Human Immunodeficiency Virus (HIV) epidemic remains a significant burden in Malaysia. Stigma related to HIV and its effect on the quality of life (QOL) of persons living with HIV (PLHIV) remains under-reported. The aim of the present study was to assess self-perceived stigma amongst PLHIV attending an urban community clinic and its influence on their QOL. Data was collected using HIV Stigma Scale and WHO-QOL HIV BREF Scale. The overall stigma experienced by PLHIV in this community was higher than previous studies (mean ± SD; 103.37 ±18.14). Majority participants had fear disclosing their disease status, while personalized stigma or the experience of prejudice and rejection was the least experienced. The overall QOL was low and was significantly impaired in social relationship domain (mean ± SD; 12.72 ± 3.59). However, their ability to perform daily activities was not affected by the illness (mean ± SD; 14.48 ± 2.91). PLHIV with higher spiritual values demonstrate lower perception of negative self-image and inferiority (r= -0.54). This finding was unique to PLHIV in this study and suggested the importance of spirituality and personal beliefs on their self-esteem. In conclusion, stigma remains as a significant problem among PLHIV in this community. Primary care offers the best platform to promote a holistic management of PLHIV, where the integration between counselors, religious experts, family and non-governmental associations could come together. The management of PLHIV is unique in every community, hence individualized approach based on cultural norms and beliefs could assist in the overall management of PLHIV.
Keywords: HIV, quality of life, social stigma
Extramammary Paget's disease (EMPD) is a rare malignant disorder of the skin, which was described in as early as the nineteenth century. EMPD usually occurs as a single lesion in the apocrine sweat gland-bearing skin with abundant hair follicles. Here, we present an elderly man who suffered from a non-resolving chronic genital pruritus for 8 months. Initially, he was managed for recurrent fungal infection and eczema. Later, a diagnosis of the rare condition multiple primary EMPD was made based on the histopathology findings and appropriate treatment was given.
Adolescent smoking is an emerging health concern in the developing countries. A cross-sectional study is conducted to determine the prevalence and smoking behaviour of adolescents in Sarawak. The prevalence of smoking is 32.8% with mean age of initiation at 12.8±1.9 years. Most (67.2%) adolescents are experimental smokers and the majority (67.9%) did not smoke on a daily basis. Branded cigarettes are preferred (83.1%) and the cigarettes are obtained either from friends (49.1%) or self purchased (43.6%). Students prefer to smoke at their friend’s house (31.0%) or at school (25.3%). Smoking prevalence among adolescents in Sarawak is high and begins early. Early intervention on smoking prevention and risk awareness is perhaps more effective if initiated before the age of 12 years.
A cross-sectional study was conducted on patients attending a primary care facility to determine the prevalence of self reported hearing loss using a single question, "Do you have hearing loss?" Pure tone audiometry was performed to compare the accuracy of the self report. A total of 111 patients were recruited. The prevalence of self reported hearing loss using a single question and pure tone audiometry was 24.3% and 36.9% respectively. By using pure tone audiometry at a cut-off-level of 25 dBHL (decibels Hearing level), the single question yielded a sensitivity of 41.4% and specificity of 85.0%.The single question performed better at 40 dBHL pure tone audiometry with sensitivity of 55.0% and specificity of 82.0%. In conclusion, the prevalence of hearing loss in elderly was high and the single question self reported hearing loss performed satisfactorily with moderate hearing loss.
Acne can affect personal appearance and impair quality of life. A cross sectional study, over a period of 12 months was conducted among medical students at Universiti Kebangsaan Malaysia to evaluate the disability, self management and help-seeking behaviour of medical students for acne. A total of 361 students were selected using stratified cluster random sampling. Acne was graded using the Comprehensive Acne Severity Score (CASS) while acne disability was assessed using the Cardiff Acne Disability Index (CADI). Acne self management and helpseeking behaviour was assessed using the acne management questionnaire. Mean CADI score was 3.35 + 2.39, with mostly mild (83.8%, n=206) and moderate (14.6%, n=36) levels of impairment. Female students and those from the nonMalay ethnic group demonstrated higher disability (3.76 + 2.24, p=0.006 and 3.79 + 2.59, p=0.018, respectively). Although the majority of students (87.4%, n=215) knew that acne can be treated, they preferred to discuss their acne problems with friends (54.1%, n=133) rather than consulting a physician (9.3%, n=23). Most of them also practiced non-evidence based measures for their acne. The results of the present study shows that young adults tend to have mild grades of acne severity and disability. However, efforts are needed to enhance their knowledge on evidence based management of acne and modify their help seeking behavior. This would help reduce complications such as permanent scars and improve quality of life, as acne is a treatable dermatological disorder.
Keywords: acne vulgaris, medical, disability, quality of life, students, severity, self care
Diabetes requires dedicated self-management to be able to achieve good control and outcome as this is a lifelong condition. The internet offers an amazing wealth of health information which may influence diabetes self-management. The aim of this study was to determine the prevalence of online health information seeking among people with diabetes and its associated factors. About 380 participants answered the online health information seeking questionnaire developed from literature search and expert panel review. Diabetes Self-Management was assessed using the Diabetes Self-Management Questionnaire (DSMQ). The prevalence of online health information seeking among people with diabetes was 38.4%. Common information sought included diabetes treatment (82.9%) lifestyle modification (77.4%) and diabetes prevention (67.3%). A large majority (93.1%) felt that the online information on diabetes was useful. Doctors and printed reading materials were the most common sources of information for diabetes (94.2% & 65.3%). Lower median age (59 years, IQR = 11), having a family member with diabetes, (COR = 1.188) tertiary education (COR = 6.037) and those who are employed (COR = 3.880) have higher odds of seeking online diabetes related health information. However, there was no significant association between online health information seeking and diabetes self-management. Prevalence of online health information seeking among people with diabetes was at an acceptable level. However, it was not associated with optimal diabetic self-management. Doctors and printed information remain as popular sources of information and hence should be maintained.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia