Displaying publications 21 - 40 of 45 in total

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  1. Nurnazahiah A, Lua PL, Shahril MR
    Malays J Med Sci, 2016 Nov;23(6):7-24.
    PMID: 28090175 MyJurnal DOI: 10.21315/mjms2016.23.6.2
    The objective of this study was to compile and analyse existing scientific evidences reporting the effects of objectively measured physical activity on the levels of adiponectin and leptin. Articles related to the effects of objectively measured physical activity on the levels of adiponectin and leptin were searched from the Medline and PubMed databases. The search was limited to 'objectively measured' physical activity, and studies that did not objectively measure the physical activity were excluded. Only English articles were included in the search and review. A total of 18 articles encompassing 2,026 respondents met the inclusion criteria. The eligible articles included all forms of evidence (e.g., cross-sectional and intervention). Seventeen and 11 studies showed the effects of objectively measured physical activity on adiponectin and leptin, respectively. Five and four cross-sectional studies showed the effects of objectively measured physical activity on adiponectin and leptin, respectively. Two out of five studies showed a weak to moderate positive association between adiponectin and objectively measured physical activity, while three out of four studies showed a weak to moderate inverse association between leptin and objectively measured physical activity. For intervention studies, six out of 12 studies involving adiponectin and five out of seven studies involving leptin showed a significant effect between the proteins and objectively measured physical activity. However, a definitive conclusion could not be drawn due to several methodological flaws in the existing articles and the acute lack of additional research in this area. In conclusion, the existing evidences are encouraging but yet not compelling. Hence, further well-designed large trials are needed before the effectiveness of objectively measured physical activity in elevating adiponectin levels and in decreasing leptin levels could be strongly confirmed.
  2. 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.
  3. Shahril MR, Wan Dali WP, Lua PL
    J Nutr Metab, 2013;2013:658642.
    PMID: 24069535 DOI: 10.1155/2013/658642
    The aim of the study was to evaluate the effectiveness of implementing multimodal nutrition education intervention (NEI) to improve dietary intake among university students. The design of study used was cluster randomised controlled design at four public universities in East Coast of Malaysia. A total of 417 university students participated in the study. They were randomly selected and assigned into two arms, that is, intervention group (IG) or control group (CG) according to their cluster. The IG received 10-week multimodal intervention using three modes (conventional lecture, brochures, and text messages) while CG did not receive any intervention. Dietary intake was assessed before and after intervention and outcomes reported as nutrient intakes as well as average daily servings of food intake. Analysis of covariance (ANCOVA) and adjusted effect size were used to determine difference in dietary changes between groups and time. Results showed that, compared to CG, participants in IG significantly improved their dietary intake by increasing their energy intake, carbohydrate, calcium, vitamin C and thiamine, fruits and 100% fruit juice, fish, egg, milk, and dairy products while at the same time significantly decreased their processed food intake. In conclusion, multimodal NEI focusing on healthy eating promotion is an effective approach to improve dietary intakes among university students.
  4. Neni SW, Latif AZ, Wong SY, Lua PL
    Seizure, 2010 Jun;19(5):280-90.
    PMID: 20466567 DOI: 10.1016/j.seizure.2010.04.006
    This study was carried out to gauge the preliminary insight regarding epilepsy among the rural society. The purposes of this study were: (1) to determine general level of awareness, knowledge and attitudes (AKA) towards epilepsy among rural communities, (2) to compare the AKA level based on socio-demographic characteristics and (3) to investigate rural cohort's perception of the best epilepsy treatment, preference for epilepsy information delivery and preference for mode of transportation to seek medical treatment. This prospective, cross sectional study included a sample of 615 rural residents enrolled via cluster sampling in East Coast region of Peninsular Malaysia (mean age=41.6+/-18.02, female=56.6%, married=65.5%, Malay=94.0%, monthly income < or = RM 500=56.9%). The Total AKA level was generally low (2.66+/-0.7). Gender-wise no significant difference was shown regarding AKA level (p>0.05). However, respondents with higher education significantly possessed better attitudes and higher Total AKA level compared to those with lower education level (p<0.001). Employed respondents reported significantly more favourable attitudes than unemployed respondents (p=0.011). Additionally, higher income rural cohorts possessed both significantly better attitudes and better AKA. These rural communities perceived modern medicine as the best epilepsy treatment (56.60%), preferred to obtain direct epilepsy-related information from health personnel (60.4%) and chose to use their own car to seek medical treatment in hospital (76.30%). The outcomes of this preliminary study signified the need to devise a dedicated epilepsy education program for implementation among rural residents. Increased AKA level in the society could enhance the people's acceptance, reduce stigmatisation and improve health-related quality of life (HRQoL) for epilepsy patients and their family.
  5. 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
  6. Wong HJ, Lua PL, Harith S, Ibrahim KA
    Health Qual Life Outcomes, 2021 Aug 30;19(1):210.
    PMID: 34461920 DOI: 10.1186/s12955-021-01847-0
    BACKGROUND: Apart from maximizing functional abilities and independence after stroke, improving overall health-related quality of life (HRQoL) should also become part of the stroke treatment and rehabilitation process goals. This study aimed to assess the HRQoL profiles and explore the dimension-specific associated factors of HRQoL among stroke survivors.

