Community pharmacists are expected to have the necessary knowledge to give advice on safe and appropriate drug use during self-medication. However, the profession of pharmacist in Yemen has become less trustworthy and less reliable. In addition, quality of medication has been raising a lot of questions among consumers and fake medications have been entering the country without quality control checks. The aim of this study was to determine the consumer perception of health care services provided and its impact on self-medication practice in Sana’a city, Yemen. A self-administered questionnaire containing open-ended and closed-ended questions was developed and distributed among 400 consumers attending 10 community pharmacies in Sana’a City. All data obtained from the questionnaires were coded, entered, and analysed using Chi-square test and multiple logistic regressions. Prevalence of self-medication was found to be 90.7 %. The majority of respondents stated that they do not trust the health care services provided by physician (68.8%), community drug dispensers (78.2%), Ministry of Health (70.5%) or the quality of medicine dispensed by community pharmacies (59.7%). The trust of health care services provided by physicians and community drug dispensers were found to be significant predictors of self-medication practice. Those who did not trust health care services provided by physicians were more likely to use self-medication compared to those who did not (OR= 21.212, CI 95% 2.678-168.001, p= 0.004). Those who did not trust health care services provided by community drug dispensers were more likely to use self-medication compared to those who did not (OR= 2.746, CI 95% 1.048-7.195, p= 0.04). Consumers in Sana’a City have a negative overall perception of the services provided by community drug dispensers, physician and Ministry of Health and the quality of medication. An urgent intervention from health care authorities to adopt and to implement a new national drug policy with necessary laws and regulations is needed.
Complementary Alternative Medicine (CAM) is broadly used as an adjunct treatment for patients to treat various kinds of disease, prevent disease and to sustain and enhance quality of life of the users. The study is aimed to investigate the association between CAM uses, Health-Related Quality of Life (HRQoL) and anthropometric indices among workers or staffs in Universiti Sultan Zainal Abidin (UniSZA) Gong Badak Campus, Kuala Terengganu. A total of 300 subjects participated in this study and completed the malay version of modified HRQol (SF-12) questionnaires. Anthropometric measurements among the subjects were done. Independent t-test, One-way ANOVA and Pearson correlation were used to test the association and the hypotheses. The prevalence of CAM users was 37.3%. The results showed that bodily pain score domain was significantly higher among non-CAM users. Overall, male had higher Mental Health Composite Score (MCS) score than female. Physical Health Composite Score (PCS) was only correlated negatively with BMI among non-CAM users but negative correlated with body fat percentage in both CAM and non-CAM users. As conclusion, HRQoL had significant negative correlation with body fat percentage among CAM users. No association was found between CAM use and HRQoL scores.
The risks of mercury use have prompted the establishment of Minamata Convention on Mercury which placed strong emphasis on management of mercury-added products. This convention aims to reduce and phase out the use, manufacturing and trade of mercury-added products including batteries, switches and non-electronic measuring devices. This commitment will cause significant impacts especially in the developing countries in designing the right approach to achieve it. This is also true for medical industry which is well known for the utilization of mercury-added devices and dental amalgam in its services but had embarked on efforts in eliminating mercury for many years. The experiences learned within a medical facility can be useful in efforts to meet this global ambition of mercury phase out. This paper aims to provide conceptual discussion on the challenges faced by developing countries and lessons learned from medical facility that can helps the formulation of appropriate approaches to manage mercury-added products. The paper adopted medical industry as a case study and used document analysis to discuss the issue. The main challenges identified for developing countries include lacks of capacity, funding, data and newer technologies. Based on analysis of previous studies, this study proposed a mercury management framework in medical facility and identified the recommended practices, namely technological application, policy instrument, capacity building and guidelines development. These identified approaches are found to have specific relationships between cost and potential impacts, hence giving flexibility for adoption based on the available resources in promoting better mercury management system.
