The aim of this study was to determine the profile of patients referred to a specialist oral medicine and oral pathology unit in Kuala Lumpur by reviewing clinical dental records received in Oral Pathology Diagnostic Service (OPDS) in Faculty of Dentistry, UKM from 2001 until 2010. A total of 547 archival biopsy clinical dental records were reviewed and analysed using SPSS version 17.0. Oral and maxillofacial diseases were frequently seen in female (1.3:1), young adults (30.0%) of Malay ethnicity (64.6%). Most of the acquired specimens were from dental specialists (n=451, 84.8%), particularly from oral and maxillofacial surgeons (OMFS) (n=349, 63.8%) compared to general dental practitioners (GDPs) (n=81, 14.8%). Almost all of the biopsy specimens were of soft tissue origin (n=462, 84.4%), derived from lining mucosa (n=197, 36.0%) and were biopsied excisionally (n=325, 59.4%) more often than by incisional biopsy (n=207, 37.8%). A large proportion of the oral and maxillofacial diseases were of reactive (n=188, 34.4%) and inflammatory (n=121, 22.1%) cause. Tumours are mainly benign (n=69, 12.6%) with only small cases are malignant (n=34, 6.2%). The most common histological diagnoses were accounted by mucocele (n=56, 10.2%), pyogenic granuloma (n=47, 8.6%), fibroepithelial polyp (n=38, 6.9%), radicular cyst (n=33, 6.0%) and periapical granuloma (n=29, 5.3%). This study characterizes the clinical profile of patients seen in our oral medicine and oral pathology unit. Present findings can be used as a reference to the clinicians and pathologists in effective patient management and organization in the future.
Introduction. In light of the important role of health-promoting expenditure in health, the objective of this study was to investigate the socio-demographic determinants of health-promoting expenditure such as purchase of medical equipment and services, food supplements and health education services and products among Malaysian adults.
Methods Third National Health and Morbidity Survey (NHMS III) consisting of 28771 observations was used for analysis. It was the latest nationally representative cross-sectional population-based survey conducted by the Ministry of Health Malaysia from April 2006 to January 2007. A censored regression model
(Tobit) was applied to examine the factors affecting health-promoting expenditure.
Results The results showed that age, income, gender, ethnicity, education, marital status, employment status and location of residence were able to affect health promoting expenditure. In particular, individuals who were younger, poor, males, Indian/others, less educated, unmarried, unemployed and residing in rural areas tended to spend less money on health promotion compared to others.
Conclusions This study reached a conclusion that socio-demographic factors were significantly associated with individual’s preferences for health promotion. Therefore, the government should devote its attention to these factors when
formulating nationwide health policies.
Study name: National Health and Morbidity Survey III (NHMS-2006)
Introduction The availability of obesity specific quality of life measurement tool is limited. The Malay version of Impact of Weight on Quality of Life-Lite is an obesity specific quality of life questionnaire which has been translated for use in Malaysia. The aim of this study is to evaluate the validity and reliability of this questionnaire to measure quality of life among different body mass index (BMI) groups.
Methods One hundred and twenty subjects with different BMI categories who attended an outpatient government clinic were recruited for this study. The translated Malay version of IWQOL-Lite was used to assess the impact of weight on quality of life of respondents. Content validity, criterion validity and construct validity were used to assess the questionnaire validity while internal consistencies and test-retest reliability were used to assess the questionnaire reliability.
Results The Malay version of IWQOL-Lite showed good psychometric properties. The content validity was agreed upon by expert panels. The mean score of all IWQOL-Lite domains were able to discriminate between different BMI groups. Good internal consistency was demonstrated by Cronbach alpha of 0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function score (IWQOL-Lite) correlated positively with Physical Component Summary of Short Form-36 questionnaire. Exploratory factor analysis found that the questions loaded on their respective five domains.
Conclusions The results suggested that the Malay version of IWQOL-Lite is a valid and reliable tool to measure quality of life among obese and overweight subjects in Malaysia.
