Introduction: Parents play an essential role in their children’s tuberculosis (TB) treatment
success despite many challenges from the beginning of their children’s symptoms until
completion of the TB treatment. The challenges can be described as perceived barriers,
according to the Health Belief Model, a theory of behaviour change. This study aims to explore
parents’ experiences on the challenges in achieving a successful TB treatment for their child
in two districts of Selangor state, Malaysia. Methods: The research was carried out using a
phenomenology study design. In-depth interviews were conducted among purposively
sampled parents of children with TB disease who have completed TB treatment or still
undergoing treatment from MyTB version 2.1, a national TB surveillance database. The
collected data was considered as achieving its saturation level if no new themes arise from
the latest interviews’ session. The R-based Qualitative Data Analysis (RQDA) package
version 0.2-8 was used for the thematic data analysis. Results: The total number of
participants in this study was 15 mothers of children with TB disease; 12 (80%) of the children
had completed TB treatment. There were six subthemes identified from this study focusing on
the theme of multiple challenges, such as health symptoms challenges, TB investigation
challenges, personal challenges, healthcare facilities challenges, administration medication
challenges, and community challenges. Conclusions: Parents highlighted many challenges
during the child’s illness phase, and they should be given adequate education and appropriate
support to ensure TB treatment adherence. TB program managers should take action
following the relevant parents’ feedback regarding the quality of TB care in a healthcare
facility
Epilepsy is the most common neurological disorder in pregnancy. The effects of epilepsy include congenital abnormalities which are increased 2-3 fold. The babies born suffer from haemorrhagic disease of newborn. Preconception management and folic acid supplementation is important in optimizing outcome. With close monitoring and proper management, more than 90% of mothers have no complications throughout their pregnancy. Hormonal contraception dosage need to be increased due to the enzyme inducing nature of the anti epileptics drugs.
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.
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.
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.
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.
Postpartum depression (PPD) is quite large, where there are 1 in 25 postpartum women experiencing PPD who still report symptoms of PPD after six months. The highest risk of experiencing PPD is more experienced by primiparas detected in 10-19 postpartum days. For PPD to not adversely affect the mother and baby, initial screening is needed to prevent the occurrence of PPD by using an Android-based EPDS application. The research objectives are an early screening of baby blues based on Android application and to determine the factors influence of baby blues. Participants download EPDS apps to make it easier for participants to screen the baby blues at the beginning of the first week after giving birth. On fourth week, the mothers refill EPDS apps screening to compare the results of screening the first week with fourth week using the Dependent T-test. In this study also analyzed the factors that influence the baby blues such as education, employment, parity, and age using the ANOVA Test. The study sample was the first-week postpartum mothers with a total sample of 64 people. The average EPDS screening results in the first week were 6.64, with a standard deviation of 2.57. The screening results on fourth week are 6.70, with a standard deviation of 2.53. The results of statistical tests obtained p-value 0.208; it can conclude that there was no difference in the results of screening tests in the first week with the fourth week. PPD events occur mostly in primiparas and women aged <20 years with p-value 0.001, while in education p-value 0.596 and employment-value 0.784. It recommended for pregnant women and health workers to do screening in the first week of postpartum so that it can detect PPD early.
Fetomaternal haemorrhage (FMH) may occur following a sensitizing event, during pregnancy or at delivery. In cases of rhesus (Rh) incompatibility between mother and the fetus, it can thus subject to the haemolytic disease of the newborn. The Kleihauer test for quantification of FMH lacks standardization and results are less accurate. Furthermore, it cannot differentiate the foetal cell from the adult HbF. Flowcytometry analysis using monoclonal antibodies, is a new technique for the quantification of FMH and it allows larger number of cells to be analysed. It is also able to differentiate the foetal cell from maternal HbF, and thus is more sensitive and accurate. The objective of our study was to determine the FMH using the flowcytometric analysis of anti-HbF antibody and to correlate the FMH using flow cytometry and the standard Kleihauer test. Ninety eight peripheral blood samples from pregnant women at more than 20 weeks of pregnancy and post delivery were analyzed by both methods. The percentage of the foetal cells were recorded and the FMH were calculated. We found a fair correlation between the two methods with the correlation coefficient r = 0.633 (p
Gestational breast cancer (GBC) or pregnancy-associated breast cancer was defined as breast cancer diagnosed during pregnancy and within 1 year of delivery. Breast cancer is the second commonest cancer after cervical seen in pregnancy and lactation. Nevertheless, the incidence is low and accounts for approximately 1 in 3000 of pregnancies. A delay in diagnosis is common and 70% to 89% of patients with operable primary lesions already have positive axillary lymph nodes. Breast cancer identified during pregnancy can be extremely distressing for the mother despite it has similar course of disease and prognosis seen in non-pregnant women of the same age and stage of disease. Diagnostic and treatment options should be carefully decided to prevent further harm to the mother or any potential risk to the developing fetus.
