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Fulltext Personal and psychosocial risk factor for low back pain among automotive manual handling workers in Selangor, Malaysia

Noor Sazarina Mad Isa @ Yahya, Baba Md Deros, Ahmad Rasdan Ismail, Mazrura Sahani

Int J Public Health Res, 2014;4(1):412-418.
MyJurnal

Introduction It is well known that low back pain among working population is a global
problem throughout the world. However, the current situation of occupational
low back pain in Malaysia is still vague due to limited number of studies
conducted locally.

Objective A cross sectional study was conducted among three automotive industry
workers in Selangor, Malaysia from October 2010 to April 2011.
Methods This study aims to determine the prevalence and risk factors of low back pain
among automotive industry workers performing manual material handling
tasks using self-administered questionnaire survey.

Results A modified Standardised Nordic Questionnaire was used to assess low back
pain problem, to obtain personal and psychosocial risk factors information.
The prevalence of low back pain showed increment in the point prevalence of
57.9%, 49.5%, and 35.1 % for 12 months, one month, and of 7 days
respectively. Working hour, frequency of overtime, stress at work, work
pace, and faster movement were found to be significantly associated with the
12 months prevalence for low back pain.

Conclusions This finding indicates that psychosocial risk factors are associated to the
occurrence of low back pain.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Weight perception among non-pregnant urban Malaysian women: is it reliable?

Fadzil F, Shamsuddin K, Wan Puteh SE, Ahmad S, Abdul Hayi NS, Abdul Samad A, et al.

Int J Public Health Res, 2015;5(2):637-642.
MyJurnal

Introduction: In maternal healthcare, pre-pregnancy weight is used to predict pregnancy outcomes. Since no recorded data on pre-pregnancy weight, perceived weight is used alternatively. This study examines the relationship between perceived and actual weight among non-pregnant urban Malaysian women of childbearing age and identifies differences in perceived and actual weight by selected socio-demographic characteristics.
Methods: A cross-sectional study was conducted between April and June 2013 among urban Malaysian women attending public health clinics in the Klang Valley. Information on height, perceived current weight and time when their weight was last taken were obtained and actual weight was the average of two measurements (TANITA-HD-323-digital-scale). Socio-demographic data collected were age, ethnicity, education level, marital and employment status and total household income.
Results: Mean age of 371 women in this study was 28.81±5.65, 82.2% were Malays, 62.8% had tertiary education, over 75% were married and employed, with more than half from middle-income households. Overall, the mean perceived and actual weight was 59.29±11.59 and 59.20±11.90 respectively. Pearson‟s Correlation test showed a very strong positive correlation between perceived and actual weight (r=0.957;p<0.0001), ranging between 0.852 to 0.994 among subgroups; 258 (69.5%) perceived their weight accurately (±2.0 kg of actual weight), 49 (13.2%) under and 64 (17.3%) overestimated their weight.Main outliers were among younger women, Malays, tertiary educated, employed, middle-income and had weight last measured a month or more ago.
Conclusion: Strong correlation between perceived and actual weight among women in this study reassured weight perception can be used more confidently in patients‟ history taking and future research among urban Malaysian women using public health services.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Association of diet practice and glycaemic control among type 2 diabetes mellitus patients attending primary care clinic in Kuala Lumpur

Ismail H, Aris T, Ambak R, Lim KK

Int J Public Health Res, 2014;4(2):465-471.
MyJurnal

Introduction Healthy dietary practice is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing the rate of diabetes complication development. It is, therefore, important at all levels of diabetes prevention. The objective of this study was to determine the association of dietary practice with glycaemic control among Type 2 diabetes mellitus (T2DM) patients, who received treatment from an urban Health Clinic in Kuala Lumpur.
Methods A total of 307 patients with T2DM aged 18 years and above participated in this study. A pre-tested structured questionnaire with guided interview was used to collect information on socio-demographic, clinical and dietary practice. Anthropometric and biological measurements were also taken. Descriptive statistics and Chi-square were used in the data analysis. Good glycaemic control was defined as HbA1c level less than 6.5%.
Results The prevalence of good glycaemic control was only 27% (n=83). The highest percentage of good glycaemic control were among male patients (29.1%), aged 60 and above (33.3%), educational level of primary school (35.4%) and those with monthly income group between RM1001 to RM1500 (32.0%). About three quarter of T2DM patient (n=224) had poor control of HbA1c (≥6.5%). Age (p=0.045) and working status (p=0.039) had significant relationship with the level of HbA1c. Dietary practice showed no significant relationship with the HbA1c level.
Conclusions Effective interventional health education strategies are needed, focussing on modification of dietary behaviour in order to achieve glycaemic control among diabetic patients.
Study site: Klinik Kesihatan, Kuala Lumpur, Malaysia

