The population of the world is ageing and Malaysia is no exception. The proportion of those above 60 will be 9.5% by the year 2020. Cognitive impairment and depression are two common problems in this age group. The objective of this study was to determine the prevalence of cognitive impairment and depression and their associated factors in the elderly population in a rural community in Kedah. The study design was descriptive cross sectional study. A standardized questionnaire was used in two villages in Mukim Kota Kuala Muda. Barthels index, geriatric depression scale and elderly cognitive assessment questionnaire were also used. The prevalence rate of cognitive impairment was 18.5%. Cognitive impairment was higher among females (22.6%) than males (12.8%). 34.8% of the widowed were cognitively impaired and it increases with age 15.1% within age groups 60 to 69 years, 42.9% in age groups 80 to 89 years and the one and only participant above 90 years was cognitively impaired. Among those with disability, the only one with very severe disability had cognitive impairment, 40% among the severely disabled and 33. 3% among the moderately disabled (p<0.05). Those with cognitive impairment were living with some functional disabilities involving feeding (p<0.05), bathing (p<0.05), grooming (p<0.05), dressing (p<0.05), bladder control (p<0.05), toilet use (p<0.05), transfer from bed to chair (p<0.05), mobility on level surfaces (p<0.05) and climbing stairs (p<0.05). The prevalence of depression was found to be 46.4%. Higher among males (48.4%) as compared to females (44.7%). Depression was 50.0% among the age groups 80 to 89 and 52.4% among the age groups 70 to 79. 63.6% of those living alone were depressed as were 54.8% of the unemployed. 43.8% of those depressed had functional disability. The only one with severe disability was depressed and 66. 7% of those with severe disability were depressed. 47.5% of those with hypertension were depressed. It is a matter of concern that even in a small population the rate of cognitive impairment and mental depression is very high. Health screening is an important aspect of health promotion and disease prevention in people over 60 years. Although screening for many conditions cannot conclusively prove benefit, special attention to these factors can decrease morbidity and improve quality of life in aging population.
Key words: elderly, cognitive impairment, depression, rural community, Malaysia
Study site: Two villages in Mukim Kota Kuala Muda, Kuala Muda District, Kedah, Malaysia
Device, Questionnaire & Scale: Barthels index; Geriatric Depression Scale (GDS-30); Elderly Cognitive Assessment Questionnaire
Accidental poisoning in children is a preventable condition. It is a problem mainly in children aged 1 to 4 years. This is a descriptive study of accidental poisoning in children below 12 years old admitted to Hospital Seremban from October 15, 1994 to October 14, 1995. A major cause of household accidental poisoning was kerosene ingestion (25%) followed by ingestion of medications (22%), liniment methyl salicylate (12 %), mothballs (12%) and hypochlorinate solution (9%). There was a higher incidence of poisoning in males (50.8%), among Indians (41.2%) and in children from lower social classes (67%). A greater proportion of the accident occurred when the child was taken care by the parents (53 %) and in the house (80%). Most of the poison was ingested from its original package (81%). The immediate action taken was sending the child to the hospital (75%) without carrying out other actions such as washing the child’s mouth. The delay of sending the child to hospital was due to husband not at home (57%). Most of the cases (72.1 %) were discharged well within 1-2 days following admission.
Worldwide maternal mortality rate had reduced tremendously including Malaysia. At the 2000 Millenium Summit, eight Millenium Development Goals (MDGs) were established with target for the year 2015. Three years remained until the deadline to achieve MDG5, which comprised of two targets and one being reducing the maternal mortality ratio by 75%.This review compared the trend of maternal mortality and its causes in our centre to the national data. The national data had shown a reduction from 44 to 27.6 in 100,000 live births in1991 and 2008 respectively. The subsequent rate had stabilized for the past seven years. In contrast the UKM Medical Centre (UKMMC) data in the past 15 years had not been stable. The target of MDG5 seemed to be achievable by our country but may require longer time as we have yet to find ways to overcome medical care inadequacy in remote areas.
