Introduction Anxiety and depression were known to bring detrimental outcome in patients
with ischemic heart disease (IHD). Notwithstanding their high prevalence
and catastrophic impact, anxiety and depression were unrecognized and
untreated. The aim of this study was to determine the prevalence of anxiety
and depression among IHD patients and the association of this condition with
clinical and selected demographic factors.
Methods This was a cross-sectional study on 100 IHD patients admitted to medical
ward in UKMMC. Patients diagnosed to have IHD were randomly assessed
using Hospital Anxiety and Depression Scale (HADS) and Perceived Social
Support (PSS) Questionnaire. Socio-demographic data were obtained by
direct interview. Fifteen percent of IHD patients in this sample were noted to
have anxiety, fourteen percent noted to have depression while thirty two
percent was noted to have both anxiety and depression. Patients’ age group
and the duration of illness were found to have significant association with
anxiety. Socio-demographic data were obtained by direct interview.
Results Fifteen percent of IHD patients in this sample were noted to have anxiety,
fourteen percent noted to have depression while thirty two percent was noted
to have both anxiety and depression. Patients’ age group and the duration of
illness were found to have significant association with anxiety. The other
clinical and selected demographic factors such as gender, race, marital status,
education level, occupation, co-existing medical illness and social support
were not found to be significantly associated with anxiety or depression
among the IHD patients.
Conclusions In conclusion, proper assessment of anxiety and depression in IHD patients,
with special attention to patients’ age and duration of illness should be
carried out routinely to help avert detrimental consequences.
Introduction Physical activity reduces risk of non-communicable diseases. Physical
activity prevalence is low due to barriers to physical activity. This study was
conducted to translate the Barrier to Physical Activity (BPA) questionnaire
into Malay and assess the reliability and validity of the translated version
Methods The Malay version of BPA was developed after translating the English
version of BPA through back to back translation process. The Malay BPA
was distributed among 306 volunteered nurses from 5 government hospitals
in Selangor state. Factor analysis, Cronbach’s alpha test and test – retest
reliability was conducted to determine psychometric properties of BPA.
Results Chronbach’s alpha coefficient was 0.79 for perceived benefits items and 0.51
for perceived barrier items (overall was 0.73). The ICC was 0.88 (95% CI:
0.78-0.93) for test-retest testing after 7 days. Two factors components were
yielded through exploratory factor analysis with eigenvalues of 3.9 and 2.0
respectively. Both the factors accounts for 31.4 % of the variance. Factor 1
included 14 items and explained 19.9% of the variance. Factor 2 consisted of
5 items and explained 11.5% of variance. CFA yielded two factor structures
with acceptable goodness of fit indices [x2/df = 23.99; GFI = 0.82, SRMR =
0.09; PNFI = 0.49 and RMSEA = 0.10 (90%CI = 0.09-0.11)].
Conclusions The Malay version of BPA had demonstrated satisfactory level of validity
and reliability to assess barriers to physical activity. Therefore, this
questionnaire is valid in assessing barriers to physical activity among
Introduction There is a strong and increased worldwide interest on the aspects of
prevention of oral disease and oral health promotion in dental education.
However, some studies imply that dental students are not knowledgeable
enough in this issue. This study aimed to evaluate the knowledge of, attitude
towards and practice on preventive dentistry among senior dental students in
Methods Self-administered questionnaires were distributed among senior dental
students in six dental schools in Yemen. The questionnaire obtained personal
information, and questions about knowledge on preventive dental care,
attitudes towards and practice on preventive dentistry.
Results Among 346 students who filled the questionnaire, a total of 91.6% has good
knowledge about fissure sealant effectiveness, only 34.7% knows about the
importance of fluoride toothpaste compared to brushing technique in
preventing caries, with significant gender difference (p=0.005). Odds of good
knowledge among non-Qat chewers was 1.9 (95%CI: 1.26-4.42).
Multivariable regression analysis indicated that female gender was associated
with higher positive attitudes (OR: 2.03, 95%CI:1.21-3.36,p=0.007).
