Introduction: Illegal immigrants refer to the migration of people into a country in ways that violates its immigra-tion laws. A stateless person is a person who is not considered as a national by any state under the operation of its law. Interestingly, many who are stateless have never even crossed an international border. The term illegal is very loosely used in places like Sabah where it is interchanged with statelessness. As of 13 November 2018, it was estimated that there are about 12 million stateless people in the world. This review seeks to understand the current demographic situation in Sabah along with the public health repercussions of this demographic change and also to look into the success stories from around the world along with the recommendations from United Nation in solving this matter. Methods: The method used is reviewing of literature of previous studies conducted on statelessness and illegals. Local as well as international studies were reviewed. The data base used was ProQuest. Results: This review identified that one third of Sabah’s population consists of non-locals and in the past 27 years, about half a million illegal immigrants have been deported from Sabah. These numbers pose major public health repercussions from the economic, crime and health point of view. The way forward involves incorporating the United Nation Action plan with the local requirements and settings. Despite challenges, Sabah is trying its best to curb this issue and the Public health repercussions through various initiatives. We have also identified that more public health actions can be taken to reduce the negative effects. Conclusion: Dealing with the stateless and illegals is a delicate matter and there is no one way to solve it. Every country and every state are unique therefore the methods used must be tailor made. This is not something that can be solved within a short period of time and therefore persistence and perseverance is very much needed to tackle this global issue.
Women with gestational diabetes mellitus (GDM) during their pregnancy have a greater risk of developing overt diabetes mellitus and dysglycemia (prediabetes, impaired glucose tolerance or impaired fasting glucose) later in future, compared to mothers with normal pregnancy. Postpartum screening is crucial for early identification of type 2 diabetes (T2DM) in women with GDM. Nevertheless, despite various strategies, its rate remains low. A systematic review using databases of PubMed/Medline, Science Direct and CINAHL from 2008 to 2018, was conducted to iden- tify the factors influencing the attendance of postpartum diabetes screening. Open access English articles, focusing on observational studies were reviewed. Primary screening of titles and abstracts of 91 articles were done, secondary screening of 31 articles resulted in 6 articles, included in this manuscript. Various factors identified to be associated with the attendance to postpartum diabetes screening, which are age, education, ethnicity, some obstetric factors like multiparty, and history of insulin usage previously. Many women fail to be screened for diabetes during the postpar- tum period, and this delays T2DM diagnosis, which in turn gives rise to various complications. Further research that considers these factors is necessary for developing interventions to improve postpartum T2DM screening for mothers with GDM during their pregnancy.
C-C motif Chemokine Ligand 3 Like 1 (CCL3L1) is characterized as a gene with copy number variable (CNV) and clustered at the segmental duplication on chromosome 17q12. CCL3L1 is responsible for the production of mac- rophage inflammatory protein (MIP) 1α that plays an important function in the immune system and host defense. Various copies range of CCL3L1 have been reported and associated with the diseases in different populations. Thus, this review aimed to summarise the distribution of CCL3L1 copy number from different populations according to the geographical region and highlighted the lacking of data from Malaysian population, which is one of the multi-ethnic countries due to the impacts of CCL3L1 copies on various diseases. Besides, we also outlined the methodologies available for the copy number typing. In overall, this review could provide significant information on the role of CCL3L1 copies in disease association and as well as providing evidence on the population diversity.
This paper studies the muscle discomfort among police officers when carrying out their work. The objective of this study is to give a basic introduction of ergonomic problems in among police officers and risk controls in relation to minimize the ergonomics risk factors. This paper gives quick review of muscle discomfort problems and prevalence of musculoskeletal disorders (MSD) among police officer. An ergonomic application has been purposed in the liter- ature to solve the problem related with design of mechanical.
To achieve rapid economic development, many countries including Malaysia resort various activities to exploit nat- ural sources such as mining. As a consequence, mining are an important economic activity which has the potential to contribute to the development of areas endowed with the ore. Studies have been carried out in countries where the impact were on the environment and health. However, fewer studies have been carried out on the effects of min- ing on health especially the children. This paper provides a review of the process description, properties of bauxite, bauxite production and the potential health effects of heavy metals from mining ores on children’s health. The aims of this article are to evaluate the most frequently reported effect towards health and heavy metals levels in biomark- ers such as blood, urine, hair and toenail among children mining areas. Respiratory problems were most commonly reported effects associated with mining activities. Heavy metals such as lead, aluminum, chromium, nickel are also elevated from normal levels due to mining activities. Specific mitigated measures need to be taken in order to solve the problems and protect the public health especially children as they are vulnerable and represent the non-occupa- tionally exposed population.
