Objective: This study aimed to determine the factors associated with body weight status misperception among reproductive-aged women at a primary care setting in Malaysia.
Methods: This is a cross-sectional study conducted at Klinik Kesihatan Durian Tunggal in 2016-2017. The questionnaire included questions on the perception of weight status, sociodemographic factors, smoking status, level of physical activity, and weight loss attempts. Logistic regressions were used for statistical analysis to examine the association between body weight status misperception and related factors.
Results: The study recruited 630 reproductive-aged women. The mean age and SD of the respondents was 32.7 + 8.9 years, and 84% of the respondents were Malays. More than three-quarters of the respondents (75.5%, n = 476) had received up to a secondary level of education. The majority of the respondents were in the overweight/obese group (59.4%, n = 374). The mean BMI of the respondents was 27.1 kg/m2 + 6.61. Approximately 65.4% (n = 412) of the respondents had an inactive lifestyle. However, 60% (n = 378) of the respondents reported that they had attempted to reduce their weight in the last year. A total of 141 respondents (22.4%) misperceived their weight status with 113 (80.1% ) of them underestimating their weight status. Women with primary-level education (OR: 3.545, 95% CI: 1.530-8.215, p = 0.003) and secondary-level education (OR: 1.933, 95% CI: 1.065-3.510, p = 0.030) had a greater likelihood of misperceiving their body weight status as compared to those who have a tertiary level of education. Women with no weight loss attempts were also at risk of body weight status misperception (OR: 1.850, 95% CI: 1.195, 2.865, p = 0.006).
Conclusion: Bodyweight status misperception among reproductive-aged women was associated with a low level of education and with those who had made no weight loss attempts. Identifying women who are at risk of misperceiving their weight status would enable early counseling on weight management.
Material and Methods: From an initial number of 10 patients, seven were contactable and available for analysis. All patients underwent PCL and/or PLC reconstruction (modified Larson's procedure) between 2017 and 2019. The mean age of our cohort was 31.4±9.6 years (range, 21 to 46). Assessment of functional outcomes pre- and post-operatively were done using the Lysholm knee scoring scale, the Knee injury and Osteoarthritis Outcome Score (KOOS) and visual analogue scale (VAS). The mean follow-up from operation at time of reporting was seven months (range, 2 to 12 months).
Results: There were four combined PCL and PLCs, two isolated PLCs and one patient who underwent an isolated PCL reconstruction. There were significant improvements between pre-operative and post-operative in all functional outcome scores utilised following PCL reconstruction and/or modified Larson's reconstruction. Lysholm knee scoring scale improved from pre-operative to post-operative at 41.14±12.32 to 74.86±13.52 (p=0.0001), KOOS from 49.71±11.19 to 71.43±13.84 (p=0.001), and VAS from 5.71±2.06 to 2.86±2.48 (p=0.001). Our sub-analysis showed that higher functional outcomes were present when surgery was done less than six months from the time of index injury. There were no complications (eg. Infections, revisions) in this cohort at the time of reporting.
Conclusion: Reconstructive surgery for PCL and/or PLC injury is successful in increasing the functional outcomes of patients post-operatively. Delays from injury to surgery remains a problem in the public setting as patients may need to await appropriate imaging and approval of funding. Increased awareness for early surgical intervention may improve overall outcomes of PCL and/or PLC reconstruction in Malaysia.
METHODS: A cross-sectional study was conducted by enrolling 937 students, pharmacy (437) and non-pharmacy (500), of Punjab University, Lahore. A self-administered questionnaire was used for data collection. Data were analyzed using SPSS. (IBM v22).
RESULTS: Data suggested that majority of students knew about the use of traditional herbs and considered massage (P: 84.4%, NP: 82%, p = 0.099), homeopathy, herbs (P: 86.5%, NP: 81%, p = 0.064], yoga [P: 357 (81.7%), NP: 84%), p = 0.42] and spiritual healing (P: 85.6%, NP: 86.2%, p = 0.55) as effective and least harmful CAM modalities. The pharmacy students had better knowledge about CAM modalities compared to non-pharmacy students. Despite utilizing non-reliable sources of CAM information and their belief that CAM is practiced by quacks, the majority of students had positive attitudes and perceptions about CAM usage. Students also believed that CAM had a positive impact on health outcomes [P: 3.19 ± 1.04, NP: 3.02 ± 1.09, p = 0.008] and acceded to include CAM in the pharmacy curriculum. However, non-pharmacy students scored higher in their beliefs that CAM usage should be discouraged due to the non-scientific basis of CAM (P: 3.04 ± 0.97, NP: 3.17 ± 1.02, p = 0.028) and a possible threat to public health (P: 3.81 ± 1.74, NP: 4.06 ± 1.56, p = 0.02). On the other hand, pharmacy students believed that patients might get benefits from CAM modalities (P: 4.31 ± 1.48, NP: 4.12 ± 1.45, p = 0.02). Majority of students perceived that spiritual healing is the most useful and safer CAM modality, while acupuncture (P: 25.4%, NP: 21.8%, p = 0.0005), hypnosis (P: 26.8%, NP: 19.6%, p = 0.001) and chiropractic (P: 18.8%, NP: 11.6%, p = 0.0005) were among the harmful ones.
