Lung cancer is by far the most lethal cancer, causing approximately 1.4 million deaths in 2008. Meanwhile, tuberculosis (TB) presents a global threat. Various research and studies had been reported in correlation of pulmonary tuberculosis and lung carcinoma. These cause diagnostic challenges from the multi-faceted presentations and lesions in radiograph mimicking each other.
The number of new dialysis acceptance and dialysis prevalence rate in Malaysia has been increasing steadily for the past 10 years, and forecasting models predict that these numbers will continue to increase. Chronic Kidney Disease (CKD) awareness may slow the progression of CKD. As CKD awareness is dependent upon general knowledge of CKD, assessing the knowledge of CKD of the local population is important, to direct future CKD education efforts.
Widespread over-prescription of proton pump inhibitors (PPIs) without an appropriate indication has financial and potentially adverse clinical consequences.
Introduction: Long-term survival in beta-thalassaemia major is strongly influenced by adherence to iron chelation therapy. Identifying factors that influence the compliance remains the first step in improving iron chelation therapy. Objective:Due to increase in number of non-compliance to iron chelation therapy for patients in Hospital Keningau, Keningau, Sabah, we aim to evaluate the compliance, identify the factors and assess disease knowledge of patients so that preventive measurement can be formulated. Methodology: This was a cross-sectional study conducted in Hospital Keningau by a combination of self-administered and interviewer-administered survey. The survey consists of 3 domains – knowledge assessment based on 10 items, identifying factors for non-compliance and compliance to treatment. Percentage of compliance was measured based on amount taken reported by patients over the intended therapy. Association between knowledge and compliance was measured using Pearson’s Chi Square. Results: A number of 52 patients completed the survey. The average age was 18 ± 4.77 years. The mean knowledge score was 6.15 out of 10. The percentage of compliance to desferrioxamine was 78.2 ± 30.2% while for deferiprone it was 72.4 ± 32.6%. There were no association between knowledge score and compliance to desferrioxamine (p = 0.893) and deferiprone (p = 0.874). Lazziness and pain were the main reasons for non-compliance chosen by patients on desferrioxamine ABSTRACTCompliance and Barriers of Beta-Thalassaemia Patients towards Iron Chelation Therapy in Hospital Keningau, SabahElfira Cassandra Enderik1*, Syahrizal Azizi bin Shaharudin1, Gan Siaw Yun1, Tan Wei Chong1, Arthur James Adong1, Jackie Ho Chit Khong1, Shamadevi Pasupathi1, Maggie Low May Yee1, Sivaraj Raman1Borneo Journal of Medical Sciences (BJMS), Special Issue, Volume 2, March 2019: 7 – 81 Pharmacy Department, Hospital Keningau, Keningau, Sabah, Malaysia* Corresponding author’s email: elfira_11@yahoo.comBorneo Journal of Medical SciencesBJMSKeywords:thalassaemia, compliance, knowledge, factor NMRR Research ID: NMRR-18-404-39581
8Borneo Journal of Medical Sciences (BJMS),Special Issue, Volume 2, March 2019: 7 – 811 (3): 35 – 38(19.2%) while for deferiprone it was lazziness (23.1%) and side effects (19.2%). The poor compliance was reflected on the high average ferritin levels of respondents (7573 ± 5749). Conclusion: Even though most adolescents had knowledge about their disease, it did not affect patients’ compliance to therapy. Lazziness was the most prominent factor for non-compliance in adolescents in our study. This might be because iron chelation therapy is usually seen as a hindrance to independence. Thus in order to improve compliances, further study is needed to investigate the association between compliance and the affecting factors identified in our study.
Apoptosis is a programmed cell death which occurs following a variety of stimuli. Physiologically the process is important for morphogenesis of organs and homeostasis of different types of cells. Apoptotic cell death is responsible for a variety of pathologic states such as elimination of cell death in mutated cells, infected cells, tumour cells and transplant rejection well as the pathological atrophy. In this review, there is discussion about the control of apoptosis, detection methods of apoptosis, its association with infectious and non-communicable diseases. Intracellular microorganisms survive through inhibition of host cell apoptosis as well as they destroy the parenchymal cells causing impaired functions. It plays important role in tumourigenesis. There are possible therapeutic roles of drugs that modify apoptosis in human diseases.