Introduction: Nutrition education is crucial to promote healthy eating behaviours and lifestyle that can prevent nutrition related non-communicable diseases. Young children are known to be amenable to nutrition education programmes and the school setting provides ideal opportunity for young children to learn. It is important to measure the impact of such programmes to determine its usefulness. Thus, the current study described the impact of a short-term nutrition education programme in kindergarteners. Methods: This pre and post-test design study involved 20 kindergarteners (aged 6 years) at Pusat Minda Lestari, Universiti Malaysia Sabah. The participants of the programme received a nutrition education module at school which comprised of nutrition lessons on key messages in the Ma-laysian Dietary Guidelines and related hands-on activities for 30min/day on 10 consecutive school days. Main outcomes were children’s nutrition knowledge and attitude, their preference for fruits and/or vegetables in a meal and types of physical activity most frequently done. These were all measured using established age-appropriate methods and tools. Results: After receiving the nutrition module; study participants’ mean score for overall nutrition knowledge significantly improved by 60%, self-reported attitude towards healthy foods were more positive and the majority of participants (85% combined) reported that they would prefer to include either vegetables, fruits or vege-tables & fruits in their meal rather than none at all (65% preferred no fruits and vegetables at baseline). The number of participants who said they preferred doing healthier types of physical activities rather than sedentary activities increased by 40% after the programme. Conclusion: This short-term nutrition programme appeared to increase kin-dergarteners’ interest in making healthy food choices and doing moderate to high intensity physical activities. Thus, the nutrition education module used in this programme may be useful in promoting healthy eating behaviours and physical activity in young children.
Introduction: Continuous quality improvement of system is essential to improve efficiency of working environ- ment. Limited financial allocation in low resource setting results in the vicious circle of having inadequate money to purchase a new system and print paper documents that are required for the operation of clinic. A staff-initiated system improvement with the name of “PRW UMS Staff Portal” was attempted to break-free from the vicious cycle. Methods: An online system covering different aspects of routine clinical work of healthcare workers was created in Dec 2019 and implemented in Feb 2020 using Google SiteTM by the nurses of a local university community clinic, which included: submission of daily reports of nurses and assistant medical officers, submission of reports of all programmes conducted by the clinic, surveillance of health status of working staffs, announcement and request of working roster, archiving of documents, and medication inventory. The system could only be accessed using official working email for general documents while accesses to sensitive documents were restricted to relevant staffs to pro- tect privacy and confidentiality of information. Qualitative interviews were performed with all nursing staff involved. Results: Qualitative feeling of improvement in coordination of workflow was reported by all 23 staffs working in the clinic in view of the easy access of system using smartphone and computer at workstation. It also reduced the need to move away from the working station in order to access, replenish, or submit the printed documents and reports. Significant amount of paper and printing were saved monthly. Conclusions: Despite positive feedback from the staffs, the system requires further improvement in terms of function and security. Further evaluation on cost-efficiency of the system can be done to promote the system to other universities.
