OBJECTIVE: This study aimed to determine the survival rate of breast cancer among the women of Malaysia and characteristics of the survivors.
METHOD: A retrospective cohort study was conducted on secondary data obtained from the Breast Cancer Registry and medical records of breast cancer patients admitted to Hospital Kuala Lumpur from 2005 to 2009. Survival data were validated with National Birth and Death Registry. Statistical analysis applied logistic regression, the Cox proportional hazard model, the Kaplan-Meier method and log rank test.
RESULTS: A total of 868 women were diagnosed with breast cancer between January 2005 and December 2009, comprising 58%, 25% and 17% Malays, Chinese and Indians, respectively. The overall survival rate was 43.5% (CI 0.573-0.597), with Chinese, Indians and Malays having 5 year survival rates of 48.2% (CI 0.444-0.520), 47.2% (CI 0.432-0.512) and 39.7% (CI 0.373-0.421), respectively (p<0.05). The survival rate was lower as the stages increased, with the late stages were mostly seen among the Malays (46%), followed by Chinese (36%) and Indians (34%). Size of tumor>3.0cm; lymph node involvement, ERPR, and HER 2 status, delayed presentation and involvement of both breasts were among other factors that were associated with poor survival.
CONCLUSIONS: The overall survival rate of Malaysian women with breast cancer was lower than the western figures with Malays having the lowest because they presented at late stage, after a long duration of symptoms, had larger tumor size, and had more lymph nodes affected. There is an urgent need to conduct studies on why there is delay in diagnosis and treatment of breast cancer women in Malaysia.
METHODS: A total of 1598 questionnaires were posted to all female staff, aged 35 years and above. Their knowledge on breast cancer, practice of BSE and detection rate of breast abnormality as confirmed by CBE was determined.
RESULTS: The response rate for this study was 45 percent (714 respondents). The rate of respondents having awareness on breast cancer was 98.7 percent. Eighty four percent (598) of the respondents had performed BSE in their lifetime. However, in only 41% was it regular at the recommended time. Forty seven percent (334) had undergone CBE at least once in a lifetime but only 26% (185) had CBE at least once in the past 3 years, while 23% (165) had had a mammogram. There was a significant relationship between CBE and BSE whereby those who had CBE were twice more likely to do BSE. Nineteen percent (84 respondents) of those who did BSE claimed they had detected a breast lump. Of these, 87% (73) had gone for CBE and all were confirmed as such.
CONCLUSION: BSE is still relevant as a screening tool of breast cancer since those who detect breast lump by BSE will most probably go for further check up. CBE should be done to all women, especially those at highest risk of breast cancer, to encourage and train for BSE.
MATERIALS AND METHODS: Thos longitudinal study started in February 2011 and the subjects were 2552 form one students aged between twelve to thirteen years of from 15 government secondary schools of Kinta, Perak. Data on demographic, parental, school and peer factors were collected using a self-administered questionnaire. We examined the effects of peer, school and parental factors on the five stages of smoking; never smokers, susceptible never smokers, experimenters, current smokers and ex-smokers, at baseline.
RESULTS: In the sample, 19.3% were susceptible never smokers, 5.5% were current smokers 6% were experimenters and 3.1% were ex-smokers. Gender, ethnicity, best friends' smoking status, high peer pressure, higher number of relatives who smoked and parental monitoring were found to be associated with smoking stages. Presence of parent-teen conflict was only associated with susceptible never smokers and experimenters whereas absence of home discussion on smoking hazards was associated with susceptible never smokers and current smokers.
CONCLUSIONS: We identified variations in the factors associated with the different stages of smoking. Our results highlight that anti-smoking strategies should be tailored according to the different smoking stages.
OBJECTIVES: The objective of this study was to examine the psychometric properties of the Hausa translated versions of the Multidimensional Scale of Perceived Social Support (MSPSS) and to validate it for future use in clinical research in Nigeria.
PATIENTS AND METHODS: This cross-sectional study was conducted on a sample of 140 adult stroke survivors attending rehabilitation services at stroke referral centers in Kano, Nigeria. The psychometric analysis of the Hausa-MSPSS involved face, content, criterion and construct validity tests, as well as internal and test-retest reliability. Confirmatory factor analysis was performed to assess validity of the three-factor (Family, Friends and Significant others) model for the Hausa-MSPSS.
