Introduction: Scarcity of data found in regard to association of vitamin D level with bone mineral density (BMD). Our study aimed to determine the correlation of vitamin D with BMD and intact parathyroid hormone (iPTH) among healthy Malay adult. Methods: This cross-sectional study recruited 126 healthy Malay volunteers (aged 21–45 years old) from Kota Bharu, Malaysia. Serum total calcium, albumin, phosphorus, 25-hydroxyvitamin D (25(OH)D), and iPTH were measured. BMD was assessed with dual energy X-ray absorptiometry (DXA) scan over left hip (right hip in case of problem with left hip) and lumbar spine (L1 – L4 vertebrae). Results: The mean serum 25(OH)D was 38.91
± 14.07 nmol/L. Out of 126 study subjects, 104 subjects (82.5%) had insufficient level of vitamin D (< 50 nmol/L). Mean hip and lumbar BMD were 0.952 ± 0.145 g/cm2 and 1.006 ± 0.133 g/cm2 respectively. According to T-score, 93 subjects (73.8%) had normal T-score of -1, 33 subjects (26.2%) had osteopenia (T-score -2.5 to -1) and none had osteoporosis (T-score -2.5). Significant positive correlation between serum 25(OH)D and hip BMD (r = 0.234, p = 0.009) was observed, but no correlation was found between serum 25(OH)D and lumbar BMD. Meanwhile, significant inverse correlation between serum 25(OH)D and iPTH was observed (r = -0.324, p < 0.001). Conclusion: High prevalence of vitamin D insufficiency was observed among healthy Malay population, but majority had normal bone density. Nonetheless, serum 25(OH)D was positively correlated with BMD and inversely correlated with iPTH. Our findings support the role of vitamin D for maintaining bone health.
Introduction: Colour stability of the material is an essential factor that contributes to the selection of a flexible den- ture material. Staining effects on the denture may result in unattractive appearance, the dissatisfaction of the wearer, and limited usage period of the denture. This study aims to identify the colour stability of the Valplast flexible denture material using three types of beverages. Methods: A total of 32 disc-shaped flexible resin materials (20 +/- 0.1 mm in diameter and thickness 3 +/- 0.1 mm) were prepared based on the manufacturer instructions. The samples were randomly divided into 4 groups of immersion: distilled water (control), coffee solution, tea solution and red wine. The samples were left in the specified immersion solution for up to 60 days. Colour changes were measured after 1, 3, 7, 14, 21, 30, 45 and 60 days of immersion. Results: The samples immersed in coffee solution changed from S1 to S2, whereas samples in tea solution changed from S1 to S3. Additionally, samples in red wine changed from S1 to S4, as observed using the Valplast colour tone guide. The highest reflection measured using spectroscopy was 65.146 at 385.19 nm of the control samples, whereas the lowest reflection was 1.974 at the wavelength of 385.97 nm on the samples immersed in the red wine. Conclusion: The most significant difference can be observed in the red wine group, followed by samples in tea and coffee solutions. Moreover, increasing the immersion period causes increasing staining effect of the denture.
Introduction: Aerobic power reflects the physical fitness of the individual. Evidences support differences in phys-iological responses to exercise. There is less data on VO2 max among common ethnic population of Sabah. Ob-jective of this study was to investigate VO2 max among Kadazan, Dusun, Brunei Melayu, Bugis, Murut and others of Sabah in male and female young adult population. Methods: A total of 385 participants were randomly selected. Monark 894 E leg bicycle ergo meter was used to measure aerobic power VO2 max. Based on the heart rate male and female respectively 450 & 300 kilogram-force meter/minute was chosen. Based on Astrand rhyming nomogram (age correction factor included-VO2 Max multiplied by 1.05) calculations Vo2Max was calculated in l/min. The age correction done VO2 Max (l/min) was multiplied by 1000 and later divided by the body weight to derive the actual VO2Max in ml/kg/min. The recovery heart rate after 1 minute was taken and the difference were calculated for the further analysis. Data was tabulated and analysed by one way ANOVA test - Hocherberg’s GT2. Results: There was no significant difference in VO2 max between the common ethnic young adult population both in males and fe-males. Conclusion: There is no significant difference in VO2 max among the common ethnic adult but have a similar aerobic capacity in the study group.
