Objective: The objective of this study was to determine the prevalence of the most common phobias and associated factors among university students. Methods: This cross-sectional study was carried out at Management and Science University (MSU). Random sampling was performed throughout all faculties. The questionnaires were distributed randomly at classes, library and university cafe within MSU. Diagnosis of anxiety disorders were established according to DSM-IV criteria. These criteria are included in Liebowitz Social Anxiety Scale (LSAS). The questionnaire consists of two sections. The first section consists of socio-demographic characteristics such as (age, sex, race, type of faculty and income); the second section is LSAS standard questionnaire. Multiple linear regression using backward analysis was performed to obtain the associated factors. Results: A total number of four hundred sixty eight (468) students participated in this study. The majority of them were older than 20
years old, female, Malay and from non-medical and heath faculties (59.6%, 69.6%, 77.8%, 68.8%; respectively). Regarding history of abuse during childhood, the majority of the university students reported that there was no sexual, physical and emotional abuse during childhood (98.5%, 97.4%, 82.1%; respectively). The majority of the students (53.85%) reported that they have phobia. The highest type of phobia reported among university students was phobia from snake (11.5%), followed by speaking in front of crowd (9.2%) and the lowest were phobia of speed, dolls phobia, ropes phobia. Types of faculty, smoking status and history of physical abuse during childhood were the factors that significantly influence the social anxiety among university students in univariate and multivariate analysis. Conclusion: The prevalence of phobic symptoms among university students was
high types of faculty; smoking status and history of physical abuse during childhood significantly influenced social anxiety among university students. Education and counseling university students is necessary to educate the students who suffer from phobia to cope with different situations during study period.
Background & Objective: Posterior reversible encephalopathy syndrome (PRES) is associated with
immunosuppressive agents used in children with haemato-oncological diseases. There are no reports
to date from the South Asia and South East Asia region. We report a Malaysian tertiary centre case
series of children with haemato-oncological disease who developed PRES. Methods: Retrospective
study of children seen with haemato-oncology diseases seen at the University Malaya Medical Centre
Kuala Lumpur who developed PRES from 2011 – 2013. Clinical details were obtained from medical
records and brain neuroimaging was reviewed. Results: Five patients met the inclusion criteria. All
5 patients had significant hypertension acutely or subacutely prior to neurology presentation. Four
presented with acute seizures and the remainder 1 presented with encephalopathy.Three patients
were on chemotherapy, 1 had renal impairment and 1 had prior immunosupression for bone marrow
transplantation. A full recovery was seen in 4 patients and 1 patient had mild residual quadriplegia.
Conclusion: Our case series expands the clinico-radiological spectrum of PRES in children with
underlying haemato-oncological disorders. It is the first to show that prior cyclosporin intake as long
as 2 months is a potential risk factor for PRES. Clinicians need to be vigilant for development of
PRES and closely monitor the blood pressure in these children who are receiving or recently had
immunosuppressive drugs and present with acute neurological symptoms.
This cross-sectional study aimed to evaluate the knowledge of a Pakistani university population (students and employees) regarding Ebola virus disease. A total of 2,200 individuals were approached and 1,647 were enrolled in the study. We observed that the vast majority of study participants (91.8%) had inadequate knowledge of Ebola virus disease (knowledge score ≤ 12). Our findings highlight the need to increase the knowledge of Ebola virus disease by using multidimensional approach involving awareness campaigns, print, electronic, and social media.
This study reported the differences in factor structure of the Spiritual Well-Being Scale (SWBS) among Jordanian Arab and Malaysian Muslim participants and further examined its validity and reliability. A convenience sample of 553 Jordanian Arab and 183 Malaysian Malay Muslim university students was recruited from governmental universities in northern Jordan. The findings of this study revealed that this scale consists of two factors for the Jordanian Arab group, representing the "Religious Well-Being" and the "Existential Well-Being" subscales, and consists of three factors for the Malaysian group, representing the "Affiliation/Meaning and Purpose," "Positive Existential Well-Being/God Caring and Love," and "Alienation/Despair" subscales. In conclusion, the factor structure of the SWBS for both groups in this study was psychometrically sound with evidence of acceptable to good validity and reliability. Furthermore, this study supported the multidimensional nature of the SWBS and the earlier notion that ethnicity shapes responses to this scale.
