Displaying publications 1041 - 1060 of 1147 in total

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  1. Myo T, Hong SA, Thepthien BO, Hongkrailert N
    Malays J Med Sci, 2021 Aug;28(4):71-86.
    PMID: 34512132 DOI: 10.21315/mjms2021.28.4.8
    Background: Postpartum depression (PPD) can have serious consequences on both the mother and infant. Despite the higher prevalence, there are limited numbers of studies on PPD in low-and middle-income countries, like Myanmar. This study aimed to explore the prevalence and associated factors of PPD in primary healthcare settings in Myanmar.

    Methods: This cross-sectional online study was conducted with 220 mothers under 6 months postpartum in April-May 2020 and who registered in public health centres in Kungyangone Township, Yangon, Myanmar. The postpartum depression was measured with the Edinburgh postpartum depression scale (EPDS, ≥ 13 scores). Independent variables included sociodemographic factors, obstetric and infant factors, psychosocial factors (social support and social media usage), health services utilisation and accessibility factors. Chi-square tests and multiple logistic regression were performed.

    Results: Overall prevalence of depressive symptoms in 220 women under 6 months postpartum was 31.8% (95% confidence interval [CI]: 25.9, 37.3). In multiple logistic regression, unplanned pregnancy (adjusted odds ratio [AOR]: 2.946), less than four times antenatal care (ANC) visits (AOR: 2.518), travel time more than 1 h to reach health centres (AOR: 3.068) and birth interval more than 5 years (AOR: 4.594) were more likely to be associated with PPD, while preterm delivery (AOR: 0.091) was inversely associated.

    Conclusion: This study showed the relatively high prevalence of PPD and the strong association with preterm delivery, pregnancy intention, breastfeeding status, birth interval as well as frequency of ANC received and travel time to health centre. It may suggest that maternal mental health services should be integrated with existing maternal and child health (MCH) services for early detection and prevention of depression symptoms with promotion of MCH services utilisation and improved accessibility among mothers in primary healthcare setting.

  2. Chime OH, Orji CJ, Aneke TJ, Nwoke IN
    Malays J Med Sci, 2021 Aug;28(4):123-137.
    PMID: 34512137 DOI: 10.21315/mjms2021.28.4.13
    Objective: Child sexual abuse (CSA) is a growing public health concern with health, academic and psychosocial implications. The aim of this study was to determine the prevalence, pattern and predictors of CSA among secondary school students.

    Methods: This was a cross-sectional study carried out among adolescents in four secondary schools in Enugu Metropolis, Nigeria. A pretested self-administered questionnaire was used to collect information from 325 adolescents and data was analysed with a significance level set at P ≤ 0.05.

    Results: The prevalence of CSA in this study was 116 (35.7%). While the majority 20 (40%) of the victims were forced to watch pornography, most of the perpetrators were neighbours 34 (29.3%). A higher proportion of the victims were abused once, 79 (68.1%); when they were between 12 and 18 years old, 62 (53.4%); and at home, 39 (33.6%). Grouped ages, whom the child lived with, father's and mother's education, and father's occupation were statistically significant on bivariate analysis. Predictors of CSA were students in senior secondary school Class 2 (SSS2) and those whose fathers were employed.

    Conclusion: Our study revealed a high prevalence of CSA. Comprehensive sexuality education and legislative policies should be implemented to educate adolescents and deter perpetrators.

  3. Jahangeer SMA, Hasnain N, Tariq MT, Jamil A, Zia SY, Amir W
    Malays J Med Sci, 2021 Aug;28(4):113-122.
    PMID: 34512136 DOI: 10.21315/mjms2021.28.4.12
    Introduction: This study aimed at determining the frequency and association of stress levels with modes of transportation and was likely to reveal the contributing transportation-related factors for stress in medical students.

    Methods: This was a questionnaire-based, cross-sectional study that included undergraduate medical students of a public sector medical university in Karachi, Pakistan. A total of 573 students participated voluntarily, of which 300 were provided a manual questionnaire and 273 filled it online. The reliability of the questionnaire was assessed using Cronbach's alpha at 0.791. The collected data were analysed using IBM SPSS Statistics for Windows, version 21.0.

    Results: Out of 573 participants, 99.3% (n = 298) of students filled the questionnaire manually, whereas 100% of students filled the questionnaire online. Almost two-thirds of students used university transport; more than 90% lived more than 5 km from the university and 56% had a traveling time of more than an hour. Approximately 15.4% of students reported physical trauma and some form of harassment. Sheldon Cohen's stress scale surprisingly revealed 90% of students to be within the moderate-to-high stress category. Risk factors were associated with stress levels and significant associations were observed with noise exposure (P = 0.023) and sleep quality (P = 0.001). The most common reported stressors associated with commuting included overcrowding, long travel, and air and noise pollution. Noise pollution was the main predictor of stress among commuters.