Satu kajian keratan rentas telah daalanlcan ke atas kanak-lcanak yang tinggal 0.5 km dari sebuah lcuari di Sungai Siput Utara. Objelctif kajian ini ialah untulc mengkaji hubungan PM10 dengan fungsi paru-paru kanak-kanak tersebut. Seramai 51 orang kanak-/canak yang ringgal berhampiran kuari dan terdedah dengan debu kaur tehih dipilih, manakala 37 orang kanak-kanak yang tinggal berjauhan tetapi di daerah yang sama telah dipilih sebagai perbandingan untuk lag ian ini. Borang soalselidik telah digunakan untuk mendapatlcan maklumat latarbelakang dan sejarah respiratori dari ibu bapa kanalc-kanak terlibat. Fungsi paru-paru kanak-kanak pula diukur dengan menggunakan Pony Graphic S pirometer. Min kepekatan PM1 0 selama 24 jam di dalam rumah kediaman di kawasan terdedah ialah 76.66 (g/m3 dan di kawasan perbandingan 41 .55 (g/m3. Perbezaan kepekatan PM10 di antara kedua kawasan ini adalah signifikan (p=0.01). Hasil ujian fungsi paru-paru menunjukkan perbezaan yang signifikan di antara fungsi paru-paru kanalc-kanalc terdedah dengan kanak-kanak perbandingan dari segi FVC % jangkaan (t = -8.227, p = 0.01) dan FEV1 % jangkaan (t = -8.729, p = 0.01). Min fungsi paru-paru kanak-kanak lelaki di kawasan terdedah, (FVC % jangkaan = 68.05, FEV1 % jangkaan = 73.71) adalah lebih rendah daripada kawasan perbandingan (FVC % jangkaan= 89.78, FEV1 %~ jangkaan = 86.97). Min fungsi paru-paru kanak-kanak perempuan di kawasan terdedah (FVC % jangkaan= 69.64, FEV1 % jangkaan =74.90) juga adalah lebih rendah daripada hawasan perbandingan ( F VC % jangkaan = 90.99, FEV1 % jangkaan : 87 .7 9). Prevalens kejejasan parurparu FVC % jangkaan l
Pre-pregnancy Clinic (PPC) services is one the plausible efforts towards achieving the Millennium Development Goals. However, various issues still need to be addressed for improvement of the services. Considering this view, an attempt was made to explore the barriers, strength and weakness of current practice of pre-pregnancy clinic services in Sarawak, since the programme has been implemented in this state from the year 2011. This cross-sectional study was conducted at nine selected health care facilities throughout Sarawak. A multistage sampling procedure was adapted to select the health care facilities. An unstructured open-ended questionnaire was administered to get the in-depth perceived views and current practice of pre-pregnancy clinic services. A total of 322 health care providers from nine selected health care facilities gave their feedback. In the present paper, a qualitative analysis was done for the openended questions to get in-depth views of barriers, strength and weakness of pre-pregnancy clinic services. The results of the study were narrated in textual form and a thematic analysis was done manually. The identified themes for perceived barriers to the provision of pre-pregnancy care were perception, attitude and acceptance of PPC services, socio-economic issues, services and client factors. The perceived weaknesses of the services are listed under two main themes: working environment and service factors, while, the strength of services produced three thematic areas which are preparation for pregnancy, prevention of mortality and morbidity and comprehensive services. Though prepregnancy services are beneficial for society wellbeing, various issues still need to be considered for the improvement of the quality of services. Lack of awareness, no ministerial guidelines or Standard Operating Procedures (SOP) and knowledge pertaining to the services were few of the main areas which need to be pondered upon. Promotional activities and campaigns should be geared up ensuring availability the services to the general population.
Majority of doctors show no interest in research although research is now a requirement and is being done in every field of medicine. The objective of this survey was to describe the involvement in research activities among doctors in Penang and Seberang Jaya hospitals in Penang. A self-administered questionnaire was used. A total of 302 doctors participated in the survey. The differences in age (p=
The best commonly applied approach in seating ergonomics is the concept that the seat must fit the sitter.
