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Study on incidence of needle stick injury and factors associated with this problem among medical students

Norsayani MY, Noor Hassim I

J Occup Health, 2003 May;45(3):172-8.
PMID: 14646293

Medical students face the threat of needle stick injury with the consequent risk of acquiring blood-borne infection by pathogens such as HIV, Hepatitis B and Hepatitis C while performing their clinical activities in the hospitals. A cross-sectional study was conducted among 417 final year medical students from Universiti Kebangsaan Malaysia (UKM), University Malaya (UM) and Universiti Putra Malaysia (UPM). The aims of the study were to determine the incidence of cases and episodes of needle stick injury among them in the past year. This study was also done to find out the factors that might be associated with the occurrence of this problem. The factors were sociodemographic factors, duration of exposure, level of knowledge of blood-borne diseases and Universal Precaution, perception of risk of blood-borne diseases and level of practice of Universal Precaution. The incidence of needle stick injury among medical students was 14.1% (59 cases). The total number of episodes of needle stick injury was 87 and the incidence of episodes among respondents was high i.e. 20.9%. The highest incidence of episodes of needle stick injury occurred in Obstetric & Gynaecology postings, followed by Medicine and Surgery. For clinical procedures, venepuncture had the highest incidence followed by setting up drips and giving parenteral injections. The results showed the students who had needle stick injury (cases) had lower scores in the practice of Universal Precautions than non-cases (p<0.05). There was a significant association between the level of practice of Universal Precautions and the number of episodes of needle stick injury, i.e. the higher the score for the practice of Universal Precautions, the lower the number of episodes (beta=-2.03 x 10(-2), p<0.05). This study showed that medical students are at risk of needle stick injury and blood-borne infections during their clinical activities while performing procedures on patients especially for those who were poor at practising Universal Precautions. Therefore some preventive measures should be taken by the management of the universities and medical students to avoid the occurrence of these problems.
Fulltext Eating style and the nature of food consumption: mapping individuals’ health risks

Shukri M, Mohd Noor NF

Malaysian Journal of Public Health Medicine, 2017;17(3):82-87.

Research examining whether psychological eating style is related to healthy or unhealthy eating patterns is required to explain the mechanisms underlying non-communicable diseases and obesity. The purpose of this study was to investigate whether eating style predicts the nature of food consumption. This was a cross-sectional study of 588 adults (males = 231 and females = 357). Eating style (i.e. restrained, emotional, external eating) was measured using the short version of the Dutch Eating Behaviour Questionnaire (DEBQ). The nature of food consumption was assessed using self-reports of consumption of fruits and vegetables, sweet foods, junk food, and snacks.The results revealed that restrained eating was higher in females and overweight participants. External eating,a higher frequency of snacking,and a higher frequency of junk food consumptionwere more prevalent among the younger participants. Consistent with previous Western studies, emotional eating was found to be the main predictor of consumption of less healthful foods (sweet foods, junk food, and snacks), whereas external eatingpredicted the intake of sweet foods. The intake of fruits and vegetableswas associated with restrained eating. In light of the significant associations between eating style and the nature of food consumption, acknowledging individuals’ eating styleshas implications for tailoring effective nutritional programs that address obesity and the chronic disease epidemic.
Fulltext Cardiac A-lines in fast scan as a sign of pneumopericardium

Md Noor J, Eddie EA

Ultrasound J, 2019 Apr 25;11(1):7.
PMID: 31359168 DOI: 10.1186/s13089-019-0123-x

BACKGROUND: Traumatic pneumopericardium is rare and usually results from blunt injury. Diagnosis through clinical and chest X-ray is often difficult. Ultrasound findings of A-line artifacts in the cardiac window may suggest pneumopericardium.
CASE PRESENTATION: A young man involved in a car accident and sustained blunt thoracic injuries, among others. As part of primary survey, FAST scan was performed. Subxiphoid view to look for evidence of pericardial effusion showed part of the cardiac image obscured by A-lines. Other cardiac windows showed only A-lines, as well. A suspicion of pneumopericardium was raised and CT scan confirmed the diagnosis.
CONCLUSIONS: Although FAST scan was originally used to look for presence of free fluid, with the knowledge of lung ultrasound for pneumothorax, our findings suggest that FAST scan can also be used to detect pneumopericardium.
Molecular diagnostics for tuberculosis

