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  1. Cheah, W. L., Lee, P. Y., Kamarudin, K., Syed Alwi, S. A. R., Albela, H., Lau, E. H., et al.
    MyJurnal
    Introduction: Acute gastroenteritis (AGE) is one of the frequent causes of hospitalization in children under the age of five, particularly in a rural setting. This study was conducted to determine the epidemiology of acute gastroenteritis in indigenous children admitted to a rural district hospital in Sarawak. Methods: A retrospective review of indigenous paediatrics cases of acute gastroenteritis
    admitted to the ward of Serian District Hospital, a rural district hospital in Sarawak, between the years
    2006-2007. The data was collected from the patients’ case notes, obtained with permission from the
    hospital management. Data was entered and analyzed using SPSS version 16. Results: During the study period, 234 indigenous children with acute gastroenteritis were admitted with the highest prevalence in 2006 (53.4%). The findings showed higher prevalence was found in children aged 3 years and below (76.5%) and male (56.4%) The minimum duration of hospital stay is 1 day, and the maximum stay is 5 days. The clinical findings showed that the majority of the cases presented with vomiting, diarrhea, dry mouth and tongue, sunken eye, with the majority (76%) reported having mild dehydration. The most common treatment used is oral rehydration solutions (85.4%), followed by intravenous bolus or drip (82.3%), paracetamol (79%) and antibiotic (36.2%). Peak incidence of admissions was between November to January. About 38.5% of the AGE cases admitted were found to be underweight (weight for- age below -2SD). Conclusion: The findings indicated children aged 3 years and below are the most vulnerable to AGE and malnutrition could be one of the predisposing factors. The peak incidence during the raining season at the end of the year indicated a possible relationship between AGE and seasonal type of virus infection. Prevention in the form of proper hygiene at the household level probably will prove to be useful.
  2. Cheah WL, Majorie Ensayan J, Helmy H, Chang CT
    Malays Fam Physician, 2018;13(1):2-9.
    PMID: 29796204 MyJurnal
    Introduction: The present study aimed to determine the prevalence of hypertension and its association with nutritional status (body mass index, body fat percentage, and visceral fat) among students in a public university in Sarawak, Malaysia.

    Methods: This was a cross-sectional study among undergraduate students aged 18 years old and above. Anthropometric measurements, such as weight, height, body composition, and blood pressure measurements, were collected. Hypertension was defined as equal or more than 140/90 mmHg. Statistical analyses were done using IBM SPSS version 20.

    Results: A total of 354 respondents participated in the study. Mean age for the respondents was 21 years (SD 1.18 years). About 40% of the respondents were overweight or obese. Prevalence of hypertension was 8.2%. Mean systolic blood pressure was 119.1mmHg (SD14.36mmHg), and the mean diastolic blood pressure was 72.6mmHg (SD 9.73mmHg). There is a significant association between male gender (odds ratio =3.519, 95% CI is 1.886-6.566), body fat percentage (odds ratio = 1.944, 95% CI is 1.050-3.601), visceral fat (odds ratio = 2.830, 95% CI is 1.346-5.951), and family history of hypertension (odds ratio= 2.366, 95% CI is 1.334-4.194) and hypertension.

    Conclusion: The prevalence of hypertension was less than 10% and is associated with male gender, body composition, and family history of hypertension.

  3. Ivan Vun JS, Cheah WL, Helmy H
    Malays Fam Physician, 2019;14(2):18-25.
    PMID: 31827731
    Introduction: Caregivers have a high risk of mental health disorders. The quality of patient care is inseparable from the mental health status of caregivers. The objective of this research was to study the mental health status among caregivers of psychiatric patients and its associated factors.

    Method: A cross-sectional study was conducted among 198 caregivers in Kuching from January till July 2014.   The respondents were recruited using systematic sampling and were required to provide information on sociodemographic and environmental factors as well as complete the Hospital Anxiety and Depression Scale (HADS) questionnaire. The data was analysed using the IBM SPSS Statistical Software Version 20.0.

    Results: The prevalence rates of anxiety and depression among caregivers were 32.8% and 27.8%, respectively.  The caregiver's age (OR=0.97, 95% CI = 0.953 - 0.996), the perception of caregiving as an economic burden (OR= 2.70, 95% CI= 1.256 - 5.803) and the dependence of the patient (OR= 2.27, 95% CI= 1.087 - 4.719) were associated with anxiety.  A caregiver who was male (OR= 2.21, 95% CI= 1.143 - 4.262), a caretaker who held the perception that a patient was dependent on them (OR=2.53, 95% CI= 1.203 - 5.337), and a caretaker who lacked stress-coping skills (OR=2.48, 95% CI= 1.030 - 5.973) were found to be significant factors in depression.

