A cross»sectional study was undertaken between April 2005 to _1 uly 2005 to determine the extent of the health problems experienced by individuals involved in the December 2004 tsunami wave disaster in the Northeast District of Penang, Malaysia. The overall health status of the respondents were evaluated using the Short Form 36 (SF-36) questionnaire. Out of 171 respondents, 160(93 .6%) were Malays, 8(4.7%) were Chinese and 3(1.8%) were Indians. The mean age ofrespondents was 45.4 years, 15.9 years. Ninety-four of the respondents were males (55.0%) while 7 7(45.0%) were females. The overall mean physical component score was significantly lower (66.9:23 .O) amongst respondents with low education level compared with those with high education level (76.3:19.1, p=0.004). This mean score was also significantly much lower ( 68.7:22 .3) amongst those who are married compared to those who were not married (79.8:1 7.4, p=0.003) . The overall mental health score was significantly much higher (78.8:14.6) amongst those who were not married compared to those who were married (68.5:19.2, p=0.001). The overall mental health score was also significantly higher amongst those in the younger age»group (62.3:16.1) compared to those in the older age»group (72.4:18.9, p=0.005). Based on the scores obtained on the Physical Health and Mental Health dimensions of the SF-36 questionnaire, it can be concluded that the health of victims with low education, elderly and those who were married were more adversely affected than others. Therefore, it is vital that medical as well as psychological attention should be channeled to these risk groups who responded more adversely to disasters.
Several studies had shown that the problem of plate waste in hospitals ranged from 17% to 67%. This study aimed to determine the extent of plate waste in a district government hospital, the type of food item wasted and the factors contributing to food waste. A oross»sectional study was conducted in a district hospital, involving four third class wards. A total of 300 patients were included in the study. A plate waste was dehned as the proportion of edible portion of food served that was discarded by patients. The serving size was established by weighing each food item served over breakfast, lunch and dinner on a seven·day rotation menu, using the procedure recommended by the National Food Service Management, During the study period, the left over from each patient’s plate was weighed for all meals. The plate waste for each patient was determined by dividing the total weight of the left over with the average serving weight for the same serving in the same ward. Each patient was also given a self-administered questionnaire to obtain information on reasons or not consuming the ood items served. The overall mean ercentage plate waste of all food served in the four wards was 42.6%. Plate wastage occurred most at dinner (53.2%) and least at breakfast (31 .3%). Vegetables were the most wasted food items. Females wasted significantly higher than males for all meals. Food taste, portion size, appetite and staff service efficiency were factors found signihcantly contributing to plate waste. With almost half of the food served was wasted, hospital management need to direct more attention towards addressing the problem of plate waste since it has both nutritional and cost implications.
Ageing anxiety is commoner among women compared to men. However, little is known on the possible contributing factors towards the development of ageing related anxiety among Malaysian women. This study aimed to explore ageing anxiety among the middle-aged women in Malaysia in facing the ageing process. Series of 6 focus group discussions (FGD) were conducted involving a total of 36 women aged between 35 and 59 years old. Each FGD consisted of 5 to 7 respondents and was conducted for an average of 1 to 2 hours. The respondents were selected using the maximum variation sampling method focussing on five age categories, between 35 to 39, 40 to 44, 45 to 49, 50 to 54 and 55 to 59 years old. Representative from several residential areas in the area of Putrajaya Federal Territory and Seri Kembangan, Selangor were involved in the selection of respondents. The interviews revealed that, majority of the respondents were seriously thinking of the possible negative experiences associated with ageing and being old, but very few experiencing ageing anxiety. Three main themes that were identified to contribute to the ageing anxiety were issues related to caregiving at old age and fear of loneliness, the welfare and care of their children when they are old and eventually die and also physical changes that occurred with ageing process. These themes were not specifically associated with any particular age groups, marital or income status. However, the development of the ageing anxiety was found to be related to their personal experiences and observations from the surrounding community. The findings show that women in Malaysia are still emphasizing on the importance of traditional caregiving system, where elderly parents are looked after by the children or extended family members rather than living in formal institutions. Despite the important role of formal institutions in the care of elderly people in the future, it is still negatively perceived. With the shrinking of the size of nuclear family and massive involvement of women in employment sector, more elderly will be expected to reside in formal institutions in the near future. Relevant authorities should be made aware on the importance to maintain the quality of care in the formal institution for elderly, in order to tackle the negative perceptions.
