Objective: To determine the prevalence of dysmenorrhea, its impact, and the treatment-seeking behavior of adolescent Asian girls.
Method: A cross-sectional study with 1092 girls from 15 public secondary schools and 3 ethnic groups in the Federal Territory of Kuala Lumpur, Malaysia.
Results: Overall, 74.5% of the girls who had reached menarche had dysmenorrhea; 51.7% of these girls reported that it affected their concentration in class; 50.2% that it restricted their social activities; 21.5% that it caused them to miss school; and 12.0% that it caused poor school performance. Ethnicity and form at school were significantly associated with the
poor concentration, absenteeism, and restriction of social and recreational activities attributed to dysmenorrhea. Only 12.0% had consulted a physician, and 53.3% did nothing about their conditions. There were ethnic differences in the prevalence, impact, and management of dysmenorrhea.
Conclusion: There is a need for culture-specific education regarding menstruation-related conditions in the school curriculum.
The influence of an individuals' belief in their ability to resist drinking alcohol has recognised importance in understanding the pattern of drinking behaviours among Caucasian samples. Measures used to investigate this construct, such as the drinking refusal self-efficacy questionnaire-revised (DRSEQ-R; [Oei, T. P. S., Hasking, P. A., & Young, R. M. (2005). Drinking refusal self-efficacy questionnaire-revised (DRSEQ-R): A new factor structure with confirmatory factor analysis. Drug and Alcohol Dependence, 78, 297-307.]) have been widely used and have established psychometric properties. However, the exploration of the utility of this questionnaire with samples of different ethnicity, religion and living in different countries remains scarce. In the current study, Arab Muslim samples living in the United Arab Emirates and Oman (n=356) and Asian predominately Muslim samples living in Malaysia and Indonesia (n=256) were used. Exploratory and confirmatory factor analysis demonstrated that the DRSEQ-R has a three factor structure. Internal consistency ranged from alpha .96 to alpha .86 and validity was good. This study offers evidence of the utility of this measure with Arab and Asian samples.
There is little information of the validity of generic instruments in measuring health-related quality of life (HRQOL) in patients with dyspepsia. We aimed to assess the reliability and validity of the EQ-5D, a brief and simple instrument, in measuring HRQOL in adult patients with dyspepsia.
OBJECTIVE: The aim of this study is to investigate if an association exists between single nucleotide polymorphism (SNP) in the tumor necrosis factor-alpha (TNF-alpha) and TNF-beta genes.
METHODS: The DNA was extracted and SNP in the human TNF-alpha and TNF-beta genes at positions -308 (G/A) and 252 (A/G), respectively, was analyzed using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Plasma levels of TNF-alpha in different stages of pregnancy were quantified using enzyme linked immunosorbent assay (ELISA).
RESULTS: There was no significant difference in genotype and allele frequency of SNP at position -308 (G/A) in the promoter region of the human TNF-alpha gene as well as the SNP at position 252 (A/G) in the human TNF-beta gene between the GDM and control subjects. Using the logistic regression model, it was found that the SNP in the TNF-alpha as well as TNF-beta were not associated with development of GDM. In addition, the TNF-alpha levels in the plasma of GDM and control mothers were not significantly different.
CONCLUSIONS: In the population studied, the SNP in position -308 (G/A) of the human TNF-alpha or in position 252 (A/G) of the human TNF-beta gene is not an independent risk factor or a predictor for GDM.
INTRODUCTION: Psoriatic Arthritis (PsA) is an inflammatory arthritis associated with Psoriasis. Its recognition as an inflammatory disease distinct from Rheumatoid Arthritis has put forward for consideration several questions regarding its specific CVS mortality and morbidity (9, 11, 16, 26). Carotid intima media thickness is a useful surrogate and sensitive marker to determine atherosclerosis even in its subclinical stages (6, 14, 22, 27, 32).
