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Fulltext Psychological insulin resistance: do individual factors play an important role among type 2 diabetes patients?

Chia Yee Kang, Salmiah Md Said, Rosliza Abdul Manaf

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):79-79.
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Introduction: Psychological insulin resistance is the reluctance of diabetes patients or physicians to initiate or in-tensify insulin therapy. The insulin usage among Malaysian type 2 diabetes mellitus (T2DM) patients is low, only 21.4% of audited T2DM patients were on insulin therapy despite 76.2% of the audited T2DM patients had poorly controlled diabetes with HbA1c ≥ 6.5% in year 2012. This study aims to identify the predictors of psychological insulin resistance (PIR) among insulin naïve T2DM patients. Methods: A cross-sectional study using interviewer assisted questionnaires was conducted among adult insulin naïve T2DM patients in government health clinics at a district of Penang, Malaysia. Insulin Treatment Appraisal Scale (ITAS) was used to assess the dependent variable (PIR) and validated self-developed questionnaires were used for assess the independent variables (socio-demographic characteristics, diabetes profile, and individual factors). Multiple linear regression analysis was performed to identify the predictors of PIR. Results: As high as 72.7% out of 385 participants were reluctant to initiate insulin therapy. Emotional factors (fears), perceived personal failure and perceived severity significantly predicted higher PIR whereas perceived benefit and self-efficacy significantly predicted lower PIR. Total 49.8% variability of PIR was explained by the entire individual predictors (R2=49.8%, p = 0.001). Emotional factor was the strongest predictor. Conclusion: This study revealed a high level of PIR among Malaysian T2DM patients. It is vital to tackle the predictors that predict high PIR and strengthen the predictors that lead to low PIR in our health education and health intervention programs.
Fulltext Job stress and its associated factors among nurses in primary healthcare facilities in Kuala Langat District, Selangor, Malaysia in 2019

Nur Emmy Fizreena Shamsuddin, Huda Zainuddin, Salmiah Md. Said

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):104-104.
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Introduction: Job stress is defined as harmful physical, negative, emotional responses that occur when the require-ments of the job do not match the capabilities, resources or needs of the worker. Factors influencing job stress among nurses in primary healthcare in Malaysia are poorly identified. The objective of this study is to assess the job stress score and identify the predictors of job stress among nurses in Primary Health Care (PHC) facilities in Kuala Lan-gat district of Selangor. Methods: A cross-sectional study conducted among 216 nurses in PHC facilities of Kuala Langat District. Data collection conducted using self-administered questionnaire adopted and modified from Job Stress Scale, Nursing Stress Scale (NSS) and Expanded Nursing Stress Scale (ENSS). Results: There is evidence of job stress with mean score of 28.4(5.5) among nurses in PHC facilities of Kuala Langat District, Selangor, Malaysia. There are association between age, role in organization, duration of services, outside job scope, family size, doing house chores, balance between work and family, balance between work and leisure activities, workload, inadequate preparation, lack of staff support, uncertainty concerning treatment, role conflicts and patients and their families with job stress (p
Fulltext Predictors of preventive practices towards HFMD among mothers of preschool children in Klang District

Qudsiah Suliman, Salmiah Md. Said, Nor Afiah Mohd. Zulkefli

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):21-32.
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Introduction: During which HFMD epidemic has kept on recurring worldwide, effective vaccine and specific treatment for HFMD are still not available, calling attention to on preventive practices as the mainstay of the management. Therefore, it is timely to renew the assessment on maternal preventive practices and its predictors in Klang District, Selangor wherein the endemicity and upsurge of HFMD cases has been demonstrated. Methods: A cross-sectional study was conducted from 1st April 2017 until 15th May 2015 among mothers of Community Development Department (KEMAS) preschool children in Klang District. Respondents were selected based on probability proportional to size sampling, whereas data collection was facilitated by validated, and reliable self-administered questionnaire, that examine on the preventive practices towards HFMD. Results: A total of 353 mothers responded to questionnaire, resulting response rate of 80.2%. Most of the respondent were housewife, married and obtained educational level up to secondary school. Insufficient knowledge score (13.61 ± 4.04) was demonstrated, with health belief highlighted on low mean score for perceived severity and perceived barrier, which was 8.30(SD=1.36) and 7.80(SD=2.14) respectively. Simple linear regression revealed significant linear relationship between preventive practices with knowledge and all health belief subscales. Hierarchical multiple linear regression reported predictors of preventive practices towards HFMD, which include knowledge, (perceived susceptibility)2, perceived severity, and perceived barrier, with the group of variables was significantly predicting the (preventive practice)3 and accounted for 13.1% variance in the (preventive practices)3 (F[5,347]=11.588, p value=
Fulltext Timing and prognostic factors of tuberculosis treatment interruption

