IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
Association between Self-esteem and Smoking among Religious Schools Students in Petaling District, Selangor
Get PDFIntroduction : 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 14-15years (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
Knowledge and Attitude towards HIV/AIDS among transsexuals in Kuantan, Pahang
Get PDFIntroduction: Lack of knowledge and negative attitude towards HIV/AIDS may be the risk factors for HIV infection among transsexuals. Research on knowledge and attitude towards HIV infection in transsexual communities is very limited at both local and international levels. This study aimed to assess the knowledge and attitude towards HIV infection among the male-to-female transsexual community in Kuantan, Pahang. Methods: A cross-sectional study was carried out from July to August 2014 among 33 male-to-female transsexuals in Kuantan, Pahang. Convenience sampling was used. Participants who gave consent answered a self-administered questionnaire. Data obtained was analyzed with descriptive statistics, χ 2 -test, and independent sample t test. Results: The majority of the subjects in this study were 29 years and below (48.5%), Muslims (93.9%), and had completed up to secondary education (60.6%). Most of them were sex workers (60.6%), and had relatively low income (no income to RM 3000, mean of RM1528). A total of 87.9% of the subjects demonstrated good knowledge and also positive attitude towards HIV/AIDS. Level of education was significantly associated with scores in knowledge (p=0.01). Conclusions: Despite the positive outcome from this study, misconceptions towards HIV/AIDS still exist among transsexuals. Education and interventions from multiple directions on HIV/AIDS are essential to deliver the correct information to this population, so as to emphasize prevention, early detection, and holistic medical care. Transsexuals also require attention from religious bodies and non-governmental organizations to help them in employment, financial, spiritual, and psycho-social issues
A Comparative Study on the Inter-Session and InterExaminer Reliability of Corneal Power Measurement Using Various Keratometry Instruments
Get PDFIntroduction: The purpose of this study was to evaluate inter-session repeatability, inter-examiner reproducibility and inter-device agreement of corneal power measurements from manual keratometer, autokeratometer, topographer, Pentacam high resolution and IOLMaster. Methods: Two sets of mean corneal power measurements (n=40) were compared for inter-session repeatability and inter-examiner reproducibility in each instrument. Repeatability and reproducibility were evaluated by within-subject standard deviation (Sw), coefficient of variation (COV) and intraclass correlation coefficient (ICC). A oneway repeated measures analysis of variance was conducted to compare differences in the corneal power between each instrument pair. The Bland and Altman analysis and Pearson’s correlation were employed to assess agreement and determine strength of relationship between measurements. Results: There were no significant differences in mean corneal power measurements between 2 different visits (p > 0.05). The Sw and COV values between 2 visits were lower than 0.09 D and 0.20 % respectively. The ICCs were stronger than 0.99 in all instruments. For reproducibility of each instrument, differences of the measurements between 2 different examiners were also insignificant (p > 0.05). The Sw and COV values between 2 examiners were lower than 0.11 D and 0.23 % respectively. The ICCs were 0.99 and above in all instruments. The 95% limit of agreement between instruments ranged from -0.29 to 1.13 D and the r-values were stronger than 0.84. Conclusion: The corneal power measurements using these 5 instruments were repeatable and reproducible. These instruments can also be used interchangeably, however the topographer should be used with caution
‘I can’t pray’ – The spiritual needs of Malaysian Muslim patients suffering from depression
Get PDFIntroduction: The mainstay of treatment of depression relies on pharmacological and psychological treatments. On top of that, evidence also recognizes the vital role of spirituality for human wellness which leads to growing interest in its utilization to treat depression. However, research on spirituality among Muslims in relation to depression is relatively scarce. The aim of this study is to explore the understanding of spirituality among Muslim patients with depression, and to explore their spiritual needs. Methods: This is a qualitative study conducted on 10 depressed Muslim patients at the UKM Medical Centre. Purposive sampling was done to ensure diversity of subjects. Individual in-depth interviews were conducted using semistructured questionnaire guidelines. The data were transcribed verbatim and analysed using a thematic approach. Result: Out of 10 patients, almost all of them expressed spiritual needs. Two