Introduction: Female Genital Cutting (FGC) is a sensitive issue as this topic is always associated with religion and culture in Malaysia. In the past, FGC is performed by the traditional midwives. However, this practice has been med-icalized nowadays. This study aimed to understand the reasons of performing FGC, the decision making, the practice and the future of FGC among rural community in Northern Malaysia. Methods: Focus group discussions (FGD) were conducted on three groups of young women aged 18-45, older women aged 45 and above and a group of married adult men. All of them were Malay Muslims who were conveniently selected from a rural village in Northern Malay-sia. A semi-structured interview guide was used to conduct the FGD focusing on the reasons, decision making, the practice and the future of FGC. Data was collected until saturation of information was achieved. These participants were chosen based on their willingness to take part in the discussion and also based on their personality of being talkative and able to give feedback to the questions. Results: The result of the interviews revealed that religion is the reason of practicing FGC. All of the participants from each FGD prefer to go to the doctor in the clinic compared to the traditional midwives. The men in this FGD mentioned that they rarely involved in the decision making of the FGC and only the mother or the grandmother to take the responsibility to decide. Conclusion: Generally, majority Malay Muslims community from the rural areas in Northern Malaysia believed that FGC is compulsory in Islam and they prefer to go to the doctors to perform FGC.
The role of a mother alone is very challenging. With an additional role as a student or a worker add more burden to them. It is undeniable that Malaysian women in the 21st century has more roles than women in the pre-independent era. Nowadays, women have equal opportunities to work and pursue higher education like men. The need to provide quality life to the children has also encouraged women to contribute more in the family income. Despite the multiple roles play by women, the household tasks are still managed by them. For this phenomenological research, in-depth interviews were conducted with two participants who studied in public university in Malaysia. By using thematic analysis, four themes were emerged from this study. The themes were challenges, role management, assistance/support and coping strategies. In this study, the major challenge was to balance the role of mother and student. But whatever challenges they faced; family was their priority. Furthermore, spousal support also helped the mothers in managing their multiple roles. From the findings, it is hoped that it gives some insights on the type of support that student mother needs and ways of coping in challenging situation.
Parents or caregivers of children with learning disabilities have been shown to experience increases in stress and greater negative caregiving consequences than those with typically developing children. The current study sought to assess the perceived stress among Malay caregivers of children with learning disabilities in Kelantan. The Malay version of Perceived Stress Scale 10 items was administered to a sample of 40 caregivers of children with learning disabilities who were registered to five Pusat Pemulihan Dalam Komuniti (PDK) in Kelantan. Higher scores indicate higher levels of stress. The caregivers had mean age of 47.68 (SD = 9.18) years old, of whom 90% were fathers or mothers. Ninety percent of them were married, majority were unemployed or housewives and had secondary school education. The majority of children with learning disabilities were males and half of them were Down Syndrome children. The mean total Perceived Stress Scale score of the caregivers was 16.77 (SD = 5.74). There were no significant associations between total perceived stress score and any of the independent variables. The mean total perceived stress score showed that the perceived stress level was in the category of slightly higher than average and health concern level was high, while the average stress level was between score of 12 to 15. In conclusion, this result indicated that the caregivers had slightly higher levels of stress than the average score, and might increase susceptibility to stress-induced illness.
The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) strongly advocate exclusive breastfeeding for the first six months after birth as the optimal way of feeding infants. Nutritional inadequacy during breastfeeding period may lead to breastfeeding problems such as inadequate milk production which is a common reason to early breastfeeding termination.
Galactagogue is one of the solutions seek by breastfeeding mothers to overcome this problem. Within the topic of prophetic medicine, scholars discussed the foods consumed by Prophet Muhammad (P.B.U.H) and their health benefits. Among the plants mentioned in Islamic literature are F.carica (figs), O.europea (olive), P.granatum (pomegranate) and N.sativa (habbatussauda). Studies on prophetic foods consumption among lactating mothers is limited in the literature. Thus, the aims of this study to explore on prophetic food consumption, among Malay mothers during
exclusive breastfeeding period. Ten subjects are interviewed by in-depth semistructured interview guide. Inclusion criteria include Malay mothers aged 18 to 40 years, deliver full term babies and were exclusively breastfeeding. Audio-recorded interviews were transcribed verbatim in Malay and translated into English. Translated transcripts were then analysed thematically with the help of NVivo software. Thematic analysis revealed three themes that represents participants’ knowledge, attitude and practice on prophetic foods consumption. The themes were 1) prophetic diet is related to Prophet Muhammad (P.B.U.H)’s practice on foods and eating manners, 2) perceived benefits and effectiveness of prophetic foods consumption, and 3) Practice of prophetic foods consumption during exclusive breastfeeding period. This study provides an insight to the understanding and
perception on prophetic foods consumption during exclusive breastfeeding period among breastfeeding mothers. It is acknowledged that prophetic foods, particularly dates may have lactogenic function. Further studies should be carried out to investigate the relationship between prophetic foods consumption and lactogenic activity.
Traditional postpartum practices generally involve food proscriptions and prescriptions. Certain foods are prohibited due to their properties such as “windy”, “cold” and “hot”. As lactating mother needs higher energy and protein intake, this practice may impact their ability to meet their nutritional requirements. Consequently, their health may not be fully restored, wound healing would be slowed, and lactation success may be interfered. This study was conducted in Kuantan, Pahang, to investigate Malay mothers’ perception on confinement dietary practices during postpartum period. A total of 80 respondents aged between 23-43 years old were interviewed using a questionnaire which consisted of an extensive list of food items. It was found that 100% of respondents mentioned that they do observe the traditional postpartum practices after childbirth with most of them (63.0%) chose to confine for up to 44 days. Flavored rice, roti canai and various types of noodle were generally avoided during postpartum period due to their ‘oily/fatty’ property. Tubers, and most fruits and vegetables were also avoided due to their ‘cold’ property. Moreover, the famous ‘reason’ for exclusion of fish was ‘bisa’ and ‘causing itchiness’ for seafood. Milk and dairy products were included in majority of respondents’ diet. Out of 80, 43 (53.8%) respondents avoided soy sauce because it was believed to give negative effect on wound healing. Other than
that, iced drink, tea and sugarcane drink were avoided due to their ‘cold’ and ‘sharp/sour’ properties. In addition, statistical tests of all food items show that there is no difference in terms of level of acceptance for each food between women delivered via normal delivery or caesarean section. It is concluded that postpartum food taboo beliefs are still prevalent among Malay women. Extensive food prohibition and restriction causes limited food choices which may affect mothers’ nutritional intake. Thus, a more balanced diet should be recommended for Malay mothers during postpartum period to ensure adequate nutrient intake, as much as culturally acceptable.
The prevalence of Autism Spectrum Disorder (ASD) cases has been increasing worldwide. There are countless aspects of challenges faced by parents to bring up children with ASD. Parents of children with ASD are often reported to have higher stress in parenting compared to parents with normal children or children with other disabilities such as Down syndrome. Therefore, this study explored the challenges faced by mothers of children with ASD. Mothers whom were selected are the primary guardians and spend a lot of time nurturing these children. This qualitative study involved in-depth interviews with five (5) informants in Selangor. The thematic analysis identified the challenges faced by the mothers of children with ASD, which are the aspects of behavioral, financial and community acceptance. The findings showed that mothers to children with ASD encountered numerous complicated challenges which require the support of all parties to address those challenges. High support and compassionate understanding are really needed from the spouse, normal children, local communities, and government to alleviate their difficulties. Thus, the findings of this study hopefully will help various parties to understand the challenges faced by the mothers of children with ASD. It can also be the guiding principle in designing supportive programs and interventions for children with ASD as well as their parents.