Attitudes were significantly associated with Qat chewing (OR = 1.95,
95%CI: 1.04-3.66, p=0.03), type of university (OR = 0.59, 95%CI: 0.36-0.94,
p=0.02), and mothers' level of education (OR = 1.91, 95%CI: 1.05-3.47,
p=0.03). There was a high percentage of competency in practicing preventive
measures among students (80.9%).
Conclusions Dental education should emphasize the overall aspects of preventive dentistry
with early exposure of preventive dental training in order to improve
students' knowledge and attitudes and consequently practice on preventive
Introduction An Analysis of a Survey Questionnaire on health care workers’ knowledge
and practices regarding of infection control and complains them to apply
universal precautions. Health care workers are at substantial risk of acquiring
blood borne pathogen infections through exposure to blood or other products
of patients. To assess of infection control among health care workers in
Sana'a healthcare centers, Yemen.
Methods A cross-sectional study was conducted in the health center to assess
knowledge and practices regarding of infection control among 237 health
workers in Sana,a city. A structured self-administered questionnaires were
used and data was analyzed using SPSS version 20 and the associations were
tested with chi-square, with p-value of < 0.05.
Results The health care workers in public centers ware (51.1%) and (48.9%) of them
works in private centers. One hundred and seventeen (49.4%) respondents
had poor infection control knowledge, 113 (43.5%) had fair knowledge, and
17 (7.2%) had good knowledge. The knowledge was significantly associated
with type of center (P < 0.018), such that the public center had the highest
proportion with poor knowledge. And nurses and midwife having the highest
proportion with fair knowledge of infection control. Eight (3.4%) respondents
had a poor practice of universal precautions, 93 (39.2%) had fair practice, and
136 (57.4%) good practice. The practice was significantly associated with the
profession, level of education and work experience (P < 0.001), (P < 0.006),
(P < 0.001) respectively, and nurses and midwives as the profession with the
highest proportion with good practice.
Conclusion We conclude that the practices and knowledge of universal precautions were
low and that's need for intensive programmes to educate health care workers
on various aspects of standard precautions and infection control programmes
Smoking is one of the addiction problems that needs an effective intervention. Smoking cessation studies have shown the promising result, but the central issue was to prevent relapse. A retrospective cohort study was conducted at Quit Smoking Clinic in Klinik Kesihatan Tanglin, Kuala Lumpur to determine the outcome and predictors of smoking cessation.
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.
Health care systems play a vital role in providing health services and in optimising the population’s health of each nation. The Malaysian health care system primarily consists of the public and private health services. One of the prominent private health care services offered in the General Practitioner’s (GP) Clinic. Despite the prominent role GPs play in the health care system in this country, little is known about their practices, the issues and challenges faced by GPs in this country. The objective of this study was to describe the current GP practice operations in Malaysia in terms of its general operations, financial expenditure and revenue, market competitiveness and laboratory services offered by the clinics.
Introduction Cardiovascular diseases are a major component of non-communicable
diseases and include coronary heart disease, stroke and peripheral vascular
disease. Public health strategies to address cardiovascular disease require
three elements: surveillance, health promotion, and individual health care.
Methods Surveillance includes monitoring of mortality and morbidity as well as
surveys to monitor risk factors levels in the community. Data on mortality
from cardiovascular diseases are readily available and analysed by age and
sex specific rates looking are secular trends, geographical and ethnical group
variations and international comparisons. However many deaths from
cardiovascular disease occur suddenly and the cause of death may be
registered without autopsy or any other validation. Cardiovascular morbidity
information is more difficult to collate and interpret as it is closely related to
availability and access to health care. Periodic surveys of cardiovascular risk
factors are essential in monitoring the underlying trends in blood pressure,
smoking, cholesterol, obesity, and diabetes as they predict future trends, and
support planning for prevention and healthcare.