Introduction: General Hospital`s Emergency Departments (ED) have become focal points for individuals presenting with mental health problems seeking help. However, frontline ED nurses and Assistant Medical Officers (AMOs) often lack the skills and competency to effectively triage and manage clients presenting with a myriad of psychiatric issues. The objective of the study is to assess ED nurses & AMOs ’s perceived competency and associated factors in providing care for clients presenting with psychiatric concerns. Methods: This study is a quantitative, cross-section- al survey design. One hundred and forty-six ED nurses & AMOs were recruited from two tertiary general hospitals in Kota Kinabalu by random sampling. A validated tool (α = 0.92), the Behavior Health Competency Care (BHCC) questionnaire was used to measure psychiatric care competency among participants. Data analyses used descrip- tive and inferential statistics to identify the association of respondent’s work setting, designation, age, years of work experience, qualification with competency scores. Findings: low total mean score of 2.52(SD 0.68) was found in perceived psychiatric competency among ED nurses & AMOs. Other findings indicate, low perceived competence in risk assessment and poor ability to provide intervention for clients presenting with acute psychiatric conditions. Con- clusion: This study found major gaps in psychiatric care competency among ED nurses & AMOs. As ED`s of general hospitals continue to be a focal point for clients with psychiatric disorders seeking help, competency shortfall among frontline ED nurses & AMOs, will negatively affect the quality of psychiatric care delivery and needs to be addressed.
Introduction: Determination of learning needs is central for holistic patient education, to sustain behavior changes and to control patient’s risk factor. However, patients often sense that their learning needs are unmet and informa- tion provided was too general. Thus, this study aimed to determine the perceived learning needs and their level of importance among Coronary Artery Disease (CAD) patients. Methods: The current investigation is a descriptive, cross-sectional study for which all CAD patients were selected using the cencus method. The data was collected us- ing Cardiac Patients Learning Needs Inventory. The questionnaire was delivered to 140 CAD patients who had their follow-up in a cardiology clinic. The instrument is reliable with a Cronbach’s alpha coefficient of 0.96. The study design followed STROBE cross-sectional design process guideline. Results: Participants’ mean age was 58.96 ± 9.42 years. More than half of the participants were males (62.9%), employed (52.0%) and had attained secondary level education (69.3%). Around two-thirds (60.7%) of the patients perceived to have high learning needs. Gender and highest educational achievement were significantly associated with perceived learning needs. The most significant perceived learning needs were medication information, risk factors for CAD, information on diet, physical activity, anatomy and physiology, and other related information. Conclusion: This study has identified the important domains of learning needs among CAD patients. Findings from the present study will provide important input for future cardi- ac educational strategies to reduce the rate of hospital readmission and death.
Introduction: Evaluation of mental health literacy is important in assisting the development of intervention and policies toward preventing mental health problems. This study aims to explore mental health literacy and its socio- demographic predictors in a group of housewives living in low-cost apartments in Selangor, Malaysia. Methods: A Malay version of the self-administered Mental Health Literacy Scale (MHLS) was used in this cross-sectional study. Age, ethnicity, religion, educational level and family income were tested using one-way ANOVA and independent t-test. Result: A total of 103 eligible respondents participated in the study. Most respondents were from the age group of 30 and above, from the Malay ethnic group, Muslims, had formal education up to secondary level with a monthly family income below RM4000 (USD980). The overall mean (sd) mental health literacy score was low 106.65 (11.21) and was significantly associated with ethnicity, religion, educational level and family income (p>0.05). Conclusion: Mental health literacy scores were low and showed variations within sociodemographic groups.
A majority of hypertensive patients will end up suffering uncontrolled hypertension, which is partly due to poor medication adherence. This paper aimed to review a range of interventions that could improve anti-hypertensive medication adherence. Literature search was conducted using PubMed, Scopus, Medline, and Science Direct da- tabases, with publication dates confined to between October 2009 and October 2019. Eventually, only 11 studies were used for this study. It was found that interventions that are based on or include patient education, patient in- terviews, patient reminders, self-management and behavioural modifications have the potential to improve patients’ adherence to anti-hypertensive therapy. Most successful interventions involve patient reminder, self-management and behavioural intervention.
