Introduction: Most health advisories related to outdoor physical activity during haze are general in nature. The advisories normally advise everyone to reduce or limit prolonged exertion or heavy exertion without mentioning the acceptable duration for performing outdoor physical activity causing difficulty for public to decide to stop or cancel a particular outdoor or sport event. The aim of this paper is to determine the acceptable duration for performing outdoor physical activity pattern during haze based on API level.
Methods: Health risk assessment approach that comprises of hazard identification, exposure assessment, dose-response, and risk characterization steps was used to determine the potential inhaled dose and risk associated with performing the physical activity during haze. We have considered many factors that include time spent for physical activity patterns for Malaysian adult, age and physical intensity-specific inhalation rate (m3/min), and the indoor/outdoor ratio of PM10. A hypothetical exposure scenario of PM10 was created using the breakpoints of PM10 concentration for the calculation of respective API levels during haze.
Results: The association between physical activity pattern, API level and risk quotient were presented in the form of risk radar diagram. Based on the 50th percentile inhalation rate, all prolonged exertion and heavy exertion should be avoided when API reach >201 (very unhealthy) and >175 (unhealthy) respectively. Below the said API, the duration for performing prolonged exertion and heavy exertion should be reduced according to the API level. When API reaches 140, high intensity physical activity should be limited to < 90 minutes. A football match which requires 90 minutes, should be postponed of cancelled if API > 140. Whereas, for the same API level, prolonged exertion (moderate intensity physical activity) should be limited to 4 hours.
Conclusions: Reducing the physical activity is an effective strategy to lower the dose of inhaled pollutants and reduce the health risk during poor air quality. Based on the assessment, taking into account the uncertainty of risk assessment methodology, we proposed all prolonged exertion should be avoided when API reach very unhealthy status (>201). Below the said API level, outdoor physical activity should be reduced according to the level of API respectively. The recommendation is not applicable for the sensitive groups. The computed risk radar provide a valuable guide for the public to organize or considering postponing an outdoor event during haze.
Air pollution has been widely known to have an influence on health of the general population.
Air pollution can result from natural causes, human activities and transboundary air pollution.
Weather and climate play crucial role in determining the pattern of air quality. In recent years,
air pollution and recurrent episodes of haze has become a major concern in Malaysia.
Surveillance data on concentrations of main air pollutants such as carbon dioxide, (CO2),
Nitrogen Dioxide (NO2), Ozone (O3), sulphur dioxide (SO2) and particulate matter (PM10)
were found to be higher during the haze days and this may have an impact on health of the
community as reflected by an increase in hospital admissions particularly the respiratory and
cardiovascular diseases.
Introduction Tuberculosis (TB) is a major global health challenge especially in low- and middle-income countries reflects improper, delayed or missed diagnosis. Contact screening should be utilized both as an efficient and effective targeted approach to intensify TB case finding.
Methods Through a comprehensive systematic literature review of online database, this paper aims at providing an insight into the current practice of TB contact screening and to provide evidence based practice for formulation of appropriate policies in low- and middle-income countries. There are 24 articles included in this review from studies published from 2005 to 2014.
Results Findings in literature varies substantially. Generally, contact screening is better intensified with clear operational guidelines, adequate training, include close contact outside household as appropriate and follow up at least for 1 year. Prioritizing high risk close contacts is helpful in resource limited setting. Tuberculin skin test is still of value as screening tool and intensified case finding must be accompanied with effective management protocol. Prophylaxis treatment is recommended especially for children especially less than 5 years old, unvaccinated, malnourished, living with person having HIV and close contact with MDR-TB.
Conclusions Policy recommendations in improving TB management must incorporate complementary strategies to enhance case finding, effective management protocol for follow up or prophylaxis treatment, training for public health capacity and concerted dedication from various stakeholders
Introduction The Acquired Immuno Deficiency Syndrome (AIDS) is caused by Human Immunodeficiency Virus (HIV) infection and a disease with high morbidity and mortality.Young mothers are sub-populations that are at high risk for HIV through sexual activity. In addition, information on the level of knowledge, attitude and practice among young mothers in Malaysia regarding HIV/AIDS prevention is still limited.Therefore, the objective of this study is to examine the level of knowledge, attitudes and practices towards the prevention of HIV/AIDS among young mothers and the factors that influence them.