    METHODS: This was a cross-sectional study of stroke survivors attending post-stroke care clinics in three public hospitals in the states of Pahang and Terengganu, Malaysia. The HRQoL was assessed by EuroQol-5 dimension-5 levels. Data on socio-demographic, clinical profiles, malnutrition risk, and physical activity level were collected through an interviewer-administered survey. Descriptive analyses for HRQoL profiles and multiple logistic regression analyses for its associated factors were performed. Crude and adjusted odds ratios were reported.

    RESULTS: A total of 366 stroke survivors were recruited with a mean age of 59 ± 11 years. The most -commonly reported health problems were mobility (85%), followed by usual activities (82%), pain/discomfort (63%), anxiety/depression (51%) and self-care (41%). The mean of the EQ visual analogue scale and the median of the EQ5D summary index was reported at 60.3 ± 14.2 and 0.67 ± 0.37, respectively. Malnutrition risk (mobility, usual activities, and self-care), wheelchair users (self-care and usual activities), speech impairment (usual activities and pain/discomfort), number of stroke episodes (self-care and pain/discomfort), body mass index, physical activity level and types of strokes (usual activities), age and use of a proxy (anxiety/depression), working and smoking status (mobility), were factors associated with either single or multiple dimensions of HRQoL.

    CONCLUSION: Routine malnutrition screening, tailored program for speech therapy, prevention of recurrent stroke, and physical activity promotion should be addressed and further reinforced in current rehabilitation interventions to improve the HRQoL among stroke survivors in Malaysia.

  7. Wong HJ, Harith S, Lua PL, Ibrahim KA
    Sci Rep, 2023 Mar 30;13(1):5189.
    PMID: 36997594 DOI: 10.1038/s41598-023-31006-y
    Individuals with stroke are at high malnutrition risk in both the acute and chronic phases. This study aimed to assess the validity of different malnutrition screening tools for stroke patients in rehabilitation phase. Participants in this study were 304 stroke patients from three hospitals in the East-Coast region of Peninsular Malaysia from May-August 2019. The concurrent validity of the Malnutrition Risk Screening Tool-Hospital (MRST-H), Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Screening Tool (MST), Malnutrition Universal Screening (MUST) and Nutritional Risk Screening (NRS-2002) was assessed with the diagnostic criteria for malnutrition proposed by the Global Leadership Initiative on Malnutrition (GLIM-DCM). Sensitivity, specificity, positive predictive value, negative predictive value, and the area under the curve were computed. MUST and MRST-H demonstrated good validity regardless of different age groups (> 80% sensitivity and specificity); meanwhile, MST and MNA-SF had fair validity, yet NRS-2002 had poor to fair validity with GLIM-DCM. Only MRST-H and NRS-2002 were significantly correlated with all anthropometric indices, dietary energy intake, and health-related quality of life in both age groups. In conclusion, MRST-H and MUST showed good concurrent validity with GLIM-DCM and can be considered as appropriate malnutrition screening tool in discriminating malnutrition among stroke individuals attending rehabilitation centre in Malaysia regardless of their age groups.
  8. 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)
  9. 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.

  10. 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.
  11. Abdullahi A, Hassan A, Kadarman N, Saleh A, Baraya YS, Lua PL
    Int J Gen Med, 2016;9:79-87.
    PMID: 27110137 DOI: 10.2147/IJGM.S98436
    Foodborne diseases are common in the developing countries due to the predominant poor food handling and sanitation practices, particularly as a result of inadequate food safety laws, weak regulatory structures, and inadequate funding as well as a lack of appropriate education for food-handlers. The most frequently involved foods in disease outbreaks are of animal origin. However, in spite of the adequate legislation and laws governing the abattoir operation in Malaysia, compliance with food safety requirements during meat processing and waste disposal is inadequate. Therefore, the present study was designed to assess the food safety knowledge, attitude, and practice toward compliance with abattoir laws among the workers in Terengganu, Malaysia.
  12. 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.

