A prospective study done In al Zaafaranya General Hospital in Baghdad/Iraq In the period between April 2003 and February 2007. Ninety two patients admitted to the surgical wards diagnosed as Intestinal obstruction. The aim is to find out the possible common conditions resulting in causing this common surgical emergency. Also to compare the provisional clinical diagnosis about ischemic obstruction and the definitive post operative diagnosis. To encourage post graduate students to use their clinical abilities with the few laboratory and radiological facilities available needed to decide about the management of those patients.
INTRODUCTION: Antenatal care is widely acknowledged as an effective tool to prevent adverse outcomes in pregnant women and their children. In Malaysia, early entry to antenatal care refers to a first visit within the 12th week of gestation. Delayed access to antenatal care has not been extensively studied in Malaysia, whereas several studies have reported a high prevalence of late antenatal booking in developing countries. The objective of this study was to determine the factors and barriers associated with late antenatal booking and the level of knowledge about the timing of antenatal booking among women of childbearing age in the Lundu District of Sarawak.
METHODS: This was a cross-sectional study among 284 pregnant women in all five Maternal and Child Health (MCH) Clinics of Lundu.
RESULTS: The prevalence of late antenatal booking in Lundu was 28.2%. Unmarried women were more likely to book their pregnancy late compared to married women. The prevalence of late antenatal booking was also higher among unemployed women than those who were employed. Respondents without their own income also tended to book their pregnancy later than those who had their own income. Significantly, a high percentage of late antenatal booking was also reported among those who never utilize any contraceptive method, did not plan their pregnancy, those without a history of past medical illness or complications in a previous pregnancy and among those who have a problem with their marriage certificate. Those who booked their pregnancy beyond the 12th week of gestation were also reported to have a lower level of knowledge about the need for an antenatal booking, as compared to those who started their antenatal care early.
CONCLUSION: Unplanned pregnancy, marriage certificate issues, an absence of past medical illness and past obstetric complications were significant predictors of late antenatal booking. Correct and appropriate information relating to antenatal care should be delivered to the public. Health education and advocacy are vital to promote the importance of early antenatal booking to achieve the goal of safe motherhood.
Study site: Maternal and Child Health Clinics, Lundu, Sarawak, Malaysia
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 Kuala Lumpur.
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.
Study site: Klinik Kesihatan, Kuala Lumpur, Malaysia
Emotional and behavioural problems among children have been increasing in many western as
well as the eastern countries. Although the problem has been given attention and priority in
terms of early detection, many children with early symptoms of emotional and behavioural
problems has still not been detected at the early stages. This phenomenon is worrying as mental
health problems were shown to be stable in the long run and if left undetected it may manifest
into various problems in adulthood. This paper explores the issues on emotional and
behavioural problems in terms of its definition, prevalence, aetiology, long term consequences
and treatment. It also explores on mental health problems in a non-western country, i.e.
Malaysia including its prevalence and intervention strategies which has been carried out in
overcoming this worrying issue. Finally this review paper stresses the importance of providing
a well-designed epidemiological study in Malaysia in assessing the current prevalence of
emotional and behavioural problems in young children and adolescent
In 2015, almost half of low birth weight babies in the world were born in Southern Asia. It is contributed by multiple factors including maternal exposure to the elements in the environment during the antenatal period. Particulate matter (PM10) pollution in Southeast Asian region have been extensively studied with known attributions and sources. It is also known that PM10 is able to restrict foetal growth at molecular level. This review intends to investigate if the unborn in Asia are affected by air pollutants indirectly through their mothers. Methods Publications from Scopus and Science Direct digital databases in Asian region from 2015 onwards were reviewed. Details collected were the year of publication and study location, the study design, investigated air pollutants, exposure estimation methods used, the timing of exposure in relation to pregnancy, pregnancy outcome measured and the relative risk or odds of effect. Results A total of eight full text articles were included. Most of the studies were of cohort and quasi experimental designs, involving local air monitoring measurements to assign exposure. Conclusions There were more studies considered multiple air pollutants as contributing risk rather than a single pollutant. The exposure was measured according to stages of pregnancy and the trimester stratification is the most often method used. Modalities used in representing birth outcomes were not confined to birth weight alone but also included the length of gestation. Exposure to PM10 have been found to be associated with reduction in birth weight and increased risk for preterm birth in Asia.