Understanding of population anthropometry is necessary because, in the mass vehicle market, a single seat should fit
a huge portion of the population. This research work proposes some automotive seat fit parameters based on a
representative Nigerian anthropometric data, to ensure an optimum fit between the vehicle seats and the occupants,
as well as providing adequate accommodation. Anthropometric data of 863 Nigerians captured with special emphasis
on the dimensions that are applicable in automotive seat design. A comparison made between the data obtained and
that of five other countries. The proposed dimensions includes: seat cushion width (475mm); seat cushion length
(394mm); seat height (340mm); seat lateral location (583mm); seat back height (480mm); seat back width (427mm);
armrest height (246mm); headrest height (703mm); armrest surface length (345mm); backrest width (thoracic level)
(524mm); seat adjustment (186mm); backrest width (lumbar level) (475mm) and distance between armrests
(475mm). A comparison made between the proposed dimensions and those recommended by four other scholars for
other populations. Finally, an ergonomic automotive seat suitable for the Nigerian population was designed using
AutoCAD 2016 software based on the proposed established dimensions.
A cross—sectional study conducted in the fasting month of Ramadan targeting muslim males assessed their religious beliefs in relation to smoking and their intentions t0 quit smoking in Ramadan. It was found that there law; is a strong association between their perceptions on the religious ruling of smoking as haram (prohibited) in relation to their smoking status. Among the non smokers and ex smokers, 87.8% and 73.6% respectively accept the ruling on smoking as prohibitea'(haram), while only 31.6% of smokers accept smoking as prohibited. Among the smokers, 97.7% smoke a lesser number of cigarettes during Ramadan, while 96.7% of them felt that it is easier to quit during the fasting month. The findings suggest that the religious department needs to provide more information and education to the Muslim population as to the reasons of the ruling on smoking as haram(prohibited) on religious grounds . It was also found that the majority felt it is easier to quit during quit smoking programmes can be emphasized and carried out on a bigger scale during fasting months in the future.
The aim of this study was to describe the sociodemographic aspect, clinical presentation and laboratory support, behaviour factor and vector situation of dengue outbreak. Data was obtained from standard investigation format of 84 cases of suspected dengue fever in two main outbreaks localities in Temerloh District from December 2001 to January 2002. The result showed that most of the cases occurred among 11 years old and above, especially in the age group of 11 to 20 years old. Students and female were the most high risk groups. Rashes and petechiae were more prevalent in Taman Sri Semantan which reflect the case incidence there. Serological result showed that seroprevalence for IgM was 66.1 %. Based on dengue rapid test, secondary infection was more prevalent in Taman Sri Kemuning whereas those in Taman Sri Semantan had more primary infection. About 25% of the cases came late to hospital for treatment. Both localities had different mosquito breeding areas. Further studies are needed to identify behaviour aspect of the population with regard to dengue fever in previous main outbreak localities. A more valid and rapid serological test is required for better case identification.
Keywords: Dengue outbreak, risk factors, patient factor, clinical finding, serological test
Backache is a common health problem associated with non ergonomic working environment. A cross sectional study amongst the rubber tappers was conducted to determine the prevalence of low back pain and ergonomic factors related to it. The respondents were 116 male rubber tappers from Felda scheme in the state of Pahang who were selected by random sampling. The result showed prevalence of low back pain was 60.3% and has significant association with history of backache (p<0.05). Rubber tappers were 6 times more higher to develop low back pain if they had history of backache (Odd Ratio =6.24, 95% CI). There were no significant association between socio-demographic factors and low back pain. Ergonomic factors such as bending during tapping, respondents’ height and duration of the tapping showed no significant association with low back pain. Further study should be done in ergonomic aspect to explore the problem.
Key words: Low back pain, rubber tapper, Felda, ergonomic.