Methods A cross-sectional study was conducted at a tertiary hospital in a city center among 147 young mothers aged 18-30 years old at the Post Natal and Obstetrics and Gynecology Ward (O & G). Data collection was conducted in April-November 2014 and the respondents' selection was based on simple random sampling. A questionnaire containing validated instruments was used in this study. Approval for conducting research has been obtained from the UKM Research Ethics Committee before the data collection procedure is implemented.
Results Majority of the young mothers have good knowledge (78.8%) and practice (71.2%) towards HIV/AIDS prevention. While more than half of them (56.7%) have positive attitude towards the prevention of HIV/AIDS. Living in the urban area and being married are significantly associated with having good knowledge and positive attitude towards HIV/AIDS prevention. While, mothers who are 5 years older compared to the younger ones and being married are significantly associated with having good practice towards HIV/AIDS prevention.
Conclusions The level of knowledge, attitudes and practices as well as the associated factors could be the baseline to formulate health intervention to prevent HIV/AIDS among this vulnerable group.
Introduction Non-specific low back pain is one of the most common physical ailments
affecting millions of people worldwide. This condition constitutes a
significant public health problem and was listed as a prevalent health
complaint in most societies. Even though there are many anecdotal claims
for reflexology in the treatment of various conditions such as a migraine,
arthritis and multiple sclerosis, but very little clinical evidence exists for
reflexology on the management of low back pain per se. This study aims to
evaluate the effects of foot reflexology therapy as an adjunctive treatment to
the Malaysian low back pain standard care in relieving pain and promoting
health-related quality of life among people with non-specific low back pain.
Methods This is a parallel randomized controlled trial with pre and post-treatment
study design. The study setting for the intervention located at Penawar
Reflexology Center, Kuala Terengganu, Malaysia. A total of 100
participants with non-specific low back pain will be allocated to one of two
groups, using a randomization computer program of Research Randomizer.
The control group will receive low back pain standard care, while the
intervention group will receive standard care plus eight sessions of foot
reflexology therapy. The pain intensity and health-related quality of life
scores will be measured using Visual Analogue Scale and Euro-quality of
life scale respectively in both groups. The study was approved by the
Human Research Ethics Committee of University Sultan Zainal Abidin
(UHREC/2016/2/011). The study protocol was registered at
ClinicalTrials.gov, with the ID number of NCT02887430.
Measurements Outcome measures will be undertaken at pre-intervention (week 1), postintervention
(week 6) and follow-up (week 10).
Conclusions This will be the first trial to compare the foot reflexology therapy with
control group among people who medically diagnosed with non-specific low
back pain in Malaysia. The result of this study will contribute to better
management of this population, especially for Malaysia healthcare setting.
Study site: Penawar Reflexology Center, Kuala Terengganu, Malaysia
Introduction Physical activity assessment in children is the first step in assessing the
relationship between activity and health, as well as the determinants of
childhood physical activity and changes in activity level.Physical Activity
Questionnaire for Older Children (PAQ-C) is self- administered
questionnaire to assess physical activity among older children. The objective
of this study was to determine the validity and reliability of Physical Activity
Questionnaire for Older Children in Malay language PAQ-C (M).
Methods The validation study was done among 73 students aged 10 to 17 years old.
The PAQ-C was translated into Malay language using forward and backward
translation. The evaluation of the psychometric properties included internal
consistency, test-retest reliability and criterion validity. Reliability of PAQ-C
(M) was determined using Cronbach alpha and intra-class correlation
coefficient (ICC). The PAQ-C (M) was administered twice in one week
interval to assess test-retest reliability. Criterion validity was assessed
between PAQ-C (M) and 3 Day Physical Activity Recall (3DPAR).