Suliman, Qudsiah, Salmiah Md. Said, Lim, Poh Ying

Pertanika Journal of Science & Technology, 2019;27(4):1509-1525.
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The global Tuberculosis epidemic (TB) poses a significant public health threat. While the consequences of TB treatment interruption are indisputable, the knowledge about the timing and prognostic factors of TB treatment interruption is fundamental. Despite a considerable amount of evaluation, the timing and prognostic factors of TB treatment interruption have been inconsistently identiﬁed from one study to another. Therefore, this study aimed to examine the evidence obtained from published literature on the timing and prognostic factors of TB treatment interruption at different points of the treatment course. In this review, three databases namely Pubmed, Scopus, and Science Direct were used to identify articles published from January 2003 to February 2018. This was based on the inclusion criteria and keywords including ‘default’, ‘survival time’, ‘tuberculosis’, and ‘treatment interruption’. The nine selected studies were prospective and retrospective cohort studies conducted in developing countries. The diversity of the study’s participants and TB treatment interruption definition were allowed, thus delineating a heterogeneous finding. This review suggests that the interruption predominantly occurred during the maintenance phase of treatment course. Despite the finding, a considerable gap in understanding the prognostic factors at different time points of TB treatment interruption was elicited. The heterogeneity across the studies may limit the inferences and warrant further evaluation. In essence, the time-related information should be integrated into framing impactful public health strategy, while a vigorous attempt on the evaluation of the cognitive, behavioural and psychosocial aspects may be beneficial.
Fulltext Dengue prevention practices and their associated factors among wet market in Hilir Perak District, Malaysia

Nur Intan Kartiniewatie Kamaruddin, Salmiah Md Said, Hayati Kadir @ Shahar, Lim Poh Ying

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):46-46.
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Introduction: Wet markets are predisposed to Aedes breeding due to nature of daily activities that involve frequent water storage and usage of water collecting containers. Large numbers of visitors patronising wet markets could cause rapid spread of dengue infection. This study aimed to determine the level of dengue prevention practices among wet market traders in Hilir Perak District and their associated socioecological factors. Methods: A cross sectional study using stratified sampling method was conducted where 246 wet market traders were interviewed to collect data on dengue prevention practices (prevention of Aedes mosquitoes breeding and prevention of mosquito bites), and so-cioecological factors. Chi square test and logistic regression modelling were performed to identify socioecological factors associated with dengue prevention practices. Results: Response rate for this study was 88.9%. Majority of the respondents were male, above 40 years old, had secondary education and above, had monthly income of above MYR2000, were owner of the shop lots, was or had ever married and sold fish, vegetable or groceries products. Most of the respondents had high level of dengue prevention practices (78%). Those who were owner of shop lots, had high perceived susceptibility, high family support, and high perceived dengue prevention and control laws and reg-ulations were predicted to have high level of dengue prevention practices. Conclusion: Level of dengue prevention practices is determined not only by individual factors, but also other factors from relationship to societal level which must also be considered in planning or evaluating current dengue control programmes.
Fulltext A protocol on information-motivation-behavioural skills risk of intensive phase treatment interruption among pulmonary tuberculosis patients in urban districts, Selangor

Qudsiah Suliman, Salmiah Md. Said, Nor Afiah Mohd. Zulkefli, Lim Poh Ying, Tan Kit-Aun