Matched MeSH terms: Cross-Sectional Studies
Fulltext Preferred modalities for learning anatomy: medical students' opinion

Thidar AM, Myint TT, Naing DKS, Mustapha ZA

Borneo Journal of Medical Sciences, 2016;10(1):1-13.
MyJurnal

Learning anatomy is the basic and essential component of medical study when students start to learn in medical career. Since five hundred years ago, the human cadaver has been used as the silent mentor for students in learning anatomy. Later, pre-dissected specimens were used in addition to hands-on dissection of human cadaver. Current advances promote the use of anatomical models as well as plastinated specimens. This study focused on analyzing the preference of students towards different learning modalities available for anatomy teaching. It was conducted on first year medical students at the Faculty of Medicine and Health Sciences, University Malaysia Sabah (FPSK, UMS). A total of 76 students (27 males and 49 females) participated in this study. Out of 76 students, 57 (75%) students preferred using human cadaver for anatomy learning. Four students (5.3%) opted for plastinated
specimen while 15 students (19.7%) chose the plastic model. Knowledge gained in learning Anatomy was said to be easier from cadaver (67.1%), followed by plastinated specimen (35.5%) and plastic models (52.6%). In the present study, 97.4% responded that plastic model was easier to apply their knowledge in objective structured practical examinations. The present study found that using cadaver was still favoured by medical students. Further studies are required to determine the preference between hands-on cadaveric dissections versus pre-dissected specimens.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Antenatal care practice and pregnancy outcome at Sikuati Area, Kudat, Sabah

Tin Tin Aye, Yusolf Ibrahim, Daw Khin Saw Naing, Than Myint, Muhammad Hj. Jical

Borneo Journal of Medical Sciences, 2016;10(2):26-38.
MyJurnal

Antenatal (AN) care is vital for all pregnant women and for reduction of maternal mortality and morbidity. AN care knowledge and specific AN care practices are some of the crucial components of what determines effective AN care. In developing nations, the health of pregnant women can be even more sensitive to these factors. Objectives of this study was to assess the antenatal (AN) care practice and pregnancy outcome of ever-married women aged 18 to 49 years old having at least one pregnancy experience ,residing in kampongs of Sikuati area, Kudat between March to December 2015. Cross–sectional descriptive study, non-probability convenient sampling method was used and 150 eligible participants were interviewed through face to face by trained interviewers using a semi-structured questionnaire and their knowledge of AN care, their AN care practices and outcomes and complications of their pregnancies were recorded. 99% of all the women received AN care, and 64% of the women received essential AN care practice (AN visit of minimum 4 times). The study revealed that overall knowledge amongst the women with good knowledge was 48% and low knowledge was 52%. Despite this, it was found that low knowledge of AN care was associated with essential AN care practice. Additionally, AN care practices, assessed through timing of first AN care visit and frequency of visits, was not significantly associated with pregnancy complications. Despite these results, outcomes were good and all complications were properly and successfully addressed. This may reflect the effectiveness of current programs in place promoting importance of AN care and delivery practices. Maintenance of current programs with targeted interventions to address low knowledge level and the low level of compliance with essential AN care completed are recommended..

Matched MeSH terms: Cross-Sectional Studies
Fulltext Redirection of non-critical patients in the emergency department of Hospital Tuaran to the primary care unit (klinik kesihatan)

Michal, C.S., Nadirah, S., Juhanah, G., Praneetha, P., Mohan, G.

