OBJECTIVES: Erectile dysfunction (ED) is a problem commonly encountered by patients on methadone maintenance therapy (MMT). This study aimed to assess the prevalence of ED among this group of patients along with its risk factors and association with quality of life (QOL).
METHODS: Male patients on MMT in a tertiary hospital in Malaysia were included in the study. A total of 134 patients with sexual partners were assessed for ED using the International Index of Erectile Function. Patients were assessed for substance use using Opiate Treatment Index (OTI) and depression using the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM). QOL was evaluated using World Health Organisation Quality of Life (WHOQOL)-BREF.
RESULTS: The prevalence of ED among patients on MMT was 67%, with 26.1% having mild ED, 30.4% having mild-to-moderate ED, 7.0% having moderate ED, and 17.2% having severe ED. Patients with depression were 4 times more likely to have ED compared with patients without depression, whereas increasing age significantly correlated with the severity of ED. Having ED predicted a poorer QOL in the social relationships domain.
CONCLUSION: Depression is highly associated with ED, which negatively influences the social aspect of QOL among patients on methadone maintenance therapy.
Study site: outpatient addiction psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
The implementation of the 1 Student 1 Sport Policy (D1M1S) focuses on the involvement of students who are less active in sports activities in order to polish and further developed their talent potential. It is
believed that the responsibility and the role of teachers are vital in ensuring the implementation of D1M1S conducted at the school level. However, the use of teachers as executors in ensuring that this policy is carried out must be studied and identified to achieve the goal of D1M1S besides improving the quality of work to a higher level. This study was conducted to identify the implementation level of D1M1S among teachers in secondary schools in Kluang, Johor, implementation of D1M1S based on gender differences and category of school and existing relationships such as elements of skill, understanding,
commitment and sports facilities. The key success of D1M1S implementation is closely
related to the teachers as executors. This study was carried out on 389 secondary school
teachers in Kluang, Johor. Questionnaire containing 36 items was developed and
administered to measure the elements of skill, commitment, understanding and sport
facilities. Cronbach Alpha reliability coefficient value of the instrument was 0.95. The data
were analysed using descriptive statistics (mean, standard deviation and frequency) and
inferential analysis (independent samples t-test and Pearson correlation). The findings
showed high level of understanding towards D1M1S while the elements of skill, commitment
and sports facilities were at a moderate level. In addition, there were significant difference in
terms of mean scores reported for the implementation of D1M1S based on the genders of the
teachers with the skills element (p = 0.00
A cross-sectional study was carried out in 2006 to determine the prevalence of Ascaris lumbricoides infection among Orang Asli (aborigines) children in Pos Lenjang, Pahang. A total of 71 faecal samples were collected from the children (40 girls and 31 boys) aged between 1-12 years. The samples were examined for the presence of the ova of A. lumbricoides using direct faecal smear and formalin-ether concentration techniques. 42.3%. The prevalence of A. lumbricoides infection was found to be slightly higher in males (45.2%) compared to females (40%) (p>0.05). The school-aged children showed higher prevalence of infection (48.6%) as compared to the preschool children (35.3%) (p
This study was to investigate the association between functional dentition with inadequate calorie intake and underweight in elderly people living in “Pondok” in Kelantan. A cross-sectional study participated by 369 elderly people was carried out. A simple random sampling method was utilized for the selection of the subjects. Subjects were interviewed using a structured form to collect information about subjects’ demographic background and self-reported health status. The 24-hour recall method was used to provide information on the subject’s exact food intake during the previous 24 hours. Body mass index was calculated from subjects’ weight and height, followed by oral assessment. The “Nutrical Software” was used for nutrient calculation, followed by SPSS version 11.5 for data analysis. The response rate was 95.6%. Majority of the respondents were female (92.4%). The percentage of subjects who had inadequate calorie intake and underweight was 71.0% and 25.7% respectively. The percentage of edentulism was 81.0%. The proportion of elderly with compromised functional dentition was 48.2% and majority was edentate elderly without wearing any complete dentures or wearing defective dentures, 23.6% and 56.2% respectively, while 20.2% was dentate elderly. The odds of having inadequate calorie intake and getting underweight among elderly with a compromised functional dentition was 3.7 times and 42.0 times respectively, compared to elderly with a non-compromised functional dentition. There was a significant association between inadequate calorie intake and underweight with functional dentition among elderly living in “Pondok” in Kelantan.
