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Use of complementary and alternative medicine in pregnancy and its impact on obstetric outcome

Yusof J, Mahdy ZA, Noor RM

Complement Ther Clin Pract, 2016 Nov;25:155-163.
PMID: 27863606 DOI: 10.1016/j.ctcp.2016.09.005

OBJECTIVE: To evaluate the prevalence of use of complementary and alternative medicine (CAM) in a Malaysian antenatal population and its impact on obstetric outcome.

DESIGN: Cross sectional study.

SETTING: Obstetric Unit, Hospital Sultanah Bahiyah, Alor Setar, Kedah.

MATERIAL AND METHOD: Women attending antenatal clinic and Patient Admission Centre (PAC) above 30 weeks gestation were given structured questionnaires to fill. Pregnancy outcome measures were documented and analyzed in relation to the information gathered through the questionnaire. SPSS Version 21 was used to analyze all data obtained.

RESULTS: Out of 447 women, the overall prevalence of CAM usage in pregnancy was 85.2%. It was popular among pregnant mothers aged between 26 and 35 years old and most commonly used in the third trimester (p = 0.0.010) to facilitate labour. Other sociodemographic factors such as race, parity, education, occupation and residence were not significantly important. Traditional herbs was the commonest type of CAM used in pregnancy (58.3%) followed by selusuh (24.3%). About 78.5% of the CAM users delivered vaginally (p = 0.020) but a significant proportion (14.3%) had fetal distress (p = 0.035) compared to non CAM users. The most common type of herbs used was akar kayu bunga Fatimah (37.7%) and gamat (13.4%). In our study, usage of selusuh product and akar kayu bunga Fatimah had a significant impact in achieving vaginal delivery and shortened the duration of labour particularly in multiparae. The usage of Kacip Fatimah and Salindah was associated with preterm labour (p = 0.04)Tongkat Ali herbal coffee had a significant association with hypertensive disorders in pregnancy (p = 0.011) and fetal distress (p = 0.04) Meanwhile, the usage of Jamu Mustika Ratu was significantly associated with low birth weight in grandmultiparae (p = 0.026)and spirulina was significantly associated with oligohydramnios (p = 0.04).

CONCLUSION: Usage of CAM in pregnancy in the Malaysian population is of high prevalence CAM in pregnancy has beneficial and adverse obstetric outcomes. More research is needed to establish the safety of usage of various forms of CAM in pregnancy.

Study site: Obstetric Unit, Hospital Sultanah Bahiyah, Alor Setar, Kedah.
Fulltext Severe epistaxis in pregnancy due to nasal pyogenic granuloma: A case report

Mohd Yusof J, Abd Halim A, Wan Hamizan AK

J Taibah Univ Med Sci, 2020 Aug;15(4):334-337.
PMID: 32982639 DOI: 10.1016/j.jtumed.2020.06.007

Mild to severe epistaxis is common in pregnancy and often results from increased vascularity of the nasal mucosa and hormonal changes. Symptoms may occur in the absence of an obvious local cause or any systemic disorder; however, thorough otolaryngological (i.e., "ENT") evaluation is always warranted. Pyogenic granuloma or lobular capillary haemangioma is a benign fibrovascular proliferative tumour that is commonly found on the face, fingers, lips, and nasal mucosa. Pregnancy-induced pyogenic granuloma is not an uncommon entity and may result in torrential epistaxis if untreated. Managing a case of severe epistaxis during pregnancy usually requires multidisciplinary management. The authors present a case of severe epistaxis in pregnancy that necessitated examination of the nasal cavity under general anaesthesia. Intraoperative findings showed a bluish-red mass occupying the patient's right maxillary sinus. Bleeding was arrested and complete haemostasis was achieved. The nasal pyogenic granuloma completely resolved in the post-partum period.
Fulltext Enterovirus 71 outbreak, Brunei

AbuBakar S, Sam IC, Yusof J, Lim MK, Misbah S, MatRahim N, et al.

Emerg Infect Dis, 2009 Jan;15(1):79-82.
PMID: 19116058 DOI: 10.3201/eid1501.080264

Enterovirus 71 (EV71) outbreaks occur periodically in the Asia-Pacific region. In 2006, Brunei reported its first major outbreak of EV71 infections, associated with fatalities from neurologic complications. Isolated EV71 strains formed a distinct lineage with low diversity within subgenogroup B5, suggesting recent introduction and rapid spread within Brunei.
Fulltext Societal influence and psychological distress among Indonesian adults in Java on the early Omicron wave of COVID-19

d'Arqom A, Akram M, Azzahranisa NS, Nasution MZ, Surjaningrum ER, Yusof J

Future Sci OA, 2023 Dec;9(10):FSO894.
PMID: 37753359 DOI: 10.2144/fsoa-2023-0104

AIM: Changes during the COVID-19 pandemic might create pressure on different people, thus this study aimed to measure respondents' psychological distress during the early phase of the Omicron wave in Java Island.
METHODS: A web-based survey on societal influence and COVID-19-related psychological distress was distributed through social media in November-December 2021, and received 396 responses.
RESULTS: This study showed that almost 50% of respondents faced psychological distress during the early phase of the Omicron variant, especially concerning hypervigilance and avoidance. Several sociodemographic factors might contribute to the incidence of psychological distress including comorbidity, age and education.
CONCLUSION: Taken together, the incidence of COVID-19-related psychological distress was still found in the early phase of the Omicron variant, especially among young adults.
Practice and knowledge of dietary supplement consumption among Indonesian adults post-delta wave of the COVID-19 pandemic

