METHODS: This study adopted a focused ethnography design within a constructivist research paradigm. Participant observations and semi-structured interviews were conducted with 21 parents, 21 children and 19 nurses in a paediatric oncology unit in Malaysia. All observation fieldnotes and interview recordings were transcribed verbatim. A focused ethnographic data analysis technique was performed to analyse the data.
RESULTS: Three themes emerged regarding parents' roles in the communication and decision-making processes involving their children: i) facilitators of communication; ii) communication brokers and iii) communication buffers.
CONCLUSION: Parents controlled decision-making processes concerning their children, while children preferred and welcomed parents as consultants in the decision-making processes regarding their health care.
METHODS: A retrospective cross-sectional study was performed on patients who received IVIG in Hospital Kuala Lumpur. Data were extracted from the request forms for IVIG recorded in the Pharmacy Department from January 2018 until December 2019. Chi-squared test and t-test analysis were used for statistical analysis, and a P-value of < 0.05 was considered significant.
RESULTS: A total of 482 patients received IVIG in Hospital Kuala Lumpur. There were 243 (50.4%) females and 228 (47.3%) males with median age of the patients was 27 years old. The highest indications for IVIG among all patients were hypogammaglobulinemia and other deficiency states in 127 patients (26.3%). The most common indication for one-off treatment in adults was hypogammaglobulinemia and other deficiency states, 35%; whereas in paediatrics, it was Kawasaki disease, 20.3%. The highest indication for regular therapy among adult patients was chronic inflammatory demyelinating polyneuropathy (23.4%), while in paediatrics it was sepsis (31.1%). The clinical category was associated with the frequency status of IVIG usage in both adult and paediatric cohorts with P = 0.004 and P = 0.017, respectively.
CONCLUSION: There were significant differences between the indication of one-off treatment and regular therapy among adult and paediatric patients. A national guideline on the prescription of IVIG for patients is instantly needed to help clinicians in prescribing IVIG appropriately.
OBJECTIVES: The study aimed to describe the epidemiology and factors associated with TB mortality in Manjung district, Perak, Malaysia.
METHODS: All confirmed TB cases from 2015 to 2020 registered in Manjung district under Sistem Maklumat Tibi (MyTB) were included. Factors associated with TB mortality were analysed by using simple and multiple logistic regression analysis.
RESULTS: A total of 742 TB cases were included in the analysis, from which 121 cases (16.3%) died before completing their treatment. The highest death was reported in 2020 (25.7%) and the lowest in 2019 (12.9%). From multiple logistic regression analysis, age 45 years old-64 years old (adjusted OR = 3.62; 95% CI: 1.38, 9.54), > 65 years old (adjusted OR = 8.67; 95% CI: 3.17, 23.74), non-Malaysian (adjusted OR = 5.18; 95% CI: 2.04, 13.14), cases notified by government hospitals (adjusted OR = 6.78; 95% CI: 3.04, 15.09), HIV-positive status (adjusted OR = 8.60; 95% CI: 3.58, 20.67) and HIV testing not offered/unknown (adjusted OR = 2.58; 95% CI: 1.18, 5.62) were significantly associated with TB mortality.
CONCLUSION: This study found that TB patients who were 45 years old and above, positive HIV, late diagnosis and are foreigners had a higher risk for TB mortality. Early diagnosis, optimised screening and close monitoring should be practised to reduce TB mortality.
METHODS: A randomised controlled trial in a parallel, single-blinded study involving 60 OAG patients was conducted. The patients were randomised into FCDT or NFDT based on a block randomisation technique. A pre-study run-in with Gutt timolol was administered for two weeks. IOP was assessed at baseline, month 1 and month 3, with a bottle weight measurement at month 3.
RESULTS: Only 55 OAG patients were analysed, with 8.4% dropping out. A statistically significant mean IOP reduction was observed in each group from baseline to month 1 (FCDT: mean difference [MD] = 4.93, 95% confidence interval [CI] = 4.00, 5.86); NFDT: MD = 4.92, 95% CI = 4.024, 5.82) and from baseline to month 3 (FCDT: MD 5.17, 95% CI = 4.19, 6.15; NFDT: MD = 4.85, 95% CI = 3.874, 5.82). The overall FCDT mean IOP was significantly lower by 1.02 mmHg (95% CI = -2.01, -0.02) than NFDT (F(1, 53) = 4.19; P = 0.046). A significant interaction was observed between time and treatment at month 3, with the mean IOP for FCDT being lower by 1.22 mg than for NFDT (P = 0.037). The mean adherence score was significantly higher in the FCDT group than in the NFDT group (t stat (df) = 3.88 (53); P < 0.001). The reduction in IOP between the groups became non-significant after adherence was adjusted (F(1, 52) = 2.45; P = 0.124).