Tooth wear is the loss of tooth tissue and structures not due to caries. It can occur in various forms either attrition, abrasion, erosion, noncaries cervical lesion (NCCL) or a combination of two or more forms. The objective of this study was to determine the patterns and associated aetiologies of tooth wear among adults in Kelantan, Malaysia. This crosssectional study involved 81 adults with tooth wear which was visually assessed using the Smith and Knight Tooth Wear Index (TWI). A questionnaire was used to seek putative aetiologies of the wear. Data were analyzed and the results were expressed as frequencies and percentages. Six thousand three hundred and eighty four tooth surfaces were examined in 1596 teeth. 17.4% surfaces had tooth wear; 80% scored 1, 18% scored 2 and 2% scored 3. Among the 81 cases of tooth wear, 29 (35.8%) had abrasion; 25 (30.9%) had attrition; 1(1.2%) had erosion while 26 (32.1%) had the combined type. Among those with abrasion, majority had the habit of eating freshwater clams (Corbicula fluminea) as local delicacy where most of the times people use their teeth to pry open the clam shells. Erosion was related to the pooling of carbonated drinks or beverages in the mouth before swallowing. In conclusion, most adults experienced abrasion and the most common possible associated aetiology is the way of eating clams.
A four-month cross-sectional study found five species of parasitoids parasitizing puparia of filth flies breeding at the Taman Beringin landfill in Kepong and a poultry farm in Sungai Pelek, Sepang, Selangor. Effect of monthly rainfalls towards density of flies and percentage of parasitoids emerging from collected puparia were also analyzed. Spalangia sp. was the most common, consisting of Spalangia endius Walker, S. cameroni Perkins and S. gemina Boucek. Other parasitoids collected were Pachycrepoideus vindemmiae Rondani and Exoristobia phillipinensis Ashmead. The parasitized fly hosts were Musca domestica Linn. and Chrysomya megacephala Fabricius. S. endius was the most common parasitoid attacking M. domestica at both locations. M. domestica was the most common fly found at the Sg. Pelek poultry farm whereas C. megacephala was the most numerous at the Taman Beringin landfill. During heavy rainfall month of November 2003, density of flies were high whereas the emerging parasitoids were low at both landfill and poultry farm. The present study revealed the endemic presence of parasitoids especially S. endius in both poultry farm and garbage landfill and the potential of the parasitoid species in fly control in Malaysia.
Osteoporosis is a global health problem both in the developed and developing countries. Patient education forms an important part in the management of osteoporosis. The objective of this study was to evaluate knowledge about osteoporosis and its correlates among women aged ≥ 40 years attending an urban health centre in India and to identify their sources of information on osteoporosis. Knowledge about osteoporosis was assessed using the Osteoporosis Questionnaire (OPQ) in 243 women over 40 years of age, attending an urban health centre in the city of Mumbai located in the state of Maharashtra in western India. This exploratory cross-sectional study was conducted over a period of eight months. The OPQ analysis was performed using SPSS for Windows Version 13.0. The scores were expressed as mean ± SD (Standard Deviation). The one sample-t test was used to study the differences in the mean scores between socio-demographic variables. The mean total OPQ score was 0.91 (SD ± 5; range -9 to 10; maximum possible score 20). There was a significant difference in the total OPQ scores by the level of education and family history of osteoporosis (p
Background and Objectives: Unmet need for contraception is the gap between women's reproductive intentions and their contraceptive behavior. This community based interventional study was carried out to determine the unmet needs for contraception, the reasons for this and to assess the impact of interventional measures on acceptance of contraception.
Subjects and Methods: This study was conducted in 52 villages in the state of Maharashtra, India, among 363 married women selected by cluster sampling. Data was collected using an interview guide. An intervention was done for the women who had an unmet need and an assessment of the change was done subsequently. Data was analyzed by using SPSS.
Results The prevalence of contraceptive usage was 59.2% and the prevalence of unmet need for contraception was 44% (160). The unmet need for spacing births was 53.8%, 38.7% for limiting births and 7.5% women were dissatisfied with the current contraceptive method. The reasons ranged from side effects to contraceptives to source of obtaining contraceptives. Age of the respondents, education and number of living children showed statistically significant association with unmet needs. Post intervention, the contraceptive prevalence rate increased significantly 85.7% and there was a significant reduction in the unmet needs for spacing and limiting births, equally there was a significant reduction of dissatisfaction with using contraception.
Conclusion: Improvement in the use of contraception and addressing the unmet need for contraception requires community involvement and ongoing, sustained efforts by health workers to ensure quality care to the beneficiaries.
Introduction: Anemia in pregnancy is still a public health problem in developing countries including Malaysia. Early screening of pregnant mothers who have risk factors of anemia could help identifying these potential anemic mothers and hence targeted for intervention.
Methodology: A cross sectional study IN 2008 was conducted among pregnant women who attended government health clinics in Johor Bahru district to assess the prevalence of anemia in pregnancy and factors associated with it using a structured questionnaire.
Result: Prevalence of anemia in pregnancy (Hb<11.0 g/dl) was 36.6% and majority in mild category (Hb 9-<11 g/dl). The associated factors of anemia in pregnancy were birth spacing, dietary intake with high iron content and iron pill consumption. Multivariate analyses revealed that iron pill intake was the most important factor influencing anemia in pregnancy.
