Prevalence of Diabetic Retinopathy (DR) and its associated factors among diabetes patients in Primary Care Clinics, Kuantan, Pahang

Introduction: Diabetic retinopathy (DR) is one of the commonest complications of diabetes mellitus. This study was to determine the prevalence of diabetic retinopathy and its association with chronic kidney disease (CKD), high HbA1c and dyslipidemia among diabetic patients in government primary care clinics. Methods: A cross sectional study was carried out. The respondents were selected from diabetic registry at two government primary care clinics in Kuantan, Pahang via stratified random sampling method during the study period from May 2010 to April 2011. The respondents were interviewed and assessed clinically using a structured questionnaire. Retinal examination was performed by accredited staff using non-mydratic retinal imaging and DR was classified according to the International Clinical Diabetic Retinopathy Disease Severity Scale. Results: Out of 400 respondents, 58.8% diagnosed diabetes less than 5 years and 51.0% had uncontrolled blood pressure (>130/80 mmHg). The prevalence of diabetic retinopathy and maculopathy were 33.5% and of 17.8% respectively. Most of these patients (22.3%) had mild non-proliferative diabetic retinopathy. DR-patients had higher percentages of chronic kidneys disease (17.9% vs. 6.8%; p<0.001) and a higher mean of HbA1C (8.69 vs. 8.11; p=0.015)compared to non-DR patients. The study revealed that DR was independently associated with chronic kidney disease {OR: 3.46, 95% CI (1.76, 6.80)} and high HbA1c {OR: 1.12, 95% CI (1.02, 1.23)}. Those with dyslipidemia however, has 39% less risk of diabetic retinopathy {OR: 0.61, 95% CI (0.39, 0.94)}. Conclusion: This study shows that diabetic patients with CKD and high HbA1c have greater risks to develop diabetic retinopathy but has protective risk with dyslipidemia

PARACETAMOL DISPENSING PRACTICE OF GOVERNMENT HEALTH CLINICS POST INFANTS’ VACCINATION IN MALAYSIA

Objective: This study obtained information on Paracetamol (PCM) Dispensing Practice of Government Health Clinics (GHC) post infants’ vaccination in Malaysia as well as identify its possible factors. Methods: This descriptive cross-sectional retrospective study (with convenient sampling) using a data collection form (DCF) to collect data. The pharmacist who is the representative of the GHC filled the DCF. Potential risk factors were evaluated by Pearson chi-square tests (expected count&lt;5 is&lt;20%) for an independent sample. Results: A total number of 254 samples were collected all over Malaysia within the period of data collection, but only 248 that met inclusion criteria. The PCM dispensing practice of GHC in Malaysia for a total period of 3 y back (from 2015-2017), tend not to give PCM post immunization with respect to age of the upon vaccination and types of vaccination, conversely for gender. Trends of PCM dispensing practice were increasing for “Not Give PCM” with respect to gender, age of the baby upon vaccination, and types of vaccination from 2015 till 2017. The PCM dispensing practice had no association with no statistically significant value (p=0.804) on genders and a weak positive association with statistically significant value (p&lt;0.05 each) on age of the baby (≤ 1year) upon vaccination and types of vaccination. Conclusion: Future research which may include the actual practice in which practices of prescribers or mother may be conducted in determining more accurate data on the giving PCM post infant’s vaccination

The relevancy of paracetamol and breastfeeding post infant vaccination: A systematic review

Paracetamol may be used as an antipyretic agent for the treatment of fever, as well as an analgesic in the treatment of mild to moderate pain post-vaccination in infants. The use of paracetamol during fever may be or may not be recommended since it may alter the natural human body immune response, although it may reduce pain

Knowledge, attitude and practice of medical personnel on smoking cessation guidelines: a review on associations and questionnaires

Number of active smokers in Malaysia is increasing despite availability of stop smoking clinics and smoking cessation medications. Other than smokers’ level of motivation to quit smoking, competency of the healthcare professionals involved in providing smoking cessation intervention using evidence-based guidelines needs to considered. Hence, knowledge, attitude and practice (KAP) of the healthcare providers in relation to existing clinical practice guidelines on smoking cessation should be assessed. In this review, we look at the previous available questionnaire, for the purpose of applying it to the context of the Malaysian healthcare providers

Depression, anxiety, and stress among adolescents in Kuantan and its association with religiosity- a pilot study

Adolescence is a period of time when the development of personality and psychology is taking place. Studies have shown that religiosity can affect the mental health of a person. Many tools have been developed to assess religiosity of a person; one of them is the Santa Clara Strength of Religious Faith (SCSORF) scale. In this study, a translation and validation for SCSORF Malay Version (SCSORF-M) is done, and subsequently used to look for the association between religiosity and mental health in adolescents. Fifty questionnaire papers have been distributed to 50 students in secondary schools in district of Kuantan. The mean score for depression, anxiety, and stress are 5.83, 5.59, and 8.34 respectively. Only 10 (24.4%) have no depression, 9 (22%) have no anxiety, and 13 (31.7%) have no stress. The mean score for SCSORF-M scale was 35.3 (range 25-40). Family income has shown to correspond negatively with the depression, anxiety, and stress, while religiosity has shown to be correlating negatively with depression and stress, but positive correlation with anxiety. SCSORF-M has positive convergent correlation with Duke’s University Religiosity Index Malay Version (DUREL-M) in all domains. SCSORF-M has shown good Cronbach’s alpha value (0.84). In conclusion, religiosity is an important factor to contribute to the outcome of mental health among adolescents. SCSORF-M can be used as an assessment tool for religiosity