Introduction: Family planning practice is important among the high-risk mothers. Thus, the knowledge, attitude and practice of family planning among health care workers are very important in influencing the use of contraception among them. The objective of this study was to determine level of knowledge, attitudes and practices related to contraception among doctors and nurses in Petaling District, Selangor, Malaysia. Methods: A cross-sectional study involving 300 doctors and nurses working in the Maternal and Child Health Unit from six large public health clin-ics in Petaling district was conducted in May 2019. A self-administered questionnaire was used for data collection. Results: A total of 109 doctors and 149 nurses participated in this study. The response rate was 86%. The median duration of service in KKM and working in MCH were 9 years (IQR 6.0) and 3 years (IQR 6.0) respectively. Majority (74%) had attended CME on family planning. The mean score of knowledge was 9.0 (out of 13) (SD 1.899). In terms of attitude, 51.6% would often suggest family planning to relatives or friends. Three common perceived barriers for effective counselling on family planning were too many patients (94.5%), time constraint (91.7%) and inadequate knowledge on contraception (60.4%). Common preferred methods of contraception among users were hormonal method (33.1%), followed by barrier (condom) method (29.5%). Medical officers had better knowledge score as compared to nurses (p
Introduction: The objective of this study was to assess parental acceptance and factors that influenced their per- ceptions towards the use of dental therapists in providing treatment to children in private dental practice settings. Methods: A cross-sectional study was conducted on randomly selected parents of 11-year-old schoolchildren in Se- langor using a self-administered structured questionnaire. The survey consisted of three sections: socio-demographic characteristics, dental service utilisation and parental acceptance towards dental therapists in providing seven types of preventive and operative dental procedures. Results: The response rate was 83.1%. Overall, most parents regarded dental therapists providing dental care to their children in private dental care settings as acceptable, particularly on preventive treatment, namely ‘seeking advice on oral hygiene care' (87.8%) and ‘applying topical fluoride' (83.2%). In the multivariate analysis, younger parents and those who had preferences over private sectors were most likely to accept at least four dental procedures to be rendered to their children by dental therapists. Overall, respondents who were younger (OR = 1.40, 95% CI = 1.62, 1.92), lived in urban locality (OR = 1.77, 95% CI = 1.28, 2.45) and had a recent dental visit (OR = 1.51; 95% CI = 1.10, 2.07) were more likely to have an overall positive perceptions towards dental therapists. Conclusion: Most parents regarded dental therapists providing care to their children in private dental settings as acceptable and this was associated with their age, place of residence and past dental experiences.
Objective: This study was done to identify blood donors with thalassaemia and iron deficiency. A cross sectional study was carried out at Pusat Darah Negara (PDN), Kuala Lumpur in November 2003.
Methods: Full blood counts were done on 242 blood donors (166 males and 76 females) Hb analysis and serum ferritin assay were done for all the samples. The first time donors were used as controls.
Results: Only 20 (8.3%) donors had MCV <80 fL and MCH <26pg. Six of the 25 donors with iron deficiency had a low MCV <80 fL) and low MCH <26 pg) but all the 8 (40%) donors with thalassaemia or HbE had a low MCV and MCH! The mean ferritin levels were found to be lower among regular blood donors (95.3 ug/L) compared to first time blood donors (116.6 ug/L) but this was not statistically significant. There were 25 donors who were iron deficient: one was a first time donor and 24 were regular donors - 12 (50%) had donated 3 times a year in the last two years. Iron deficiency was seen in 12 Malays, and 9 Chinese, and 4 Indians. 13.3% of the males (22 out of 166 donors) and 4% (3 of 76) of female donors were iron deficient. Thalassaemia and HbE were found in 8 donors. HbE trait was identified in 5 Malay donors. One Malay and 1 Chinese donor had beta-thalassaemia trait. Another Chinese had alpha (a^o) thalassaemia trait. Neither HbE nor thalassaemia were seen in the Indian donors.
Conclusion: In this study thalassaemia and RbE were seen in 3.3% and iron deficiency in 10.3% of the 242 blood donors at PDN. Iron deficiency was present in 3.2% of the first time donors and 12.8% of the regular donors. Regular donors should have the serum ferritin done for their iron status and if their MCV and MCH are low, Hb analysis for thalassaemia or haemoglobinopathy.
Keywords: Blood donors, serum ferritin, iron deficiency, haemoglobinopathy
Introduction: Acute Lymphoblastic Leukemia (ALL) is the most common childhood cancer. The leukemia affects not only the quality of life (QOL) of children but also their caregivers. This study aimed to identify the Quality of Life of parents of children with ALL and to find out the association between QOL of parents of children with ALL and the selected demographic variables. Methods: A descriptive study was conducted to assess the QOL among parents of children with ALL. Non-probability purposive sampling technique was followed to select 70 parents of children with ALL attending oncology Outpatient Department in selected hospitals of Kolkata, West Bengal. Semi-structured inter- view was conducted and the ‘Adult Carer Quality of Life (ACQOL)', the standardized questionnaire was used to assess the quality of life. Results: The study findings revealed that majority (71.43%) of the parents were mother, maximum (77.14%) parents were belonged to the 30-40 years of age group, majority (42.86%) of the parents spent more than 60 hours per week for caring. It was found that majority of the clients 48 (68.57%) had perceived their quality of life as ‘Mid-range'. There was a significant association between QOL and monthly family income and time (in hours) spent for caring per week. Conclusion: The study was believed to be a helpful guide for future study on assessment of Quality of Life of any other caregivers in a large sample for better generalization.
