Lymphangioleiomyomatosis (LAM) is a rare disease. The reported prevalence is around one per million in the West but the exact prevalence in Asia is unknown. It affects primarily young women of reproductive age, with a mean age of onset at 34 years. The disease is characterised by an abnormal proliferation of smooth muscle-like cells that grow over a course of time to obstruct airways, lymphatic and blood vessels. We report a case of LAM in a young woman who presented with a spontaneous pneumothorax. Computed tomography scan of the thorax and abdomen showed homogenous thin-walled cystic lesions with normal intervening lung parenchyma and multiple lesions in her kidneys with Hounsfield units similar to that of fat.
Accidental needle-stick injuries (NSIs) are a hazard for health-care workers and general public health. Orthopaedic surgeons may be more prone to NSIs due to the prevalence of bone spikes in the operative field and the use of sharp orthopaedic instruments such as drills, saws and wires. A hospital-based cross sectional study was conducted in the orthopedic wards of Melaka General Hospital. The prevalence of NSIs was 32 (20.9%) and majority of it occurred during assisting in operation theatre 13(37.4%). Among them six (18.8%) were specialist, 12(37.5%) medical officer, 10 (31.2%) house officer and four staff nurses (12.5%). Among the respondents 142 (92.8%) had been immunized against Hepatitis B and 148 (96.7%) participants had knowledge regarding universal precaution. The incidence of NSI among health care workers at orthopaedics ward was not any higher in comparison with the similar studies and it was found out that the prevalence was more in junior doctors compared with specialist and staff nurses and it was statistically significant.
Background: Nosocomial infection is among the leading problem in many major hospitals resulting in soaring cost expenditure in managing its affect.Hand washing practice is a crucial preventive way to contain such mischief but many ignored its importance. This is perhaps due to lack of appropriate role modeling from senior practitioners.
Subjects and methods: Our study examined the prevalence of hand washing practice among medical students from year 3 to 5 and compared it to their knowledge and level of awareness on its importance in clinical practice. 142 students were randomly observed during their clinical work in the wards on this practice and questionnaires were later distributed to 268 students from all semesters on their knowledge on the technique and awareness on its importance.
Results: Out of 142, almost 80% washed their hands but only 41.6% performed effective hand washing. In contrary, 80 to 90% showed good level of knowledge and awareness as well as perception about its importance in clinical practice.
Conclusions: The contradictory findings between the actual practice of hand washing and knowledge as well as awareness suggest that enforcement on the practice is necessary. This requires motivation and cooperation from all health alliances and higher authority in the health system. Remedial measures are much needed in order to contain high incidence of nosocomial infection in our local practice.
This study was done in all UNIMAS medical students from year 1 to year 5 in the year 2004. A questionnaire was used. 290 students participated with a response rate of 72.5%. There were more male students snoring than female (ratio 5.9:1.3). The habitual snoring percentages for all years, first year and final year medical students are 7.2, 9.9 and 3.6 respectively and these are comparatively and relatively low with other studies reported in the last 10 years, and the reasons for this are unknown. However it was interesting to note in this study and others that there are relatively more snoring medical students in the first year than subsequent years. Significant positive correlation of snoring was found with the factors of gender, weight, height and sleep apnoea, all having p<0.0005, but no significant correlation was found in others including examination results.
Abstract: A total of 307 Malaysian children and their parents were surveyed to ascertain the prevalence of mental health problems amongst urban primary and secondary school children. The results indicated that secondary school children report slightly higher rates of depressive symptoms, whereas primary school children report higher rates of social problems. There was also a discrepancy between child and parents reports of children’s emotions and behaviours. Children’s self-reports of aggressive behaviours where higher than their parents’ reports. Alternatively, parents reported lower levels of their childrens’ emotional problems, as compared with the childrens’ self-report. When gender was taken into consideration, females were reported to be more aggressive, withdrawn, and have more attention problems when compared with males.