Noor KM, Shephard L, Bastian I

Pathology, 2015 Apr;47(3):250-6.
PMID: 25719854 DOI: 10.1097/PAT.0000000000000232

The phenotypic methods of smear microscopy, culture and indirect drug susceptibility testing (DST) remain the 'gold standard' diagnostics for tuberculosis (TB) in 2015. However, this review demonstrates that genotypic methods are in the ascendancy. Current-generation nucleic acid amplification tests (NAATs) are important supplementary tests for the rapid direct detection of (multidrug-resistant) TB in specific clinical settings. Genotypic detection is already the preferred method of detecting rifampicin and pyrazinamide resistance. Next-generation NAATs able to detect about 10 colony forming units/mL of sputum could replace culture as the initial test for detecting TB. Whole genome sequencing could also plausibly replace phenotypic DST but much work is required in method standardisation, database development and elucidation of all resistance gene determinants. The challenge then will be to rollout these increasingly complex and expensive diagnostics in the low-income countries where TB is prevalent.
Fulltext Assessing biomarkers on exposure, effects and susceptibility for environmental and occupational exposure of various range of benzene

Noor Fatihah MF, Suhaili A, Juliana J

Malaysian Journal of Public Health Medicine, 2017;17 Special(1):7-18.

Background: Benzene is primarily routed by inhalation which highly sensitive to blood parameters as bone marrow is their target organ. The ability of benzene even in low exposure levels may induce human bone marrow suppression resulting in blood diseases such as leukopenia, anemia, thrombocytopenia, aplastic anemia, and pancytopenia. In the occupational setting, the most common benzene-exposed workers are from the petrochemical industries and petrol distribution such as gasoline pumps. Benzene also generated primarily by mobile exhaust and some from various of anthropogenic sources at environmental atmosphere and occupationally exposed in the policemen traffic, taxi and bus drivers, and street vendors in long-length time with low concentration exposure. Methodology: This paper reviewed published articles on biomarkers exposure, effects and susceptibility as the useful tools for benzene exposure assessment in the occupational and environmental setting. Data from previous epidemiological studies relevant to benzene exposure in various occupational and environmental setting is also summarized. Results: Based on these analyses, the findings agreed that these biomarkers are could suggest in linking the benzene exposure with possible adverse health effects. The biological monitoring used in epidemiological studies is useful in providing an understanding of activation and detoxification of benzene in both the occupational and general population as they are exposed to wide range of benzene concentration. Conclusion. The biomarkers of exposure, effects, and susceptibility utilized for benzene exposure assessment are valid tools in determining the greatest potential risk as well as an early biological effect which then caused a related specific disease.
A rare case of a mother with gestational diabetes complicated with fulminant type 1 diabetes mellitus post-delivery

Ting Tai Y, Mohd Noor N

J R Coll Physicians Edinb, 2022 Jun;52(2):120-123.
PMID: 36147001 DOI: 10.1177/14782715221103668

Fulminant type 1 diabetes mellitus (FT1DM) is recognised as a novel subtype of type 1 diabetes mellitus characterised by the abrupt onset of insulin-deficient hyperglycaemia and ketoacidosis. Fulminant type 1 diabetes mellitus is known to be associated with pregnancy and had been associated with high fetal mortality. We report a case of a gestational diabetes mellitus (GDM) mother complicated with FT1DM immediately post-delivery. A 29-year-old Malay lady who was diagnosed with GDM at 19 weeks of pregnancy, underwent emergency lower segment caesarean section (EMLSCS) due to fetal distress at 36 weeks of gestation; 18 h post-EMLSCS, she developed abrupt onset Diabetic ketoacidosis (DKA) (blood glucose 33.5 mmol/L, pH 6.99, bicarbonate 3.6 mmol/L, ketone 4.4 mmol/L and HbA1c 6.1%). She received standard DKA treatment and discharged well. Her plasma C-peptide level 3 weeks later showed that she has no insulin reserve (C-peptide <33 pmol/L, fasting blood glucose (FBS) 28 mmol/L). Her pancreatic autoantibodies were negative. This case highlights that FT1DM not only can occur in pregnancy with normal glucose tolerance but can also complicate mother with GDM.
Synchronous glomus tumors in a distal digit: a case report