OBJECTIVE: Prevalence of carotid intima media thickness in patients with Psoriatic arthritis is unknown in Asian population. We aim to identify the presence of subclinical atherosclerosis in patients with psoriatic arthritis and disease activity association and its predictors in a series of patients with PsA attended to the rheumatology clinic, tertiary hospitals.
METHODS: A total of 63 patients with PsA who fulfilled the CASPAR criteria were recruited from UKM Medical Centre and Hospital Putrajaya. Common carotid intima media thickness (IMT) was measured in both right and left carotid artery by using high resolution B-mode ultrasound. This was a cross sectional study first done in Malaysia for PsA patients.
RESULTS: The positive IMT (IMT > 1.00 mm) among PsA was observed in 10 out of 63 patients (15.9 %) regardless of background cardiovascular risk. The mean +/- SD of IMT was 0.725 +/-0.260 mm for this study. Variables significantly associated with positive IMT (p < 0.05) included age at the time of study (p = 0.005), waist circumference (p = 0.001), Hypertension (p = 0.007), Diabetes (p = 0.002) and Metabolic syndrome (p = 0.001) and not associated with gender, ethnicity, duration of PsA disease, pattern of PsA, disease activity and severity. Above all, only age had positive IMT independent predictor (p = 0.032), with OR 1.116; 95 % CI (1.010-1.234).
CONCLUSIONS: There was a significant association between CVS risk and positive Intima Media Thickness in Psoriatic Arthritis patients. Otherwise, there was no association in disease activity, disease severity and DMARDS therapy with positive Intima Media Thickness in Psoriatic Arthritis patients. The study was approved by Research and Ethics Committee of the faculty of medicine, Universiti Kebangsaan Malaysia with project code FF-114-2008 and by Community Research Center (CRC) of National Institutes of Health (NIH) for the case study in Hospital Putrajaya with the project code NMRR-08-970-2125.
Cutaneous larva migrans is a common parasitic skin disease that can be easily prevented by wearing 'protective' footwear. However, this has been under-emphasized in terms of what constitutes the protective footwear. Even though the disease resolves spontaneously, the significant duration of the disease along with severity of pruritus make treatment unavoidable. Here, we present a very long-standing creeping eruption, which puzzled many attending clinicians handling the case, and the possibility of long socks as a causal effect on the development of cutaneous larva migrans infection.
As well as dengue fever (DF) and dengue haemorrhagic fever-dengue shock syndrome (DHF/DSS), other atypical manifestations of dengue virus infection have also been reported. The frequency of CNS involvement in dengue remains unknown, although isolated cases with neurological manifestations have been reported in Southeast Asia, Malaysia, Burma, Puerto Rico and India. We present two cases of encephalitis associated with DF and DHF from New Delhi, India.
A health screening was done in UNIMAS in August 2008 for 237 undergraduate students. Body mass index (BMI), waist circumference (WC) and blood pressure (BP) were measured for all subjects. Total cholesterol and glucose levels were checked for those who fulfilled the screening criteria. The proportion of participants with cardiovascular (CVD) risk factors was high. The strategies for health promotion should not only be targeted to the older community but also to the younger community.
Previous works on the effects of salivary alpha amylase in respond to various stressors report encouraging findings on it being a good indicator of stress. Ellestad protocol is a clinical procedure to screen for coronary artery disease by introducing exercise induced physical stress. If a salivary based biomarker profile in accordance to a stress test protocol could be established, the critical stress state which disable rational decision making could be ascertained in a standardized procedure. This technique would serve to aid human resource management in times of critical events such as rescue, firefighting or even military, that would potentially prevent unnecessary sacrifice of human lives. In this pilot study with five healthy volunteers performing the Ellestad protocol treadmill, a measurement profile with physiologic and salivary based biomarker is obtained. It is found that the alpha amylase levels or the changes in it as workload changes from resting-walking-running at ease-exhaustive running, is relatively more significant in reflecting the stress state than heart rate and blood pressure. Moreover, it is strongly associated with mood state with correlation coefficient of 0.8 and significance of 0.01.
