Introduction: Doppler mode ultrasound is widely used in prenatal scanning and known to produce a higher acoustic
output which later leads to higher heat energy conversion compared to other ultrasound modes. It has been reported
that the use of Doppler imaging might increase the temperature of tissues, thus, when Doppler is used in combination with 2D ultrasound, the risks of bioeffects tend to increase more. It is also known that prolonged exposure to
ultrasound during pregnancy can cause irreversible biological destructions to the fetus. Despite the benefits of using
Doppler ultrasound, its potential adverse effects have received scant attention in the research literature. Therefore,
this study aimed to examine a correlation between gestational stages (GS) and newborn rabbit’s body weight at different prenatal Doppler ultrasound exposure durations. Methods: Twelve pregnant New Zealand white rabbits (NZWR)
were exposed once using three different Doppler ultrasound exposure durations (30, 60, 90 minutes exposure) at
three different GSs (1st, 2nd, and 3rd GS). After delivery, the mean weights of the 62 newborns were statistically analysed. Results: Strong negative and positive correlation between newborn’s body weight at different GSs and Doppler
ultrasound exposure durations with a significant result found in 60 minutes exposure (p =
Introduction: Evaluation of mental health literacy is important in assisting the development of intervention and policies toward preventing mental health problems. This study aims to explore mental health literacy and its socio- demographic predictors in a group of housewives living in low-cost apartments in Selangor, Malaysia. Methods: A Malay version of the self-administered Mental Health Literacy Scale (MHLS) was used in this cross-sectional study. Age, ethnicity, religion, educational level and family income were tested using one-way ANOVA and independent t-test. Result: A total of 103 eligible respondents participated in the study. Most respondents were from the age group of 30 and above, from the Malay ethnic group, Muslims, had formal education up to secondary level with a monthly family income below RM4000 (USD980). The overall mean (sd) mental health literacy score was low 106.65 (11.21) and was significantly associated with ethnicity, religion, educational level and family income (p>0.05). Conclusion: Mental health literacy scores were low and showed variations within sociodemographic groups.
Introduction: Iron deficiency (ID) has recently been identified as a threat to patients with heart failure with reduced ejection fraction (HFrEF). This study was conducted to determine the occurrence of ID among HFrEF patients in a Malaysian tertiary hospital and its correlation between left ventricular ejection fraction (LVEF). Methods: Stable patients with LVEF less than 45% were included. Demographic data, LVEF (Simpsons) and cardiac functional status were studied, along with full blood count and iron profile. Results: 81 patients with a mean LVEF of 33.6% were recruited. 43.2% of them were NYHA class II patients, followed by 38.3% class III, 13.6% class I and 4.9% class IV patients. About 2/5 of the study population were anaemic, and of those, 48.5% were iron deficient. Majority of these anaemic patients (87.5%) had an absolute iron deficiency. Pearson’s statistical analysis showed positive correlation between ejection fraction and serum ferritin (r=0.624, p< 0.001), serum iron (r= 0.302, p
Introduction: Tobacco induced illness remains a major contribution to premature death and global burden of dis- eases. The introduction of MPOWER policies by World Health Organization held the value to monitor the imple- mentation of the anti-smoking measures in all signatory countries. This paper aimed to investigate the application of the six MPOWER indicators among Malaysia population. Methods: We utilized the data of Global Adult Tobacco Survey-Malaysia (GATS-M) which recruited 5112 nationally representative samples of Malaysians of 15 years old and above. Descriptive statistical analysis was used to illustrate the social demographic characteristic of the respon- dents while cross tabulation was employed to describe all elements of the MPOWER indicators. Results: About one quarter (23.1%) of Malaysian adults were current tobacco users. The SHS exposure at home (38.4%) and restaurant (42.1%) were high. Approximately eight in ten (80.2%) of the smokers intended to quit, while for those attempted to quit in past one year, 9.0% utilized pharmacotherapy and 4.4% attended counseling. The awareness about tobacco related diseases was generally excellent. The overall tax make up of the cigarettes’ retail price ranging from 41.7% up to 80%. Conclusion: Tobacco consumption remains prevalent and plateau among Malaysian adults over the last two decades with substantial proportion of the population exposed to SHS. The inadequacy in the current anti-smoking policies needs urgent improvement in order to reduce the smoking norms among Malaysians population besides to achieve the ultimate goal of tobacco control end game by year 2045.