Noor MA, Masbah O, Lumpur K

J Hand Surg Am, 1997 May;22(3):508-10.
PMID: 9195463

Glomus tumors occurring synchronously in the subungual region and the pulp of a fingertip are extremely uncommon. Awareness of this will lead to early diagnosis and treatment.
Refractive errors and biometry of primary angle-closure disease in a mixed Malaysian population

Mohamed-Noor J, Abd-Salam D

Int J Ophthalmol, 2017;10(8):1246-1250.
PMID: 28861350 DOI: 10.18240/ijo.2017.08.10

AIM: To assess the refractive status, anterior chamber depth (ACD) and axial length (AL) of patients with primary angle-closure disease (PACD).
METHODS: Retrospective cohort. Data was collected from charts of all PACD patients treated from April 2013 to December 2015. Analysis was done on 137 patient charts with complete biometric data. Patient demographics, PACD type, refractive status (spherical equivalent), ACD and AL were studied.
RESULTS: The median age of 137 subjects [53 with primary angle-closure suspects (PACS), 27 with primary angle-closure (PAC) and 57 with primary angle-closure glaucoma (PACG)] was 68y (range 21-88y). The majority was Chinese (n=68; 49.6%) and most of them were women (n=75; 54.7%). The distribution of myopia (n=51; 37.2%) and hyperopia (n=49; 35.8%) was similar. The ACD was shallower in myopes compared to hyperopes (P=0.02) and emmetropia (P=0.049) but the AL was not significantly different between groups. There were no patients blind from PACG.
CONCLUSION: Both myopia and hyperopia can occur in PACD. Despite a shallower ACD in angle closure myopes, the AL was not different between groups.
Ecotoxicological risk assessment on coagulation-flocculation in water/wastewater treatment: a systematic review

Mohamed Noor MH, Ngadi N

Environ Sci Pollut Res Int, 2024 Aug;31(40):52631-52657.
PMID: 39177740 DOI: 10.1007/s11356-024-34700-0

It is undeniable that removal efficiency is the main factor in coagulation-flocculation (C-F) process for wastewater treatment. However, as far as environmental safety is concerned, the ecotoxicological aspect of the C-F process needs to be examined further. In this study, a systematic review was performed based on publications related to the toxicity research in C-F technology for wastewater treatment. Through a series of screening steps, available toxicity studies were categorized into four themes, namely acute toxicity, phytotoxicity, cytotoxicity, and genotoxicity, which comprised 48 articles. A compilation of the methodologies executed for each theme was also outlined. The findings show that conventional metallic coagulants (e.g., alum, iron chloride, and iron sulfate) were less toxic when tested on test species such as Daphnia magna (water flea), Lattuca sativa (lettuce), and animal cells compared to synthetic polymers. Natural coagulants such as chitosan or Moringa oleifera were less toxic compared to metallic coagulants; however, inconsistent results were observed. Moreover, an advanced C-F (electrocoagulation) as well as integration between C-F and Fenton, adsorption, and photocatalytic does not significantly change the toxicological profile of the system. It was found that diverse coagulants and flocculants, species sensitivity, complexity in toxicity testing, and dynamic environmental conditions were some key challenges faced in this field. Finally, it was expected that advances in technology, interdisciplinary collaboration, and a growing awareness of environmental sustainability will drive efforts to develop more effective and eco-friendly coagulants and flocculants, improve toxicity testing methodologies, and enhance the overall efficiency and safety of water and wastewater treatment processes.
Thymoquinone-PLGA-PF68 Nanoparticles Induce S Phase Cell Cycle Arrest and Apoptosis, Leading to the Inhibition of Migration and Colony Formation in Tamoxifen-Resistant Breast Cancer Cells

Noor NS, Hamid SBS

Curr Mol Med, 2025 Jan 15.
PMID: 39819413 DOI: 10.2174/0115665240347014241203065055