Introduction This paper aims to investigate the potential pesticide dermal contamination
among the agricultural community by observing the microenvironmental and
macroactivity interaction between farm children and adult farmer.
Methods A 24 hours timeline activity was observed and recorded in the agricultural
farming village, Kuala Selangor. In this study, 2 homes were monitored for 2
days following a pesticide application. A total of 2 adult farmers and 5
children (7-10 year old) were recruited to participate in this study. Twentyfour
hour videotape segments and time-activity diaries were collected during
the study.
Results The microenvironment and macroactivity interaction were modelled in this
study. By considering only the potential dermal exposure pathway, the
different biological vulnerability and exposure pattern to pesticides were
observed. Finding showed a greater extent of interaction between human and
its environment, where adult farmers are the main contributor of
environmental contaminants, and children is one of the vulnerable receivers
of the contaminants’ residuals from the environment.
Conclusion The daily activities and behaviors practiced by the agricultural community
were among the contributing factors which help to highlight the pesticide
dermal contamination pathway in the farming village. This study
recommends the necessary to consider the microenvironment and
macroactivity of the target community when assess their exposure levels to
the environment contaminants.
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.
Introduction Tong Nibong is a Bidayuh village located at Sarawak Kalimantan border.
Since the year 2004 to 2009, a total of 537 cases of malaria were recorded in
Serian District of which 14 cases were reported from Kampung Tong
Nibong. Community empowerment programme for malaria infection
prevention showed tremendous improvement in implementation. This
intervention study aims to gauge the effectiveness of community
empowerment approach in malaria elimination programme in Kampung Tong
Nibong Serian.
Methods An intervention study was conducted with pre and post data collection. Data
was collected using validated questionnaire by face to face interview.
Universal sampling method was used to select respondents from head of
household and post data was collected after intervention activities were
carried out within a year of study period.
Results The study showed significant difference on level of knowledge of
respondents on vector of malaria between pre and post data with a P < 0.05.
There was significant difference between pre and post data on practices on
control and prevention of malaria with a P < 0.05. The same goes to level of
positive attitude of respondents towards malaria control.
Conclusions In conclusion, the study can be considered successful because there is
significant difference in knowledge, attitude and practice among the
respondents between pre and post data. This indicates that community
empowerment (voluntary participation) measures can be implemented in high
risk or endemic areas where malaria is a persistent problem to the community
and health institutions faces many limiting factors.
The aim of the Fourth Millennium Developmental Goal is to reduce mortality among children less than 5 years by two thirds between 1990 and 2015. Efforts are more focus on improving children's health. The aim of this study was to describe the trend of stillbirth and neonatal deaths in University Kebangsaan Malaysia Medical Centre from 2004 to 2010. A retrospective cross-sectional study was conducted using hospital data on perinatal mortality and monthly census delivery statistics. There were 45,277 deliveries with 526 stillbirths and neonatal deaths. More than half of the stillborn cases were classified as normally formed macerated stillbirth and prematurity was common in neonatal deaths. The trend of SB and NND was found fluctuating in this study. However, by using proportionate test comparing rate, there was a transient significant decline of stillbirth but not neonatal deaths rates between 2004 and 2006. On the other hand, the neonatal deaths rate showed significant increment from 2006 to 2008. When both mortality rates were compared using proportionate test, from the start of the study, year 2004 with end of the study, year 2010, there was no significant decline noted. Trends of stillbirth and neonatal death rates in University Kebangsaan Malaysia Medical Centre within 7 years study period did not show the expected outcome as in Millennium Developmental Goal of two thirds reduction.
Introduction The prevalence of Type 2 diabetes mellitus (T2DM) is increasing worldwide
and many of these affected individuals remain unidentified. Undiagnosed
T2DM may impose substantial public health implications because these
individuals remain untreated and at risk for complications. The objective of
this study was to determine the national prevalence of undiagnosed T2DM
and to identify the associated risk factors.
Methods A nationwide cross-sectional study was conducted involving 17,783
respondents. Two-stage stratified sampling design was used to select a
representative sample of the Malaysian adult population. Structured
validated questionnaires with face to face interviews were used to obtain
data. Respondents, who claimed that they were not having diabetes, were
then asked to perform a fasting blood glucose finger-prick test by Accutrend
GC machine.