    Conclusion: A high prevalence of probable anxiety and depression among caregivers points to the need to screen caregivers. There is a vital need to train healthcare workers to be able to detect early anxiety and depression. Culturally sensitive research should be carried out for different ethnicity, and improving the support system for caregivers is necessary.

  4. Cheah WL, Edmund Shin CV, Ayu Akida AR
    Malays Fam Physician, 2019;14(1):2-9.
    PMID: 31289625
    Introduction: This study aimed to determine the blood pressure profile for preschool children in Kuching Sarawak and its relationship with sociodemographic characteristics, nutritional status and parental hypertension.

    Methods: This was a cross sectional study conducted in a government preschool in Kuching district from January to June 2017. Data were collected using questionnaire as well as anthropometric and blood pressure measurements. Data were entered into and analyzed using SPSS Version 22.

    Results: A total of 229 preschool children participated in this study (response rate of 81%). About 9.7% of the respondents were at risk for hypertension. The mean systolic blood pressure was 95.6 mmHg (SD=8.36), and the mean diastolic blood pressure was 59.9 mmHg (SD=6.09). Ten percent of the children were overweight and 7.4% were obese. Binary logistics regression analysis indicated that gender (Male: OR = 3.085, p< 0.05), parent's education level (comparing primary education and below with secondary education: OR = 4.88, p<0.05; comparing primary education and below tertiary education: OR = 7.63, p<0.05) and ethnicity (comparing Malay with Chinese: OR = 0.10, p< 0.01) were significantly associated with being at risk for hypertension.

    Conclusion: The study showed that 9.7% of the children were at risk for hypertension and that 17.4% had abnormal body weights. Identifying and tackling the factors leading to these issues will help to improve and ensure a better quality of non-communicable disease programs offered in primary health clinics and school health programs.

  5. Lai YKI, Ting SL, Cheah WL, Sunder R, Jamalia R
    Med J Malaysia, 2019 08;74(4):266-269.
    PMID: 31424031
    OBJECTIVE: To determine the socio-demographic and clinical profile of exotropia surgery outcomes amongst paediatric patients.

    METHODS: This is a descriptive, retrospective, clinical study of surgeries performed between 2014 and 2016 at the Sarawak Heart Centre, Malaysia. Medical records of patients with primary and secondary exotropia were reviewed. The following factors that affected the surgical outcomes were collected: onset age of squint, age at the time of surgery, the interval between diagnosis and surgery, the type of exotropia, visual acuity, presence of amblyopia, previous patching, anisometropia, refractive error, type of surgery, preoperative and postoperative deviation, pre-existing ocular comorbidity and systemic illness.

    RESULT: A total of 15 patients were studied with more than two thirds being females. Seven patients had primary exotropia while eight patients had secondary exotropia. Average interval between diagnosis and surgery was 1.3 years (±0.82) for primary exotropia and 1.2 years (±0.84) for secondary exotropia. Average pre-operative angle for primary exotropia was 50.57PD (±10.83) whereas secondary exotropia was 39.38PD (±8.63). Seven patients had successful surgical outcomes of within 10 prism dioptres, five for primary exotropia and two for secondary exotropia. The response to surgery was 3.0PD/mm (±0.59) for primary exotropia and 2.2PD/mm (±0.74) for secondary exotropia.

    CONCLUSION: In our study, primary exotropia had larger preoperative angle than secondary exotropia. The response to surgery was positively correlated with the preoperative angle of deviation. Primary exotropia showed better surgical outcome.

  6. Lee PY, Cheah Wl, Chang CT, Siti Raudzah G
    Malays J Nutr, 2012 Aug;18(2):207-19.
    PMID: 24575667 MyJurnal
    There is limited data on childhood obesity and its impact on children from diverse cultural backgrounds. This study is aimed at determining the association between obesity, self-esteem and health-related quality of life (HRQOL) among Malaysian urban primary school children of different ethnicity.
  7. Cheah WL, Chang CT, Helmy H, Wan Manan WM
    Malays Fam Physician, 2019;14(3):46-54.
    PMID: 32175040
    Introduction: Physical inactivity is the one of the leading causes of major non-communicable diseases in the world. The aim of this study is to assess the feasibility of an intervention program based on the stages of change, physical activity levels and health profiles of selected overweight and obese adults in Sarawak.

    Methods: This intervention study was carried out using selected overweight and obese adults in Sarawak. A total of 75 participants were placed in the intervention group, and 80 respondents were placed in the control group participated. Respondent-determined weekly aerobic exercise sessions were conducted for six months. The Malay version of the long-form International Physical Activity Questionnaire (IPAQ) and Transtheoretical model of change (TTM) questionnaire were used, together with anthropometric measurements and the collection of venous fasting blood profiles. Data was entered and analyzed using SPSS Version 20.