Haematological parameters decrease following one unit of whole blood donation which results in a detrimental effect on cardiorespiratory fitness and maximal exercise capacity. However, it remains unclear to what extent blood donation will impact exercise performance across varying levels of cardiorespiratory fitness. The aim of this study is to compare the effects of a standard blood donation on maximal exercise performance performed 24 h post-blood donation in individuals with varying levels of cardiorespiratory fitness. Methods: Forty-two males (mean age 22 ± 2.1 years) were recruited and segregated into Low, Moderate and Superior fitness groups. Subjects performed a multi-stage shuttle run test on the day prior to a standard blood donation procedure, and subsequently 24 h post-blood donation. Blood samples were taken on both test days and analysed for haematological parameters. Results: Exercise performance, represented by predicted VO2max were 0.6%, 1.0% and 4.1% lower in the Low, Moderate and Superior fitness groups respectively. However, the magnitude of reduction was only statistically significant in the Superior fitness group (p = 0.017). Compared to baseline, all fitness groups demonstrated significant reductions in haematocrit (Low: -8.4%, Moderate: -9.1%, Superior: -7.2%) and haemoglobin (Low: -7.6%, Moderate: -7.8%, Superior: -5.5%) levels at 24 h post-blood donation. Spearman correlation analysis revealed that changes in haemoglobin concentrations were not associated with changes in exercise performance in all groups. Conclusion: Exercise performance was only significantly reduced in the Superior fitness group. Well-trained individuals should be refrained from blood donation just prior to competitions.
Exercise has been suggested as the best and the most affordable way for managing blood pressure. The insertion/ deletion of angiotensin I-converting enzyme (ACE) I/D gene polymorphism had been reported to be linked with sev- eral diseases such as hypertension and diabetic nephropathy. Several studies showed that blood pressure response to exercise training for health management also vary among individuals with different genotypes of ACE I/D gene poly- morphism. A study of 9 months of endurance exercise training at 75 to 85 % of VO2max showed that the decrease of resting blood pressure in I allele carriers wass greater than D allele carriers. In contrast, other study discovered that adult women with D allele had greater reduction in resting blood pressure than those with I allele, following a 12-week combined aerobic and resistance exercise training. Despite the inconsistencies of some findings, it has remained unknown if the ACE I/D gene polymorphism would also influence blood pressure response to isometric handgrip training that had been found to be superior to the dynamic resistance exercise training in controlling and preventing high blood pressure. Thus, this article was to review the literature on ACE I/D gene polymorphism and blood pressure response to exercise training that could serve as the basis for future research to identify individuals who will lower resting blood pressure the most with exercise training program for health management.
Introduction:Tropical herbs are used as a medicine long before the introduction of modern medicine, especially by traditional healers. However, its’ scientific benefits are not widely investigated. There is a belief that the use of tradi-tional herbs potentially causing health deterioration due to its unknown mechanism of actions and interactions, and the nature of its unregulated processing as a health supplement. Parkia speciosa (local: petai) and Pithecellobium jir-inga (local: jering) are two tropical herbs from the Leguminosae family that are widely used raw as salads with many perceived health benefits and harms. We reviewed both species, looking into scientific pieces of evidence supporting the belief. Methods: The databases of MEDLINE, PubMed, EBSCOhost, and Google Scholars were systematically searched for both in vitro and in vivo effects of both species with no language restriction. Data were extracted using standardised fashioned. Results:P speciosa has pharmacological properties including antioxidant and anti-inflam-mation. It has shown to have antibacterial properties and glucose-lowering activity. P jiringa contains known an-tioxidant metabolites such as flavonoids, phenolics and terpenoids. It also contains antiangiogenic properties with potential use in retinopathy, cancer, and Rheumatoid arthritis. However, both herbs have potentially harmful effects which include liver injuries. Large consumption of P jiringa leads to acute kidney injury. Conclusion: Consumption of both P speciosa and P jiringa has medicinal properties as well as health harm. If taken as a supplement, rigorous clinical trials are needed to delineate benefit vs harm effect of both herbs.