Results The internal consistency of PAQ-C (M) assessment calculated in this study
was α = 0.75 and α = 0.77 for assessments one and two, respectively. The
ICC between individual items of PAQ-C (M) was 0.59 to 0.91, indicating
moderate to good correlation. The Spearmen correlation coefficient between
PAQ-C (M) and 3DPARwas acceptable (r=0.60, p
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.
Substantial advances on the life expectancy have been achieved in Malaysia over the past few decades. It is essential that elderly lead a healthier old age which leans towards successful aging. Thus, this study describes the major causes of premature mortality among the elderly population in Malaysia, 2014.
Introduction. The care of children with leukemia requires a high degree of observation and attention to ensure that the recommended treatment by the specialists is well implemented. This could somehow affect the social functionality, increase stress, anxiety and depression among caregivers of children with leukemia. Thus, this cross-sectional study was conducted to examine the prevalence and factors influencing stress, depression and anxiety among caregivers of
children with leukemia.
Methods. Number of sample is 54 respondents. Data were measured using the Bahasa Malaysia version of DASS-21 which was validated in previous study.
Results The results showed that prevalence of low level stress among caregivers to children with leukemia was 88.9% while prevalence of high level stress was 11.1%. The prevalence of low level anxiety was 90.7% and the prevalence of
high level anxiety was 9.3%. The prevalence of low level depression was 96.3% and the prevalence of high level depression was 3.7%. There were several factors that significantly influenced the stress and depression among
the caregivers (p <0.05). Among the factors associated with stress status were the religion of caregivers and gender of the patients (p <0.05). Factors associated with depression status were the sex of caregivers and the relationship between caregivers and family members (p <0.05).
Conclusions. In conclusion, socio demographic factors and the relationship between caregivers and family members affect stress and depression among caregivers while factors of knowledge-level do not affect stress, anxiety and depression among caregivers. Strategies are needed to help reduce stress, anxiety and depression among caregivers of children with leukemia.
Keywords: Stress - Anxiety - Depression - Caregivers - Children with leukemia.
Introduction: Rheumatic Heart Disease (RHD) has been thought as a disease of poor socioeconomic status. It is more prevalent in underdeveloped and developing countries than in developed countries. It is also common among the population with multiple social issues such as overcrowded dwellings, undernutrition, poor sanitation and suboptimal medical care. This study was done to review the socio demographic profiles of RHD patients in Hospital Queen Elizabeth (HQE) II, Kota Kinabalu, Sabah.
Methods: A secondary data review of all patients registered under the RHD registry in HQE II for one- year starting from July 2013 to June 2014.
Results: 204 RHD patients were included. Nearly three quarter (74.0%) were female. The mean age was 40.43 (14.75) years old. 61.1% has completed secondary
education. 42.7% were housewives. The mean monthly income was RM 1363.83 (1297.05) which was categorized under the vulnerable income group. When they were categorized under the poverty level and the vulnerable income group, 42.6% and 76.5% of them fell under those categories respectively. The nearest health facilities to their houses were district hospitals (33.3%) with the mean distance of 9.17 km and health clinics (30.8%) with the mean distance of 4.27 km. Only 11.5% of them lived near the specialist hospitals with the mean distance of 21.32 km.
Conclusions: Results from this review suggested that majority of RHD patients were in the low socioeconomic group with less access to health care facilities with specialist care. They are the most vulnerable groups and need to be prioritized in the specialized care program. .
Rheumatic heart disease is still endemic in developing countries and among the indigenous population in developed countries. However, there is no comprehensive data on rheumatic heart disease patients in Malaysia. The Cardiology Department of Queen Elizabeth ll Hospital (QEH ll), Sabah started this hospital-based registry in 2010. The objective of this analysis was to report the demographic profile, severity of disease, types of valve involvement and the practice of secondary prophylaxis among these patients.
Introduction Breast cancer is ranked number one from the ten most frequent cancers in
female, Peninsular Malaysia. Various studies provide negative evidence on
malignancies and one of the end results is impaired quality of life (QOL).