major themes emerged in relation to the spiritual needs which are (i) religious needs; need for worship, religious knowledge and guidance, religious reminders, and (ii) existential needs; need for calmness, sensitivity and empathy, self-discipline, certainty, hope , physical help, ventilate and meaning of illness. These needs are essential for patients during the time of crisis. Conclusion: The majority of patients expressed spiritual needs which are required during the process of recovery and this provides an opportunity to incorporate spiritual approaches in the treatment of depression. However, more studies are needed to demonstrate its scientific basis and to design an effective psycho-spiritual treatment modality so that the ‘holistic’ or ‘biopsychosocial-spiritual’ treatment can be integrated by health care professionals to those in need
Pedunculated Hepatocellular Carcinoma: Distinguishing Features from Conventional Hepatocellular Carcinoma
Get PDFMalignant pedunculated (exophytic) hepatocellular carcinoma (P-HCC) is a rare entity of hepatocellular carcinoma. Due to its unique characteristics, it gives a different spectrum of clinical findings, radiological presentation and different management approach with reported better outcome to the patients. We present a case report of a lady diagnosed with malignant pedunculated hepatocellular carcinoma
Depression symptoms in patients with thyroid disorder at the tertiary hospital in northern region of Malaysia
Get PDFIntroduction: Thyroid disorder patients have a high risk to experience depression symptoms resulting from the thyroid hormone fluctuations. The aims of this study were to evaluate the occurrence of depression symptoms and to analyze the association between depression symptoms and social-demographic of the patients affected by different thyroid disorders. Methods: This was a cross-sectional study of one of the non-profit hospitals in the northern region of Malaysia. Depression symptoms were measured using the Depression Anxiety Stress Scale-21 (DASS-21). Socio-demographic characteristics of the patients were gathered using the questionnaire. Patients with any thyroid disorders, above 18 years old and did not have any psychiatric disorders were included in this study. Results: The total numbers of subjects in this study were 199. The female consisted of 76.9% (153). The mean age was 46.32±15.16 years. Regarding the thyroid disorder; 35.2% (70) had hyperthyroidism, 23.6% (47) had goitre, 14.1% (28) had hypothyroidism, 14.6% (29) had autoimmune thyroid disorders while thyroid cancer was found in 12.6% (25). Determination of depression symptoms showed that 85.9% (171) had no depression, 6.0% (12) and 4.5% (9) had mild to moderate depression respectively while severe depression was found in 3.5% (7) cases. Age and patients, those not living alone significantly associated with depression symptoms (p<0.05). Conclusions: These findings would suggest that some of the thyroid patients had depression symptoms. In addition, the patients in middle aged and staying with family seem to have depression symptoms. Further studies should be performed, in order to confirm these findings
The application of the theory of planned behavior to understand the intention of weight loss practice among overweight adolescents
Get PDFIntroduction: Overweight adolescents have been reported to struggle in losing weight. However, their intention to engage in weight loss practice remains unclear. Therefore, the aim of this qualitative study was to understand the factors that lead to the intention of weight loss practice among overweight adolescents using the Theory of Planned Behavior (TPB). Methods: Thirty-three overweight adolescents aged between 13 to 17 years old were recruited from three secondary schools in Selangor. They responded to a semistructured interview based on TPB that has three core antecedents; i) Attitude toward the behavior, ii) Subjective norm, and iii) Perceived behavioral control. Results: There is a high possibility that overweight adolescents will perform weight loss practice if the diet plans they followed, or physical activity they performed, or slimming product they consumed prove to make them lose some kilograms (Attitude). Besides that, the social pressure received from social interactions with parents and peers in a form of weightrelated criticisms and weight-related teasing may encourage overweight adolescents to be thin and reducing weight (Subjective norm). Finally, the emergence of intention that subsequently lead to weight loss practice is either driven by social interactions and media influences, or limited by some of the identified barriers (Perceived behavior control). Conclusions: The TPB is suggested to be an effective framework to understand the intention of weight loss practice among overweight adolescents, allowing for the development of obesity intervention program
Preoperative Acetate Templeting in Primary Total Knee Replacement: Does it Matter?