Background: Benzene is primarily routed by inhalation which highly sensitive to blood parameters as bone marrow is their target organ. The ability of benzene even in low exposure levels may induce human bone marrow suppression resulting in blood diseases such as leukopenia, anemia, thrombocytopenia, aplastic anemia, and pancytopenia. In the occupational setting, the most common benzene-exposed workers are from the petrochemical industries and petrol distribution such as gasoline pumps. Benzene also generated primarily by mobile exhaust and some from various of anthropogenic sources at environmental atmosphere and occupationally exposed in the policemen traffic, taxi and bus drivers, and street vendors in long-length time with low concentration exposure. Methodology: This paper reviewed published articles on biomarkers exposure, effects and susceptibility as the useful tools for benzene exposure assessment in the occupational and environmental setting. Data from previous epidemiological studies relevant to benzene exposure in various occupational and environmental setting is also summarized. Results: Based on these analyses, the findings agreed that these biomarkers are could suggest in linking the benzene exposure with possible adverse health effects. The biological monitoring used in epidemiological studies is useful in providing an understanding of activation and detoxification of benzene in both the occupational and general population as they are exposed to wide range of benzene concentration. Conclusion. The biomarkers of exposure, effects, and susceptibility utilized for benzene exposure assessment are valid tools in determining the greatest potential risk as well as an early biological effect which then caused a related specific disease.
Solid waste collection has been a major challenge for local council Municipal workers in urban areas where the population is growing rapidly and the need for local councils to ensure they provide service to clear solid waste in a timely manner without disrupting the existing system. This case study is a review of awareness of health and safety among municipal workers on solid waste collection. The study is an examination of such awareness in Malaysia which involves the Petaling Jaya City Council in the state of Selangor. We review the operating system of the Petaling Jaya City Council and the risks which are being exposed to the municipal workers in their daily operations. Health and Safety of municipal workers in the areas of public health, safety, and industrial hygiene has been a concern for a long time. In most cases the majority of municipal workers exposed are from the contractual aspect of outsourced labour. It is important to understand how large the area of a solid waste is and to identify, evaluate, and eliminate or control risks and hazards across the operation zone of the municipal workers which involves environmental and occupational demands. The data we find provides the latest perspectives on topics of widespread concern such contractors management, ergonomic safety, confined space, motor vehicle safety, machinery safety, fall hazard safety, electrical safety and emergency response. Management of legal requirements is also discovered to be important to ensure any organization conducting business is not in violation of any law, and if there is a change of process how is this being addressed. Finally, we look at the control measures needed to support a operation on a large scale where it will not endanger the health and safety of municipal workers when they are involved in solid waste management. The recommendation we have based on the review are to ensure there is a holistic approach and systems in place to address all the concerns that will be faced by the local municipal council in their daily operations and responsibilities at every level of the organization. Conclusion: Research material and data related to this area is limited and we hope future holistic research can be conducted to future enhance the study of health and safety effecting the municipal workers. Health and Safety management system and procedures are the key elements in ensuring a successful organization.
Achieving smoking cessation is an arduous process, where smokers try different methods or approaches to achieve cessation. Quit smoking attempts play an important role in smoking cessation.Thus, this study was conducted to determine the factors associated with attempt-to-quit smoking among the currentsmokers in Sarawak.This cross-sectional study was conducted among adult smokers in Sarikei, Sarawak by face-to-face interview using an adapted and validated questionnaire. Non-probability sampling method was used to select the study place. An adult smoker was selected systematically from each selected household. A total of 482 smoker households were identified with a response rate of 92.3%. Data was analysed using IBM SPSS Version 22.0. A p-value of <0.05 was considered statistically significant. The mean (SD) age of the smokers was 36.3(13.3) years. However, the mean (SD) age of smoking initiation was 18.5(4.8) years. Majority of the smokers were male (91.5%), with the male to female ratio being 1:0.1. Mean (SD) score on The Fagerström Test for Nicotine Dependence was 4.75(2.4), while motivation to quit smoking score was 3.04(1.0). Majority of the smokers (83.1%) hadever seen pictorial health warnings on cigarette packs. More than half of the smokers (54.8%) had ever tried to quit smoking. Binary logistic regression analysis revealed that marital status, religion, ethnicity, pictorial health warnings on cigarette packs and motivation to quit smoking appeared to be the significant predictors of attempt-to-quit smoking (p<0.05). Understanding the attempts to quit smoking will assist inclinical expectations. Thus, a smoking cessation programme should be designed in line with these factors, to aid quit smoking attempts.