Discussion and conclusion: Even though Johor Bahru is a big town with good health facilities, the prevalence of anemia in pregnancy was quite high. Results were compared with previous studies. Emphasis on compliance to iron pills is very important in prevention and treating anemia in pregnancy
Key Words: anemia in pregnancy, birth spacing and iron pill intake
Study site: Four urban and two rural klinik kesihatan, Johor, Malaysia
Contact time was defined as the time spent by health personnel with a patient. The study was conducted for four months in 2007 to assess the contact time and to determine the appropriate contact time as perceived by patients attending clinics of various clinical disciplines as well as Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals. This study was a cross-sectional study carried out on out-patients who came to the hospitals’ clinics for treatment. Information was gathered through self-administered questionnaires, distributed at twenty-one hospitals. The respondents were selected using stratified random sampling method. Out of 21,750 questionnaires distributed, 13,463 patients responded, a response rate of 61.9%. This study shows that the average contact time increases from small hospitals (8 minutes) to bigger hospitals (15 minutes). The contact time also varies between the clinics of various disciplines. Obstetrics and Gynecology (O&G) clinics and Pediatric clinics had the longest average contact time of 20 minutes and 15 minutes respectively. The percentage of patients who were satisfied with the contact time corresponded with the type of clinics and hospitals which had the longest contact time. Thus, it is suggested that clinics and hospitals, whenever possible try their best to follow the duration of contact time as perceived appropriate by the patients.
Study site: Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals (21)
Smoking among school children is becoming a serious problem in developing countries, including Bangladesh. The early initiation of smoking needs urgent intervention to protect this vulnerable group and preventing them to be addicted. This study aims to determine the age at initiation of smoking and factors affecting it. A two-stage cluster sampling was used with a selection of schools on probability proportional to enrolment size followed by stratified random sampling of government and private schools and then a random start in classes VIII, IX and X of each school targeting the students aged 13 years and above. Data collected from secondary school students using self-administered structured questionnaire. All analyses were performed with SPSS version 20.0. Missing value was treated by multiple imputations. A total of 6877 data were analysed in which 84.7% were non-smoker, 9.5% were ever smoker and 5.8% were current smokers. Among the ever smoker (n=823), 38% were current smokers, 56.5% former and 5.5% were recent quitters. The mean (SD) age at initiation of smoking was 10.9 (0.2) years. Multinomial regression analysis revealed that class grade, peer pressure and offered free cigarette appeared to be significant predictors of smoking initiation (p0.05). Promotion of smoking resistance skills among children and teens through comprehensive approaches designed to enhance general personal competence by teaching an array of personal and social life skills is recommended.
A cross sectional study was carried out to determine the relationship between dust exposure and pulmonary function in male steel workers in Terengganu, Malaysia. The investigation included spirometric testing and detailed personal interviews using a structured questionnaire adopted from British Medical Research Council (BRMC) Questionnaire on respiratory symptoms. Respiratory symptoms commonly reported by the male workers were morning phlegm (33.1%), shortness of breath (31.9%), chest tightness (30.4%), and morning cough (17.8%). Age and duration of employment were among the factors associated with respiratory symptoms (p
The level of patient satisfaction is important for service quality in hospitals. This study aims to measure the level of patient satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC) and the factors affecting it. A cross-sectional study was conducted on 520 respondents at the outpatient department in four clinics in UKMMC by using self-administered questionnaires. Respondents were selected using a systematic sampling method based on the list of patient appointments. The level of patient satisfaction was measured using the PSQIII domain. Less than half of the respondents were satisfied with the overall service provided (41.0%), while the others (59.0%) were not satisfied. Based on the domain studied, the level of satisfaction varies widely: the highest satisfaction were interpersonal relationships (75.8%) followed by the registration process (73.8%), technical quality (71.3%), communication (66.7%), physical facilities (64.6%), accessibility (60.2%), and financial (47.3%). The level of patient satisfaction was low and financial domain should be given more attention to in order to ensure an increase in patient satisfaction levels.