Borneo Journal of Medical Sciences, 2016;10(2):47-59.
MyJurnal

The Emergency Department (ED) provides treatment for acutely ill patients in need of urgent medical attention. Despite the availability of the primary care unit ‘Klinik Kesihatan’, where non urgent patients should be treated, Malaysia’s public hospitals still need to deal with overcrowding of non-urgent patients in ED. The main aim of the study was to assess the willingness of non-urgent patients to be redirected to Klinik Kesihatan. This was a cross-sectional study conducted at Hospital Tuaran Emergency Department, Sabah. Non-urgent patients were interviewed using a questionnaire, to find out the purpose of their visit to Emergency Department. A total of 318 non-urgent patients out of 457 patients were interviewed during the study duration. 41 respondents (12.9%) were willing to be redirected towards a Klinik Kesihatan. No associated factors were found when compared with the unwilling to be redirected group. Among 277 respondents who rejected redirection to Klinik Kesihatan, 70.4% agreed to pay a surcharge to be treated in the Emergency Department and there was no association found with the employment status (p= 0.391). Most patients were not willing to accept redirection to a Klinik Kesihatan and would prefer to visit the Emergency Department despite knowing that their condition or illness is one that does not require emergency treatment. Social media, advertisements and pamphlets must be made available to educate patients on the proper use of the Emergency Department.

Matched MeSH terms: Cross-Sectional Studies
E-cigarette users' attitudes on the banning of sales of nicotine e-liquid, its implication on e-cigarette use behaviours and alternative sources of nicotine e-liquid

Wong LP, Alias H, Agha Mohammadi N, Ghadimi A, Hoe VCW

J Community Health, 2017 Dec;42(6):1225-1232.
PMID: 28589268 DOI: 10.1007/s10900-017-0374-z

The banning of sales of nicotine e-liquid in e-cigarette shops has been implemented in several states in Malaysia. The distribution of nicotine e-liquid can only be allowed by licensed pharmacies or registered medical practitioners. This study aimed to evaluate e-cigarette users' responses to the control policy in a cross-sectional survey of 851 e-cigarette users by utilizing a self-report questionnaire that assessed (1) attitudes on regulation policy of e-cigarette banning; (2) e-cigarette use behaviors; and (3) sources of e-liquid after the regulation policy has been implemented. Participants from the state of Selangor where the banning policy was implemented were surveyed. The majority (95.8%) opposed the banning and believed e-cigarettes should be sold to anyone aged 18 years or above as with tobacco cigarettes, only a minority believed that nicotine e-liquid should only be available for sale over the counter in pharmacy stores (14.6%) and in clinics with a doctor's prescription (11.8%). The majority (44.2%) reported that they would continue their e-cigarette use as before the banning policy, while 20% plan to completely stop e-cigarette usage without replacing it with any alternatives. The vast majority (87.9%) was still able to obtained nicotine e-liquid from e-cigarette shops in spite of the ban and the second most common source was from online purchase (63.1%). The sales of nicotine e-liquid from black-market were evidenced as many reported obtaining zero nicotine e-liquid from the black market (54.4%). Self- or home-made (30.8%) nicotine e-liquid was also reported. Majority of respondents that self-made e-liquid were from the average monthly income group (below MYR3000). Obtaining nicotine from the pharmacy was least preferred (21.4%). Provision of professional advice to nicotine e-liquid users along with the ban may lessen the likelihood of users switching to tobacco cigarettes or other nicotine alternatives. Banning of sales of nicotine e-liquid in e-cigarette shops resulted in a boom in the black market supplying nicotine e-liquid and, self- or home-made nicotine e-liquid. Enforcing regulations and monitoring black market sales is warranted. Efforts to educate e-cigarette users of the danger of sourcing nicotine e-liquid from the black market and self- or home-made nicotine e-liquid are essential.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Prevalence of poor glycemic and blood pressure control and pattern of drug use among primary health-care outpatients in Al Ahsa Saudi Arabia