Introduction: Increased monocyte percentage and monocyte anisocytosis were suggested as new markers for den- gue fever detection. This study aims to investigate and evaluate monocyte volume standard deviation (MoV-SD) and monocyte percentage (Mono %) parameters using Coulter automated haematology analyser as screening parameters in discriminating between dengue infection and other febrile illness. Methods: A cross-sectional laboratory analysis using suspected dengue fever patients were included in this study. The study was conducted in the Department of Pathology, Hospital Tuanku Jaafar Seremban from June 2016 until June 2017. Patients were classified into dengue positive and dengue negative based on dengue IgM and NS1 result. The diagnostic performance of MoV-SD and Mono % was analysed by receiver operating characteristic (ROC) curve analysis. The cut-off value of the MoV-SD and Mono % was determined and evaluated with the validation group. Chi-square test was used to assess the as- sociation between the parameters. Results: 88 (48.4%) from 182 samples were confirmed to have dengue infection. ROC curve analysis showed Mono % at cut off value of 10.5 % with area under the curve (AUC) of 0.869 with 84.1% sensitivity and 84% specificity (95% CI: 0.812-0.925) and MoV-SD cut off value at 22.2 (AUC 0.776, 80.7% sensitivity, 61.7% specificity, 95% CI: 0.709-0.843) are an excellent parameters in separating dengue positive and dengue-negative patients. A cut-off value of 10.5 of Mono % and 22.2 of MoV-SD were applied to the validation group showed 83.1%, 66.4% sensitivity and 84.9%, 77.3% specificity respectively. Conclusion: MoV-SD and Mono
% parameters are a potential parameter for the screening of dengue infection in acute febrile illness patients with good specificity and sensitivity.
ABSTRACTS FOR INTERNATIONAL HEALTH AND MEDICAL SCIENCES CONFERENCE 2019 (IHMSC 2019). Accelerating Innovations in Translational and Precision Medicine. Held at Taylor’s University Lakeside Campus, Subang Jaya, Selangor, Malaysia. 8-9th March, 2019
Introduction: According to the National Health and Morbidity Survey (NHMS) 2015, 47.7% of the Malaysian population are either obese or overweight. The increased obesity prevalence has caused major health problems including cardiovascular diseases and diabetes. Although several anti-obesity drugs have been developed, they are limited due to adverse side effects. Previous studies demonstrated that xanthorrhizol (XNT) reduced the levels of serum free fatty acid and triglyceride in vivo, but the detailed anti-obesity activities and its related mechanisms are yet to be reported. Thus, this study aims to evaluate its abilities to inhibit adipocyte hyperplasia and hypertrophy employing 3T3-L1 adipocytes.
Methods: Statistical significance was established by one-way ANOVA, where p < 0.05 was considered statistically significant.
Results: In this study, the IC50 value of XNT (98.3% purity) from Curcuma xanthorrhiza Roxb. in 3T3-L1 adipocytes was 35 ± 0.24 μg/mL. The loss of cell viability was due to 20.01 ± 2.77% of early apoptosis and 24.13 ± 2.03% of late apoptosis. XNT elicited apoptosis via up-regulation of caspase-3 and cleaved PARP-1 protein expression for 4.09-fold and 3.12-fold, respectively. Moreover, XNT decreased adipocyte differentiation for 36.13 ± 3.64% and reduced GPDH activity to 52.26 ± 4.36%. The underlying mechanism was due to impaired expression of PPARγ to 0.36-fold and FAS to 0.38-fold, respectively. On the other hand, XNT increased glycerol release by 45.37 ± 6.08% compared to control. During lipolysis, XNT up-regulated the leptin protein for 2.08-fold but down-regulated the protein level of insulin to 0.36-fold. These results indicated that XNT reduced the volume of adipocytes through modulation of leptin and insulin.
