IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
Peptoniphilus asaccharolyticus Septic Abortion Precipitating Cerebral Venous Thrombosis
Get PDFPeptoniphilus, a Gram-positive anaerobic coccus, is an opportunistic bacterium in the human microbiota. Obstetrics-associated Peptoniphilus asaccharolyticus infections are rarely reported, with only four reported cases, all patients recovered without complications. We describe a P. asaccharolyticus septic abortion at 8 weeks of gestation, complicated with cerebral venous thrombosis (CVT) and septic ileus. A 33 year-old Indonesian lady who is 8 weeks pregnant presented with sudden right-sided body weakness, with heavy vaginal bleeding and fever. She had attempted a self-induced abortion using over-the-counter medication prior to symptom onset. She was pale and septic. Besides evacuation of conception products, the patient was hospitalized for parenteral antibiotics therapy. Brain CT angiography revealed CVT. Anaerobic blood culture grew P. asaccharolyticus, identified via MALDI-TOF mass spectrometry. Her admission was complicated with septic ileus. Following eight days of antibiotics treatment, she requested a transfer to her hometown hospital for care continuation. P. asaccharolyticus is a disastrous organism to complicate septic abortions. Early clinical suspicion and prompt initiation of effective antibiotics are critical
Addressing Mental Health Challenges: A Community Based Survey on Depression, OCD, Eating Disorders, and Psychosis Risk Among 18-44-year-olds in India
No full textINTRODUCTION: Mental health is a complex issue with high prevalence but poor health facilities and health-seeking behaviour. The age group of 18-44 year-olds is socioeconomically crucial, however, their mental health is largely neglected. This research was conducted to study mental health problems among the 18–44-year-old age group. MATERIALS AND METHODS: This cross-sectional study was conducted among 1700 participants, aged 18-44 years old, from the urban and rural areas of Sangli district (Maharashtra state), India, using stratified random sampling. All ethical considerations were adhered to during data collection. Pre-validated tools namely, WHO-5 Well-Being Index, OCI-R, CAPE, etc., were used in data collection interviews. Statistical analysis was done using frequency (%) and the chi-squared test. RESULTS: The highest number of participants were positive for symptoms of obsessive-compulsive disorder (OCD) (n=336, 19.8%), followed by depression (n=326,19.2%), a high risk of psychosis (n=164, 9.6%) and an eating disorder (n=144, 8.5%). The area of residence (urban/rural) was associated with these mental illnesses. Depression was not significantly associated with any socio-demographic factors. OCD was significantly higher in participants from rural area, females, illiterates, and belonging to socioeconomic class III. Eating disorders were associated with rural areas, widowed status, and illiteracy. Psychosis risk was significantly higher in males, rural areas, joint families, and widower status. CONCLUSIONS: A very high proportion of 18-44-year-olds suffer or are at risk of various mental health conditions, requiring the development of targeted preventive and curative services. Rural areas should receive sufficient attention regarding mental health services
Intestinal Barrier Integrity: The Essential Role of Neuropeptides and Their Implications in the Pathogenesis of Gastrointestinal Diseases:
Get PDFThe intestinal barrier relies on tight junctions and proteins including claudins, occludins, and zonula occludens, helping to seal the epithelial cell gaps and hence controlling permeability. When tight junctions are disrupted, intestinal permeability increases, a condition recognised as "leaky gut." This condition is linked to gastrointestinal (GI) disorders including inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). Neuropeptides are crucial in modulating the tight junctions’ integrity within the GI epithelial barrier. This review focuses on neuropeptide Y, vasoactive intestinal peptide, cholecystokinin, and substance P in regulating intestinal barrier integrity. Studies included in this narrative review were selected based on their relevance to the topic, identified through searches in databases such as Google Scholar, PubMed, and Mendeley using relevant keywords. Understanding the mechanisms of these neuropeptides may provide pathophysiological insights and potential treatment strategies for restoring intestinal barrier integrity in GI disorders