Introduction: The survivorship of mosquito is the most important aspect that affects its ability as a pathogen trans- mitting vector such as Aedes albopictus which is a vector of dengue. In this study, temperature stress effect on the survival of adult Aedes albopictus were investigated. Methods: It was conducted by manipulating different constant temperatures (15°C to 35°C) on juvenile stage of Ae. albopictus in natural and artificial container. Then, the devel- opment growth of adult mosquito was observed under laboratory condition. The effects of exposed temperature on certain biological parameters of adult mosquito were evaluated in terms of survival rates, longevity of female mosquito, fecundity rate, gonotrophic cycle and wing length of the adult mosquito. Results: In higher temperatures, the longevity of adult female was reduced and the highest longevity was found at optimum temperature (25°C) with average of 8.6 ± 0.18 days and 6.7 ± 0.29 days in natural and artificial container respectively. Both sexes showed a clearly tendency towards decreasing survivorship with increasing temperature where the highest survival was found at 15°C. Conversely, survival was lowest at a high temperature (30°C to 35°C). This study also showed that the wing length of both sexes was significantly affected by the rearing temperature where the longest found at 15°C and the shortest at 35°C. Conclusion: Thus, this study provide useful information of mosquito ecology in response to varia- tion of temperatures.
ABSTRACTS FOR INTERNATIONAL FAMILY HEALTH CONFERENCE 2019 (I-FaH 2019)
Introduction: As cervical cancer is the third most common cancer among women and ten percent of cervical cancer incidence among those 65 years and above, Pap smear is still relevant to be performed among older women. The aim of this study was to determine the determinants of Pap smear screening among older women in an urban setting.
Methods: This cross-sectional study was conducted among 515 women aged 50 and above in two urban health centres in Gombak, Selangor. The sampling technique conducted was random systematic sampling. The indepen-dent variables were age, marital status, employment status, gynaecological history (family history of cervical cancer, menopause, hysterectomy), obstetric history (number of live births, ever had contraception), presence of chronic diseases (hypertension, Diabetes Mellitus, heart disease). Results: Only 202 (39.2%) out of 515 undergone Pap smear screening. An estimated 80.7% of them had their last Pap smear a year ago. The mean age of the respondents was 58.83± 7.05 years old and 77.3% had one and more comorbidities. The respondents preferred health care person-nel as the source for the pap smear information compared to reading materials and internet. Married vs divorced (aOR=1.89,p=0.02); those with heart disease (aOR=0.32,p value=0.01; those with Diabetes Mellitus (aOR=0.57,p value=0.01; those who had hysterectomy (OR=2.89, p value=0.04) and those who had contraception (aOR=3.72, p value =
Introduction: Police work has been recognised worldwide as a very stressful job. Those especially in road traffic control department encounter an additional possible cause of fatigue which is noise exposure that rarely being explored. Methods: A cross-sectional study was conducted among traffic police officers in Kuala Lumpur to assess their level of fatigue and its risk factors including noise exposure, work stressors and individual factors. A total of 171 traffic police officers in Kuala Lumpur participated in this study. A set of questionnaires on socio-demographics, work characteristics, perception regarding noise pollution, PSQ and CIS were distributed to 200 traffic police officers in Kuala Lumpur. Five locations with heavy traffic volume in Kuala Lumpur were selected for ambient noise measure- ment, three times a day during peak hour by SLM. Results: The mean age, job tenure and BMI of respondents was 30.49±7.12yo, 4.73±4.62 years and 24.83 respectively. Most of them were Malay (81.9%), married (60.8%), and secondary school graduated (84.8%). The traffic noise exposure levels ranged between 69.50 dB(A) to 82.80 dB(A) (mean = 76.77±4.39 dB(A). Almost 20% of respondents reported to have fatigue level that puts them at risk for sub- sequent work disability. After considering several potential factors, lower educational levels (β=-3.67, p
Introduction: The Environment of Care (EoC) is less being the highlight as one of the important components in hospi-tal administration. The EoC is the interface between the patient and the organisation and it provides both a practical and safe area in which to provide patient care. The study aims to determine the correlation between the environment of care, patient satisfaction and willingness to recommend. Methods: This was a cross-sectional study conducted in one of the teaching hospitals in Malaysia. A Malay validated Hospital Consumer Assessment of Healthcare Provider and System (HCAHPS) questionnaire was used. The multistage sampling was applied. 13 wards represent medical, surgical and O&G based wards were selected randomly. Systematic random sampling method was used for pa-tient selection. Number of samples for each ward was calculated proportionately based on the average number of discharge patient monthly. The global rating item in HCAHPS was used to determine satisfaction level. Data was collected and analysed using SPSS version 22.0. Results: 547 respondents were involved in the study with 61.6% of them were female. Majority of respondents were young adult less than 60 years old. 36.9% of the respondents had positive experience with cleanliness of the ward meanwhile 26.7% had positive experience with quietness of the ward. 57.6% of the respondents were satisfied with the services and 64.5% were willing to recommend the hos-pital to others. There was a significant correlation between environment of care, satisfaction level and willingness to recommend. Conclusion: The healthcare facility needs to concentrate on creating a positive experience on EoC component as this can influence satisfaction level and willingness to recommend the hospital.