Results Prevention and health promotion activities are informed by the levels and
trends in cardiovascular disease and its risk factors. There has been debate
about population health promotion and individual health care strategies, but
both are necessary. Cigarette smoking, nutrition and physical exercise are the
main behaviours to be addressed but these are complex and require
multifaceted approaches. Education alone is insufficient to change health
behaviours and health promotion needs to look to changing attitudes.
Legislation, taxation and other fiscal interventions have been shown to be
effective however these can be difficult for legislators as there are other
competing interests, particularly in the area of nutrition and tobacco. Creating
health promoting environments that make healthy behaviour choices easier
can be beneficial.
Conclusions Health care interventions are also effective in reducing the burden of
cardiovascular disease. A balanced approach of health promotion and
individual health care is recommended in the development of a strategy for
Introduction Food labeling regulation has been implemented to enable consumers,
including those with chronic diseases to make healthy informed choices
before purchasing pre-packaged foods. The purpose of this study is to
determine the prevalence of obese adults in Malaysia who practice reading
food labels. It explored types of labels read and understanding of the
Methods Findings presented in this study were captured from the secondary analysis of
National Health and Morbidity Survey’s (NHMS, 2006) food label study
which focused only on obese adults (BMI > 30 kg/m2) aged 18 and above.
This nation-wide cross sectional study was conducted from April to August
2006 using an interview-based questionnaire. Complex data analysis was
done using Stata version 12.0.
Results There were 4565 obese respondents with the mean age of 33 ± 9.7 (18 – 60
years old). About 54.7% completed high-school and 9.9% were higher degree
holders. Prevalence of obese adults who claimed to read label was 80.5%
(95%CI: 79.3, 81.6). Findings showed significant results in reading and
understanding labels among all age group categories, Malay, Indian and other
Bumiputras, all education categories and married respondents. Expiry date
was the highest percentage being read (74.5%), followed by fat content
(15.3%), vitamin (11.8%) and carbohydrate (10.9%).
Conclusions The obese population in Malaysia claimed to read and understand the food
label but did not focus on specific macronutrients related to their health
condition. Findings can be used to implement effective education
programmes targeting the relevant groups to instill an awareness to read,
understand and use the label information as one of the means in combating
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
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
Introduction In Malaysia although mortality rate among women of reproductive ages has
reduced over the years, the reduction has been stagnant for the past ten years.
In order to achieve the 5th Millennium Development Goal, several measures
need to be taken including a proper implementation of pre-pregnancy
services in this country. This study explores the awareness, intention and
usage of pre-pregnancy care (PPC) services and its determinant among
women of reproductive ages in Kedah, Malaysia.
Methods This is a qualitative study, which consisted of a focus group discussion
(FGD) among women in the ages of 18 to 45 years old from all ethnic groups
who attended four government clinics in the state of Kedah. The mothers
were chosen through purposive sampling from twelve districts that were
selected through a multistage random sampling. A semi-structured
questionnaire was utilized during the FGD. The results from the FGD were
recorded verbatim and thematic analysis was finalized once saturation of
information from respondents was achieved.
Results These are two themes was identified, namely personal reasons and reasons of
service and there are several subthemes under two main themes. Under the
Personal reason themes, the subthemes including awareness and intention to
used the services, knowledge, perception, social support and history of
medical illness. While under pre-pregnancy care services themes, the
subthemes including the promotion of the services, the communication
relationship with the health staff, the waiting time and also the accessibility
of the service.
Conclusions As a conclusion, there is still part of society who was unaware of prepregnancy
services and its importance in reducing maternal mortality rate as
well as producing good pregnancy outcome. Information and knowledge on
pre-pregnancy care services should be disseminated among community
members through various means including roadshows and pre wedding
Introduction Healthy dietary practice is important in preventing diabetes, managing
existing diabetes, and preventing, or at least slowing the rate of diabetes
complication development. It is, therefore, important at all levels of diabetes
prevention. The objective of this study was to determine the association of
dietary practice with glycaemic control among Type 2 diabetes mellitus
(T2DM) patients, who received treatment from an urban Health Clinic in
Methods A total of 307 patients with T2DM aged 18 years and above participated in
this study. A pre-tested structured questionnaire with guided interview was
used to collect information on socio-demographic, clinical and dietary
practice. Anthropometric and biological measurements were also taken.