A large data gap remains on suicidal behaviors among youth in the Association of Southeast Asian Nations (ASEAN) countries, despite the increasing rates of suicide in Asian cultures that may be related to rapid economic changes and the loss of social stability. This study was therefore conducted to explore the prevalence of and factors associated with suicidal ideation and suicide attempts among university students in six ASEAN member states. Data were collected in a cross-sectional survey of 4675 undergraduate university students, mean age 20.6 years (SD=2.7), range of 18-30 years, from Cambodia, Indonesia, Malaysia, Myanmar, Thailand and Vietnam. The overall prevalence of ever suicidal ideation and ever suicide attempt among students in this study was 11.7% and 2.4%, respectively. Different rates of these suicidal behaviors were observed across the countries. In multivariable logistic regression models, suicidal ideation was significantly associated with psychosocial factors including childhood sexual abuse, depressive symptoms, involvement in physical fights, and poor academic performance as well as socio-environmental factors including living with parents or guardians and low involvement in organized religious activity. Suicide attempt was significantly associated with childhood sexual abuse, depressive symptoms, low involvement in organized religious activity and being underweight or overweight. Our findings suggest that individual-level strategies for suicide prevention should be targeted toward students with poor academic performance, mental health problems and a history of adverse childhood experiences. Particular attention should be paid to the role of families that could be a potential stressor in the lives of university students.
Behavioural self-analysis projects were introduced into the second year medical curriculum in behavioural sciences at the University of Malaya. Students performance and evaluation of the experience were compared with those of American medical students. It was concluded that receptivity of medical students to principles of behaviour therapy is relatively similar in the two societies.
Pre-hypertension increased the risk of morbidity and mortality from non-communicable diseases. Whereas, psychological factors such as depression, anxiety and stress have been associated with increased in blood pressure. However, previous studies more focuses on psychological determinants of hypertension than prehypertension. Thus, this study aims to determine the association between these psychological factors with pre-hypertension. A cross-sectional study was conducted in 2012 among first year students of a public Malaysian university. A random cluster sampling was used to select 5 out of 15 faculties and a total of 495 students participated in this study. The Malay version of DASS-21 was used to elicit their levels of depression, anxiety and stress. Blood pressures were measured twice using sphygmomanometer and the averages were taken. Data analyses used chi-square test and binary multiple logistic regression. The prevalence of pre-hypertension was 30.1%. The percentage of severe and extremely severe depression was 3.8% and 1.2%; both severe and extremely severe anxiety was 16.4%; and severe and extremely severe stress was 4.2% and 0.2% respectively. Severe/extremely severe depression had more than 3 times higher in getting pre-hypertension than no depression. In conclusions, almost one third of respondents had pre-hypertension and only severe/extremely depression was associated with pre-hypertension.
Down Syndrome (DS), is a complex genetic disease resulting from the presence of 3 copies of chromosome 21. It is the most common autosomal abnormality among live births and the most commonly recognized genetic cause of mental retardation. The only well established risk factor for DS is advanced maternal age. The Human Genome Center , University Sains Malaysia, Kelantan has been carrying out cytogenetic studies in DS patients. Here we, report the karyotype pattern of Down Syndrome patients in correlation with maternal age, among referral cases to our Center.
Introduction: Medical school expected to be a time of personal development, achievement, and well-being. However, research shows that there are many negative effects on students’ mental health due to the current educational process. Objective: This research aimed to determine the prevalence and risk factors of depression, anxiety, and stress among medical students of a private medical university in Malaysia. Method: Cross sectional study was conducted using self-administered questionnaires including socio-demographic factors, DASS-21 and MSSQ-40 questionnaires. Result: Prevalence of stress, anxiety, and depression were 46.9%, 76.2% and 60.2% respectively. Multiple logistic regression analysis showed that academic related stressors were only associated with stress [adjusted OR 1.78, 95% CI (1.23, 2.58), p=0.002]. Group activities related stressors were significantly associated with stress [adjusted OR=1.45, 95%CI (1.20, 1.75), p
Introduction: Task-based learning (TBL) has been accepted as an effective tool in teaching and learning activities in most medical schools. Many studies have looked at competencies and learning outcomes essential for undergraduates. Among the essential competencies are interpersonal skills and the ability to engage in a group discussion which this study has focused on. The evidence supporting higher interpersonal skills is however limited because many relevant competencies are hard to measure and require long observational periods.