Results The prevalence of undiagnosed T2DM was 8.9% (n=1587). The highest
percentage of undiagnosed T2DM was found among males (10.2%), 55-59
years old (13.4%), highest education attainers of primary school (11.1%),
Indians (10.3%), married (10.3%), working (8.9%) and living in the urban
areas (9.2%). Multivariate analyses showed that factors associated with
undiagnosed T2DM were gender, age group, ethnicity, marital status, obesity
and hypertension.
Conclusion This study found an increasing trend of undiagnosed T2DM in Malaysia
compared to 2006. This finding is alarming as risk factors associated with
undiagnosed diabetes were related to most of the socio-demographic factors
studied. Therefore, early diabetic screening is crucial especially among adults
aged 30 and above to prevent more serious complications of this disease.
Introduction: Premature ejaculation (PE) is an important sexual problem among men attending health clinic. Impacts of this condition towards quality of life still require further exploration. Aims of the study is to determine the proportion and determinants for PE and its impact on Quality of Life (QOL) among men attending a public health clinic in Kuantan
Methods: A cross-sectional study involving 290 respondents was conducted at a public health clinic over the period of five months (Nov 2015-March 2016). A validated self-administrated questionnaire that consisted of sociodemographic questionnaire, clinical characteristics, premature ejaculation diagnostic tool (PEDT) and WHO quality of life (WHOQOL-BREF) were used.
Results: The proportion of PE was 33.9% with PE 18.1% (49/271) and probable PE 15.8% (43/271). Multivariate analysis showed that level of education (p=0.002, OR 3.281/95% CI 1.183, 9.101) and hypertension (p=0.047, OR 1.788/95% CI 1.008, 3.170) were the only significant predictors for PE after controlling self-reported erectile dysfunction, pulmonary and neurological disorder. PE patients had lower median scores QOL in all four domain namely physical health, psychological, social relationship, environment (all domains with p<0.001).
Conclusions: The proportion of men diagnosed with premature ejaculation in this study is high and possibly associated with level of education and hypertension. Men with PE had lower quality of life in domains of physical health, psychological, social relationship and environment. Hence, it is
recommended for PE screening among male attendees to primary health clinic especially those with hypertension and moderate level of education.
Keywords Premature ejaculation - Quality of life - Sexual dysfunction.
Study site: Klinik Kesihatan Jaya Gading, Kuantan, Pahang, Malaysia
In July 2010 Universiti Kebangsaan Malaysia (UKM) and Niigata University (NU) signed a memorandum of agreement to continue collaboration in joint planning and implementation of education, research and practice services in the field of medicine.This collaboration is also a good opportunity for Doctor of Public Health (DRPH) postgraduate candidates to gain experience on the practice of public health in handling public health issues, planning the healthcare facilities, delivering a quality public health services, enforcing public health policies/regulations and finally learn about the health systems in general at other countries especially from developed country like Japan. Experiencing Health Care and Culture in Niigata, Japan.
Osteoporosis-related fractures have been recognized as a major health problem, particularly in the elderly with a high morbidity and mortality rate. The aims of the study were to identify knowledge and perception toward calcium intake among students at UiTM and to explore the differences between genders in dietary calcium intake. A cross sectional study was conducted through 336 students aged 18 to 34 years old. The participants were randomly chosen from the student’s enrolment list. A modified questionnaire was used to obtain the knowledge and perception of the participants. More than half of the participants have low knowledge regarding dietary calcium intake (58.6%), positive view towards the benefits of calcium intake and low perception towards the barrier of calcium intake. Chi square analysis showed a significant difference between male and female for knowledge (p=0.034) and barrier (p=0.002) for calcium intake. Intervention programs should be adopted to increase the knowledge among young adults to improve their health and prevent risk factors. So, health education specifically on calcium intake will be very useful to improve the knowledge and behavior of students.
BACKGROUND: The aim of the study was to assess the knowledge and attitude of secondary school students in Sana'a Yemen related to exposure to second-hand smoking.
METHODS: A cross-sectional study was conducted in Sana'a city. The total sample size was 336 students in which 63 were males and 273 were females. These students were stratified random sampling . Data were collected by using Questionnaire comprising of 3 parts: Part 1- consists of socio-demographic data. Part 2- consists of the knowledge regarding smoking and second-hand smoking and Part 3-consists of adolescents' attitude in relation to second-hand smoking.
