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  1. Fulltext Remeasurement, evaluation and comparison the health services utilization among women staff at Universiti Kebangsaaan Malaysia after eleven years period (2001-2012)
    Siti Fatimah, A.G., Aniza, I., Shamsuddin, K., Zailiza, S.
    Malaysian Journal of Public Health Medicine, 2013;13(2):48-64.
    MyJurnal
    A cross-sectional study was carried out in July-October 2012 in UKM to remeasure, evaluate and compare the changes in health services utilization level among women staff in UKM with a previous study done in 2001 and its influencing factors. The services studied were blood pressure (BP) measurement and Pap smear test. A total of 234 respondents aged between 18 and 55 were selected using stratified random sampling from Bangi, Kuala Lumpur and UKMMC, Malaysia. Data was collected via self-administered questionnaire and was analyzed by using SPSS version 17.0. Majority 85.9% of the respondents were found to have utilized at least one BP measurement which is higher compared to previous study. The Pap smear test, 64.5% of women have had a Pap smear test done also higher compared to previous study. Multivariate analysis shows the factors associated with BP measurement are age (OR 2.7, CI 95% 1.2, 6.3), family history of general health problems (OR 3.4, CI 95% 1.5, 7.6), and health staff influence (OR 5.2, CI 95% 1.1, 25.5). The factors associated with Pap smear test are marital status (OR 62.8, CI 95% 7.2, 546.4), general health problems (OR 2.3, CI 95% 1.2, 4.5), family planning (OR 6.9, CI 95% 3.0, 16.5) and self-interest (OR 3.3, CI 95%, 1.3, 8.6). The level of health services utilization on BP measurement and Pap smear test in 2012 is higher than 2001. For both BP measurement and Pap smear test the determinant factors are differed in the aforesaid years.
  2. Fulltext Utility of Pap Smears and Mammograms in Midlife Urban Malaysian Women
    Adeeb, N., Nur-Azurah, A.G., Ong, F.B., Seri, S.S., Shamsuddin, K., Noor-Aini, M.Y., et al.
    Medicine & Health, 2008;3(1):59-68.
    MyJurnal
    Cancers of the breast and cervix made up 30.4% and 12% of all cancer cases in Malaysia. Thus screening for reproductive organ cancers as women approached menopause becomes exceedingly important. The study reports the baseline assessment tests of 495 disease free urban Malaysian women aged 45 years and above who volunteered in a healthy lifestyle intervention study. The sample comprised of 58.0% premenopaused and 42.0% postmenopaused women with an average age of 51.27±5.35 years old. Over two thirds were Chinese followed by Malays and Indians. Overall, abnormal Pap smears were seen in 7.6% comprising of 1.3% cervical intraepithelial neoplasia (CIN), 6.1% human papilloma virus (HPV) infection and 0.2% atypical squmous cells of undetermined significances (ASCUS). Yeast and other infections were found in 6.9% and 1.9% respectively. Comparatively, postmenopausal women had a 2.8 fold higher cancerous changes whereas premenopausal women had a higher infection rate, 11.8% vs. 4.7% respectively (p=0.024) with comparable HPV infection rates in both. This study found 1.3% had breast cancer (BC) with 3.6% requiring a biopsy while 3.4% needed regular follow up. Postmenopaused women had more abnormal mammograms (p
  3. Fulltext Risk factors for antenatal hypovitaminosis D in an urban district in Malaysia
    Bukhary NBI, Isa ZM, Shamsuddin K, Lin KG, Mahdy ZA, Hassan H, et al.
    BMC Pregnancy Childbirth, 2016 07 13;16(1):156.
    PMID: 27411716 DOI: 10.1186/s12884-016-0939-3
    BACKGROUND: Pregnant women form one of the high risk groups facing hypovitaminosis D. Low level of vitamin D will affect directly or indirectly both mother and fetus. Screening vitamin D in the first trimester of pregnancy is important to determine the necessary preventive action. Therefore, this study was aimed to determine the prevalence of hypovitaminosis D and its risk factors among pregnant women in the first trimester.

