Diabetes mellitus is the most common endocrine defect among children. Good diabetes management is important to give better health for both the children and the whole family. The goal of this study was to identify the level of mother involvement in children type·1 Diabetes Mellitus management, to identify factors related with mother involvement and to determine the relationships between mother
involvement and glycemic control. A cross·sectional study was carried out with 92 respondents selected by universal sampling from mothers who had diabetic children aged 5-15 years old and from medical visit appointment at University Kebangsaan Malaysia Medical Centre (UKMMC) and Putrajaya Hospital (HP1). Data was obtained through medical record and self reporting questionnaire. The study shown that 58.6% mothers had high involvement and 41.4% mothers had low involvement. Mothers' education level had a significant (p=0.0Z) relationship with a level of mother involvement. Most mothers gave high involvement in diet management (64.1%) and blood glucose monitoring (52. 7%), however most mothers gave low involvement in exercise management (63.0%) and insulin injection (60.9%). Mothers involvement in four management tasks were not statistically significant (p>0,05) with glycemic control. Mothers involvement in children diabetic management was high. There was high mother involvement in children's insulin injection and dietary intake and low mother involvement in children`s blood glucose monitoring and exercise, This study abo showed that there was no significant relationship between level of mother involvement and glycemic control.
Great importance has been attributed to birth weight all over the world because it is considered as one of the best predictors of prenatal survival and a good indicator of quality life. The objective of this study was to determine the prevalence of low birth weight babies (LBW) and factors related to it in Baghdad city. A cross sectional study was carried out in four general hospitals in Baghdad city, Iraq. A total of 225 newborn babies, alive, singleton and without congenital malformation were selected randomly from these four general hospitals.The result of the study showed the prevalence rate of low birth weights was 21.3%. Mothers’ educational level, monthly family income, mothers with chronic hypertension, mothers with history of previous low birth weight infants and anemic mothers were significantly associated with low birth weight babies (P= 0.03, 0.01, 0.02,
Dioxins are a most toxic compound ever studied by human until today. Their significant health effects involved all ranges of age, including infants due to exposure to contaminated breast milk. The objective of the study was to appraise the status of dioxin contamination in breast milk among postnatal mothers live in urban and suburban areas in Klang Valley. It was conducted as a cross sectional study involving 101 postnatal mothers who came for their infant second hepatitis B vaccination. The samples were analysed using High Resolution Gas Chromatography (HRGC) following the USEPA Method 8290. About 70.3% of the samples were found detected with dioxin congeners. More suburban mothers have positive breast milk dioxins compared to urban mothers, 100.0% and 67.0% respectively. Significant associated factors include high fat daily intake (p=0.013), high milk daily intake (p= 0.044), high meat daily intake (p=0.001), body mass index more than 30 kg/m2 (p=0.005), and body fat % of more than 26% (p=0.046). In conclusion, amount daily intake of fat diet, meat, milk, body mass index and body fat are significant associated factors for the present of dioxins in breast milk among postnatal mothers in Klang Valley. More suburban mothers contain dioxins in their breast milk, which poses higher risk of health problems among their infants. A comprehensive study need to be conducted and regular followup need to be established in monitoring the future severity of maternal breast milk contamination to ensure the health of the next generations.
Adolescents are known to obtain information regarding sexual and reproductive health from a variety of sources and not just during formal lessons in schools. This cross-sectional descriptive study was carried out to determine the source of information on sexual and reproductive health among Form four secondary schools girls in the Klang Valley as well as parents’ relationship profile. A total of 520 secondary school girls were recruited for the study. In this study, the source of information on puberty and sexual topics were categorized as follows: first level of importance - mothers, second level of importance - siblings, third level of importance - fathers, fourth level of importance - friends, fifth level of importance - teachers and sixth level of importance - books/internet. A majority of respondents agreed that their mothers were the first level of importance they sought for information on puberty (74.8%) and sexual topics (53.8%). Thirty nine point three percent (39.3%) of respondents reported it was very easy to have a dialogue with their mothers while only 10.0% of the respondents said it was very easy to have a dialogue with their fathers. While this was the case, only 6.3% of the respondents reported discussing sex-related matter with their mothers.