d'Arqom A, Nasution MZ, Kadir SZSA, Yusof J, Govindaraju K

F1000Res, 2023;12:3.
PMID: 37469719 DOI: 10.12688/f1000research.129045.2

Background: Increasing dietary supplement (DS) consumption was observed during the COVID-19 pandemic, including during the post-Delta wave period. This study aimed to measure the practice of DS consumption and respondents' knowledge of DS. Methods: An internet-based survey was distributed from October-December 2021 and obtained 541 valid and completed responses. Descriptive analysis was performed to present the practice of DS consumption, including frequency, duration, aim, preferable dosage form etc. Level of knowledge on DS principles, side effects and regulation were also measured. Inferential analyses were conducted to determine the predictors of the respondents' DS practice and level of knowledge. Results: Data from 541 valid responses showed that 77.63% of respondents consumed DS in the last 3 months, with only 59.52% reporting also consuming DS before the COVID-19 pandemic. One half of the respondents had good knowledge about DS; however, some knowledge regarding side effects and possible drug-supplement interaction needed improvement. Their DS consumption practice was affected by their economic status and history of contracting COVID-19. Nevertheless, the level of knowledge was not affected by the sociodemographic factors and DS supplement experience. Conclusions: Taken together, the practice of self-consumption of DS in Indonesia is increasing; hence, knowledge of DS is necessary to avoid detrimental effects that might occur in the future. Increasing access to information on better labelling and educating consumers about DS are important actions to consider.
Fulltext Dietary Supplement Consumption and Mental Health in Indonesian Adults During Second Wave of COVID-19 Pandemic

Yusof J, d'Arqom A, Andriani AP, Nasution MZ, Fatimah N, Mustika A, et al.

Patient Prefer Adherence, 2023;17:1799-1811.
PMID: 37520062 DOI: 10.2147/PPA.S415925

PURPOSE: This study aimed to measure supplement consumption behavior and mental health status among Indonesian adults during the second year of COVID-19.
PARTICIPANTS AND METHODS: Online questionnaire regarding supplement consumption, and Depression, Anxiety, Stress Scale 21 (DASS-21) was distributed from March to June 2021 and obtained 1006 valid and completed questionnaires. Descriptive and inferential analyses were conducted to determine the frequency and predictor factors of the respondents' supplement consumption behavior and mental health status.
RESULTS: Respondents were divided into two groups, vulnerable and non-vulnerable individuals. The finding showed that 34.5% respondents were vulnerable individuals, including the elderly and those with comorbid disease(s). The vulnerable and non-vulnerable groups exhibited a high prevalence of supplement consumption, with the vulnerable group demonstrating a greater tendency for regular use. The incidence of mental health problems in both groups did not significantly differ (23-38%), where anxiety was higher than depression and stress. Supplement consumption was associated with mental health status. Several positive predicting factors for supplement consumption behavior included older age, higher economic status, and higher education. While the younger age and unmarried respondents were more likely to develop mental health problems.
CONCLUSION: Taken together, given dietary supplement consumption increased during the pandemic and the potential associations between supplement consumption and mental health, controlling the correct information and regulation regarding supplements, especially their risks and benefits, was important. Additionally, support for mental health issues was necessary, since it might affect self-medication behavior.
Fulltext A quantitative approach to measure women's sexual function using electromyography: a preliminary study of the Kegel exercise

Mohktar MS, Ibrahim F, Mohd Rozi NF, Mohd Yusof J, Ahmad SA, Su Yen K, et al.

Med Sci Monit, 2013 Dec 13;19:1159-66.
PMID: 24335927 DOI: 10.12659/MSM.889628

BACKGROUND: Currently, the reference standard used to clinically assess sexual function among women is a qualitative questionnaire. Hence, a generalised and quantitative measurement tool needs to be available as an alternative. This study investigated whether an electromyography (EMG) measurement technique could be used to help quantify women's sexual function.
MATERIAL AND METHODS: A preliminary intervention study was conducted on 12 female subjects, who were randomised into a control (n=6) and an intervention (n=6) group. Intervention involved a set regimen of pelvic floor muscle exercises (Kegel) and the control group did not have any treatment. All subjects were asked to answer a validated, self-rated Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ). EMG measurements of the pelvic floor muscles (PFM) and the abdominal muscles were taken from all women at recruitment and 8 weeks after study commencement.
RESULTS: After 8 weeks, most of the subjects in the control group did not display any noted positive difference in either PISQ score (4/6) or in their muscle strength (4/6). However, a noted progressive difference were observed in subjects who were placed in the Kegel group; PISQ score (5/6) and muscles strength (4/6).
CONCLUSIONS: The noted difference in the Kegel group subjects was that if progress is observed in the sexual function, improvement is also observed in the strength of at least 2 types of muscles (either abdominal or PFM muscles). Thus, EMG measurement is a potential technique to quantify the changes in female sexual function. Further work will be conducted to validate this assumption.