IIUM Medical Journal Malaysia (IMJM)
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Prevalence of Anxiety and Depression among Caregivers of Cancer Patients A Case Study in a Public Hospital in Malaysia
Get PDFINTRODUCTION: Anxiety and depression are common mental illnesses among cancer caregivers. Most caregivers often sacrifice a lot of time, energy and their own physical and emotional needs. MATERIALS AND METHOD: A cross sectional study was conducted among 156 caregivers of cancer patients who were providing treatment and moral support to cancer patients at the Oncology clinic of Sultan Ismail Hospital (SIH), Johor Bahru, Malaysia. The Hospital Anxiety Depression Scale (HADS) was used to assess the depression and anxiety levels among the respondents. Data was analysed using Statistical Package for Social Sciences version 17.0 software. The P value of less than 0.5 was taken a significant. RESULTS: In general, there was moderate relationship between cancer caregivers and patients in term of emotional, care and patient treatment, but in some circumstances, caregivers were also exposed to risk during care period of cancer patients. There was a significant relationship with moderate correlation between factors of taking care of emotion of patients (p<0.05, r=0.403), their diseases (p<0.05, r=0.456) and treatment (p<0.05, r=0.600) with the level of anxiety. There was a strong correlation between caring and anxiety in the item of lack of attention on patient demand (p< 0.05, r=0.91) and not angry to patient (p<0.83). CONCLUSION: The awareness regarding the anxiety and depression among caregivers need to be increased among health professionals such as physicians and nurses. Although the interventions are aimed to help the patients, but this can also cause anxiety and depression to caregivers.
Effectiveness of a Dietitian-led Healthy Lifestyle Education Package in Improving Health Behaviours of Stroke Survivors in Malaysia: A Pilot Study
Get PDFINTRODUCTION: Despite a higher risk of a recurrent cerebrovascular event, many stroke survivors failed to achieve their targeted treatment goals. This study aimed to examine the effectiveness of a dietitian-led healthy lifestyle educational package targeted at improving stroke risk factors and lifestyle practices among stroke survivors. MATERIALS AND METHODS: A quasi-experimental pilot study was undertaken in general medical wards of two public hospitals in Malaysia. Patients were allocated into either intervention or control groups based on the week of screening. Adults aged more than 18 years old, with first-ever stroke, and the willingness of caregivers to participate were included. The intervention group (patient-caregiver dyad) received three dietitian-led healthy lifestyle education sessions underpinned with Health Belief Model and Reflection and Refractive theories and was followed up for three months. The control group received the usual stroke care. Outcome variables included blood pressure, body mass index, waist circumference, dietary intake, physical activity levels, smoking status, alcohol consumption, malnutrition risk, and health-related quality of life. McNemar, Chi-square, and repeated measures Analysis of Covariance tests were conducted to examine the within - and between-group differences. RESULTS: A total of 54 participants (27 in each group) were included in this study. The intervention group had a significantly lower intake of sugar (P=0.002, effect size=0.50) and sodium (P=0.044, effect size=0.31), a lower proportion of active smokers (7% versus 33%, P=0.039), lesser sitting time (P=0.012, effect size=0.37), and lower proportion having pain/discomfort issues (22% versus 63%, P=0.005) than the control group. CONCLUSION: Early dietitian-led lifestyle modification sessions underpinned with behavioural change theories paired with the involvement of family members appear to be beneficial among stroke survivors
Impact Factors in a Curriculum Vitae for Scholarship Application
Get PDFIntroduction. Scholarship applicants often receive different advice on what should be included in their Curriculum Vitae (CV). This study aims to investigate what the essential components of a CV being prepared for scholarships are, how to present them, and what their level of impact is. Materials and Methods. The authors sent an online structured questionnaire to 7512 corresponding authors of recent published papers in Scopus; 124 completed questionnaires were returned. Recommended elements for a CV were chosen according to the Delphi consensus technique with a threshold of 50%. Results. This survey revealed that headings, bullet points and careful error checking were essential parts of the layout. For the content of the CV, besides publications, education and training background, research experience and research interest were also necessary. Moreover, almost all respondents ranked publications as the most important qualification of an academic scholarship candidate. Publications also came first as the most impressive factor, followed by awards and honours. The number of publications, quality of journal, impact factor and total citation should be presented in publication section. The importance of publications in getting academic scholarships is significantly emphasized in this recent study. Conclusions. Having research experience and papers in peer review journals, are highly recommended for students seeking academic scholarships
Risk Perception Survey on Developing Diabetes Questionnaire: Translation and Validation of the Malay Version
