A study on knowledge, decision-making and acceptance of human papilloma virus vaccination among parents of primary school students in Kota Bharu

Introduction: Human Papilloma Virus Vaccine plays an important role in HPV related illness prevention. Cervical cancer is the second most common cancer in women and forth most common cancer in the entire general population in Malaysia. The primary prevention, HPV vaccine is approved as national vaccination program for females in Malaysia. Children rely on parents not only for the consent but for the guidance and information about the vaccines. Objectives: The study aims to describe knowledge, decision-making and acceptance of Human Papillomavirus (HPV) vaccination among parents of Primary School students and its associated factors. Methodology: This cross sectional study was conducted among 280 parents of primary school students in Kota Bharu from January 2015 till May 2015. Systemic random sampling and a validated self-administered questionnaire was used to assess knowledge of HPV vaccination. Data was analysed using SPSS ver 22. Result: Proportion of good knowledge among parents in Kota Bharu was 38%. Most decision regarding vaccination was a shared decision, 72%. The proportion ofacceptance of HPV vaccine for girls was 63%. Age and knowledge show significant association with HPV vaccine acceptance. Parents with good level of knowledge were more likely to accept HPV vaccine. Conclusion: Majority of parents had poor knowledge of HPV vaccine despite the implementation of the HPV vaccine since 2010. Vaccine acceptance is dependent on the level of knowledge. Parents play an important role in determining the success of HPV vaccine program. The trend of decision-making has changed in Malaysian family as most couples make shared decisions in allowing vaccinations on their child as compared to traditionally decision making by father

Study on Knowledge, Decision Making and Acceptance of Human Papilloma Virus Vaccination among Parents of Primary School Students in Kota Bharu

NTRODUCTION: Cervical cancer is the third most common cancer in women and fifth most common cancer in the entire general population in Malaysia 1. The primary prevention, HPV vaccine is only approved for use in females in Malaysia2. Children rely on parents not only for the consent even for the guidance and information about the vaccines3. OBJECTIVES: The study to determine the level of parental knowledge, decision making and acceptance of HPV vaccination, and association between knowledge and acceptance. METHODS: This cross sectional study was conducted among 280 parents of primary school students in Kota Bharu for 12 months duration. Systemic random sampling and a validated self administered questionnaire was used to assess knowledge of HPV vaccination. Data was analysed using SPSS ver 22. RESULTS: Parents with good knowledge in Kota Bharu was 38% and 62% was poor. Most decision regarding vaccination was a shared decision, 72%. The proportion of acceptance of HPV vaccine for girls was 63%. Level of knowledge (good) has significant association with acceptance of HPV vaccine (95% CI 7.319,36.403, p<0.001). CONCLUSION :Parent’s level of knowledge is low despite the implementation of the HPV vaccine since 2010. Vaccine acceptance is dependent on the level of knowledge. Parents play an important role in determining the success of HPV vaccine program4. The trend of decision making has changed in Malaysian family as most couples make joint decisions in allowing vaccinations on their child as compared to traditionally decision making by father5. KEYWORDS: HPV vaccine, knowledge, decision making, acceptance, parent

Association between Diabetes Mellitus and Sepsis for the Glycemic Control Outcome of Two Intensive Care Units in Malaysia

Close monitoring and tight glycemic control are required among critically ill patients as they have dynamic metabolism which may precipitate stress-induced hyperglycemia. Clinically, diabetes mellitus (DM) patient with sepsis indicated a high mortality rate. This study investigates the association between DM and non-DM related to sepsis and non-sepsis patients from different insulin infusion therapy management. This study used 128 retrospective data from Hospital A, and 37 retrospective data from Hospital B. ICU patients who received insulin infusion therapy during their stay in the ICU were selected. Both centres implement the sliding scale-based insulin infusion therapy with the target range for blood glucose (BG) level within 6.0 – 10.0 mmol/L. The retrospective clinical data were compared among cohorts for DM and non-DM associated with sepsis and non-sepsis conditions. Findings showed that the DM group had higher insulin sensitivity than non-DM for both cohorts. Meanwhile, cohort B had higher insulin sensitivity than cohort A for all classes. Cohort A (DM+Sepsis) had low insulin sensitivity (66.7 L/(mU.min) and worst condition with sepsis&nbsp;which resulted from the lowest percentage (30.81%) of BG measurement within the target range. The (nonDM+nonSepsis) class had the tightest glycemic control for cohort A (3.4 mmol/L) and cohort B (2.2 mmol/L), as observed by the BG interquartile range. Furthermore, cohort A (nonDM+nonSepsis) had a 41.55% of severe hyperglycemia and 0.12% for severe hypoglycemia. Contrary, cohort B (nonDM+nonSepsis) had the highest percentage within the target range (74.31%) and the lowest percentage of hyperglycemia (18.78%). There was significantly different (p-values &lt;0.05) between cohort A and cohort B in BG level and glucose intake, likewise between sepsis and non-sepsis of non-DM for both cohorts. The findings indicate that a successful glycemic control protocol is much influenced by insulin sensitivity, patient variability, diabetes condition, and patient sepsis status