Ovarian cancer is the fourth most common cancer among women in Peninsular Malaysia. Epithelial ovarian cancer accounts for 90% of all ovarian tumours. Herein, we present a rapidly growing ovarian tumour in a young female patient, following an uneventful vaginal delivery at home. We discuss on the challenges of making said diagnosis in a post-partum patient who presented with abdomen distension. A 19-yearold lady presented to the Emergency Department three days after spontaneous vaginal delivery at home. Her chief complaint was that of a rapidly progressive abdominal distension. Diagnostic and therapeutic emergency laparotomy were done, revealing a huge cystic ovarian mass. Histopathology reported a high grade, serous ovarian carcinoma. There are multiple causes for abdominal distension in post-partum women, however priority should be given into looking for gynaecological origin, given the changes in hormone. Sudden abdominal distension during post-partum period is rare and a systemic approach in its management is vital. There is, inarguably, a role of diagnostic and therapeutic laparotomy in this.
The three plasmid borne alternative dihydropteroate synthetase (DHPS) genes namely sul1, sul2 and sul3 genes were heterologous in amino acid sequence and have about 40 – 50% identity. However, they have same DHPS activity with disc diffusion zone size of 6 mm with suphamethoxazole disc in our previous study. Sul1, sul2 and sul3 genes were observed in sulphamethoxazole resistant uropathogenic Escherichia coli (UPEC). In this study, all the three genes were cloned into E. coli host and minimum inhibitory concentration (MIC) was investigated for each sul gene to compare the activities of sul genes. The MIC values of E.coli containing sul2, sul1 and sul3 genes inserted recombinant plasmid were observed to have 18.5 mg/ml, 18 mg/ml and 17.5 mg/ml respectively as mean value of five experimental results. Although comparable MICs were obtained as a result, the MIC value was highest in E. coli carrying sul2 gene indicating that this DHPS enzyme activity of sul2 was strongest among three sul genes.
Posterior capsular rupture (PCR) is a common and serious complication of cataract surgery. It complicates the process of inserting posterior chamber intraocular lens and affects the visual outcome. This study is a review on visual acuity of patients that had PCR during cataract surgery in Hospital Melaka, risk factors of PCR, and factors that cause poor visual outcome. The record of all patients that had PCR during cataract surgery from 1 January 2014 till 31 March 2017 was traced using National Eye Database (NED) and the patients’ folders were reviewed retrospectively. Data collected was demographic data, type of cataract surgery, status of surgeon, underlying ocular diseases, risks factors for PCR, postoperative visual acuity, and factors that cause poor visual outcome. There were 238 eyes that had PCR during cataract surgery, from 126 (53%) female and 112 (47%) male patients. The mean age was 66.62 years old, ranging from 9 to 87 years old. Major risk factors identified were hard cataract, polar cataract, uncooperative patients, extended continuous capsulorhexis, subluxated lens, myopia, vitrectomised eyes, and poor pupil dilatation. From 153 cases that had no pre-existing ocular diseases, 119 (78%) cases had normal vision (best corrected visual acuity – BCVA) two months after surgery, 10 (7%) cases had moderate visual impairment, and four (2%) cases had severe visual impairment. Causes of BCVA poorer than 6/18 were high astigmatism, CMO, and prolonged inflammation. Cataract surgery, even complicated by PCR, is compatible with good visual outcome if the complications are managed promptly.
Alcohol misuse compromises the quality of life of individuals, families, communities and whole societies in a variety of ways. Malaysia acknowledges the problems, implementing policies and health promotion activities in line with the World Health Organization Global Strategy to reduce the harmful use of alcohol by 10% between 2010 and 2025. Sabah, one of two Malaysian states on the island of Borneo, has more than 30 different indigenous ethnic groups. Alcohol production and consumption have traditional and unique roles in the cultural practices of many of these groups, making one common programme difficult to implement. Preliminary research suggests that alcohol is a serious problem in indigenous communities in Sabah. It also shows lack of knowledge on recommended limits for alcohol consumption and understanding of alcohol-related harm. The objective of this action-research is to produce a toolkit that will transfer knowledge and empower communities to adopt safer drinking and reduce alcohol-related harm. It must be attractive, appropriate, easily understood and be able to be tailored to suit different communities. The alcohol tool-kit was developed by a group of academicians using evidence-based information. Qualitative research methods were used to evaluate the initial alcohol tool-kit. A purposive sample of 45 village representatives was selected and divided into 5 groups for focus group discussion. Their feedback was recorded and transcribed verbatim. The alcohol tool-kit was edited accordingly. All participants agreed the alcohol tool-kit was important and can empower communities to reduce alcohol-related harm directly improving their quality of life. The amended alcohol tool-kit will be recommended for health promotion material and evaluated from time to time.