Pregnant women are at higher risk of transmitting the infections to their foetus. This prompted the “Prevention of Mother to Child Transmission (PMTCT) Program” in Malaysia since 1998. The objective of this cross sectional study was to determine the knowledge, attitude and practice (KAP) of pregnant mothers in the west of Sabah towards HIV/AIDS and its influencing factors. Data were obtained through self administered questionnaires. Results showed that only 32.2% of the
respondents have good knowledge compared to 67.8% who had poor knowledge (p
The Use of Complementary and alternative medicine (CAM) is a common phenomenon among women with breast cancer in Malaysia. This study examines the prevalence, types, influencing factors and source of information regarding CAM among women with breast cancer, using a cross sectional research design. A purposive sampling was used to recruit 103 women with breast cancer who were attending follow up care at the Radiotherapy and Oncology unit of Universiti Kebangsaan Malaysia Medical Centre. Data was gathered through the use of self–administered questionnaires. Ninety one women identified themselves as CAM users while twelve were non users. Among the CAM users, 57(62.6%) were Malays, 27(29.7%) Chinese and 7(7.7%) Indians. The common types of CAM used were vitamins, nutritional supplements and traditional medicines (TM). CAM was used more frequently upon diagnosis (63.7%) and after completion of conventional treatment (97.8%). With regard to decision-making, most of the women (62.6%) did not make the decision to use CAM and were mostly influenced by their husband and mother (67%). Mother (71.4%), husband (67%), and relatives (56%) were the main sources of information and all values showed significant association with CAM use (p
Iodine is an essential micronutrient for normal physical and mental development. Iodine deficiency is endemic in 130 countries worldwide, including Malaysia. This is a cross-sectional study done to determine the prevalence and risk factors of iodine dejiciency among 342 rural mothers attending antenatal clinics in Bachok, Kelantan. A self-adrninistered questionnaire on the knowledge, attitudes, practices and other risk factors relating to iodine deficiency was done. Physical examination for thyroid enlargement was carried out and urine samples were taken for urine iodine determination. The prevalence of iodine deficiency based on urine iodine Q level of less than 100 mcg/l was 63.0 % (95% CI: 57.8, 68.2). The mean urinary iodine level was 87.3 mcg/l with a median of 78.0 mcg/l. However, the goiter prevalence was only 9.4%. The total mean scores of knowledge, attitudes and practices were generally low at 58.6 (SD 7.9), 52.9 (SD 7.9) and 42.9 (SD 10.9) respectively. Logistic regression analysis found that a smoking husband is a risk for iodine deficiency (OR=2.0). In conclusion, iodine deficiency disorders among rural antenatal mothers were still prevalent in Bachok. Their level of knowledge on the causes, effects, prevention and clinical presentations of Q iodine deficiency disorders were poor. In addition, having a husband who is a smoker increases the risk of the antenatal mothers developing iodine denciency.
Study site: Antenatal clinic (klinik kesihatan), Bachok, Kelantan, Malaysia
On December 26, 2004, an earthquake triggered a devastating tsunami that caused death and destruction in twelve countries including India, Indonesia, Malaysia, Maldives, Seychelles, Somalia, Sri Lanka and Thailand. One of the authors was a volunteer with FELDA WAJA AMAN MALAYSIA medical relief team that served the Aceh victims from 16th February to 24th February 2005 (8 weeks post tsunami). A study to determine the pattern of health ailments was conducted among children aged 18 years and below based at Seuneubok Camp, 30 km from Banda Aceh. All respondents were from Pulau Aceh and the total number of children seen and examined was 60. About 18% had lost their fathers, 10 % had lost their mothers and 27% had lost one or more of their siblings. 77% suffered some form of health ailments. The common health ailments were diarrhea (61%), respiratory complaints (59%) and fever (20%). About 38 % of preschoolers had loss of appetite and 28% had sleep disturbances. About 35% of the elementary school children suffered from sleep disturbances, 29% of the young adolescents suffered from headaches and 24% had sleep disturbances. Nearly a quarter (24%) of all the children felt fearful and anxious about the disaster. Nevertheless, 56% of the respondents wanted to return back to Pulau Aceh, although 14 % did not want to go back. Interestingly, 73% of the children voiced their gratitude to God for having been saved from death.