Although the Ministry of Health Malaysia has been encouraging the practice of Traditional and Complementary Medicine (T&CM)1, 2 , 3, 4 but patients/clients has not been able to apply it for their need of medical treatments and sometimes it leads to negative outcomes due to lack of knowledge on T&CM and its safe applications5,6’ 7,8 Most of the western-trained physicians are ignorant of risk and benefits of T&CM9,10,11 . This study was aimed to determine the gap between knowledge regarding T&CM and perception on education in T&CM among the medical staffs in five selected hospitals in Malaysia. A cross-sectional survey was done at five public hospitals among medical staff in Malaysia by using quantitative methods. A total of 477 medical staffs were involved in this study. The study showed that the overall knowledge of T&CM among the medical staffs were poor (61.2%). Having good knowledge regarding T&CM were significantly higher in Hospital Duchess of Kent (52%, p=0.001), among the non-Malays (44%, p=0.047) and pharmacists (47.2%, p=0.030). Positive perception on health education in T&CM among medical staffs were high (85.3%) especially among females (88.1%, p=0.002) and pharmacists (93.7%, p< 0.001). The use of T&CM among the general population is relatively high in Malaysia and many patients increasingly seek the information on T&CM therapies from medical staffs. Knowledge regarding T&CM was poor in this study because most of the medical staffs have not been exposed to T&CM education. This interesting scenario between poor knowledge and high positive perception on health education in T&CM shows the demand of urgent intervention in educating the medical staffs. We recommend that medical staffs must have some basic education and knowledge about T&CM before they could offer advice to their patients. Doctors are of the utmost important in this regard because they play a very important role in patient care. Providing T&CM education to medical staff may help to integrate T&CM into the mainstream medicine.
Indonesian government secures the access of the poor towards health services through subsidised schemes. This study is aimed to describe the pattern of health expenditure by households and to describe the pattern of health service utilisation across household’s socioeconomic level in the city of Padang after seven years of the introduction of subsidised schemes. A household survey was conducted involving 918 households, with multistage random sampling method. The proportion of out-of-pocket (OOP) health spending as a share of household’s capacity to pay was regressive across consumption quintiles. The proportion of households with catastrophic health expenditure was 1.6% while 1.1% faced impoverished health expenses. Among those who need health care, the utilisation among the rich was higher than the poor. Health insurance schemes in Padang provides financial protection, however with regards to household’s capacity to pay, the poor has the higher burden of health payment. The gap on health service utilisation between the poor and the better-offs was still apparent for outpatient services and it has been narrowed for inpatient care. This study suggests that the subsidised schemes for the poor are highly needed and the possibility of the leakage of subsidies to the rich should be considered by the government.
Ergonomic is important in classroom. Sitting for protracted period in class may lead students to develop musculoskeletal disorders. Their physical health and performance in the class may increase by designing school furniture that match with human body. In Malaysia, there is a lack of ergonomic assessment for school environment especially in urban areas. The aim of this study is to determine the mismatch between the furniture dimension and anthropometric parameters among primary school children in Putrajaya. This is a cross-sectional study which involved 100, Year 1 and Year 6 primary school students randomly selected in Putrajaya. Five anthropometric measurements (popliteal height, buttock popliteal length, elbow height, shoulder height (sitting), hip breadth) as well as five furniture dimensions (seat height, seat depth, seat width, backrest height and seat to desk height) were measured. Instrument used is Martin type anthropometer set, SECA body meter, and SECA weighing scale. Calculation for determining mismatch between the furniture and anthropometric measures were calculated using a standard mismatch formula. There was 100% mismatch for seat height, seat depth, and seat to seat to desk height for Year 1. As for Year 6, mismatch was reported 100% for backrest height and seat to desk height. There were significance difference for parameters of popliteal height between Year 1 and Year 6 and between male and female of Year 1. There was a presence of mismatch between furniture dimension and children anthropometric measurement. Proposed dimension of furniture shows decrease in percentage of mismatch for the most parameter of anthropometric measurement.
The knowledge, attitude and practice of breastfeeding among young mothers during pre-Baby Friendly Hospital Initiative implementation was conducted at seven private hospitals in Malaysia. A structured interviewer administered questionnaire was given to all mothers (n=Z52) visiting the antenatal/postnatal clinic of the hospitals. The main respondents were Malays (57.5%) and Chinese (35%) . For most mothers, breastfeeding was combined with supplementary feeds of formula milk, with only 30% breastfed exclusively. The majority of mothers knew that breast-milk contained antibodies and can prevent illness, however many were unaware of breastfeeding's contraceptive effect if practised exclusively. Most mothers did not relate breastfeeding as being environmental friendly. Generally, there was no knowledge gained from the experience of having more children with reference to breastfeeding. Most mothers were influenced by their own beliefs regarding choice of feeding method. Therefore, a mother was empowered with the knowledge of all practical aspects of breastfeeding, it would encourage her to breastfeed her baby.