Descriptive statistics and Chi-square were used in the data analysis. Good
glycaemic control was defined as HbA1c level less than 6.5%.
Results The prevalence of good glycaemic control was only 27% (n=83). The highest
percentage of good glycaemic control were among male patients (29.1%),
aged 60 and above (33.3%), educational level of primary school (35.4%) and
those with monthly income group between RM1001 to RM1500 (32.0%).
About three quarter of T2DM patient (n=224) had poor control of HbA1c
(≥6.5%). Age (p=0.045) and working status (p=0.039) had significant
relationship with the level of HbA1c. Dietary practice showed no significant
relationship with the HbA1c level.
Conclusions Effective interventional health education strategies are needed, focussing on
modification of dietary behaviour in order to achieve glycaemic control
among diabetic patients.
Introduction The health of newborns is inextricably linked to that of their mothers. Some
maternal factors can influence neonatal survival, particularly for low birth
weight babies who are more vulnerable to diseases than normal weight
babies. The aim of this study is to assess the impact of maternal factors on
neonatal mortality among low birth weight babies in Aceh Province,
Methods Study design was unmatched case control. Data collected from 2010 to 2012
in 8 districts in Aceh province, Indonesia. Total sample was 500, divided into
250 LBW who died in neonatal period (case group) and 250 who did not die
in neonatal period (control group). There were 6 maternal variables analysed.
Results Three of six variables analysed were not associated with neonatal mortality
among LBW (P > 0.05); these were: maternal death, parity and education
level. The age of the mother had a significant association with neonatal
mortality among LBW (P < 0.05), but was not a determinant factor. The
maternal illness and birth interval were determinant factors of neonatal
mortality among LBW(P < 0.05); maternal illness (Adj OR= 2.6; 95 % CI:
1.68 - 4.0) and birth interval (Adj OR= 1.8; 95 % CI: 1.20 - 2.91).
Conclusions Maternal illness and birth interval were determinant factors of neonatal
mortality among LBW. Appropriate care throughout stages of pregnancy and
increasing women’s knowledge on high risk pregnancy are the key factors to
the decrease of the neonatal mortality related to the maternal factors.
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. .
Introduction This study investigates work engagement of employed breast cancer
survivors in comparison to unmatched control samples of healthy working
women without cancer and any other chronic diseases from the general
Methods A case-control study design using unmatched controls was adopted in this
study. The case comprised of 80 female breast cancer survivors who have
returned to full-time employment selected using purposive sampling
technique. Meanwhile, controls were 88 healthy female working women in
full time paid employment, selected using quota sampling. Questionnaire
covering socio-demographic characteristics and self-rated work engagement
measured using Utrecht Work Engagement Scale (UWES) was distributed to
the cancer survivors through face-to-face meeting during their hospital visits.
For the healthy controls the questionnaires were distributed using drop-andcollect
method through the human resource personnel of the participating
Results The results revealed, after controlling for age, marital status, ethnic group and
tenure with organization, no significant differences in the overall work
engagement was found between the breast cancer survivors [mean (SD) =
4.66 (0.92)] and the healthy controls [mean (SD) = 4.75 (0.85)]; F(1, 163)
=1.70. In comparison to the work engagement domains, only the Vigor
domain was found to be significantly lower for the survivors, survivors [F (1,
163) =14.94; p
Introduction Drug abuse has been a global threat not only in Malaysia but worldwide,
especially among adolescents. This is alarming issue had been a serious
public health problem worldwide. The aim of the study is to access the
knowledge and attitude on drug abuse among Pahang Matriculation students
Methods A cross¬-sectional study was conducted involving 217 matriculation
students. A self-determined questionnaire was distributed among the students
regarding knowledge and attitude about drugs.
