IIUM Medical Journal Malaysia (IMJM)
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Prevalence of the Unmet Needs and its Predictors among Working Mothers of Children with Epilepsy Attending Specialist Hospitals in Kelantan
Get PDFINTRODUCTION: Unmet needs arise when everyday assistance is lacking. Epilepsy's unpredictability creates significant work-family conflict for working women, potentially leading to increased unmet needs. This study aimed to determine the prevalence and the factors related with the unmet needs of working mothers with children with epilepsy (CWE) in Kelantan. MATERIALS AND METHODS: A crosssectional study using the validated Malay version of the Family Needs Survey questionnaire was conducted among 204 working mothers aged 18 to 60 of CWE attending specialist hospitals in Kelantan. Data were analysed using descriptive statistics and multiple linear regression. RESULTS: The highest unmet need was for community services (81.6%), followed by information (71.9%), social support (53.1%), financial (43.2%), explaining to others (28.9%), and family functioning (28.4%). Having follow-ups at tertiary hospitals reduced the unmet need score for information (B=-0.669, 95%CI=-1.276,0.081, p=0.021) and social support (B=-1.454, 95%CI=-2.225, -0.683, p=<0.001). Living in nuclear types of family reduced the unmet need score for community services (B=-0.669, 95%CI=-1.276,0.081, p=0.021) and information (B=-1.216, 95%CI=-1.965,-0.466, p=0.002). Working in the government sector increased the unmet need score for social support (B=0.437, 95% CI=0.062, 1.454, p=0.033). Full-time employment (B=-0.761, 95%CI=-1.244,-0.279, p=0.002) reduced the unmet need score for family functioning. Contract employment status (B=0.566, 95%CI=0.074,1.058, p=0.024) increased the unmet need score for family functioning. CONCLUSION: Mothers of CWE working in the government sector, under contract employment, and seeking follow-up care in secondary hospitals were related to higher unmet needs. The study findings may assist policymakers in introducing a child-friendly employment policy and flexible working arrangements among working parents of children with chronic illnesses such as epilepsy
Complicated Appendicitis-Shifting towards Early Appendectomy-A Comprehensive Review
Get PDFThe management of complicated appendicitis has undergone a transformative shift in recent years, moving away from the traditional conservative approach followed by interval appendectomy towards early appendectomy. This review article explores the current landscape of complicated appendicitis management, investigating the roles of conservative treatment, interval appendectomy, and early appendectomy. With no definitive consensus in place, the choice of treatment largely depends on the individual surgeon. The emergence of laparoscopic appendectomy has played a pivotal role in this paradigm shift, further highlighting the need to reevaluate and understand the various management options available. A total of 43 articles, 24 from Asia, 12 from Europe, 5 from the USA and 1 from Africa were retrieved from PubMed, Google scholar and the Cochrane database of clinical reviews. This review synthesizes existing literature, shedding light on the advantages and considerations associated with each approach
LPA Gene Copy Number Variation and APOE Gene Polymorphism in Young Acute Myocardial Infarction
Get PDFINTRODUCTION: An early onset of acute myocardial infarction (AMI) and a strong family history suggest the possibility of its genetic predisposition. Lipoprotein(a) (LPA) and Apolipoprotein E (APOE) genes are known to be involved in lipid metabolism which may contribute to the development of atherosclerosis leading to AMI. This study aims to assess the association between LPA gene copy number variation (CNV) and APOE gene polymorphism in young AMI patients. MATERIALS AND METHODS: A total of 40 DNAs were extracted from the buffy coat. APOE genotyping and detection of LPA gene CNV were performed using multiplex PCR technique and digital PCR. After tabulation of the results of the current study, meta-analyses were performed from selected studies among Asian populations using the Comprehensive Meta-analysis version 3 software program. RESULTS: No significant association was found between CNV of the LPA gene and the polymorphism of the APOE gene with Young AMI patients in the current study. However, our meta-analysis confirmed that the E4 allele increased the risk for CAD with the E3/E4 genotype [p=0.000, OR= 1.60 (95% CI: 1.41-1.83) significantly increased risk of CAD and individuals with E3/E3 genotype [p=0.000, OR=0.73 (95% CI: 0.66-0.81) were protective against CAD. The gain of LPA CNV was higher in YAMI [n=5 (25%)] than in control [n=2 (10%)] but they are not significant. CONCLUSION: There is no association between the LPA gene CNV and the presence of APOE polymorphism in young AMI, but our meta-analysis confirmed that the E4 allele increased the risk for CAD
Overview of the Prevalence and Contributing Factors for Occupational Noise-Induced Hearing Loss (NIHL) in Malaysia