CONCLUSION: In conclusion, despite poor knowledge about CAM, students demonstrated positive attitudes and beliefs regarding CAM. They exhibited better awareness about yoga, spiritual healing/prayer, herbs, and massage. Students also showed willingness to advance their knowledge about CAM and favored its inclusion in the curriculum.
METHOD: A total of 328 municipal workers were enrolled in April to March 2016 were asked to recall if they experienced eleven HRI symptoms during the previous work day. Rasch Measurement Model was used to examine the unidimensional parameters and bias for gender before identifying the threshold of HRI symptoms. We determined the threshold symptom based on the person-item map distribution on a logit ruler value.
RESULTS: A total of 320 respondents were analysed. The psychometric features HRI symptoms suggested evidence of unidimensionality and free of bias for gender (DIF size =0.57; DIF t value =1.03). Based on the person-item map distribution, the thirst item was determined as the threshold item (Cut-off point = -2.17 logit) for the preventative action purposes to group the person as mild and moderate/severe HRI groups.
CONCLUSION: Thirst item is viewed as threshold symptoms between mild and moderate or severe HRI symptoms. It is a reliable symptom to initiate behavioural response to quench the thirst by adequate fluids. Failure to recognise the thirst symptom may lead to devastating unwanted health complications.
METHODS: This is a retrospective study of all the patients who had undergone colonoscopy at Gastroenterology endoscopy unit, Serdang Hospital from 1st January 2010 to 31st December 2016. Patients who had a history of colorectal cancer, polyp or inflammatory bowel disease were excluded. Data collected which included patients' demography, indication for colonoscopy, colonoscopy finding, and histopathology results. Data was analysed with SPSS version 16.
RESULTS: Among the 559 patients who had fulfilled the inclusion criteria (68 males, 44 females), 112 patients were found to have at least one polyp giving the polyp detection rate (PDR) of 20% and 168 polypectomies were performed. The PDR among male patients was higher than that of females (22.5% vs 17.1%, p<0.05). The detection rate of polyp was nearly equal in Malays, Chinese, Indians, and Others. The polyps were more common in those of age 40 years old and above (p<0.05), with the mean age of 63.0±1.5 years. The commonest morphology of polyp in our patients was sessile (58%) and majority was medium size (5-9mm). Otherwise, the polyps were commonly found in the distal colon those that in proximal colon (55.3% vs 38.7%, p<0.05). The adenoma detection rate (ADR) was 19.1% (107/559).
CONCLUSION: The detection rate of colonic polyp from colonoscopy is 20% in our centre.
OBJECTIVE: This study aims to evaluate the effectiveness of carbon monoxide measurement feedback and the standard brief motivation adopted to encourage the smoker to quit.
METHODS: A single-blind, cluster randomised controlled trial was conducted at ten tertiary colleges in Selangor. The study recruited young adult smokers at the precontemplation and contemplation stages. The subjects in the control group received a standard brief motivational strategy. On the other hand, the intervention group received additional carbon monoxide measurement and a motivational feedback module. A follow up was conducted at the first, third and sixth month to measure changes in smoking cessation stage. Subsequently, the secondary outcomes of a mean number of cigarette consumption and quit smoking attempt were analysed. A total of 160 subjects were required to detect the expected difference of 17% in primary outcomes between the groups. This study utilised Generalised Estimating Equations (GEE) to handle the clustering effects.
CONCLUSION: Biomedical risk assessment feedback mechanism by using carbon monoxide is a promising aid to motivate the smoker to quit. This mechanism is a relatively easy, quick and non-invasive technique. Thus, it can be utilised as a reinforcement relating to the harmful effect of smoking. Besides, it can also increase the smokers' selfefficacy and decisional balance to adopt behavioural changes.
METHODS: This is a cross-sectional study which involved medical students in their final two years of study at a public university in Malaysia. Self-administered Hospital Anxiety and Depression scale (HADS) and World Health Organisation QOL questionnaire (WHOQOL-BREF) were used to assess their psychological symptoms and QOL.