ntroduction: The child health record book was long established in Malaysia, but no evaluation study on the util-isation of the book has ever been done. The objectives of the study were to determine the proportion of optimum record book use and the factors associated with it. Methods: A cross-sectional study was conducted among 415 ran-domly selected parents of children aged below six years old attending government health clinics in Putrajaya using a self-administered questionnaire. Optimum use of child health record book was defined by respondents reading all the sections and recording comments in the book. Factors studied were sociodemographic characteristics; ante-natal and breastfeeding history; child’s health and immunisation status; perceptions and level of knowledge on the book and child health; and healthcare providers’ performance. Multiple logistic regression was used to identify the determinants of optimum use. Results: In total, 36.1% of respondents optimally used the record book. The five de-terminants of optimum use identified were mother’s age group between 35-39 years and ≥40 years old (AOR: 2.24, 95% CI 1.13-4.44; AOR: 3.36, 95% CI 1.24-9.07), a mother with a higher level of education (AOR: 2.67, 95% CI 1.43-5.00), delivered in a government hospital (AOR: 3.01, 95% CI 1.11-8.16), had good level of knowledge on the record book and on general child health (AOR: 3.69, 95% CI 2.08-6.56; AOR: 2.07, 95% CI 1.19-3.60). Conclusion: The proportion of optimum child health record book use is relatively low. Based on the findings, improving the par-ents’ knowledge on the child health record book utilisation is vital to increase the optimum usage particularly among mothers with low education level, aged less than 30 years old and those who delivered in non-government hospitals.
VACTERL association is a rare genetic disorder involving at least three of the following congenital
malformations: vertebral defects (V), anal atresia (A), cardiac defects (C), trachea-oesophageal fistula with
or without oesophageal atresia (TE), renal anomalies (R) and limb abnormalities (L). Until now, the
aetiology of VACTERL association is unknown, particularly at the molecular level. Here, we performed
whole exome sequencing (WES) of an infant with VACTERL association. The patient was delivered
prematurely at 30 weeks and had 4/6 of the VACTERL malformations. Trio-WES analysis was performed
using Torrent Suite and ANNOVAR. Polymorphisms with an allele frequency of >0.01 were excluded, and
the remaining variants were filtered based on de novo mutations, autosomal recessive, X-linked and di-genic
inheritance traits. In this patient, no homozygous, compound heterozygous or X-linked mutations was
associated with VACTERL. However, we identified two heterozygous mutations; KIF27
(ENST00000297814: c.3004A> C:p.N1002H) and GNAS (ENST00000371098: c.205C>A:p.H69N) genes that
were inherited from her father and mother respectively. A de novo, IFT140 gene mutation
(ENST00000426508: c.683C>G:p.S228C) was also identified in this patient. The VACTERL phenotype in
this patient may due to heterozygous mutations affecting KIF27 and GNAS genes, inherited via autosomal
recessive trait. In addition, the IFT140 gene mutation may also be involved. These genes are known to be
directly or non-directly involved in the sonic hedgehog signalling that is known to be implicated in
VACTERL. This is the first report of these genetic mutations in association with VACTERL.
To verify the actual immunisation coverage in Kuala Lumpur, City Hall Health Department and the Malaysian Paediatric Association (NGO ) carried out a survey. The survey revealed that the immunisation coverage determined at the child's first birthday for BCG was 95%, DPT 3 94%, OPV 3 94%, and measles = 27% (59% at 2 years). These figures correspond closer to City Hall's estimated coverage rather than the rates projected by the Ministry of Health. The main reasons for immunisation failure were, child ill 31.8% (not brought = 20.1%, brought but not given vaccine 11.7%), lack of information 28.6%, lack of motivation 9.1%, mother too busy 9.1%. Measles immunisation coverage at 1 year was low because of wrong information on schedules. Tetanus toxoid immunisation coverage of pregnant women was low. Only 27% of children were protected against neonatal tetanus although 97% of pregnant women received antenatal care and 50% had attended other health facilities as well during pregnancy. Private medical practitioners were responsible for more than 40% of all immunisations but were not submitting returns to the Health Department. Recommendations to improve immunisation coverage include education and motivation of the public and also doctors and health personnel on prevention of missed opportunities, contraindictions to immunisation and correct schedules. (Copied from article).