Maternal self-efficacy in breastfeeding is one of the potential modifiable factors which is consistently linked with positive breastfeeding outcomes. This study aimed to develop a Malay translation of the original English BSES-SF and to conduct a validity and reliability assessment on both antenatal and postnatal questionnaires among 101 pregnant women in their third trimester and 104 women on their first week postpartum. The Malay translation of the English BSES-SF was conducted by using back-to-back translation processes, followed by validity and reliability evaluation. The validated Malay version of the questionnaire BSES-SF was then administered on the respondents. The questionnaire comprised of socio-demographic, antenatal, and breastfeeding information. Furthermore, data on infant feeding method were collected via telephone call made to the respondents at four weeks postpartum. The Cronbach’s Alpha value for antenatal BSES-SF questionnaire was0.94, while the value for postnatal BSES-SF questionnaire was 0.95. The factor analysis identified a one-dimensional structure which able to explain 59.02% of the variance for antenatal questionnaire and 60.43% of the variance for postnatal questionnaire. In addition, high antenatal and postnatal breastfeeding self-efficacy scores were significantly associated with the practice of exclusive breastfeeding at four weeks postpartum. As a conclusion, Both Malay versions of the antenatal and postnatal BSES-SF questionnaires are valid and reliable tools to assess breastfeeding self-efficacy among Malaysian mothers.
Dengue fever is one of the most dangerous vector-borne diseases. According to the World Health Organization (WHO), dengue fever is a mosquito-borne infection caused by virus serotype DEN-1, DEN-2, DEN-3 and DEN-4. In Malaysia, dengue fever cases are on the rise from 6,000 cases in 1995 to over 40,000 in 2010, and this number is still rising. In 2014, the increase of dengue fever cases was alarming. It was reported that up to the end of the year 2014, there were 108,698 notified cases, indicating an increment of 151% compared to the same period of time in 2013 with only 43,346 reported cases. Selangor was the highest contributor of dengue fever cases in 2014. The objective of this paper is to study the relationship between climatic factors namely temperature, rainfall and humidity to the prevalence of dengue fever in Subang Jaya and Sepang district, Selangor. Data on monthly average temperature, precipitation, relative humidity and dengue fever cases for each month in 2014 and 2013 were collected. Data collection was dealt with a few institutions such as Malaysian Meteorological Department, Subang Jaya and Sepang Municipal Council and health district offices. Data were analysed using SPSS (Statistical Package for the Social Sciences) Version 20. General linear model analysis was used to investigate the relationship between the climatic variables and dengue prevalence. Results and Discussion: Based on the general linear model, rainfall and humidity were found to have significant relationships to monthly dengue fever cases (p= <0.001, p= 0.002). Rainfall was identified as the most significant predictor because rainfall can provide more breeding places for Aedes mosquitoes. As for humidity, higher relative humidity had been associated with increased Aedes aegypti feeding activity, survival and egg development. Temperature was not significantly related to monthly dengue fever cases (p= 0.561) in this study. However, this could be due to the short period of study. Conclusion: Climatic factors play an important role in the prevalence of dengue fever. However, there are many other factors of dengue fever that should be considered such as urbanisation as well as community knowledge, attitude and practice.
Brain tumour occurrence in Malaysia demonstrates an increasing trend from year to year among adults and the second most common cancer among children. Thus, the expansion of numerous research for novel therapy and treatment are necessary. The distribution of brain tumour in a specific population is important to provide substantial information about the current trends for developing new diagnostic technique and research. Consequently, this study is opted to provide descriptive data of brain tumour in Hospital Universiti Sains Malaysia (USM). 217 brain tumour cases were collected from the hospital record between 2011 and 2014. The brain tumour cases were confirmed by pathologists according to WHO classification and grading. Descriptive analysis was evaluated by using Microsoft Excel and IBM SPSS version 22. Gender preponderance in this study shows very little difference. The most common adult primary brain tumour in this study was meningioma (32.7%) followed by glioblastoma (7.8%), a type of diffuse astrocytic tumour. According to age factor, brain tumour distribution pattern shows an increasing trend as the age increases and meningioma is the most common among the elder patients. Secondary tumour takes more than 10% from overall percentage of brain tumour cases. In conclusion, the descriptive data presentation in this study is very helpful to provide baseline information on the current brain tumour occurrence in this region.
