The effectiveness of health education package on knowledge, attitude and practice of influenza a (H1N1) among secondary school children in Kelantan

Health education is crucial in providing individuals with the information, skills and motivation necessary for decision making about lifestyle and personal health behavior. An effective health education is vital as the pandemic will affect a very large numbers of people. People must be well informed with factual and up to date information. This study was conducted to determine level of knowledge, attitude and practice among secondary school children on influenza A (H1N1) and to evaluate the effectiveness of health education package on influenza A (H1N1). A community intervention trial was conducted among secondary school children in two districts in Kelantan; namely Kota Bharu and Bachok from July to December 2010. Students in one school in Bachok were allocated as the intervention group and those in Kota Bharu as the control group. Form four students were selected by using cluster sampling according to class. Data was collected using knowledge, attitude and practice questionnaire before, immediately after and intervention. The intervention group was given a lecture, video shows and printed materials (booklet and pamphlet) on influenza A (H1N1). The control group was given a video show on hazards of smoking. Repeated measures analysis of covariance (ANCOVA) was applied in data analysis. A total of 436 students in SMK one month after the Bachok (intervention group) and SMK. Kota (control group) were included in the study. The study involved all Malay students aged 16 years old. More than half of them were females (62.6% for control group and 52.8% for intervention group). The baseline mean (SD) for knowledge, attitude and practice scores were 69.35 (8.81), 65.77 (7.14) and 35.42 (6.19) respectively. After controlling the potential numerical covariate, there were significant improvements in knowledge (F=53.70, p<0.001) and attitude (F=5.37, p=0.005) scores in the intervention group compared to the control group over time. However there was no significant difference between the groups for practice. This study suggests that health education package is an essential component in improving knowledge and attitude of students on influenza A (H1N1). Having good knowledge and attitude will lead to better prevention and control and this in turn will reduce the incidence of disease and cost due to influenza A (H1N1) infection and may halt the epidemic

Foot reflexology therapy for non-specific low back pain condition : a protocol for a randomized controlled trial

Introduction Non-specific low back pain is one of the most common physical ailments affecting millions of people worldwide. This condition constitutes a significant public health problem and was listed as a prevalent health complaint in most societies. Even though there are many anecdotal claims for reflexology in the treatment of various conditions such as a migraine, arthritis and multiple sclerosis, but very little clinical evidence exists for reflexology on the management of low back pain per se. This study aims to evaluate the effects of foot reflexology therapy as an adjunctive treatment to the Malaysian low back pain standard care in relieving pain and promoting health-related quality of life among people with non-specific low back pain. Methods This is a parallel randomized controlled trial with pre and post-treatment study design. The study setting for the intervention located at Penawar Reflexology Center, Kuala Terengganu, Malaysia. A total of 100 participants with non-specific low back pain will be allocated to one of two groups, using a randomization computer program of Research Randomizer. The control group will receive low back pain standard care, while the intervention group will receive standard care plus eight sessions of foot reflexology therapy. The pain intensity and health-related quality of life scores will be measured using Visual Analogue Scale and Euro-quality of life scale respectively in both groups. The study was approved by the Human Research Ethics Committee of University Sultan Zainal Abidin (UHREC/2016/2/011). The study protocol was registered at ClinicalTrials.gov, with the ID number of NCT02887430. Measurements Outcome measures will be undertaken at pre-intervention (week 1), post-intervention (week 6) and follow-up (week 10). Conclusions This will be the first trial to compare the foot reflexology therapy with control group among people who medically diagnosed with non-specific low back pain in Malaysia. The result of this study will contribute to better management of this population, especially for Malaysia healthcare setting

Assessment on Oral Health Knowledge, Attitude, and Behaviour and its Association with Sociodemographic and Habitual Factors of South Indian Population

Objective: To assess the oral health knowledge, attitude, behaviour, and its association with sociodemographic and habitual factors among South Indian Population. Material and Methods: A total of 288 adults living in a residential community situated in Chennai were selected by systematic random sampling method participated in this cross-sectional study. Data collection was carried out using a validated questionnaire. Results: About 97.9% of the participants in our study had good knowledge, 33.3% had a positive attitude and 48.2% had adequate oral health behaviour. Sociodemographic and habitual factors like diet (p=0.006), education (p=0.009), and employment (p=0.003) were significantly associated with knowledge. On the other hand, diet (p=0.012) was the only factor significantly associated with attitude. Ownership of house (p= 0.030) was significantly associated with behaviour and no factor was associated with all three KAB profiles. Absence of correlation were identified between Knowledge-Attitude (r=0.11, p=0.23), Knowledge-Behaviour (r= -0.037, p= 0.68) and Attitude-Behaviour (r =0.01, p=0.94). Conclusion: It has been found a massive number of participants possessed a high knowledge level towards oral health. On the other hand, less than half of the participants had a positive attitude and adequate behaviour towards oral health. No positive linear correlation was seen among knowledge, attitude, and behaviour towards oral health