Conclusion: To conclude, XNT exerted its anti-obesity mechanisms by suppression of adipocyte hyperplasia through induction of apoptosis and inhibition of adipogenesis whilst reduction of adipocyte hypertrophy through stimulation of lipolysis. Thus, XNT could be developed as a potential anti-obesity agent in the future.
ABSTRACTS FOR INTERNATIONAL FAMILY HEALTH CONFERENCE 2019 (I-FaH 2019). Health Intervention Towards Community Wellness, Held at Oriental Crystal Hotel, Kajang, Selangor, Malaysia. 4-5th September, 2019
Introduction: In Malaysia, the proportion of safe deliveries remains above 98% since 2010. Safe delivery is defined as deliveries conducted by trained personnel; either doctors, nurses with midwifery training or community nurses. Despite the good coverage of trained personnel and continuous effort to promote birth preparedness among antenatal mothers, unsafe delivery still occur in Malaysia and reported as 0.5% in NHMS 2016.
Methods: A retrospective analysis on the characteristics of unsafe deliveries from the national surveillance data for the period of 2015 to 2017 was carried out. Characteristics of mothers are extracted from the reports of unsafe delivery investigation by Ministry of Health Malaysia and descriptive analyses are carried out by year for trending.
Results: Total of 985 unsafe deliver-ies were reported and investigated in 2015, 1201 in 2016 and 1045 in 2017. About 37.7% to 49.9% (n=453-521) of these deliveries were among Malaysians followed by 22.9% to 40% (n=239-394) among non-citizen without identification document and 11.1% to 27.6% (109-332 deliveries) among non-citizen with identification document. It is commonly reported among mothers aged 26 to 35 years old (38.6% to 43.4%; n=454-463) and multiparous (47.3% to 52.0%; n=494-512). About 25.5% to 35.4% (n=251-370) of these mothers never attended antenatal check-up. Five main reported reasons which had contributed to the unsafe deliveries in 2015 to 2017 were; invalid identification documents, financial constraints, transportation problems, far distance from health facilities and mother’s personal choice.
Conclusion: These findings translate into possible intervention targeted the above population on unsafe deliveries. Multi-sectoral strategies and inter-agency partnership are needed in strengthening the intervention.
ABSTRACTS FOR THE 1ST INTERNATIONAL BORNEO HEALTHCARE AND PUBLIC HEALTH CONFERENCE AND 4TH BORNEO TROPICAL MEDICINE AND INFECTIOUS DISEASE CONGRESS. New Frontiers in Health: Expecting the Unexpected
Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia. 3rd-5th September 2019
Introduction: Smoking kills 5 million people a year and it is known to cause several types of cancer and chronic diseases. Majority of smokers started smoking during adolescence and therefore preventing tobacco use among adolescents is critical to prevent them from future smoking. Our study aims to investigate the prevalence of current cigarette smoking and its associated factors among male adolescents in Malaysia.
Methods: Data was obtained from the National Health and Morbidity Survey (NHMS): Adolescent Health Survey (AHS) 2017 which was a cross-sectional study. A two-stage stratified cluster sampling design was used to select a nationally representative sample of school-going adolescents in Malaysia. Data collection was conducted using a validated self-administered questionnaire. Multiple logistic regression analysis was performed to identify the associated factors of current cigarette smoking among male adolescents in Malaysia.
Results: Approximately one-fifth (22.4%) of male adolescents were current cigarette smokers. Male adolescents who aged 16-17 years, from rural schools, those whose parents were widowed/ divorced/ separated, those who had either one or both parents/guardians who used tobacco product, those who were current illicit drug users and current alcohol users were more likely to be current cigarette smokers.
Conclusion: A substantial percentage of Malaysian male adolescents were current cigarette smokers. Anti-smoking campaigns and tobacco prevention initiatives should be targeted at adolescents at risk to prevent them from becoming cigarette smokers.