Osteopoikilosis is a rare bone dysplasia which is inherited as an autosomal dominant trait with a prevalence of less than 0.1 per million.1 It is characterised by dense ovoid or circular spots in cancellous bone which may appear at birth or during skeletal growth. It is usually found in the metaphyseal and epiphyseal regions of long bones, the carpals and tarsals, the end of large turbular bones and around the acetabula. It is clinically asymptomatic and occasionally associated with hereditary multiple exostosis and dermatofibrosis lenticularis disseminata. It is not associated with spontaneous fractures and treatment is unnecessary. However a case of osteosarcoma developing in a man with osteopoikilosis has been reported. The first case of osteopoikilosis was reported in Malaysia four years ago in a 25 years old lady who is also of Indian descent. It would be interesting to know if these two patients are related. Since the bone lesions could easily be mistaken for metastatic disease, it is important that family physicians be aware of the benign nature of this condition.
Cystic Fibrosis (CF) is a life-threatening inherited disease that particularly affects the airways and digestive systems, which is caused by mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene. CF is considered as the most common autosomal recessive disorder in the Caucasian population. However, the prevalence of this disease amongst Asians is considered to be low, hence the lack of awareness of this disease amongst geneticists and physicians in Malaysia. This review will describe the features of CF, its molecular genetics, the current classification of CFTR mutation classes, the genotype-phenotype correlations, the effects of modifier genes, and the discourse of the disease pathogenesis, in the hope of raising public awareness of the condition and ultimately to improve the clinical and social care of those affected by CF in Malaysia.
Background and objectives: Radiation treatment in nasopharyngeal carcinoma (NPC) is known to be associated with increased prevalence of carotid stenosis. The objectives of the study was to determine the prevalence of radiation-induced extracranial carotid stenosis, plaque, carotid intima thickness (CIMT) in NPC patients; to explore whether the stenosis is due to direct effect of radiation rather than general tendency to atherosclerosis. Methods: This was a cross-sectional study conducted in the University Malaya Medical Centre from July 2011 to February 2012. The study subjects consisted of 47 NPC patients who were treated with radiation, and 47 healthy control. The patients and control had carotid duplex ultrasound and transcranial Doppler (TCD). Results: The mean age of the patients was 55.1 years, the time lapse from radiation was 76.7 ± 95.3 months. Internal carotid artery (ICA) and common carotid artery (CCA) stenosis of ≥50% was seen in 17.0% of patients vs 2.1 % of controls (p = 0.031), with 61.7% of patients and 19.1% of controls having plaque in ICA and CCA (p=0.004). CIMT was increased in 70.2% of patients and 44.7% of controls (p =0.022). Both the patient group and control had similar rate of intracranial stenosis of 12.8% in TCD.
Conclusion: Extracranial internal carotid artery is the most common site of stenosis following radiotherapy in NPC. This suggests that local trauma from irradiation is the most important factor in predisposition to atherosclerosis following radiation therapy.
Background: A cross sectional study was carried out to determine the prevalence of microbiological contamination in ready- to-eat food and factors affecting it in Melaka from February 2008 till May 2008 in collaboration with the Food Safety and Quality Unit and District Health Offices in Melaka Tengah, Alor Gajah and Jasin.
Methods: A purposive sampling of 101 food premises was carried out and 202 ready- to-eat food samples were collected and analysed microbiologically using standard methods. A total of 202 food handlers were randomly selected for questionnaire interview while rectal and nasal swabs were taken from them to determine their healthy carrier status of pathogenic food bacteria.
Results: Results showed that the overall prevalence of microbiological contamination in ready- to-eat food was 35.1%, while prevalence by type of food was 42.0% for main dishes and 9.8% for staple food. The majority of the contaminations were due to coliforms (14.9%), total plate counts (12.4%) and Staphylococcus aureus (3.5%). The mean score for food premise inspection was 77.21 ± 10.32 and the prevalence of healthy carrier status of pathogenic food bacteria among the food handlers was 15.8%. The level of food handling practices among food handlers was influenced by sex (p=0.012) and formal training on food handling courses (p=0.009). There was a significant negative correlation between age and level of food handling practices among the food handlers (r = -0.163; p = 0.02). Poor food handling practices (p=0.02) and poor hygiene status among the food handlers (p
Background: This cross-sectional study aimed to investigate the prevalence of the caregiving burden among women who are caregivers to elderly with stroke and factors influencing it. Respondents identified through purposive sampling at the Universiti Malaya Medical Centre from October to December 2007.