Results The prevalence of good knowledge on drug abuse was (82.03%). The
prevalence of students’ attitude on drug abuse has higher number of good
attitude with the sum of 182 (83.9 %). Only gender showed a significant
association with students’ knowledge (P= 0.046).
Conclusion The knowledge, attitude, and practice of drug abuse among Pahang
Matriculation students are good.
Introduction Iodine deficiency disorders (IDD), is one of the most important micronutrient
deficiencies which has multiple adverse effects on growth and development.
The aim of this study was to determine the prevalence of IDD among school
children and to elucidate the distribution of iodized salt at household level in
Sarawak, East Malaysia.
Methods This cross-sectional study was conducted among school children aged 8 to 10
years in 2008. A multi-stage probability proportionate to population size
(PPS) cluster sampling method was used to obtain a representative state
sample of 1200 school children. Spot urine samples were collected for the
determination of urinary iodine concentration while the iodine content in salt
was determined using field rapid test kits. The thyroid status was determined
Results Response rate was 92.0% (n=1104/1200). The prevalence of goitre among
school children in Sarawak was 2.9% (5.2% in urban, 0.7% in rural). The
median urinary iodine concentration (UIC) among the school children was
102.1 μg/L (IQR, 62.3-146.5 μg/L). Urban children had significantly higher
median UIC of 109.3 μg/L (IQR, 72.4-159.0 μg/L) than their rural
counterparts [91.9 μg/L (IQR, 55.7-140.2 μg/L)]. The salt samples tested by
rapid test kit (RTK) showed only 46.0% of household salt contained iodine.
Conclusions The present study revealed that the population in Sarawak were of borderline
iodine sufficient with mild IDD seen in rural areas. Hence, the state IDD
control programmes need to encourage and advocate the consumption of
iodized salt in order to eliminate IDD-related health problems in Sarawak.
Introduction The prevalence of non-communicable diseases (NCDs) in Malaysia shows a
rising trend that influences the society in many respects. Country specific
evidence is vital for effective intervention. The aims of this study were to
identify the role of gender and urbanisation status on NCDs prevalence and
its effect on health care demand, specifically doctor visits among elderly in
Malaysia. We focused on two of the highest occurrence NCDs in the country
– diabetes mellitus and hypertension.
Methods A total of 1,414 respondents aged 60 years and above were selected using a
multistage sampling for face-to-face interview. We started the analysis with
descriptive analysis of the prevalence, taking the effect of gender and
urbanisation status of residing area. We extended the study with parametric
analysis to find the effect of these health problems on the likelihood of doctor
visits as it reflects the equity for access and utilisation issues.
Results Results showed that there were no significant difference of prevalence by
gender and urbanisation for hypertension and diabetes mellitus. By utilising
probit model, we found that those with diabetes mellitus or hypertension,
controlling for other variables, were more likely to utilise doctor services.
Conclusion This result implies that the prevalence of NCDs may further increase demand
for health care, especially in the state with a high proportion of older age
Introduction Sleep has played a very important role in maintaining our health with good
living quality therefore the aim of this study is to determine the pattern of
sleep duration, especially short sleep and its associated factors among
workers in a tertiary institution.
Methods A cross-sectional study was conducted from January until May 2012 among
128 randomly selected Universiti Kebangsaan Malaysia Medical Centre
(UKMMC) staffs. Data was collected using a guided standardized data sheet
which consist of three sections; (1):sociodemographic &socioeconomic, (2):
lifestyle and, (3): anthropometric measurement and sleep diary. Data entry
and analysis were done using Statistical Package for Social Sciences (SPSS)
Results Majority of the staffs had normal sleep duration (67.2%) followed by short
sleep duration (26.6%) and long sleep duration (6.3%). Simple logistic
regression analysis indicated that late night snacking was significantly related
to short sleep (cOR=3.47, 95% CI: 1.12, 12.23, p=0.048).
Conclusions Adequate sleep is important to maintain one’s health. Steps can be taken to
limit late night snacking in order to improve the sleep pattern in this study