Introduction: In Malaysia, about 800 children are diagnosed with cancer, a globally a dreadful disease, each year, and osteosarcoma accounts for approximately 3% of such cancer. The early detection of the type and extent of bone cancer is important for effective management through surgery. But, the presence of soft tissue edema around a neoplasm can interfere with accurate local tumor staging and subsequent surgical planning. However very scanty research is done on this; none of the past studies focused specifically on the incidence and quantity of extraosseous edema and its impact. Our interdisciplinary retrospective study with objectives to study the presence of soft tissue edema adjacent to the tumors in the extremities, characterize their pattern and distribution involved 82 patients of wide range of age attending the Hospital Universiti Sains Malaysia with a histologically proven tumor or tumor-like lesion of bone. Methods: This paper emphasizes avoiding misinterpretation of such edema and subsequent over-staging of musculoskeletal tumor. We exclusively used 1T-Magnetic Resonance Imaging due to its excellent resolution. All cases were imaged (T1W, T2W, T1W fat suppressed Gadolinium enhanced, and STIR images) by using 1.5 Tesla MRI unit. STIR images permit study of larger volume of abnormal tissue than spin echo images. Results: Peritumoral edema in 5 cases, Paratumoral edema in 11 patients and mixed type in 45 cases were found including 10 benign tumors. Overall, 5 malignant lesions did not show any sift tissue edema! All the data were analyzed and interpretation and charecterisation of the edema was done by an experienced radiologist. The findings were correlated with histopathology examination results. Conclusion: In conclusion, accurate definition of the local extent of a bone tumor and exploration of soft tissue edema is required to maximize the success of diagnostic work-up and staging prior to biopsy and subsequent interventions while minimizing the amount of tissue removed.
Saccular aneurysms associated with moyamoya disease are commonly located in the vertebrobasilar circulation. Anterior circulation aneurysm associated with moyamoya disease is uncommon and is usually treated by neurosurgical clipping. Objective: We report a succesful treatment using the endovascular approach in a case of ruptured anterior communicating artery aneurysm in unilateral moyamoya disease. Clinical Presentation: A 23 year old man presented with a 5 day history of headache, diplopia and fever. Computed Tomography (CT) scan and cerebral angiogram showed a bilobed anterior comunicating artery aneurysm. There was also severe M1 segment stenosis of the left middle cerebral artery with multiple collaterals, representing moyamoya vessels. Intervention: Treatment was done under general anesthesia and followed the standard practice for endovascular treatment. The aneurysm was occluded with three detachable platinum microcoils (Microplex®, Microvention®). Conclusion: Endovascular treatment can be a treatment option for ruptured anterior circulation saccular aneurysms associated with moyamoya disease.
Introduction: Tanjung Karang is a paddy growing town in Selangor, Malaysia. The paddy farmers in Tanjung Karang were using pesticides to control pests from invading the crops during agricultural activities with limited knowledge of its deleterious effects on their health. Objective: This study aims to (i) determine the respiratory health symptoms of paddy farmers due to occupational exposure of commonly used pesticides through inhalation and (ii) assess correlations between climatological conditions and the concentrations of pesticides in personal air samples among paddy farmers in Tanjung Karang, Malaysia. Methods: A cross-sectional study was carried out to assess the occupational exposures to pesticides among 83 paddy farmers in Kampung Sawah Sempadan. The data were collected with face-to-face interviews with the farmers based on a set of questionnaire. Results: The self-reported respiratory health symptoms of paddy farmers were as follows: breathing difficulty (16.9%), chest pain (15.7%), cough (41.0%), phlegm (39.8%), and wheezing (18.1%). Simple logistic regressions analysis indicated that exposure to azoxystrobin, buprofezin, chlorantraniliprole, fipronil, isoprothiolane, pretilachlor, propiconazole, tricyclazole and trifloxystrobin were contributing factors that affect self-reported respiratory health symptoms in this study. Spearman’s correlation coefficient test stated that the concentrations of chlorantraniliprole, fipronil and pymetrozine were affected by wind speed and temperature. Conclusion: The information obtained in this study is useful to understand the exposure of pesticides among paddy farmers and useful for risk management in the agricultural community.