Smaller family size and advancing parental age have increased the demand for prenatal diagnosis.
Prenatal cytogenetic diagnoses currently used, such as amniocentesis and chorionic villus
sampling, are usually not preferred by the expectant couples due to the risk imposed on the mother and child. High false positive rates (5%) of current non-invasive screening methods, such as serum analysts or ultrasound, cause a large number of unnecessary invasive practices to be performed, which apart from the associated risk, place considerable psychological distress on the couples
involved (Wald et al., 1999). (Copied from article).
Breast-feeding offers many benefits to the baby and the mother. For instance, breast milk provides the right balance of nutrients to help an infant grow into a strong and healthy toddler. Even though breastfeeding is a natural process, it is not always easy. In certain situations, some mothers are unable to breastfeed their babies or the babies are unable to adapt to breastfeeding. This will lead to the use of bottle-feeding. The effect of breast-feeding and bottle-feeding on physical growth has been well established but less has been concentrated on the craniofacial growth and dental development. This review reveals the effects of breast-feeding and bottle-feeding on craniofacial growth and dentoalveolar development based on the available literature.
Placenta praevia is a known obstetric condition that causes complications to mother and fetus. This study was done to evaluate the knowledge of placenta praevia amongst the obstetric patients. A cross sectional study was carried out in Hospital Ipoh, Perak among 323 antenatal and postnatal patients. Socio-demographic parameters (ie age, race, parity, occupation, educational level) and history of placenta praevia were studied in relation to level of knowledge and attitude towards placenta praevia. Twenty (6.2%) from 323 women had current or past history of placenta praevia. Three had history of placenta praevia while 17 had current placenta praevia with prevalence of 5.3%. The mean score of knowledge achieved by patients was 11.8 which indicated overall poor knowledge. Occupation, level of education and history of placenta praevia were found to have a relationship with level of knowledge regarding placenta praevia in all obstetric patients. There was a significant relationship between attitude of patients with current and history of placenta praevia to level of knowledge regarding placenta praevia. (p=0.037,
Introduction: The aims of this study were to assess the differences in the percentages of abnormal morphology between the epididymal and testicular spermatozoa of mature male offspring mice whose mothers were injected with various doses of lead acetate during gestation. Materials and Methods: Seventy two healthy female mice were divided into three major groups according to the number of injections involving 1, 2 or 3 injections at 8th day; 8th and 13th days; and 8th, 13th and 18th days of gestation period, respectively. Each major group was subdivided into four minor groups according to the dosage of lead administered (0, 25, 50 and 100) mg/Kg. Results: The percentages of abnormal morphology of epididymal and testicular spermatozoa were studied and the data were statistically analyzed. The results of this study proved that an increased number of injections and/or dose of lead acetate injected to the mothers during gestation cause an elevation in the percentage of abnormal morphology of both epididymal and testicular spermatozoa of the male mice offspring. Conclusion: In conclusion this study demonstrated that lead acetate when exposed prenatally have toxic effects on the sperm in the offspring male mice resulting in abnormal morphology of spermatozoa. The most likely causative factor is disturbances in the phase(s) of spermatogenesis and/or spermiogenesis.
Objectives: This is a retrospective study in which all neonates with confirmed dengue fever mother admitted to our special care nursery from March 2014 to March 2015 were recruited. This is to determine the percentage of positive dengue serology in the neonates of mother with confirmed dengue fever and to investigate the correlation between the duration of maternal illness with these neonatal seropositivity of dengue antibody and their presenting symptoms.