Get PDFINTRODUCTION: This manuscript aims to provide a synopsis of the current situation surrounding noise exposure at work and the risk of noise-induced hearing loss (NIHL) in Malaysia. NIHL is an occupational illness that affects most many people and can be prevented in many countries in the world. The production and agriculture businesses and the extraction of natural resources and urban traffic all contribute to ambient noise levels. Working in a noisy environment is the main occupational risk factor for adult-onset hearing loss. In this study, we investigate the prevalence of NIHL across different industries, as well as research publication trends on NIHL. MATERIAL AND METHODS: Conducted thorough several online databases, like Science Direct, Web of Science, and Google Scholar, for related research that had already been published. The review phases were carried out according to the recommendations laid out by the preferred reporting items for systematic reviews. A set of criteria was developed for selecting relevant studies. RESULTS: The prevalence of NIHL among workers in Malaysia, varies across different industries and has been reported to range from 5.0% to 82.6%. NIHL has multiple contributing factors, including noise intensity, long-term exposure to daily noise, hearing protection devices and age. A review of these studies found varying percentages of individuals affected by each contributing factor. CONCLUSION: Occupational NIHL is a preventable health risk for workers across industries. Employers must adopt engineering and administrative controls (education and training) and provide personal hearing protectors to protect workers from noise
Prior Knowledge, Acceptance, Adaptation, and Challenges Following Stoma Formation among Colorectal Cancer Patients in Northern Peninsular of Malaysia: A Qualitative Study
Get PDFINTRODUCTION: Stoma formation affects an individual in various ways, including physical, emotional, social, and cognitive functions. Diverse studies report ways of an individual lives with new stoma formation. However, the comprehensive understanding of the entire process by the patient, which includes knowledge before the surgical procedure, as well as the subsequent acceptance, adaptation, and challenges to living with a stoma is lacking. MATERIALS AND METHODS: In-depth interview session were conducted with 12 colorectal cancer patients who have undergone surgical procedures for intestinal stoma formation. The patterns and themes within the data were identified by thematic analysis, involving data familiarisation and coding followed by themes’ generation and refinement of the themes. RESULTS: Four themes and 9 subthemes were identified, which revealed the sufficiency of stoma-related information and understanding prior to surgery as well as positive acceptance of self and family members reflected through their reactions and support. Nonetheless, the challenges were anticipated which highlights the complications of the stoma itself, obstacles surrounding social life, and financial burdens. CONCLUSION: This study provided valuable insights into the experiences of individuals living with a stoma following colorectal cancer surgery. The themes and subthemes highlight the need to address social stigma as well as financial issues to alleviate the burden of stoma-related expenses. Increasing public awareness and improving financial assistance could be a way to enhance the overall quality of life for patients living with stom
Subcutaneous Panniculitis-like T-cell Lymphoma: A Case Report of A Solved Conundrum
Get PDFSubcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare primary cutaneous lymphoma which often be very complexed to be diagnosed. Here we reported a case of a 38-year-old lady with wax and wane course of left facial swelling associated with prolonged pyrexia of unknown origin, lethargy and prominent weight loss. Multiple investigations were conducted to reach to the conclusive diagnosis. Histopathological showed infiltration of neoplastic lymphoid cells within the adipocyte clusters with hyperchromatic nuclei, small nucleoli and scant cytoplasm. Immunohistochemical analysis were immunoreactive to CD3, CD8 & TIA and negative to CD20, CD4 & CD56. Based on clinical findings, histopathology report and immunohistochemical analysis, the patient diagnosed with SPTCL. Hence, any suspicious maxillofacial swelling without obvious sign of infection and trauma shall be investigated until a final diagnosis is reached
Microbiome Dysbiosis in Depression: A Narrative Review
Get PDFThe comprehensive exploration of the microbial composition of the gut and its role in depression underscores a complex interplay involving alterations in gut microbiome, immune pathways, and inflammatory control. Studies reveal potential biomarkers and therapeutic targets linked to depression, with particular bacterial genera correlated with the severity of depressive symptoms. The dysregulation extends to disruptions in metabolic pathways and functions of bacterial proteins within the gut, contributing to intestinal barrier dysfunction and increased gut permeability. Notably, alterations in microbial composition are observed in various depressive conditions, including major depressive disorder (MDD), post-stroke depression (PSD), and depression during neoadjuvant cancer treatment. The influence of the gut microbiome on the central nervous system and the bidirectional relationship between depression and microbial changes are highlighted. Regulatory interventions, including antidepressants and probiotics, show promise in modulating the gut microbiome and alleviating depressive symptoms. The combination of probiotics with antidepressants emerges as a potential strategy for inducing a balanced microbiome. However, a lack of consensus exists regarding specific bacterial taxa associated with depression, emphasizing the need for further research to refine the therapeutic approaches for managing depression and related mood disorders. This review aims to explore the relationship between microbiome dysbiosis and depression, highlighting the role of dysbiosis as a potential contributing factor to depressive symptoms