Emeka PM, Mukalaf AA, Helal HA, Khan TM, Almukalf MA

Int J Health Sci (Qassim), 2017 Jul-Sep;11(3):38-44.
PMID: 28936150

OBJECTIVES: To assess drug use pattern and the effect on glycemic and blood pressure (BP) control in type 2 diabetes mellitus (T2DM) and hypertensive patients. Furthermore, to evaluate the duration of drug use and antecedence in diagnosis.
METHODOLOGY: A cross-sectional study design, comprising interview/questionnaire targeting outpatients attending primary health centers in Al Ahsa was adopted. During the interview, their fasting blood glucose, weight, and height were measured, along with their BP. Time and duration of drug use were recorded. The history, sociodemographic data and the presence of any other disease conditions were also documented.
RESULTS: The highest number of uncontrolled BP and poor glycemic control was among the age group of 45 and 49 years. Significant number of the patients (92.9%) had body mass index >30 kg/m(2). The prevalence of developing hypertension before T2DM among participants was 59.9%. A significant number (84%) had uncontrolled hypertension, and 67.3% had uncontrolled T2DM. Drug use pattern revealed single or combinations according to clinical guidelines initially but did not follow through in meeting targets. Majority received angiotensin converting enzyme inhibitors, amlodipine or atenolol for BP control and metformin for T2DM. Patients diagnosed between 1 and 5 years displayed significant poor glycemic and BP control. Significantly, most patients appeared to have been on same prescriptions for a longer time without review.
CONCLUSION: Poor glycemic and BP controls observed in this study could be due to deficient treatment strategy among others. Patients were, however, not adequately managed in line with prescribed clinical guidelines.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Knowledge, attitude and practice towards religious obligations among healthcare workers in hospital Langkawi, Malaysia

Hafiz J., Dzulkhairi, M.R., Shamsir, M.A., Abu, N.

International Medical Journal Malaysia, 2016;15(2):3-6.
MyJurnal

Introduction: Islamic prayers involve certain physical movements and positions. These positions may be
difficult to achieve in Muslim patients who suffer from any illness that limit their physical movements.
Therefore, Islam introduced the concept of Rukhsah or exemptions. The objective of this study was to
assess the knowledge, attitudes and practices of healthcare workers related to performing prayers during
illness. Materials and Methods: A cross sectional study was conducted among 121 healthcare workers in
Hospital Langkawi, between 22nd to 24th April 2014. Simple random sampling method was used to select the
participants among healthcare workers in Hospital Langkawi to attend a workshop on Rukhsah Ibadah. The
participants were given a set of questionnaire to answer and all the data were collected just before the talk
began. Results: The majority of the participants 108 (89.3%) were female and more than half of them 74
(61.2%) were staff nurses. The mean age for the participants was 32.4 (SD: 9.42) years. About 73 (60.3%) of
the participants have good knowledge, 62 (51.2%) have good attitude and 73 (60.3%) have good practice
towards religious obligations and Rukhsah. Bivariate analysis shows no correlation between age and
knowledge, attitude and practice score. There was also no correlation seen between knowledge, attitude
and practice score. Conclusion: Almost half of the participants have good knowledge, attitude and practice
on performing prayers during illness. By conducting proper training and coaching, it is hoped that their level
of understanding towards Rukhsah can be improved.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Knowledge, attitude and practice towards smoking among International Islamic University Malaysia Kuantan communities

Nurul ‘Izzati, A.H., Nor Azlina, A.R., Nor Iza, A.R., Mainul, H.

International Medical Journal Malaysia, 2016;15(2):19-26.
MyJurnal

Smoking is an issue that has spread around the world throughout the years. The majority of smokers have the intention to quit smoking, but due to some factors, it may prevent their intention. Research and interventions have been done in many countries to decrease the smoking prevalence. This cross-sectional study aimed to find out the associations of knowledge, attitude and practice (KAP) towards smoking and to identify the factors associated with knowledge and attitude towards smoking, in priority to sociodemographic factors among the International Islamic University Malaysia Kuantan (IIUMK) communities, including between students and workers. One hundred fifteen respondents of students and workers from IIUMK were investigated with a self-administered questionnaire starting from 10-01-2014 to 10-02-2014. The data were analysed using SPSS software.Respondents had good knowledge and practice, and moderate attitude towards smoking. There was weak positive correlation between knowledge with attitude (r=+0.193, p=0.038) and practice (r=+0.206, p=0.028), also moderate correlation between attitude and practice towards smoking (r=+0.626, p<0.001). There was no factor found to be associated with knowledge, but significant association was found between attitude towards smoking with gender (p<0.001), education level (p=0.016) and smoking status (p<0.001). Although, the mean values of KAP levels were higher for workers, but it was not statistically significant as compared to the students. These study findings suggested that the main obligation are more for students to improve their KAP level towards smoking as they are fresh generation who will educate and lead the upcoming generation of Malaysia.
KEYWORDS: Health Knowledge, Attitudes, Practice, Smoking, Students, Workers.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Norms for eating disorder examination questionnaire (EDE-Q) among secondary school students in Kuala Lumpur, Malaysia

Musa, R., Haniff, J., Bujang, M.A., Mohamad, N.A., Omar, K., Radeef, A.S.