Knowledge, attitude and practice of medical personnel on smoking cessation guidelines: a review on associations and questionnaires

Number of active smokers in Malaysia is increasing despite availability of stop smoking clinics and smoking cessation medications. Other than smokers’ level of motivation to quit smoking, competency of the healthcare professionals involved in providing smoking cessation intervention using evidence-based guidelines needs to considered. Hence, knowledge, attitude and practice (KAP) of the healthcare providers in relation to existing clinical practice guidelines on smoking cessation should be assessed. In this review, we look at the previous available questionnaire, for the purpose of applying it to the context of the Malaysian healthcare providers

Prevalence of depressive symptoms and its associated factors among elderly in private nursing homes in Kuantan

Introduction: mental health constitutes a major component of the global burden of disease worldwide. Residing in a nursing home poses a greater challenge for the elderly physically and mentally. This study aimed to determine the prevalence of depressive symptoms and its associated factors among elderly in private nursing homes in Kuantan. Materials and Methods: This was a cross-sectional study conducted at thirteen private nursing homes in Kuantan. 115 elderly residents aged 60 years old and above were recruited to complete the interview-based questionnaire. Participants were assessed with the Malay Geriatric Depression Scale(M-GDS-14), Elderly Cognitive Assessment Questionnaire (ECAQ), and Modified Barthel Index(MBI). Data were analyzed using SPSS version 25.0. Descriptive statistics was used to measure the prevalence and logistic regression to explore the association of depressive symptoms with the background variables. Results: The mean age of respondents was 74.1(SD ± 8.87) and the majority were Chinese (67%) and male (51.4%). The overall prevalence of depressive symptoms was 40% with 23.5% being major depression and 16.5% of clinically significant depression. This study revealed a significant association between depressive symptoms with chronic disease {AOR 3.956, CI 95% (1.071-14.608)}, cognitive impairment {AOR 3.185, CI 95% (1.325-7.655)}, and functional disabilities {AOR 4.314, CI 95% (1.799-10.345)}. Conclusion: This study revealed more than 1/3 of the elderly in nursing homes living with depressive symptoms. Residents with chronic diseases, cognitive impairment, and functionally dependent should receive greater attention as early recognition and intervention are crucial to prevent further disability and dysfunction

Reliability and construct validity of knowledge, attitude and practice of medical doctors on smoking cessation guidelines

Introduction: Islam forbids any forms of tobacco smoking. Prevalence of active smokers in Malaysia is increasing despite availability of stop-smoking clinics. Thus, the practice of healthcare professionals involved in providing smoking cessation intervention needs to be assessed using validated assessment tool. Objective: This study aimed to develop and validate a questionnaire that assesses the knowledge, attitude, and practice of medical doctors based on the national smoking cessation guideline. In addition, we aimed to evaluate factors that contribute to the score. Methods: The 26 items consists of mixture of true/false choice questions and Likert scaling response based on domain of 5A’s (ask, assess, advice, assist, arrange) and 5R’s (relevant, risks, rewards, roadblocks, repetitions) of the national stop-smoking guideline. The questionnaire was distributed to 141 medical doctors. Reliability was determined using Cronbach’s alpha for internal consistency while construct validity was assessed using factor analysis. Results: A high degree of internal consistency was observed for this 26 items (Cronbach’s alpha= 0.824) and for practice subscale (Cronbach’s alpha 0.83). Subsequently, three items were removed due to poor inter item correlation. Factor analysis extracted seven meaningful components from this remaining 23 items, in which three components with least items were deleted due to overlapping subscale with other components, leaving four meaningful components which consist of (1) practice of ask, advice and assess components and practice of 5R’s (total of 10 items); (2) practice of assist components for those willing to quit (two items); (3) knowledge (two items) and (4) attitude (three items).These final 17 items still demonstrate high internal consistency with Cronbach’s alpha of 0.832. Conclusion: This study indicates that this questionnaire is a reliable and valid tool to assess the knowledge, attitude, and practice of healthcare professionals on stop smoking guidelines

Knowledge, attitude and practice on smoking cessation guideline among medical doctors attending Family Medicine Scientific Conference 2016

Prevalence of active smokers in Malaysia remains high despite the availability of stop-smoking services. Rather than focusing on patients’demotivating factors, possible poor performance from providers should be evaluated. Thus, knowledge, attitude and practice of the healthcare professional on smoking cessation intervention needs to be assessed, especially among primary care doctors