Approximately 50% patients with psychotic illnesses on antipsychotic drugs have an increased risk of obesity. This study aimed to determine changes in body weight, body fat percentage and lipid profiles and to stress the importance of early nutrition intervention in the management of psychotic illness patient treated with antipsychotic drugs. This is a prospective longitudinal study conducted for 3 months in Hospital Mesra Bukit Padang, Kota Kinabalu, Sabah. A total of 150 patients with Diagnostic and Statistical Manual IV (DSM-IV) diagnosis of psychotic illness (either Olanzapine or Risperidone only at any dosage) first started or restarted after a treatment gap of at least 6 months were recruited. Weight, height and body fat percentage were measured using Bioelectrical Impedance Analysis (BIA) (Model Omron HBF-375) and blood fasting lipid test were taken from the point of starting medication for 12 weeks. Data were analysed using repeated measures of ANOVA for statistical method. All variables showed significant mean differences (p < 0.05) in increasing pattern throughout the 12 weeks of treatment. However, the total cholesterol of risperidone patients had no significant mean difference from initial to week 6 (p = 0.282). It was proven that there was increase in body weight, body fat percentage and lipid profiles among patients on olanzapine and risperidone. The limitation of this study might relate to the drugs’ dosage and method used in assessing the body composition. It is suggested that early nutrition intervention is needed to control unnecessary gain of weight, body fat and lipid profiles in the management of patient with psychotic illnesses.
Trauma is a major health problem in Malaysia. An understanding of the trauma epidemiology is important in developing a reliable trauma service. The aim of this study is to understand the pattern of trauma in our institution and to highlight the need for a dedicated trauma service. In this database, 142 cases were included. Majority were males (127, 89.4%). Most common injury types are motor vehicle accidents (87.3%) followed by falls (7.7%) and stabs (3.5%). Most Injury Severity Score (ISS) falls under moderate score with 38.7%. Mean Abbreviated Injury Score (AIS) was 3 with most involving the chest and 90% of the patients have injuries involving at least 2 regions. Average hospital length of stay (LOS) was 11.4 days ±11.5 SD; with most patients (71.8%) were discharged without permanent disability. The mortality rate was 9.2% with all having ISS>16. ISS found to be strongly related to longer hospital stay and worse outcome (0.59, p < 0.0001, 0.4, p < 0.0001). This data is equivalent to the compared registries from 4 different trauma centres. However, steps need to be taken to improve this database. In conclusion, this university hospital receives a reasonable load of trauma cases yearly which is equivalent with other trauma centres. The increasing trauma cases will benefit from an implementation of a dedicated trauma service. This trauma database needs more depth in its elements and better data handling to ensure a quality and complete registry.
Abstracts of 4th Scientific Research Conference, organised by the Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah.
Background: Malaysia has been ranked the fattest country in Southeast Asia. Overweight and obesity are the fifth leading risk factor for death globally in 2008. It may lead to increase of risk of non-communicable diseases such as cardiovascular diseases, diabetes, cancer and hypertension.
Objectives: This research aimed to determine the prevalence of overweight and association of overweight with sociodemography, lifestyle as well as its health related conditions of adults in Kampung Tiga Papan.
Methods: Cross-sectional analytical study was used to achieve our specific objectives. A total of 199 adults aged 18 years and above in Kampung Tiga Papan had been recruited by non-probability sampling method. Sociodemographic data and lifestyle adopted were obtained via validated questionnaire, the BMI status of respondents were calculated, blood pressure was measured and DASS-21 score was used to assess mental health of the respondents.
Results: There are 118 (59.3%) respondents categorized into overweight group (BMI>23 kg/m2) and 130 (65.3%) respondents are having abdominal obesity (Waist-hip ratio: male>0.9 and female>0.8). There are significant association between gender, household-income, alcohol status and preference of food and BMI status. Besides, there are significant association between gender, household income, alcohol and smoking status and significant increased risk of hypertension in overweight group.