Several anatomical variations concerning the median nerve have surfaced in the medical literature. Among them, bifid median nerve or median nerve bifurcation with or without persistent median artery has been widely reported. Sporadic case reports describe median nerve trifurcation (trifid median nerve) as well. In the present report, we describe carpal tunnel syndrome manifestations in association with trifid median nerve unveiled incidentally under high-frequency musculoskeletal ultrasonogram in a lactating mother-a first in the medical literature.
A cross sectional descriptive study on breast feeding practices in an urban clinic was conducted among 136 mothers aged between 21-49 years who were interviewed using a questionnaire. Malays constituted 61% of the respondents, Chinese 22.8% and Indians 16.2%. Mojority of these were working mothers and although the initiation of breastfeeding was high (99.3%), exclusive breastfeeding was only 12.5%. A large proportion (33.8%) dtopped prior to 3 months. Majority of the Chinese mothers (61.3%) stipped before 3 months as compared to the Indian (40.9%) and Malay (21.7%) mothers (p<0.001). Mean age of introducing complementary foods at 3 months is below the accepted age of 4 to 6 months for weaning. Ever-breast feeding rate is high in this urban setting but more efforts are needed to effect a higher rate of exclusive breastfeeding and longer duration of breastfeeding.
Comprehensive feeding practices questionnaire (CFPQ) is an instrument specifically developed to evaluate parental feeding practices. It has been confirmed among children in America and applied to populations in France, Norway, and New Zealand. In order to extend the application of CFPQ, we conducted a factor structure validation of the translated version of CFPQ (CFPQ-M) using confirmatory factor analysis among mothers of primary school children (N = 397) in Malaysia. Several items were modified for cultural adaptation. Of 49 items, 39 items with loading factors >0.40 were retained in the final model. The confirmatory factor analysis revealed that the final model (twelve-factor model with 39 items and 2 error covariances) displayed the best fit for our sample (Chi-square = 1147; df = 634; P < 0.05; CFI = 0.900; RMSEA = 0.045; SRMR = 0.0058). The instrument with some modifications was confirmed among mothers of school children in Malaysia. The present study extends the usability of the CFPQ and enables researchers and parents to better understand the relationships between parental feeding practices and related problems such as childhood obesity.
Objective: Parents’ positive attitudes and psychological wellbeing play an important role in the development of the children with developmental disability. This study aimed to measure the prevalence of psychological problems among mothers of children with autism disorder, intellectual disability, and Down syndrome. The second aim was to assess the differences in mothers’ attitudes and psychological problems among their children with intellectual disability, autism disorder, and Down syndrome. The third aim was to identify whether negative attitude was a predictor of psychological problems in these mothers.
Methods: In this study, 112 mothers of children having mild and moderate levels of autism disorder, Down syndrome, and intellectual disability were assessed using the Parental Attitude Scale and General Health Questionnaire–28.
Results: Overall, mothers of children with intellectual disability were found to have the most negative attitude towards their child. Mothers of children with autism disorder exhibited higher scores on somatic symptoms, anxiety, and social dysfunction when compared with their counterparts with Down syndrome and intellectual disability. Negative attitude was a significant predictor of psychological problems.
Conclusion: Parental attitudes and psychological problems would vary among mothers of children with different types of developmental disability.