Student's feedback is one of the most important considerations in health profession quality management. One of the most popular approaches for receiving feedback from students within individual institutions is the Student Satisfaction Approach. The aim of this study was to measure the satisfaction with educational services among health profession students and the determinants of satisfaction. Cross-sectional study was conducted in the main campus of the High Institute of Health Sciences in Yemen, including its eight branches. A self-directed questionnaire was distributed to 327 students who were randomly selected. The participation rate was very high: 94% (309/327); 57.9% were male and 42.1% were female. Overall, 59% of students were totally satisfied, 35% were partially satisfied; however only 6% of them were not satisfied. Results showed that personal development was the highest component of satisfaction among students, while the research subjects showed less–satisfaction with the learning resources. The findings provide valuable insights and offer recommendations for improvement in terms of quality management in health profession education.
The uprising needs of traditional & complementary medicine (T&CM) despite the availability of conventional medical (CVM) treatments has gained a serious concern to the authorities in hospital care delivery systems. It was about suffices the supply and demand for T&CM and its absence may interfere the quality of patient care. Malaysia was not exempted of this phenomenon. Moreover, its rich tropical biodiversity and multi-ethnical medical systems promoted T&CM usage. This research was aimed to determine the overall T& CM preferences, the preferred future patient care services (FPCS) and its socio-demographic and warding characteristics. Using a self-administered standardised questionnaire, instrumented by cross sectional study, a total 132 warded patients in a UKM Medical Center (UKMMC) were interviewed. T&CM preferences were the composite of seven domains. The finding revealed that the T&CM preference was 64.4%, dominated by older age (66.2%), women (68.2%), low education (66.0%), employed (66.7%), high income (67.5%) and married (66.0%). Oncology (81.3%) and orthopaedic (75.7%) ward patients were more in preference compared to other wards. When asked about the FPCS preference, about 80.3% expected integrative medicine services to be provided, whereas the remaining were still exclusively preferred modern medicine (15.2%) and alternative medicine (4.5%) respectively. As conclusion, this study has affirmed that there is a great need towards T&CM among hospitalized patients who are accessible to modern CVM.
Introduction: Leptin is an adipokine that has strong correlation with the body mass index (BMI). Gestational diabetes mellitus (GDM) is a common medical complication associated with pregnancy. Leptin may lose its correlation with the body mass index (BMI) during diabetes due to hormonal rearrangement. Diet control is the first line management in GDM. Leptin reported to increase in pregnancy and further increases in diabetic patients during GDM screening. There is paucity in the reports concerning Leptin levels in GDM patients on diet control. The present study was aimed to evaluate the changes in maternal leptin in pregnancy complicated by GDM on diet control compared to the normal pregnancy in the 3rd trimesters by comparing the means and to find the correlation of Leptin with the body mass index in both groups.
Methods: The study included 2 groups: normal pregnancy (n = 40) and pregnancy with GDM under diet control (n = 60) both groups are at 38-40 weeks of gestation. Leptin concentration in serum was measured in both groups and statistically tested using student t test. The BMI were measured and correlated with the Leptin level in test groups.
Results: the results indicated that Leptin will nearly triple in the third trimester (38±30 ng/ml) of pregnancy compared to the standard normal non-pregnant. Leptin level was significantly lower in diabetic women on diet control (28±16 ng/ ml) when compared with the non-diabetics (38±30 ng/ml). The hormone has no correlation with the age of the patients but have a positive correlation with the body mass index before and during pregnancy in both groups.