  13. Nurnazahiah A, Shahril MR, Syamimi ZN, Ahmad A, Sulaiman S, Lua PL
    Health Qual Life Outcomes, 2020 Aug 06;18(1):259.
    PMID: 32762686 DOI: 10.1186/s12955-020-01513-x
    An amendment to this paper has been published and can be accessed via the original article.
  14. 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 

  15. Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Hassan H, et al.
    J Integr Med, 2021 Jan;19(1):1-5.
    PMID: 33162374 DOI: 10.1016/j.joim.2020.10.006
    Obesity and overweight problems are serious global health issues today and despite many efforts, the prevalence has continued to rise for decades. Interestingly, hypnotherapy has been gaining recognition as an effective treatment for obesity and overweight problems. This review compiles contemporary scientific research on the effectiveness of hypnotherapy for weight reduction. Scopus, PubMed and EBSCO Host databases were applied in the study. The search identified 119 articles, of which seven met the inclusion criteria. A total of 539 respondents (82.7% women and 17.3% men) between the ages of 17 and 67 years were represented in the seven studies. Most studies incorporated lifestyle changes, such as changes of dietary habit and behavioral recommendations in the hypnotic procedure. Their results suggested that the use of hypnotherapy not only promoted weight reduction during the treatment period but also after treatment cessation, and in some cases, one to ten kilograms were lost during follow-up periods. In addition, one study even showed increased physical activity among the hypnotised individuals. This use of hypnotherapy also improved respondents' eating behavior and quality of life. However, a definitive conclusion could not be drawn due to several methodological flaws and the limited number of published studies in this area. Therefore, further well-designed studies are needed to substantiate the effectiveness of hypnotherapy for this modern-day health problem.
  16. 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.

  17. 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.

  18. Lua PL, Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F
    J Evid Based Integr Med, 2021 9 10;26:2515690X211043738.
    PMID: 34496677 DOI: 10.1177/2515690X211043738
    Despite various strategies, overweight and obesity problems are still increasingly prevalent worldwide with serious health outcomes. Consequently, the continuous demand for more effective, safe and acceptable therapies for reducing body weight is also escalating-including complementary and alternative therapies (CATs). The aim of this review is to provide a summary of the most commonly- and recently-used CATs, with evaluation of their safety and efficacy for weight loss. Electronic scientific databases such as Scopus, PubMed and EBSCO Host were explored for articles that reported CATs for overweight and obesity treatment from 2015 to December 2019. Only systematic reviews, meta-analysis and randomized controlled trials (RCTs) published in English were included. Studies whereby CATs were not utilized for reducing body weight were excluded. Eight systematic reviews and meta-analyses and 11 additional RCTs with 765 participants (50.2% overweight and 49.8% obese) related to hypnotherapy, acupuncture and dietary supplements met the inclusion criteria. Their results suggested that spirulina, chitosan, probiotic, EPA + DHA, vitamin D, fiber, and herbal extract supplementation may all provide small reductions in body weight (ranging from 1-10 kg). Interestingly, hypnotherapy and acupuncture reported significantly greater reduction in body weight compared with placebo (p < 0.001 and p < 0.0001, respectively). Nonetheless, the evidence is still relatively limited and not encouraging to provide a definitive conclusion due to the methodological shortcomings and the presence of adverse events in chitosan and fiber supplementation. Hence, studies of this nature need to be further replicated and improved to corroborate the efficacy and safety of the CATs to combat weight issues.
  19. Roslim NA, Ahmad A, Mansor M, Aung MMT, Hamzah F, Shahril MR, et al.
    Am J Clin Hypn, 2022 Feb 02.
    PMID: 35108492 DOI: 10.1080/00029157.2021.2010642
    Hypnosis has been increasingly used in recent years as an alternative treatment to maintain well-being. Yet, limited evidence is available regarding its role in weight management, especially in Malaysia. Hence, this quasi-experimental study was conducted to evaluate the effectiveness of hypnosis on weight loss and body composition (body mass index, waist circumference and body fat percentage) among staff and students of a public university in Terengganu, Malaysia. Participants with body mass index (BMI) ≥ 25.0 kg/m2 were randomly assigned to either intervention group (IG = 53) or control group (CG = 54), for 12 weeks. All participants received health education (diet + exercise + behavioral recommendations) with those in IG had additional three hypnotherapy sessions, once a month. Body weight was measured at week 1, 7, and 12 while body compositions were measured at weeks 1 and 12. Descriptive, univariate, and repeated-measures analysis of covariance (ANCOVA) were utilized. A total of 104 participants completed the trial (mean age = 26.28 ± 8.01; female = 82.2%; BMI = 31.39 ± 4.89). A significant weight loss was observed in the intervention (-4.61%) and control (-3.04%) groups (mean difference = -1.57; 95%CI: -2.59, -0.54; p = .003) after 12 weeks. Participants that frequently practiced self-hypnosis lost more weight (-6.27%; t(50) = -5.331, p < .001). Body fat percentage and waist circumference did not significantly change from baseline in both groups. Essentially, the positive outcomes indicated the promising potential of hypnosis as an alternative tool in facilitating weight loss efforts for those in need.
  20. 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.
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