Methods: We used cross-sectional data on 6759 children and adolescents aged 6-19 years living in Segamat, Malaysia. We compared prevalence estimates for stunting defined using the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) references, using Cohen's κ coefficient. Associations between sociodemographic indices and stunting risk were examined using mixed-effects Poisson regression with robust standard errors.
Results: The classification of children and adolescents as stunted or normal height differed considerably between the two references (CDC v. WHO; κ for agreement: 0.73), but prevalence of stunting was high regardless of reference (crude prevalence: CDC 29.2%; WHO: 19.1%). Stunting risk was approximately 19% higher among underweight v. normal weight children and adolescents (p = 0.030) and 21% lower among overweight children and adolescents (p = 0.001), and decreased strongly with improved household drinking water sources [risk ratio (RR) for water piped into house: 0.35, 95% confidence interval (95% CI) 0.30-0.41, p < 0.001). Protective effects were also observed for improved sanitation facilities (RR for flush toilet: 0.41, 95% CI 0.19-0.88, p = 0.023). Associations were not materially affected in multiple sensitivity analyses.
Conclusions: Our findings justify a framework for strategies addressing stunting across childhood, and highlight the need for consensus on a single definition of stunting in older children and adolescents to streamline monitoring efforts.
METHODS: A one-year survey was conducted in three states of the east coast region of Peninsular Malaysia involving 204 CBR workers selected through universal sampling method where all CBR staff who fulfilled the inclusion criteria were selected as participants. Self-completed questionnaires consisted of 20 association factors on six-point Likert scale responses were distributed. Total mean satisfaction level and mean associated factors were reported in this study.
RESULTS: The results showed that the majority of the participants were between 20 and 40 years old (72%), female (96%), Malay (99%) and had 1-5 years of working experience. The mean total satisfaction score was 79.8 ± SD = 7.85. The highest mean satisfaction level for the associated factor was 4.6 ± SD = 0.59 with about 95% of the participants were satisfied that "CBR programme is a challenging work", while the lowest satisfaction level for associated factor was on "salary of community-based rehabilitation staff is acceptable", with mean score of 2.3 ± SD = 0.97 with about 59% of the participants felt dissatisfied. The results of this study determined that the highest dissatisfied factors among CBR workers were on salary.
CONCLUSION: These findings provided useful information for policymakers to evaluate this issue for a sustainable CBR programme in the future.
TRIAL REGISTRATION: This study has been registered for trial as 'retrospective registered' in the Australian New Zealand Clinical Trials Registry (ANZCTR) (registration no.: ACTRN 12618001101279 ) on 5th October 2018.
METHOD: A single-blind RCT was conducted among 30 randomized patients with dental phobia to either VRET or informational pamphlet (IP) condition. Primary outcome anxiety measures (VAS-A, MDAS and DFS) were evaluated at baseline, pre- and post-intervention, 1-week, 3-months and 6-months follow-up. Secondary outcome measures assessed were pre-post behavioral avoidance, temporal variations of heart rate and VR-experience during and post-VRET, and dental treatment acceptance in both conditions at 6-month follow-up.
RESULTS: Intention to treat analysis, using a repeated measures MANOVA, revealed a multivariate interaction effect between time and condition (p = 0.015) for all primary outcome measures (all ps
METHODS: A cross-sectional online survey was conducted among Malaysian youth aged 18-25 years who were recruited through social media.
RESULTS: Among 1530 respondents who completed the survey, 57.1% sought online STI information in the past 12 months mostly from general Internet websites, health websites, and Facebook. Respondents' overall STI knowledge was low. Young people who had higher STI knowledge (OR = 2.47, 95% CI = 1.87-3.25, P = 0.000), had intention-to-seek online STI information (OR = 2.02, 95% CI = 1.23-3.30, P = 0.000), identified as homosexual or bisexual (OR = 1.67, 95% CI = 1.08-2.57, P = 0.020), experienced STI symptoms (OR = 1.51, 95%CI = 1.02-2.22, P = 0.040), were in a relationship (OR = 1.42, 95% CI = 1.08-1.86, P = 0.012) and had high perceived quality of online STI information (OR = 1.41, 95%CI = 1.09-1.83, P = 0.009) were more likely to seek online STI information.
CONCLUSIONS: Findings suggest the need to increase STI knowledge and perceived quality of online STI information among Malaysian youth. Young people with low STI knowledge, who are heterosexual, sexually active without STI symptoms and single would benefit from reliable sources of online STI information for STI prevention.
METHODS: Thirty patients requiring aesthetic restorative dental treatment completed three questionnaires, namely 1) a pre-treatment expectation assessment, 2) an SCL-90-R analysis pre-treatment and 3) an outcome assessment post-treatment to assess patient's expectations and satisfaction of the proposed dental treatment relating to function, aesthetics, comfort and tissue preservation. Logistic regression models were used to assess the impact of psychological variables on patient satisfaction after adjusting for baseline expectations (P
METHOD: This study investigates three-dimensional (3D) soft-tissue craniofacial variation, with relation to ethnicity, sex and age variables in British and Irish white Europeans. This utilizes a geometric morphometric approach on a subsampled dataset comprising 292 scans, taken from a Liverpool-York Head Model database. Shape variation and analysis of each variable are tested using 20 anchor anatomical landmarks and 480 sliding semi-landmarks.
RESULTS: Significant ethnicity, sex, and age differences are observed for measurement covering major aspects of the craniofacial shape. The ethnicity shows subtle significant differences compared to sex and age; even though it presents the lowest classification accuracy. The magnitude of dimorphism in sex is revealed in the facial, nasal and crania measurement. Significant shape differences are also seen at each age group, with some distinct dimorphic features present in the age groups.