Introduction:Gliosarcoma is a rare malignant brain tumor. The clinical presentation is acute with rapid progression of symptoms. Commonly affecting the elderly, it is rare to happen in youngsters. Case description: A 28-year-old radiographer presented to us with two episodes of unprovoked seizure. He denied any medical illnesses, or trauma, fall, motor vehicle accident and fever prior to these attacks. The computed tomography (CT) of brain was normal. He was managed as epilepsy and remained symptom-free for 3 years until the unprovoked seizure recurred. Another CT of brain performed and revealed a right parietal intracranial mass. This finding was supported by magnetic reso-nance imaging scan. The histologic examination showed a biphasic pattern of glial with predominant sarcomatous component giving a diagnosis of gliosarcoma of the brain. He had completed six cycles of adjuvant chemotherapy and was asymptomatic during clinic follow up with no tumor recurrence. Conclusion: Individuals with high risk of radiation exposure particularly radiographer as in our case requires a special attention when it comes to the diagnosis of malignancy. Despite of indolent clinical presentations, a close monitoring is needed to avoid mismanagement and subsequent morbidities.
Introduction: Iontophoresis of vasoactive substances such as acetylcholine (ACh) and sodium nitroprusside (SNP) combined with Laser Doppler fluximetry (LDF) is a non-invasive tool used to determine microvascular endothelial function. This study aims to test the effect of sodium chloride on
non-specific vasodilatation when used as a vehicle in the process of iontophoresis. This study also aims to define the number of current pulses needed to get the maximum effect during iontophoresis with ACh and SNP using low current strength. Methods: The experiment was conducted in five healthy females. Baseline skin perfusion was taken before administration of seven current pulses. Current strength of 0.007 mA and current density of 0.01 mA/cm2 were used. Acetylcholine was used to assess endothelial dependent vasodilatation, while SNP was used to assess endothelial independent vasodilatation. The mean skin perfusion (AU) responses to the iontophoresis of ACh at the anodal and SNP at the cathode leads were recorded. Sodium chloride (0.9%) was used as a vehicle to obtain concentration of 1% for both ACh and SNP. Iontophoresis of pure vehicle (NaCl) was conducted on a separate day to observe the effect of vehicle only on the iontophoresis process at both anode and cathode. Results: Iontophoresis of NaCl showed no significant increase in perfusion compared to baseline at both anode and cathode. Significant increases in skin perfusion were observed with SNP and ACh; a plateau of ACh was reached from the 3rd pulse onwards; while the plateau of SNP was reached from the 4th pulse onwards. Conclusion: NaCl could be used as a vehicle for Ach and SNP during iontophoresis as it did not cause non-specific vasodilatation. Using five current pulses are adequate for iontophoresis of ACh and SNP to assess microvascular endothelial function.
