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

Metabolic, inflammatory, and oxidative stress markers in women exposed to secondhand smoke

Background Secondhand smoke (SHS) exposure has adverse effects on the cardiovascular system. This study aimed to determine the effects of SHS on the cardiovascular disease biomarkers, namely the metabolic, inflammatory, and oxidative stress markers in healthy adult women. Methods This comparative cross-sectional study was conducted among healthy women. The cases included those women exposed to SHS, and the controls included those women not exposed to SHS. SHS exposure was defined as being exposed to SHS for at least 15 min for 2 days per week. Venous blood was taken to measure the metabolic markers (high molecular weight adiponectin, insulin level, insulin resistance, and nonesterified fatty acids), oxidative stress markers (oxidized low density lipoprotein cholesterol and 8-isoprostane), and inflammatory markers (high-sensitivity C-reactive protein and interleukin-6). A hair nicotine analysis was also performed. An analysis of covariance and a simple linear regression analysis were conducted. Results There were 101 women in the SHS exposure group and 91 women in the non-SHS exposure group. The mean (with standard deviation) of the hair nicotine levels was significantly higher in the SHS exposure group when compared to the non-SHS exposure group [0.22 (0.62) vs. 0.04 (0.11) ng/mg; P = 0.009]. No significant differences were observed in the high molecular weight adiponectin, insulin and insulin resistance, nonesterified fatty acids, 8-isoprostane, oxidized low density lipoprotein cholesterol, interleukin-6, and high-sensitivity C-reactive protein between the two groups. The serum high molecular weight adiponectin was negatively associated with the insulin level and insulin resistance in the women exposed to SHS. However, no significant relationships were seen between the high molecular weight adiponectin and nonesterified fatty acids, 8-isoprostane, oxidized low density lipoprotein cholesterol, high-sensitivity C-reactive protein in the SHS group. Discussion There were no significant differences in the metabolic, oxidative stress, and inflammatory markers between the SHS exposure and non-SHS exposure healthy women. A low serum level of high molecular weight adiponectin was associated with an increased insulin level and resistance in the women exposed to SHS

Design and Implementation of Fibre Optic Sensor for Soil Moisture Detection

In this paper, the design and implementation of a fibre optic sensor system for moisture detection are reported. The basic concept of a fibre optic sensor is to detect any changes in the intensity of light that travels inside the fibre. The paper describes the sensor design, the experimental setup and four examples of sensor prototypes. A phototransistor is used to detect light in the fibre optic, while Arduino nano is utilised to read the output data. Four different sensors with different length and width are employed to detect the level of soil moisture. The effects of sensor dimensions on the soil moisture detection are studied. The most stable response provided by two sensors, one with 1-inch width and 0.63 inches length and the other design is with the dimension of 1- inch and 0.87 inches length

An association of myasthenia gravis with Hashimoto’s thyroiditis in a patient with a multinodular goitre

Introduction: The association of myasthenia gravis (MG) with other autoimmune diseases including autoimmune thyroid disease (ATD) is well recognised, although rare. The occurrence of both diseases can occur in two ways: either disease preceding the other, or concurrently. The presentation of MG in association with ATD can range from ocular to generalised disease. Case Summary: A 26-year-old Malay female with persistent hyperthyroidism secondary to Hashimoto’s thyroiditis in multinodular goitre was diagnosed with generalised MG after 2 years. She presented with right eye ptosis (ocular) and difficulty in swallowing and chewing (bulbar). The diagnosis of MG was confirmed by fatigability testing, electromyography and the presence of AChR antibodies. Her symptoms showed improvement with pyridostigmine (Mestinon) 60 mg 6-hourly. Her antithyroid drug was tapered down according to her thyroid function test. Throughout a year of follow-ups, her hyperthyroidism and fatigability symptoms improved with treatment. She was later counselled for total thyroidectomy and thymectomy. Conclusion: Myasthenia gravis and hyperthyroidism may present with similar symptoms such as dysphagia due to neuromuscular weakness or fatigue. When the diseases occur together, one of the diagnoses may be missed. Therefore, the occurrence of new symptoms in a patient with underlying ATD should should trigger the early identification of other autoimmune diseases by primary care doctors

Nutritional Assessment among Type 2 Diabetes Mellitus Patient in Southeast Asian Countries: A Scoping Review