In the cold winter month of January 2012, two post graduate students from the Department of Community Health, Universiti Kebangsaan Malaysia (UKM), went on a two weeks field attachment with the Division of International Health (Public Health), Niigata University Graduate School of Medical & Dental Sciences (NU). This report is an account of our first hand learning experience about the public health system and culture in Niigata, Japan. Famously known as the 'Snow Country', Niigata prefecture is approximately 350 kilometers north of Tokyo, in the middle of the west coast of Honshu island, facing the Sea of Japan. It borders on the east with Fukushima prefecture, which was badly affected by the great tsunami disaster in March 2011. Niigata has a population of two and a half million, of which 21.3% is above the age of 65. Niigata University is located in Niigata City, the capital of Niigata prefecture. This attachment was under the UKM-Global Student Mobility Programme (Outbound) and it was taken as an opportunity to improve the memorandum of understanding between UKM and NU. The objectives were to gain knowledge and experience in various public health issues in a developed nation like Japan. Specifically, we were interested to learn about the local public health programmes, the influenza surveillance system, public health programmes for the elderly population, the Geographical Information System (GIS) and the Japanese culture in general. (Copied from article).
Rapid Rural Appraisal (RRA) is a systematic, semi-structured activity carried out in the field by a multidisciplinary team that is designed to obtain new information and hypotheses about rural life. This article reports the results of an RRA conducted in Kampung Paris 1 (KGP1), Kinabatangan, Sabah under the Annual Health Promotion Program of the School of Medicine, Universiti Malaysia Sabah. A systematic random sampling was used to recruit the villagers and data was obtained through compilation of pre-existing data, field observation, structured interviews with key informants and villagers. Cardiorespiratory diseases were prevalent in KGP1. Common water sources such as rain water collected in dug wells in KGP1 were unhygienic. Dangerous toxic fumes were produced by the burning of municipal wastes nearby village houses. The villagers of KGP1 were exposed to various farm animals, which may harbor zoonoses. Health care services are limited in KGP1. Villagers who were not poor (>RM897) represented 48% of the population, followed by the poor (RM503-897), 20% and the hardcore poor (1.00 person per bedroom. Poor water hygiene, polluted air from open burning, exposure to farm animals, poverty, poor education, overcrowding and inadequate health care services were among the few possible factors affecting the health of villagers in KGP1. Formal rigorous research should be conducted in the future to facilitate specific health interventions in areas of need such as KGP1.
Belaga District, in the heart of Borneo, is probably the most remote district in Sarawak. Although Belaga town is now accessible by land (50% are timber camp unsealed road) from Bintulu, the journey takes 5 hours and transport cost is high. Accessibility to Belaga by river is also subject to weather conditions and the town often gets cut off during the dry season and also during the wet season. All these pose immense challenges to the delivery of health care services to the people of Belaga and greatly reduce their accessibility to even basic health services. Access to specialist services is even more challenging as it is only available in Sibu and Bintulu; and visiting clinics in Belaga are infrequent due to the shortage of specialists and difficult transport. (Copied from article).
Accepted 11 August 2011.
Introduction Despite of its importance for preventing fatal and severe injuries in an event of a crash, limited studies were conducted to find out the status of seatbelt use among rear passengers in Malaysia. This study was conducted to the determine seatbelt use among rear passengers in Malaysia in conjunction with the introduction of the rear seatbelt law that took effect on 1st January 2009.
Methods Two methods were used; the roadside observations and surveys. A total of 4180 rear passengers were observed during the road side observation and 793 rear passengers were interviewed in the survey.
Results About 41.8 % (95 % CI: 38.3, 45.4) of rear passengers interviewed reported that they “Always/Often’ wore safety belts, while roadside observation recorded slightly lower rate (36.2 % [95 % CI: 34.8, 37.7]). Based on the roadside observation method, male rear passengers were more likely to use rear seatbelts as compared to female rear passengers (with Odd Ratio: 1.17 (95 % CI: 1.03, 1.33)). Both methods consistently reported that rear passengers of Multipurpose Vehicle (MPV)/Sport Utility Vehicle (SUV) (survey method “always wear”: 39.3 %, Odd Ratio: 2.02 [95 % CI: 1.13, 3.61], roadside observation method: 51.9 %, Odd Ratio: 2.23 [95 % CI: 1.89, 2.62]) were two times more likely to wear seatbelts as compared to rear passengers of a car.
Conclusions The two research methods indicate rear passengers in Malaysia were consistently having low seatbelt usage rate. As the rear seatbelt advocacy and enforcement programme are new in Malaysia, efforts to advocate rear seatbelt use should be strengthened. The changes in rear seatbelt usage rate need to be tracked regularly and as an alternative to roadside observation method, interview survey method could be used to measure the seatbelt usage rate and to identify the reason for not using safety belt among rear passengers.
Introduction: Validation of instruments is essential when assessing physical activity (PA). The aim of this study was to validate a Malay language version of the International Physical Activity Questionnaire (IPAQ-M) against Actical accelerometer and to determine its reliability and validity.