    Conclusion: Poor transportation has adverse effects on health and academic performance. Administration in their respective jurisdictions is needed to investigate this matter to make commuting a routine rather than a hassle.

  4. Mat Din H, Raja Adnan RNE, Nor Akahbar SA, Ahmad SA
    Malays J Med Sci, 2021 Aug;28(4):138-145.
    PMID: 34512138 DOI: 10.21315/mjms2021.28.4.14
    In response to the rising number of COVID-19-related deaths among older adults in Malaysia, observation concerning COVID-19-related mortality among older adults is of urgent public health importance. This study presents a review of the COVID-19-related death cases among older adults in Malaysia. Clinical and social demographic data of death cases officially released by the Ministry of Health Malaysia were reviewed. As of 12 June 2020, 81 older adult death cases were identified and included in this study. The mean age of the death cases was 71.88 years old. Even though 79% of these cases were male, gender was not likely to be associated with mortality. A substantial difference between the prevalence of diabetes among death cases and the nationwide population indicated that diabetes was more likely to be associated with mortality. Most of the studied deaths were individuals with pre-existing medical conditions, predominantly diabetes and hypertension, and those aged 70 years old or above. The mean time from hospitalisation to death was 11.83 days. Extra focus should be given to older adults in the prevention and control of COVID-19.
  5. Rajah R, Lim KY, Ng BH, Soo CI
    Malays J Med Sci, 2021 Aug;28(4):146-152.
    PMID: 34512139 DOI: 10.21315/mjms2021.28.4.15
    Acute dyspnea is one of the prevalent reasons for admission to the emergency department. The use of N-terminal pro-B-type natriuretic peptide (NT-proBNP) as an adjunct for assessing acute dyspnea is not a common practice in many public hospitals in Malaysia. This retrospective review is part of our clinical audit to determine the utility of NT-proBNP as an adjunct to non-standardised clinical evaluation in identifying acute heart failure (HF) in patients with persistent dyspnea (24 h) post-admission. In this cohort of 30 patients with acute dyspnea, NT-proBNP was positive in 20 patients (87%) with acute HF. Three patients (13%) who were treated for septic shock recorded a NT-proBNP false-positive. NT-proBNP demonstrated an overall sensitivity of 90%, a specificity of 70%, a positive predictive value of 85.7% and a negative predictive value of 77.8% in identifying acute HF. These results reinforce that age-stratified NT-proBNP cut-off values are useful for ruling-in or -out acute HF. Thus, NT-proBNP should be considered a crucial point of care, testing to decifer the conundrum of acute dyspneic patients.
  6. Teo CH, Hing HL, Hamzah NH, Hamzah SPAA
    Malays J Med Sci, 2021 Aug;28(4):103-112.
    PMID: 34512135 DOI: 10.21315/mjms2021.28.4.11
    Background: Examination of post-mortem changes is one of the ways to assess decomposition process on buried bodies. Nonetheless, studies on such assessment are still lacking, especially on the effects of body coverings by different materials in burial conditions. The aim of this research is to study the effect of different types of covering towards decomposition on buried rabbit carcasses by using Total Body Score (TBS) system.

    Methods: Twenty-seven rabbit carcasses were divided into: (i) No Clothing; (ii) Thick Clothing and (iii) Plastic Wrapping groups, and buried into individual shallow graves. One subject was exhumed from first to ninth post-burial week and assessed by using TBS system.

    Results and Discussion: There are significant differences among TBS between different coverings while controlling the time factor, F (2, 23) = 4.80, P < 0.05, partial η 2 = 0.294. TBS score for Plastic Wrapping group is significantly lower than No Clothing group over times at α = 0.05, P < 0.05. The slightly delaying effect of thick clothing is caused by design of jacket, which allows arthropods access and microbial activity. Relatively strong delaying effect by plastic covering could be caused by impermeable property that caused accumulation of decompositional products and slow down the degradation.

    Conclusion: In conclusion, TBS system is a potential tool in describing rate of decomposition for buried cases in Malaysia.

