IIUM Medical Journal Malaysia (IMJM)
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Stigma and Depression among Tuberculosis Patients in Kedah, Malaysia
Get PDFINTRODUCTION: Tuberculosis (TB) related stigma is one of the significant barriers in the global TB control programme and it may lead to depression. This study aims to assess the level of stigma among TB patients and its associated factors, as well as to ascertain the correlation between stigma and depression in Kedah, Malaysia. MATERIALS AND METHODS: This was a cross-sectional study using the proportionate sampling method. TB patients were recruited from respiratory clinics in three government hospitals in Kedah. Case report form, Malay version of TB stigma scale (TSS) and Beck Depression Inventory (BDI-Malay) were used for data collection. Data were then analyzed using the linear regression and correlation analysis. RESULTS: A total of 200 respondents were enrolled and the mean score of TB stigma from patient’s perspective was 13.3 (6.87). Younger patient, currently married, higher education, unemployment, and HIV co-infection were significantly associated with the stigma experienced. 27.5% (n=55) of the TB patients were found to be depressed, with the majority categorized into mild severity (20%, n=40), followed by moderate (5.5%, n = 11) and severe depression (2%; n = 4). There was a moderate, positive correlation between stigma and depression which was statistically significant (r = 0.345, p<0.001). CONCLUSION: Although the stigma score among TB patients was not as high as has been postulated, there was a moderate, positive correlation between stigma and depression. Thus, the intervention to reduce the stigma among TB patients may be helpful as it may reduce the depression level
Optimal dose of granisetron in reducing the incidence and severity of pruritus post intrathecal morphine for Caesarean deliveries: Granisetron for pruritus post intrathecal morphine
No full textINTRODUCTION: Pruritus is one of the common side effects observed after intrathecal morphine (ITM) especially among parturients. Granisetron, a 5-HT3 antagonist has been shown to reduce this side effect. MATERIAL AND METHODS: This prospective randomised double-blind control trial compared two different doses of granisetron for anti-pruritic efficacy. One hundred and twenty parturients with a singleton uncomplicated pregnancy undergoing Caesarean section received spinal anaesthesia with ITM 0.1 mg. After the delivery of baby, they were randomised to receive either granisetron 1 mg (Group 1) or 3 mg (Group 2). The severity of pruritus was assessed within 24 hours at different intervals and were graded. RESULTS: Patients demographic and clinical characteristics were comparable between the two groups. The incidence for pruritus between Group 1 and 2 was 63.3% and 65.0% respectively with p value of 0.849 with a proportion of difference of 1.7%. Similarly, the severity of pruritus at different intervals, the need for rescue treatment and patient satisfaction for both groups were not statistically significant. CONCLUSION: Granisetron 1mg is effective when given as prophylaxis in reducing the incidence, severity and the need for rescue treatment in ITM-induced pruritus among Caesarean delivery patients
Pedobarography Study among Malay Population in Kuantan, Pahang: A Pilot Study
No full textINTRODUCTION: Pedobarography has been widely used in developed countries for few decades. However, in Malaysia it is still in its infancy. Studies showed that the normal values of pedobarography vary between races. To the best our knowledge there is no standard value available for Malaysian or Southeast Asia. This study is designed to measure the pressure values in the normal foot of Malays in Pahang, Malaysia and its difference between different gender and body mass index (BMI). Materials and Methods: A total of 400 feet of adult Malay subjects with no existing diabetes mellitus, lower limb and spine pain or problem are measured using Emed-q100 pedobarography device. Results: 226 (56.5%) were females. 44.5% were with normal BMI followed by overweight (31.5%), and obese (24%). The mean-maximum-peak pressure (MPP) is 509kPa (SD 167) with no significant difference among gender and BMI. Most (38.5%, n=154) of the peak pressure area (PPA) are observed in 1st metatarsal head and big toe region (1MH&T), followed by 2nd metatarsal head (2MH) (34.3%, n=137). In the normal BMI group, 48.3% were in 1MH&T region while in the overweight and obese groups, 42.1% and 43.8%, respectively were in 2MH. This difference is significant (x2(df=8)=36.963, p<0.001). There was no significant difference between PPA and gender. ConClusion: The MPP among Malays in this study was 509kPa(SD 167) and it is not affected by different genders or BMI. The PPA are most commonly fall on 1MH&T. There is a significant shift in the overweight and obese groups to the 2MHT. This finding can be used as initial reference for further studies, in Malaysia particularly.
The Impact of Cognitive Intervention on the Cognition of Adults Over 50 with Mild Cognitive Impairment (MCI) in Asia: A Systematic Review
Get PDFThe cognitive intervention for the ageing population is growing rapidly. This review aimed to explore the impact of cognitive intervention on the cognitive abilities among adults over 50 with mild cognitive impairment (MCI) in Asia. Articles on randomised controlled trials (RCT) studies published between 2010 and December 2020 in PubMed, Science Direct, Web of Science, and Scopus databases were searched. A total of 13 studies were included in this review for further analysis. The results showed that cognitive training can be effective in improving the cognitive function in adults with MCI in various aspects, including memory, attention, executive functioning, reducing subjective memory complaints, and improving daily living skills. The findings indicated that different modalities of cognitive intervention, namely single-domain, multi-domain, and multimodal modalities could be a promising intervention in improving the overall cognitive abilities of adults with MCI in Asia. The single-domain cognitive intervention was influenced by the far transfer effect that improved other untrained cognitive areas. Both multi-domain and multimodal cognitive interventions showed improvement in the global cognitive function and transfer effect on the non-cognitive areas such as daily activities and mood. Future review could explore the impact of intervention duration on cognitive abilities and the transfer effect for each modality to understand the ideal intervention package for adults over 50 with MCI in Asia
Preventive Behaviors among Malaysian Parents towards Hand, Foot, and Mouth Diseases using Health Belief Model
No full textBackground: Hand, foot mouth disease (HFMD)is caused by a virus and commonly affects children five years or below. However, the determinants of the associated factors with preventive behaviour among parents are still lacking. This study aims to assess the range of preventive behaviour towards HFMD among parents in Selangor, Malaysia.