Methods: A total of 90 Malay adults aged 35-65 years old participating in The Malaysian Cohort project were recruited for this study. The IPAQ-M is comprised of 12 items, covering vigorous, moderate, walking, sitting and sleeping activities, and was administered on two occasions (Day 1 and Day 9) by interviewing the participants. Participants wore the Actical accelerometer for seven consecutive days between the two interview sessions. Results Validity tests showed that time spent in moderate-vigorous physical activity (MVPA) (min/wk) from IPAQ-M was significantly correlated with MVPA from accelerometer (rho=0.32, p<0.01). Time spent in vigorous activity (rho=0.44) and total activity (rho=0.36) from IPAQ-M were significantly correlated (p<0.01) with that measured by accelerometer, but no correlation was observed for sedentary behaviour. Reliability tests revealed significant correlations between the two interview sessions for all intensities of PA (rho=0.55 to 0.71, p<0.01). Bland-Altman plots showed that time spent in MVPA for IPAQ-M was significantly different from that measured by accelerometer (mean difference: 98.02 min/wk; 95% limits of agreement: -785.33 to 1317.83 min/wk; p<0.01). When classifying people into meeting PA recommendation, the agreement between the two instruments was fair (κ=0.22).
Conclusions The IPAQ-M has acceptable validity for MVPA, vigorous and total physical activity, and was reliable for assessing the physical activity of Malay adults.
Keywords Health care workers - Knowledge - Practice - Universal precaution - Health center.
Study name: The Malaysian Cohort (TMC) Project
Introduction Physical activity assessment in children is the first step in assessing the
relationship between activity and health, as well as the determinants of
childhood physical activity and changes in activity level.Physical Activity
Questionnaire for Older Children (PAQ-C) is self- administered
questionnaire to assess physical activity among older children. The objective
of this study was to determine the validity and reliability of Physical Activity
Questionnaire for Older Children in Malay language PAQ-C (M).
Methods The validation study was done among 73 students aged 10 to 17 years old.
The PAQ-C was translated into Malay language using forward and backward
translation. The evaluation of the psychometric properties included internal
consistency, test-retest reliability and criterion validity. Reliability of PAQ-C
(M) was determined using Cronbach alpha and intra-class correlation
coefficient (ICC). The PAQ-C (M) was administered twice in one week
interval to assess test-retest reliability. Criterion validity was assessed
between PAQ-C (M) and 3 Day Physical Activity Recall (3DPAR).
Results The internal consistency of PAQ-C (M) assessment calculated in this study
was α = 0.75 and α = 0.77 for assessments one and two, respectively. The
ICC between individual items of PAQ-C (M) was 0.59 to 0.91, indicating
moderate to good correlation. The Spearmen correlation coefficient between
PAQ-C (M) and 3DPARwas acceptable (r=0.60, p
Introduction Prolonged mechanical ventilation among cardiac surgery patient has been
found to be correlated with negative clinical outcome and increased
healthcare resources utilization. Prolonged mechanical ventilation (PMV)
was defined as the accumulative duration of 24 hours or more of
postoperative endotracheal intubation starting from transfer of the patient to
cardiac ICU. This study is aimed to identify the risk factors preoperative,
intra operative and postoperative for prolonged ventilation among cardiac
patients in AL-Thawra Modern General Hospital (TMGH).
Methods Observational study design was conducted during a two-month period (from
1 August 2014 to 30 September 2014). It was among 70 patients who were
admitted to cardiac surgery intensive care unit in Al-Thawra Modern General
Hospital and selected by convenient sampling. The soci-demographic
characteristic and clinical patient data were collected using short
questionnaire developed by researcher. All patients had the same anesthetic
and postoperative management. Statistical analysis was performed with SPSS
version 20 and using bivariate analysis and multivariate logistic regression.
The p-value of < 0.05 was found to be statistically significant.
Results Incidence of prolonged mechanical ventilator post cardiac surgery was 37.1%
(26/70) through bivariate analysis, multivariate logistic regression. Low
Ejection fraction of Left Ventricle was inversely related to mechanical
ventilation time (AOR= 0.872) with 95% confidence interval [0.790 - 0.963],
hemodynamic instability were associated with prolonged mechanical
ventilation time (AOR=16.35) with 95% confidence interval [2.558 -
104.556].
Conclusion Low ejection fraction of Left Ventricle and Hemodynamic Instability post
operation were identified risk factors for prolonged mechanical ventilation
post cardiac surgery.
