Aims: To assess the association between non-steroidal anti-inflammatory drug (NSAID) use and upper gastrointestinal (GI) tract-related hospitalizations and to evaluate inpatient healthcare resource utilization associated with these complications in Malaysia.
Methods: A retrospective case control study was performed using medical records of patients admitted to two Malaysian hospitals during 1999 and 2000. Cases were identified based on mode of presentation at hospital admission. One control was identified for each case, matched by age, sex and admission date. NSAID exposure was determined by drug use during one year prior to admission. Conditional logistic regression analysis was used to determine the association between NSAID use and upper GI complications, adjusting for predictors.
Results: The 273 cases were significantly more likely to have used NSAIDs in the year prior to hospitalization than controls (27.8% vs. 6.2% of patients; P < 0.0001). Conditional logistic regression analysis adjusting for other predictors showed that the odds of being hospitalized for upper GI tract complications were 4.1 times higher among NSAID users than non-users (95% CI = 1.88-9.12). Other risk factors for GI-related hospitalizations were a history of upper GI tract complications (OR = 5.8, 95% CI = 1.28-26.53), use of gastroprotective agents (OR = 5.3, 95% CI = 1.67-16.79), and use of antacids (OR = 5.0, 95% CI = 2.10-11.91) in the previous year.
Conclusion: This study demonstrated that NSAID exposure was significantly higher among patients hospitalized for GI-related complications than for other reasons, indicating that NSAID use is an independent risk factor for upper GI tract complications in this Malaysian sample.
Aim: To determine the prevalence of the use of complementary medicine in patients with systemic lupus erythematosus (SLE)., Method: A prospective survey was conducted of 132 patients using a standard questionnaire., Results: Of the 132 patients, 15.2% were on alternative therapy and 56.7% were taking food supplements. The common types of alternative therapy taken were oral traditional herbs (50%) and noni juice (20%). Vitamin C, calcium, vitamin E, vitamin B, Spirulina, evening primrose oil, fish oil and multivitamins were the commonest food supplements. There was no significant relationships between taking alternative treatment and educational level (P = 0.16), income (P = 0.05) or race (P = 0.42) of the patients. The majority of these patients took these therapies or supplements for up to 1 year. Up to 70% of the patients had not consulted a doctor before taking these therapies, with immediate family members and friends being the main sources of recommendation. The majority of patients spent RM50-RM500 (US$13-US$132) for 2 months' supply of medications. In conclusion, 15.2% of SLE patients in our study were on alternative therapy and 57.6% on food supplements., Conclusion: Physicians should be aware of these practices which should be taken into account during the history-taking and subsequent management of the patients.
Objective: To determine the number of RA cases and to evaluate the demographic patterns in all 4 Rheumatology Referral Centers under the Ministry of Health Malaysia. Materials and methods: One thousand and eighty-four rheumatoid arthritis patients from all 4 centers i.e. Hospital Selayang, Putra Jaya, Seremban and Taiping which are situated in the west coast of West Malaysia, using rheumatoid arthritis database comprising of basic clinical and patient questionnaire, until the end of year 2004 were analysed. Results: At the time of documentation, 88.6% were female at all range of ages especially between age of 25 and 54 years (77.6%) with female to male ratio 8 :1. 52.1% were housewives. Mean age of onset of RA was 49.6 ± 11.8 SD with female 49.3 ± 11.7 SD and male 52.0 ± 12.0 SD (p < 0.05). Indian was the predominant ethnic group (54.5%), followed by Malay (31.4%), Chinese (11.6%) and others (27%). Majority had their education up to secondary level (50.8%), followed by primary (32.6%), and tertiary (6.3%) levels while 10.3% of cases had not received any formal education in their lives. 74.4% were seropositive and 87.3% fulfilled at least 4 out of 7 American College of Rheumatology (ACR) revised criteria for rheumatoid arthritis. 74% were diagnosed RA within 2 years after the onset of arthritis. Seropositivity was not significantly related to gender. Positive rheumatoid factor was dominated by Indian followed by Malay and Chinese. 83.3% were married. 23.3% female and 33.9% male between age group 25-54 were employed. 7.4% had achieved their retirement at time of entry whilst 8.9% were unemployed. Employment status was statistically significant across gender (p < 0.001). The cases differed between rheumatology centers as well as individual practices. Conclusion: There are increasing numbers of RA cases in Malaysia. Results from this study did not reflect the true prevalence of RA in Malaysia. Hence, a larger and more comprehensive database on RA with collaboration of all Government and Private Hospitals in the whole nation will provide better information about the patient case mix in different healthcare settings, treatment practice as well as disease complications. The implementation of rheumatology centers with better regional cooperation, will lead to better treatment and outcome in terms of identification of early as well as established RA cases. Early referral to the centers will be made possible for proper treatment institution and rehabilitation. Hence, improve quality of life including socio-economic status especially among those within the productive age.