Study name: National Health and Morbidity Survey (NHMS-2017)
Introduction: Poor hygiene practice is an important factor that lead to morbidity and mortality among young chil- dren which are common among the indigenous population due to the lack of access to health services and their unique beliefs and practices. This study aimed to identify the socio-demographic determinants of hygiene practices among the indigenous (known as Orang Asli in Malaysia) primary caregivers of children under the age of three in Malaysia. Methods: A cross-sectional study was conducted among 166 primary caregivers of Orang Asli children of below three years old in Kuala Langat District. Data was collected using a validated and pre-tested questionnaire via face-to-face interviews with individual respondents. The questionnaire consisted of two main sections: sociodemo- graphics and hygiene practice. Results: A majority of the Orang Asli primary caregivers had good hygiene practices (78.9%). The number of children under five years old living at home was significantly associated with hygiene prac- tice and it was the only significant determinant or predictor of good hygiene practice among the Orang Asli primary caregivers. Conclusion: The number of children under five years old living at home is an important factor to ensure good hygiene practices among the primary caregivers of Orang Asli children. This factor need to be taken into con- sideration in monitoring children health status by the health staff by emphasizing the importance of hygiene practice in the prevention of infectious diseases and malnutrition among Orang Asli children.
Introduction: This study examines the psychometric characteristics of a translated version of the Beck Depression Inventory II (BDI – II) among Malaysian school students. Methods: The sample consisted of 257 boys and 302 girls. This study employed WINSTEPS 3.74 to provide statistics and other information from Rasch Model analysis, namely, the fit statistics, dimensionality analysis, rating scale analysis, reliability and separation indices, differential item func- tioning analysis, and distribution of items difficulty and students’ ability. Results: Rating scale analysis showed that category 2 and category 3 of the ratings were not different. Meanwhile, Item 19 did not fit the model’s expectations; and thus, it was omitted from further analyses. The scale demonstrated a high person reliability and a high person separation index. There were no items demonstrating gender DIF. The school students endorsed feeling guilty as the least severe symptom of depression, while committing suicide as the most serious symptom. Conclusion: In general, the BDI-II demonstrated acceptable properties in measuring depression symptoms among school students.
Introduction: Falls among the elderly can be associated with serious complications such as fractures, injuries and death. This study aims to ascertain the factors associated with falls among the elderly patients attending a government clinic located in Kuala Lumpur. Method: This was a cross-sectional study using a convenience sampling method. Data collection in 2017 from 322 elderly who attended the above clinic. A modified assisted self-administered ques- tionnaire was used that contained the socio-demographic data, falls profile as well as extrinsic and intrinsic factors associated with falls. Analysis was done with SPSS v20.0. Results: 120 (37.27%) elderly reported falls in the past one year. The majority who had falls were females (n=76, 41.8%) and between the age of 80-89 years old (n=29, 44.6%). Malay ethnicity group, reported more falls compared to other ethnicities (n=93,44.5%). Significant associations were found between age, ethnicity and history of falls with falling (p
Introduction: Compression of the median nerve in pregnancy is thought to be due to fluid retention within the carpal tunnel space. We aim to discover the cause of carpal tunnel syndrome (CTS) in pregnancy using high resonance ul- trasonography. Methods: This is a cross-sectional study where obstetric patients were screened for CTS and subjected to a non invasive ultrasonic imaging. Results: A total of 63 patients were seen with 25 diagnosed to have CTS (39.7%) and 38 patients had none (60.3%) based on a screening tool. Age ranged from 20-42 years old with the highest range in the 28-30 year old group (34.9%). In patients with CTS, the cross sectional area of the median nerve inside the tunnel was a mean of 0.908 cm ie larger, while non-CTS patients had a mean of 0.797 cm inside the tunnel. The transverse carpal ligament (TCL) measured a mean of 0.0988 cm in the CTS group (ie thinner) and 0.1058 cm in the non-CTS group. Median nerve mobility at equal to or less than one tendon width was 80% in pregnant women with CTS and 92.1% for those without. No fluid was present within the carpal tunnel of all patients. The results were sta- tistically not significant. Conclusion: Ultrasonographic evidence in pregnant women with CTS shows a larger median nerve, a more mobile median nerve and a less thick transverse carpal ligament. There is absence of fluid retention and synovitis ruling out extrinsic compression of the median nerve as cause of CTS in pregnancy.