Objective: To determine students’ self-perceived value of TBL in enhancing their interpersonal skills during the clinical phase.
Material and Methods: All students’ (semesters 6-10) in the clinical school of International Medical University (IMU) were invited to participate in this cross-sectional study done in December 2007 utilising a self-administered questionnaire with a 5-point Likert scale. It assessed the students’ perception on TBL sessions conducted during their clinical attachments in the various disciplines. Mean-scores, standard deviations, and confidence interval were used.
Results: Response rate was 62%. The results indicated that students were favorable in their opinion on TBL as a suitable forum for active communication and participation in group discussion. The results also show that both male and female students’ have similar perception. As for the comparison according to semesters, this showed that students’ maturity does not influence their perception as well.
Conclusion: In conclusion, the study has shown positive students’ perception on the effect of TBL on acquired skills such as interpersonal communication. Our findings are consistent with many earlier studies which show students’ perception of the method of learning as important factor in the enhancement of their interpersonal skills which is fundamental to clinical practice. Further research is necessary; long-term and larger scale observational studies would undoubtedly be optimal to minimise response bias.
Eating disorders are a group of mental health concerns characterized by disturbance in eating behaviour that include, anorexia, bulimia, binge eating disorder, and other types of disordered eating. Adolescents are becoming increasingly vulnerable to eating disorders. The Eating Disorder Attitude Test (EAT-40) is a widely used screening instrument for detecting eating disorders. Several authors have translated the EAT-40 in various languages and validated the scale. The objective of the study included determining the factor structure of EAT-40 and to find the reliability. Method: 217 undergraduate university students in Malaysia were administered the EAT-40. In addition, they were also administered the Rosenberg’s Self Esteem scale to study the correlates of EAT-40. Results: The mean age of students was 22 years. The factor analysis of EAT-40 revealed a 34 item EAT model, with four subscales, ‘Dieting Behaviour’, ‘Oral Control’, ‘Food Preoccupation’ and ‘Body Image’. The short form is composed of 34 items and shows good internal consistency = 0.799.
Conclusion: It may be established that the EAT-34 shows an unidimensional structure with good internal consistency even though some items needs to be revised.
Cancer of the cervix is the second most common cancer among Malaysian women. Pap smear screening can detect precursors of cervical cancer. This paper attempts to determine the factors that influence the uptake of Pap smear screening. This was a cross sectional study with 112 Malay women recruited from a public university. A questionnaire enquiring sociademographic characteristics and health seeking behaviour based on the Health Belief Model was modified, translated and pre·tested. Testeretest reliability was also conducted. The mean age of the participants was 35.8 + 9.1 years. Majority was married and had at least secondary education. Only 62% of them had ever undergone Pap smear screening. Multiple logistic regression analysis showed women who were married or divorced (OR: 50.79, 95% C1: 4.33; 596.36), older age (OR: 1.12, 95% CI: 1.03; 1.22) or perceived higher benefits of Pap smear (OR; 4.80, 95% CI: 1.14; 20.15)
were more lilcely to have undergone Pap smear screening. Measures in reducing barriers and educating the public on the benefits of Pap smear are strongly recommended.
Various studies have reported that excess body weight may increase the risk to various diseases and death. A study reported that adolescents who were overweight were almost 18 times more likely than their leaner peers to be obese in early adulthood and were 8.5 times more likely to have hypertension as young adults. Therefore, this study was conducted to determine the body composition and four dietary factors i.e., prudent diet habits, calorie control habits, dietary fat/ cholesterol and sodium/salt control which may affect blood pressure and the risk of heart disease among year 1 medical students in a public university in Selangor. Body composition was determined by measuring the body mass index (BMI) and body fat percentage. None of the female students showed excellent/good eating habits while majority were fair (37.7%) and poor/very poor (62.3%). Nearly half of the male students showed excellent/good eating habits (42.5%), but more than half (57.5%) were poor/very poor. Majority of the female (85.7%, 85.7% and 94.8% respectively) and male students (80.9%, 57.5% and 93.6% respectively) showed excellent/good eating habits in calorie, dietary fat and salt control. Majority of the students (64.9% female and 61.7% male) have normal BMI values while 24.7% of female and 10.6% of male students were underweight (BMI values less than 18.5). Only a small number of female students were overweight (5.2%) and obese (5.2%). However 14.9% of male students were overweight and another 12.8% were obese.