    METHODS: A cross sectional study was carried out among first trimester pregnant women during their first antenatal visit. Samples were taken from different ethnicities in an urban district in Malaysia. A total of 396 respondents (99 % response rate) aged 18-40 years completed self-administered and guided questionnaire (characteristics and risk factors), validated semi-quantitative food frequency questionnaire for vitamin D in Malaysia (FFQ vitamin D/My), anthropometric measures (weight and height), blood test for serum 25(OH)D, skin measurement using Mexameter (MX 18) and Fitzpatrick Skin Type Chart Measurement (FSTCM). Data were analyzed to determine the association between risk factors and hypovitaminosis D.

    RESULTS: The prevalence of hypovitaminosis D (serum 25(OH)D 

  4. Fulltext Lifestyle intervention improved nutritional knowledge, dietary composition and health status of midlife Malaysian women
    Noor-Aini, M.Y., Pon, L.W., Ong, F.B., Adeeb, N., Seri, S.S., Shamsuddin, K., et al.
    Malays J Nutr, 2006;12(2):125-146.
    MyJurnal
    Lifestyle has been shown to exert a major impact on the quality of life and health in mid-life women coping with menopausal changes. This study aimed to assess the efficacy of a lifestyle intervention package in improving nutritional knowledge and composition, dietary habits and related health status in mid-life women. Between Nov 1999 to Oct 2001, 360 disease free women, non users of HRT, aged 45 years and above with intact uterus were recruited into the study. The women were randomised into three groups - I (control), II (lifestyle intervention) and III (lifestyle intervention with HRT) respectively. After 12 months, 85.6% completed the study. The lifestyle intervention programme, well accepted by the participants, brought about an improved dietary composition, better eating habits, more exercise participation and increment in knowledge with concomitant improvement of the health status. The benefits observed were significant reduction in energy, fat and carbohydrate intake with increased intake of legumes; milk and cheese/yogurt; and reduction of tea and coffee. Body weight was reduced and more importantly preventing abdominal obesity in the intervention groups with HRT was more effective. Further adaptations of the dietary component with advice on obtaining micronutrients from local produce would contribute towards a more balanced diet in midlife women as dairy products were not popular and these women had low meat intake.
  5. Traditional Postpartum Practices Among Malaysian Mothers: A Review
    Fadzil F, Shamsuddin K, Wan Puteh SE
    J Altern Complement Med, 2016 Jul;22(7):503-8.
    PMID: 26167656 DOI: 10.1089/acm.2013.0469
    To briefly describe the postpartum practices among the three major ethnic groups in Malaysia and to identify commonalities in their traditional postpartum beliefs and practices.
  6. Diet, nutritional knowledge and health status of urban middle-aged Malaysian women
    Pon LW, Noor-Aini MY, Ong FB, Adeeb N, Seri SS, Shamsuddin K, et al.
    Asia Pac J Clin Nutr, 2006;15(3):388-99.
    PMID: 16837432
    The objective of the study was to assess nutritional and health status as well as nutritional knowledge in urban middle-aged Malaysian women. The impact of menopause on diet and health indices was also studied. The study included 360 disease free women, non users of HRT,aged > or =45 years with an intact uterus recruited from November 1999 to October 2001. Personal characteristics, anthropometric measurements and blood sample were acquired followed by clinical examination. Nutrient intake and nutritional knowledge was determined by a quantitative FFQ and KAP. The findings showed that urban middle-aged women, aged 51.65+/-5.40 years had energy intakes (EI) 11% below RDA, consisting of 53% carbohydrates, 15% protein and a 32% fat which declined with age. The sample which comprised of 42.5% postmenopausal women had a satisfactory diet and healthy lifestyle practices. Premenopausal women consumed more dietary fat (6%) with other aspects of diet comparable to the postmenopausal women. Iron intake was deficient in premenopausal women, amounting to 56% RDA contributing to a 26% prevalence of anaemia. Overall, calcium intake reached 440 mg daily but dairy products were not the main source. The postmenopaused had a more artherogenic lipid profile with significantly higher total cholesterol (TC) and LDL-C, but more premenopausal women were overweight/obese (49% versus 35%). EI was the strongest predictor for BMI and waist circumference (WC), with WC itself an independent predictor of fasting blood sugar and TC with BMI strongly affecting glucose tolerance. High nutritional knowledge was seen in 39% whereas 20% had poor knowledge. Newspapers and magazines, followed by the subject's social circle, were the main sources of nutritional information. Nutritional knowledge was positively associated with education, household income, vitamin/ mineral supplementation and regular physical activity but inversely related to TC. In conclusion, middle-aged urban women had an adequate diet with low iron and calcium intakes. Nutritional knowledge was positively associated to healthier lifestyle practices and lower TC. A comparable nutrient intake and lifestyle between pre and postmenopausal women suggested that health changes associated with menopause was largely independent of diet.