RESULTS: Out of 336 students, majority were between 14-18 years old (75.9%), males (81.2%) , (55.7%)of them was fathers' occupation private employee and low educated mother was (86.3%).The students who do not have smoking habit were (94.3%),and those who do not have friends with the habit of smoking was (57.4%). (57.10) having some one else at home who smokes beside them .The reaction of non printed mass media for SHS warning was (83.3%) . The exposed to smoke out door was (60.1%) . In this study, the majority of students had inadequate knowledge about the second-hand smoke was (52.7%). A higher percentage of students who had unfavorable attitudes toward secondhand smoke was(86.6%).
CONCLUSION: We concluded that The level of knowledge and attitude about the second-hand smoke is relatively low among the secondary school student in Sana'a Yemen .The finding of this study emphasized the need of effective awareness programs to increase level of consciousness and knowledge regarding SHS. Keywords: Second-hand Smoking, Secondary School, Adolescent, Sana'a .
Introduction: In maternal healthcare, pre-pregnancy weight is used to predict pregnancy outcomes. Since no recorded data on pre-pregnancy weight, perceived weight is used alternatively. This study examines the relationship between perceived and actual weight among non-pregnant urban Malaysian women of childbearing age and identifies differences in perceived and actual weight by selected socio-demographic characteristics.
Methods: A cross-sectional study was conducted between April and June 2013 among urban Malaysian women attending public health clinics in the Klang Valley. Information on height, perceived current weight and time when their weight was last taken were obtained and actual weight was the average of two measurements (TANITA-HD-323-digital-scale). Socio-demographic data collected were age, ethnicity, education level, marital and employment status and total household income.
Results: Mean age of 371 women in this study was 28.81±5.65, 82.2% were Malays, 62.8% had tertiary education, over 75% were married and employed, with more than half from middle-income households. Overall, the mean perceived and actual weight was 59.29±11.59 and 59.20±11.90 respectively. Pearson‟s Correlation test showed a very strong positive correlation between perceived and actual weight (r=0.957;p<0.0001), ranging between 0.852 to 0.994 among subgroups; 258 (69.5%) perceived their weight accurately (±2.0 kg of actual weight), 49 (13.2%) under and 64 (17.3%) overestimated their weight.Main outliers were among younger women, Malays, tertiary educated, employed, middle-income and had weight last measured a month or more ago.
Conclusion: Strong correlation between perceived and actual weight among women in this study reassured weight perception can be used more confidently in patients‟ history taking and future research among urban Malaysian women using public health services.
It all started with a SSM research. SSM, which is an abbreviation for ‘Special Study Module’ is a unique module in the curriculum of the Medical Faculty National University of Malaysia (UKM), where each students were required to do a medical research in the field that we have interest in. Being interested in the field of public health, 3 of my friends and I did a research on the prevalence of tuberculosis in Cheras using the graphic informational system (GIS) to map each case of tuberculosis on the map of Kuala Lumpur. Our supervisor was Associate Professor Dr Shamsul Azhar, who is himself an expert on the field of GIS study and has been doing his PhD research using the same system in Niigata University, Japan for almost 4 years. During one of our SSM meetings, he mentions that the post-graduate students in UKM has done several visits to Niigata University and brought up the idea that maybe the undergraduate students like us could do the same. (Copied from article).
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.
Introduction There is an increasing trend of obesity in children and adolescent globally. The objectives of this study were to identify the prevalence of overweight and obesity among students from secondary schools and to determine the mean random blood sugar (RBS) for the overweight and obese students.
Methods This was a cross sectional study. Two secondary schools that were scheduled for visit by the School Health Team, Taiping in July 2016 were included. A standardized data collection sheet was used to collect the data. Overweight and obesity were defined based on WHO 2007 reference for BMI-for-age criteria. Random blood glucose was checked for overweight and obese students.
Results A total of 184 school students consented and participated. 128 (69.6%) were female and 90 (48.9%) were Malays. The mean weight and height were 56.21 kg and 1.61 m respectively with BMI of 21.49 kg/m2. Overall, the prevalence of obese and overweight were 12.5% and 10.9% respectively. Among the 4 BMI groups, there were no significant difference found in sex (p=0.849) and races (p=0.536). However, there was significant difference (p=0.042) in mean RBS for obese and overweight students between races. RBS readings among overweight and obese students were within normal range with mean of 5.95 (0.67) mmol/l (range between 4.60 – 7.70 mmol/l).
Conclusions The overall prevalence of overweight and obesity were comparable with other studies done in Malaysia. Nevertheless, there was no prevalence of Type II diabetes mellitus among them.
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.
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.