Family planning is a method of controlling fertility which helps to prevent unwanted pregnancies among couples. Unwanted pregnancy has negative effects for mothers and children. The aims of this study were to determine the prevalence of family planning practices among women in Serdang area and associated factors with their family planning practices. A cross sectional study was conducted with a systematic random sampling of 349 women of reproductive age, who attended Sri Kembangan Polyclinic. Descriptive analysis with chi-square and multiple regression analysis were conducted to identify factors associated with the family planning practice. The prevalence of family planning practice was 38.4%. Family planning was significantly associated with age (p=0.001), marital status (p=0.001), mode of delivery of the last pregnancy (p=0.001), number of children (p=0.001), source of information (p=0.004), level of knowledge (p=0.001), and the attitude (p=0.004). Using multiple logistic regression, four factors contributed to family planning practice, were identified as statistically significant: marital status (married OR=40, 95% CI: 9.45, 169.8), religion (Muslim OR=1.9, 95% CI: 1.14, 3.4), number of children (children>4 OR=2.98, 95% CI:1. 74, 5.09) and attitude (positive attitude OR=1.88, 95% CI:1.11, 3.18). The prevalence of family planning practice in Serdang was low even though knowledge was sufficient. The use of pamphlets and booklets are still needed to enhance efforts in health education. Currently, practice on family planning will determine the future structure of the community and the economic wellbeing of a country. Future study should focus on family planning practice among teenager and types of methods for women.
Health impact related to smoking is a critical public health predicament especially in pregnancy. However there is not much data available to describe the magnitude of the problem. Hence this study was conducted to determine the prevalence of smoking and its socioeconomic factors among antenatal mother and their opinion related to tobacco control measures. A cross sectional study was carried out involving newly registered antenatal mothers attending all government health clinics in Penang. Prevalence of ever smoking among antenatal mother is 1.4%, of which 42.4% is still smoking at first antenatal visit. It was found that single mothers are more likely to smoke (OR, 14.23: C12.52-53.27). It was also noted that spouse smoking (OR, 5,14: CI 1.95-17.09), primigravida (OR, 2.7: C1 1.3-5.62), age group less than 30 years old (OR, 2.41; CI 1.03-6.09) and living in urban area (OR, 2.33; CI 1.01 — 6.47) have a higher risk to indulge in smoking behaviour. Muslim OR 0.29; C1 0.14 - 0.60) and Malay (OR 0.22; CI 0.10 - 0.47) pregnant mothers are noted to be less likely to smoke as compared to non Muslim and non Malay. More than 85% of them agreed with the tobacco control measures regardless of their smoking status. Most of respondents agreed the influential people in community L;11T · such as medical personnel, teachers and parents should not smoke.
The prevalence of cleft lip and palate in human is 1 in 500 live births worldwide. Non·syndromic clefts are a complex trait with both genetic and environmental etiology. The aim ofthe study was to assess the association between maternal exposure to second-hand smoke during pregnancy and ruk of having cleft child. Unmatched case-control study was carried out among Malays in Kelantan.
1 Case and control subjects were denned as mothers of cleft children and mothers of normal children respectively. The cleft children were recruited from the Combined Cleft Clinic at Kota Bharu Dental Clinic. Normal chiMren were selected at Orthodontic Clinic, Kota Bharu. A total of 184 cases and controb with age range from 17 to 50 years were interviewed using the standard craniofacial
registration form. Multiple Logistic Regression modeling was used to estimate adjusted odds ratio of factors associated with non-syndromic oral cleft. Signijicant factors include history of miscarriage (OR: 3.40; 95% C1:1.05, 11 .08) p=0.042; duration of exposure to second-hand smoke for 15-30 minutes (OR: 2.41; 95% C1:1.42, 4.09) p 30 minutes (OR: 5.16; 95% C1:Z.87, 9.28) p
National Antenatal HIV Screening Programme has been integrated as a routine screening in antenatal care in early 1998 and in Terengganu since May 1998 involving all health centers in the state. As of December 2001, a total number of 57,882 antenatal mothers were screened (97.5% of all new antenatal mothers). The HIV prevalence rate among antenatal mothers was found to be 0.052%. All HIV positive mothers were married and majority were Malays (93 .3%). Ninety percents of them revealed that the only risk factorfor HIV was through sexual contact. HIV positive status was confirmed in 66 .7% ofthe husbands. All twenty eight mothers that managed to be followed up delivered to live birth babies. All newborns reported to have good Apgar score (9 at 5 minutes of life). Mean birth weight was 3 .08 kilograms 1- 0.45 and only 8% were premature babies. The observed rate of HIV vertical transmission was 6.25% and this is lower than the expected mother to child transmission rate of 30% without intervention.