CONCLUSIONS: The patterns of shape variation show that white British individuals have a more rounded head shape, whereas white Irish individuals have a narrower head shape. White British persons also demonstrate higher classification accuracy. Regarding sex patterns, males are relatively larger than females, especially in the mouth and nasal regions. Females presented with higher classification accuracy than males. The differences in the chin, mouth, nose, crania, and forehead emerge from different growth rates between the groups. Classification accuracy is best for children and senior adult age groups.
METHODOLOGY: A retrospective review was conducted from January 2008 until December 2011. All patients diagnosed with zygomatic complex fractured that met the inclusion and exclusion criteria were included in the study. Zingg's Classification was used in the study.
RESULTS: The median age was 23.5. Type A was the most common fracture type made up 26.6%. About 90.8% of the injury was caused by road traffic accident. Forty-four patients were treated with open reduction and internal fixation and 4 patients were treated with close reduction only. Fifty patients were treated conservatively. Gillies approach in combination with fixation is the most common procedure accounted for 50%. Three-point fixation at infraorbital, maxillary buttress, frontozygomatic suture, and zygomatic arch was the most common site. However, there were no significant associations between the number of fixation and the occurrence of the complication (P = 0.307). About 29.2% in the treatment group and 66% in the conservative group had complications. About 35.7% of patients in treatment group had complications, while 66% had trismus in conservative group.
CONCLUSION: There was a significant association between types of treatment and the occurrence of complication (P = 0.001). However, there were no significant association between number of fixation and the occurrence of complications (P = 0.307).
CASE REPORT: Herein is an acute promyelocytic leukemia case of a 22-year-old young pregnant woman who had various social problems. The patient was diagnosed with acute promyelocytic leukemia in her the second trimester of her first pregnancy.Management and outcome: She was treated with all-trans-retinoic acid with idarubicin and successfully delivered a healthy baby. She completed induction with idarubicin but defaulted her all-trans-retinoic acid, 6-mercaptopurine and methotrexate maintenance. She relapsed after one year and was salvaged with all-trans-retinoic acid high dose cytarabine and arsenic trioxide. She went into remission and had autologous stem cells collected and was planned for an autologous stem cell transplant but she defaulted. She relapsed when she was pregnant with her second baby during her third trimester (29+weeks) 10 months later. Salvage chemotherapy with arsenic trioxide, all-trans-retinoic acid and idarubicin was given. Patient underwent an emergency lower segment caesarian section at 31 weeks of pregnancy due to abnormal fetal cardiotocography. A healthy baby was delivered.
DISCUSSION: This drug regimen is controversial during pregnancy owing to the teratogenic effects and fatal retinoic acid syndrome especially in early gestation. In this case, patient was started the induction therapy of all-trans-retinoic acid treatment at her second trimester during her first pregnancy.
CONCLUSION: Our lady demonstrated the possibility of using all-trans-retinoic acid and arsenic trioxide and chemotherapy during second and third trimester with successful pregnancy outcomes.
METHODS: This controlled community trial involved 210 women from the districts of Alor Setar and Sungai Petani. Simple random sampling was applied to select 105 women from each district. Self-administered questionnaires were used to obtain information about the variables of interest. Health education intervention program included educational talk, demo video, experience sharing, pamphlet distribution, and text message reminders. Evaluation of outcomes was performed twice. The text message reminders acted as the cues to action that were sent between the two evaluation times at one-month interval. Women in the control group received educational talk alone. In the control group, evaluation of outcomes was done only once, which was one month after the educational talk.
RESULTS: Knowledge on cervical cancer and Pap smear, and attitude towards Pap smear among women in both intervention and control group improved significantly at Evaluation stage 1. However, no further improvements were observed in the intervention group at Evaluation stage 2. The uptake of Pap smear in the intervention group increased significantly from 48.0% at Baseline to 68.0% at Evaluation stage 1 (P<0.001), and from 68.0% to 79.0% at Evaluation stage 2 (P<0.001). A significant increase in Pap smear uptake was also seen in the control group from 63.0% at Baseline to 76.0% at Evaluation stage 1 (P=0.003).
CONCLUSIONS: Educational talk alone was effective in improving knowledge on cervical cancer and Pap smear, attitude towards the test, and the actual uptake of the test. However, text reminders were more effective than having an educational talk alone in increasing uptake of Pap smear test among participants.
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MATERIALS AND METHODS: Using registry-based secondary data, a retrospective cohort study was conducted. TB patients' sociodemographic characteristics, clinical disease data and treatment outcomes at one-year surveillance were extracted from the database and analyzed. Logistic regression analysis was used to determine factors associated with unsuccessful treatment outcomes and all-cause mortality.
RESULTS: A total of 97,505 TB cases (64.3% males) were included in this study. TB treatment success (cases categorized as cured and completed treatment) was observed in 80.7% of the patients. Among the 19.3% patients with unsuccessful treatment outcomes, 10.2% died, 5.3% were lost to follow-up, 3.6% had outcomes not evaluated while the remaining failed treatment. Unsuccessful TB treatment outcomes were found to be associated with older age, males, foreign nationality, urban dwellers, lower education levels, passive detection of TB cases, absence of bacille Calmette-Guerin (BCG) scar, underlying diabetes mellitus, smoking, extrapulmonary TB, history of previous TB treatment, advanced chest radiography findings and human immunodeficiency virus (HIV) infection. Factors found associated with all-cause mortality were similar except for nationality (higher among Malaysians) and place of residence (higher among rural dwellers), while smoking and history of previous TB treatment were not found to be associated with all-cause mortality.
CONCLUSIONS: This study identified various sociodemographic characteristics and TB disease-related variables which were associated with unsuccessful TB treatment outcomes and mortality; these can be used to guide measures for risk assessment and stratification of TB patients in future.