Introduction: The daily life problems of patients with schizophrenia as well as their symptoms are challenging sit- uations that may interfere with their psychological well-being. The purpose of this study is to investigate the factors affecting the psychological well-being of patients with schizophrenia and factors affecting it. Methods: A cross sec- tional study was conducted to examine the socio-demographic factors, health level, social support and self-esteem of patients with schizophrenia. A total of 255 respondents consisting of patients on follow-up from specialist clinics at three Psychiatric Hospitals in this country were selected to answer the questionnaire. The questionnaires used were the Affect Balance Scale, the Multidimensional Scale of Perceived Social Support Scale and the Rosenberg Self-Esteem Scale for the measurement of the psychological well-being, social support and self-esteem respectively. The data was analysed using Chi-Square and Mann-Whitney U test. Results: A total of 62% of the respondents had positive psychological wellbeing. Socio demographic factors, namely occupation (p=0.007), overall social support (p=0.023), family support (p=0.040), significant others’ support (p=0.046), and self-esteem (p < 0.001), were associ- ated with positive psychological well-being. Conclusion: This study has proven that patients with schizophrenia who regularly received treatment can achieve positive psychological well-being when they have high self-esteem, strong support from their family members as well as people around them and are stable occupation.
Introduction: The magnitude of drowning as one of the leading causes of death among children in Malaysia may have been underestimated. Little is known on the level of awareness on water safety among parents as it might be associated with appropriateness and adequacy of the supervision. This study aims to describe perceptions of water safety among parents of primary school children. Methods: A cross-sectional survey with 719 respondent conduct- ed to obtain information on parents self-reported on their children’s water-involved activity and swimming ability, self-estimated ability to rescue their child and perceptions of the risk of drowning and water safety for their children. Results: The result revealed that about 21.6% of respondents did not perceive drowning as one of the unintentional injury leading causes of death among children. Parents reported that their children had experienced a near- drown- ing incident (16.1%), and only 12.2% of the child had attended a formal swimming lesson. Majority of the parents did not involve in any water safety program (98.7%), can’t swim (61.6%), not been certified in CPR (87.3%) and not confident (87.3%) to perform resuscitation (CPR). Respondents also perceived their children could swim (42.1%), and they felt confident when their child in the water (45.6%). There were statistical differences between parents who reported their child had a near-drowning experience with their perception of children’s swimming ability. Conclu- sion: An exploration of parent’s perception of water safety provided an overview of the need for promoting aware- ness on drowning risk and water safety education in this country.
Introduction: Hepatitis C virus (HCV) infection is known as contributing to high morbidity and mortality globally. Major liver complications such as liver failure and liver cancer which can lead to fatality have been associated with persistent HCV infection. Globally, it is estimated that 5.6 million chronically infected HCV are among people who inject drugs (PWID). Malaysia has estimated that 59% HCV infections were among PWID. The aim of this study is to determine the prevalence of HCV infection and its predictors among PWID in Negeri Sembilan. Methods: A cross-sectional study based on random proportion to size sampling was conducted among 212 out of 1414 regis- tered Methadone Maintenance Therapy (MMT) clients with PWID attending health clinics in Negeri Sembilan from February 2018 to July 2018. Data were collected using questionnaires administered through face-to-face interviews. Data were analyzed using Statistical Package of IBM SPSS Statistics Version 23 and p-value of
Introduction: Regular aerobic exercise and low-fat milk consumption can improve certain cognitive functions and reducing emotional distress. However, the impacts of combining these modalities are less explored. Thus, the present study examined the effects of combining aerobic exercise and low-fat milk intake among sedentary female students. Methods: Using a nonrandomized pretest – posttest with a control group research design, 85 sedentary females aged 16 years old were assigned into either milk (n = 21), exercise (n = 22), combined low fat milk and exercise (n = 23), or control (n = 19) groups. One serving of low-fat milk was provided to the students during each school day, and a 1-hour supervised step aerobics exercise was conducted twice per week for 3 months. Emotional distress and sus- tained attention were measured at baseline, 6th and 12th weeks after the intervention. A mixed factorial ANOVA was used to analyse the data. Results: The results revealed significantly less emotional distress in the combined (p < 0.01) and exercise groups (p < 0.05) compared with the control group after 12 weeks. Additionally, significant reductions were observed in the total time taken and errors of omission for both digits 6 and 9 of the Digit Vigilance Test in the combined group (p < 0.05, p < 0.001) compared with the control group. Conclusions: The results showed that low fat milk alone did not provide any additional benefits related to distress regulation, but the combination of exercise and low-fat milk contributed to improving sustained attention.
