IIUM Medical Journal Malaysia (IMJM)
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The Development and Content Validation of a Needs Assessment Questionnaire for Visual Attributes Profiling in Students with Visual Impairment
Full text linkINTRODUCTION: Conducting a needs assessment is imperative to identify gaps in the current data management practices for visually impaired students. This study aims to evaluate the content validity of a needs assessment questionnaire, a critical precursor to developing a systematic visual attributes profile for this student population. By validating the questionnaire, the challenges and needs of visually impaired students can be accurately identified, enabling targeted interventions and informed policy decisions in special education. Ensuring the precision of the questionnaire establishes a foundation for understanding and addressing these students' needs, ultimately contributing to more effective educational environments. MATERIALS AND METHODS: The instrument underwent two phases, i.e. item development and a comprehensive assessment of item validity by six experts. The experts evaluated the instrument’s relevance and comprehensibility using a four-point Likert scale. Microsoft Excel facilitated the analysis of the Content Validity Index (CVI), Content Validity Ratio (CVR), and modified kappa (K) statistics. RESULTS: The item content validity index (I-CVI) ranged from 0.83-1, with a Scale-level Content Validity Index (S-CVI/Ave) of 0.97, indicating acceptability. The Content Validity Ratios (CVR) for most items surpassed 0.7, indicating strong agreement among experts on their relevance with the interpretation of the K analysis of 70% excellent. However, three items in the second and third domains required revision and clarity enhancement. CONCLUSION: The content validity analysis showed that all items in the questionnaire were deemed appropriate. This suggests that the questionnaire is suitable for assessing the need to develop a systematic visual attribute profiling for students with visual impairment
Effectiveness of Defocus Incorporated Multiple Segments (DIMS) Lens in Slowing Myopia Progression among Malay Schoolchildren
Full text linkINTRODUCTION: Defocus Incorporated Multiple Segments (DIMS) lens imposes simultaneous myopic defocus for myopia control and has been proven to be effective in controlling myopia progression in children. However, the effectiveness of the DIMS lens may vary between different ethnicity due to different retinal profiles among children. This study aims to determine the effectiveness of DIMS lens in controlling myopia progression among myopic Malay schoolchildren. MATERIALS AND METHODS: This is a randomized control trial and was conducted as a single-site study where forty-two myopic Malay schoolchildren, (mean age of 9.53±1.50 years old) were recruited. The effectiveness of the DIMS lens was measured via changes in spherical equivalent refraction and axial length elongation for 12 months, and findings were compared with children wearing single vision (SV) lens. Data was analysed using repeated analysis of variance (ANOVA), between-within with Bonferroni correction, and p<0.05 indicated a significant difference. RESULTS: After 12 months, 38 subjects completed the study, with 20 subjects in the DIMS group and 18 subjects in the SV group. The DIMS group showed a significantly lower myopia progression; with 0.07±0.10mm increment in axial length elongation and -0.16±0.30D in spherical equivalent refraction increment compared to the SV group. The main effect comparing the changes in axial length elongation and spherical equivalent refraction increment between the DIMS group and the SV group was significant, (F=7.61, p <0.05) and (F=3.23, p<0.05), respectively. CONCLUSIONS: Full time wear of the DIMS lens is significantly effective in slowing myopia progression compared to SV lens in myopic Malay schoolchildren
Factors Related to Parental Perceptions and Awareness of Adolescent Cyberbullying in Selangor, Malaysia
Full text linkINTRODUCTION: The rise of digital technology has heightened concerns about adolescent cyberbullying, emphasizing the importance of parental perceptions and awareness. This study assessed parental perceptions and awareness of adolescent cyberbullying and identified associated factors among secondary school parents in Selangor, Malaysia. MATERIALS AND METHODS: A cross-sectional study was conducted from June-September 2023 involving 522 parents, selected through multistage cluster sampling. Data were collected using the validated 33-item Parental Perception and Awareness of Cyberbullying Questionnaire (KEPS-I). Multiple linear regression analyses identified associated factors. RESULTS: The overall mean score for parental perceptions and awareness was 3.96 (SD=0.44). Parents demonstrated the highest awareness in cyberbullying prevention strategies but scored lowest in knowledge of internet and social media platforms. Younger parents exhibited greater awareness, likely due to their familiarity with digital technology (adjusted b=-0.475, P<0.001). Parents who used the internet daily were also more aware (adjusted b=5.670, P=0.041), while non Bumiputera parents showed lower scores, reflecting gaps in digital literacy or access to information (adjusted b=-3.035, P=0.037). Only 2.5% of parents reported their child’s experience with cyberbullying, indicating possible underreporting. CONCLUSION: Gaps in digital literacy, particularly among older and non-Bumiputera parents, highlight the need for targeted educational initiatives and school policies to improve parental awareness and intervention strategies. Future research should evaluate digital literacy programs and explore adolescent perspectives to better address underreporting and strengthen prevention efforts
Panax Ginseng for Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis
Full text linkINTRODUCTION: Panax ginseng is a traditional Chinese medicine used for chronic obstructive pulmonary disease (COPD). The study assessed Panax ginseng's advantages for patients with COPD. MATERIAL AND METHOD: PRISMA guidelines were used based on the PICOS model. A systematic search of PubMed/Medline and the Cochrane Library was conducted till March 2022. I2 statistic and random effects model was employed to assess heterogeneity, and GRADE assessment was used to evaluate the quality of outcomes. RESULTS: Four trials involving 469 participants were included. Panax ginseng had no significant effects in reducing the frequency of COPD exacerbations (p=0.08) or improve FEV1 (p=0.22), FEV1 (p=0.28), FVC (p=0.20), FVC (p=0.79), and FEV1/FVC ratio (p=0.06) as compared to the placebo. No effects on the mental health-related quality of life (p=0.94), physical health-related quality of life (p=0.92), and respiratory health-related quality of life (p=0.29) were observed. The severity of COPD (p=0.64) was also not affected. Adverse effects documented by Panax ginseng, including insomnia (p=0.15), epistaxis (p=0.69), respiratory tract infection (p=0.83), and white blood cells (p=0.33), were insignificant compared with placebo. CONCLUSIONS: There is low to moderate certainty of evidence that Panax ginseng improves exacerbation or lung functions in COPD patients. Thus, more high[1]quality double-blind RCTs are required to establish its clinical effectiveness, and at present, Panax ginseng should not be considered a substitute for conventional COPD treatment
Prevalence of Chronic Kidney Disease and Its Associated Factors among Type-2 Diabetes Mellitus Patients at Kuantan Primary Health Clinics
Full text linkINTRODUCTION: Chronic kidney disease (CKD) in type-2 diabetes mellitus (T2DM) patients leads to end-stage renal failure and cardiovascular complications. This study aims to determine the prevalence of CKD and its associated factors at primary health clinics in Kuantan. MATERIALS AND METHODS: 304 T2DM patients’ records aged 18 years and above were retrospectively selected by systematic random sampling in four health clinics, analyzed using descriptive statistics and multiple logistic regression. CKD is defined as positive proteinuria, or microalbuminuria in at least two of three consecutive urine specimens or calculated eGFR <60ml/min/1.73 m2 for more than three months. RESULTS: The mean age was 59.1 +8.89 years, 69.1% (n=210) Malay and 57.6% (n=175) females. The prevalence of CKD among T2DM was 55.3% (n=168) (95% CI=54.8 to 55.9%). Out of 168 T2DM with CKD, 87.5% (n=147) had diabetes for ≥ five years, 90.5% (n=152) had at least two comorbidities, and 54.2% (n=91) were on insulin. Glycaemic(HbA1c<7%) and blood pressure(<130/80) among T2DM with CKD achieved targets were 28% (n=64) and 38.1% (n=47) respectively. Multivariable analysis showed higher odds of having CKD among T2DM with poor blood pressure (AOR=2.634, p-value=0.001) and glycaemic control (AOR=4.178, pvalue=<0.001) compared to those with good control and among those with retinopathy (mild NPDR AOR=7.472, p-value=<0.001; moderate NPDR AOR=13.594, p-value=<0.001) compared to no retinopathy. CONCLUSION: CKD present in half of T2DM. It's associated with poor blood pressure, glycaemic control and retinopathy. Early detection of retinopathy and CKD, and aggressive diabetic intervention are vital to curbing CKD progression
The Modification and Validation of the Medication Compliance Questionnaire (MCQ) for the Assessment of Adherence to Antiretroviral Therapy (ART)