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):85-93.
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Introduction: Despite advancement of treatment modalities, Tuberculosis (TB) treatment interruption rate has glob- ally accelerating, calling for greater framework shifting towards psychosocial intervention. Similarly, Selangor state had reported the perturbing TB treatment interruption rate, which was figured persistently above 10% in the interval year of 2014 to 2018, thus signifies an empirical assessment on Information-Motivation-Behavioural skills (IMB) determinants of TB intensive phase treatment. This study aims to determine the time to intensive phase TB treatment interruption and its prognostic factors among newly diagnosed pulmonary Tuberculosis (PTB) smear positive patients in urban district Selangor. Methods: A multi-centric prospective cohort study will recruit 695 newly diagnosed PTB smear positive patients at treatment centres in urban districts, Selangor. This study will utilize validated self-admin- istered questionnaire and standardised data collection form (PROFORMA). At baseline, we will elicit information on IMB models constructs, additionally on socio-demographics, health service factors and clinical characteristics. Meanwhile, four points follow up will be executed to retrieve information on treatment status and time varying effects of body weight, treatment side effects, symptoms improvement and internalised stigma. Finally, survival analysis will be computed to identify the time to intensive phase treatment interruption and its prognostic factors. Conclusion: This study will enlighten IMB model determinants of intensive phase treatment interruption, hence to endeavour psychosocial elements in designing time relevant public health strategies in TB case management.
Fulltext Reproductive risk factors of ovarian cancer among women at selected hospitals in Klang Valley

Osmond John Ugwu, Salmiah Md Said, Nor Afiah Mohd Zulkefli, Zulida Rejali, Zainab Yahaya, Noraihan Nordin

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):110-110.
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Introduction: Ovarian cancer is the fourth most common cancer among Malaysian women. Despite being a malig-nancy with low incidence, ovarian cancer has a high mortality rate with just about 35.2% of 5-year survival. There is a limited published study on the risk factors for this cancer in Malaysia. This study aimed at identifying the repro-ductive risk factors of ovarian cancer among women at selected hospitals in Klang Valley. Methods: A hospital-based case-control study was conducted from April 2017 to November 2019. Subjects were Malaysian citizens and aged 18 years and above. The case referred to a known case ovarian based on histopathological examination (HPE) and had been diagnosed not more than 2 years during the recruitment into the study. Controls were selected based on a negative result of HPE or intra-operative visual inspection and examination or normal findings from the ultrasound. Data was collected using a self-administered questionnaire. Results: A total of 111 cases and 134 controls who ful-filled the inclusion criteria participated in this study. Binary multiple logistic regression analysis showed that age at first pregnancy and infertility experience were significantly associated with risk of ovarian cancer. The odds of first pregnancy after the age of 25 years among cases was higher compared to the odds among controls (AOR=2.997, 95%CI: 1.295, 6.932, p=0.010). On the other hand, the odds of infertility experience among cases was lower com-pared to the controls (AOR=0.289, 95%CI: 0.099, 0.846, p=0.024). The lower odds of infertility experience among cases shown in this study must be interpreted with care because of wide interval and as infertility was reported to be a risk factor of ovarian cancer elsewhere. Conclusion: Reproductive risk factor for ovarian cancer were aged at first pregnancy of 25 years and above. Prevention of ovarian cancer should be targeted to his group.
Fulltext Urbanization and tuberculosis in Peninsular, Malaysia (2011-2015)

Kirandeep Kulwant Kaur, Salmiah Md Said, Poh Ying Lim, Sharifah Norkhadijah Syed Ismail

Malaysian Journal of Medicine and Health Sciences, 2020;16(111):63-69.
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Introduction: Tuberculosis (TB) is a major global concern as it continues to kill million people annually despite the availability of effective treatment. One of the social factors affecting the spread of tuberculosis is urbanization. Tuberculosis remains as the leading cause of death from communicable diseases in Malaysia for more than a decade. Geographic information system (GIS) has been used to understand the epidemiology of infectious diseases, to identify hot spots/ clusters of areas/ populations at high risk. The aim of this study was to determine the correlation between urbanization and TB in the Peninsular of Malaysia during 2011-2015 and develop TB incidence risk map using GIS. Methods: A cross-sectional study was conducted using TB cases data on tuberculosis incidence, tuberculosis deaths, urban population, population and population density from the Ministry of Health, Malaysia for the period 2011 to 2015. This data was analysed using SPSS version 23.0 and Arc GIS. Results: The number of TB cases and urbanization varied in the Peninsular. There was a statistically significant strong positive correlation between the number of TB cases and urban population (r=.884, p
Fulltext Prevalence of obesity and associated factors among secondary school students in Slemani City Kurdistan Region, Iraq

Muhammad Saeed Qadir, Rampal, Lekhraj, Sherina Mohd Sidik, Salmiah Md Said, Zhian Salah Ramzi