Worldwide prevalence of obesity among children and adolescents increased substantially over decades. Addressing potential risk factors of obesity among adolescents is very important for a successful intervention program in this population. The present study aimed to identify the sociodemographic determinants of obesity among school adolescents in Terengganu. A cross-sectional survey involving 3,798 school adolescents age 12 years old from 136 government primary schools in Kuala Terengganu and Besut districts were carried out from November 2014 to June 2015. For the purpose of this paper, the data for 2,842 school adolescents classified as either normal BMI (< +1SD) (n= 2,305) or obese (+2SD) (n= 537) based on WHO cut-off points were taken for analysis. Sociodemographic information on subjects and their parents were obtained from self-reported questionnaire. Anthropometric measurements were conducted by Physical Education teachers and uploaded into a specific developed database. The prevalence of obesity was relatively high in both genders in this study. Binary logistic regression analysis found gender, parental BMI, household income, household size and maternal working status were independently associated with obesity among school adolescents in this population. In the final model, being male, having working mother, and having obese parents were identified to be potential risk factors for obesity whilst having large household size lower the risk of obesity among these adolescents. Prevention programs are needed to increase awareness about the risk factors of obesity in adolescent and interventions should now focus on family member as well mainly the parents.
Our study aimed to assess the knowledge, attitudes and practice behaviours of primary healthcare professionals in government Maternal and Child Healthcare Clinics (MCHC) on the association between oral health and pregnancy outcomes namely pre-term and/or low birth weight (PT/LBW) infants and to identify the barriers of utilisation of oral healthcare services by pregnant mothers. Questionnaires were distributed to government healthcare professionals working at all seven government MCHC in the Manjung District, Malaysia. 136 out of 158 questionnaires were returned completed yielding a 92% response rate. The questionnaire covers respondents characteristics, attitude and practice behaviours related to oral health and barriers faced when referring pregnant mothers to the dental clinic. 65% of respondents noticed dental/ gum problems in the pregnant mothers that they encountered. The two most frequent response for outcome of delivery linked to gum/ dental problems were premature delivery (49%) responses and low birth weight (27%). Although 95% of the respondents believed that regular dental check-ups is compulsory for pregnant mothers, only 69% regularly refer pregnant mothers for dental check-ups. There was a significance between healthcare professionals that receive continuing dental education and their referrals of antenatal mothers for dental check-ups .
Study site: Maternal and Child Health Clinics (Klinik Kesihatan), Manjung District, Perak, Malaysia.
Worldwide prevalence of obesity among children and adolescents increased substantially over decades. Addressing potential risk factors of obesity among adolescents is very important for a successful intervention program in this population. The present study aimed to identify the sociodemographic determinants of obesity among school adolescents in Terengganu. A cross-sectional survey involving 3,798 school adolescents age 12 years old from 136 government primary schools in Kuala Terengganu and Besut districts were carried out from November 2014 to June 2015. For the purpose of this paper, the data for 2,842 school adolescents classified as either normal BMI (< +1SD) (n= 2,305) or obese (+2SD) (n= 537) based on WHO cut-off points were taken for analysis. Sociodemographic information on subjects and their parents were obtained from self-reported questionnaire. Anthropometric measurements were conducted by Physical Education teachers and uploaded into a specific developed database. The prevalence of obesity was relatively high in both genders in this study. Binary logistic regression analysis found gender, parental BMI, household income, household size and maternal working status were independently associated with obesity among school adolescents in this population. In the final model, being male, having working mother, and having obese parents were identified to be potential risk factors for obesity whilst having large household size lower the risk of obesity among these adolescents. Prevention programs are needed to increase awareness about the risk factors of obesity in adolescent and interventions should now focus on family member as well mainly the parents.
Postnatal depression is common and affects 10-15% of postpartum women. While there are many studies on the depressive episode in the postnatal period, its association with the bipolar spectrum disorder is often go unrecognized and undiagnosed.
Objective: To study the rate of bipolar spectrum disorder in mothers presented with postpartum depression and its associated factors.
Method: This is a cross sectional study on the women who visited the postnatal clinic in University Malaya Medical Centre. Subjects who consented were asked to complete a short questionnaire looking at the socio-demographic details and asked to answer the Multidimensional Scale of Perceived Social Support (MSPSS), Mood Disorder questionnaire (MDQ) and Edinburgh Postnatal Depression Scale (EPDS) whish assess the perceived social support and mood disorder.