Little new evidence on the prevalence of injury to the anterior teeth of children has been reported in the past five years and, in South Africa, trauma to the teeth of children in different ethnic groups has not been compared respectively. The purpose of this investigation was to determine the prevalence of dental trauma using well-defined criteria and to sample a specific age-group. Five regions were chosen and 1035 children in the eleven-year age-group were examined. No statistical significance was found between the ethnic groups related to the amount of injury sustained. For all groups, boys received more injuries than girls. The most common injury was fracture of the enamel of the maxillary central incisor. With 15 percent of the children receiving some level of trauma by age eleven years, this is one of the main dental treatment needs for South African children.
Objective: In the process of growing, adolescents experience stress either good or bad depending on how they cope. School training further adds to this stressful situation. It is noteworthy that persistent over stress will impair students’ academic achievement, personal and professional development. This preliminary study is meant to obtain initial data on the stress prevalence, stressors, and coping strategies among secondary school children in Malaysia. Data gained from this preliminary study provides valuable data for subsequence research in the future. Methods: This is a cross-sectional study involving 100 secondary school students from a Malaysian government secondary school. The validated Malay version 12-item General Health Questionnaire (GHQ-12), Soalselidik Stressor Sekolah Menengah (SSSM) and Malay version of Brief COPE were used to identify stress level, stressors, and coping strategies. Results: A number of 90 (90%) students participated in this study. The prevalence of stress among secondary school students was 26.1%. It was found that the main stressors were related to academic. The top five coping strategies were religion, positive reinterpretation, active coping, planning, and use of instrumental support. Conclusion: The prevalence of stress among secondary school students in a Malaysian
stressor among the students. The most frequent coping strategies being used by the students were positive coping strategies.
Objective: The aim of the study is to examine the prevalence and factors influencing PTSD among a sample of help-seeking women experiencing domestic violence. Methods: This was a cross-sectional survey study of 40 women in two shelters in Malaysia from 2007 to 2008. Measures include the Detailed Assessment of Posttraumatic Stress; the Measure of Wife Abuse; the Posttraumatic Cognitions Inventory; the Coping Scale for Adults; and the Provision of Social Relations. Results: Results showed that 60% of subjects
exhibited patterns of symptoms consistent with the diagnosis of PTSD. The most prominent posttraumatic symptoms reported were re-experience, avoidance, dissociative responses, and symptoms of increased arousal. Both negative appraisals about themselves and self blame for the abusive situations were positively associated with increased tendency to develop PTSD. The greater use of optimism coping style and the higher quality social
support appeared to lead to a significantly reduced tendency of developing PTSD. Negative appraisals about themselves were found to be the strongest positive predictor of PTSD [R² = 0.32, F(1,38)=17.67, p
Objective: To investigate the prevalence of Female Orgasmic Dysfunction (FOD) focusing on the orgasm domain among female patients attending PPUKM Psychiatric clinic. To compare the prevalence of orgasmic dysfunction between female patients on Escitalopram and on Fluoxetine therapy.
Methods: A validated questionnaire for sexual function was used to assess orgasmic function. A total of 112 women aged between 24 and 57 participated in this study. The orgasmic dysfunction was compared between patients on selective serotonin reuptake inhibitors (SSRIs) fluoxetine and escitalopram.
Results: The prevalence of female orgasmic dysfunction was 58.9% (33/56) among patients treated with Fluoxetine and 41.1% (23/56) among patients treated with Escitalopram. However, there was no statistically significant difference between these two treatment groups (p=0.059). The odds to have FOD among patients on higher dose of antidepressants was found to be higher compared to those patients who were on lower dose of antidepressants (Odds ratio 5.32, p= 0.001).