Malaysian Journal of Medicine and Health Sciences, 2014;10(2):27-38.
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Obesity is a well-established risk factor for cardiovascular disease. The objective of
the study was to determine the prevalence of obesity and factors associated among secondary school students aged between 13 to 17 years at Slemani City Centre, Iraq. Methodology: A cross sectional study design was used. The calculated sample size was 1656. Probability proportional to size sampling technique was used to select the sample. A validated pretested questionnaire was used to collect the data. Weight and height were also taken. Data were analyzed using SPSS version 21. Chi-square test was used to determine an association between two categorical variables. Independent t-test was used to compare two means. Multiple logistic regression was used to determine the predictors for obesity. Results: The response rate was 92.54% and the overall mean age of the 1588 respondents was 15.42 (95% CI = 15.35, 15.49) years. The prevalence of overweight and obesity was 20.6% and 11.3% respectively. Variables significantly associated with overweight and obesity (age, monthly family income, education level of parents, body part satisfaction and body size perception) were entered into the logistic regression model. Multiple logistic regression analysis showed that the predictors for overweight and obesity were age, monthly family income, body part dissatisfaction and body size perception. Conclusion: The prevalence of overweight and obesity is high (20.6% and 11.3% respectively). The predictors of obesity among secondary school students aged between 13 to 17 years old at Slemani City Centre Kurdistan Region, Iraq were age, family income and body image dissatisfaction.
Fulltext Patched-1 and smoothened, a hedgehog receptor and signal transducer are highly expressed in diffuse large B-cell lymphoma

Siti Nur Lina Azman, Huzlinda Hussin, Salmiah Md Said, Zanariah Alias, Maizaton Atmadini Abdullah

Malaysian Journal of Medicine and Health Sciences, 2017;13(2):1-6.
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Introduction: The Hedgehog (Hh) signalling pathway is a developmental signalling pathway involved in normal mammalian developmental and homeostasis of adult renewable tissues. In most adult tissues, this pathway remains silent and previous studies have shown that constitutive activation of Hedgehog signalling pathway leads to various types of malignancies including medulloblastomas, basal cell carcinoma, gastrointestinal, breast and prostate cancer. The purpose of this study was to investigate the immunohistochemical expression of Hedgehog pathway proteins in Diffuse Large B-cell Lymphoma and determine their association with overall survival (OS). Methods: Positive control using normal tonsils were included in each batch of immunohistochemical staining procedure. Results: PTCH1 proteins were highly expressed in DLBCL and showed strong staining intensity in 107 (100%) cases and SMO proteins were expressed in 105 (98.1%) cases. PTCH1 proteins were localised in the nucleus of tumour cells, whereas SMO proteins were mainly localised in the cytoplasm of tumour cells. Positive expression of PTCH1 and SMO proteins and overall survival of DLBCL patients were correlated with age, gender, race and tumour location. There was no significant correlation between the expression of these two proteins with any of the parameters. PTCH1 expression showed significant association with SMO expression (P=0.03). Conclusions: Our findings suggest that high expression of both PTCH1 and SMO may be important in the pathogenesis of DLBCL. However, additional mechanisms that may contribute to the activation of HH signalling in DLBCL needs to be further explored.
Fulltext Determinants of Leptospirosis preventive practices among the community in a flood-prone residential area in Kuantan, Malaysia

Edre Mohammad Aidid, Hayati Kadir@Shahar, Salmiah Md Said, Sharifah Norkhadijah Syed Ismail

Malaysian Journal of Medicine and Health Sciences, 2018;14(3):27-33.
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Introduction: Leptospirosis is a preventable zoonosis of public health importance. Due to increasing incidence of leptospirosis and seasonal floods affecting Kuantan community, a study was conducted to identify the determinants of leptospirosis preventive practices. Methods: A cross-sectional study was carried out in Perkampungan Sungai Isap, Kuantan, Pahang, Malaysia, which obtained 568 respondents by stratified proportionate random sampling technique. Data was collected using a modified guided questionnaire and analysed using IBM SPSS version 22.0. Results: Majority of the respondents were females (52.6%), Malay ethnicity (98.8%), attended up to secondary school (57.2%), worked in low-risk occupational group (96.0%) and reside in moderate-risk stratum (55.6%). Overall, majority (68%) of the respondents had good knowledge. However, only 38% of the respondents had satisfactory attitude and 18% had satisfactory practice. There were significant associations between stratum and leptospirosis preventive practices (χ2=11.84, df=2, p=0.003), age group and leptospirosis preventive practices (χ2=7.41, df=2, p=0.03) and personal income and leptospirosis preventive practices (χ2=6.32, df=1, p=0.01). Multivariate logistic regression showed that the predictors of satisfactory leptospirosis preventive practices were high-risk stratum (aOR: 3.69, 95% CI: 1.71-8.00, p=0.001) and monthly personal income of less than RM1000 (aOR: 1.65, 95% CI: 1.05-2.59, p=0.03). Conclusions: Leptospirosis can be prevented by having adequate awareness regarding the disease through health promotional activities especially before, during and after flooding, targeting more on those in low to moderate risk areas and higher income group to prevent potential outbreaks.
Fulltext A narrative review of natural history, epidemiology and risk factors for Hepatitis C infection