Full text linkINTRODUCTION: Anti-retroviral therapy (ART) significantly improves the prognosis of human immunodeficiency virus (HIV) infection. Yet long-term and complex regimens often lead to non-adherence. Maintaining at least 95% adherence is crucial for effective ART and thus preventing drug resistance. The Medication Compliance Questionnaire (MCQ) has been used for adherence assessment in antihypertensive treatment, with an 80% cut-off level. This study aimed to modify and validate the MCQ for assessing adherence to ART. MATERIALS AND METHODS: The MCQ underwent modification with the incorporation of a new rating scale and scoring method. A pilot study was conducted at the Infectious Disease Clinic, Hospital Raja Perempuan Zainab II, Kelantan. Inclusion criteria were adults living with HIV (PLHIV), on ART for at least two months and who can communicate in Malay. Fisher’s Exact test was used to determine validity, sensitivity, and specificity. Cronbach's alpha and intra-class correlation coefficients were used to evaluate reliability, with significance set at p <0.05. RESULTS: A total of 60 PLHIV adults participated in this pilot study. Viral load served as the validity criterion for the modified MCQ, showing a significant association with adherence (p=0.018). Sensitivity and specificity values were 100.0% and 79.5%, respectively. Cronbach’s alpha coefficients for drug-taking and drug-stopping behaviour domains were 0.65 and 0.90, respectively. CONCLUSION: The modified MCQ is a valid and reliable tool for assessing adherence to ART, demonstrating high sensitivity and adequate specificity. It is suitable for use in clinical practice to improve medication therapy management for PLHI
Aspergillus ochraceus: A Rare Cause of Paranasal Fungal Ball
Full text linkInfection of paranasal sinuses is not uncommon. Fungal ball of the paranasal sinuses is a non-invasive form of paranasal sinus infection that has been documented to be more frequently caused by Aspergillus fumigatus than by other Aspergillus species and typically affects immunocompetent individuals more than those who are immunocompromised. Here, we report the first case of Aspergillus ochraceus (A. ochraceus) in an immunocompromised patient with post-trauma maxillary implant who presented with transient ischemic attack and incidental findings of fungal ball within the right maxillary sinus from the Computed Tomography (CT) scan. A. ochraceus is a species under the Aspergillus section Circumdati, a widely distributed fungus which is pathogenic to humans that can lead to various clinical implications. A. ochraceus was detected from paranasal tissue sent for culture. The laboratory culture findings were further supported by histopathological evidence of fungal hyphae and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF) identification
Cervical Intramedullary Cavernous Haemangioma: A Rare Cause of Acute Hemiparesis
Full text linkThis case report describes a 45-year-old female who presented with acute hemiparesis and was initially diagnosed with acute ischemic stroke. Subsequent evaluation of her non-contrast computed tomography (NCCT) brain revealed a lesion in her spinal cord, which was further identified as intramedullary mass on cervical spine magnetic resonance imaging (MRI). This case underscores the importance of differential diagnosis in patients presented with acute hemiparesis, comprehensive assessment of NCCT scan, and the crucial role of MRI in diagnosing spinal cord lesions. Surgical intervention, involving laminectomy and excision of the lesion, was essential and resulted in significant postoperative improvement, highlighting the pivotal role of surgery in managing such conditions.
Mapping the Landscape: Malaysian Muslim Women's Insights on Human Milk Banking Through the Islamic Lens
Full text linkINTRODUCTION: Donated human milk in human milk bank (HMB) is healthier for preterm babies compared to formula milk. In 2022, Halimatussaadiah milk bank was established in Pahang, Malaysia. The objective of this study was to determine the knowledge, attitudes, and behaviours of Malaysian Muslim mothers towards HMB and its Islamic perspectives. MATERIALS AND METHODS: From July 2021 to January 2023, a Pahang state multicentred cross-sectional study was carried out at Sultan Ahmad Shah Medical Centre, Hospital Tengku Ampuan Afzan, and Hospital Sultan Haji Ahmad Shah. 793 Muslim Malaysian women who had delivered and breastfed at least one child before, completed validated self-administered Google Form questionnaires, encompassing knowledge, attitude, and behaviour towards HMB. RESULTS: The participants, averaging 32.67 years old, were mostly well-educated with an average of 2 children and a monthly household income of approximately MYR 4,500.00. 62.3% recognized HMB as a crucial element for the wellbeing of premature infants. Strong support for Shariah-compliant HMB was evident, with 64.3% advocating for donor-recipient identity disclosure. 34.9% were open to their babies receiving milk from multiple donors, although opinions were divided on accepting milk from non-Muslim women in life-threatening situations, and their willingness to donate breastmilk, both to known and unknown babies. Out of 793 women, only 1.3% had donated their breast milk to HMB. Yet, 45.6% were willing to volunteer and give their milk to a Shariah compliant HMB. CONCLUSION: Generally, Malaysian Muslim women in Pahang showed a strong acceptance to the establishment of HMB provided that religious concerns were appropriately addressed