Prevalence and management of menopausal symptoms in malaysian women during peri and post menopause

Women upon reaching menopause often silently suffer debilitating physical and psychological symptoms. The peri and postmenopausal period constitutes a challenging transition time for women’s health, and good menopausal health is a crucial aspect in healthy and successful aging. These situations affects women globally however Malaysian women are mostly unaware how to manage onset of menopause. This study aims to systematically review published data for the prevalence and management of menopausal symptoms in Malaysian women. Findings indicated that Malaysia women experienced similar menopausal symptoms as other women globally. However, these studies indicated that Malaysian women lack the knowledge to manage and prepare for menopause. The menopausal transition demarks dramatic changes at the hormonal, physiological, and metabolic level. Eventually, our study will develop an online tool to provide information and manage menopausal symptom

CMPH eBulletin - Issue no 5 (July 2018) eISSN 2636-9729

This is an eBulletin produced by the Department of Community Medicine and Public Health of the Faculty of Medicine and Health Sciences. It contains articles, researches write up, opinion pieces related to public health from members and students of the department

Policy Implementation Analysis of District Health System to Improve Health Services: Study in North Central Timor Regency, East Nusa Tenggara Timur Province, Indonesis

Context: Improving degree of public health in a region requires quality health services. For this reason, district health system has been formed which can be implemented comprehensively to the target community. A study is needed to find out the factors that influence policy implementation so that quality of health services can be improved. This study used quantitative method with structural equation models to find patterns of the relationship between the district health system and health services. The results showed that there are 7 indicators that are part of the district health system factors, 2 indicators that are part of the resposivensss factor, 8 indicators that are part of the policy implementation factor, and 3 indicators that are part of the health service factor. These indicators have loading factor ≥ 0.5. The district health system consisting of 7 subsystems if properly implemented will have a positive impact on health services by 1.98. Contribution of policy implementation in improving health services will be great if the district health system is implemented together with responsiveness, so that the total effect becomes 2.20

Safety and efficacy of basal bolus and premixed insulin intensification regimes in the management of type 2 diabetes mellitus : A 13 year narrative review of literature

Background: Type 2 Diabetes Mellitus (T2DM) is a chronic condition due to insulin resistance or relative insulin deficiency. Although insulin intensification regimens are commonly prescribed for the management of T2DM, there is uncertainty regarding their optimal use. We conducted a 13 Year narrative review to compare outcomes of these regimens in the treatment of T2DM. Method: We searched electronic databases (PubMed, Scopus, Proquest and Google Search), and “grey literature” from January 2000 to December 2013 to identify studies comparing insulin intensification regimens. Results: Out of 17 studies identified, we only included 10 studies specifically comparing Basal-Bolus regimens (BB) versus Pre-mixed Insulin Regimens (PM). Seven trials comparing regimens other than the studied regimens; with study duration lesser than 12 weeks; or involving Type 1 diabetes mellitus patients were excluded. The outcomes measured were divided into safety and efficacy parameters. Among the safety outcomes measured were Hypoglycemia, Weight Gain, Quality of Life (QoL), and other Adverse Events (AE). Whereas, efficacy outcomes measured were Glycosylated Haemoglobin (HbA1c), Fasting Plasma Glucose, Daily Plasma Glucose, Post Prandial Plasma Glucose, Carotid Intima Media Thickness (IMT), Adinopectin Level, 1-5-anhydroglucitol(1,5-AG),Total Daily Insulin (TDI) Dose and Cost. Mixed results were discovered among all the parameters measured favoring in between BB and PM regimens. Conclusion: We found that BB regimens showed better glycemic control especially in terms of the primary endpoint of HbAlc but at the expanse of significantly higher TDI dose, weight gain, and further increase in cost of treatment. Whereas, all other parameters measured were comparable between regimens. Locally, conventional human insulin is still the mainstay of insulin therapy in health facilities nationwide. Yet, none of the identified studies compared head-to-head human insulin in both arms. Thus, future researches comparing non-analogue insulin may be conducted to gather new evidence in the field of diabetes locally