    Results: The intervention group had significant better stage transitions compared to the control group (p<0.01). They also had significantly lower total cholesterol, although both groups showed significant results (difference= 0.53, p<0.01; difference= 0.38, p=0.01). The respondent-determined intervention program was effective in improving stage transition; however, an intervention of longer duration could provide more conclusive health outcomes.

    Conclusion: Physical activity plays a role in assisting overweight and obese adults to be more active and healthier.

  8. Mallika PS, Aziz S, Goh PP, Lee PY, Cheah WL, Chong MS, et al.
    Med J Malaysia, 2012 Aug;67(4):369-74.
    PMID: 23082443
    This study aims to determine the risk factors associated with diabetic retinopathy (DR) among natives and non-natives Sarawakians who were seen at 3 public hospitals and one health clinic in Sarawak. It is a cross sectional study where data on patients with DM were collected by staff at these healthcare facilities and entered into the web-based Diabetic Eye Registry. Univariate and multivariate analysis was used to determine the association factors for DR. DR was significantly less associated with natives (24.4%) compared to non-native Sarawakians (34.1%) (p < 0.001). The odds of getting DR was higher in patients whose duration of DM was more than 20 years (OR = 2.6), who have renal impairment (OR = 1.7) and non-natives (OR = 1.4).
  9. Cheah WL, Francis Wing CB, Zahari AN, Idris AS, Maksul NAA, Yusman NAL, et al.
    Ethics Med Public Health, 2021 Jun;17:100651.
    PMID: 33754125 DOI: 10.1016/j.jemep.2021.100651
    Background: The COVID-19 pandemic has resulted in many changes in the delivery of health service which not only affect the public as well as healthcare workers, and also among medical and nursing students who are currently undergoing their training. This study aims to determine the commitment and willingness of medical and nursing students in Sarawak in treating patients with COVID-19 and its associated factors.

    Methods: It was a cross-sectional study using online questionnaire, carried out in a public university in Sarawak, Malaysia. All medical and nursing students were invited to participate in this study. Data was entered and analysed using IBM SPSS version 22.

    Result: A total of 304 respondents participated in the study, with 81.6% female and 69.4% medical students. Majority of the respondents were most willing to take a medical history, do a physical examination, throat swabbing, draw blood and perform IV drip insertion. There was a high commitment among respondents to treat COVID-19 patients regardless of personal risks. Majority of the respondents also agreed that medical staff who are involved in treating COVID-19 patients should be receiving a salary increase and compensation should be given to affected healthcare families, and all non-medical staff should be involved in treating COVID-19 patients. About 71% agreed about a law mandating medical staffs to treat patient.

    Conclusion: The willingness and commitment of medical and nursing students to treat COVID-19 patients was high, indicating their potential work force as healthcare providers.

  10. Cheah WL, Poh BK, Ruzita AT, Lee JAC, Koh D, Reeves S, et al.
    BMC Public Health, 2023 Jun 06;23(1):1082.
    PMID: 37280555 DOI: 10.1186/s12889-023-16023-w
    BACKGROUND: Toybox is a kindergarten-based intervention program that targets sedentary behavior, snacking and drinking habits, as well as promoting physical activity in an effort to improve healthy energy balance-related behaviors among children attending kindergartens in Malaysia. The pilot of this program was conducted as a randomized controlled trial (RCT) involving 837 children from 22 intervention kindergartens and 26 control kindergartens respectively. This paper outlines the process evaluation of this intervention.

    METHODS: We assessed five process indicators: recruitment, retention, dosage, fidelity, and satisfaction for the Toybox program. Data collection was conducted via teachers' monthly logbooks, post-intervention feedback through questionnaires, and focus group discussions (FGD) with teachers, parents, and children. Data were analyzed using quantitative and qualitative data analysis methods.

    RESULTS: A total of 1072 children were invited. Out of the 1001 children whose parents consented to join, only 837 completed the program (Retention rate: 88.4%). As high as 91% of the 44 teachers and their assistants engaged positively in one or more of the process evaluation data collection methods. In terms of dosage and fidelity, 76% of parents had received newsletters, tip cards, and posters at the appropriate times. All teachers and their assistants felt satisfied with the intervention program. However, they also mentioned some barriers to its implementation, including the lack of suitable indoor environments to conduct activities and the need to make kangaroo stories more interesting to captivate the children's attention. As for parents, 88% of them were satisfied with the family-based activities and enjoyed them. They also felt that the materials provided were easy to understand and managed to improve their knowledge. Lastly, the children showed positive behaviors in consuming more water, fruits, and vegetables.

    CONCLUSIONS: The Toybox program was deemed acceptable and feasible to implement by the parents and teachers. However, several factors need to be improved before it can be expanded and embedded as a routine practice across Malaysia.

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