Get PDFINTRODUCTION: The Risk Perception Survey on Developing Diabetes questionnaire identifies how women with gestational diabetes mellitus (GDM) perceived the risk of developing diabetes after their pregnancy has ended. The objective of this study was to translate and validate an English questionnaire into Malay. MATERIALS AND METHODS: A cross-sectional study was conducted from February 2019 to July 2019 among 200 women with GDM who attended public health clinics in Johor Bahru, Malaysia. The original author of the questionnaire granted us permission to use for this study. The translation of the questionnaire, content, and face validation was performed. It was followed by confirmatory factor analysis using R version 3.5.3 and item analysis for the knowledge domain. The composite reliability and internal consistency reliability using Cronbach alpha were also computed. RESULTS: The Malay version consists of 20 items in five domains; personal control (2 items), optimistic bias (2 items), knowledge of diabetes risk factors (11 items), benefits and barriers of preventive behaviour (3 items), and risk perception (2 items). Confirmatory factor analysis confirmed the structure of the model. The goodness-of-fit values were adequate [comparative fit index=0.994, Tucker-Lewis Index=0.990, standardized root mean square residual=0.038, root mean square of approximation=0.021 (90% CI: 0.000,0.064)]. The four domains had composite reliability values between 0.60 and 0.88. The Cronbach alpha value for knowledge of diabetes risk factors domain was 0.843. CONCLUSION: The translated Malay questionnaire is valid and reliable to assess the perception of women with GDM towards their future risk of getting diabetes
Nutritional Rickets in Three Toddlers during Covid-19 Pandemic Lockdown
Get PDFNutritional rickets is a worldwide problem which has been increasingly reported globally. Three toddlers aged 1-2 years presented in March to April 2021 with bony deformities following one year of national Covid-19 pandemic lockdown since March 2020. All threepatients were breastfed till presentation without formula milk supplementation. Weaning occurred at 4-6 months of age but without proper complementary food intake. All three patients and their nursing mothers were mostly confined indoors during the pandemiclockdown. Bone metabolic profile and radiological imaging confirmed vitamin D deficiency rickets. All three patients responded well to vitamin D3 treatment and calcium supplementation for 3-6 months duration. Vitamin D deficiency rickets appears to be anincreasing problem in breastfed toddlers following the prolonged movement control order, particularly amongst picky eaters and young children on restrictive diets. Sun exposure and early vitamin D supplementation are crucial to prevent the development of nutritional rickets
In vitro and In vivo Assessments on Nutraceutical and Safety of Herb-Fruit Based Drink on Female Wistar Rats
Get PDFINTRODUCTION: The study aimed to assess the safety and nutraceutical properties of ALLURATM related to women’s health and skin beautification. MATERIALS AND METHODS: Determinations of total phenolic (TPC) and flavonoid contents (TFC) were done using the colorimetric method, followed by the identification of gallic acid via highperformance liquid chromatography (HPLC). Antioxidant activity was analyzed using 2,2 -diphenyl-2-picrylhydrazyl (DPPH) and 2,2’-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid (ABTS) radicals while its anti-inflammatory activity was measured using enzymelinked immunosorbent assay (ELISA). Anti-aging and whitening effects were determined by porcine elastase and mushroom tyrosinase activities, respectively. Skin cell growth promotion and rejuvenation were evaluated using in vitro scratch assay. Cytotoxicity assay was done using HSF1184 and 3T3 BALB/c cell lines. While, acute toxicity test was done on two groups (control and treatment) of six Wistar rats each. The nutraceutical properties were evaluated based on proximate analysis. RESULTS: ALLURATM exhibited DPPH-IC50 values of 180.40 µg/mL and ABTS-IC50 value of 174.40 µg/mL. TPC and TFC were 67.31 mg GAE/g extract and 43.21 mg CE/g extract, respectively while 10.98 mg/g of gallic acid were quantified. ALLURATM reduced pro-inflammatory cytokines of TNF-α and IL-6 and showed anti-aging (IC50-162.40 µg/mL) and whitening effects (IC50- 167.70 µg/mL). ALLURA™ also increased the proliferation of HSF1184 (≤ 1000 µg/ mL), producing significant secretion of epidermal growth factor (EGF) and shown to be non-cytotoxic. No mortality was observed at the highest dose of 2000 mg/kg b.w.t. nor the behavioral and morphological changes in rats. The proximate analysis resulted in high content of moisture and low calories. CONCLUSION: These findings provided preliminary reports for the first time on the functionality of ALLURA™ for its anti-inflammatory, antioxidant, and nutraceutical properties
Preventive Interventions to Reduce Second-Hand Smoke Exposure Among Non-Smoking Pregnant Women: A Systematic Review
Get PDFThe alarming number of smokers have increased public health concerns regarding the effects of second-hand smoke (SHS) on non-smokers, especially amongst pregnant women and unborn babies. This paper aims to review the existing interventions used to reduce SHS exposure amongst non-smoking pregnant women. This review was guided by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) review method. Published articles were identified through three databases: ProQuest, Science Direct, and Scopus within the 2010–2021 timeframe. Articles related to the intervention to reduce SHS exposure among non-smoking pregnant women were included. Nine studies were identified and reviewed. Most of the preventive interventions primarily focused on pregnant women as the target group, whereas a few interventions directly focused on changing the smoking behaviour of their spouses. This review suggests that using theories as a foundation in designing the intervention effectively reduces exposure to SHS among non-smoking pregnant women. The main limitation as reported by most studies was the lack of biochemical verification. Thus, future intervention should consider both pregnant women and their smoking spouses as the target group and include relevant theories in clinical intervention