Conclusion: Leptin is increasing in pregnancy as part of the physiological changes. Dieting can decrease Leptin level in diabetics’ pregnant women. Diet can restore the hormonal dysregulation of Leptin. Assessment of Leptin level might be used as an indicator for good diet control during pregnancy.
Study site: Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
A study to determine average knee laxity in the Malaysian population and how it affects daily living was conducted at the University Malaya Medical Centre between January and April 2004. Fifty two male and 76 female subjects were recruited for this study, all of whom were healthy volunteers with no ambulatory problems. Side to side knee laxity testing was performed using a KT-1000 arthrometer. Significant differences in knee laxity were noted among different races and between sexes. For instance, overall, Chinese and female study participants had higher knee laxity: (left knee, 2.17 mm (SD=1.30) and right knee was 2.88 mm (SD= 1.51)). On average, the difference between knees was 0.70 ± 1.26 mm (less than 1 mm) which is a smaller variation than reported in previous studies which suggested 3 mm. Despite finding knee laxity ranging from 0 to 8mm, no correlations were found between Lysholm, IKDC and Tegner knee outcome scores and the degree of knee laxity. No other predictors such as height, weight and age correlated with levels of knee laxity. We therefore conclude that knee laxity is a common occurrence in the normal population and is therefore not suitable as a sole predictor of knee function and should not be used as the only criteria for surgical intervention.
Study site: Orthopedic clinic, Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Congenital partial aplasia of the atlas with a posterior arch remnant is rare. It may be found as an incidental radiological finding or patients can present with neurological signs and symptoms after head or neck trauma. A 36-year-old female presented with a 3-day history of right sided neck pain radiating down the right arm. Radiographs of the cervical spine showed a radiolucent area in the region of the posterior arch of the atlas. Computed tomography subsequently revealed partial absence of the posterior arch of the atlas with a defect at the anterior ring. Her clinical condition subsequently improved with rest, analgesia and physiotherapy. This case report illustrates a situation where congenital defect of the posterior arch of the atlas was revealed in a patient with neck pain. Awareness of the existence of this condition will help clinicians avoid misdiagnosis and excessive investigations.
Heart failure is chiefly the end stage of primary hypertension and a major public health problem in Malaysia. The aim of this work is to investigate the level of BNP that may discriminate between primary hypertension patients without heart failure and primary hypertensive patients with heart failure. This study was conducted on 60 hypertensive patients without any clinical symptoms of heart failure referred for echocardiography to evaluate the ventricular function. Patients with metabolic diseases and terminal diseases were excluded from the study. The BNP levels were assessed using the Triage Meter from Biosite Diagnostics. Results showed that BNP level display a negative correlation with ejection fraction (Pearson correlation test). The significant result (paired t test, p < 0.05) proves that both predictors are very important and relates to each other. Low ejection fraction is significantly marked with raised BNP level suggesting that BNP may play potential role as screening tool for early detection of heart failure in primary hypertensive patients.
Study site: (Universiti Kebangsaan
Malaysia Medical Center and International Medical University cardiology clinic, Seremban
The sale of tobacco-based cigarettes has declined in western countries, and ‘Big Tobacco’ is trying to make up the deficit in profits from the developing world. The recent introduction of e-cigarette, in which they have invested both their hopes and their finances, has been a boon to them as it serves to confuse smokers and non-smokers about the real issues relating to the toxicity, dangers, and the promotion of nicotine addiction especially among youths who have not previously smoked cigarettes. E-cigarettes cause inflammation and damage to epithelial cells in human airways and increased risk of infection. E-cigarette vapour contains more carcinogens like formaldehyde and acetaldehyde compared to a regular cigarette. Longterm vaping is associated with an incremental lifetime cancer risk. E-cigarettes are neither safe nor effective in helping smokers quit; there is enough evidence to caution children, adolescents, pregnant women, and women of reproductive age about e-cigarette’s potential for long term consequences to foetal and adolescent brain development that sub-serve emotional and cognitive functions. The nicotine effects that cause modification of late CNS development constitute a hazard of adolescent nicotine use. The American Heart Association (AHA), Food and Drug Administration (FDA), World Health Organisation (WHO) and two-thirds of the major nations in the world discourage the promotion of e-cigarettes as an alternative to proven nicotine-addiction treatments. Doctors, health care workers, and medical students should be armed with the facts about e-cigarettes, its dangers, and the legal status concerning its use, in order to be able to offer proper counselling to patients and adolescents, in particular, with special reference to the Malaysian context.