The aims of this study were to establish the physical and physiological attributes of elite and sub-elite Malaysian male badminton players and to determine whether these attributes discriminate elite players from sub-elite players. Measurements and tests of basic anthropometry, explosive power, anaerobic recovery capacity, badminton-specific movement agility, maximum strength, and aerobic capacity were conducted on two occasions, separated by at least one day. The elite (n = 12) and sub-elite (n = 12) players' characteristics were, respectively: mean age 24.6 years (s = 3.7) and 20.5 years (s = 0.7); mass 73.2 kg (s = 7.6) and 62.7 kg (s = 4.2); stature 1.76 m (s = 0.07) and 1.71 m (s = 0.05); body fat 12.5% (s = 4.8) and 9.5% (s = 3.4); estimated VO(2max) 56.9 ml . kg(-1) . min(-1) (s = 3.7) and 59.5 ml . kg(-1) . min(-1) (s = 5.2). The elite players had greater maximum absolute strength in one-repetition maximum bench press (P = 0.015) compared with the sub-elite players. There were significant differences in instantaneous lower body power estimated from vertical jump height between the elite and sub-elite groups (P < 0.01). However, there was no significant difference between groups in shuttle run tests and on-court badminton-specific movement agility tests. Our results show that elite Malaysian male badminton players are taller, heavier, and stronger than their sub-elite counterparts. The test battery, however, did not allow us to discriminate between the elite and sub-elite players, suggesting that at the elite level tactical knowledge, technical skills, and psychological readiness could be of greater importance.
It has been suggested that a birthweight limit of 2.5 kg should not be regarded as valid for all populations as the cut-off point of low-weight births because of demographic, genetic and environmental differences. Countries often choose alternative cut-off values for low birthweight for clinical purposes. Bangladesh also needs to choose a convenient cut-off value for low birthweight. A total of 770 live singleton full-term normal newborns were included in this study by stratified sampling; birthweight was measured using the Detecto-type baby weight machine. Newborns were followed up to the end of their first week of life. For data collection a pretested structured questionnaire and an Apgar Score estimating checklist were used. Chi-square test was applied to assess the association of different birthweight strata and neonatal health outcomes. Multiple logistic regression analyses were carried out to identify the independent effects of different levels of birthweight on early neonatal health. The neonates having birthweight < or = 2 kg had a significantly higher risk of early neonatal mortality and morbidity than the higher level birthweight group. Birth asphyxia was the commonest cause of early neonatal mortality and morbidity. Borderline birthweight (>2 to <2.5 kg) neonates experienced the same mortality and morbidity rates as the normal birthweight neonates during their early neonatal life. Birthweight < or = 2 kg may be one of the criteria for admission to a neonatal intensive care unit whereas more than 2 kg may not require admission unless otherwise necessary.
Renal hyperparathyroidism with attendant osteodystrophy is a frequent and severe morbidity affecting the quality of life of end stage renal failure patients surviving on long-term renal replacement therapy. A small subgroup of these patients with severe cardiorespiratory dysfunction was deemed at very high risk for general anaesthesia (GA). We report on a series of total parathyroidectomy under local anaesthesia (LA) for these patients.
Verbal memory tests-although important to the neuropsychological assessment of memory-are biased to many cultures. In the present article, we highlighted the limitations associated with the direct translation of tests and word matching, as well as the lack of ecological validity and cultural appropriateness when tests developed in one culture are used in another. To overcome these limitations, a verbal memory paradigm was developed that framed the memory assessment with a shopping-list format, but that developed culturally specific stimuli for the different language groups. The aim of the present study was to determine the equivalence of this shopping list memory test in different cultural and language groups. Eighty-three adults from English-, French-, Malay-, and Chinese-speaking cultures participated in four experiments. The results of all the experiments indicated that performance of verbal list learning is equivalent, irrespective of the language used. These results support the use of this methodology for minimizing cross-cultural test bias, and have important implications for testing culturally and linguistically diverse individuals.