Key words: Autistic disorder; Down syndrome; Intellectual disability; Mothers
A case-control study among Singapore Armed Forces' newly enlisted Servicemen was conducted to examine factors associated with male obesity. Four hundred and fifty-nine individuals from the Obese Basic Military Training program were selected as "cases" (average age: 19.5, body mass index: 30.4) and another 340 individuals were selected from the Normal Basic Military Training program as "controls" (average age: 19.3, body mass index: 21.4). Information such as family background, socioeconomic factors, and lifestyle practices were captured using facilitator-led questionnaires. Several variables were significantly associated with obesity after adjustments for possible confounders. These include childhood obesity (odds ratio [OR] = 2.06), less than an hour of exercise per day (OR = 2.97), Indian ethnicity (OR = 2.22), specific education backgrounds (especially that of Institute of Technical Education-OR = 2.75), father's employment at nonmanagerial/professional jobs (OR = 1.52), mother's employment at managerial/professional jobs (OR = 2.02), regular smoking (OR = 1.73) and alcohol consumption (OR = 2.26), 6 hours or less of sleep (OR = 3.73), obesity among family members (OR = 1.86 for mother; OR = 2.98 for siblings), parental history of diabetes mellitus (OR = 2.22 for father; OR = 2.70 for mother), and eating at inexpensive local food stalls (OR = 1.82). Our study found that a number of factors, ranging from personal and family backgrounds to lifestyle choices, were significantly associated with obesity among male youths.
Background:Candida chorioamnionitis is rarely encountered, even though vulvovaginal candidiasis incidence is about 15%. Interestingly, it has characteristic gross and histological findings on the umbilical cord that are not to be missed. Case Report: We report two cases of Candida chorioamnionitis with presence of multiple yellowish and red spots of the surface of the umbilical cord. Microscopically, these consist of microabscesses with evidence of fungal yeasts and pseudohyphae. The yeasts and pseudohyphae were highlighted by periodic acid- Schiff and Grocott methenamine silver histochemical stains. Both cases were associated with a history of gestational diabetes mellitus. Discussion: Peripheral funisitis is a characteristic feature of Candida chorioamnionitis. It is associated with high risk of adverse perinatal and neonatal outcomes, such as preterm delivery, stillbirth and neonatal death. We recommend careful examination of the umbilical cord of mothers with gestational diabetes mellitus.
Refugee families experience uncertainty and stress when residing in countries of first asylum, such as Malaysia, and may benefit from supportive parenting interventions. In the greater Kuala Lumpur, Malaysia area we piloted an eight-week parenting program with 79 Rohingya and Afghan mothers in nine separate groups. Participants were randomized to an intervention group or a waitlist control group and those in each arm completed a 3-month follow-up assessment. Program content addressed positive discipline, strengthening family relationships, adapting to a new environment, and improving health and emotional well-being. Measures assessed included child intensity and parenting self-efficacy from the Child Adjustment and Parent Efficacy Scale; positive parenting, inconsistent discipline, and poor supervision from the Alabama Parenting Questionnaire-Short Form; family intimacy and family conflict from the Family Functioning Scale, and emotional well-being from the Refugee Health Screening-15. Participating in the intervention led to beneficial changes in child intensity, parenting self-efficacy, family intimacy, family conflict, and emotional distress for the treatment group, and all changes except for emotional distress were maintained over time. However, the intervention did not lead to changes in positive parenting, inconsistent discipline, or poor supervision in the treatment group. Findings point to the potential benefits of parenting programs for refugee communities in transitory settings and contribute to the limited body of literature examining such programs.