CONCLUSION: Both drugs showed a decrease in IOP but more so in FCDT. However, no difference was found in terms of medication adherence. An emphasis on treatment compliance is needed.
METHODS: Forty-eight young female college students were assigned into four groups: i) 16S (16 weeks of sedentary activity); ii) 8E×8S (8 weeks of exercise followed by 8 weeks of sedentary activity); iii) 8H8S (8 weeks of honey supplementation followed by 8 weeks of sedentary activity) and iv) 8E×H8S (8 weeks of combined exercise and honey supplementation followed by 8 weeks of sedentary activity). Blood samples were collected from the participants prior to the intervention, at week 8 and at week 16 for the analysis of bone metabolism markers and antioxidant status.
RESULTS: At the mid test, bone speed of sound (SOS) (P < 0.01), serum alkaline phosphatase (ALP) (P < 0.001) and serum osteocalcin (P < 0.01) were significantly higher in the 8E×H8S group as compared to 16S group. After 8 weeks of cessation of exercise and honey supplementation, bone SOS was also significantly higher (P < 0.001) in the 8E×H8S group as compared to 16S group. In addition, the serum total calcium (P < 0.001), serum ALP (P < 0.01), total antioxidant status (TAS) (P < 0.01) and glutathione (GSH) (P < 0.01) in the 8E×H8S group were significantly higher at the post-test as compared to their respective pre-test values.
CONCLUSION: These findings demonstrate that there was improved maintenance of the beneficial effects induced by 8 weeks of combined exercise and honey supplementation on bone properties and the antioxidant status after 8 weeks of cessation of exercise and honey supplementation as compared to exercise and honey supplementation alone.
METHODS: In this cross-sectional study, data of patients presented with ocular trauma injury to the Ampang Hospital during the COVID-19 era from 18 March 2020 to 17 September 2020 were retrieved and compared with the similar period of the previous non-COVID-19 era year.
RESULTS: Among the total number of 453 patients, 76.82% (n = 348) were predominantly males. The commonest age group was between 21 years old-40 years old (49.45%, n = 224), and the commonest location of ocular trauma injury occurred at the workplace (38.19%, n = 173); welding was the commonest work-related injury (13.83% in 2019; 12.50% in 2020). Injury-to-treatment time was significantly longer during the COVID-19 era, where patients who sought treatment within a day of injury were 27.27% (n = 69) in 2019 and 18.50% (n = 37) in 2020 (P = 0.030). During the COVID-19 pandemic, patients with vision worse than 6/60 on presentation were higher at 8% compared with 3.56% before the COVID-19 pandemic (OR = 2.35; 95% CI: 1.01, 5.48; P = 0.047). Similarly, patients with a vision worse than 6/60 post-treatment during the COVID-19 period were significantly higher at 7.00% compared with 1.58% before the COVID-19 pandemic (OR = 4.72; 95% CI: 1.53, 14.62; P = 0.007).
CONCLUSION: The majority of ocular trauma cases in this study population were male adults between 21 years old and 40 years old, and welding was the commonest work-related injury. COVID-19 era has a higher percentage of patients presented with severe visual impairment, longer injury-to-treatment time and poorer post-treatment visual outcomes.
METHODS: A convenience sampling method was used in a cross-sectional study of 290 undergraduate Health Sciences students in public universities. The Perceived Stress Scale (PSS-10) was used to measure the perception of stress, and the Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure perceived social support from three sources, including family, friends and significant others.
RESULTS: A statistically significant correlation was found between the stress level and the total score of the MSPSS (r = -0.432), perceived social support from family (r = -0.429), significant others (r = -0.328), and friends (r = -0.219, P < 0.001). Over three-quarters (73.4%) of the students have a moderate stress level (mean = 21.17, SD = 5.75). The highest social support perceived was from a family (mean = 5.21, SD = 1.48).