  7. Bone health in urban midlife Malaysian women: risk factors and prevention
    Lim PS, Ong FB, Adeeb N, Seri SS, Noor-Aini MY, Shamsuddin K, et al.
    Osteoporos Int, 2005 Dec;16(12):2069-79.
    PMID: 16234999 DOI: 10.1007/s00198-005-2003-4
    The aim of this study was to identify risk factors associated with osteoporosis in urban midlife Malaysian women and to assess the effectiveness of lifestyle intervention in bone loss prevention with hormone replacement therapy (HRT) as a positive control. A total of 514 disease-free, uterus-intact, non-HRT-using women aged 45 years and older were recruited into the study. After initial bone mineral density (BMD) assessments, they were randomized into three groups: GI (control), G2 (lifestyle intervention), and G3 (lifestyle intervention with HRT). The study group was composed of 67.5% Chinese, 27.8% Malay, and 4.2% Indians with a mean age of 51.07+/-5.28 years. Two-fifths were postmenopausal, and the prevalence of osteoporosis was 24.1%, seen predominantly at the hip. Postmenopausal women had significantly lower mean BMD and a higher incidence of osteoporosis compared with the premenopausal women, 42.1% vs. 11.1% (p<0.0005). A lower incidence of osteoporosis was found in women who took calcium supplementation regularly as opposed to those who do not, 18.7% vs. 29.3% (p=0.036). Age and a greater postmenopausal duration showed a significant negative association with BMD, whereas higher family income, weight, body mass index, and waist and hip circumference were positively correlated. After 18-20 months, the effect of intervention was assessed based on BMD values of 279 women at baseline and after intervention. Lifestyle intervention alone was effective in premenopausal women, preventing over 90% of spinal bone loss compared with the controls, who lost 11.6% (0.046 g/cm2) bone mass with similar losses of hip bone, 2.0% (0.026 g/cm2) vs. 1.5% (0.020 g/cm2). Premenopausal women on HRT also showed a substantial decrease in spine and hip BMD, 18.6% (0.081 g/cm2) and 9.0% (0.122 g/cm2), respectively. The lifestyle intervention program retarded postmenopausal bone loss by 21% and 37% compared with controls, who lost 9.6% (0.141 g/cm2) and 6.0% (0.138 g/cm2) bone mass at the spine and hip. In comparison, lifestyle intervention with HRT increased postmenopausal BMD by 12.7% (0.216 g/cm2) at the spine and 1.9% (0.042 g/cm2) at the hip. The changes in hip BMD were influenced by current age, ethnicity, and income, while intervention had the strongest effect on spine BMD changes. In conclusion, lifestyle intervention prevented spinal bone loss in premenopausal women and retarded postmenopausal spine and hip bone loss compared with controls. The benefits of physical activity on spine and hip BMD highlight its potential as a safe and cost-effective alternative to HRT, which is not advocated because of its potential adverse effects.
  8. Fulltext Questionnaire development and validity to measure sexual intention among youth in Malaysia
    Muhammad NA, Shamsuddin K, Mohd Amin R, Omar K, Thurasamy R
    BMC Public Health, 2017 02 02;17(1):157.
    PMID: 28152993 DOI: 10.1186/s12889-016-3949-1
    BACKGROUND: From the Theory of Planned Behaviour perspective, sexual intention is determined by a permissive attitude, perception of social norms and perceived self-efficacy in performing sexual activity. The aim of this study was to develop and validate the Youth Sexual Intention Questionnaire (YSI-Q), which was designed to measure sexual intention among youths in Malaysia.