  7. Udompanich N, Thanasootr KO, Chanavirut R, Chatchawan U, Hunsawong T
    Malays J Med Sci, 2021 Aug;28(4):87-96.
    PMID: 34512133 DOI: 10.21315/mjms2021.28.4.9
    Background: Balance impairment is a common consequence of chronic ankle instability (CAI). This study aimed to assess the discriminative validity of four clinical tests for quantifying balance impairment in individuals with CAI.

    Methods: Participants were screened for their balance using the single-leg balance test (SLBT) and were assigned to either the positive or the negative SLBT groups. Fifty-four individuals with CAI (N = 27 per group) were recruited and completed four clinical tests including the foot-lift test (FLT), the time-in-balance test (TIBT), the modified star excursion balance test in the posteromedial (mSEBT-PM) direction and the side-hop test (SHT). The receiver operating characteristics (ROC) curve coupled with Youden index were calculated to determine the optimal cut-off scores of each test.

    Results: We found significant differences in balance between groups for all tests, with good to excellent values for the area under the ROC curve (AUC). All four tests reached good to excellent sensitivity and specificity values and had significant cut-off scores to discriminate balance performance among CAI participants.

    Conclusion: All four clinical tests can be conducted with their respective cut-off scores to quantify balance impairment in individuals with CAI.

  8. Cheraghali R, Farshidmehr P
    Malays J Med Sci, 2021 Aug;28(4):97-102.
    PMID: 34512134 DOI: 10.21315/mjms2021.28.4.10
    Background: This prospective cohort study aims to evaluate the primary and exchanged femoral catheter patency rates, as well as mortality rates and determine the probable risk factors affecting femoral catheter survival.

    Methods: All 79 tunneled femoral catheters created in our hospital from 2017 to 2020 were included in this study. Patients having no other means for dialysis access other than the femoral catheter was recruited in this study. Data collected included patient age, sex, comorbidities (diabetes and hypertension), transplant history, dialysis duration, catheter complications, femoral access history, and primary and exchanged femoral patency rates. Patients were followed for 4-36 months.

    Results: The median catheter primary patency was 7 months (95% confidence interval [CI]: 5.77, 8.22) and the primary patency rates at 2, 4 and 6 months were 79%, 68% and 48%, respectively. The median exchanged catheter survival was 8 months (95% CI: 0.83, 15.17) and the exchanged patency rates at 1, 3 and 8 months were 72%, 64% and 32%, respectively. Of the patients (n = 62), 8% (5 patients) died because they had no other option for dialysis access.

    Conclusion: Tunneled femoral catheters have a low patency rate and should be the last option for haemodialysis patients when other probable accesses are not available.

  9. Mushi V, Mushi L
    Malays J Med Sci, 2021 Aug;28(4):153-155.
    PMID: 34512140 DOI: 10.21315/mjms2021.28.4.16
    Social and behavioural change strategies are crucial to facilitating the adoption of preventive behaviours during the COVID-19 pandemic. For the success of such social and behavioural changes, the community should be aware of the interventions and willing to adhere to health advice. This letter details the strategies employed in Tanzania to accelerate the adoption of preventive behaviour and contain the spread of COVID-19.
  10. Abdullah N, Kueh YC, Kuan G, Yahaya FH, Lee YY
    Malays J Med Sci, 2022 Dec;29(6):77-88.
    PMID: 36818903 DOI: 10.21315/mjms2022.29.6.8
    BACKGROUND: Abdominal bloating (AB) is a common medical complaint known to diminish patients' quality of life. However, lifestyle and behavioural changes could mitigate its expression and severity. This study sought to explore the health beliefs, intentions and health-promoting behaviours among people with AB in Kelantan, Malaysia.

    METHODS: The theory of planned behaviour (TPB) was employed to explore the factors that influence the management of adults with AB, namely health beliefs and intentions. An interview guide was developed by adapting the TPB and the findings of prior studies concerning the factors associated with AB management. All eligible participants took part in in-depth interviews.

    RESULTS: The mean age of the participants was 32.5 years old (standard deviation [SD] = 14.19 years old) and the majority of participants were female (58.3%). The themes and sub-themes that emerged following the application of the TPB framework represented the qualitative results of this study, which indicated that the health beliefs, intentions and health-promoting behaviours observed among people with AB were closely related.

    CONCLUSION: The findings of this study suggest that the adoption of a healthy lifestyle could be an effective means of improving AB. Thus, it is vital to implement a health education programme that promotes health-related beliefs and intentions in order to trigger health-promoting behaviour among people with AB.