Method: A total of 22 neonates whose mother with confirmed dengue fever were recruited out of which 14 (63.6%) neonates of confirmed dengue fever mothers had positive dengue serology.
Results: Eight out of fourteen neonates were dengue seropositive when mother dengue illness was between day 1 to 5 of illness (acute phase) at the time of delivery. Thirteen out of twenty-two neonates (59%) were symptomatic, out of which 61.5% (8 out of 13) were delivered during maternal acute phase of illness.
Conclusion: From this study, we concluded that neonates were more likely to be dengue seropositive and symptomatic when mother presented in acute phase of illness during delivery. However, our sample size was small, only 22 neonates were recruited from a single centre, therefore a larger sample size from multicentre is required in future.
The awareness of the Muslim community on the importance of understanding breastfeeding according
to Islamic perspective needs to be emphasized in promoting the implementation of breastfeeding in the
best way. This proved that breast milk is the major food after birth and a mother should know the right
and the regulation of breastfeeding in order to be in line with Islamic law. This article aims to discuss
the level of awareness among the Muslim community in Selangor regarding breast milk donation. Data
were collected through a questionnaire distributed to 400 respondents involving three locations in
Selangor, namely in the northern zone (Hulu Selangor district), central zone (Klang district) and
southern zone (Sepang district). The findings showed that the respondents had a moderate level of
awareness regarding milk donation laws with average mean value of 3.26. This finding shows that the
Muslim community in Selangor are concerned about the rights and the regulation of breastfeeding.
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.
Some of the factors that could contribute towards influencing a mother's decision on breast-feeding and its success were discussed. One of the most important of such factors is the information and encouragement a mother receives, or fails to receive, when she needs it most. Such information, which is mostly non-medical, includes the technique of breast-feeding. Some of the negative influences on breast-feeding discussed include old wives' tales about diet and elements secreted through the mother's milk, the fear of losing one's figure, the fear by working mothers that breast-feeding is impossible to manage, the hospital practice of separating the mother and new-born for the first 24 hours, the shyness of breast-feeding babies in front of others, the lack of confidence in their own efficiency in breast-feeding, and the belief that breast-feeding is inconvenient. Some of the positive influences which can help towards successful preast-feeding are assistance and support from Breast-feeding Associations, a supportive husband and family, and the physician who makes a point of spending a few minutes to encourage his patient to breast-feed her forthcoming infant. The author called for combined efforts towards the restoration of breast-feeding as every infant's basic right.
Anaemia still constitutes a public health problem in the world, especially in the developing countries (1). Nutritional deficiency remains a major causative factor (2). During pregnancy, growth of the foetus, placenta and the larger amount of circulating blood in the expectant mother will lead to an increase in the demand for nutrients, especially iron and folic acid. Many women start their lives with insufficient iron stores, but also, because of inadequate child spacing, they have little time to build up their iron levels between pregnancies. In pregnancy, anaemia has been shown to be associated with an increased risk of maternal and fetal morbidity and mortality (3,4,5). Iron and folic acid supplementation is routinely given to pregnant mothers in Malaysia. It is anticipated that pregnant mothers who comply strictly with the prescribed iron supplement will maintain adequate iron stores at parturition. However, the compliance rate among rural mothers in Kelantan is often poor (6). Kelantan is also one of the most socio-economically underdeveloped
Mass vaccination of all newborns against hepatitis B virus infection has been implemented in Malaysia since January 1989. The significance of perinatal transmission of hepatitis B virus and the prevention of the disease are discussed. Routine screening of 6443 mothers in the University Hospital showed an overall carrier rate of 1.9%; whilst this was high amongst the Chinese (4.7%), a significant number of Malays were also infected (1.6%). The mechanism of perinatal transmission of hepatitis B and the important role of routine screening of antenatal mothers in eradicating the disease are discussed.
The authors report a case of a cephalopagus conjoined twin that was diagnosed at 29 weeks of gestation despite the mother having had two ultrasounds done previously. The fetus had one head and face, fused thoraces, common umbilicus but had two pelvises and two sets of genitalia. The fetus had four normally formed legs and arms.Antenatal ultrasound images are supplemented by post natal photographs. A review of literature, clues to ultrasound diagnosis and possible causes of missing this significant abnormality until the 3rd trimester are discussed.