    METHODS: A total of 25 items were developed based on literature reviews encompassing four main constructs: sexual intention, attitude, social norms and self-efficacy. The YSI-Q then underwent a validation process that included content and face validity, exploratory factor analysis (EFA), reliability analysis, and confirmatory factor analysis (CFA). This study was conducted on unmarried youths aged 18 to 22 years who were studying in colleges around Klang Valley, Malaysia.

    RESULTS: EFA supported the four factor structure, but five items were removed due to incorrect placement or low factor loading (<0.60). Internal reliability using Cronbach's alpha ranged between 0.89 and 0.94. The CFA further confirmed the construct, convergent and discriminant validity of the YSI-Q with χ 2 = 392.43, df = 164, p 

  9. Fulltext Dietary and other factors associated with overweight among women workers in two electronics factories in selangor
    Lim HM, Chee H, Kandiah M, Shamsuddin K, Jamaluddin J, Nordin N, et al.
    Malays J Nutr, 2003 Sep;9(2):105-24.
    PMID: 22691732 MyJurnal
    This study was a cross-sectional survey conducted among 122 women workers employed in the electronics factories in the Ulu Klang Free Trade Zone (FTZ) and the Bangi FTZ, Selangor, Peninsular Malaysia. The purpose of the study was to examine the problem of overweight (>25.0 kg/m2) among this group of women, and factors (socio-demographic, work, exercise, and dietary) associated with overweight, and, to study the food intake pattern of the women in both the overweight and non-overweight groups. Data was collected using a set of questionnaires, while anthropometric measurements were obtained to calculate body mass index (BMI) and waist hip ratio (WHR). The results of the study indicated that 64.0% of the women were overweight (29.5% pre-obese, 34.5% obese). About one-tenth of the women (11.5%) had a WHR of above 0.85. From the bivariate analysis, it was found that women who were older, ever married, had lower educational level, had higher salary, not living in the hostel, involved in shiftwork, and trying to lose weight were more likely to be overweight. After adjusting for age, each of the above factors, except for educational level, remained significantly associated with overweight. Women's diet was found to be monotonous and lacking in variety as accessibility to and availability of a variety of food was a problem for them due to the nature of their work. They also had a sedentary lifestyle. Therefore, further research focusing on changing the poor dietary habits and sedentary lifestyle of the women workers is necessary to address the problem of overweight.
  10. Fulltext Knowledge and practice of breast self examination and Pap smear screening among a group of electronics women workers
    Chee HL, Rashidah S, Shamsuddin K, Sharifah Zainiyah SY
    Med J Malaysia, 2003 Aug;58(3):320-9.
    PMID: 14750370
    A total of 486 Malaysian women electronics workers participated in a study of reproductive health knowledge and cancer screening. The practice of Breast Self Examination (BSE) was found to be related to educational attainment; while ever having had a Pap smear was found to be related to being older than 30 years old, being ever married, living with family or relatives, and not staying in hostels. Knowledge on reproductive health was found to be higher for older women, married women, living with family or relatives, not staying in hostels, ever having done BSE and ever having had a Pap smear.
  11. Fulltext Late-life leisure constraints among Malaysian elderly: a qualitative approach
    Minhat, H.S., Mohd Amin, R., Shamsuddin, K.
    Malaysian Journal of Public Health Medicine, 2012;12(2):24-30.
    MyJurnal
    Leisure involvement is an essential element in the daily life of the elderly people. Little is known, however, about the perceived leisure constraints among them, especially among the increasing elderly population in Malaysia. This study aims to explore constraints perceived by the elderly that prevent them from actively involved in leisure. In depth interviews were conducted, involving a total of 20 elderly aged 60 years and above with stratification by background characteristics. Each interview was conducted for an average of 15 to 30 minutes and discontinued when a saturation point was achieved. They were purposively selected from two health clinics located in two different districts in the state of Selangor, representing an urban and a rural area. Elderly participation in leisure activities was constrained by many factors. These factors can be divided into individual, family and community factors such as increasing age and related physical deterioration , education level, health status and the existence of chronic illness, absence of family member or friends to perform the activity together and non-conducive environment. The constraints should be endorsed and acknowledged by the relevant agencies and authorities in order to facilitate effective implementation of related policies, strategies and programmes to improve the health of the elderly people. These include the provision of appropriate services and facilities to cater senior citizens from various health and demographic perspectives.