Knowledge and Attitude on COVID-19 Appropriate Behavior among Frontline Healthcare Workers in a Tertiary Care Hospital: A Cross Sectional Study
Get PDFIntroduction: Frontline healthcare workers (HCWs) are at higher risk of Covid-19 infection compared to general population. Adherence to COVID-19 preventive measure is an important factor in reducing the risk of exposure to the HCWs. Thus, we conducted a study to evaluate the knowledge and attitude toward COVID-19’s preventive measure among the HCWs. Material and Methods: We performed a cross-sectional study among HCWs in COVID care center of Bharati Hospital, Sangli, between June 2021 to December 2021, A validated self-questionnaire on the knowledge of hand-washing and donning-doffing, as well as the attitude towards covid-19 appropriate behavior was administered to the HCWs. A statistical analysis was performed using a Microsoft Office 365 and SPSS-22. Results: Evaluation of knowledge on hand-washing and donning-doffing shown that majority of study participants had an average knowledge (77.12%), whereas only 7.7% had good knowledge and another 14.9% had poor knowledge. Knowledge of HCWs were significantly associated with donning-doffing training (p &lt;0.05). Majority of study participants (94.29%) demonstrated an appropriate behavior to COVID-19. Conclusion: As the study demonstrated an average knowledge on Covid-19 appropriate behavior after receiving a training, a periodic training on infection control and prevention in a healthcare setting and orientation programs related to COVID-19 appropriate behavior is indicated
Carbapenem-Resistant Enterobacteriaceae Bacteraemia in Intensive Care Unit: A Descriptive Study on Risk Factors and Clinical Outcome
Get PDFINTRODUCTION: Over the past 10 years, the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing dramatically with numerous hospital outbreaks reported. Bacteraemia caused by CRE have limited treatment options and have been associated with high mortality rates. As a result, preventing both CRE transmission and CRE bloodstream infections have become important objectives in managing intensive care unit (ICU) patients. The study aims to determine the incidence and risk factors of CRE bacteraemia in intensive care settings, and its’ clinical outcome. MATERIALS AND METHODS: A retrospective, descriptive study was conducted, where data of the patients admitted to general ICU of Hospital Pulau Pinang from January 2017 till December 2018 were collected and assessed for incidence, presence of predisposing factors and clinical outcome for CRE bloodstream infection. RESULTS: Out of 2,585 total ICU admissions, there were 37 cases of CRE bacteraemia with an incidence rate of 1.43%. An analysis of risk factors revealed that the use of indwelling catheter has the highest association with CRE bacteraemia in which 95% of the patients were exposed. The commonest organisms of CRE bacteraemia were Klebsiella pneumoniae (97.3%) and Escherichia coli (2.7%). The 30-day mortality rate after CRE bacteraemia was 78.4%. CONCLUSION: CRE bacteraemia among ICU patients showed a high mortality rate. Most of the patients were exposed to multiple risk factors. A high index of suspicion and rapid identification of patients at risk for CRE infection are important for effective therapy and initiation of infection control measures to prevent further spread
The Integration of Islamic Values in Daily Clinical Practice among Healthcare Professionals: A Scoping Review
Get PDFIslam is a major world religion that has a universal system encompassing every aspect of daily human activities. In this regard, Islam also provides principles and values related to the practice of medicine. However, it is not known how much of the practices have been practiced in daily clinical settings. Therefore, this paper aims to chart the overview of the studies and publications that have been done related to the integration of Islamic principles and values being incorporated in clinical practice. This paper is a scoping review. Databases like PubMed, PLOS, BMJ, Cochrane, EBSCo, Emerald, ProQuest, ScienceDirect, Scopus, and ACI were used to conduct the literature search. MeSH terms like “Islam," “religion and medicine,” and “attitude of medical staff” are among the keywords used, along with synonyms like “Islam," “Islamic," “Muslim," “medicine," “clinical," “practise," “healthcare," “professionals," “Islamic medical practise," “doctor," “nurse,” and “healthcare professionals.” The Boolean operators “AND” and “OR” were applied during the search. In addition to databases, manual internet searches were conducted to find relevant papers. The review has found that Islamic concepts and ideals have been sporadically incorporated into medical practice worldwide, whether by Muslim or non-Muslim healthcare professionals. The three key themes related to Islamic practice in medicine: are (a) attitude and character of healthcare professionals, (b) clinical decisionmaking, and (c) holistic spiritual care. There is still a big gap and differences in integrating Islamic values into clinical practice. Further work on defining and constructing a framework for a holistic Islamic medical practice is warranted