New Insights on Dietary Assessment Recommender System For Pre-University Adolescents
Get PDFINTRODUCTION: An individual's health status will be influenced by their nutritional status, which is mainly based on their eating habits. Adolescence is an essential phase for growth and development that will be influenced by healthy eating habits. In view of this, a dietary recommender system to understand and improve dietary habits is crucial. In this study, the dietary recommender system, consisting of meal routines, food preferences, and dietary practices of pre-university adolescents, will be presented. MATERIALS AND METHODS: This study was conducted at a pre-university centre, involving a sample of 125 students. A self-administered structured questionnaire was used to collect demographic data, daily meal routines, food intake frequency, and dietary behaviour patterns. Two weeks before completing the questionnaire, the students were instructed to monitor their dietary practices. RESULTS: The food intake frequency survey was divided into two categories: food intake less than three times a week (< three times/week) and three times a week or more (≥ three times/week). The results showed that cereal consumption was most frequent at 87.2% for food intake < three times/week, while meat consumption was highest for food intake ≥ three times/week (84.8%). Almost 81% of students reported snacking between meals, with the majority snacking less than twice daily (60.8%). Females showed a higher tendency to snack. In terms of dietary behaviour patterns, there were significant differences between genders in terms of overeating and unbalanced food intake. The four primary dietary behaviour patterns were found to be positively correlated with each other. The correlation study results indicated positive relationships between dietary behaviour patterns and body mass index (BMI), except for a negative relationship between high fat/high calorie diet and BMI. CONCLUSION: Multiple regression analysis suggested that overeating, having a high fat/high calorie diet, unbalanced food intake, and dietary impulses collectively explains variations in BMI
The Malay Version of the Theory of Planned Behaviour Questionnaire on the Intention of Pre-Pregnancy Care Services Utilisation: A Validation Study
Get PDFINTRODUCTION: This study aims to translate and adapt the Theory of Planned Behaviour questionnaire on intention of pre-pregnancy care services utilisation (IPCSU) from English to Malay and determine its validity and reliability. MATERIALS AND METHODS: This was a cross-sectional validation study conducted at UiTM Shah Alam, Selangor, Malaysia from October to December 2022 among 145 unmarried female undergraduate students aged 18 to 25 years who could speak and understand written Malay. Participants were excluded if they were currently pregnant or had been pregnant in the past. Convenience sampling was employed for participant selection. The English version of the 25-item IPCSU questionnaire was subjected to translation, adaptation, content validation, and face validation, ; followed by field testing to create the Malay version. Psychometric analysis was performed using exploratory factor analysis, internal consistency, and test-retest reliability. RESULTS: A total of 145 participants (91% response rate) were recruited, with 89.7% being Malay and a mean age of 21.7 years (±SD 1.6). The scale-level content validity index/average (0.98) and scale-level face validity index/average (0.88) were acceptable. Exploratory factor analysis found that the Malay version of IPCSU had four conceptually equivalent domains, with four items removed due to a low inter-item correlation matrix. The construct validity achieved an acceptable factor loading for each construct (0.47 to 0.80). The overall Cronbach's alpha was 0.95, indicating excellent internal consistency, and the intraclass-correlation coefficient values ranged from 0.46 to 0.86, indicating moderate to excellent reproducibility. CONCLUSION: The Malay version of the IPCSU questionnaire is valid, reliable, and stable over time
The Effects of Mindfulness-Based Cognitive Therapy in Multicultural Settings: A Scoping Review
Get PDFMindfulness-Based Cognitive Therapy (MBCT) is an experiential group intervention adapted from Buddhist meditational practice aimed at treating recurrent depression. Our scoping review explored the MBCT effectiveness in multicultural settings and whether any adaptations were made to enhance it. By using Arksey and O’Malley's framework, our review examined randomized controlled trials (RCTs) published between 2010 and 2023, focusing solely on studies from non-English speaking countries. Out of 1461 published RCT, only 15 of them met our study criteria and they were mainly from China, Denmark, Germany, Hong Kong, Iran, Netherlands, and Switzerland. Out of 15 selected RCT publications, 10 studies shown that MBCT significantly improved symptom-based measures (e.g., Beck Depression Inventory-II), one study shown little difference between MBCT compared to Cognitive Behavioural Therapy (CBT), and four studies shown that comparative treatments were more effective than MBCT, in which two of them were culturally specific interventions, Traditional Yoga and Qigong. Two studies found MBCT effective when combined with Mindfulness-Based Stress Reduction (MBSR) and Loving-kindness meditation. Common themes including (1) reduction in psychological distress across all studies, (2) trials used small sample sizes, and (3) the feasibility of using MBCT in multicultural settings, with cultural interventions showing greater effectiveness. MBCT interventions reported promising results when used in a multicultural setting, with a potential for culturally integrated intervention. Our results conclude an opportunity for future research to embed psycho-spirituality with MBCT
Challenges in Providing Spiritual Care among Healthcare Workers: A Qualitative Study
Get PDFINTRODUCTION: Spiritual care has been identified as an integral component of holistic, culturally competent, and empathetic care. Although spiritual care offers tremendous benefits for patients, it can be challenging to implement. Despite its importance, there is a lack of literature in Malaysia on the challenges that healthcare workers encounter in providing spiritual care. Therefore, this study aimed to explore healthcare workers’ challenges in providing spiritual care to the hospitalised patients. MATERIALS AND METHODS: A qualitative study was conducted among healthcare workers at one hospital in Malaysia. A semi-structured interview was used to collect data from May 2023 until November 2023. All interviews were meticulously recorded, transcribed, and analysed using thematic analysis. RESULTS: Ten participants with diverse backgrounds willingly participated in the study. Analysis reveals a few challenges in providing spiritual care among healthcare workers such as time constraints, lack of knowledge, experience shortfalls, doubts about the efficacy of spiritual care, awareness deficiency among staff, and impact of patients’ conditions. CONCLUSION: Healthcare workers are unable to fulfil patients' spiritual care for a variety of reasons. These findings have important implications for healthcare settings, highlighting the need for ongoing awareness and training in spiritual care competencies for healthcare workers
A Follow Up Study on Lung Cancer Survival in the State Hospital in East Coast State of Pahang
Get PDFINTRODUCTION: There is lack of data of lung cancer survival in Malaysia. MATERIAL AND METHODS: This study was to determine the survival of lung cancer patients and factors affecting the survival in Kuantan, Pahang. A total of 170 lung cancer patients confirmed by histology from 1st January 2014 to 31 December 2017 were recruited in the study. Their demographic data, ECOG performance status, staging and treatment were recorded. Survival time was defined in weeks from the date of histological diagnosis made to the date of death of the patients. Kaplan-Meier curve was used to determine the median overall survival and log-rank test was used to test the survival differences between each subgroup. Multivariate analysis using COX regression was used to determine factors affecting its survival. RESULTS: The median age of the 170 patients was 63 years old, majority were males (74%) and smokers (64%). Adenocarcinoma (74.7%) was the most common histology followed by squamous cell carcinoma (18.8%). Almost all patient presented at the clinic at stage 3 or 4 (98%) but majority had ECOG 0-2 (64.3%). Median overall survival was 28.7 weeks. In the multivariate analysis, “supportive treatment” and “poor ECOG performance status” were independent predictors of death with the hazard ratio of 1.4 (95%CI 1.17 to 1.66) and 3.0 (95%CI 2.05 to 4.39) times respectively. CONCLUSION: Majority of lung cancer patients in Pahang presented with advanced disease with overall median survival of 28.7 weeks. Patients treated with supportive care and poor ECOG performance status were the two independent poor prognostic factors for survival