotein cholesterol goals. Patients with a longer stroke duration (Adjusted odds ratio, AOR 3.33, 95% confidence intervals, CI: 1.09, 10.13, p = 0.034), elevated blood pressure (AOR 4.74, 95% CI: 1.65, 13.62, p = 0.004), chronic kidney disease (AOR 3.30, 95% CI: 1.05, 10.34, p = 0.041), abdominal obesity (AOR 3.14, 95% CI: 1.20, 8.21, p = 0.020), excessive energy intake (AOR 2.72, 95% CI: 1.07, 6.91, p = 0.036), and excessive saturated fatty acids intake (AOR 2.85, 95% CI: 1.02, 7.93, p = 0.045) were significantly associated with suboptimal lipid profiles. Conclusion: The lipid goals attainment was low, particularly the LDL-C levels among Malaysian stroke survivors. Greater efforts are warranted to fully utilise the lipid-lowering therapy and the lifestyle changes in these high-risk patients.
Fulltext Knowledge of Medical Students Towards the Re-emergence of Human Monkeypox Virus

Raman H, Jamil A, Rasheed A, Abdulrahman Jairoun A, Lua PL, Ibrahim UI, et al.

Cureus, 2023 Oct;15(10):e46761.
PMID: 37954738 DOI: 10.7759/cureus.46761

INTRODUCTION: Declaration of human monkeypox(HMPX) virus as Public Health Emergency of International Concern (PHEIC) by World Health Organisation (WHO) has raised concerns among the public andlack of knowledge is a prominent challenge in curbing this outbreak. Therefore, assessment ofknowledge level on this outbreak among the medical students is also necessary due to the fact that they are the future healthcare practitioners who will be directly involved in the disease management as well as a major source of knowledge dissemination to the public.
AIM: The main objective of this study is to assess the knowledge level of medical students at Universiti Sultan Zainal Abidin (UniSZA) regarding the emergence of HMPX. Additionally, the study aims to investigate potential associations between socio-demographic characteristics and knowledge levels, while also identifying factors that predict a high level of knowledge in this context..
METHODS: A descriptive cross-sectional study was conducted among UniSZA undergraduatemedical students from Year 1 to Year 5. A validated questionnaire comprising six socio-demographic variables and 27 knowledge items was shared online. Descriptive statistics, non-parametric tests and multivariate logistic regression were performed using SPSS software.
RESULTS: A total of 138 medical students out of 300 participated in this study. Overall, the average knowledge score was 73.95% ±4.43, which indicates that the medical students have moderate knowledge level. Nearly half of them had good knowledge level (n= 68; 49.3%), 43 of them had moderate knowledge level (31.2%), and 27 of them had poor knowledge level (19.6%). There was a significant association between knowledge level and two factors: receiving information on HMPX during their education and seniority (P-value < 0.01 and P-value < 0.05, respectively). Besides, received information on HMPX during their education was a significant predicting factor of good knowledge level (P-value = 0.002).
CONCLUSION: The knowledge level among the medical students was relatively inadequate.
Fulltext Knowledge and Perception of Facial Candling for Allergic Rhinitis among University Staff and Students

Hamdan NKA, Lean QY, Neoh CF, Abdullah AH, Lim SM, Ramasamy K, et al.

Evid Based Complement Alternat Med, 2020;2020:5713134.
PMID: 32831870 DOI: 10.1155/2020/5713134

Introduction: Facial candling is a traditional method used for relieving symptoms of allergic rhinitis (AR). This study aims to investigate the knowledge and perception of facial candling in a sample of staff and students in a public university in Malaysia.
Methods: An online questionnaire survey method was used. Based on sample size calculation, a total of 1,508 UiTM staff and students from ten selected campuses of Universiti Teknologi MARA (UiTM) were invited to participate in this survey. An up-to-date e-mail list of staff in the selected campuses was used as the sampling frame for the study, whereas the students were recruited from the official university student Facebook portal.
Results: A total of 788 respondents participated in this survey, 72.2% of them knew about facial candling, though only 35.4% had tried the treatment. Approximately one-fifth of respondents agreed that facial candling might treat AR. It was found that a higher number of users than nonusers agreed that facial candling was a traditional medicine (78.9% vs 55.0%); could be used on the face and ears (83.5% vs 45.4%); and could be self-administered at home (83.5 vs 45.4%). Interestingly, more than half of them were uncertain about its long-term effects and adverse reactions.
Conclusion: This study confirms the facial candling use among patients with AR although the percentage is low. The patients and general public need to be better informed about the use of facial candling in AR and its associated risks.
Improving awareness, knowledge, and attitude among Malaysian parents of children with epilepsy using an Interactive Animated Epilepsy Education Programme (IAEEP)

Fong CY, Hong SY, Ong LC, Lim WK, Lua PL

Epilepsy Behav, 2019 May;94:52-58.
PMID: 30884408 DOI: 10.1016/j.yebeh.2019.02.008

BACKGROUND: An information technology (IT)-based epilepsy educational program, the Interactive Animated Epilepsy Education Programme (IAEEP), can potentially help improve awareness, knowledge, and attitude (AKA) of parents of children with epilepsy (CWE) enabling CWE to lead a normal life. Our study aimed to assess the following: i) baseline level of epilepsy AKA of Malaysian parents of CWE and explore potential characteristics associated with low levels of AKA; ii) effectiveness of the IAEEP in improving parental AKA, and whether these effects remained stable over time; and iii) effects of the IAEEP on parental mental state and perception of their child's quality of life.
METHODS: This prospective study includes parents of CWE aged 8-18 years old with no comorbidities. Epilepsy education was delivered using the IAEEP. Parents completed an AKA questionnaire before (time point 1 [TP1]), immediately after (TP2), and 4-6 months (TP3) after the provision of IAEEP. Parent proxy report of Health-Related Quality of Life Measurement for Children with Epilepsy (CHEQOL)-25 questionnaire and Depression, Anxiety, and Stress Scale (DASS)-21 questionnaire was completed at TP1 and TP3.
RESULTS: A total of 78 parents participated in the study. At baseline (TP1), parental responses were rated as "moderate" for awareness domain, "high" for knowledge domain, "very positive" for attitude domain, and "good" for total AKA score domain. No epilepsy or parental characteristics were associated with the low baseline parental AKA levels. After IAEEP intervention, there was a significant increase in all AKA subdomain scores. Post-IAEEP, the AKA of parents were rated as "very high" for awareness domain, "very high" for knowledge domain, "very positive" for attitude domain, and "excellent" for total AKA domain at both TP2 and TP3. Parent proxy CHEQOL-25 report showed significant increments in interpersonal/social and secrecy scale scores between TP1 and TP3. There were no significant differences in the DASS-21 scores between TP1 and TP3.
CONCLUSION: The IAEEP is an effective epilepsy educational tool to increase the levels of AKA among parents of CWE. Following the use of the IAEEP, parents of CWE also reported an improvement of their child's quality of life in the interpersonal/social and epilepsy secrecy CHEQOL-25 domains. There was no impact on parental mental health following exposure to the IAEEP.

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