IIUM Medical Journal Malaysia (IMJM)
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Factors Associated with Intention to Report Child Abuse among Early Childcare Providers in North-eastern Preschools, Malaysia
Get PDFINTRODUCTION: Despite the rising number of child abuse in Malaysia, there are only few studies documenting early childcare providers' (ECPs') intention to report child abuse. ECPs play a vital impact because they closely interact with the children and nearly daily observe them. They should take the lead in ending the cycle of abuse in order to safeguard the children. The aim of our study was to determine the factors that influence ECPs' intentions to report child abuse. MATERIALS AND METHOD: 457 ECPs working in preschools registered under the Community Development Department in Kelantan, the North-eastern part of peninsular Malaysia participated in a cross-sectional study utilising the Early Childhood Educators Child Abuse Questionnaire (ECECAQ) in Malay, which has been validated. RESULTS: Increasing knowledge was significantly associated with the intention to report to the authorities as revealed by multiple logistic regression. CONCLUSION: Our findings justify the need for a comprehensive module and integrated standardized training on child abuse for ECPs in Malaysia to improve their knowledge, thus empowering them to report any child abuse case
Reliability and Validity of the Sexual Intention Questionnaire for Adolescent Boys (SIQ-AB) in Malaysian Context
Get PDFINTRODUCTION: The newly developed Sexual Intention Questionnaire for Adolescent Boys (SIQ-AB) is an adapted tool from the Youth Sexual Intention Questionnaire (YSI-Q) and Theory of Planned Behaviour (TPB), aimed to assess the influence of knowledge, permissive attitude, social norms, and self-efficacy toward the sexual intention. Thus, the aim of this study was to validate the newly developed SIQ-AB to determine Malaysian adolescent boys’ sexual intention. MATERIAL AND METHODS: The SIQ-AB validity and reliability were assessed in this study. A total sample of 252 (Exploratory Factor Analysis, n=126 and Confirmatory Factor Analysis, n=126) among adolescent boys from Serian and Kota Samarahan, Sarawak were included in this study. The exploratory factor analysis (EFA) assessed three constructs of sexual intention which include attitude, self-efficacy, and social norms with a 4-point Likert scale with a total of 19 items. The confirmatory factor analysis (CFA) assessed the TPB constructs of sexual intention, attitude, self-efficacy, and social norms with a 4-point Likert scale with a total of 19 items adopted from YSI-Q. RESULTS: The four-factor structures were supported by the EFA which had 19 items which accounted for 65.79% of the variation overall. Four items were removed due to improper positioning or low factor loading (<0.50), even though EFA supported the four-factor structure. Using Cronbach’s alpha, internal reliability varied between 0.77-0.89. Construct, convergent and composite validity of the SIQ-AB were further validated by the CFA with χ 2=199.0, df=129, p< 0.001, χ 2/df =1.54, CFI=0.98 and TLI=0.98 and RMSEA=0.06. CONCLUSIONS: The result proved that the SIQ-AB instrument is a valid and highly reliable tool to assess adolescent boys' sexual intention
Outcome of Negative Computed Tomographic Angiography in the Management of Gastrointestinal Bleeding at a Tertiary Centre: A Cross-sectional Study
No full textINTRODUCTION: Acute gastrointestinal bleeding is a common gastrointestinal emergency. Only limited studies are available regarding the clinical outcomes after computed tomographic angiography (CTA) mesentery showed negative for active bleed. This study aims to determine the clinical outcome of negative mesentery CTA in patients with clinically active acute gastrointestinal (GI) bleeding. MATERIAL AND METHODS: A cross-sectional study with a universal sampling method was used. Patients who underwent CTA to detect gastrointestinal bleeding in the National University Hospital of Malaysia from December 2015 until March 2021 were retrospectively analysed. The outcome of each patient, risk of re-bleeding, and 30-days mortality rate were evaluated and assessed. RESULTS: In total, 280 CTAs were performed on 232 patients, with 186 of them showing negative results on their first initial CTA. 40.8% (76/186) of those with negative initial CTA had recurrent bleeding and 73.6% (56/76) of them required active intervention. We found that the risk of re-bleeding is lower in the upper gastrointestinal group compared to the lower gastrointestinal group (OR=1.5, 95% CI: 0.877- 2.852, p: 0.128). The overall 30 days mortality rate after the first negative CTA was 23.1% (43/186). Among those patients who experienced re-bleeding, 32.8% (25/76) died within 30 days, with 18.4% (14/76) succumbing to massive bleeding. CONCLUSION: From our analysis, it can be concluded that a clinically active GI bleeding with negative mesentery CTA has a 40.8% chance to re-bleed with 23.1% 30-day mortality rate. Close observation and follow-u