Methods: Direct methods of data collection (clinical and housing) and indirect (postal) used a structured questionnaire distributed to the guards. Measurements taken include sociodemographic variables of patients and caregivers, the patient, the care, relationships with caregivers and patients with information about stroke. Zarit Burden Interview (ZBI) short version was used to measure the burden of care. Carers' Assessment of Managing Index (Cami) was used to assess coping strategies. A total of 96 respondents took part in this study.
Results: The study showed that prevalence of caregiving burden was 35.4%. Burden of care was found to have significant relationships with factors such as marital status, caregivers (p = 0.017), family income (p = 0040) and the patients (p = 0.000). Significant correlation obtained for the coping strategies with the burden (r =- 0228, p 0026).
Conclusion: The conclusion shows that policy makers and program managers should appreciate and assist caregivers in performing the role of care. Intervention programs should be designed to suit the needs of the heterogeneous guardian.
Red cell alloimmunisation is defined as the development of antibodies in response to foreign red cell antigens through transfusion or pregnancy. In pregnant women even without the history of previous blood transfusion, this is possible through previous or current pregnancy with the presence of paternal red cell antigen inherited by the fetus. This study was aimed to determine the prevalence of red cell alloimmunisation among pregnant women without previous history of blood transfusion and the association with number of pregnancy and history of obstetric complications. This was a cross-sectional study in which 150 pregnant women were randomly selected from the antenatal clinic. Ten mls of peripheral blood was obtained for antibody screening using indirect antiglobulin test besides the routine antenatal screening. In this study, the majority (37.3%) of the women were primigravidae. Red cell alloantibodies were detected in two out of 150 (1.3%) patients which were subsequently identified as anti-C and anti-D. However none of the primigravida was alloimmunised. One woman of gravida 2 (2.9%) and gravida 3 (3.6%) each were positive for alloimmunisation. One of them also had a bad obstetric history. This study showed that the prevalence of red cell alloimmunisation among pregnant women was low in this centre. Nevertheless, red cell alloantibody screening test should be made available to reduce possible complications of alloimmunisation in mothers and fetuses.
Study site: Antenatal clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Functional recovery in the immediate post stroke period predicts the long-term prognosis of post stroke patients. Despite the advancement in stroke rehabilitation in improving the physical function of survivors, there are other factors that may influence functional recovery. We aimed to assess the functional recovery of ischaemic stroke patients attending a tertiary hospital and its associated factors in order to make recommendations for post stroke care after hospital admission. A three months prospective observational study looking at functional recovery using the Modified Barthel’s Index (MBI) and depression (Patient Heath Questionnaire-9) score of post stroke patients. There were 46 ischaemic stroke patients who were recruited for the study. At three months, only 37 patients were eligible for analysis. The mean age was 67.2 (SD 11) years with the Malays (50%) making up the majority of the patients, followed by Chinese (41.3%) and Indians (8.7%). There was a total of seven (15.2%) deaths. Hypertension was the most common risk factor (89.1%) followed by dyslipidaemia (65.2%) and diabetes mellitus (63.0%). The mean MBI difference was 45.2 (SD 27.0) with a median MBI of 17.0(IQR 33.0) at baseline compared to 85.0(IQR 42.0) at three months (p < 0.001, CI 35.98,55.45). The prevalence of depression (PHQ-9≥10) was 21.6%. Lower functional recovery was found among depressed patients (p
To assess their awareness and usage of mouthguard and occurrence of sports-related oral injuries in athletes who involve in various sports activities in Kota Bharu. A cross-sectional study was carried out among 180 athletes aged 12 to 27 years. A structured interviewer-guided questionnaire was used to determine the prevalence of oral injuries sustained during sport activities, the use of mouthguard as well as the athletes' awareness of mouthguard use. The respondents consisted of 107 males (59.5%) and 73 females (40.5%) with a mean age of 16.7 years (SD 5.53). There were 60 (22.2%) athletes who had one or more types of sports-related oral injuries sustained. Laceration of lips, tongue and gums were the most frequent injuries (57.5%) while loosening of teeth and fracture of teeth sustained in 12.5% and 10.0% of athletes respectively. Malay traditional martial arts silat athletes, 17(68.0%) experienced the highest oral injuries among athletes. The prevalence of oral injuries was significantly different between ball sports, martial arts and other non-contact sports (p=0.002). Sixty-one athletes (33.9%) reported that they were aware of mouthguard; however none of the athletes used the mouthguards during their sports activities. Malay traditional martial arts silat was the most common susceptible to sustain oral injuries. None of the athletes were wearing mouthguard. Education on prevention of orofacial trauma should be given to the coaches and athletes. Wearing of mouthguard during sport activities should be compulsory during practice and competition events.