As Malaysia races towards a developed nation status, children are increasingly being ferried daily in vehicles almost exclusively as the majority of the population are able to afford private transportations. This paper reviews the current safety concerns for children whilst going in vehicles on Malaysian roads and the steps undertaken to address the need to enhance children’s safety whilst going in these vehicles and suggest possible remedial action to counter the possible lack of awareness for children’s safety whilst in these vehicles. This paper focuses on children on motorcycles and private vehicles (cars, vans and multi-purpose vehicle (MPV)) and excludes other form of transport (buses, lorries) as this paper tries to put forth measures that can be undertaken by the children’s parents and guardian to better enhance the safety of their children. A search was undertaken of all the major database of articles. Articles related to children’s safety systems, children related injuries, children related accident data, available laws and legislation were reviewed to present the need for greater awareness of children’s safety while going in vehicles in Malaysia. There are currently already safety legislations, measures, steps and equipments in place in ensuring the safety of children whilst going in vehicles on Malaysian roads. However, enforcement of laws in developing countries are not easy and we have to start at the root of the problem which is the parents and adults who ferry these children in vehicles. There is a pressing need to educate parents and adults alike on the urgent undertaking of child safety whilst in vehicles. Engineering countermeasures and intervention are probably needed to protect these vulnerable users. For vehicles, a device capable of providing some sort of protection to the child whilst riding pillion should be designed and developed. A legislation mandating the use of child seats whilst ensuring the child seats are affordable to the masses.
The passing of The Occupational Safety Health Act and the subsequent release of the Institute of Medicine (IOM) report had resulted a stronger sense of awareness towards workplace and patient safety in the Healthcare Industry. The World Health Organization (WHO) recommended Interprofessional education as one of the preparative module in handling safety issues in the healthcare Industry.The aim of this paper was to evaluate the students’ knowledge, perception, attitude, interrelationship, inclusion, understanding and teamwork towards patient and workplace safety.The research was conducted by administering questionnaires to returning allied health students from their internship in the healthcare settings. The overall results indicated that 63.4% of the students Agreed, 18.3% Neutral, 17.9% Strongly Agreed and only 0.3% had Disagreed on the impact of Interprofessional education towards patient and workplace safety in the Healthcare Setting.Occupational Safety Health and Interprofessional Education are relatively new concepts in Malaysia and require a strong understanding before a strong concluding stand could be established. The researcher feels a more concurrent approach should be implemented to actually know the impact of Interprofessional education towards patient and workplace safety in the healthcare settings.
Indoor air quality (IAQ) has become a major concern nowadays because of the universality of exposure and its potential negative impact on human health especially on children. This study is intended to explore the association between IAQ and the respiratory health among preschool children in urban and suburban area. A cross-sectional comparative study was carried out among Malay preschool children in urban (N= 60, Puchong) and suburban (N=60, Hulu Langat) areas. An indoor air quality assessment was conducted in 12 preschools and 60 houses which include parameters of PM2.5, PM10, VOCs, mold, bacteria, Gram-negative bacteria and physical parameters. A set of standardized questionnaire was distributed to obtain respondents’ background information, exposure history and respiratory health symptoms. Spirometry test was carried out and the data obtained were analyzed to determine the lung function of the respondents. There was a significant difference between IAQ in urban and suburban preschools for all parameters measured (p<0.05). Most of the pollutants were significantly associated with respiratory health symptoms. There was a significant association between the level of indoor pollutants with the lung function abnormalities among the respondents. Even though this study is the first to take Gram-negative bacteria as an indoor air pollutant, the finding also shows that there is a significant association between exposure of Gram-negative bacteria with lung function impairment and higher reported respiratory symptoms among the respondents. The finding concluded that exposures to indoor air pollutants, especially PM2.5 increases the risk of getting lung function abnormality and respiratory health symptoms among respondents.