In today's highly competitive health care environment, many private health care settings are now looking into customer service indicators to learn customers' perceptions and determine whether they are meeting customers' expectations in order to ensure that their customers are satisfied with the services. This research paper aims to investigate whether the human elements were more important than the nonhuman elements in private health care settings. We used the internationally renowned SERVQUAL five-dimension model plus three additional dimensions-courtesy, communication, and understanding of customers of the human element-when evaluating health care services. A total of 191 respondents from three private health care settings in the Klang Valley region of Malaysia were investigated. Descriptive statistics were calculated by the Statistical Package for Social Sciences (SPSS) computer program, version 15. Interestingly, the results suggested that customers nowadays have very high expectations especially when it comes to the treatment they are receiving. Overall, the research indicated that the human elements were more important than the nonhuman element in private health care settings. Hospital management should look further to improve on areas that have been highlighted. Implications for management practice and directions for future research are discussed.
OBJECTIVES: Better outcomes of human papillomavirus (HPV) vaccination would be expected if men become full partners and advocates in vaccination initiative. Men involvement has important implication especially within the context that they are equally responsible for spreading the virus.
METHODS: Twenty-seven men took part in four focus group discussions carried out to assess men's attitudes toward the HPV vaccine between October and November 2007.
RESULTS: The results revealed that men have low awareness about the newly release vaccine and minimal knowledge of HPV and its association with cervical cancer. When provided with information, most men were in favor of protecting their spouses, partners, or daughters from cervical cancer using the vaccine. They were aware of the effects of men's risk behavioral patterns on women's risk for acquiring HPV infections. Many needed assurance about the vaccine's long-term safety and efficacy. They also expressed concern over the high cost of the vaccine. Men in this study played an influential role in the vaccination decision of their child and sexual partners. Many were in favor of male vaccination for cervical cancer prevention of their spouse or partner.
CONCLUSIONS: Vaccine advocacy should put special emphasis on men as sexual partners, husbands, and fathers from a gender equality and partnership perspective. The findings are useful in facilitating the development of strategies for effective immunization initiatives.
The anterior loop is defined as where the mental neurovascular bundle crosses anterior to the mental foramen then doubles back to exit the mental foramen. It cannot be seen clinically but can be detected in 11-60% of panoramic radiographs. As this anatomical structure is important in determining the placement position of endosseous implants in the mandibular premolar region, a pilot study was undertaken to determine its visibility on dental panoramic radiographs in dentate subjects of various age groups. One or more anterior loops were visible in 39 (40.2%) radiographs encompassing 66 sites (34.4%). Interestingly, anterior loops were most commonly observed bilaterally, followed by on the right side of the mandible only. An anterior loop on the left side only was observed in just 1 radiograph. Visibility of anterior loops reduced as the age of subjects increased. More than half (58.1%) of subjects aged 20-29 years exhibited at least one anterior loop; this gradually reduced to only 15 percent of subjects aged 50 and older. There was no association between visualization of the anterior loop and subject gender.
BACKGROUND: The ideal method for diagnosis of breast cancer is debatable.
METHODS: The methods of diagnosis of 436 new cases of breast adenocarcinoma presenting from Jan 2005 till Dec 2006 at the University Malaya Medical Centre (UMMC) were examined in this study.
RESULTS: A total of 388 cases presented to the breast unit in UMMC primarily and 48 cases were diagnosed in non-breast units in other hospitals and referred for management. Fine needle aspiration cytology (FNAC) was the commonest mode of initial diagnosis in 278 cases followed by core needle biopsy and surgical excision. In UMMC, FNAC was the commonest initial method (68.3%) compared to cases diagnosed outside UMMC, where 37.5% of cases were diagnosed by excision. Tumours less than 2cm were more likely to be diagnosed by excision biopsy.
CONCLUSION: The biopsy method used to confirm the diagnosis is influenced by where the patient first presents, and by the size of the tumour.