his study assesses inter-examiner reproducibility in recording various malocclusion parameters and Index of Orthodontic Treatment Need (IOTN) grade during patient examination by utilising the kappa statistic. Five previously calibrated orthodontists clinically examined 233 non-orthodontically treated schoolchildren aged 14-17 years for recording various malocclusion parameters. The examination was repeated twice, thirty days apart and precluded the use of study-models or radiographs. Although good inter-examiner reproducibility was observed in recording incisor class, IOTN dental health grade, type of posterior crossbite, and excellent for parameters with absolute criteria like
erupted supernumeraries, etc, substantial examiner variation resulted in only fair reproducibility for recording IOTN esthetic category, canine class, overbite category, traumatic overbite and upper centre-line shift of two millimetres or more from the facial midline. Reproducibility for detecting occlusal displacement in the presence of crossbite was poor, and kappa statistic was incalculable for recording openbite and number of upper incisors rotated 30° or more. Kappa was also incalculable for recording IOTN dental health subcategory due to the creation of asymmetric tables caused by rarely chosen subcategory options. Despite prior agreement between previously calibrated examiners on evaluation criteria, detection of certain malocclusion parameters during an epidemiological examination can prove to be challenging. Epidemiological studies that report on prevalence of malocclusion in the population should always report on the kappa reproducibility, especially if the study is carried out by multiple examiners.
A cross-sectional study was done to determine the prevalence of violence among 15-year-old adolescents and to identify associated protective or risk factors. The study involved 758 adolescents, 384 males and 3 74 females in the District of Kuala Terengganu and Besut, Terengganu. About 39.0% of adolescents under study were ever involved in violence. Percentage of girls were slightly higher 19.8% as compared to boys 19.2%. About 30% of the violent adolescents were from Kuala Terengganu and 9.1% from Besut. There was no significant relationship between violence and ethnic groups. Family total income above poverty line was significant protective towards violent behaviour < 0.01, OR 0.61, CI 0.45 - 0.82). Using univariate analysis, selected parental factors were protective against violence, such as good parental connection (p < 0.01), presence of parental regulation (p < 0.001), religious parents (p < 0.05) and parents who had dinner everyday with adolescents (p < 0.01, OR 0.59, CI 0.43 - 0.80). Adolescent who perceived to have interest in learning (p < 0.001, OR 0.32, CI 0.17 - 0.59) were less likely to involve in violence. Adolescent who felt well connected to their school (p < 0.01), and perceived themselves religious (P < 0.001) were more likely to be non-violent. Those who felt satisfied with day to day life were less likely to be involved in violence (p < 0.001, OR 0.52, CI 0.37 - 0.71). On the contrary, adolescents who ever had the feeling to run away from home (p < 0.001), had 3 times risk of violence, ever smoked cigarette had 2.4 times risk (p < 0.001, CI 1.55 - 3.69) ever been bullied by peers were 2.3 times risk (p < 0.001, CI 1.46 - 3.60) to violence. Same factors remained significant in multivariate analysis. Such factors were total family income below poverty line (p < 0.001, OR 1.82,CI 1.28 - 2.59), parental regulation (p < 0.05, OR 0.34, CI 0.13 - 0.89), had dinner every night and frequently (p < 0.01, OR 0. 62, CI 0.43 - 0.89), and adolescents' religiosity (p < 0.05, OR 0.81, CI 0.66 - 0.98) were protective, whereas ever· smoke cigarettes (12 < 0.01, OR 2.24,Cl 1.38 - 3.62), being bullied by peers (o < 0.01, OR 2. 09, C1 1.26 - 3.45), and frequently felt depressed previous one year (p < 0.001, OR 3.01,CI 1.79 - 5.07) were risk factors. The findings of the study will serve as baseline in planning adolescent health programme specifically to prevent violence behaviour from developing right from young, in the home and in the school environment.