BACKGROUND: A biocompatible polymeric nanoparticle, TQ-PLGA-PF68, was developed through the interaction of the phytochemical thymoquinone (TQ) encapsulated in poly(L-lactide-co-glycolide)-b-poly(ethylene glycol) (PLGA-PEG) with Pluronics F68. So far, this combination has not been assessed on breast cancer cells resistant to anti-cancer drugs. Therefore, this study aimed to assess the cell death caused by TQ-PLGA-PF68 nanoparticles, particularly in resistant breast cancer cell lines expressing estrogen receptor (ER) positivity, such as TamR MCF-7.
METHODS: The antiproliferative activity of TQ-PLGA-PF68 nanoparticles was measured using the MTS assay. The cytotoxic effects were further evaluated through colony formation assay and scratch-wound healing assay. Terminal deoxynucleotidyl transferase dUTP Nick End Labeling (TUNEL) assay was performed to determine the characteristics of the apoptosis as well as cell cycle arrest induced by TQ-PLGA-PF68 nanoparticles. The localization of these nanoparticles in the cells was examined using Transmission Electron Microscopy (TEM).
RESULTS: With a TQ concentration of 58.5 μM encapsulated within the nanoparticles, cytotoxicity analysis revealed a significant inhibition of cell proliferation (p<0.05). This finding was corroborated by the results of the colony formation assay. Treatment with TQ-PLGA-PF68 nanoparticles significantly decreased the number of surviving TamR MCF-7 cells by 35% (p<0.001) compared to untreated TamR MCF-7 cells. Concurrently, the scratch-wound healing assay indicated a closure rate of 50% versus >80% (p<0.05) in untreated TamR MCF-7 cells at 12 hours post-wounding. The TUNEL assay successfully confirmed the apoptosis characteristics associated with cell cycle arrest. TEM observation confirmed the cellular internalization of these nanoparticles, suggesting the in vitro therapeutic potential of the formulation.
CONCLUSION: In this study, a significant functional change in TamR MCF-7 cells induced by the TQ nanoparticles was observed. The unique incorporation of TQ into the PLGA-PEG and Pluronics F68 formulation preserved its bioactivity, thereby reducing the migratory and proliferative traits of drug-resistant cells. This discovery may pave the way for exploring the application of biocompatible polymeric TQ nanoparticles as a novel therapeutic approach in future studies pertaining to resistant breast cancer.
Fulltext High glycemic load diet, milk and ice cream consumption are related to acne vulgaris in Malaysian young adults: a case control study

Ismail NH, Manaf ZA, Azizan NZ

BMC Dermatol., 2012;12:13.
PMID: 22898209 DOI: 10.1186/1471-5945-12-13

BACKGROUND: The role of dietary factors in the pathophysiology of acne vulgaris is highly controversial. Hence, the aim of this study was to determine the association between dietary factors and acne vulgaris among Malaysian young adults.
METHODS: A case-control study was conducted among 44 acne vulgaris patients and 44 controls aged 18 to 30 years from October 2010 to January 2011. Comprehensive acne severity scale (CASS) was used to determine acne severity. A questionnaire comprising items enquiring into the respondent's family history and dietary patterns was distributed. Subjects were asked to record their food intake on two weekdays and one day on a weekend in a three day food diary. Anthropometric measurements including body weight, height and body fat percentage were taken. Acne severity was assessed by a dermatologist.
RESULTS: Cases had a significantly higher dietary glycemic load (175 ± 35) compared to controls (122 ± 28) (p 0.05).
CONCLUSIONS: Glycemic load diet and frequencies of milk and ice cream intake were positively associated with acne vulgaris.
Effect of ion pair on thermostability of F1 protease: integration of computational and experimental approaches

Rahman RN, Muhd Noor ND, Ibrahim NA, Salleh AB, Basri M

J Microbiol Biotechnol, 2012 Jan;22(1):34-45.
PMID: 22297217

A thermophilic Bacillus stearothermophilus F1 produces an extremely thermostable serine protease. The F1 protease sequence was used to predict its three-dimensional (3D) structure to provide better insights into the relationship between the protein structure and biological function and to identify opportunities for protein engineering. The final model was evaluated to ensure its accuracy using three independent methods: Procheck, Verify3D, and Errat. The predicted 3D structure of F1 protease was compared with the crystal structure of serine proteases from mesophilic bacteria and archaea, and led to the identification of features that were related to protein stabilization. Higher thermostability correlated with an increased number of residues that were involved in ion pairs or networks of ion pairs. Therefore, the mutants W200R and D58S were designed using site-directed mutagenesis to investigate F1 protease stability. The effects of addition and disruption of ion pair networks on the activity and various stabilities of mutant F1 proteases were compared with those of the wild-type F1 protease.
Fulltext Factors associated with physical activity barriers among adult community in Putrajaya