  12. Illness perceptions of Libyans with T2DM and their influence on medication adherence: a study in a diabetes center in Tripoli
    Ashur ST, Shah SA, Bosseri S, Morisky DE, Shamsuddin K
    Libyan J Med, 2015 Jan;10(1):29797.
    PMID: 28349791 DOI: 10.3402/ljm.v10.29797
    Background The surrounding environment influences the constitution of illness perceptions. Therefore, local research is needed to examine how Libyan diabetes patients perceive diabetes and how their perceptions influence their medication adherence. Methods A cross-sectional study was conducted at the National Centre for Diabetes and Endocrinology in Tripoli, Libya, between October and December 2013. A total of 523 patients with type 2 diabetes participated in this study. A self-administered questionnaire was used for data collection; this included the Revised Illness Perception Questionnaire and the eight-item Morisky Medication Adherence Scale. Results The respondents showed moderately high personal control and treatment control perceptions and a moderate consequences perception. They reported a high perception of diabetes timeline as chronic and a moderate perception of the diabetes course as unstable. The most commonly perceived cause of diabetes was Allah's will. The prevalence of low medication adherence was 36.1%. The identified significant predictors of low medication adherence were the low treatment control perception (p=0.044), high diabetes identity perception (p=0.008), being male (p=0.026), and employed (p=0.008). Conclusion Diabetes illness perceptions of type 2 diabetic Libyans play a role in guiding the medication adherence and could be considered in the development of medication adherence promotion plans.
  13. Predictors of parenting stress among Malaysian mothers of children with Down syndrome
    Norizan A, Shamsuddin K
    J Intellect Disabil Res, 2010 Nov;54(11):992-1003.
    PMID: 20868445 DOI: 10.1111/j.1365-2788.2010.01324.x
    Having children with intellectual disability can be stressful for most parents. Currently there are very few studies focusing on parenting stress among mothers of children with Down syndrome (DS) in Asia. The present study examined the level of parenting stress experienced by Malaysian mothers of children with DS and evaluated the child and maternal factors that contributed to parenting stress based on Hill's ABC-X Model (Hill 1949).
  14. Fulltext Work related determinants of breastfeeding discontinuation among employed mothers in Malaysia
    Amin RM, Said ZM, Sutan R, Shah SA, Darus A, Shamsuddin K
    Int Breastfeed J, 2011;6(1):4.
    PMID: 21342506 DOI: 10.1186/1746-4358-6-4
    This cross-sectional study assesses factors that contribute to discontinuing breastfeeding among employed mothers in Malaysia.
  15. Smoking among young urban Malaysian women and its risk factors
    Manaf RA, Shamsuddin K
    Asia Pac J Public Health, 2008;20(3):204-13.
    PMID: 19124314 DOI: 10.1177/1010539508316973
    This study was conducted to measure the prevalence of cigarette smoking and to determine the individual, family, and environmental factors associated with smoking among young urban women. A cross-sectional study through self-administered questionnaire was conducted on female students enrolled in private higher learning institutions in Kuala Lumpur and Selangor, Malaysia, between July and October 2005. Analysis on 408 respondents showed that current smoker prevalence rate was 18.6%. Adjusted analyses showed significant association between smoking and individual factors, which are the importance of slim image, average monthly allowance, and car ownership. For family factors, analyses showed significant association between smoking and parental marital status and smoking status of male siblings. Strong associations were seen between female smoking and environmental factors, such as having more smoker friends, having smokers as best friends, keeping cigarette-brand items, being offered free cigarette, and perceiving female smoking as normal. The identified risk factors could be used to develop more effective prevention programs to overcome smoking among young urban women.
  16. Knowledge, attitudes and preventive efforts of Malaysian medical students regarding exposure to environmental tobacco and cigarette smoking
    Frisch AS, Kurtz M, Shamsuddin K
    J Adolesc, 1999 Oct;22(5):627-34.