There is an enduring disconnect between the routine surveillance of mosquitoes that transmit dengue viruses and control activities to limit disease spread. A great variety of methods used to collect vector surveillance data exists globally, with program design typically influenced by historical, socio-cultural and cost factors. Surveillance data can be expensive to collect, meaning that without demonstration of its usefulness in directing mosquito control it may be deprioritized or even abandoned. Given that universally prescribed surveillance methods are unlikely to be sustainable and successful, we propose that strategies be designed according to the local terroir of dengue transmission. Strategy design should consider not only costs, but the amenability of workers and the public to various methods, the utility of methods for directing control and reducing disease, and the underlying spatial structure of the vector populations locally. A process of evaluating each of these factors should precede strategy design and be part of on-going review processes. In the case that the usefulness of vector surveillance cannot be demonstrated, then it may be argued that resources could be allocated to other aspects of disease control.
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)
version 20.0.
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
population.
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. .
Medical and health insurance provides financial protection against the consequences of the occurrences of health risks. Different perceptions have led to resistance to change, as well as the acceptance level from Malaysians. It is fundamental to study the reception and acceptance of all types of insurance schemes by Malaysians and to identify the knowledge and information pertaining to reception by Malaysians. A systematic search was performed from six major search engines from 2013– 2018 in searches of published articles on factors that influence the demand or willingness to pay for health insurance among Malaysians. There were nine articles included, in which personal factor was found to influence the most when demanding for health insurance. Higher education level, younger age group, and good knowledge were associated with higher demand for health insurance. Higher household monthly income and the cost to pay were among the positively significant economic determinant factors to demand for medical insurance. Education and promotion are important to understand why such policies were introduced and how they intend to serve the public before implementing major policies. These elements capture the essence of ‘health promotion’, which is about enabling people to take control over their health and thereby, improving their health.
The World Health Organisation (WHO, 2006) defines teenage pregnancy as a 'teenaged or underaged girl (usually within the ages of 13-19) becoming pregnant.' The term usually refers to women who become pregnant, who have not reached legal adulthood; legal adulthood varies in different countries. The term teenage pregnancy is widely used however, to mean unmarried adolescent girls who become pregnant. Pregnant teenagers face many additional obstetric, medical & social issues compared to women who give birth in their 20s and 30s. Most at risk are mothers under fifteen and those living in developing countries. Complications during pregnancy and delivery are the leading causes of death for girls aged 15 to 19 in developing countries; they are twice as likely to die in childbirth as women in their twenties, with adolescents accounting for 13% maternal deaths worldwide. There is evidence to show (UNICEF Malaysia, 2008) that teenage pregnancy is associated with lower educational levels, higher rates of poverty and that the situation is often repeated with children of teenage parents. In addition, teenage pregnancy is often outside of marriage and therefore carries a social stigma in many cultures and community.
Dengue is a disease propagated by vectors namely Aedes spp. mosquitoes. One of the effective approaches to control dengue is through integrated vector management and intervention programs. COMBI or Communication for Behavioral Impact is a strategic approach to control the Aedes population as well as dengue cases. This study was conducted at Taman Desa Kolej, Nilai, Negeri Sembilan, an suburban residential area to determine the effectiveness of COMBI, by using questionnaire and entomological survey as well as implementation of an intervention program. We carried out activities such as the establishment of COMBI promoter team, clean up events, talk shows with the residential community and distributed pamphlets containing information about dengue. Results indicated significant difference (p
Introduction The most effective and affordable public health strategy to prevent
hypertension, stroke and renal disease is by reducing daily salt consumption.
Therefore, this study aims to determine the association of knowledge, attitude
and practice on salt diet intake and to identify foods contributing to high
sodium intake.
Methods Secondary data analysis was performed on MySalt 2016 data. It was
conducted from November 2015 until January 2016 which involving Ministry
of Health Staff worked at 16 study sites in Malaysia. Salt intake was
measured using 24 hours urinary sodium excretion. Food frequency
questionnaire was used to determine the sodium sources. Knowledge, attitude
and practice of salt intake were assessed using a validated questionnaire
adapted from WHO. Demographic data and anthropometric measures also
were collected. Sodium levels of more than 2400mg/day was categorised as
high sodium intake. Data were analysed using SPSS software version 21.