The objective of the study was to determine the prevalence of hypertension in healthy primary school children. A cross-sectional survey by manual blood pressure measurement of healthy children aged 6-12 years attending a national type school was carried out. Children with previous renal, cardiac and endocrine disorders were excluded. Korotkoff 1 represented the systolic blood pressure (SBP) and Korotkoff 5 was taken as the diastolic blood pressure (DBP). Hypertension was defined as the SBP or DBP above the 95th centile according to age group and sex regardless of ethnicity. A total of 1756 children were studied with 895 boy and 861 girls. The results showed that 109 children (6.2%) were found to have hypertension and the incidence was similar in boys and girls (6.4% vs 6.0%, p = 0.69). Fifty-three (48.6%) children had an elevated SBP and the DBP was elevated in 43 (39.4%) children. Only 12 (12.0%) children had both elevated SBP and DBP. Children found to have hypertension were more likely to be Chinese (p = 0.009) and obese (p = 0.04). In conclusion the overall prevalence of hypertension in children aged 6-12 years based on a single blood pressure measurement was 6.2%. Hypertension was more likely to be found in Chinese children and those who were obese.
Background: Kawasaki Disease (KD) and acute rheumatic fever are the two leading causes of acquired heart disease in children in the developing countries. Objectives: To determine the epidemiology of KD and its short-term outcome in Malaysian children. Materials & Methods: A retrospective study of patients with a diagnosis of KD at the Kuala Lumpur Hospital from January 1999 to December 2003. Results: 84 patients with KD were seen over the 5 year period. Of these, 52 (61.90%) were male and 32 (38.10%) female. Malays comprised 51 (60.71%), Chinese 30 (35.71%) and Indian 3 (3.57%). Their ages ranged from 2 months to 11 years 1 month old. There were 25 (29.76%) patients less than one year old, 50 (59.52%) aged 1-4 years, 4 (4.76%) aged 5-7 years and 5 (5.95%) were more than 7 years old. Echocardiographic examination during the acute phase showed that 24 patients (28.57%) had coronary artery dilatation; 23 had mild dilatation and one had giant aneurysm involving both coronary arteries. Echocardiographic examination at 8 weeks showed that 5 (21.74%) of the 23 patients with mildly dilated coronary arteries had resolved; the bilateral giant coronary aneurysms remained the same. There was no death due to KD over the 5 year period. Conclusion: KD occurred most commonly in children aged 1-4 years old with a peak at 17 months. There was male preponderance with a male to female ratio of 1.6:1. Despite immunoglobulin therapy, 29% of patients had coronary artery involvementduring the acute phase; 22% of those with mild coronary artery dilatation resolved at 8 weeks after disease onset.
Life (QOL) of patients with childhood leukaemias presenting at the Hospital Universiti Kebangsaan Malaysia (HUKM). The objectives of this pilot study were 1) To assess the feasibility and applicability of assessing quality of life in leukaemia patients using the adult-based SF-36 questionnaire. 2) To compare the differences of QOL scores among patients based on gender and treatment status. The Short-Form-36 Health Survey (SF36) was used. The items in SF-36 were drawn from the original 245-item MOS questionnaire, which includes multi-item scales that measured the eight dimensions of quality of life namely physical function, role limitations (physical problems), bodily pain, general health, vitality, social functioning, role limitations (emotional problems) and mental health. Patients with acute leukaemias were chosen to participate in the study. Twenty-eight patients were recruited, twelve were males and 16 were females. Ten patients had completed therapy whilst 18 others were still undergoing treatment. The results showed that those patients off treatment have a better quality of life than those on chemotherapy. However, this was only significant with respect to the role limitation pertaining to physical problems. Although the use of the SF-36 was feasible, there were limitations especially in the younger age group.