Conclusion: There was no significant difference of Female Orgasmic Dysfunction between patients on Fluoxetine and Escitalopram.
Study site: Psychiatric clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Introduction and Objective: Tobacco use is a significant risk factor for oral diseases. Periodontal disease has been known to be associated with tobacco use for over twenty years. Despite that, dentists and particularly periodontist does not include tobacco use cessation as part of their initial treatment in treating periodontal disease or placing implants in patients who use tobacco. The increase in prevalence and severity of periodontitis among smokers
cannot be explained by differences in the amount of plaque between smokers and nonsmokers. A possible explanation is that smoking may alter the quality of the flora. Dental professionals also have a crucial role to play in tobacco cessation counseling, particularly for patients with chronic periodontitis. More patients will be affected by periodontitis than will ever be affected by oral cancer. Methods and Results: Reviews of literatures were
done on a clearly formulated question on the need of smoking cessation intervention to increase positive outcome of treatment on periodontal disease. Conclusion: Various epidemiological studies strongly suggest that tobacco use cessation is beneficial to patients following periodontal treatments for a better outcome.
Objective: This study was aimed to determine the prevalence of anxiety and depressive symptoms , to examine their association with health-related quality of life (HRQoL) profiles and to determine the predictors on overall HRQoL. Methods: This was a cross-sectional study conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia. The Malay Hospital Anxiety and Depression Scale (HADS) and McGill Quality of Life Questionnaire (MMQoL) were administered to a sample of 150 cancer patients (mean age = 50.4 years).
Chi-square test, correlation and multiple regression were utilised for data analysis. Results: The prevalence for mild anxiety and depressive symptoms was 30.7% and 23.3% espectively. The HADS-A correlated strongest with Total MMQoL Score (r = - 0.578) and Psychological Well-Being (r = -0.526). Only HADS-A (beta = - 0.486), and HADS-D (beta = -0.173) were significant in predicting overall health-related quality of life. Conclusion: Findings in our study indicated that the prevalence of anxiety and depressive symptoms in
Terengganu cancer patients are moderate. If anxiety and depression are identified and treated, health-related quality of life among oncology patients appropriately could significantly be improved.
Objectives: The objective of the study is to determine the prevalence of substance abuse for alcohol, cannabis, opiates, stimulants, solvent and other substances among patients with schizophrenia in Hospital Bahagia Ulu Kinta (HBUK), Perak , Central Peninsular of Malaysia. This study also aims to determine the association of substance abuse with aggression, the demographic characteristics and total duration of hospitalization.
Methods: This was a retrospective cross-sectional study whereby the first 194 subjects diagnosed to have schizophrenia based on International Classification of Disease, 10th edition (ICD-10) criteria were taken from data registry of patients admitted to HBUK from January until February 2004. The subjects’ medical files were examined for documentation of substances abuse, aggression and accumulative duration of hospitalization.
Results: The results showed the prevalence of substances misuse among patients with schizophrenia in general (including alcohol) was 24.7%. Cannabis 16.7%, alcohol 13.4%, opiates(heroin) 6.7%, Amphetamine type stimulants (amphetamine, metamphetamine, ecstacy) 5.7%, and other substances (benzodiazepine, solvents) 1.5%.
Conclusion: There is higher prevalence of substance misuse in patients with schizophrenia as compared to general population. Male patients with history of substance misuse are more likely to have aggression than female. This group needs special precaution and probably in need of specialist help.
Objective: This review paper will be discussing on mental health of children and adolescents in Malaysia. Behavioural problems, academic failure and underachievement in school are common reasons for referral of children to the medical services. Epidemiological research has substantiated a possible seriously mismatch between the rates of child mental health problems across a broad spectrum and the number of children actually referred to existing services. These data suggest it is imperative in Malaysia to empirically investigate the present realities in the schools in regard to special education needs and their neglect. Methods: The present preliminary study is based on a literature review of epidemiological features of learning disorders and comorbidities using the Cochran library key word search. Available statistics for learning disorders from the WHO are compared with records for the
year 2007 from the Ministry of Education in Malaysia. Results: Findings of this comparison with international prevalence rates of learning disorders and related diseases show a sizable gap between real existing needs in Malaysia, and their perception. Based on quantitative estimates, the findings suggest that some 1.4 million children in Malaysia have mental health difficulties that interfere with normal functioning and development, but adequate services for intervention are largely not available. Conclusion: The present undersupply of adequate service for children with learning difficulties is aggravated by the lack of systematic developmental screening in early childhood in Malaysia. This status affects the outcomes and development of the general education system in efforts to meet challenges in the new century.