  11. Shaharudin MI, Abd Rahman NFN
    Malays J Med Sci, 2022 Dec;29(6):34-45.
    PMID: 36818895 DOI: 10.21315/mjms2022.29.6.4
    Frailty is conceptually defined as a state of increased vulnerability in older persons, resulting from age-associated declines in physiological reserve and function as they cope with everyday life stressors. To date, the prevalence of frailty has been assessed in various ways. The objective of this study was to identify the prevalence of the condition and the assessment tools used to determine its occurrence among Malaysian older individuals. A systematic literature search was performed on electronic bibliographic databases, namely, Web of Science, Scopus, EBSCOHost: MEDLINE Complete and Google Scholar. Ten eligible articles were reviewed and evaluated using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Newcastle-Ottawa Scale. Frailty was diagnosed using Fried's frailty phenotype and the Groningen Frailty Indicator (GFI). Assessment tools that included physical performance tests detected a lower prevalence of frailty than that determined using questionnaire-based tools. The prevalence of frailty ranged from as low as 6% to as high as 76%, and there was a higher prevalence among older persons living in aged care homes. This review suggests increasing prospective and interventional studies on frailty to establish a cause-effect relationship between standardised tools of assessing frailty and its prevalence among Malaysian older persons and provide guidelines for health professionals on promoting active lifestyles among older populations.
  12. Abas R, Masrudin SS, Harun AM, Omar NS
    Malays J Med Sci, 2022 Dec;29(6):6-14.
    PMID: 36818899 DOI: 10.21315/mjms2022.29.6.2
    During the third week of human pregnancy, an embryo transforms from two germinal disc layers of hypoblast and epiblast to three germinal layers of endoderm, mesoderm and ectoderm. Gastrulation is a complex process that includes cellular mobility, morphogenesis and cell signalling, as well as chemical morphogenic gradients, transcription factors and differential gene expression. During gastrulation, many signalling channels coordinate individual cell actions in precise time and location. These channels control cell proliferation, shape, fate and migration to the correct sites. Subsequently, the anteroposterior (AP), dorsoventral (DV) and left-right (LR) body axes are formed before and during gastrulation via these signalling regulation signals. Hence, the anomalies in gastrulation caused by insults to certain molecular pathways manifest as a wide range of body axes-related disorders. This article outlines the formation of body axes during gastrulation and the anomalies as well as the clinical implications.
  13. Kour I, Vasesi D, Singhal L, Gupta V
    Malays J Med Sci, 2022 Dec;29(6):60-66.
    PMID: 36818898 DOI: 10.21315/mjms2022.29.6.6
    BACKGROUND: To determine the antibiotic resistance pattern, the prevalence of extended-spectrum beta-lactamases (ESBLs) and carbapenem resistance in blood culture isolates of E. coli. Further, we evaluated and compared Carba NP, Modified Carba NP and a kit-based Rapidec Carba NP test to detect carbapenem resistance rapidly.

    METHODS: Twenty-six carbapenem-resistant strains and four susceptible strains were selected. The three methods mentioned above were evaluated as per Clinical Laboratory Standards Institute (CLSI). These tests are based on biochemical detection of the hydrolysis of the beta-lactam ring of a carbapenem-imipenem, followed by the colour change of a pH indicator.

    RESULTS: Carba NP test was positive in 24 out of 26 isolates; the Modified Carba NP and Rapidec Carba NP tests were positive for all the isolates (26/26). All the carbapenemase non-producers (100%, 04/04) were negative.

    CONCLUSION: Modified Carba NP is a more effortless and inexpensive alternative to the Carba NP test, allowing the detection of carbapenemase activity directly from bacterial cultures of Enterobacteriaceae. The test could be used in low-income countries with large reservoirs for carbapenemase producers and can be implemented in any laboratory worldwide.

  14. Khoo CS, Ramachandram S
    Malays J Med Sci, 2022 Dec;29(6):146-157.
    PMID: 36818902 DOI: 10.21315/mjms2022.29.6.14
    BACKGROUND: Children with autism spectrum disorder (ASD) are susceptible to excessive electronic screen media (ESM) use. This study aimed to evaluate the effectiveness of a parent training programme in improving the screen time and social functioning of children with ASD.

    METHODS: This pre-/post-test quasi-experimental study involved parents by providing them with structured education based on the American Academy of Pediatrics (AAP)' screen time recommendations. In total, 259 children with ASD aged 3 years old-12 years old were eligible. Of those children, 26 were excluded due to comorbidities or taking medications. Additionally, 28 parents participated. Children's screen time were recorded, and social behaviour was scored using the Social Responsiveness Scale pre- and post-intervention.