International Medical Journal Malaysia, 2016;15(2):57-61.
MyJurnal

Introduction: The Eating Disorder Examination Questionnaire (EDE-Q) has been widely used as a tool to
detect eating disorders. We aimed to identify the EDE-Q normative data among secondary school students in
Kuala Lumpur, Malaysia. Methods: This is a cross-sectional study involving four secondary schools in an
urban area. The respondents of secondary school students were selected using stratified sampling. Results:
There were 298 teenagers 12 to 17 years of age who participated in the study. The EDE-Q mean scores ±
standard deviation was 1.27 ± 1.08 for the total score (Global Score), 0.78 ± 0.95 for Restraint Domain, 1.02
± 1.03 for Eating Concern, 1.76 ± 1.55 for Shape Concern and 1.54 ± 1.43 for Weight Concern. Conclusion:
Mean values obtained from this study were relatively lower when compared to western populations. Shape
Concern and Weight Concern had higher scores compared to the other domains. These values are useful for
EDE-Q interpretation in Malaysia.

Matched MeSH terms: Cross-Sectional Studies
Complete immunization coverage and its determinants among children in Malaysia: findings from the National Health and Morbidity Survey (NHMS) 2016

Lim KK, Chan YY, Noor Ani A, Rohani J, Siti Norfadhilah ZA, Santhi MR

Public Health, 2017 Dec;153:52-57.
PMID: 28915402 DOI: 10.1016/j.puhe.2017.08.001

OBJECTIVES: The success of the Expanded Program on Immunization among children will greatly reduce the burden of illness and disability from vaccine preventable diseases. The aim of the study was to evaluate the complete immunization coverage and its determinants among children aged 12-23 months in Malaysia.
STUDY DESIGN: Cross-sectional study.
METHODS: Data on immunization were extracted from the 2016 National Health and Morbidity Survey. Complete immunization coverage was classified as received all recommended primary vaccine doses by the age of 12 months and verified by vaccination cards, and incompletely immunized if they received partially recommended vaccine dose or not received any recommended vaccine dose or had no vaccination card. The multiple logistic regression analyses were conducted to determine the sociodemographic factors associated with complete immunization coverage.
RESULTS: The overall complete immunization coverage among children (verified by cards) was 86.4% (n = 8920, 95% confidence interval: 85.4-87.4). Multivariable logistic regression analyses model revealed that factors significantly associated with complete immunization coverage were ethnicity, occupation of the mother, head of household's education level, and head of household's occupation. While sex, citizenship, household income, mother's age, and marital status were not significantly associated with complete immunization coverage.
CONCLUSIONS: According to the World Health Organization criteria, the present study demonstrated that the immunization coverage of 86.4% is still unsatisfactory. Thus, the current intervention program should be enhanced in order to achieve the 95% coverage for all antigens in the national vaccination program.
Study name: National Health and Morbidity Survey (NHMS-2016)

Matched MeSH terms: Cross-Sectional Studies
The prevalence of medication nonadherence in post-myocardial infarction survivors and its perceived barriers and psychological correlates: a cross-sectional study in a cardiac health facility in Malaysia

Ganasegeran K, Rashid A

Patient Prefer Adherence, 2017;11:1975-1985.
PMID: 29263654 DOI: 10.2147/PPA.S151053