The objectives of the research are to identify the noise sources and noise level exposure inside C130H aircraft’s hangar; to produce noise mapping; to identify hearing status of C130H aircraft maintenance crews (MC); and suggesting the noise control measure that can be applied. A field survey on noise level by using a digital sound level meter and producing noise mapping. A hearing testing among 63 MC was carried out in Institute of Aviation Medicine, Royal Malaysian Air Force (RMAF). Reviewing the literature and analyzing some control measures to be taken. Hearing test result shown 41.2% of the MC are having hearing impairment. The highest noise level at the central of the hangar is 92.2 dBA (day-time) and 94.2 dBA (night-time) when there is a C130H aircraft starting its engine at 50 meters from the central of the hangar, 95.3 dBA (day-time) and 97.3 dBA (night-time) when there is a C130H aircraft Engine Ground Run at 150 meters from the central of the hangar. Besides, Auxiliary Power Unit is producing the highest noise level which is 125.7 dBA (day-time) and 127.7 dBA (night-time). The application of Personal Protective Equipment (PPE) is the very likely control measure to be taken while engineering control is very costly but can be considered. Since noise is recognized as a hazard, hearing protection as PPE will not be the ultimate solution as a control measure. Hence, the Engineering Control must be identified and studied to be implemented as an ultimate solution to control the noise hazard in long term duration.
The prevalence of Non Communicable Diseases (NCD) and its risk factors among Malaysian adults are still high. National Health Morbidity Survey (NHMS) 2015 shows that 17.5% of Malaysian adults have diabetes, out of which 53% are undiagnosed, 30.3% are hypertensive whereby 57% of them were undiagnosed. 1 in every 2 Malaysian adults is overweight or obese. Except for hypertension which prevalence is slightly lower compared to 2011 NHMS, all of these prevalences are increasing over the years in spite of vigorous efforts that have been conducted in educating and creating public awareness on the disease and its prevention and control. The increasing trend in NCD and its related risk factors have proved that the educational sensibility is not sufficient in prompting the adoption of healthy behaviors. Obstacles include lack of perceived priority for health, and lack of perceived priority for NCD within the health sector itself. NCD is very much associated with human behavior, environment, economic and social factors. Many studies and experiences have shown that carefully planned and fully implemented community-based intervention program play a big role in overcoming the problem of NCD. The intervention should consist of community and individual empowerment, environmental support and reorienting health services. In 2013, the ministry has taken a big step by embarking on a nationwide community based intervention program namely Komuniti Sihat Perkasa Negara (KOSPEN). This initiative brings the NCD prevention and control program to the community through trained health volunteers, who will function as health agent of change or health enablers that introduce and facilitate healthy living practices amongst their respective community members. This would serve as a mean to control NCD such as high blood pressure and diabetes and its associated risk factors such as obesity, unhealthy diet, smoking and sedentary life style within local communities Combining public education and efforts to prompt behavioral changes, KOSPEN is based on three main strategies which are advocacy and awareness, health policy adoption and establishment of healthy environments and routine NCD risk factors screenings. Trained volunteers are also capable of measuring blood pressure, blood glucose levels and body mass index (BMI) following which, at risk cases are referred to nearby health clinics for further confirmation and management. In addition to these, the volunteers who will be known as Gerak Sihat Malaysia (GSiM) are also trained to plan and organize related intervention programs at the community level for those who need it. As of May 2016, there is 5,000 KOSPEN localities nationwide with 30,000 volunteers trained. 300,000 adults have been screened for high Blood Pressure, at risk blood sugar level, overweight and smokers, out of which 70% have been referred to health clinics for Diabetic confirmation, 36% for high risk Blood Pressure and 6.5% for class II Obesity. In addition to this, weight management program is now being piloted in 134 KOSPEN localities. The Health Ministry is targeting as many as 10,000 KOSPEN localities and 50,000 GSiM by 2022. With this individual and community empowerment effort, almost six million citizens is estimated to get benefit from the program, while 1.6 million adults are expected to undergo NCD screening tests by KOSPEN volunteers.