Mohd Azri Mohd Suan, Ahmad Zaid Fattah Azman, Salmiah Md Said, Muhammad Radzi Abu Hassan

Pertanika Journal of Science & Technology, 2019;27(3):1341-1359.
MyJurnal

Hepatitis C infection is a major public health problem that can be dealt with urgent and timely attention. Recently, WHO Global Hepatitis Report showed that 71 million people, equivalent to approximately 1% of the world population, are infected with hepatitis C. The disease incidence, mortality rate and risk factors vary across geographical regions. The virus is transmitted primarily through drug injection and exposure to infected blood products in healthcare and community settings. The common causes of death related to virus infections are decompensated liver cirrhosis and hepatocellular carcinoma. Hepatitis C infection is mainly prevented by identifying and controlling any possible risk factors for virus transmission because treatment is costly and limited in availability. In this review, articles discussing the natural history, epidemiology and risk factors for hepatitis C infection are reviewed.
Fulltext Risk factors of insulin refusal among type 2 diabetes mellitus patients with poor glycaemic control at Tanglin Health Clinic, Kuala Lumpur

Puvanese Rebecca Pillai Simon, Salmiah Md. Said, Ahmad Zaid Fattah, Shamsul Azhar Shah

Malaysian Journal of Medicine and Health Sciences, 2019;15(2):84-92.
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Introduction: The number of patients with poor glycaemic control who refuse insulin therapy is alarming. Factors that contribute to insulin refusal are important to study to identify high risk groups so that appropriate measures can be taken to prevent progression of uncontrolled diabetes. The objective of this study is to determine the risk factors of insulin refusal among type 2 diabetes mellitus patients with poor glycaemic control at Tanglin Health Clinic, Kuala Lumpur, Malaysia. Methods: A case control study was conducted among 216 cases and 230 controls using stratified sampling method. Cases were defined as patients with HbA1C more than 7.5% but not on insulin therapy despite being offered by the doctor whereas controls consist of patients with HbA1C of more than 7.5% but already on insulin therapy. Data was collected from April until May 2018, using a self-administered questionnaire. Analysis was done via IBM SPSS version 23.0. Results: Response rate for cases was 93.9% and response rate for controls was 100%. Risk factors of insulin refusal among poor glycaemic control includes age above 60 years old, tertiary level education, duration of diabetes less than 10 years, poor level of knowledge on insulin, fear on injection pain and fear to bruising due to injections. Conclusion: Hence, efforts must be taken to tackle the modifiable factors such as knowledge on insulin and diabetes, and fear on injections and bruises.
Fulltext Internalized stigma among urban tuberculosis patients in Selangor: the prediction

Qudsiah Suliman, Salmiah Md. Said, Lim Poh Ying, Nor Afiah Mohd. Zukefli, Tan Kit-Aun, Alif Ramli, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):60-60.
MyJurnal