Parental Experience on Female Circumcision in East Coast of Malaysia
Get PDFINTRODUCTION: Female circumcision (FC) is a deep-rooted tradition in Malaysia, influenced by religious, cultural, and health beliefs. However, it has drawn criticism for its similarities to Female Genital Mutilation (FGM) in Africa, particularly during the 2018 Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) by the United Nations Human Rights (UNHR). Amidst this backdrop, this study aimed to investigate parents' perspectives and experiences concerning female circumcision, as well as the factors driving its persistence. MATERIALS AND METHODS: This qualitative study used phenomenological approach and 20 in-depth interviews were conducted using a semi-structured questionnaire until data saturation were reached. We employed convenience and snowball sampling methods. The interviews were recorded, transcribed, and analyzed using NVivo 12 software. We used thematic analysis to identify key themes in the data. RESULTS: Three themes emerged from the interviews: (1) FC is a ‘fitrah’, (2) maintaining good health is the main influence; and (3) FC causing no harm. The main influences on this practice are religious, cultural, and health factors. Parents described the procedure as simple and harmless for the baby and themselves, both physically and emotionally. CONCLUSIONS: This research shown that FC in Malaysia is not solely religious but deeply embedded in culture. The blend of cultural and religious aspects makes it a crucial practice for some
A Rare Case of Diabetic Papillopathy Presenting with Pseudo-Foster Kennsedy Syndrome
Get PDFPseudo-Foster Kennedy syndrome (PFKS) is defined as unilateral disc oedema with contralateral optic nerve pallor, in the absence of intracranial pathologies. Diabetic papillopathy is a rare ocular manifestation of diabetes mellitus (DM). We report a rare case of PFKS secondary to diabetic papillopathy in a young patient with type 2 DM who had poor glucose control. There was optic disc swelling over the right eye and optic disc pallor over the left eye. His visual field assessment showed right inferior field defect and general depression in the left. Optical coherence tomography retinal nerve fibre layer showed normal thickness over the right eye and generalized thinning over the left eye. Neuroimaging and other laboratory investigations were unremarkable. With good glycemic control, the optic disc swelling over the right eye resolved. Visual field defect remained the same but retinal nerve fiber layer showed thinning in areas where the edema had resolved
A Scoping Review of Female Genital Mutilation and its Effects on Sexual Function and Sexual Satisfaction
Get PDFThe practice of female circumcision (FC), particularly female genital mutilation/cutting (FGM/C), has been controversial as it is regarded as physically and mentally harmful and violates human rights. The purpose of this study is to perform a scoping review aiming to evaluate and compare the effects of FC and FGM/C on the sexual function of the affected women, including the Google Scholar, EBSCO Discovery Service, PubMed, ProQuest Health & Medical Complete, and Wiley Online Library between the year 1999 to 2020. The following keywords were used: ‘Female Circumcision’, ‘Female Genital Mutilation, ‘Female Genital Cutting’, ‘Female Circumcision and Sexual Function’, and ‘Female Circumcision and Sexual Satisfaction. A total of 72 articles related to FC and sexual function or satisfaction were retrieved, and 30 articles met the inclusion criteria. Based on the analysis of the final 30 articles, most of the articles described the detrimental effects of FGM/C on sexual function and sexual satisfaction. However, future studiesMaround the less invasive types of FGM/C are required to better reflect on FGM/C on female health. FGM is detrimental to female sexual satisfaction. However, a different method of FC that is less invasive may provide different outcomes. Therefore, a comprehensive guideline on proper FC techniques is needed for education among medical practitioners to prevent any adverse effects on sexuality
Nutritional Status, Vitamin D and Lifestyle of Adults with and without Type 2 Diabetes in Baghdad, Iraq: A Comparative Cross-Sectional Study