Get PDFIntroduction: Preoperative templating is a crucial step in a total knee arthroplasty. We conducted a prospective study of 100 patients subjected for total knee arthroplasty. The aim of this study is to determine whether the size of the prostheses used in primary knee arthroplasty may be reliable and accurately predicted using acetate templating techniques. Methods: A cohort of 100 patients plan for Total Knee Arthroplasty was included in this cross-sectional study. Pre-operative radiographs were templated using acetate templates (Zimmer, Warsaw, Indiana, USA). The mismatch between templated and implanted sizes were observed and recorded. The accuracy and reliability of preoperative templating were assessed and analyzed using student t-test and ANOVA. Results: Using the acetate template technique, it was possible to accurately predict the tibial component size in 48% and femoral component in 47% of the knees. When the accuracy to within one size was included, the templating was correct in 95% and 97% respectively. There was no size mismatch for more than 2 sizes. This study has shown a higher tendency to template smaller size for both components in total knee arthroplasty. Conclusions: We conclude that the acetate templating method is reliable method in determining and guiding the surgeon to predict for varies prostheses sizes preoperatively in centre where the digital template facility is not available
A temporal analysis of maternal deaths in some selected health facilities in Zamfara State, Northwest Nigeria: How far were United Nations Millennium Development Goals (MDG) 5 achieved?
Get PDFIntroduction: The steady increase in maternal deaths in Nigeria is a serious source of concern to policy makers and key stakeholders as one of the major threats to the achievement of the MDGs. Nigeria is reported to have one of the highest maternal mortality ratios in the world. This study was aimed at examining the challenges confronting the achievement of the MDGs Goals 5 in Zamfara State northwest Nigeria in terms of maternal mortality ratio, causes and frequency of antenatal visits. Methods: Health facility based approach and statistics were used in assessing maternal mortality ratio. Data was collected from health facility records and folders of patients who lost their lives due to pregnancy and childbirth related illnesses in some selected health facilities in Zamfara State from 2011- 2015. Results: The results showed the highest maternal deaths are in the rural areas 5120/100,000 as compared to 750/100,000 urban health facilities. Haemorrhage was the leading medical cause of maternal death. Others include sepsis, eclampsia, sickle cell anaemia, obstructed labour and abortion. However, there was a significant increase in the number of antenatal care visits from 7.20% to 30.93% within the last five years. However, the maternal mortality rate has increased, though not stable from 735/100,000 in 2011 to 1248/100,000 in 2013 and 930/100,000 in mid-2015. Conclusions: There was an increase in maternal deaths in rural compared to urban areas health clinics despite increased in the attendance of ante natal care visits thus the 5th Millennium Development Goal in Zamfara State not achieved
A prevalence study into use and management of peripheral intravenous catheters
Get PDFIntroduction: There are over half of patients admitted to the hospital required peripheral intravascular catheter (PIVC) inserted. However, there are no data reported on the use of PIVC in Malaysia. Thus, this study aims to determine the prevalence of PIVCs use and PIVC complications in patients with PIVC. Methods: An observational study was conducted on patients who had PIVC in medical, surgical, obstetric and orthopedic wards in Hospital Tunku Ampuan Afzan, Kuantan, Malaysia. Results: Over 2 months, the total admission for 4 wards was 1466 and out of this total admission, 490 patients were recruited. Reasons for PIVC insertion were for IV fluids (62.4%) and for medication administration (31.8%). Most of the PIVC inserted in the general ward (91.8%) followed by from an emergency department. The PIVC insertion was done by the doctor (84.5%). All patients used the same brand of catheter, which is Vasofix Branulle and used transparent polyurethane dressing. There were 28 (5.7%) patients have signs of thrombophlebitis. The Chi-square test showed that there was a significant association between day of PIVC insertion with thrombophlebitis (p = 0.006). Conclusions: In conclusion, the study processes resulted in a proportion of 33.4% of patients with PIVC with the total number of admission to the 4 wards and 5.7% patients have signs of thrombophlebitis