Materials and Methods: A cross-sectional survey was conducted using a three-stage cluster sampling method. The associations between independent variables and preventive behaviours were assessed with multivariate regressions.
Result: In total, 556 parents completed the survey. The majority of the parents had good preventive behaviours towards HFMD. Age, gender, income, perceived susceptibility and the perceived benefit was associated with preventive behaviour.
Conclusion: Although, the preventive behaviour of HFMD among parents is crucial, however, it is influenced by parents own perceptions. The strategies to enhancing the parent’s perception are needed to increase the preventive behaviour towards HFMD infection. 
In Vitro Study on Collagen Application in Wound Healing: A Systematic Review
Get PDFCollagen is key component of extracellular matrix for human and animals. It can be extracted and applied for various field especially in tissue engineering as main component for wound healing. Collagen especially type I collagen is used in skin regeneration process due to its high compatibility with donor site and low antigenicity besides of having suitable properties for wound healing like high cell proliferation and adhesion. However, the usage of collagen alone would not give maximum wound healing since collagen degrades faster, has poor structure for a scaffold and attracts bacteria due to high moisture content. Therefore, to produce a good collagen scaffold, it must be incorporated with functional biomaterials to enhance the characteristic of the collagen and fabricated for a better scaffold structure. The objective of this systematic review is to summarize the relevant literature for in vitro study on collagen application in wound healing by focusing on the source of collagen, biomaterials and fabrication methods used in making collagen scaffold. Three databases were searched; PubMed, Scopus and Science Direct. Keywords used were: collagen, recombinant collagen, collagen scaffold, application and wound healing. A total of 1105 were articles screened but only 50 articles were suitable and were further reviewed. Collagen in wound healing study has versatility in terms of the source of collagen used, the biomaterials combined with the collagen to make an enhanced scaffold, and the fabrication methods to create a desirable structure of collagen scaffold
Community-acquired Covid-19 Cluster among Non-Clinical Staff in a Teaching Hospital, Malaysia
Get PDFA novel coronavirus, COVID-19 is responsible for the current outbreak of pneumonia. As of 16 September 2021, a total of 2,049,750 COVID-19 cases were recorded in Malaysia. In this study, we aimed to describe a cluster of COVID-19 cases among non-clinical staff in a teaching hospital in Kuala Lumpur Malaysia. We obtained epidemiological and clinical data from patients with confirmed COVID-19, via phone interviews and patient medical records. We performed chronological mapping of the cases to identify the possible period, mode of transmission, and cluster pattern. Three laboratory-confirmed COVID-19 cases were identified from the teaching hospital cluster. These three cases were linked epidemiologically to the religious gathering cluster in Malaysia. Seventy-four close contacts consisting of teaching hospital staff were quarantined. The median incubation period was four days (IQR 1-7). The need for intensified surveillance and a high level of alertness is vital to minimise the risk of widespread transmission in Malaysia.
A Review of Dietary Intake during Postpartum Period
Get PDFThe postpartum period is a critical period for maternal and infant health. There is clear evidence showing the short- and long-term health benefits for women to adopt a healthy diet during this period. An unhealthy diet during this period can lead to cardiovascular disease and mental health problem among the mothers. Besides, optimal food consumption during postpartum is crucial to support the additional nutrient requirements for breastfeeding and to reduce postpartum weight retention. Lack of social support and some harmful traditional dietary practices are among the barriers which prevent postpartum women from consuming balanced and nutritious food. Therefore, there is a need for effective nutritional intervention to promote better health for the population. Furthermore, the intervention should be culturally sensitive to respect the local traditional dietary practices for better community acceptance
Understanding the Healthcare Practitioners’ Experience in Managing Women with Postnatal Depression: A Qualitative Study in Malaysia
Get PDFINTRODUCTION: Postnatal depression is largely underdiagnosed in many low-and middle-income countries, including Malaysia. Healthcare practitioners’ perceptions towards postnatal depression were identified as one of the main barriers to seeking help. Objective: This study aimed to explore the perceptions of healthcare practitioners about postnatal depression, and their experience in managing women with postnatal depression in Malaysia. Materials and methods: Eighteen healthcare practitioners (5 head nurses, 9 nurses, and 4 doctors) working in maternal and child health clinics and a female psychiatric ward in Kuala Lumpur were individually interviewed following a generic qualitative research design. Interview data were transcribed verbatim, and the transcripts were analyzed using framework analysis. Results: Healthcare practitioners reported that their management of women with postnatal depression was limited by the absence of a specific screening tool, and presence of stigma associated with postnatal depression. Discussion and conclusion: Healthcare practitioners were found to be aware of poor maternal mental health provision within their clinical setting and are ready to contribute to developing protocols to improve maternal mental health. As its diagnosis and treatments vary from general depression, there should be a specific direction addressed in the policy to assist in actions for managing postnatal depression. Professional training and continuous education on postnatal depression are a fundamental component in fostering quality of care, and public awareness as well as improving stigma within the Malaysian healthcare system.