Get PDFINTRODUCTION: Understanding the status of diabetes is important to predict thevariables that affect risks due to diabetes or can be used to prevent diabetes. This studyaimed to compare the socio-demographic characteristics, nutritional status, vitamin D(VitD) levels, and lifestyles of diabetic versus non-diabetic adults in Baghdad, Iraq.MATERIALS AND METHODS: A comparative cross-sectional study was carried out fromOctober to December 2019, and data were collected from adults aged 20 to 65 years.Logistic regression analysis was used to identify factors that contributed to thedevelopment of Type 2 Diabetes Mellitus (T2DM). Data was analyzed using SPSSVersion 22. RESULTS: One-hundred seventy subjects were divided into two groups of85 respondents in non-diabetic and diabetic groups, respectively. Educational level, vitDlevel and daily consumption of red meat, pizza, pastries, nut and bread were significantlyhigher in the non-diabetic than in the diabetic group (p<0.05). On the other hand,respondents with T2DM had higher family history of T2DM, waist-to-hip ratio (WHR),body fat percentage (BF%), fasting blood glucose (FBG) and daily consumption of brownbread (p<0.05). Multiple logistic regression showed that the only significant factorscontributing to the status of diabetes were educational attainment and FBG (p<0.05).CONCLUSION: Higher educational level and decreasing one unit of FBS reduced the riskof T2DM by 10% and 67%, respectively. Future Interventions on fostering educationallevel, normal BMI, healthier diet and vitamin D intake are recommended for T2DMprevention and control in Iraqi adults
Daycare and Inpatient Hemithyroidectomy: A Cost Minimisation and Safety Study-Hospital Kuala Lumpur Malaysia Experience
Get PDFIntroduction: The duration of daycare surgery (DS) is relatively shorter compared to other types of surgeries. The main objective here is to provide comfort to the patients and family members without compromising safety and quality of medical care for the patients. In addition, there are many proven advantages of DS such as shorter waiting time, earlier return to work, reduced cross-infections, reduced cancellation rates due to emergency cases and cost-effective. Due to the constraints of inpatient operating time and availability of hospital beds, thyroid surgery is performed as DS in our centre. In this study, we analysed the cost-effectiveness and safety between the daycare and inpatient hemithyroidectomy. Methods: This cost minimisation comparative study was conducted in Kuala Lumpur Hospital, Malaysia, from January 2019 to June 2021. The total cost for each hemithyroidectomy for providers and patients were calculated for both groups. Any complications in the surgery for the two groups were documented. Result: Seventy-one patients were recruited: forty-one (57.7%) daycare hemithyroidectomies and thirty (42.3%) inpatient hemithyroidectomies. The cost of daycare hemithyroidectomy were significantly lower than the inpatient hemithyroidectomy with a median percentile of RM1089.00 (IQR= RM 339.48) and RM 1477.10 (IQR = RM 434.02) respectively (p-value <0.001). None of the patients in either group developed any surgical complications. Conclusion: Daycare hemithyroidectomy minimises the cost for providers while still maintaining the safety of the procedure. Therefore, daycare hemithyroidectomy is cost-effective and should be advocated in all tertiary hospitals in Malaysia
Correlations of Estimated Serum Small Dense Low-Density Lipoprotein and Isoprostane with Metabolic Syndrome Criteria between Metabolic Syndrome and Non-Metabolic Syndrome Subjects in Selangor
Get PDFIntroduction: Metabolic syndrome (MetS) is a global healthcare burden associated with increased risk of atherosclerosis (ATH). The relationship between atherogenic lipoprotein and oxidative stress biomarkers with clinical risk factors of MetS have not been fully explored. Therefore, the objective of this study is to determine the correlation between small dense low-density lipoprotein (sdLDL-c) and isoprostane (ISP) with MetS criteria and comparing these biomarkers between MetS and non-MetS. Materials and Methods: This was a cross sectional study involving 67 MetS and 43 non-MetS diagnosed by JIS criteria 2009. Demographic details and anthropometric measurements were recorded. Blood samples were collected to analyse serum plasma glucose, direct LDL, calculated sdLDL-c and ISP. Results: Mean serum sdLDL-c and ISP levels were significantly higher among those with MetS compared to non-MetS (1.14+0.44 mmol/L vs 0.87±0.38 mmol/L respectively, p=0.005). Similarly, mean serum ISP concentration was higher among MetS compared to non-MetS (884.40+602.69 ng/L vs 657.89±616.42 ng/L respectively, p= 0.054). sdLDL-c was positively correlated with TG in the MetS (Pearson correlation 0.501, p<.001) whilst HDL-c was positively correlated with sdLDL-c among the non-MetS (Pearson Correlation 0.422, p<.005). Conclusion: This study highlights the correlation between sdLDL-c and TG in among MetS, emphasizing the need to closely monitor and manage TG among this cohort to reduce the risk of ATH. It was also noted that HDL-c showed positive correlation with sdLDL-c among non-MetS. This discordant finding suggests that HDL-c itself may not be causally associated with cardiovascular benefits and that perhaps HDL-c subfractions may be a better approach to determine cardioprotective effects of HDL-c