Malnutrition is associated with childhood diseases such as diarrhea or other severe illness. Children who suffer from
repeated episodes of diarrhea are more likely to suffer from malnutrition. In addition, the source of drinking water is
a very important factor affecting the nutritional status. The objective of this study was to find out the prevalence of
malnutrition condition among children aged 3 to 5 years old and the factors associated with it. A cross sectional study
using simple random sampling was conducted among 220 children aged 3 to 5 years old from four kindergartens in
Baghdad city, Iraq. Nutritional assessment was carried out using the indicator weight-for-age z-score based on World
Health Organization cut off points. Acute malnutrition was found in 18.2 % of the respondents. In this study 65 % of
the respondents used tap water to drink as compared to 35 % who used sterilized bottles as source of drinking water.
The environmental factors mainly the source of drinking water was significantly associated with child nutritional
status (p=0.034). The prevalence of diarrhea and admissions to the hospital due to diarrhea were also significantly
associated with malnutrition (p < 0.01, p
The relationship between dust exposure and lung function were investigated in a cross-sectional study of 70 male quarry workers. The investigation included spirometric testing and detailed personal interviews using a structured questionnaire adapted from British Medical Research Council questionnaire on respiratory symptoms. Respiratory symptoms commonly reported by the male workers were shortness of breath (42.9%), chest tightness (37.1 %}, morning phlegm (20.0%) and morning cough (0.8%}. Prevalence of respiratory symptoms was greater in current smokers. Age and duration of employment also had significant relationship with chest tightness. Both FEV, and FVC of these workers were significantly reduced when compared to healthy population. Smoking status, age, and duration of employment were also associated with reduced pulmonary function (p<0.01).
Key words: respiratory symptoms, lung function and quarry workers
This two-phase study examined the prevalence of depressive disorders among married working women in a sub-urban area in Malaysia. The Malay version of the General Health Questionnaire-12 (GHQ-12) was used for initial screening. Using multistage cluster sampling, there were 700 subjects from 25 workplaces that were approached, of which 307 filled out GHQ-12 in the initial phase. The prevalence of psychological distress (GHQ 2/3 cut off) is 22.8% (n=70, 95% CI 18.1-27.5). In the second phase, all 49 consenting patients who were screened positive for severe psychological distress (GHQ 3/4 cut off point) were telephone-interviewed by a trained psychiatrist with the Malay version of Mini International Neuropsychiatric Interview (M.I.N.I) to diagnose depressive disorders. The prevalence of depressive disorders was 5.5% (n=17, 95% CI 3.5-7.5). The prevalence of depressive disorders is comparable to those found in the working population worldwide.
Objective: To investigate the prevalence of parental stress and psychological wellbeing among parents with autistic children and their associations with dimensions of support system.
Methods: This is a preliminary cross sectional study which randomly selected parents with clinically diagnosed autistic children. Those parents who attended psycho-education session on management of autistic children at Health Psychology Unit were randomly selected to enroll in the study. Psychological wellbeing, parental stress and dimensions of support system were assessed by using the General Health Questionnaire (GHQ-28), the Parenting Stress Index (PSI) and the Provision Social Relation (PSR), respectively.
Results: Of 52 parents with autistic children (34 female and 18 male), about 90.4% of parents had significant parenting stress, and 53.8% of parents showed clinical disturbance in psychological wellbeing. Gender (t=1.67, p=0.02) and occupation (F=4.78, p=0.01) showed statistically significant association with psychological wellbeing. No association found between other socio-demographic factors, parental stress and psychological wellbeing with dimensions of support system among parents with autistic children.
Conclusion: Parents with autistic children have high prevalence of stress and psychological disturbances. Interactions of various factors need to be acknowledged and considered in order to reduce the burden of parents with autistic children.
Objective: This descriptive cross-section, community-based study examined the prevalence of psychiatric morbidity and quality of life (QOL) and the associated factors among family caregivers of hospice patients with cancer. Methods: Subjects were 50 family caregivers of cancer patients under the care of Hospice Malaysia homecare. Home visits were done in Klang Valley. Psychiatric morbidity was detected using GHQ-30 English and Bahasa Malaysia versions, and the QOL was assessed by the Short Form 36 items (SF-36) questionnaire. Results:The study results showed that 54% of respondents had psychiatric morbidity. The educational status and the relationship between family caregivers and the cancer patients were statistically significant (p