Health-Related Quality of Life (HRQOL) is an important data in managing Chronic Obstructive Pulmonary Disease (COPD). Therefore, it is essential to determine factors that associated with HRQOL and identify the gaps for future research. A systematic search using PubMed, Science Direct and Scopus was performed to discover factors that could impact HRQOL among COPD patients. Socio-demographic factors like age, gender, educational level, smoking status, income were found associated with HRQOL. Other factors included Body Mass Index (BMI), comorbidities, sleep quality and exercise capability also could influence HRQOL of COPD patients. Other than that, lung function, dyspnea and exacerbation also found closely related with HRQOL. However, future study is needed to explore more factors such as nutritional status. Besides that, the finding only focused on general population and very little infor- mation on elderly population.
Anaemia is a common health problem during pregnancy, which leads to adverse health consequences to both moth- ers and infants. Health education is an important strategy in preventing anaemia. It’s success to improve haemoglo- bin level depends on the methods and design. This review aimed to identify the methods used and the effectiveness of health education intervention in improving anaemia in pregnancy. A systematic review of studies published in MEDLINE, CINAHL, Science Direct and PubMed from January 2010 to April 2017 was conducted using various keywords. Initial search revealed 274 articles, which later reduced to eight after being screened for inclusion crite- ria that consist of intervention study and involving pregnant women as participants. Health education intervention program with various delivery methods were proven to significantly reduce the prevalence of anaemia in pregnancy. Group discussion, health talk, poster presentation and educational pamphlet were common methods used in health education intervention.
The current study aims to investigate the validated measures used to assess anxiety in Malaysia through a systematic review. The PsycINFO and MEDLINE databases, and 28 local journals were used to search for published papers in this particular area. Twenty articles met the inclusion criteria and reviewed. The results showed that majority of the studies have validated self-report inventories, rather than structured clinical interviews. The preferred measures validated were Depression Anxiety and Stress Scale, Hospital Anxiety and Depression Scale, and General Health Questionnaire-12 item. The psychometric properties of the validated measures were also reported in this review. In general, the measures have a wide range of reliability, validity, and factor structures. However, not all of the studies adhere to the standard procedures for adapting Western-based measure. The limitations of the studies under review were also being highlighted.
Introduction: Zika infection was declared as Public Health Emergency of International Concern since year 2015. Despite of no new reported case via National Surveillance System for flavivirus, an underestimated seroprevalence might occur as the country contributes to the Asian lineage of the virus. Methods: Systematic literature search using PICO framework and PRISMA checklist across four databases for articles published from year 2013-2018 yielded 189 results, 37 articles accepted by titles following criteria were subjected to abstract screening, leaving 8 articles with clear risk proceed to full text analysis using Cochrane checklist and GRADE assessment. Results: There were four high quality articles and four low quality articles based on biases in studies. Blood product management and vac-cination are strategies strongly recommended to be implemented as Zika response while vector control and family planning are public health measures to be proposed as policy if feasible. Successful factors to improve Zika surveil-lance and management includes developing algorithm for blood product management, anti-Zika vaccine research, algorithm for new-born screening, participation of policy makers, healthcare capacity building, raising healthcare and public awareness on the infection, international funding, utilization of technology in data management and bio-logical control of vector. Conclusion: Implementation of Zika response as policy is timely, should be evidence-based and follow guidelines from WHO / CDC / FDA US after cost-effectiveness evaluation for Malaysia setting.
We describe a patient who had fever and bilateral cortical blindness and was later found to have leaking intracerebral mycotic aneurysm secondary to Staphylococcus aureus endocarditis. He had a vegetation at the .tricuspid valve with evidence of systemic embolisation, however, chest radiograph did not reveal any evidence of pulmonary emboli.
Keywords: Endocarditis, cortical blindness, mycotic aneurysm, Staphylococcus
Focal eventration involving the posterior segment of the
hemidiaphragm is a rare congenital anomaly. We report of a 10-
day-old infant who presented with significant respiratory
insufficiency and failure to show any responses to standard
treatment. The diagnosis of focal eventration of the diaphragm
was not anticipated until ultrasonographic examination revealed
the defect. Diaphragmatic plication resulted in complete
resolution of symptoms. A high level clinical awareness is
crucial as a relatively simple surgical procedure could avert long
term life-threatening complications.