    PMID: 10527534 DOI: 10.1006/jado.1999.0258
    A longitudinal study was conducted to determine changes in knowledge, attitudes and preventive efforts of Malaysian medical students concerning cigarette smoking and environmental exposure to tobacco smoke from their first pre-clinical year in medical school until their final clinical year. There were significant improvements in knowledge about cigarette smoking and in knowledge, attitudes and efforts concerning environmental exposure to tobacco smoke. Overall attitudes concerning cigarette smoking did not change over this period. The same pattern was found for male non-smokers. Women improved on all five scales; male smokers improved on none over the 3-year period. Male non-smokers had better scores on these scales than male smokers in both beginning and ending years. Women excelled in comparison to male non-smokers on smoking attitudes in the pre-clinical year and on all scales except preventive efforts in the final clinical year.Although medical students experienced no changes in the amount of pressures not to smoke from family and friends, there was a significant increase in the amount of prohibition on smoking from their teachers. Male non-smokers alone accounted for this increase. Women experienced more pressure than men not to smoke from their teachers in both years, but the male smokers and non-smokers did not differ in teacher pressure for either year.
  17. Fulltext Serological assessment of the establishment of herd immunity against measles in a health district in Malaysia
    Hazlina Y, Marlindawati MA, Shamsuddin K
    BMC Infect Dis, 2016 Dec 08;16(1):740.
    PMID: 27931192
    BACKGROUND: Malaysia still faces challenges optimizing resources to effectively eliminate measles through high immunization and herd immunity, with sporadic outbreaks of measles as evidence. The objective of this study is to determine the age-specific positive measles antibodies seroprevalence used for assessing the establishment of herd immunity against measles in different age groups. This is useful for identifying vulnerable age groups requiring supplementary immunization.

    METHODS: A seroprevalence study was conducted among respondents aged 6-9 years, 15-24 years and 45-54 years attending government health clinics in Seremban between September 2014 and January 2015. A total of 1541 measles IgG antibody status were determined using ELISA technique (NovaTec Immundiagnostica GMBH) and assessment of establishment of herd immunity was based on indicators developed by Plans. Data on socio-demographic background as well as medical and medication history were also gathered.

    RESULTS: Seropositive rate for all respondents were 87% (95% CI 85-89), while the rest had either indeterminate [6% (95% CI 5-7)] or negative titre [7% (95% CI 6-8)]. None of the factors analyzed except for age were significant predictors of positive measles antibodies. Seropositive rate differed by age with the highest rate seen in adults (94%; CI 92-96), followed by children (90%; 95% CI 87-94) and adolescents, and young adults (74%; 95% CI 70-78). Based on Plans' indicators, herd immunity was established in adults and children, but not in adolescents and young adults.

    CONCLUSIONS: To tackle the most susceptible group in the present study, it is advisable to give booster vaccination to secondary school students and freshmen who enter colleges and universities in Malaysia.
  18. Fulltext Malaysian Females With Congenital Adrenal Hyperplasia: Surgical Outcomes and Attitudes
    Zainuddin AA, Grover SR, Soon CH, Nur Azurah AG, Mahdy ZA, Wu LL, et al.
    Front Pediatr, 2019;7:144.