Students in tertiary level education are mostly young adults that are transiting from the teenage years to adulthood. Since there is less restriction as compared to their teenage years, university and college students might involve in risky behaviours that may affect their health, social and academic performance. Thus, the purpose of this study is to investigate and identify the differences of health risk factors and health promoting behaviour that have been practiced by students in Malaysia. A cross sectional study was conducted using closed-ended questionnaires distributed to university and college students via emails. The results showed that 77.0% students claimed they have no health problem. However 49.0% of the non-medical students did not know whether they have normal BMI. Among the medical students, 62.0% rarely do physical exercise even though most are seriously concern about their fat consumption (95.0%). Only 30.0% of the total students have awareness of wearing seat belt. For health promoting behaviour, 33.0% of female students have never perform breast self examination (BSE), while 65.0% of male students have never perform testicular self examination (TSE). These findings confirmed that there are differences in health risk factors and health promoting behaviour that have been practiced by the students.
As the Malaysian population ages, the burden of age-related cognitive disorders such as dementia and Alzheimer’s disease will increase concomitantly. This is one of the sub-study under a research project titled by quantify the cost of age-related cognitive impairment in Malaysia, which was undertaken to develop a clinical pathway for Mild Cognitive Impairment (MCI) and Dementia. The clinical pathway (CP) will be used to support the costing studies of MCI and Dementia. An expert group discussion (EGD) was conducted among selected experts from six (6) government hospitals from different states of Malaysia, Ministry of Health, and United Nations University, International Institute for Global Health, UKM and UPM. The expert group includes psychiatrist specialists and public health medicine specialists. A total of 15 participants took part in the EGD. The group was presented with the different approach in managing MCI and Dementia. Finally, the group came to the consensus agreement on the most appropriate and efficient ways of managing the two conditions. In the EGD, an operational definition for MCI and Dementia was agreed upon and a pathway was developed for the usual practice in the Malaysian health system. A typical case used, as a reference is a 60-year-old patient referred to a memory clinic with complaint of “forgetfulness”. After three outpatient visits in the clinic, the diagnosis of MCI and Dementia could be clinically established. The clinical pathways covered all active clinical and non-clinical management of the patient over a period of one year. The experts identified the additional resources required to manage these patients for the whole spectrum of lifetime based on the expected life expectancy. The Clinical pathway (CP) for MCI and Dementia was successfully developed in EGD with strong support from practitioners in the health system. The findings will help the researchers to identify all-important clinical activities and interventions that will be included in the costing study.
Autologous chondrocyte implantation (ACI) is a significant technique that has gained widespread use for the treatment of focal articular cartilage damage. Since its inception in 2004, the Tissue Engineering Group (TEG) of the Faculty of Medicine, University Malaya has been dedicated to carrying out extensive research on this cell-based therapy. The objective of this report, comprising one clinical case report, six animal studies and one laboratory study, is to summarise and discuss TEG’s key findings. On the whole, we observed that the ACI technique was effective in regenerating hyaline-like cartilage in treated defects. Autologous chondrocytes and mesenchymal stem cells (MSC) were found to produce comparable tissue repair irrespective of the state of MSC differentiation, and the use of alginate-based scaffolding and oral pharmacotherapy (Glucosamine and Chondroitin Sulphate) was shown to enhance ACI-led tissue repair. ACI is suggested to be an efficient therapeutic option for the treatment of articular cartilage defects of the knee.
Objective: The objectives of this study were to asses body mass index, fasting blood sugar , serum cholesterol levels and prevalence of Diabetes Mellitus among outpatients attending the Clozapine clinic at University Malaya Medical Center. Method: 36 patients had their height and weight taken at the start of the study. Their BMI (body mass index) was calculated. Fasting blood sugar, (FBS) and Fasting Serum Lipid (FSL) were performed. Result: The mean body mass index was 24.63. The prevalence of obesity was 13.89%. The prevalence of overweight was 27.8 % and the prevalence of underweight was 5.55%. The prevalence of Diabetes Mellitus was 2.78 %. Serum triglyceride levels appear to be elevated in those receiving Clozapine.Conclusion: It appears that Clozapine may predispose one to obesity. From our study we cannot conclude if Clozapine causes Diabetes Mellitus. However treatment with Clozapine may be associated with elevated levels of serum triglycerides.