The effects of insulin infusion protocol on the glycemic level of the intensive care patients

Insulin infusion protocol is the standard protocol that has been practiced in Malaysia's intensive care unit (ICU) for controlling the hyperglycemia. Multiple sliding scale method of the insulin infusion protocol may drive conflict in selecting an appropriate scale to be applied to the patient. The objective of this paper is to analyse the blood glucose outcome of eight sliding scales insulin infusion protocol adopted in the Universiti Sains Malaysia Hospital (HUSM). A retrospective data of 78 ICU patients of HUSM were fitted using a validated glucose-insulin system to identify insulin sensitivity profiles of the patients. Then, these SI profiles were simulated on various scale protocols. The results obtained from this study showed that among eight scales, Scale 4 had the highest percentage of BG within the HUSM's target of 6.0-10.0 mmol/L. Scale 1 had the highest percentage of BG for the BG measurement more than 10.0 mmol/L while Scale 8 had the highest percentage of BG measurement of less than 6.0 mmol/L. However, none of the scale shown better performance than the current clinical practice. Furthermore, all of the eight scales had a more substantial number of BG measurement compared to the clinical. This study shows that Scale 2 and Scale 3 result in a similar outcome. Similarly, Scale 5 is almost the same as Scale 6. Thus, at least two sets of scale can be combined to reduce the number of scales. The reduction of scales consequently avoid confusion and helps the clinician in selecting the appropriate scale to be applied to the patients. From this study, it can be concluded that the HUSM protocol is a combination of scales. The scales may be shifted from one to another scale depending on patient condition and clinician judgement. A proper guideline for the scale shifting seems necessary to allow optimum glycemic management in the ICU

Validation of Modified Questionnaire on Knowledge of Human Papilloma Virus Vaccination among Parents

INTRODUCTION: Knowledge on Human Papilloma Virus (HPV) vaccination plays an important role in determining the acceptance of HPV vaccine for the daughters after implementation of HPV vaccine as nation immunisation program since 20101,3. OBJECTIVE: This study aimed to determine the reliability and validity of a modified questionnaire to assess parents’ knowledge on HPV vaccination. METHODS: The study was conducted using self-administered questionnaire in January 2015 among parents of SK Pasir Putih (P). Content and face validity were performed. This questionnaire was modified from previous studies among women in Malaysia (Sami et.al 2010) and parents in Thailand (Archin et.al 2012) with 4 and 9 items respectively on knowledge of HPV infection and HPV vaccine constructs. Construct validity was assessed using factor analysis with varimax rotation while reliability was assessed using Cronbach’s alpha. Data was analysed using SPSS version 22. RESULTS: Sixty-five parents participated in this study. The final model consists of 4 and 9 items with factor loading of 0.59 – 0.78, 0.68 – 0.87, respectively on knowledge of HPV infection and knowledge of HPV vaccine constructs. The Cronbach’s alpha for each construct was 0.64, 0.80 and overall Cronbach’s alpha was 0.86. CONCLUSION: This 13 – item modified questionnaire is reliable and valid to be used for assessing knowledge on HPV vaccination among parents. Keywords: knowledge, HPV vaccine, parent

Pelvic Actinomycosis: a report of two cases with different presentations

Actinomycosisisa type of bacterial infection which manifests in a subacute and chronic manner. It is characterized by a contiguous spread with suppuration and granulomatous inflammation. Actinomycesis a normal flora inhabiting the oral cavity, gastrointestinal and urogenital tract. Thecommonesttype of infection is the cervico facial followed by abdominal and thoracic type. Pelvic actinomycosisis a subtype of abdominal actinomycosis and it is commonly associated with intrauterine contraception device (IUCD) use. The most challenging aspect in management of actinomycosis is to reach the diagnosis early. In cases diagnosed early, removal of IUCD with antibiotic treatment may lead to complete remission averting operative measure and its’ complications. We reporttwo cases of pelvic actinomycosis with different presentations. The first case was diagnosed after patient was operated for suspected gynaecological malignancy while the second case was diagnosed with Papanicolaou smear from routine cervical cancer screening