RESULTS: Based on expert panel, clinicians' review and patients' feedback, the 12 item Hausa-MSPSS had sufficient face, content and criterion validity. In reliability analysis, the Cronbach's alpha was 0.781. In test-retest reliability analysis, the minimum kappa value was 0.673. In Confirmatory factor analysis, the three-factor model was not acceptable. An alternative two-factor model with Family and Friends, as the two domain was found to be acceptable (Chi-square/df < 3, TLI, CFI > 0.9, RMSEA < 0.08). The average variances extracted for the two constructs were 0.5 and 0.7, respectively. The R-squared value between the two constructs was 0.397. Cross validity tested using 1000 bootstrap resamples gave satisfactory results (P = 0.079).
CONCLUSIONS: The 11 item Hausa-MSPSS index is valid for the assessment of perceived social support among stroke survivors in Nigeria.
OBJECTIVE: To investigate the relationship between the dietary intake of calcium and vitamin D, physical activity, and bone mineral content (BMC) in 13-year-old Malaysian adolescents.
DESIGN: Cross-sectional.
SETTING: Selected public secondary schools from the central and northern regions of Peninsular Malaysia.
PARTICIPANTS: The subjects were from the Malaysian Health and Adolescents Longitudinal Research Team Cohort study (MyHeARTs).
METHODS: The data included seven-day diet histories, anthropometric measurements, and the BMC of calcaneal bone using a portable broadband ultrasound bone densitometer. Nutritionist Pro software was used to calculate the dietary calcium and vitamin D intakes from the diet histories, based on the Nutrient Composition of Malaysian Food Database guidance for the dietary calcium intake and the Singapore Energy and Nutrient Composition of Food Database for vitamin D intake.
RESULTS: A total of 289 adolescents (65.7% females) were recruited. The average dietary intakes of calcium and vitamin D were 377 ± 12 mg/day and 2.51 ± 0.12 µg/day, respectively, with the majority of subjects failing to meet the Recommended Nutrient Intake (RNI) of Malaysia for dietary calcium and vitamin D. All the subjects had a normal Z-score for the BMC (-2.00 or higher) with a mean of 0.55 ± 0.01. From the statistical analysis of the factors contributing to BMC, it was found that for those subjects with a higher intake of vitamin D, a higher combination of the intake of vitamin D and calcium resulted in significantly higher BMC quartiles. The regression analysis showed that the BMC might have been influenced by the vitamin D intake.
CONCLUSIONS: A combination of the intake of vitamin D and calcium is positively associated with the BMC.
METHODS AND FINDINGS: Stratified random sampling design was used to select adolescents from 15 urban and rural secondary schools in Selangor, Perak and Kuala Lumpur, Malaysia. Data collection was carried out from 1st April 2014 to 30th June 2014. Information regarding socio-demographic characteristics, sun exposure and sun protective behaviours, clinical data and environmental factors were collected. Blood for total vitamin D was sampled. Descriptive and multivariate logistic regressions were performed. Total 1061 participants were analyzed (62% were female; mean age 15.1 ± 0.4 years). The prevalence of vitamin D deficiency was 33%. Mean vitamin D was lower in female (53 ± 15 nmol), obese (body fat percentage (≥25%m; ≥33.8%f) (56 ± 16 nmol/L), Malays (58 ± 18 nmol/L) and Indians (58 ± 15 nmol/L). In multivariate analysis, female (OR = 5.5; 95% CI: 3.4-7.5), Malay (OR = 3.2; 95% CI: 1.3-8.0), Indian (OR = 4.3; 95% CI: 1.6-12.0) and those always wearing long sleeve (OR = 2.4; 95% CI: 1.1-5.4) were more likely to have vitamin D deficiency. For female participants, ethnicity {Malays (OR = 6.7; 95% CI: 2.0-18.5), Indian (OR = 4.5; 95% CI: 1.8-19.3)} was an important risk factors. Cloud cover, school residence, skin pigmentation, sun-exposure and sun-protective behaviours were not significant risk factors. The limitation of this study was recall bias as it relied on self-reported on the sun exposure and protective behaviours. The diet factors were not included in this analysis.
CONCLUSIONS: The prevalence of Vitamin D deficiency among Malaysian adolescents was considerable. Gender, ethnicity and clothing style were important risk factors.