In Vitro

This study aimed to evaluate in vitro whole blood (WB) clot lysis method for the assessment of fibrinolytic activity. Standardized unresected (uncut) retracted WB clot was incubated in pool platelet poor plasma (PPP) for varying incubation times and in streptokinase (SK) at different concentrations. The fibrinolytic activity was assessed by D-dimer (DD), confocal microscopy, and clot weight. DD was measured photometrically by immunoturbidimetric method. There was a significant difference in mean DD levels according to SK concentrations (P=0.007). The mean DD±SD according to the SK concentrations of 5, 30, 50, and 100 IU/mL was: 0.69±0.12, 0.78±0.14, 1.04±0.14 and 2.40±1.09 μg/mL. There were no significant changes of clot weight at different SK concentrations. Gradual loss and increased branching of fibrin in both PPP and SK were observed. Quantitation of DD and morphology of fibrin loss as observed by the imaging features are in keeping with fibrinolytic activity. Combination of DD levels and confocal microscopic features was successfully applied to evaluate the in vitro WB clot lysis method described here

Changes in health‑related lifestyles and food insecurity and its association with quality of life during the COVID‑19 lockdown in Malaysia

Background: The pandemic of SARS CoV2 virus has severely impacted the entire world population. The lockdown imposed during the pandemic has created enormous challenges particularly on the health, economic and social life of most individuals. This study aimed to investigate the changes in health-related lifestyle and food security during the lockdown and how they influenced the quality of life (QoL) of Malaysian adults. Methods: An online survey using a structured questionnaire consisting of sociodemographic, body weight, diet quality, physical activity, sleep quality, food insecurity, and QoL was conducted among adult respondents across Malaysia. Multivariate linear regression analyses were conducted to assess the associations between the changes in each component and QoL based on the total score before and during the lockdown. Results: A total of 759 valid responses were included in the final analysis (75% female and 24.5% male). There was a significant improvement in diet quality during the lockdown while sleep quality and food insecurity worsened significantly. As for physical activity, metabolic equivalents (METs) in moderate activity increased significantly, whilst there was a significant decrease in the METs in walking and total minutes spent on physical activity during the lockdown. Overall, independent of age, gender, ethnicity, and religion, there were significant associations between QoL during lockdown and changes in BMI, METs of moderate activity, sleep quality, and food insecurity. Conclusions: The unprecedented COVID-19 outbreak and the lockdown measure during the pandemic have caused significant negative changes in health-related lifestyles and affected the QoL of Malaysian adults. Despite the new norms and rules to prevent disease transmission, efforts to maintain a healthy lifestyle and food security among the population must be rolled out to improve the QoL and prevent further adverse mental and physical health outcomes

Increased endothelial progenitor cells with age and grade of malignancy in astrocytic glioma patients

Astrocytic gliomas are the most common primary brain tumours that originated from human glial cells. The tumours rely upon endothelial progenitor cells (EPCs) for neoangiogenesis. This study aimed to investigate the association between tissue resident EPCs in a brain tumour and normal adjacent tissue in relation to age and grade of astrocytic glioma. Astrocytic glioma patients (n=22), grade I to grade IV were consented from Hospital Universiti Sains Malaysia. Brain tumour tissue and normal adjacent brain tissue samples were obtained from each patient during surgery. The EPCs were stained with CD133+ and VEGFR-2+ markers. The tissue residents EPCs for each sample were determined using the immunofluorescence microscopy method. The age of the patients increased by disease severity in the following order (Grade I: 21.33±20.79 years) < (Grade II: 46.50±0.707 years) < (Grade III: 47.38±11.95 years) < (Grade IV: 48.44 ±10.66 years). The EPCs in brain tumour correlated significantly with the age of the patients with positive correlation (Spearman's rho correlation test, r=0.52; p=0.013). The tissue resident EPCs in the brain tumour (median=0.40, IqR=0.59) were significantly higher compared with the adjacent normal brain (median=0.067, IqR=0.29) (Wilcoxon Signed-Rank Test, Z stat=-3.587, p<0.001). Higher tissue resident EPCs were found in high grade (III & IV) glioma compared with EPCs in low grade (I & II) glioma (median=0.61, IqR=0.70 vs. median=0.26, IqR=0.30; z=-1.763 p=0.078). This study showed increased EPCs with age and grade of malignancy in astrocytic glioma patients. Therefore, targeting EPCs in gliomas based on tumour grade malignancy and age of the patients might be useful in effective treatment of astrocytic glioma