Objective: Female sexual dysfunction is a known complication of diabetes mellitus. The aims of this study is to estimate the prevalence of sexual dysfunction and the types of sexual dysfunction experienced by Malay women with type 2 diabetes mellitus.
Methods: Cross sectional study was conducted on married Malay women with type 2 diabetes mellitus, receiving treatment from two community clinics in Selangor, Malaysia. Female sexual function was assessed using Malay version of Female Sexual Function Index.
Results: This study found that sexual dysfunction was present among 18.2% women. Lack of libido was the commonest symptom among these women and was observed in 40.9% of women followed by sexual dissatisfaction (36.4%). Sexual arousal disorder was observed in 22.7%, 18.2% complained of lack of lubrication, and 22.7% had vaginal discomfort. Orgasmic dysfunction was found in only 4.5% of these women.
Conclusion: This preliminary research showed sexual desire disorder was the commonest type of sexual disorder among diabetic women.
Objective: This paper aimed to determine the prevalence of sleeping pills use among university students and its associated factors in Malaysia. Methods: This cross-sectional study was conducted in January 2010 among 200 Malaysia. The survey was conducted by distributing self-administered questionnaires. The questionnaire was developed based on the literature review. The students were chosen randomly using convenience sampling.
Results: A total of 200 university students participated in this study. The prevalence of using sleeping pills among university students is 7.5%. The majority of the participants were Malay 146 (73.0%), from urban area 169 (84.5%), from medical and health sciences background 101 (50.5%). This study showed that there is a significant relationship between using sleeping pills and depression (p= 0.03). There is also a significant relationship between
using sleeping pills and inducing sleep by reading (p=0.04). Conclusion: The prevalence of sleeping pills usage among university students is relatively high. This study showed that there is a significant relationship between using sleeping pills and depression.
Objective: Postgraduate medical training has always been regarded as a highly stressful environment to students. This article described an initial finding on prevalence and sources of stress among postgraduate students. Method: This is a cross-sectional study conducted on postgraduate students in the School of Medical Sciences, Universiti Sains Malaysia. Sample size as calculated for this preliminary study was 38 and convenient sampling method was applied. The 12 items General Health Questionnaire (GHQ-12) and Postgraduate Stressors Questionnaire (PSQ) were administered during a workshop involving postgraduate students. Data was analysed using SPSS version 12. Results: Thirty three participants participated in this study. This study found that the prevalence of distressed postgraduate students was 36.4%. The top ten stressors were tests and examinations, large amount of content to be learnt, time pressure to meet deadlines, doing work beyond
ability, work overload, unfair assessment by superior, fears of making mistakes that can lead to serious consequences, doing work that mentally straining, work demands affect my personal and home life, and lack of time to review what have been learnt. Conclusion: This study found that there was a high prevalence of distressed postgraduate students. It also found that the major stressors were related to academic and performance pressure.
Objective: The objective of this study was to determine the prevalence of the most common phobias and associated factors among university students. Methods: This cross-sectional study was carried out at Management and Science University (MSU). Random sampling was performed throughout all faculties. The questionnaires were distributed randomly at classes, library and university cafe within MSU. Diagnosis of anxiety disorders were established according to DSM-IV criteria. These criteria are included in Liebowitz Social Anxiety Scale (LSAS). The questionnaire consists of two sections. The first section consists of socio-demographic characteristics such as (age, sex, race, type of faculty and income); the second section is LSAS standard questionnaire. Multiple linear regression using backward analysis was performed to obtain the associated factors. Results: A total number of four hundred sixty eight (468) students participated in this study. The majority of them were older than 20
years old, female, Malay and from non-medical and heath faculties (59.6%, 69.6%, 77.8%, 68.8%; respectively). Regarding history of abuse during childhood, the majority of the university students reported that there was no sexual, physical and emotional abuse during childhood (98.5%, 97.4%, 82.1%; respectively). The majority of the students (53.85%) reported that they have phobia. The highest type of phobia reported among university students was phobia from snake (11.5%), followed by speaking in front of crowd (9.2%) and the lowest were phobia of speed, dolls phobia, ropes phobia. Types of faculty, smoking status and history of physical abuse during childhood were the factors that significantly influence the social anxiety among university students in univariate and multivariate analysis. Conclusion: The prevalence of phobic symptoms among university students was
high types of faculty; smoking status and history of physical abuse during childhood significantly influenced social anxiety among university students. Education and counseling university students is necessary to educate the students who suffer from phobia to cope with different situations during study period.