Conclusion: Overweight is associated to some sociodemographic and lifestyle factors. It helps to target high risk population and community intervention can be done to reduce the prevalence of overweight
Malaria is a major health problem in various parts of the world especially affecting the tropical countries. It affects the vital organs causing severe complicated malaria. Clinical syndromes like severe cerebral anaemia, coagulation abnormalities, respiratory distress and severe anaemia can increase the mortality of malaria infected cases. Variation in individual susceptibility and severity and type of clinical presentations of malaria raises the need for study of both the parasite and host immune reactions as well as the contribution of inflammatory cytokines in malaria pathogenesis. This study explored the immunopathological basis and advances of severe malaria and their importance in pathogenesis of malaria and its complications. Previous and ongoing studies indicate that changes in endothelium during the sequestration of parasites in organs causes disruption of endothelial barrier function leading to serious effects of malaria. Parasite and host factors contribute to disturbance of cytokine regulation and escape of parasites from the immune system of the host. Immunopathological changes and dysregulation of cytokine production play central role in pathogenesis and disease severity in malaria.
hildhood undernutrition while being a preventable condition remains a major public health issue because it contributes to the mortality and morbidity of children globally. Intervention to improve the nutritional status of children includes supplementary feeding, fortified foods, cash transfers and nutritional education.
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Vaccination is considered to be one of the most successful achievements of public health intervention either in developed or developing countries. “Vaccine hesitancy†is described as anyone who is suspected of vaccination or who chooses to delay or refuse vaccination. Nowadays, parental refusal or delay of childhood vaccines is increasing. The studies show that 77% of parents polled are reported of having concerns about one or more childhood vaccinations. It became a concern for the increased occurrence of vaccine preventable diseases in children.
Non-communicable diseases are the leading causes of mortality and morbidity worldwide. Non-communicable diseases (NCDs) kill 40 million people each year and accounts for 70% of all deaths globally. NCDs were previously considered to only affect high-income countries. However, they now account for a very large burden in terms of both death rates and disability in low- and middle-income countries. Also, age standardized mortality rates from NCDs are greater in these countries as compared to high-income countries. By 2020, it is predicted that these diseases will be causing 7 out of every 10 deaths in developing countries. NCDs also have potentially serious socioeconomic implications through increasing individual and household impoverishment thereby hindering social and economic development. This article is an effort to determine the magnitude and consequences of this expeditiously growing public health problem of NCDs through published literature.
Age Under Five Mortality Rate is one of the important child mortality indicators that could reflect a child’s population well-being in a society. It is defined as the probability per 1000 live births that a newborn baby will die before reaching the age of five.
Melioidosis an infectious disease caused by gram-negative bacteria, Burkholderia pseudomallei is highly endemic in Malaysia, Thailand, Singapore and parts of northern Australia. The district of Tuaran which is located on the west coast of Sabah had reported an increasing trend of Melioidosis cases where in 2017, a total of 19 cases were reported, more than doubling the number of cases reported the prior year (7 cases).
The population of Malaysia is estimated in 2018 to be around 32.04 million and 23.5% of the population resides in rural areas. The Ministry of Health has provided healthcare services to the rural areas with the access of modern healthcare facilities based on the two-tier healthcare system. In remote areas, mobile health clinic is the extension of healthcare service by the nearest static health clinic. However, most of the remote areas only covered by a community clinic or Klinik Desa which is limited for mother and child healthcare. There is demand from the people in remote areas for static health clinic or Klinik Kesihatan. Objectives: This study is to evaluate and compare the effectiveness between two health services in remote areas applied in Sabah. This study also determines which type of health services that able to worth the service to people in remote areas. Methods: This is a descriptive study. Data was taken from HMIS report (Per PL 206) under Sabah State Health Department. The data analysed by using Microsoft Excel. Results: This study was conducted based from the data obtained in 2015 till 2017 for the number of patients attended to static health clinics and mobile health clinics on selected remote areas. For example, Jambongan Health Clinic only have an average of 10 – 15 patients per day while the Mobile Health Clinic team under Beluran Health District which covers the adjacent remote areas of Jambongan Island have more than 20 patients per day on a single visit. Another example is from Terian Health Clinic in Penampang, which only have an average of 5 – 10 patients per day. However, on the mobile health team on a single visit to the village next to Terian which is Kg. Buayan, the average patients attended for the service is mo re than 20 patients. Conclusion: From the study, it was noted that people in remote areas prefer the mobile health service to visit their villages. This can be due to financial issue and limitation of transportation service to the nearest static clinic. The density of population and the development of the rural areas play important roles for the healthcare service to be effective in remote areas.
Schools provide an efficient and effective way to reach large numbers of people. In 2013, over 90% children of primary school age and over 80% children of lower secondary school age were enrolled in schools globally. Behaviours and habits are developed in early childhood. The effective way to prevent non-communicable disease (NCD) is from early education as primary prevention. This platform had been in the system since early millennium but the NCD risk factor is still increasing.