Study site: seven private hospitals in Malaysia
This study was conducted to determine the patterns of disease and treatment at two disaster sites. Studies prior to this have shown that all natural disasters are unique in that each affected region of the world have different social, economic and health backgrounds. However, similarities exist among the health effects of different disasters which if recognized can ensure that health and emergency medical relief and limited resources are well managed. This study found that although Aceh and Balakot were two totally different areas with reference to locality and climate it was noticed that the patterns of disease two months post disaster are similar the commonest being respiratory conditions followed by musculoskeletal conditions and gastrointestinal conditions. For the treatment patterns it was observed that the two areas prescribed almost similar, types of medicine mainly for gastrointestinal and respiratory systems. However in Aceh, there were more skin treatment and in Balakot there was more usage of musculoskeletal drugs.
A cross-sectional study was conducted in May 2007 on stress and stress self management among the prisoners and wardens of a prison in Selangor. This study was conducted as part of an elective posting for second year medical students and the topic was chosen to add on to the body of knowledge on stress among prisoners and wardens. A self administered questionnaire was distributed by random sampling and the respondents consisted of 100 prisoners and 97 wardens. Majority of the prisoners did not have stress with reference to interpersonal factors such as conflict with cellmates, conflict with wardens and conflict with inmates, For interpersonal factors, majority of the prisoners experienced stress because they felt bored (78%), thought they had no bright future (63%) and they also had no visitors (61%). Stress resulted in physical effects, whereby 67% admitted that they experienced health problems and 64% experienced sleep disturbance. Emotional effects of stress experienced by the prisoners were sadness (67%), anxiousness (63%) and confusion (56%). The major spiritual effect was regret (84%) followed by feeling closer to God (78%) and feeling high spirited (59%). The major social effects experienced by
the prisoners were low self esteem (63%) and embarrassment (58%). Methods of stress self management were prayers and conduct of religious activities (87%), sharing problems with friends (78%), doing recreational activities (77%), sleeping (72%) , doing a hobby (68) and seeking help from doctors (57%). As for the wardens, with reference to interpersonal factors, high level of stress was experience with reference ta prisoners behavior (82.5%) and problems with higher authorities (83.5 %), For intrapersonal factors, sleep disturbances (64%), career problems (76.3%), financial problems (73.2%) and feeling bored (75.3%) highly contributed to stress. Wardens physical effects were 38.1% health problems and 29.9% sleep disturbances. For emotional effects, must of them were depressed (54.6%), anxious (67%), angry (63.9%), confused (64.9%), frustrated (59.8%), threatened (53.6%) and patriotic (51.5%). The spiritual effect were feeling closer to God (86.6%), feeling responsible for duties (82.5%), regret doing the job (74.2%), feeling high spirited (58.8%). For social effects, low self esteem is the highest effect experienced (68%). Wardens managed stress by praying and conducting religious activities (91.8%), recreational activities (88.7%), doing a hobby (85.6%), sleeping (74.2%), and sharing problems (68%).
Home phototherapy treatment has been available in the Klang Valley (comprising Petaling ]aya, Kuala Lumpur; Shah Alam and Klang) since 2003. This study was conducted to create awareness of the existence of home phototherapy and its usage in Malaysia. This was a retrospective study using 1297 informed consent forms that parents had to read and sign prior to the commencement of home phototherapy. lt was found that the majority ofthe babies was males (41.2%), at or over 36 weelds gestation (97.2%), from areas in Selangor (57.4%), fully breastfed (53 %) and referred by doctors (98%). The mean age of the babies at initiation of lwme phototherapy was 6. 7 days. The mean bilirubin level at the start of home phototherapy was 243.8 umoVL and the mean bilirubin level at the end of home phototherapy 5 was 139.3 umoVL. The mean decrease in bilirubin level was 103.12 umoVL and the mean number of days of usage was 3.5 days which is a daily decrement of about 29 umoVL (29.46 + 13.8). Home phototherapy remains a viable clinical option for full term babies with physiological jaundice.