Background: Although evidence-based practice has shown the benefits of prescribed cardioprotective drugs in post-myocardial infarction (MI) survivors, adherence rates remain suboptimal. The aim of this study was to determine the prevalence and factors associated with medication nonadherence among post-MI survivors in Malaysia.
Materials and methods: This cross-sectional study was conducted from February to September 2016 among 242 post-MI survivors aged 24-96 years at the cardiology outpatient clinic in a Malaysian cardiac specialist center. The study utilized an interviewer-administered questionnaire that consisted of items adapted and modified from the validated Simplified Medication Adherence Questionnaire, sociodemographics, health factors, perceived barriers, and novel psychological attributes, which employed the modified Confusion, Hubbub, and Order Scale and the Verbal Denial in Myocardial Infarction questionnaire.
Results: The prevalence of medication nonadherence was 74%. In the multivariable model, denial of illness (AOR 1.2, 95% CI 0.9-1.8; P=0.032), preference to traditional medicine (AOR 8.7, 95% CI 1.1-31.7; P=0.044), lack of information about illness (AOR 3.3, 95% CI 1.1-10.6; P=0.045), fear of side effects (AOR 6.4, 95% CI 2.5-16.6; P<0.001), and complex regimen (AOR 5.2, 95% CI 1.9-14.2; P=0.001) were statistically significant variables associated with medication nonadherence.
Conclusion: The relatively higher medication-nonadherence rate in this study was associated with patient-, provider-, and therapy-related factors and the novel psychological attribute denial of illness. Future research should explore these factors using robust methodological techniques to determine temporality among these factors.
Study site: Cardiology clinic, Serdang Hospital, Selangor, Malaysia

Matched MeSH terms: Cross-Sectional Studies
Fulltext The risk and associated factors of female sexual dysfunction (FSD) in women with psoriasis

Adawiyah J, Moonyza AAK, Mohd Rizal AM, Hatta S, Nik Ruzyanei NJ, Marhani M, et al.

International Medical Journal Malaysia, 2017;16(1):107-114.
MyJurnal

Introduction: Psoriasis is a chronic, immune mediated, hyperproliferative skin disease that has substantial impact on the sexual functions. This study aimed to determine the prevalence and associated factors of female sexual dysfunction (FSD) in patients with psoriasis.
Methods: A cross-sectional study involving 79 women with psoriasis attending two Dermatology Outpatient Clinics were interviewed and assessed for female sexual dysfunction and severity of psoriasis. The socio-demographic and clinical characteristics of the subjects were compared between the women with and without sexual dysfunction. The subjects were interviewed using Mini International Neuropsychiatric Interview (M.I.N.I.) to exclude any existing psychiatric illness. Sexual dysfunction was assessed using a validated questionnaire on sexual function and the severity of psoriasis was assessed using Psoriasis Area and Severity Index (PASI).
Results: The prevalence of FSD in the patients with psoriasis was 20.3%, with hypoactive sexual desire being the most prevalent problem (44.3%). Sexual dysfunction was associated with older age, menopause, low body mass index, longer duration of marriage and presence of psoriasis in the genital area. Female sexual dysfunction was highly prevalent in patients with psoriasis.
Conclusion: Management of psoriasis should include assessment in patients’ sexual health. Genital area involvement with psoriasis should not be overlooked as it can cause significant psychosexual distress.
Keywords: Psoriasis, female, sexual dysfunction, prevalence, risk factor, Malaysia
Study site: Dermatology clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia

Matched MeSH terms: Cross-Sectional Studies
Reliability of the ultrasound classification system of thyroid nodules in predicting malignancy

Farihah AG, Nurismah MI, Husyairi H, Shahrun Niza AS, Radhika S

Med J Malaysia, 2018 02;73(1):9-15.
PMID: 29531197 MyJurnal

AIM: This study aims to evaluate the reliability of the Ultrasound (U) Classification system in predicting thyroid malignancy by using pathology diagnosis as the reference standard.
METHODS: It was a cross-sectional study carried out at Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Malaysia. Records of patients with focal thyroid nodules on ultrasound (US) for which US-guided fine needle aspiration cytology (FNAC) was performed and pathology results were available, from January 2014 to May 2016 were selected for review. Correlation of the U Classification with pathology results was assessed. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, predictive value, negative predictive value and accuracy were calculated in a conservative and non-conservative method. The threshold for statistical performance was set at 0.05. Each sonographic feature was also compared with its pathology results.
RESULTS: A total of 91 patients with 104 nodules were eligible. 12 nodules out of 104 (11.5%) were malignant. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value and accuracy were 100%, 91.3%, 11.5, 0.0, 60%, 100% and 92.3%, and 100%, 91.4%, 11.7%, 0.0, 78.6%, 100% and 93.5%, for the non-conservative and conservative method of calculations respectively.
CONCLUSION: The U Classification is reliable in predicting thyroid malignancy. More evidence is nevertheless necessary for widespread adaptation and use.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Satisfaction of patients receiving value added-services compared to traditional counter service for prescription refills in Malaysia

Lau BT, Nurul-Nadiah-Auni AR, Ng SY, Shuen-Wong N

Pharm Pract (Granada), 2018 03 23;16(1):1075.
PMID: 29619135 DOI: 10.18549/PharmPract.2018.01.1075

Background: Patients' satisfaction is the key parameter to measure the quality of healthcare services. Value added-services (VAS) were introduced to improve the quality of medication deliveries and to reduce the waiting time at outpatient pharmacy.
Objective: This study aimed to compare the satisfaction levels of patients receiving VAS and traditional counter service (TCS) for prescription refills in Port Dickson Hospital.
Methods: A single-center, cross-sectional study was conducted in the outpatient pharmacy department of Port Dickson Hospital from 1 March to 30 June 2017. Systematic sampling method was utilized to recruit subjects into the study, except mail pharmacy in which universal sampling method was used. Data collection was done via telephone interviews for both groups.
Results: There was 104 and 105 in TCS and VAS group respectively. The response rate was 99.5%. Overall, a significant higher total mean satisfaction score in VAS group was observed as compared to TCS group (43.39 versus 40.49, p=0.002). The same finding was observed after confounding factors were controlled (VAS=44.66, 95% CI 43.07:46.24 versus TCS=39.88, 95% CI 38.29:41.46; p<0.001). VAS respondents reported more satisfaction than TCS respondents for both general and technical aspects. Among the VAS offered, mail pharmacy service respondents showed highest total mean satisfaction score, but no significant different was seen between groups (p=0.064).
Conclusion: VAS respondents were generally more satisfied than TCS respondents for prescription refills. A longitudinal study is necessary to examine the impact of other dimensions and other types of VAS on patients' satisfaction levels.
Study site: outpatient clinic, Hospital Port Dickson, Negeri Sembilan, Malaysia

Matched MeSH terms: Cross-Sectional Studies
Fulltext Knowledge, attitudes, and barriers toward research: The perspectives of undergraduate medical and dental students

Kyaw Soe HH, Than NN, Lwin H, Nu Htay MNN, Phyu KL, Abas AL

J Educ Health Promot, 2018;7:23.
PMID: 29629384 DOI: 10.4103/jehp.jehp_61_17

CONTEXT: Scientific research not only promotes health and combats diseases of an individual, but also it can strengthen the effectiveness of health systems. Hence, understanding of scientific methods becomes a crucial component in the medical profession.
AIMS: This study was conducted to assess the knowledge, attitudes, and barriers toward research among undergraduate medical and dental students.
SETTINGS AND DESIGN: This cross-sectional study was conducted among 295 undergraduate Bachelor of Medicine and Bachelor of Surgery (MBBS) and Bachelor of Dental Surgery (BDS) students from a private medical college in Malaysia.
MATERIALS AND METHODS: We purposively selected 360 students attending the 3rd, 4th, and 5th year in MBBS course and BDS course in September 2015. A total of 295 students who were willing to provide written informed consent were included in this study. We collected data using a validated, self-administered, structured questionnaire which included 20 questions about knowledge toward scientific research, 21 attitude items in regard to scientific research, a list of 10 barriers toward conducting medical research, and 5 questions of confidence to conduct the medical research.
STATISTICAL ANALYSIS USED: Data were analyzed using descriptive statistics, independent t-test, ANOVA, and multiple linear regression.
RESULTS: Among the students, 56.9% had moderate knowledge while the majority (83.3%) had moderate attitude toward scientific research. The majorly cited barriers were the lack of time (79.9%), lack of knowledge and skills (72.1%), lack of funding (72.0%) and facilities (63.6%), and lack of rewards (55.8%). There was a significant association between age, academic year, and knowledge of research as the older age group, and 4th- and 5th-year students had higher knowledge score. The students of higher attitude score had better-perceived barriers score toward research with regression coefficient 0.095 (95% confidence interval 0.032-0.159).
CONCLUSIONS: Even though the students had the positive attitudes toward scientific research, a supportive and positive environment is needed to improve skills and knowledge of research and to overcome the barriers toward the conduct of scientific research.
Study site: Melaka-Manipal Medical College (MMMC), Melaka, Malaysia

Matched MeSH terms: Cross-Sectional Studies
Fulltext Second-hand smoke exposure and psychological distress amongst non-smoking pregnant women in Malaysia

Siti Munira Yasin, Khairul Mizan Taib, Mohd Rodi Isa, Mohd Ariff Fadzil, Mohd Razilan Abdul Kadir

Pertanika Journal of Science & Technology, 2017;25(104):181-190.
MyJurnal

This study aimed to examine the association between second-hand smoke (SHS) exposure and psychological distress amongst non-smoking pregnant women. A cross-sectional study was used to obtain a representative sample of non-smoking pregnant women attending health clinics (n = 661) across six states in Malaysia. The duration of SHS exposure inside and outside the house was recorded from the participants. Psychological distress was assessed via General Health Questionnaire (GHQ12). The analyses were conducted using a logistic regression adjusted for demographic variables and other variables. Amongst non-smoking pregnant women, the prevalence of global SHS exposure and psychological distress was 80.4% and 64.2%, respectively. In the multivariate adjusted odds ratio (OR) models for psychological distress and the duration of SHS exposures, there was an OR of 1.04 (95% CI: 0.61-1.77) for individuals with SHS exposure of 1-4 hours/week, 0.44 (95% CI: 0.23-0.81) for SHS exposure of 5-14 hours/week and 0.84 (95% CI: 0.32-2.22) for exposures of >15 hours/week compared to those with no SHS exposure outside the home. Meanwhile, SHS exposure outside the house with the duration of 5-14 hours might have temporary calming effects against psychological distress. Nonetheless, more research is needed to ascertain this.

Matched MeSH terms: Cross-Sectional Studies
Fulltext A study on the health economics of General Practitioners in Malaysia: Trends, challenges and moving forward

Kenny K, Omar Z, Kanavathi ES, Madhavan P

Int J Public Health Res, 2017;7(1):765-773.
MyJurnal

Health care systems play a vital role in providing health services and in optimising the population’s health of each nation. The Malaysian health care system primarily consists of the public and private health services. One of the prominent private health care services offered in the General Practitioner’s (GP) Clinic. Despite the prominent role GPs play in the health care system in this country, little is known about their practices, the issues and challenges faced by GPs in this country. The objective of this study was to describe the current GP practice operations in Malaysia in terms of its general operations, financial expenditure and revenue, market competitiveness and laboratory services offered by the clinics.

Matched MeSH terms: Cross-Sectional Studies
Fulltext Exposure to second-hand Smoke among adolescent in secondary school students in Sana’a, Yemen

Fateh Addin Nejm Addin Al-Emad, Zaleha Md. Isa

Int J Public Health Res, 2017;7(1):783-790.
MyJurnal

BACKGROUND: The aim of the study was to assess the knowledge and attitude of secondary school students in Sana'a Yemen related to exposure to second-hand smoking.
METHODS: A cross-sectional study was conducted in Sana'a city. The total sample size was 336 students in which 63 were males and 273 were females. These students were stratified random sampling . Data were collected by using Questionnaire comprising of 3 parts: Part 1- consists of socio-demographic data. Part 2- consists of the knowledge regarding smoking and second-hand smoking and Part 3-consists of adolescents' attitude in relation to second-hand smoking.
RESULTS: Out of 336 students, majority were between 14-18 years old (75.9%), males (81.2%) , (55.7%)of them was fathers' occupation private employee and low educated mother was (86.3%).The students who do not have smoking habit were (94.3%),and those who do not have friends with the habit of smoking was (57.4%). (57.10) having some one else at home who smokes beside them .The reaction of non printed mass media for SHS warning was (83.3%) . The exposed to smoke out door was (60.1%) . In this study, the majority of students had inadequate knowledge about the second-hand smoke was (52.7%). A higher percentage of students who had unfavorable attitudes toward secondhand smoke was(86.6%).
CONCLUSION: We concluded that The level of knowledge and attitude about the second-hand smoke is relatively low among the secondary school student in Sana'a Yemen .The finding of this study emphasized the need of effective awareness programs to increase level of consciousness and knowledge regarding SHS. Keywords: Second-hand Smoking, Secondary School, Adolescent, Sana'a .

Matched MeSH terms: Cross-Sectional Studies

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