8th National Public Health Conference 2016, Managing Society in Combating Public Health Challenges, 2-4 August 2016
Lifestyles such as unhealthy dietary habits, physical inactivity and smoking are considered fundamental risk factors for cardiovascular disease. Preventive activities have been shown to reduce mortality and morbidity from cardiovascular disease. This study aimed to determine the prevalence of cardiovascular lifestyle risks and cardiovascular preventive activities among healthy government servants in Kuala Terengganu, Malaysia. A cross-sectional study was done from June to September 2013 among 121 government servants working at the Federal Complex, Kuala Terengganu. A questionnaire which consists of socio-demographic data, International Physical Activity Questionnaire (IPAQ), the dietary component of WHO STEPS and cardiovascular screening activities were used as tools. Clustering of cardiovascular lifestyle risks was defined as the presence of two or more of smoking, physical inactivity and unhealthy diet. Optimal cardiovascular screening is defined as having done the required screening for hypertension, diabetes, dyslipideamia and obesity. The study response rate was 90.9% (110 of 121). Prevalence of smoking, physical inactivity and unhealthy diet were 20%, 50% and 87% respectively. The prevalence of clustering of cardiovascular lifestyle risks was 57%. The prevalence of optimal cardiovascular screening for age was 49%. The prevalence of cardiovascular lifestyle risks among government servants in Kuala Terengganu is still high. About half of them did not have the optimal screening for cardiovascular disease. Measures need to be done to promote healthy lifestyle behaviors in the community. Effort should be made at the primary care level and public health to screen those with multiple cardiovascular lifestyle risks in order to optimize cardiovascular disease prevention.
Increasing physical activity level during and after treatment is recommended by the American Cancer Society because of the many benefits namely reducing fatigue and improves psychological distress which leads to an improvement in the quality of life. This study is aimed to compare physical activity level and body composition between oncology patients who are still undergoing treatment and those on medical follow-up. Patients were recruited based on convenience sampling from the Oncology Outpatient Clinics of Universiti Kebangsaan Malaysia Medical Center (UKMMC). Anthropometric measurements and body compositions were measured using calibrated tools while physical activity level were assessed using Global Physical Activity Questionnaire (GPAQ). Medical treatment history was obtained from patients medical records. A total of 53 patients (n=38 were undergoing treatment and n=15 was on follow-up) consisting of Malays (54.7%) and Chinese (45.3%) and with mean age of 55.3 ± 9.3 years. Most patients were previously diagnosed with ovarian cancer (39.6%) and colon cancer (18.9%) patients and they were at cancer stage III (18.8%). Body mass index (BMI) and percent fat mass were significantly different (p<0.05) between patients undergoing treatment (22.8 ± 2.7 kg/m2, 28.7 ± 7.2%) and on follow-up (26.2 ± 5.5 kg/m2, 37.1 ± 11.9%). Majority of the patients undergoing treatment were categorized under low physical activity compared to those on follow-up (p<0.05). Physical activity level measured as METS-minutes/week is also found to be significantly different (p<0.05) between patients on treatment and follow-up. As a conclusion, cancer patients undergoing treatment have low physical activity, with lower BMI and fat mass compared to those on follow-up. This is consistent with their nature of living where during treatment the patients will resting while coping with side effects of treatments.
We do not know how medical doctors perceive the risk of cancer as a cause of death. Medical doctors provide advice and information on health risks to the general public. How they perceive these risks influences the way they behave towards these risks and the way they will communicate these risks. We would like to ascertain how medical students perceive cancer as a health risk. This will hehv us determine misperceptions among medical students that need to be addressed before they practice medicine. A cross-sectional study was conducted among
all UPM medical students (2000-2001) using sefadministered questionnaires. A total of 339 (88.3%) students responded to the questionnaires. The internal consistency of items was good (Cronbach Alpha >0,7). Cancer was perceived as the 3rd leading risk of death after motor vehicle accidents (I") and heart diseases/cardiovascular disorders (2"d ). The breast was perceived as the organ with the highest risk of developing cancer. Smoking was perceived to be the leading risk factor for developing cancer. There is a dpjference in risk perception of diseases, cancer target organs and cancer risk factors based on gender and ethnicity. There was moderate to fair correlation ( r = 0.41-0.57) between perception of risks of death, cancer target organs and risks factors of cancer (p
To examine the reliability and construct validity of the Malay Version of the Depression Anxiety Stress Scales (DASS), a validation study was conducted in 184 automotive assembly workers. The internal consistency and construct validity were assessed using Cronbach's alpha coefficient
and exploratory factor analysis. The Cronbach's alpha coefficients for DASS-Depression, DASS-Anxiety and DASS-Stress were 0.91, 0.88 and j 0.89, respectively, indicating satisfactory internal consistency Exploratory factor analysis showed three meaningful common factors that could
explain the three theoretical constructs of this instrument. These results suggested that the Malay version DASS is reliable and valid for assessing, the self perceived depression, anxiety and stress among Malaysian automotive workers.
Study site: Two automotive assembly plants, Pahang, Malaysia