Employee satnfaction surveys can provide the information needed to improved levek of productivity, job and loyalty. Management can identify the factors of job issues and provide solutions to improve the working environment. A cross sectional descriptive study on employee satisfaction among a health care district office’s staff was conducted in Perak in March - April 2006. A total of 19 staff were randomly picked and interviewed in the data collection process. Almost all understand the objectives of the administration unit (94%) and were satisfied with the management leadership’s style (78%- l 00%) . Majority agreed that their relationship with immediate superior and within the group was harmonious and professional (89%) and they preferred an open problem solving method in handling conflict (72 %). The most common type of incentive rewarded by the administration to express gratitude to their staff was certificate (56%); bonus and medal (33%); and informal gesture (28%). Majority (83%) were also satisfied by the method used to disseminate the information in their units. Majority agreed that the working environment in the administration unit were conducive (72%), their ideas were equally considered during decision making sessions (89%) and training opportunities were similarly given to them by the management (72%). This study revealed that employee satisfaction was determined by several factors such as management leadership's style, opportunity to contribute skills and idea; reward and incentive; and conducive king environment.
Stress has been recognized one of the factors causing disease. About 70-80% of all diseases may be stress related. Thus, stress management can be a part of an early measure of disease prevention. A descriptive cross sectional, randomized study was conducted to determine the stress inducing factors among preclinical students (universal sampling) in a public university in Selangor, Malaysia from 24th April to May 2005. A total of 163 students (52.8% year 1, 36.8% year 2 and 10.4% year 3) were interviewed in the data collection process. The main reasons students entered - medical school was because of their own interest or ambition (65%) and family influence (20.9%). Majority (76.4%) suffered moderate to great stress over hot conditions in lecture hall, tutoriaV small group session rooms and laboratories while 53.4% suffered when using the other facilities like cafeteria, toilet and transportation:. Almost all (95.1%) felt that examination was the most stressful, followed by early clinical exposure sessions (68.1%), problem·based learning sessions (62.5%), hospital visitations (59.7%), tutoriay small group sessions (49.3%), practical class (44.5%) and attending lectures (3 8.5%). Musculoskeletal System was the most stressful module among the first year students, followed by Nervous System and Gastrointestinal System with the percentage of 94.2%, 90.7% and 88.4% respectively while, 95% of the second year students felt that General, Hemopoietic ci? Lymphoid and Nervous System are the most stressful modules. This study revealed that academic sessions and lack of conducive teaching and learning environment as the main stress inducing contributors to preclinical medical students.
On December 26, 2004, an earthquake triggered a devastating tsunami that caused death and destruction in twelve countries including India, Indonesia, Malaysia, Maldives, Seychelles, Somalia, Sri Lanka and Thailand. One of the authors was a volunteer with FELDA WAJA AMAN MALAYSIA medical relief team that served the Aceh victims from 16th February to 24th February 2005 (8 weeks post tsunami). A study to determine the pattern of health ailments was conducted among children aged 18 years and below based at Seuneubok Camp, 30 km from Banda Aceh. All respondents were from Pulau Aceh and the total number of children seen and examined was 60. About 18% had lost their fathers, 10 % had lost their mothers and 27% had lost one or more of their siblings. 77% suffered some form of health ailments. The common health ailments were diarrhea (61%), respiratory complaints (59%) and fever (20%). About 38 % of preschoolers had loss of appetite and 28% had sleep disturbances. About 35% of the elementary school children suffered from sleep disturbances, 29% of the young adolescents suffered from headaches and 24% had sleep disturbances. Nearly a quarter (24%) of all the children felt fearful and anxious about the disaster. Nevertheless, 56% of the respondents wanted to return back to Pulau Aceh, although 14 % did not want to go back. Interestingly, 73% of the children voiced their gratitude to God for having been saved from death.