HIV-related stigma will discourage the efforts in preventing new infections and engaging people to receive treatment, care and support programmes. Identifying the valuable interventions programmes to reduce HIV-related stigma in a healthcare setting is vital in order to deliver the best health services. A scoping systematic review was conducted. Articles were searched based on Pubmed and ScienceDirect search engines. The key words used were HIV stigma, intervention and healthcare. Published English articles in the past ten years involving HIV stigma intervention studies, and studies that involved healthcare workers in a healthcare setting were included. Reviewed articles, systematic review and meta-analysis articles were excluded. Primary screening of titles and abstract of 85 articles were done. Secondary screening of 19 articles resulted in 8 articles, included in this manuscript. Most of the reviewed articles showed, application of the Integrated Theoretical Model in the intervention programme as a guide and utilising combined intervention components are effective tools in delivering the intervention programme. The stigma reduc- tion-intervention programme should focus on the intervention components as a whole including training of HCW, role plays, group discussions, games, sharing of information and contacts with PLHIV as well presentations and lec- tures. An integrative model of behavioural prophecy is perceived and it is particularly essential for interventions that focus on creating and fortifying the aim in conducting the chosen behaviour.
Laboratory workers exposed to diverse occupational exposures to accidents. Evidently, extant, yet very limited em- pirical underpinnings suggest that knowledge, practices and awareness of safety precautions are uncharacteristically poor among laboratory workers. As such, their demonstration of safety-related attitudes and practices have remained questionable. This paper, thus presents a systematic search of the literature on laboratory workers’ safety-related knowledge, attitudes, and practices. Specifically, literature published between 2007 and 2017 that characteristically attempted to evaluate knowledge, attitudes and practices among laboratory workers on Occupational Safety and Health were reviewed. Evidently, results from the review indicate poor knowledge, attitude and practice among the laboratory workers. It is critical that strategies be put in place by the management of the health facilities to institute and undertake activities in the form of training, improved safety management practices, organizational commitment and improved safety culture.
Wandering spleen is renowned as a surgical enigma due to its diverse presentations. Due to lack of its attaching ligaments which would usually place it at the left hypochondrium region, the spleen ‘wanders’ and may be located anywhere within the abdominal cavity. This condition has been associated with many complications such as splenic torsion, pancreatitis and portal hypertension. We report a case of a wandering spleen presenting as acute appen- dicitis in an 18-year-old young active sportsman. The patient developed post-operative ileus and later intestinal obstruction which necessitated exploratory laparatomy onto which the final diagnosis of splenic and small bowel infarct due to splenic torsion with small bowel volvulus was made. Splenectomy, small bowel resection and primary anastomosis were performed and the patient made a full recovery.
Chikungunya is an infection caused by chikungunya virus which at present has spread to new countries and con- tinents. Chikungunya is associated with self-limiting and non-fatal infection in the past. However, in recent times, increased severity of the disease has been reported resulting in health and economic burden. The threat and bur- den of chikungunya would grow in future in the absence of specific antiviral or vaccine to control or eliminate the infection. This review discusses chikungunya in general including transmission of its etiological agent and clinical manifestations of the disease. Subsequently, management and treatment of chikungunya virus will be reviewed with particular emphasis on natural products or their active compounds with potential anti-chikungunya virus activities.