Cancer of the cervix is caused by micro-organisms called Human Papilloma Virus (HPV). This virus is only transmitted to women from their partners/spouses through sexual intercourse. In Malaysia, cancer of the cervix is the second most common cancer among females after breast cancer. The incidence is 21.5 per 100,000 population, with incidence among the Chinese being highest at 33.6 per 100,000 and among Malays the lowest being 12.6 per 100,000. For the past twenty years or so the Annual Reports of Ministry of Health recorded an average of 2500 new cases per year. Cancer of the cervix is preventable. The precursor cancer cells can be easily detected provided the women do regular screening tests called Pap Smear. In nearly all cases this cancer arises from the transformation
zone of the cervix. This is the zone in the cervical mucosa in which the epithelium abruptly changes from hardy squamous epithelium of the ectocervix to the fragile columnar epithelium of the endocervix.
Cervical cancer is the first solid tumour to be shown directly induced by virus. HPV is found in virtually all cervical carcinomas and their precursors.
Objective: This study aims to establish the validity and reliability of the Malay- translated version of the CES-D. Methods: This study employed a cross-sectional study design. The participants were female inmates (n=90) from local prisons which were selected based on purposive-selective sampling. The analyses include face validation, factor analysis, and reliability testing. A test-retest was conducted within a one-week interval. Results: The mean score for depression among the participants is 18.97 (SD=6.51). Further descriptive analysis showed that 58.9% of them scored above the mean score, which is considered high. Preliminary construct validation analysis confirmed that factor analysis was appropriate for the Malay-translated version of the CES-D. Furthermore, the factor analysis showed similar factor loadings to the original English version. The total internal consistency of the translated version, which was measured by Cronbach’s alpha coefficient, was equal to 0.75. The test-retest reliability of the total score, measured by Pearson’s correlation was equal to 0.69. Conclusions: Face validity, construct validity, and reliability analysis were found satisfactory for the Malay-translated version of the CES-D. The Malay-translated version of the CES-D was found valid and reliable to be used in future studies, with comparable properties to the original version and to previous studies. ASEAN Journal of Psychiatry, Vol. 15 (1): January - June 2014: 54-65.
Objective: The family caregiver has a pivotal role in the management of HIV/AIDS patients and their well-being is consequently crucial as it could impact negatively on the quality of caregiving. This preliminary qualitative investigation intended to explore and describe the challenges and experiences of HIV/AIDS family caregivers in Terengganu, Malaysia. Methods: A convenient sample of family caregivers of HIV/AIDS patients who were aware of the diagnosis was enrolled. Recruitment was conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia and semi-structured interviews were used. Results: Results were transcribed into verbatim before being subjected to analysis. Twelve Muslim caregivers consented participation (age range = 18.0 - 81.0; female = 75.0%, mother/wife = 50.0%; married = 83.3%; ≤ primary school
= 50.0%; and self-employed = 66.7%). The four major themes that emerged were challenges of caregiving, financial issues, stigma and discrimination, and support for caregivers. Additionally, caregivers did mention several positive aspects of their caregiving role including satisfaction from helping family member and improved family relationships. Conclusion: A variety of life aspects were negatively affected by caring for HIV patients, thus requiring a multidisciplinary approach to address such issues. ASEAN Journal of Psychiatry, Vol. 15 (2): July - December 2014: 120-130.
A cross-sectional study was conducted on 83 female electronics factory workers. The respondents comprised 50 exposed workers who use lead alloy solder and 33 unexposed workers. The objective of this study was to assess the lead exposure of these workers. Breathing zone were sampled using air sampling pumps. Dust samples were collected by wipe method. Venous blood collected and blood pressure were measured. All lead analyses were carried out with Graphite Furnace Atomic Absorption Spectrophotometer. The mean air lead for exposed workers (57 0. ± 0.93 μg/m³) was significantly higher than the unexposed workers (0.0067 ± 0.0045μg/m³) (p