    RESULTS: There were significant reductions in the average daily screen time of children with ASD after their parents attended the training programme (-51.25 min; 95% CI: -78.40, -24.10). In subgroups with reduced screen time, the treatment effect of the intervention was significant in improving the social responsiveness total score (-3.09; 95% CI: -5.96, -0.22), the social communication scale (-3.64; 95% CI: -5.91, -1.36) and the restricted interest and repetitive behaviour (RRB) scale (-5.27; 95% CI: -10.29, -0.25).

    CONCLUSION: Parental training is effective in reducing screen time and improving social functioning in children with ASD.

  15. Dauda KA
    Malays J Med Sci, 2022 Dec;29(6):67-76.
    PMID: 36818901 DOI: 10.21315/mjms2022.29.6.7
    BACKGROUND: Random Forest (RF) is a technique that optimises predictive accuracy by fitting an ensemble of trees to stabilise model estimates. The RF techniques were adapted into survival analysis to model the survival of patients with liver disease in order to identify biomarkers that are highly influential in patient prognostics.

    METHODS: The methodology of this study begins by applying the classical Cox proportional hazard (Cox-PH) model and three parametric survival models (exponential, Weibull and lognormal) to the published dataset. The study further applied the supervised learning methods of Tuning Random Survival Forest (TRSF) parameters and the conditional inference Forest (Cforest) to optimally predict patient survival probabilities.

    RESULTS: The efficiency of these models was compared using the Akaike information criteria (AIC) and integrated Brier score (IBS). The results revealed that the Cox-PH model (AIC = 185.7233) outperforms the three classical models. We further analysed these data to observe the functional relationships that exist between the patient survival function and the covariates using TRSF.

    CONCLUSION: The IBS result of the TRFS demonstrated satisfactory performance over other methods. Ultimately, it was observed from the TRSF results that some of the covariates contributed positively and negatively to patient survival prognostics.

  16. Tan PP, Abdul Rahman J, Sarah MN, Mohamad Azlin SAA, Zambree N, Mohd Noor S
    Malays J Med Sci, 2022 Dec;29(6):170-172.
    PMID: 36818896 DOI: 10.21315/mjms2022.29.6.17
    Songs are commonly used in educational public health programmes to facilitate the understanding of health messages. During the COVID-19 pandemic, national blood banks witnessed a pronounced reduction in blood donors. Thus, we created a song with the title 'Keep the World Beating' to raise awareness of the need for blood and to promote blood donation. To maximise participation, we carried out a live broadcast of the donation process and the music video on social media, increasing visibility and accessibility to the event. The number of donations increased in the month after the song was released. Songs can be used to strengthen current entertainment-education strategies promoting blood donation and to increase the level of awareness among the local population, thus motivating people to donate blood in a time of need.
  17. Haron MZ, Rohana AJ, Hamid NAA, Omar MA, Abdullah NH
    Malays J Med Sci, 2023 Oct;30(5):155-168.
    PMID: 37928780 DOI: 10.21315/mjms2023.30.5.13
    BACKGROUND: Child malnutrition problems still occur in Malaysia, particularly stunting. This study aimed to determine the proportion of stunting among children below 5 years old and investigate the factors associated with stunting on the East Coast of Peninsular Malaysia.

    METHODS: This study utilised data from the 2016 National Health and Morbidity Survey (NHMS). Multiple logistic regression was used to determine the factors associated with malnutrition among non-stunted and stunted children.

    RESULTS: The proportion of stunting among children below 5 years old in this East Coast region was 26.2%. When divided by state, Kelantan had the highest proportion of stunting, followed by Pahang and Terengganu, at 28.8%, 26.2% and 23.4%, respectively. In this study, the factors associated with stunting were children aged 24 months old-59 months old (adjusted odds ratio [aOR]: 1.52; 95% CI: 1.26, 1.83; P < 0.001), male children (aOR: 1.47; 95% CI: 1.23, 1.76; P < 0.001), Orang Asli children (aOR: 2.84; 95% CI: 1.86, 4.32; P < 0.001), children with low birth weight from 1,500 g to 2,499 g (aOR: 1.86; 95% CI: 1.36, 2.55; P < 0.001) and children from households that practice unsanitary waste disposal (aOR: 1.42; 95% CI: 1.16, 1.74; P = 0.001).

    CONCLUSION: Stunting among children under the age of 5 years old on the East Coast of Peninsular Malaysia remains a public health problem. To reduce the prevalence of stunting in this region, intervention programmes should be intensified. Emphasis should be placed on public health programmes that target the associated factors, such as dietary habits, Orang Asli children, low birth weight and unsanitary waste disposal.

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