The attenuation degree labelled on hearing protectors is based on internationally set standards. The attenu- ation is measurement in laboratories using methodology of real-ear attenuation at threshold (REAT), microphone in-real ear (MIRE) and acoustics test feature (ATF). The measured attenuation gap from the actual workplace is a problematic predicament. The conceptual review of how far these methods affect the gap could embark future researches. Therefore, a conceptual review of the conducted methodologies according to standards for attenuation which include Noise Reduction Rating (NRR) and Single Number Rating (SNR) are discussed in this paper. 23 papers from ProQuest, EBSCOhost and Google Scholar databases are chronologically reviewed. Summarily, the improved attenuation measurement methods will help close the gap between laboratory data and field performance and sub- sequently will better prevent Noise-Induced Hearing Loss. Most of the latest findings after year 2010 were in agree- ment with the studies in 2000 to 2009.
Introduction: The persistently increasing number of dengue cases costs a significant amount of health financial ex-penditure by the government. Communities throughout the country should be equipped with adequate knowledge and have a good practice in the avenue of reducing dengue infection incidence. This study aims to describe the knowledge and practice levels on dengue fever and their associated factors among adults in a rural village in Negeri Sembilan. Methods: This cross-sectional study was conducted in a village of Tampin District using a pretested struc-tured questionnaire. Face-to-face interview was conducted among participants whose houses were randomly select-ed. The questionnaire consisted of sections identifying the socio-demographic factors and assessing their knowledge and practice on dengue fever. Knowledge that was assessed includes the sign and symptoms of dengue fever, knowl-edge on the vector, preventive measures and legislation related to it while practice includes their routine action in preventing dengue fever. Results: A total of 221 respondents responded to the questionnaire. The prevalence of re-spondents ever had dengue fever was 10.4% (n=23). Out of 100, the mean (s.d.) knowledge and practice score was 77.2(13.1) and 75.8(16.7) respectively. Good knowledge and practice on dengue fever was found among 52.0% and 47.5% of the respondents respectively. Good knowledge was associated with being middle aged (p=0.001), married (p=0.010) and having higher household income (p= 0.037). There was a significant but weak positive correlation between knowledge and practice of dengue fever (r=0.237, p
Introduction:Simulation training in airway management among nursing students was recommended to enhance skills, knowledge and confidence during their clinical attachment in the Emergency Department but the efficacy was not being explored adequately. The objective of this study was to determine the efficacy of simulation training in airway management among final year nursing student Kota Kinabalu Training Institute (KKTI). Methods: This was quasi-experimental research design, which the participant was divided into test and control group without random-ization. A sample of forty final year nursing students was selected for this study. This was a comparative study in-volving twenty KKTI final year nursing students (test group) with simulation versus twenty final year nursing students (control group) without simulation on airway before and after posted to Emergency and Trauma Department (ETD). Two instruments were used, i) Pretest/posttest survey design by Porter et al (2013), and; ii) The Simulation Efficacy Tool-Modified (SET-M). SPSS version 24 Independent T test was used to analyse the mean score between the groups. Results: Levene’s test for equality of variance shown significant (t= -.005, df = 38, p
Introduction: Anatomy continues to be an important basic subject in medicine and other related health sciences which is delivered by method of either through lectures or demonstration. Thus, having a gross anatomy practi- cal with cadaver is a crucial phase for the students to have a deep understanding about anatomy of human body. The objective of this study is to explore the attitude and perception of medical and health science students in the importance of cadaver dissection in learning anatomy. Methods: A cross-sectional study was conducted by distrib- uting closed structured questionnaires to 270 respondents consisting of socio-demographic in part one, frequency on practical with dissected cadaver in part two, the attitude of student towards the dissected cadaver in part three, suggestion for improvement during practical with cadaver in part four and the value of cadavers during practical in part five. The collected data were processed by using Statistical Package for Social Sciences (SPSS) version 23.0. Result: Descriptive statistical evaluation shows majority of the students perform practical with cadavers. They find cadaveric dissection exciting with no feeling of stress and anxiety. Many of them never had an emotional shock when exposing themselves to the cadavers for the first time accepting the cadaveric dissection ethically. The students recommended keeping cadaveric dissection in the health science curriculum. Conclusion: The cadaveric dissection helps in grounded understanding of anatomy. It promotes and develops psychomotor skills in students. The findings of the study discovered dissection to be a motivating tool in learning anatomy.