RESULTS: A total 149 students participated. The prevalence rates of anxiety and depression were 33% and 11% respectively. Malay students had significantly more anxiety compared to the other ethnic groups, P<0.05. Female students had significantly lower psychological score compared to male; 70.73 vs 66.32(P<0.05). Anxiety and depression were associated with significantly poorer QOL. Students with depression symptoms were associated with lower physical, psychological and environmental domain score whereas those with anxiety had lower psychological, social and environmental scores, P<0.05. Overall QOL score was significantly lower in Chinese students (P<0.05) and those with depression (P<0.001).
CONCLUSION: QOL of medical students are significantly affected by the presence of anxiety and depression. It is recommended that medical schools implement measures which can identify students at risk and to offer comprehensive intervention and preventive programmes to improve the students' wellbeing.
AIM OF THE STUDY: To determine the self-reported prevalence and severity of opioid-related adverse effects after kratom initiation in a cohort of illicit opioid users.
MATERIALS AND METHODS: A total of 163 illicit opioid users with current kratom use history were recruited through convenience sampling from the northern states of Peninsular Malaysia. Face-to-face interviews were conducted using a semi-structured questionnaire.
RESULTS: Respondents were all males, majority Malays (94%, n = 154/163), with a mean age of 37.10 years (SD = 10.9). Most were single (65%, n = 106/163), had 11 years of education (52%, n = 85/163) and employed (88%, n = 144/163). Half reported using kratom for over >6 years (50%, n = 81/163), and 41% consumed >3 glasses of kratom daily (n = 67/163). Results from Chi-square analysis showed kratom initiation was associated with decreased prevalence of respiratory depression, constipation, physical pain, insomnia, depression, loss of appetite, craving, decreased sexual performance, weight loss and fatigue.
CONCLUSIONS: Our findings indicate that kratom initiation (approximately 214.29 mg of mitragynine) was associated with significant decreases in the prevalence and severity of opioid adverse effects.
DESIGN/METHODOLOGY/APPROACH: This cross-sectional study comprised 252 patients visiting HUSM. Patients were selected using the convenience sampling method. The PGQ (Bahasa Melayu version) had three main factors: during your visit; your care provider and overall assessment. Data were analyzed using the structural equation modeling.
FINDINGS: The exploratory factor analysis resulted in item reduction from 21 to 17, which contained four factors with eigenvalues greater than 1. Meanwhile, confirmatory factor analysis results showed that data fitted the model: χ2/df at 1.764, comparative fit index at 0.952, Tucker-Lewis index at 0.941 and root mean square error of approximation at 0.073. The average variance extracted value for the four factors was greater than 0.50, which indicated that PGQ convergent validity was met. Overall, PGQ produced good reliability with composite reliability score equals to 0.966. Four factors were reclassified as "during your registration," "hospital staff attitude," "doctor's attitude" and "overall assessment."
RESEARCH LIMITATIONS/IMPLICATIONS: Patient satisfaction is an important and frequently used indicator for measuring healthcare quality; hence, a validated and reliable instrument is important for measuring patient satisfaction that leads to healthcare service quality assessment.
PRACTICAL IMPLICATIONS: Validated PGQ provides some useful information for doctors, medical assistants, nurses and staff in the emergency department to help them become more prominent and efficient in their role as healthcare providers.
SOCIAL IMPLICATIONS: Validated PGQ will help healthcare providers to deliver the best and exceptional care toward emergency patient, and thus improve their quality of work life. The findings in this study can be used as a guide or as baseline data for further research in this area.
ORIGINALITY/VALUE: The PQG (Bahasa Melayu version) was confirmed as a reliable and valid instrument for measuring patient satisfaction. This research is the first PGQ validation study in Southeast Asia, specifically focusing on Malaysian respondents.
METHODS: An exploratory review of past literatures on the usage of ultrasound technique in the diagnosis of acute appendicitis in adult patients, and the role of other imaging techniques were undertaken for the study.
RESULTS: The gold standard for the diagnosis of acute appendicitis still remains a histopathological confirmation after appendectomy. The study further shows imaging has high diagnostic accuracy in the diagnosis of acute appendicitis with low rate of negative appendectomy (<10%). Multiple reasons are identified, including the introduction of computed tomography imaging especially in those patients where ultrasound was unequivocal, more education on imaging which leads to better operator skill or improved performances of machines.
CONCLUSION: Imaging undoubtedly plays an important role in the diagnosis of acute appendicitis with ultrasound remaining the first-line method in patients referred with clinically suspected acute appendicitis. Nevertheless, those with borderline ultrasound findings or unable to visualize appendix on ultrasound with highly suspicious sign and symptoms were offered other imaging modalities such as CT scan.
RECOMMENDATION: It is recommended that the managing team balance the risk of radiation exposure, risk of delay in urgent operation and risk of perforation prior to a decision.