    PMID: 31058121 DOI: 10.3389/fped.2019.00144
    Background: Girls born with congenital adrenal hyperplasia have virilized external genitalia. There is considerable debate regarding both the outcomes of feminizing genitoplasty and timing of the surgery in this population. Objective: To investigate outcomes of females 46,XX individuals with CAH in Malaysia, the surgical outcomes of feminizing genitoplasty (FG) and their attitudes toward surgery. Study Design: This is a cross-sectional study involving the two main tertiary centers in Malaysia. All 46,XX patients with CAH and raised female, who had undergone FG were identified and invited to participate. Data on socio-demographic, medical profiles, and attitudes toward surgery were collected. A standardized evaluation of the external genitalia was undertaken including the anatomic and cosmetic evaluation by independent gynecologists. Results: Of 61 individuals identified, 59 participated-consisting of children (n = 12), adolescents (n = 29) and adults (n = 18). All but one had classical CAH (98.3%) and had undergone FG (n = 55, 93.2%) with surgery mostly undertaken by pediatric surgeons trained in DSD work (n = 44, 74.6%). Complications overall were low (20.3%), with repeat surgery rate of 9.1%. External genital examination was performed in 38 participants. Overall 36.8% had absent clitoral glands and 39.5% had a persistent urogenital sinus and in 10.5%, no vaginal orifices were seen. Poor cosmetic outcomes were present in 42.1% with 55.3% recommended for further assessment under general anesthetic. Almost half participants did not venture an opinion on FG, those who did varied from having a positive attitude toward it (18 participants) to 3 opining that it should not be done, or avoided or delayed. From the participants, 35.5% preferred FG to be done early in life compared to 44.0% of the parents. Conclusions: The reoperation rates of the feminizing genitoplasty surgeries were low however due to the anatomic and cosmetic outcomes, reassessment of the external genitalia of these CAH patients may be required once they consider becoming sexually active as they may require further treatment. Many factors such as cultural sensitivities and access to medical treatment and late diagnoses have an impact on attitudes toward FG.
  19. Glycaemic control status among type 2 diabetic patients and the role of their diabetes coping behaviours: a clinic-based study in Tripoli, Libya
    Ashur ST, Shah SA, Bosseri S, Fah TS, Shamsuddin K
    Libyan J Med, 2016 Jan;11(1):31086.
    PMID: 28349838 DOI: 10.3402/ljm.v11.31086
    Background Achieving good glycaemic control is important in diabetes management. However, poor glycaemic control is widely reported. This article assessed the prevalence of uncontrolled and poor glycaemic control among Libyans with type 2 diabetes and examined the relative contribution of diabetes coping behaviours to their glycaemic control status. Methods A cross-sectional study was undertaken in 2013 in a large diabetes centre in Tripoli. The study included 523 respondents. Diabetes coping behaviours were measured using the revised version of the Summary of Diabetes Self-Care Activities measure (SDSCA) and the eight-item Morisky Medication Adherence Scale (MMAS-8(©)), while glycaemic control status was based on the HbA1c level. Results Mean HbA1c was 8.9 (±2.1), and of the 523 patients, only 114 (21.8%) attained the glycaemic control target of HbAc1 of less than 7.0%. Females (OR=1.74, 95% CI=1.03-2.91), patients on insulin and oral hypoglycaemic agents (OR=1.92, 95% CI=1.05-3.54), patients on insulin (OR=3.14, 95% CI=1.66-6.03), and low-medication adherents (OR=2.25, 95% CI=1.36-3.73) were more likely to have uncontrolled and poor glycaemic control, while exercise contributed to glycaemic control status as a protective factor (OR=0.85, 95% CI=0.77-0.94). Conclusion The findings from this study showed the considerable burden of uncontrolled and poor glycaemic control in one of the largest diabetes care settings in Libya. Medication adherence as well as exercise promotion programs would help in reducing the magnitude of poor glycaemic control.
  20. Fulltext Use of traditional medicine among type 2 diabetic Libyans
    Ashur ST, Shah SA, Bosseri S, Shamsuddin K
    East Mediterr Health J, 2017 Jul 16;23(5):375-382.
    PMID: 28730591 DOI: 10.26719/2017.23.5.375
    The use of traditional medicines is common among patients with chronic illnesses and this practice might pose health risks. The use among Libyan patients with diabetes is unknown. Therefore, this study aimed to estimate the prevalence of traditional medicine use in the previous year among Libyans with type 2 diabetes and to examine the association between its use and sociodemographic and clinical characteristics of the patients. A cross-sectional study was conducted at a large diabetes centre in Tripoli. A self-reported questionnaire was used for data collection. Of the 523 respondents, 28.9% used traditional remedies. Sex was the only variable significantly associated with traditional medicine use; more women used traditional medicines (P = 0.01). A total of 77 traditional medicine items were reported to be used, of which herbs were the most common. The use of traditional medicine for diabetes is prevalent and some of the reported items could pose health risks. Health education programmes are suggested to raise the awareness of the health risks of this practice.
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