CONCLUSION: The study suggested that social support from family is the strongest for students to go through the stress of tough times. It also highlighted the need for attention to stress management among undergraduate students for healthy well-being. Future studies that involve other academic fields of study and qualitative research would give useful information on perceived social support among students.
METHODS: This was a pilot prospective observational study involving 12 pregnant Malay women without any endocrine disorders and on neither antibiotics nor probiotics. Demographic details and anthropometric measurements were obtained, and the faecal 16S ribosomal ribonucleic acid (rRNA) metagenome microbiota of the first and third trimesters (T1 and T3) were analysed. Univariate and multivariate statistics, partial least squares discriminant analysis (PLSDA) and Kendall rank correlation testing were used to identify key genera and associations with pregnancy trimester and body mass index (BMI).
RESULTS: The most abundant phyla were Bacteroidetes, Firmicutes, Proteobacteria and Actinobacteria, with significant differences in composition at the genus level demonstrated between T1 and T3. Sequencing showed a statistically significant difference in beta diversity between normal and abnormal BMI at all taxonomic ranks (R 2 = 0.60; Q 2 = 0.23) and genus levels (R 2 = 0.57; Q 2 = 0.37). The relative abundances of Akkermansia (P < 0.05; false discovery rate [FDR] < 0.05), Olsenella (P < 0.05; FDR < 0.05) and Oscillospira (P < 0.05; FDR < 0.05) were found to be significantly higher in normal BMI cases by 2.4, 3.4 and 3.1 times, respectively.
CONCLUSION: Three genera (Akkermansia, Olsenella and Oscillospira) were correlated with normal BMI during pregnancy. All three could be promising biotherapeutic targets in body weight regulation during pregnancy, subsequently reducing complications associated with higher BMI.
METHODS: The Trypan blue viability assay used to examine cell death. Immunofluorescence assay, glial fibrillary acidic protein (GFAP) was used to portray the morphology of astrocytes. The hypoxia-inducible factor 1 (HIF-1) staining was performed to confirm hypoxia induced cell death and there was a dramatic expression of HIF-1α displayed in exposed astrocyte cells compared to the control. In molecular level, genes were chosen, such as glyceraldehyde 3-phosphate dehydrogenase (GAPDH), GFAP, HIF-1α and B-cell lymphoma 2 (Bcl-2) and ran the reverse transcription-polymerase chain reaction (RT-PCR).
RESULTS: Microscope revealed a filamentous and clear nucleus appearance in a control whereas the rupture nuclei with no rigid structure of the cell were found in the 3% oxygen. The control and hypoxia cells were also stained with the annexin V-fluorescein isothiocyanate (annexin V-FITC). Fluorescence microscope reveals astrocyte cells after hypoxia showed higher expression of nuclei but not in control. Merging PI and FITC showed the differences of nuclei expression between the control and hypoxia. In the molecular analysis, there were significant changes of GFAP, HIF-1α and Bcl-2 in hypoxia exposed cells when compared to the control group.
CONCLUSION: Cells that were exposed to hypoxia (3% oxygen for 15 min) clearly showed damage. General view of human hippocampal astrocyte genomic response to hypoxia was obtained.
METHODS: A cross-sectional study was conducted in five schools in Jeddah, Saudi Arabia, among a representative random sample of female adolescent students aged 13 years old-18 years old. A simple random sampling method was used to select the participants. An online self-administered questionnaire, the Arabic version of eating attitude test (EAT-26) and socio-cultural attitudes toward appearance questionnaire (SATAQ-4), was used.
RESULTS: More than half (53.6%) of adolescent girls scored at or above the cut-off point of EAT-26. Around 45% of the participants had experienced family influence on their appearance and body shape, 36.7% had experienced peer influence on these factors, and 49.4% had experienced media influence. Family influence was significantly associated with EDs (P = 0.013).
CONCLUSION: The high prevalence of EDs among female going-school adolescents in Jeddah, Saudi Arabia, is of great concern. To mitigate this problem, effective programmes must be designed to change their dietary habits while considering the effects of family, peer and media influence, as well as focusing on the importance of eating breakfast and practising physical activity.