Result: A total of 93 women were recruited into the study. Independent t-test and stepwise regression analysis identified that unemployment and baby with health problem were the only associated factors for postnatal depression. 28.6% of the mother with possible postnatal depression (EPDS = 12) might have bipoar spectrum disorder (MDQ = 7).
Conclusion: Postnatal depression as part of bipolar spectrum disorder needed additional attention. Postnatal check with screening tools may help to identify mood disturbance in postpartum women
Study site: Postnatal clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Depression is usually discussed as an adult problem; however there is a need to recognize it being a significant problem for children. Rarely is depression focused on how it affects parenting and child outcomes, particularly for young children.Often women are victims of violence, and the devastating effects of depression are significant in such households. However one must not ignore, the effect depression has on parenting, where in these contexts, women themselves, become the perpetrators of violence. When mothers are not well-2 central parental functions are threatened: the ability to foster healthy relationships and to carry out the practical functions of parenting2.When this is not carried out, one sees obvious reductions in young children’s behavioral, cognitive, and social and emotional functioning. Neuroscience is clearly evident that the primary ingredient for healthy early brain development is the quality of the earliest relationships from a baby’s primary caregiver.
The objective of this study is to evaluate the depression and coping strategies used by postnatal mothers during the postpartum period.This study used cross-sectional design and was conducted at the University Malaya Medical Centre from November 2013 to January 2014. This study involved 150 respondents (postnatal mothers) and used instrumentation adopted from the Malay version of Edinburgh Postnatal Depression Scale (EPDS) and the Malay version of Brief COPE. The results showed 32 (21.3%) postnatal mothers have had severe depression. Emotional coping strategies were reported to be the most used by postnatal mothers (mean = 4.77 ± 0.70). There was a significant association between problem-focused coping strategies and race (p=0.045) where it was mostly used by Malay participants (mean = 3.39±0.46). There was a mild negative relation between EPDS and problem focus (r=-0.168, p=0.04). On the other hand, there was a mild positive relation between depression level and avoidant emotion (r= 0.162, p= 0.047). The psychological support from nurses and family was needed to improve depression and coping strategies used so that it can improve health outcome among postnatal mothers.
Living with epilepsy is equally demanding for both patients and their caregivers. The caregivers’ tasks are not limited to caring for the patients only but also the need to improve their awareness, knowledge and attitude (AKA) level as lack of understanding has a major impact on health-related quality of life (HRQoL). Little is known about the influence of AKA on family caregivers’ HRQoL. Objective: Therefore, this study aimed to assess and relate the AKA and HRQoL profiles of epilepsy carers. Methods: This prospective, cross-sectional study included a sample of 32 epilepsy family caregivers who were recruited from the Neurology and Paediatric Clinics of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu. Results: Majority were Muslims (93.8%), married (65.6%), housewives (31.2%), who earning monthly income of not more than RM 1000 (34.4%) and was the patients’ mothers (40.6%). The Total AKA score was generally good (mean=123.4±16.8, median 122.5) with awareness being good, knowledge moderate and attitude positive whereas HRQoL score for Disruptiveness was the highest (good) compared to other domains. There were significantly higher scores for Sexual Functioning (p = 0.039) among Poor AKA group and Pain Management (p = 0.040) among Good AKA. Conclusion: The overall outcomes signified that family caregivers with Good AKA experienced better well-being compared to those with Poor AKA while carrying out their roles as caregivers. Consequently, carers clearly require constant epilepsy education to enhance skill-building in order to understand and keep updates with the disease, thus indirectly sustaining their desired HRQoL status from time to time.
Study site: Neurology and Paediatric Clinics of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu
The authors report a case of co-morbid diagnosis Anorexia Nervosa (AN) with co-morbid diagnosis of Obsessive-compulsive Disorder (OCD) by proxy. The patient is a 16-year-old female who presented to the emergency department with features of AN and also OCD. To reduce the anxiety of her AN, she incorporated her mother as a proxy to follow specific instructions. The patient received both inpatient and outpatient support, and her condition gradually improved with antidepressants and antipsychotics. This case illustrates a co-morbid presentation of OCD with AN and also the result of family accommodation that led to the family member aiding with the compulsion. Treatment for the case was also briefly discussed.
Study site: emergency department (unspecified)