Objective: The objective of this study is to identify the correlation between psychological factors and insomnia and the impact of insomnia on daytime sleepiness. Methods and Results: The participants were recruited through convenient sampling and consist of 173 working adults in Georgetown, Penang, aged 20 to 60 years. Participants completed the General Health Questionnaire (GHQ), Athens Insomnia Scale (AIS) and Epworth Sleepiness Scale (ESS). The results revealed that the prevalent of insomnia was 34.7%. There was a positive correlation between psychological distress and insomnia r = .481, p < .001 and also a positive correlation between insomnia and daytime sleepiness r = .334, p < .001. Conclusion: It is concluded that psychological distress typically causes sleep difficulties, and sleep deprivation leads to daytime sleepiness.
Objective: Truancy is a disciplinary problem, which frequently occurs among school students and it has many contributory as well as inter-related factors. It is a growing problem in this country and it often becomes a prelude to other delinquent behaviours. The study objective is to determine the prevalence of truancy as well as factors related to it including psycho-behavioural factors. Methods: A cross-sectional study involving 556 Malay student’s selected using multi-stage sampling was conducted. Results: The overall prevalence of truancy is 30.2%. The predictors to truancy are age, students who frequenting entertainment centre, students who have not completed Quran recital, coping strategies using problems solving methods and time spent watching television/video. There is a significant association between truancy and psycho-behaviour such as watching video/internet pornography, frequenting entertainment centre, smoking, motorcycle racing and dating a special friend. Conclusion: Truancy is a social issue, which must be given serious attention by all concerned components of the society.
Objective: The objective of the present study was to determine the prevalence and factors contributing to psychological morbidity among doctors in Sana’a city, Yemen. Methods: A cross sectional study was conducted among 442 Yemeni doctors. The (GHQ12) was used as a measure of psychological morbidity. Sources of job stress were determined using a 37-item scale questionnaire. Results: The prevalence of psychological morbidity was 68.1 %. Gender, age range of 30 – 39 years old, chewing Khat, type of residence and income were significantly associated with psychological morbidity (p
Objective: This study aimed to determine the prevalence of obesity among patients with schizophrenia and its association with the demographic profile. Methods: This is a cross sectional study. Subjects were selected using systematic sampling. Patients attending the out patient psychiatric clinic, Hospital Universiti Kebangsaan Malaysia, who fulfilled the criteria and able to give consent were included in this study. Diagnosis of schizophrenia was made using Structured Clinical Interview (SCID) for DSM-IV. Demographic profiles of the patients were obtained and anthropometric measurements were measured and classified according to Body Mass Index (BMI) and Waist Circumference (WC) of Asian population. Results: A total of 97 patients were included. The prevalence of overweight (BMI: 23.0- 27.4 kg/m2) was 39.2% (n=38), and the prevalence of obesity (BMI: >27.0 kg/m2) was 35.1% (n=34). BMI was higher among non-Chinese (Malay and Indian, p=.03) and those who had low total household income (p=.03). Sixty-two patients (63.9%) had high WC, which was associated with male (p=.003) and non-Chinese (p=.03). Conclusions: Obesity is highly prevalent among patients with schizophrenia. The risk factors for obesity include male, non-Chinese and those with low total income. The high WC among non-Chinese and male patients suggests that they are at a higher risk of developing obesity-related physical illnesses. These findings support that obesity is a common critical issue among schizophrenic patients, and it warrants serious clinical interventions.
Study site: Psychiatric clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)