Study site: Surgery, Orthopaedic, Obstetric and Gynaecology, and Medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Spirituality and mental adjustment have been widely adopted as coping strategies among women with breast cancer. Little information was available locally on the use of spirituality and mental adjustment as coping mechanisms to fight breast cancer. A cross-sectional study was conducted to assess spirituality and mental adjustment as coping strategies and its association with socio demographic data on 216 women with breast cancer. The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp) and Mental Adjustment to Cancer (MAC) Scales were used to assess spirituality and mental adjustment. Negative correlation between spiritual well-being and helplessness/hopelessness (r=-0.690; p=0.000), anxious preoccupation (r=-0.277; p=0.000) and avoidance (r=-0.235; p=0.000) and positive correlation between spiritual well-being and fighting spirit (r=0.668; p=0.000) were identified. Socio-demographic factors such as race (p=0.000), religion (p=0.000), academic qualification (p=0.004) and type of surgery (p=0.016) revealed significant relationship with spiritual well-being. Fighting spirit, hopelessness/helplessness and anxious preoccupation also yielded significant relationship with race (p
Breast feeding has been actively encouraged in Malaysia in the last few years in all public hospitals. This study proposes to find out the prevalence of breast feeding in three villages in a rural community in Kedah, Malaysia. This was a cross sectional study on breastfeeding practices in Kubang Pasu, a district of Kedah. Majority of the mothers initiated breast feeding but exclusive breastfeeding was only 21% for four months and predominant breastfeeding was about 12.6%. The breastfeeding practice was more prevalent among women from the higher educational strata and higher income than those from the lower strata and lower income (p
Accidental needle-stick injuries (NSIs) are a hazard for health-care workers and general public health. Orthopaedic surgeons may be more prone to NSIs due to the prevalence of bone spikes in the operative field and the use of sharp orthopaedic instruments such as drills, saws and wires. A hospital-based cross sectional study was conducted in the orthopedic wards of Melaka General Hospital. The prevalence of NSIs was 32 (20.9%) and majority of it occurred during assisting in operation theatre 13(37.4%). Among them six (18.8%) were specialist, 12(37.5%) medical officer, 10 (31.2%) house officer and four staff nurses (12.5%). Among the respondents 142 (92.8%) had been immunized against Hepatitis B and 148 (96.7%) participants had knowledge regarding universal precaution. The incidence of NSI among health care workers at orthopaedics ward was not any higher in comparison with the similar studies and it was found out that the prevalence was more in junior doctors compared with specialist and staff nurses and it was statistically significant.
Background: Circumcision though not mentioned in the Quran is believed to be a compulsory practice among the Muslims. In Malaysia, although there are several methods of circumcision available and traditional circumcision is still popular.
Methods: A cross-sectional survey was carried out in a small fishing village of Kedah to study the methods of circumcision available to the villagers. This was followed with an in-depth interview conducted with ‘Tok Mudim’, a practitioner of traditional method of circumcision.
Results: Forty three of the eligible 71 subjects participated in the study giving the response rate as 60.5%. The most common age for circumcision was 9 years old. Despite private clinics being the most common place of circumcisions, there was an increasing number of boys going to the ‘Tok Mudim’ for circumcision. A Mass Circumcision Ceremony is traditionally practiced. The ‘Tok Mudim’ described the procedure in detail and was of the opinion that the reason traditional method is still popular was because of the fear of injections and impotency among the parents. Most common complication faced by the ‘Tok Mudim’ was bleeding and infection.
Discussion and Conclusion: Till the community shifts entirely to using modern medicine, there is a need to integrate traditional practitioners into the system. Training the ‘Tok Mudim’ to use modern instruments and aseptic techniques should be considered.
This study was done in all UNIMAS medical students from year 1 to year 5 in the year 2004. A questionnaire was used. 290 students participated with a response rate of 72.5%. There were more male students snoring than female (ratio 5.9:1.3). The habitual snoring percentages for all years, first year and final year medical students are 7.2, 9.9 and 3.6 respectively and these are comparatively and relatively low with other studies reported in the last 10 years, and the reasons for this are unknown. However it was interesting to note in this study and others that there are relatively more snoring medical students in the first year than subsequent years. Significant positive correlation of snoring was found with the factors of gender, weight, height and sleep apnoea, all having p<0.0005, but no significant correlation was found in others including examination results.
Current asthma treatment is directed by severity of symptoms and lung function. In Malaysia, spirometry is not widely available and therefore not used in most medical consultations. In 163 asthmatic patients [mean (95% CI) age: 41 (38-44) yrs; 29% male; 32% Malays, 32% Chinese, 34% Indians] who were being followed up in a State Hospital medical outpatient clinic and a large urban-based health clinic, we studied the effect on Global Initiative for Asthma (GINA) disease severity classification and the appropriateness of currently prescribed treatment when forced expiratory volume in one second (FEV1) was considered together with symptom severity. We showed that 52% of the patients were upgraded to a higher severity classification and 71% of the patients were under-treated. If based on symptoms alone to assess severity, 39% of the patients were still under-treated. We concluded that the disease severity in many asthmatic patients might have been underestimated and therefore not adequately treated, because spirometry was not available or used to assess asthma severity. The use of spirometry should be advocated more widely among clinicians treating asthma in Malaysia.
Study site: Hospital Tuanku Jaafar, Seremban, Negeri Sembilan; Klinik Kesihatan Seremban, Malaysia