Studies show lifestyle approaches are key factors in enhancing the QOL
among cancer survivors. The purpose of this study is to describe the lifestyle
practices (LP) among breast cancer survivors (BCS) which consist of dietary
intake, exercise habits, and stress management and to determine whether
these practices have influence on the QOL among Malaysian BCS.
Methods This study adopts a cross-sectional study design using a self-administered
questionnaire. A total of 280 BCS from public and private hospitals
throughout Peninsular Malaysia had participated. The questionnaire covers
QOL and LP items which consist of dietary intake (consumption of high-fat
food, high-fibre food, fruits and vegetables), exercise habits, and stress
management. Descriptive statistics and one-way ANOVA were used to
determine the relationship between LP and QOL.
Results Mean age of the study sample was at 41 (SD=7.37). Majority of them were
Malay (74%), 53% were diagnosed with breast cancer between 1 to 2 years
whereas 54% were presented with stage 2 at diagnosis. There was a
statistically significant difference (p
Emergency work with regular exposure to traumatic events may cause a large burden of mental health consequences. Among the first responders, firefighters are generally said to have a larger risk for PTSD as they involve directly and indirectly with critical incidents and traumatic events as part of their duties. This systematic review will determine the prevalence of PTSD and identify factors which associated to the PTSD among firefighters.
Introduction Prevalence of adolescents involved in sexual and reproductive problems is on
rise and it was associated with its knowledge. Several factors found to be
associated with the knowledge and various sources of knowledge are chosen
by adolescents for this information. Thus, this study was to determine the
knowledge score, its influencing factors and the preference of the sources of
knowledge.
Methods A cross-sectional study was done using adopted questionnaire involving 330
respondents aged 18 and 19 years old in Kolej MARA Seremban selected by
simple random sampling. They were gathered in the halls and 338
adolescents from 454 students consented to involve in this study. Selfadministered
questionnaire was used whereby a correct response was given a
score of 2, 0 for an incorrect response and 1 for an answer of don’t know.
Total score for all correct answers was 42. Descriptive analysis, bivariate and
multivariate analysis was done in the analysis.
Results The mean knowledge score was 37.32 (±2.967) with a significant difference
for gender. Internets were the most common and preferred sources of the
knowledge among them. There was 5.2% of them had heard on SMS
intervention and 37.0% of them disagreed on SMS intervention.
Conclusions The result showed that the knowledge score was lower in males than females
and internets were the most preferred source of the knowledge. Thus,
interventions for knowledge improvement should be more on male
adolescents.
Smoking is the leading preventable cause of non-communicable disease mortality worldwide. Therefore, effort for the effective measure in smoking cessation is important. However, the central problem in the nicotine addiction treatment is relapse. A retrospective cohort study was done at Tanglin Quit Smoking Clinic to determine the outcome of smoking cessation and its predictors. A cohort of 770 smokers between 2008 and 2015 were identified through simple random sampling. Smokers were defined as current smoker, while smoking abstinence is defined as cessation more than 6 months and relapse as any smoking episode even a puff since the quit date. Majority were Malays, Muslims and had secondary or higher education. The mean initiating age for smoking was 17.6 years old, with majority smoke between 11 to 20 sticks, and had high nicotine dependence score (43%). At the end of the study 52.5% of them abstinence from smoking. The predictors for smoking cessation were number of quit attempt (1 to 10 times) (AOR = 1.582, 95% CI = 1.012-2.472) and pharmacotherapy (AOR = 0.711, 95% CI=0.511-0.989). More frequent follow up was required during the first crucial 6 months to prevent relapse. Number of follow up can enhance not only the medication compliance but also motivational aspect to smokers to reduce relapse rates. Healthcare provider should give extra attention to the potential relapser especially to those who attempt for the first time.
Keywords: Malaysia, Quit Smoking Clinic, Smoking Cessation, Cohort, Survival analysis
Introduction The quality of education is one of the controversial topics and vital issues that
requires more emphases from researchers due to the current challenges in
education at the university level. Involvement and participation from the
studentis essential to implement quality assurance and to reach for academic
accreditation. The aim of this study is to assess knowledge, attitudes, and
practices (KAP) of students towards TQM in education and its influencing
factorsatHigh Institute of Health Sciences (HIHS) in Sana'a, Yemen.