Introduction: Evidently, stigma has potentially prompted the negative outcome in Tuberculosis (TB) control through delayed diagnosis and poor adherence to treatment. Amidst accelerating treatment interruption in Selangor, little attention is paid to the quantitative assessment of stigma, thus warrant further characterisation of TB stigma in ur-ban districts, Selangor. This study aimed to determine the predictors of internalised stigma among newly diagnosed PTB smear positive in urban districts, Selangor. Methods: A multi-centric longitudinal study recruited 345 newly diagnosed PTB smear positive patients who started TB treatment from November 2018 until June 2019. Baseline assessments utilised pre-tested self-administered questionnaire and standardised data collection form. Using IBM SPSS version 25.0, multiple linear regression was computed to determine the predictors. Results: The response rate was 84.7% with most of respondents were married and attained educational level up to secondary school. Other than low mean score of social support [mean (SD)=33.39(5.86)], the prominent findings were lacking knowledge of anti-TB side effect and wrongly perceived damaging effect of anti-TB drug to internal organ. The mean internalised stigma score was 24.88 (SD=4.70), which predicted by age, educational level (no formal education), employment status (retiree), alternative medicine practice, baseline symptoms score, perceived barrier, and social support, with entire group of variables significantly predicted TB stigma (F [9, 331] =21.476, p
Fulltext Bone Turnover Markers and Sphingosine-1-phosphate levels among the Chinese Community in Selangor, Malaysia and its Correlation with Bone Density

Nasrin Shahifar, Intan Nureslyna Samsudin, Subashini C. Thambiah, Swan, Sim Yeap, Siti Yazmin Zahari Sham, Geeta Apannah4, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(109):46-51.
MyJurnal

Introduction: Prevention of osteoporotic fracture requires identification of individuals at high risk. Bone mineral
density(BMD) is commonly used to estimate fracture probability despite inadequate predictive discrimination ability.
Sphingosine-1-phosphate(S1P), a new marker of bone metabolism and bone turnover markers(BTM) such as procollagen-type-1 amino-terminal propeptide(P1NP) and C-terminal telopeptide of type I collagen(CTX) may complement
current assessment. The study determined P1NP, CTX and S1P levels and their correlation with BMD, 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone(PTH) in selected subjects. Method: A cross-sectional study involving
Malaysian Chinese men and women aged 50-90 years old from Puchong and Kajang, Selangor. Each subject had
BMD determined by dual-energy x-ray absorptiometry and blood samples taken for 25(OH)D, PTH, P1NP, CTX and
S1P. Results: A total of 131 subjects [45(34.4%) males and 86(65.6%) post-menopausal women] with median age
of 65(IQR=17) were recruited. P1NP and CTX were significantly higher in post-menopausal women (P1NP=61.71
ng/ml, CTX=0.489 ng/ml) compared to men (P1NP=46.94 ng/ml, CTX=0.381 ng/ml). P1NP and CTX differed significantly according to BMD categories with values highest in osteoporosis. S1P between men (2.12±0.75 µmol/L) and
post-menopausal women (1.96±0.68 µmol/L) did not differ significantly and did not differ according to BMD categories. S1P did not correlate with BMD, P1NP, CTX and 25(OH)D. P1NP and CTX negatively correlated with BMD
at all measured sites but not 25(OH)D. Conclusion: CTX and P1NP, but not S1P negatively correlated with BMD.
CTX and P1NP were highest in those with osteoporosis. In this group of Malaysian Chinese subjects, CTX and P1NP
rather than S1P reflects bone health.
Fulltext Association between self-esteem and smoking among religious schools students in Petaling District, Selangor

Jinadu LO, Salmiah M S, Azuhairi AA

International Medical Journal Malaysia, 2016;15(1):3-11.
MyJurnal

Introduction: According to the Youth Behaviour Risk Factor Surveillance (YBRFSS, 2011) in Malaysia, the prevalence of smokers nationally among Form 1, 2 and 4 students government secondary school students was 9.1% (ever smokers) and 8.7% (current smokers). However, there is limited information on the prevalence of smoking among religious secondary school students and self-esteem as risk factor. Thus, this study was conducted to determine the prevalence and factors associated with smoking among the religious secondary school students in Petaling district, Selangor.
Methods: A cross-sectional study was conducted among 899 students. The schools were selected using cluster sampling and self-administered questionnaire was used. Data was analyzed using chi-square test and multivariate logistic regression to identify the independent factors for smoking.
Results: The response rate was 94%. The prevalence of ever smoking was 10.1%; 3.9% among female and 18.6% among male. The median age (interquartile range) of smoking initiation was 12.00 (4.01) years. The results showed that independent factors for smoking were: males (OR= 5.47); age group 14-15 years (OR=2.82) and 16-17 years (OR=3.63) and having low self -esteem (OR=6.24).
Conclusion: prevalence of ever smokers is higher when compared to YBRFSS, (2011) and it was revealed that most of the smokers started smoking even before secondary school. The results also revealed the importance of promoting self-esteem. Efforts in smoking prevention should therefore be focused on curbing the initiation of the acts and improving students’ self-worth.
Fulltext Effect of a Nurse-Led Diabetes Self-Management Education Program on Glycosylated Hemoglobin among Adults with Type 2 Diabetes

Azami G, Soh KL, Sazlina SG, Salmiah MS, Aazami S, Mozafari M, et al.