This cross-sectional study assessed household food insecurity among low-income rural communities and examined its association with demographic and socioeconomic factors as well as coping strategies to minimize food insecurity. Demographic, socioeconomic, expenditure and coping strategy data were collected from 200 women of poor households in a rural community in Malaysia. Households were categorized as either food secure (n=84) or food insecure (n=116) using the Radimer/Cornell Hunger and Food Insecurity instrument. T-test, Chi-square and logistic regression were utilized for comparison of factors between food secure and food insecure households and determination of factors associated with household food insecurity, respectively. More of the food insecure households were living below the poverty line, had a larger household size, more children and school-going children and mothers as housewives. As food insecure households had more school-going children, reducing expenditures on the children's education is an important strategy to reduce household expenditures. Borrowing money to buy foods, receiving foods from family members, relatives and neighbors and reducing the number of meals seemed to cushion the food insecure households from experiencing food insufficiency. Most of the food insecure households adopted the strategy on cooking whatever is available at home for their meals. The logistic regression model indicates that food insecure households were likely to have more children (OR=1.71; p<0.05) and non-working mothers (OR=6.15; p<0.05), did not own any land (OR=3.18; p<0.05) and adopted the strategy of food preparation based on whatever is available at their homes (OR=4.33; p<0.05). However, mothers who reported to borrow money to purchase food (OR=0.84; p<0.05) and households with higher incomes of fathers (OR=0.99; p<0.05) were more likely to be food secure. Understanding the factors that contribute to household food insecurity is imperative so that effective strategies could be developed and implemented.
Background: Increased maternal anxiety level has been reported to have detrimental effects on the physical outcome of pregnancies such as not achieving vaginal births. This study thus aims to determine the level and factors affecting mental preparedness among mothers with normal pregnancies and its correlation with birth outcomes.
Methods: Three hundred healthy mothers above 37 weeks of gestation in the early stage of labour were assessed for their level of mental preparation before birth process and outcomes after births which include general feeling (euphoria), ability to withstand labour pain and bonding with the new born. The successfulness of vaginal birth and other data on factors affecting mental preparation were also collected.
Results: The level of mental preparedness was found good in 78% of the mothers, mainly determined by their socioeconomic status, family support and personal ability to adjust to changes. Age (p= 0.048), parity (0.00) and income (0.01) were found to influence mental preparedness significantly. Race, occupation, education level and marital status are however not significantly related. Poor mental preparedness is associated with greater pain during labour. A correlation analysis also found a positive relationship between the level of mental preparation and mental outcomes following birth in these mothers but it did not significantly influence the mode of delivery.
Conclusion: Mental preparation before birth seems to have an effect on mental outcomes of mothers following birth process. It is vital that mothers of the younger age group with no previous obstetric experience be given more attention in preparing them mentally before they face the painful birth process.
This paper discusses the roles and challenges of the national language, which is Malay as a language in
uniting the various ethnic groups in Sabah. On September 16, 1963, the Federation of Malaysia was
officially declared which comprised of the Malay States, Singapore, Sabah and Sarawak. In line with
that, the special provisions on the national language in Sabah are contained in Article 161 of the
national constitution. Although the provision of the constitution clarify that Sabah was given a 10-year
period to use Malay and English as the official languages but later on September 16, 1973 the Malay language was declared the sole official language for the state of Sabah. Hence, various efforts have
been made by the government to ensure the national language can play its role as a language that can
unite the various ethnic groups in Sabah. However, ethnic diversity with their own ethnic mother
tongue languages has resulted in the Malay language as a national language as well as the language of
unity to face many challenges. Therefore, the discussion in this paper is focused on policies undertaken
by the government to strengthen the national language in various fields in Sabah and the challenges
faced by the national language to foster unity among the various ethnic communities in the state. This
study was conducted using a qualitative analysis approach and used archive study methods as well as
library study to obtain research information sources. This study will produce an analysis that can be
used as a reference to improve or formulate policies particularly in matters that benefit in strengthening
the multi-ethnic communities in Sabah.
Pregnant women are at higher risk of transmitting the infections to their foetus. This prompted the “Prevention of Mother to Child Transmission (PMTCT) Program” in Malaysia since 1998. The objective of this cross sectional study was to determine the knowledge, attitude and practice (KAP) of pregnant mothers in the west of Sabah towards HIV/AIDS and its influencing factors. Data were obtained through self administered questionnaires. Results showed that only 32.2% of the
respondents have good knowledge compared to 67.8% who had poor knowledge (p