Results The mean sodium intake estimated by 24 hours urinary sodium excretion was
2853.23 + 1275.8 mg/day. Food groups namely rice/noodles (33.8%),
sauces/seasoning (20.6%), meat and poultry (12.6%) and fish/seafoods
(9.3%) were the major contributors of dietary sodium. In multiple logistic
regression analysis, being a male (aOR=2.83, 95% CI 2.02 – 3.96) and obese
(aOR=6.78, 95% CI 1.98 – 23.18) were significantly associated with high
urinary sodium excretions. In addition, those who were unsure that high salt
intake can cause hypertension (aOR=1.24, 95% CI 0.65 – 2.36), those who
think that they consumed too much salt (aOR=2.10, 95% CI 1.13 – 3.87) and
those who only use salt rather than other spices for cooking (aOR=2.07, 95%
CI 1.29 – 3.30) were significantly associated with high urinary sodium
excretion.
Conclusions This study showed that the main sources of sodium among Malay healthcare
staff is cooked food. Poor knowledge and practice towards reducing salt
consumption among them contributes to the high sodium consumption. The
practice of healthy eating among them together with continuous awareness
campaign is essential in order to educate them to minimize sodium
consumption and to practice healthy eating.
The increase in car usage due to economic prosperity has led to increase in occupant injuries. One way to reduce the injuries encountered by road accident victims is by implementing the rear seatbelt (RSB) law. Rear seatbelt wearing has been proven to save lives. In Malaysia, the implementation of the restraint system for front occupant has started in the 70's. However, the rear seatbelt enforcement law only came in 2009, after six months of an advocacy program. Prior to the introduction of the rear seatbelt law, rear seatbelt wearing rate was rather low, started to increase gradually during the advocacy period and jumped to the highest level after two month of the enforcement. This paper attempts to assess the effectiveness of the rear seatbelt intervention in reducing injuries among passenger car occupants in Malaysia using the generalized linear model (GLM). In GLM procedure, the dependent variable is the number of people from passenger vehicles that sustained severe and slight injuries, for the study period. The study period selected covers six months before implementation, six months during advocacy program, and six months after the law is implemented. The independent variables considered are enforcement and balik kampung activities (both are dummy variables) and time effect. Our results suggest that RSB intervention (p-value= 0.0001) had significantly reduced the number of people sustained serious and slight injuries by about 20%. The implementation of change in the RSB law has benefited not only in reducing the number of injuries but also result to great impact to the health outcomes.
OBJECTIVE. Chronic obstructive pulmonary disease (COPD) is a one of the major cause of death and disability worldwide. This study aimed to compare the quality of life (QOL), Activity of Daily Living (ADL), Pulmonary Function Test (PFT) and general health symptoms pre and after hospital-based respiratory physiotherapy program among COPD patients. METHODS. Pre and post intervention study was conducted between January and July 2010. A total of 54 subjects aged between 30 to 40 years old were recruited for this study using universal sampling method from Alzawia Teaching Hospital, Libya. Data collected were socio-demographic data, QOL (before and after the intervention) using the Short Form-36 (SF-36) questionnaire, ADL using the Barthel Index and the General Health Symptoms.
RESULTS.. The mean SF-36 score for QOL is 30.13 (SD = 8.06) and 63.46 (SD = 13.53) before and after the physiotherapy respectively (with the p <0.0001). Patients’ Activity of Daily Living mean scores are 70.18, (SD = 16.50) and mean = 88.89 (SD = 13.28) before and after program (p< 0.0001). The general medical condition mean score after respiratory physiotherapy is 3.72 as compared to 4.96 before the respiratory physiotherapy (p< 0.0001). Pulmonary Function Test shows improvement in actual/predicted FEV1 ratio in all 54 cases with mean improvement from 55.85 before to 81.67 after the pulmonary physiotherapy (with the p <0.0001).
CONCLUSION. Hospital based respiratory physiotherapy program had significantly improved QOL, pulmonary function and activities of daily living among the subjects.
Air pollution has been widely known to have an influence on health of the general population.
Air pollution can result from natural causes, human activities and transboundary air pollution.
Weather and climate play crucial role in determining the pattern of air quality. In recent years,
air pollution and recurrent episodes of haze has become a major concern in Malaysia.
Surveillance data on concentrations of main air pollutants such as carbon dioxide, (CO2),
Nitrogen Dioxide (NO2), Ozone (O3), sulphur dioxide (SO2) and particulate matter (PM10)
were found to be higher during the haze days and this may have an impact on health of the
community as reflected by an increase in hospital admissions particularly the respiratory and
cardiovascular diseases.