This scoping review aims to determine the available nutritional assessments for people with Type 2 Diabetes Mellitus (T2DM) in Southeast Asian countries. The methodology used for this research was based on the PRISMA-ScR standards. An extensive electronic search was carried out for papers published between 2012 and 2022 that pertained to studies conducted in Southeast Asian countries and were written in English. The eligibility criteria for this review were T2DM patients aged 20 years and older. The search was carried out using PubMed, Science Direct, Scopus, and Google Scholar databases. Hence, out of 5,445, fourteen articles met the eligibility requirements of the analysis. According to the findings, twelve studies used anthropometry measurements and biochemical tests, followed by eight studies using clinical assessments and four studies using dietary assessments. The research utilized various nutritional assessment methods such as weight, height, Body Mass Index (BMI), waist and hip circumference, body fat percentage, Fasting Blood Glucose (FBG), Glycated Hemoglobin (HbA1c), lipid profiles, Blood Pressure (BP), 3-day and 24-hour dietary recall. This review examined how the available nutritional assessments for T2DM are frequently carried out in Southeast Asian countries. The review discovered that weight, height, BMI, waist and hip circumference, FBG, HbA1c, BP, and 3-day dietary recall are the most commonly reported nutritional assessment methods

The effects of Secondhand Smoke (SHS) exposure on microvascular endothelial function among healthy women

Background We studied 127 women; and based on their hair nicotine levels measured using gas chromatography-mass spectrometry, 25 of them were categorized as having higher hair nicotine levels, 25 were grouped as having lower hair nicotine and 77 women were grouped into the non-detected group. The non-detected group did not have detectable levels of hair nicotine. Anthropometry, blood pressure (BP), lipid profile and high-sensitivity C-reactive protein (hsCRP) were measured accordingly. Microvascular endothelial function was assessed non-invasively using laser Doppler fluximetry and the process of iontophoresis involving acetylcholine and sodium nitroprusside as endothelium-dependent and endothelium-independent vasodilators respectively. The mean hair nicotine levels for higher and lower hair nicotine groups were 0.74 (1.04) and 0.05 (0.01) ng/mg respectively. There were no significant differences in anthropometry, BP, lipid profile and hsCRP between these groups. There were also no significant differences in the microvascular perfusion and endothelial function between these groups. Methods We studied 127 women; and based on their hair nicotine levels measured using gas chromatography-mass spectrometry, 25 of them were categorized as having higher hair nicotine levels, 25 were grouped as having lower hair nicotine and 77 women were grouped into the non-detected group. The non-detected group did not have detectable levels of hair nicotine. Anthropometry, blood pressure (BP), lipid profile and high-sensitivity C-reactive protein (hsCRP) were measured accordingly. Microvascular endothelial function was assessed non-invasively using laser Doppler fluximetry and the process of iontophoresis involving acetylcholine and sodium nitroprusside as endothelium-dependent and endothelium-independent vasodilators respectively. The mean hair nicotine levels for higher and lower hair nicotine groups were 0.74 (1.04) and 0.05 (0.01) ng/mg respectively. There were no significant differences in anthropometry, BP, lipid profile and hsCRP between these groups. There were also no significant differences in the microvascular perfusion and endothelial function between these groups. Conclusions In this study, generally healthy non-smoking women who have higher, lower and non-detected hair nicotine levels did not show significant differences in their microvascular endothelial function. Low levels of SHS exposure among generally healthy non-smoking women may not significantly impair their microvascular endothelial function

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

Frontal meningioma with psychiatric symptoms

Frontal meningioma is often asymptomatic and patient may present with psychiatric symptoms. We report a case of 45- year-old female patient with no premorbid medical illness presented with 6 months history of depressive symptoms and changes in personality. Her worsening cognitive impairment brought her to psychiatry clinic and led to further investigation with contrast-enhanced computed tomography (CECT) Brain. The result showed well defined markedly enhancing lesion in the frontal region measuring 5.5 cm X5.2 cm X 4.4 cm with mass effect to the adjacent brain parenchyma and associated surrounding edema. Diagnosis of bifrontal tumour-olfactory Groove Meningioma was made. Patient underwent bifrontal craniotomy and tumour excision. The quality of life improved after surgical excision

Tai Chi Exercise for Mental and Physical Well-Being in Patients with Depressive Symptoms: A Systematic Review and Meta-Analysis

Tai Chi is a mindfulness–body practice that has physiological and psychosocial benefits and can be integrated into the prevention and rehabilitation of various medical conditions; however, the effectiveness of Tai Chi in the treatment of depression remains unclear. This review aimed to determine the effects of Tai Chi exercise on mental and physical well-being in patients with depressive symptoms. We searched databases for English language publications that appeared during January 2000–2022. The included trials were RCTs that involved people with depression with no other medical conditions, and included both adolescent and adult samples. A meta-analysis was performed using a random effects model and the heterogeneity was estimated using I2 statistics. The quality of each trial was assessed according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology. The eight trials were divided into two comparisons: (1) a combination of Tai Chi and antidepressants versus standard antidepressants; (2) Tai Chi versus no intervention. The Tai Chi intervention showed improvements in mental and physical well-being as evidenced by the reductions in depression and anxiety and improved quality of life (QOL) of the patients with depressive symptoms. Further well-controlled RCTs are recommended with a precision trial design and larger sample sizes