Methods A cross-sectional study using a self-administered questionnaire was
conducted in 2016. A total of 208 students from second and third study levels
in HIHS had participated from 268 students were observed (study
population). Descriptive statistics, chi-square, and one-way ANOVA were
used to determine the association between students’ KAP towards TQM in
education with its influencing factors.
Results Mean age of the students were 22.44(SD±2.027) year old. Majority of HIHS
students were male 135 (64.9%) and 108 (51.9%) were from the third
studying level. The highest students' KAP scores were 53.4%, 65.4%, and
41.3% for good knowledge, good attitudes, and moderate practices
respectively. Education Department was found to be significantly associated
with students' knowledge and practices with p
Introduction Strongyloides stercoralis is an intestinal helminth that infects humans
through contact with soil containing the larvae.
Methods A systematic search was performed for relevant titles, abstract and keywords
in database from Cochrane Library, PLOS One, PubMed and several other
sources in October 2017 based on PICO strategy. Out of 511 papers that were
evaluated for possible inclusion, final assessment for eligibility has yielded a
total of 17 papers to be included which were found suitable for analysis
covering period from 2012 till 2016.
Results A major challenge of giving an overview of prevalence data for S. stercoralis
lies in the low sensitivity of diagnostic method used which resulted in very
low prevalence in certain countries. Cambodia and Laos presented with high
prevalence ranging from 17.4% to 45.9% by using high sensitivity of
diagnostic methods. The current prevalence situation of S. stercoralis in
Southeast Asia still have wide gaps remains due to several reasons.
Conclusions The information we have today only scratches the surface which cannot truly
reflect the true burden of S. stercoralis in Southeast Asia The main risk factor
is personal hygiene practices especially amongst males.
Introduction A study was conducted to determine the level of mothers' perception on children with cleft deformity and its associated factors
Methods This was a cross sectional study involving 110 mothers with children attending the Plastic And Reconstructive Surgery Clinic. Data was gathered from a face to face interview based on a questionnaire that assesses the level of perception and its associated factors. The level of perception was evaluated from a scoring method and divided into four domains namely psychosocial, care management, treatment and education.
Results The level of perception was high in all four domains ranged from 62% for treatment and 80% for education. Factors that were significantly associated with the level of perception were ethnicity, religion, type of cleft deformity and level of information.
Conclusions Information regarding cleft deformity must be tailored toward mothers’ personal characteristics and type of cleft deformity to improve mothers' perception on this problem.
Study site: Plastic And Reconstructive Surgery Clinic, Hospital Kuala Lumpur, Malaysia
Introduction Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. A physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. This paper presents some information regarding medical ethics, including the values and principles of ethical conduct. Later the requirements of consent form is presented to guide the researchers before conducting a study.
Introduction The availability of obesity specific quality of life measurement tool is limited. The Malay version of Impact of Weight on Quality of Life-Lite is an obesity specific quality of life questionnaire which has been translated for use in Malaysia. The aim of this study is to evaluate the validity and reliability of this questionnaire to measure quality of life among different body mass index (BMI) groups.
Methods One hundred and twenty subjects with different BMI categories who attended an outpatient government clinic were recruited for this study. The translated Malay version of IWQOL-Lite was used to assess the impact of weight on quality of life of respondents. Content validity, criterion validity and construct validity were used to assess the questionnaire validity while internal consistencies and test-retest reliability were used to assess the questionnaire reliability.
Results The Malay version of IWQOL-Lite showed good psychometric properties. The content validity was agreed upon by expert panels. The mean score of all IWQOL-Lite domains were able to discriminate between different BMI groups. Good internal consistency was demonstrated by Cronbach alpha of 0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function score (IWQOL-Lite) correlated positively with Physical Component Summary of Short Form-36 questionnaire. Exploratory factor analysis found that the questions loaded on their respective five domains.
Conclusions The results suggested that the Malay version of IWQOL-Lite is a valid and reliable tool to measure quality of life among obese and overweight subjects in Malaysia.