Mohd Tariq Mhd Noor, Hayati Kadir Shahar

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):48-48.
MyJurnal

Introduction: Prevalence of physical inactivity in the Federal Territory of Putrajaya on 2015 was 32.5% compared to 2011 with 56.5%, as reported in National Health Morbidity Survey. The public do not use the facilities as much as they should, although various facilities have been provided in Putrajaya and was selected as garden city concept town. The objective of this study was to determine the perceived barriers (personal, environmental, total barriers) of physical activity among Komuniti Sihat Pembina Negara (KOSPEN) community in Putrajaya. Methods: A cross sectional study was conducted using adopted self-administered Perceived Barriers questionnaires to assess the per-ceived barriers of physical activity with socio-demographics, economic and personal characteristic. An Independent t-test was used to test the association between independent variables with perceived barriers of physical activity. Re-sults: There were significant association between personal barriers with marital status (p
Fulltext Knowledge, attitudes, and practices of students towards total quality management in education at high institute of health sciences in Sana'a, Yemen

Mosa'ad Mohaideen, Aref Yousuf, Azimatun Noor Aizuddin

Int J Public Health Res, 2017;7(2):852-859.
MyJurnal

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
Fulltext Shear bond strength and failure mode of different dental adhesive systems

Azizah Murtuzah Shekh, Noor Azlin Yahya

Ann Dent, 2019;26(1):1-7.
MyJurnal

The study aimed to evaluate the shear bond strength (SBS) and to analyse the failure mode at the resin-dentine interface of different dental adhesive systems. A total of 75 sound premolar teeth were selected and randomly assigned into five different adhesive groups (n=15): OptiBond Solo (OBS, total-etch), OptiBond Versa (OBV, two-bottles, self-etch), Adhe SE Ivoclar (ADHE, two-bottles, self-etch), G-Bond (GB, one-bottle, self-etch), and OptiBond All in One (OBO, one-bottle, self-etch). The occlusal surface of each tooth was flattened and composite resin cylinder (4x2 mm) was built up on the flat dentine surface using a custom made mould. The specimens were then subjected to 500 thermal cycles between 5 °C and 55 °C and dwell time of 20s. The SBS test was conducted using a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed using one-way ANOVA and Dunnett T3 Test. Failure mode was determined as adhesive, cohesive or mixed mode using a stereomicroscope and the data were analyzed using Fisher's exact test. The total-etch (OBS) had significantly higher value of SBS than the two self-etch (ADHE and GB) adhesive systems. Within the self-etch systems, OBV showed significantly higher SBS value compared to ADHE and GB. There were no statistically significant differences between types of failure mode (p > 0.05) and adhesive group. It can be concluded that the different compositions in the self-etch adhesive materials may contribute to the different SBS value. The failure modes detected within all tested groups did not show clinically important differences.
Fulltext Willingness to pay for outpatient services user fees: Malaysian community perspective

Syed Mohamed Al Junid, Azimatun Noor Aizuddin

Jurnal Sains Kesihatan Malaysia, 2018;16(1):145-153.
MyJurnal

Health care services are not often accessible and available for all people in one country due to multiple reasons such as the geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcare services user fees among Malaysian population and determine its’ influencing factors. Structured interviews were conducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with open ended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptively and with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTP more than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority of respondents not WTP more than usual for private clinic simple outpatient treatment charges with the mean MYR38.76 (SD5.45). Factors that were found to have significant associations with WTP for both government and private clinic were income and having health insurance. Community willing to pay for healthcare services user fees and charges but at certain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoid from catastrophic expenditure.
Fulltext V-Shaped Bending Support helps in 3-Point Bending Test experiment for small mice bone

Noor Shafini Mohamad, Mohd Hafizi Mahmud

Jurnal Inovasi Malaysia, 2020;4(1):1-14.
MyJurnal

Three-point bending test is one of the main methods used in long bones to characterise bone material and determine the biomechanical properties. We have examined the mechanical competencies of the mouse bones at four-week-old by using a three-point bending jig so that the potential genotype-related deficiencies in mechanical properties of bones explored. The available bending jig was not suitable for small animal model and may cause slippage when applying the load. The tibial gross length measurements of the four-week-old mouse measured using the proximal anatomical point of the centre of the condyles to the distal anatomical significance of the medial malleolus (~16 mm). The mid tibia diameter measurement is taken at the middle tibia (~1 mm) and metaphyseal diameter (~3 mm). The bending jig was custom-made, where both ends support were cut in a v-shape to provide stability. The tibias were mechanically tested with the v-shape support under three-point bending using a Bose ElectroForce® 3200 until failure. The test revealed a significant result of flexural strength, work-to-fracture and strain to failure obtained from the load-displacement curves. The finding may be useful in the studies of quantitative assessments of the strength and toughness of small animal bones.
Fulltext Effect of residual toxicity of selected insecticides to the Malaysian stingless bee Heterotrigona Itama