Study site: Clozapine clinic at University Malaya Medical Center
Objective: To determine the incidence and predictors of early ankle contracture in adults with acquired brain injury. Methods: A prospective cohort study of patients admitted to Neurosurgical Intensive Care Unit (NICU), University Malaya Medical Centre and referred for rehabilitation within a period of 12 months. Adult patients with newly diagnosed acquired brain injury with no prior deformity to lower limbs, Glasgow Coma Scale ≤ 12, no concomitant spinal or lower limb injuries, medical stability at inclusion into the study and agreed to participate for the total duration of assessment (3 months) were recruited. We conducted weekly review of ankle muscle tone and measurement of ankle maximum passive dorsiflexion motion. The end point is reached if ankle contracture developed or completed 3 months post injury assessment. Results: The cohort included 70 patients, of which only 46 patients completed the study. Twenty-eight patients suffered from severe brain injury whilst 18 from moderate brain injury. Out of the 46 patients, 13 (28%) developed ankle contracture at the end of the study period. Abnormal motor pattern was significantly associated with incidence of ankle contracture, which included spasticity (p
The present study is to determine the level of depression, anxiety and stress among Universiti Kebangsaan Malaysia (UKM) clinical year medical students and their help seeking behaviour in relation to their psychological aspect. A cross-sectional study was conducted in UKM Medical Centre for three months duration. The study population was the third, fourth and fifth year medical students via proportional sampling. They were given questionnaires consisting of socio-demographic items, Depression, Anxiety and Stress Scale 21 – Bahasa Malaysia version BM-DASS21 and questions regarding help-seeking behaviors. Psychometric assessment (BMDASS21) estimated the level of depression, anxiety and stress among medical students. Help-seeking behavior questions assessed the use of medical facilities and other help-seeking sources. Regarding questions on the barriers towards seeking help from the primary health-care, three parts were evaluated: structural barriers, barriers towards perceptions on mental-health disorder and barriers towards use of primary health-care services. There were 380 medical students who were involved in this research. It was found that some students experienced depression (1.3%), anxiety (2.4%) and stress (2.4%). Majority of them preferred to seek help from friends (283; 74.5%) followed by parents (275; 72.4%). There was a significant association between students who were anxious and help seeking behaviour from formal sources: counselor (p=0.001) and religious personnel (p=0.03). Hence, it is essential to increase their awareness on psychological disorders and more efficient screening programme should be used to recognize medical students with possible emotional disorders.
Maternal Home-based Record (MHR) is a concise medical record that can be kept by the pregnant women for regular documentation throughout pregnancy stages. This study was done to assess the usage of the MHR among the pregnant women and its associated factors. A good MHR usage was assigned using mean value as cut-off point that has been agreed by an expert group from scoring system which incorporates usage elements in term of follow-up, information documentation, knowledge seeking, continuity of care and self-monitoring of pregnancy. A cross-sectional survey was conducted in University Kebangsaan Malaysia Medical Centre (UKMMC) and a total of 79 pregnant women who attended the antenatal clinic were recruited. A validated self-administered questionnaire was used. The questionnaire was newly developed in Bahasa Malaysia. Content validity and reliability test for internal consistency for the knowledge, satisfaction and usage scale was performed. The Cronbach’s Alpha value for each domain was 0.764, 0.716 and 0.877 respectively. The results showed that the prevalence of good MHR usage was 51.3%. There were significant association found between level of education (Adj OR=0.32, 95% CI 0.12, 0.85, p=0.023) and doctor as birth attendant in previous pregnancies (Adj OR= 2.54, 95% CI 1.97, 6.59, p=0.045) with good usage of MHR. There was a positive significant relationship between satisfaction level among the respondent and the level of the usage (p=0.01, r=0.377), whereby with every increase in 1 score in satisfaction level will increase the usage score by 0.4 (95% CI 0.2 to 0.7) units, p<0.01. Therefore, MHR is still relevant as antenatal care monitoring instruments and it is important to make an effort to improve patient satisfaction in using MHR. Health care providers can use this validated self-administered questionnaire to assess function of MHR to remain relevant to the pregnant women population in their locality.
Key words: Antenatal care, home-based maternal record, usage, satisfaction
Study site: Antenatal clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia