Assessment of menopausal symptoms using modified Menopause Rating Scale (MRS) among middle age women in Kuching, Sarawak, Malaysia

<p>Abstract</p> <p>Background</p> <p>Menopausal symptoms can be assessed by several tools, and can be influenced by various socio-demographic factors.</p> <p>Objectives</p> <p>To determine the commonly reported menopausal symptoms among Sarawakian women using a modified Menopause Rating Scale (MRS).</p> <p>Methods</p> <p>By using modified MRS questionnaire, 356 Sarawakian women aged 40-65 years were interview to document of 11 symptoms (divided into somatic, psychological and urogenital domain) commonly associated with menopause.</p> <p>Results</p> <p>The mean age of menopause was 51.3 years (range 47 - 56 years). The most prevalent symptoms reported were joint and muscular discomfort (80.1%); physical and mental exhaustion (67.1%); and sleeping problems (52.2%). Followed by symptoms of hot flushes and sweating (41.6%); irritability (37.9%); dryness of vagina (37.9%); anxiety (36.5%); depressive mood (32.6%). Other complaints noted were sexual problem (30.9%); bladder problem (13.8%) and heart discomfort (18.3%). Perimenopausal women (n = 141) experienced higher prevalence of somatic and psychological symptoms compared to premenopausal (n = 82) and postmenopausal (n = 133) women. However urogenital symptoms mostly occur in the postmenopausal group of women.</p> <p>Conclusions</p> <p>The prevalence of menopausal symptoms using modified MRS in this study correspond to other studies on Asian women however the prevalence of classical menopausal symptoms of hot flushes, sweating was lower compared to studies on Caucasian women.</p

Interesterified palm olein (IEPalm) and interesterified stearic acid-rich fat blend (IEStear) have no adverse effects on insulin resistance: a randomized control trial

Chemically-interesterified (CIE) fats are trans-fat free and are increasingly being used as an alternative to hydrogenated oils for food manufacturing industries to optimize their products’ characteristics and nutrient compositions. The metabolic effects of CIE fats on insulin activity, lipids, and adiposity in humans are not well established. We investigated the effects of CIE fats rich in palmitic (C16:0, IEPalm) and stearic (C18:0, IEStear) acids on insulin resistance, serum lipids, apolipoprotein concentrations, and adiposity, using C16:0-rich natural palm olein (NatPO) as the control. We designed a parallel, double-blind clinical trial. Three test fats were used to prepare daily snacks for consumption with a standard background diet over a period of 8 weeks by three groups of a total of 85 healthy, overweight adult volunteers. We measured the outcome variables at weeks 0, 6, and at the endpoint of 8. After 8 weeks, there was no significant difference in surrogate biomarkers of insulin resistance in any of the IE fat diets (IEPalm and IEStear) compared to the NatPO diet. The change in serum triacylglycerol concentrations was significantly lower with the IEStear diet, and the changes in serum leptin and body fat percentages were significantly lower in the NatPO-diet compared to the IEPalm diet. We conclude that diets containing C16:0 and C18:0-rich CIE fats do not affect markers of insulin resistance compared to a natural C16:0-rich fat (NatPO) diet. Higher amounts of saturated fatty acids (SFAs) and longer chain SFAs situated at the sn-1,3 position of the triacylglycerol (TAG) backbones resulted in less weight gain and lower changes in body fat percentage and leptin concentration to those observed in NatPO and IEStear

May Measurement Month 2017 blood pressure screening: findings from Malaysia—South-East Asia and Australasia

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. However there are still many individuals, particularly in many countries in Asia, who have poor BP control. In Malaysia, less than two-fifths have achieved BP control. We participated in BP screening in Malaysia in conjunc- tion with the May Measurement Month 2017 (MMM17), a global initiative by the International Society of Hypertension (ISH) aimed at screening more individuals for earlier detection of hypertension. A nationwide screening of adults aged 18 was carried out through health campaigns at clinics, hospitals, during family day events, and charity runs from 1 April 2017 to 31 May 2017 in 42 centres. We used the detailed protocol provided by ISH for data collection. A total of 4116 individuals were screened during MMM17. After multiple imputation, 32.4% (n1⁄41317/4059) had hypertension. Out of this, 63.9% (842/1317) of those with hypertension were on treatment. Of individuals receiving antihypertensive medication with an imputed BP, 59.5% (n1⁄4496/834) of them had controlled BP. MMM17 was the largest organized BP screening campaign undertaken by health profes- sionals in Malaysia. This study identified that 32.4% of screened individuals had hypertension and 59.5% individu- als with treated hypertension had achieved BP control

Prevalence of white coat hypertension in adult primary care attenders

BackgroundWhite coat hypertension (WCH) is common but such data is lacking in Malaysia. AimsTo determine the prevalence of WCH and its associated factors among healthy adults in the Malaysian primary care setting. Methods This was a cross-sectional study conducted from January to June 2014 in 5 primary care clinics in Negeri Sembilan, Malaysia. Previously healthy adult who found to have persistently elevated BP fulfilling all the inclusion and exclusion criteria of our study at clinic were recruited. The validated BP set Omron HEM7200 was used for home BP monitoring in making the diagnosis of WCH. Patients were guided to do home BP monitoring. Results A total of 105 subjects completed the study, with a response rate of 92.1 per cent. The prevalence of WCH among Malaysian primary care attenders was 52.4 per cent. There was no correlation found between WCH and socio-demographic variables. ConclusionMore WCH studies using ambulatory blood pressure monitoring with larger sample size are needed for Malaysian primary care setting. Accurate diagnosis of hypertension could have saved money on the unnecessary anti-hypertensive agents

Dysmenorrhoea and its Effects on School Activities Among Adolescent Girls in a Rural School in Selangor, Malaysia

ABSTRAK Objektif kajian ini adalah untuk menentukan prevalens senggugut dan kesannya terhadap aktiviti sekolah di kalangan remaja perempuan di sebuah sekolah menengah luar bandar di Daerah Hulu Langat, Selangor. Kajian rentas telah dijalankan di sebuah sekolah kerajaan. Responden kajian dipilih melalui kaedah persampelan rawak stratum dan terdiri daripada pelajar-pelajar Tingkatan 1 hingga 5. Mereka diberi borang soal-selidik yang mengandungi 20 soalan mengenai haid dan sosio-demografi. Tahap kesakitan senggugut diukur menggunakan skala numerikal. Seramai 300 pelajar terpilih untuk kajian ini dan prevalens senggugut dikalangan mereka ialah 62.3%. Penyakit senggugut mempunyai kaitan yang bermakna dengan kumpulan remaja pertengahan umur (15-17 tahun) (p=0.007), mereka yang mempunyai kitaran haid yang tetap (p=0.007) dan mempunyai sejarah keluarga yang positif (p=0.0001), tetapi tidak dengan umur bermulanya haid dan jangkamasa haid. Tahap kesakitan senggugut yang lebih tinggi pada seseorang pelajar mempengaruhi kadar keciciran sekolah (p=0.0005), daya tumpuan di dalam kelas (p=0.0005) dan penglibatan dalam sukan (p=0.008). Kajian ini menunjukkan prevalens yang tinggi di kalangan remaja perempuan dan memberi kesan negatif terhadap aktiviti sekolah mereka. Kata kunci : senggugut, remaja perempuan, sekolah luar bandar, aktiviti sekolah ABSTRACT The objective of this study is to determine the prevalence of dysmenorrhoea, its associated factors and its effects on school activities among adolescent girls in a secondary school in a rural district of Selangor, Malaysia. This is a cross-sectional study conducted in a public secondary school. A stratified random sampling of 300 female students (12 to 17 years old) from Form one to Form five classes were selected. A self-administered questionnaire consisting of 20-items was used to collect sociodemographic and menstrual data. Pain intensity for dysmenorrhoea was measured by numerical rating scale. The prevalence of dysmenorrhoea was 62.3%. It was significantly higher in the middle adolescence (15 to 17 years old) age group (p=0.003), girls with regular menstrual cycle (p=0.007) and a positive &amp; Health 2007; 2(1): 42-47 family history (p&lt;0.05). There was no significant association with mean age of menarche and duration of menstruation. The number of school and class absences increased with increasing severity of dysmenorrhoea (p&lt;0.05). The mean pain score was significantly higher in girls who reported to be unable to participate in sports (p=0.008) and with poor concentration in class (p&lt;0.05). Dysmenorrhoea among the adolescent girls was common in this rural school. It had significant negative impact in their school performance and activities

What does the multiple mini interview have to offer over the panel interview?

Introduction: This paper compares the panel interview (PI) performance with the multiple mini interview (MMI) performance and indication of behavioural concerns of a sample of medical school applicants. The acceptability of the MMI was also assessed. Materials and methods: All applicants shortlisted for a PI were invited to an MMI. Applicants attended a 30-min PI with two faculty interviewers followed by an MMI consisting of ten 8-min stations. Applicants were assessed on their performance at each MMI station by one faculty. The interviewer also indicated if they perceived the applicant to be a concern. Finally, applicants completed an acceptability questionnaire. Results: From the analysis of 133 (75.1%) completed MMI scoresheets, the MMI scores correlated statistically significantly with the PI scores (r=0.438, p=0.001). Both were not statistically associated with sex, age, race, or pre-university academic ability to any significance. Applicants assessed as a concern at two or more stations performed statistically significantly less well at the MMI when compared with those who were assessed as a concern at one station or none at all. However, there was no association with PI performance. Acceptability scores were generally high, and comparison of mean scores for each of the acceptability questionnaire items did not show statistically significant differences between sex and race categories. Conclusions: Although PI and MMI performances are correlated, the MMI may have the added advantage of more objectively generating multiple impressions of the applicant's interpersonal skill, thoughtfulness, and general demeanour. Results of the present study indicated that the MMI is acceptable in a multicultural context

Eating self-efficacy changes in individuals with type 2 diabetes following a structured lifestyle intervention based on the transcultural Diabetes Nutrition Algorithm (tDNA): A secondary analysis of a randomized controlled trial.

ObjectiveEating self-efficacy behavior is an important predictor of successful lifestyle intervention. This secondary analysis evaluated the changes in eating self-efficacy behavior in patients with type 2 diabetes (T2D) and overweight/obesity following structured lifestyle intervention based on the Malaysian customized transcultural Diabetes Nutrition Algorithm (tDNA).MethodsPatients with T2D and overweight/obesity (n = 230) were randomized either into the tDNA group which included a structured low-calorie meal plan using normal foods, incorporation of diabetes-specific meal replacements, and an exercise prescription or usual T2D care (UC) for 6 months. Patients in the tDNA group also received either counseling with motivational interviewing (tDNA-MI) or conventional counseling (tDNA-CC). The UC group received standard dietary and exercise advice using conventional counseling. Eating self-efficacy was assessed using a locally validated Weight Efficacy Lifestyle (WEL) questionnaire. All patients were followed up for additional 6 months' post-intervention.ResultsThere was a significant change in WEL scores with intervention over one-year [Group X Time effect: F = 51.4, df = (3.4, 318.7), pConclusionEating self-efficacy improved in patients with T2D and overweight/obesity who maintained their weight loss and glycemic control following a structured lifestyle intervention based on the Malaysian customized tDNA and the improvement was further enhanced with motivational interviewing.Clinical trialThis randomized clinical trial was registered under National Medical Research Registry, Ministry of Health Malaysia with registration number: NMRR-14-1042-19455 and also under ClinicalTrials.gov with registration number: NCT03881540

Decision making process and factors contributing to research participation among general practitioners: a grounded theory study

The effectiveness of rubberwood modified with acetic, propionic and butyric anhydrides against white rot Trametes versicolor was investigated. Specimens measuring 5 mm × 20 mm × 20 mm (l × w × t) underwent a Soxhlet extraction with toluene/methanol/acetone (4:1:1 by volume) for 8 h, and then oven-dried at 103 °C for 24 h. The specimens were vacuum-impregnated with anhydrides for durations ranging from 0.25 to 24 h at 120 °C. The weight percent gain (WPG) was calculated and the chemical bonding was analysed with Fourier transform infra-red (FTIR). The specimens were leached in deionised water according to EN 84 (1997) and exposed to white rot in an incubation room at 22 °C for 16 weeks. The study found that the acetic, propionic and butyric anhydrides reduced the rate of decay but did not totally protect rubberwood from T. versicolor. All the modified rubberwoods were classified as durability class 1 comparable to Scots pine and European beech. The final moisture content had a positive correlation with weight loss following decay. Scanning electron microscopy showed that hyphae penetrated cells in both untreated and modified rubberwood

Interesterified Palm Olein (IEPalm) and Interesterified Stearic Acid-Rich Fat Blend (IEStear) Have No Adverse Effects on Insulin Resistance: A Randomized Control Trial

Chemically-interesterified (CIE) fats are trans-fat free and are increasingly being used as an alternative to hydrogenated oils for food manufacturing industries to optimize their products&rsquo; characteristics and nutrient compositions. The metabolic effects of CIE fats on insulin activity, lipids, and adiposity in humans are not well established. We investigated the effects of CIE fats rich in palmitic (C16:0, IEPalm) and stearic (C18:0, IEStear) acids on insulin resistance, serum lipids, apolipoprotein concentrations, and adiposity, using C16:0-rich natural palm olein (NatPO) as the control. We designed a parallel, double-blind clinical trial. Three test fats were used to prepare daily snacks for consumption with a standard background diet over a period of 8 weeks by three groups of a total of 85 healthy, overweight adult volunteers. We measured the outcome variables at weeks 0, 6, and at the endpoint of 8. After 8 weeks, there was no significant difference in surrogate biomarkers of insulin resistance in any of the IE fat diets (IEPalm and IEStear) compared to the NatPO diet. The change in serum triacylglycerol concentrations was significantly lower with the IEStear diet, and the changes in serum leptin and body fat percentages were significantly lower in the NatPO-diet compared to the IEPalm diet. We conclude that diets containing C16:0 and C18:0-rich CIE fats do not affect markers of insulin resistance compared to a natural C16:0-rich fat (NatPO) diet. Higher amounts of saturated fatty acids (SFAs) and longer chain SFAs situated at the sn-1,3 position of the triacylglycerol (TAG) backbones resulted in less weight gain and lower changes in body fat percentage and leptin concentration to those observed in NatPO and IEStear