Noor Albannia Natasya Jabi, Hazmi Awang Damit

Borneo Akademika, 2019;3(1):1-9.
MyJurnal

Heterotrigona itama is a Malaysian stingless bee species that actively reared for meliponiculture. This stingless bee is cultivated in a commercial scale for its honey production, propolis and among the greatest commercial potential as crop pollinators. However, this species has been potentially exposed to agronomic practices, among which the use of synthetic insecticides against pests.The indirect toxicity effect of the post-insecticide had affected the mortalities of H. itama especially, to the foragers. Due to that, a study has been conducted to determine the lethal concentration of 50% (LC50) and 95% (LC95) of the selected insecticides against stingless bee forager workers through residual exposure. The bioassay test was conducted to the local stingless bee H. itama at Agricultural Research Station, Tenom. Four commonly used insecticides in crop protection; Deltamethrin, Chlorpyrifos, Cypermethrin and Malathion were tested at five concentrations that diluted with 500 ml of distilled water in three replications for each insecticide. Lethal concentrations (LC50 and LC95) were obtained from probit analysis after 1-hour dry residues exposure and 24-hour mortality observation. The result shows that; all four tested insecticides were harmful to H. itama through dry residue. Deltamethrin shows the higher value of LC50 (1.256 ml) and LC95 (3.582ml) that make it less toxic to the H. itama than cypermethrin, malathion, and chlorpyrifos, however, as the concentration gets higher it becomes more toxic.
The prevalence of depression among elderly patients attending a rural primary health care clinic

Mohd Noor N, Mohd Sidik S

Family Physician, 2003;12:30-35.

Introduction: Depression is an important problem in primary care practice and is the commonest psychiatric disorder among the elderly.
Aim: To assess the prevalence of depression among the elderly patients attending a rural primary health care clinic in Malaysia and to identify its associated factors.
Method: The Geriatric Depression Scale (GDS) questionnaire was used as a screening instrument. Patients with positive GDS scores for depression were further assessed for Major Depression.
Results: 14% of the patients were found to have depression. The associated factors identified were gender, marital status, educational level, total family monthly income, living arrangement and if they had someone to confide in. Further clinical evaluation using the DSM IV Criteria for major depression revealed that two-thirds of the patients with depression were suffering from major depression.
Conclusion: The prevalence of depression among the elderly patients at a rural primary health care clinic was high. Primary health care doctors and staff should take extra care to detect depression when managing elderly patients.
Fulltext Menstrual care for individuals with disability: a case report

Nadia, A.B., Leelavathi M., Noor Azimah, M.

Medicine & Health, 2019;14(1):209-214.
MyJurnal

Individuals with disabilities have different needs and concerns at different stages of life. The arrival of puberty brings about new challenges especially for females with issues related to menstrual care involving both the patient and their caregivers. This case report is about a 13-year-old girl with Down syndrome who was cared for by her widowed father since the age of six. She was suffering from severe mental disability. Her father was concerned, because she was unable to maintain personal hygiene during menses such as changing sanitary napkins and managing stains, hence requested for menstrual manipulation. Options for menstrual manipulation for individuals with disabilities include both medical and surgical interventions. Hormonal therapy options include oral contraceptive pills, depo-provera, progestin implants and progesterone release intra-uterine contraceptive devices. Surgical options such as hysterectomy or endometrial ablation may be considered as a last resort as it is more invasive and irreversible, involving ethical and legal implications. Selection of the suitable therapy involves shared decision making between health care provider and caregiver taking into consideration the patient’s best interest. This case report also highlights the role of family physicians in managing and coordinating care on delicate issues related to menstrual care for people with disabilities. This case report may serve as a guide to physicians and families with special needs children, while approaching issues on menstrual care.

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