A Comparative Study of the Tolerance to Stress Response Under Spinal Anaesthesia in Diabetic Versus Non-Diabetic Patients
Get PDFINTRODUCTION: Activation of sympathetic nervous system, increase of catabolic hormone release and pituitary gland suppression are responses to surgical stress. Neural blockade via epidural or spinal anesthesia, intravenous administration of high-dose of strong opioid analgesics, and infusion of anabolic hormones such as insulin are three main methods for balancing stress responses to surgery. However, there are conflicting reports about the extent of autonomic disturbances occurring after inducing spinal anesthesia in diabetic patients due to underlying autonomic neuropathy. METHODOLOGY: An observational cohort study was conducted in an operative room of a tertiary health care center involving 25 diabetic patients and 25 non-diabetic patients to evaluate the tolerance to stress. The diabetic patients undergone an exercise tolerance test to evaluate for postural hypotension which would indicate presence of autonomic neuropathy. Stress parameters such as heart rate, mean blood pressure, blood glucose level, and temperature were measured at regular intervals pre, peri- and post-operatively. RESULTS: Intraoperative heart rate, mean blood pressure, and blood glucose level were high in diabetic patients with autonomic neuropathy (p≤0.05). Temperature was higher in diabetic patients with autonomic neuropathy initially (p≤0.05) and had a higher fall peri-and post-operatively (T=15 minutes, T=20 minutes, and T=after surgery). A significant differences in the parameters of stress response were observed in diabetic patients with autonomic neuropathy. CONCLUSION: By understanding the correlation between stress-response in diabetic patients with autonomic neuropathy peri-operatively will help the anesthetist to provide customized services to every patien
In Vivo Studies of Lepidium meyenii or Maca in Animal Models of Diabetes Mellitus and Other Metabolic Syndrome-Related Diseases- A Scoping Review
Get PDFLepidium meyenii or Maca is a Peruvian plant that belongs to the Brassicaceae family. Maca has various attributed health benefits due to the diversity of its bioactive compounds. Studies reveal that Maca is effective for many purposes including in the treatment of diabetes mellitus (DM) and other metabolic syndrome-related diseases. This review aims to uncover previously identified underlying anti-diabetic effects of Maca as well as its potential in the treatment of other conditions linked to metabolic syndrome in animal models in vivo. A scoping review of the literature was conducted using a protocol by Arksey and O’Malley. The protocol centred on the identification of research questions, identification and selection of relevant studies, data charting and collating, summarizing, and reporting the findings. Searches were conducted using Semantic Scholar, Scopus, PubMed Central, and ScienceDirect. Six studies were included in the review. The studies varied in terms of purpose, methodology, and detail of findings. They include the administration of Maca in different types of animal models and its effect on several biochemical parameters. There is fundamental scientific evidence from this review that supports the anti-diabetic properties of Maca in animal models of DM and other metabolic syndrome-related diseases. However, the scarcity of reports indicates the need for more rigorous studies in the future
Prevalence and Factors Determining Adolescents Risk Taking Behaviours in Sarawak, Malaysia
Get PDFINTRODUCTION: During adolescence, significant physical, emotional, and social changes influence growth. This phase exposes adolescents to risky situations. Understanding adolescent risk-taking is crucial. This study aims to determine the extent of risk-taking behaviour among Malaysian adolescents and identify associated factors. MATERIALS AND METHODS: In a community-based study, we surveyed 1,344 Malaysian adolescents aged 10-19 across 22 districts in Sarawak using multi-stage cluster sampling and face-to-face interviews. Data analysis was performed with IBM SPSS v28.0. RESULTS: Analysis found that 43.7% of adolescents engaged in risky behaviours, with a higher incidence in males (50.1%) compared to females (37.4%). Multinomial logistic regression analysis identified for low-medium risk behaviours were being aged 15-19 (AOR=1.52; CI:1.14-2.02), infrequent religious practice (AOR=1.70; CI:1.01-2.84), poor parent-child relations (AOR=2.02; CI:1.07-3.83) and having a history of mental abuse (AOR=3.02; CI:1.37-6.62). However, a larger family size appeared to be a protective factor (AOR=0.39; CI: 0.18-0.89). High-risk behaviours were more prevalent in older (AOR=2.65; CI:1.91, 3.68) male adolescents (AOR=2.75; CI: 2.02, 3.75) and low religious value (AOR=3.55; CI: 1.32-9.52), larger families (AOR=2.03; CI: 1.38-3.00), lower school grades (AOR=1.74; CI: 1.27-2.38), physical ailments (AOR=2.63; CI:1.60-4.32), and a history of mental abuse (AOR=3.85; CI:1.78-8.31). CONCLUSION: Adolescents aged 15-19 with weak family ties, low religious engagement, and a history of mental abuse tend to exhibit low to medium risk behaviours. Older male adolescents with health issues are more likely to engage in high-risk behaviours, whereas those from larger families show fewer such tendencies. These insights are crucial for shaping targeted interventions and policies