J Diabetes Res, 2018;2018:4930157.
PMID: 30225268 DOI: 10.1155/2018/4930157

In recent years, great emphasis has been placed on the role of nonpharmacological self-management in the care of patients with diabetes. Studies have reported that nurses, compared to other healthcare professionals, are more likely to promote preventive healthcare seeking behaviors. The aim of this study was to investigate the effectiveness of a nurse-led diabetes self-management education on glycosylated hemoglobin. A two-arm parallel-group randomized controlled trial with the blinded outcome assessors was designed. One hundred forty-two adults with type 2 diabetes were randomized to receive either usual diabetes care (control group) or usual care plus a nurse-led diabetes self-management education (intervention group). Duration of the intervention was 12 weeks. The primary outcome was glycosylated hemoglobin (HbA1c values). Secondary outcomes were changes in blood pressure, body weight, lipid profiles, self-efficacy (efficacy expectation and outcome expectation), self-management behaviors, quality of life, social support, and depression. Outcome measures were assessed at baseline and at 12-week and 24-week postrandomizations. Patients in the intervention group showed significant improvement in HbA1c, blood pressure, body weight, efficacy expectation, outcome expectation, and diabetes self-management behaviors. The beneficial effect of a nurse-led intervention continued to accrue beyond the end of the trial resulting in sustained improvements in clinical, lifestyle, and psychosocial outcomes. This trial is registered with IRCT2016062528627N1.
Fulltext The Socio-Demographic and Clinical Factors Associated with Quality of Life among Patients with Haematological Cancer in a Large Government Hospital in Malaysia

Priscilla D, Hamidin A, Azhar MZ, Noorjan K, Salmiah MS, Bahariah K

Malays J Med Sci, 2011 Jul;18(3):49-56.
PMID: 22135601 MyJurnal

The paper examined the quality of life of haematological cancer patients according to their socio-demographic profiles and clinical diagnoses.

Study site: Ampang Hospital, Kuala Lumpur
Fulltext A cluster-randomized trial study on effectiveness of health education based intervention (HEBI) in improving flood disaster preparedness among community in Selangor, Malaysia: a study protocol

Mohd Tariq MN, Shahar HK, Baharudin MR, Ismail SNS, Manaf RA, Salmiah MS, et al.

BMC Public Health, 2021 09 24;21(1):1735.
PMID: 34560858 DOI: 10.1186/s12889-021-11719-3

BACKGROUND: Flood disaster preparedness among the community seldom received attention. Necessary intervention must be taken to prevent the problem. Health Education Based Intervention (HEBI) was developed following the Health Belief Model, particularly in improving flood disaster preparedness among the community. The main objective of this study is to assess the effect of HEBI on improving flood disaster preparedness among the community in Selangor. This study aims to develop, implement, and evaluate the impact of health education-based intervention (HEBI) based on knowledge, skills, and preparedness to improve flood disaster preparedness among the community in Selangor.
METHOD: A single-blind cluster randomized controlled trial will conduct at six districts in Selangor. Randomly selected respondents who fulfilled the inclusion criteria will be invited to participate in the study. Health education module based on Health Believed Theory will be delivered via health talks and videos coordinated by liaison officers. Data at three-time points at baseline, immediate, and 3 months post-intervention will be collected. A validated questionnaire will assess participants' background characteristics, knowledge, skill, and preparedness on disaster preparedness and perception towards disaster. Descriptive and inferential statistics will be applied for data analysis using IBM Statistical Package for Social Sciences version 25. Longitudinal correlated data on knowledge, skills, preparedness, and perception score at baseline, immediate post-intervention, and 6 months post-intervention will be analyzed using Generalized Estimating Equations (GEE).
DISCUSSION: It is expected that knowledge, skills, preparedness, and flood disaster perception score are more significant in the intervention group than the control group, indicating the Health Education Based Intervention (HEBI).
TRIAL REGISTRATION: Thai Clinical Trial TCTR20200202002 .

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