Depression and quality of life in patients with neurological disorder in a Malaysian hospital

Objective: To investigate association between major depressive disorder (MDD) and quality of life in patients with neurological disorder. Methods: This cross-sectional study was carried out at a Malaysian hospital between April 2016 and December 2016 using convenience sampling. Patients aged ≥18 years with intracranial tumour or other brain disorders were invited to participate. Quality of life was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life questionnaire version 3.0; diagnosis of MDD was made using Mini International Neuropsychiatric Interview. Results: Of 122 patients approached, 100 (66 women and 34 men) were included (response rate, 93.5%), with a mean age of 45.3 years. The prevalence of MDD in patients with neurological disorder was 30%. Compared with non-depressed patients, patients with MDD had poorer global health status / quality of life (p = 0.003), and reduced physical (p = 0.003), role (p = 0.021), emotional (p < 0.001), cognitive (p = 0.004), and social (p = 0.007) functioning, as well as more symptoms of fatigue (p = 0.004), pain (p < 0.001), dyspnoea (p = 0.033), insomnia (p < 0.001), appetite loss (p = 0.002), constipation (p = 0.034), diarrhoea (p = 0.021), and financial difficulties (p = 0.039). Conclusion: Patients with MDD had reduced quality of life. Fatigue, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea, and financial difficulties were prevalent among patients with MDD

Quality of life among patients with brain pathology in a Malaysian hospital

The objective of this study was to determine the prevalence of symptoms and problems in Malaysian brain pathology patients. A total of 100 respondents in Kuala Lumpur Hospital were included in this cross-sectional study. The study utilized European Organization for Research and Treatment of Cancer Quality Of Life questionnaire (EORTC QLQ-C30). Patient with a "symptom/problem" having the minimum response of "a little". A response of "quite a bit" was defined as having a "severe symptom/problem". The two most prevalent "symptoms/problems" among the neurological disorder patients were fatigue (65%; severe: 28%) and reduced cognitive functioning (64%; severe: 25%). The mean number of "symptoms/problems" ranged from 4.63 (meningioma) to 6.80 (cerebellar edema) while the mean number of "severe symptoms/problems" ranged from 1.39 (astrocytic glioma) to 2.8 (cerebellar edema). Therefore special attention should be given to these patients in order to improve the overall quality of life of the patients

The socio-demographic and clinical factors associated with quality of life among patients with brain pathology in a tertiary referral hospital in Malaysia

Background: This paper investigates the quality of life of brain pathology patients in relation to their socio-demographic profiles and clinical factors. Methods: This is a cross-sectional study done at a tertiary referral hospital in Kuala Lumpur. A total of 100 patients were recruited in the study after excluding 22 patients who did not met the exclusion criteria. The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) self-administered questionnaire was utilized in the study. The Global health status/QoL, Physical functioning, Role functioning, Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Pain, Dyspnoea, Insomnia, Appetite loss, Constipation, Diarrhoea, and Financial difficulties were assessed in this study. Results: The most severe impairment in functioning was with lowest score of cognitive functioning (mean score=61) and the most severe symptom was fatigue (mean score=45). There were significant differences in quality of life scores in different socio-demographic groupsand types of brain pathology patients. Patients aged below 40 years old or less had better physical functioning, less symptoms of fatigue and insomnia compared to patients who were more than 40 years old. Male patients faced more financial difficulties compared with female patients. Patients who were married had increased insomnia compared to the single patients. Employed patients had better physical functioning and less financial difficulties compared with patients who were unemployed. Patients who earned >RM 2500.00 monthly had better physical functioning, less symptoms of pain and less financial difficulties than patients who earned ≤RM 2500.00. Patients with qualifications lower than SPM tended to face more financial difficulties compared to patients with qualifications of SPM or higher. Meningioma patients had better social functioning compared with others, whereas Carvenoma patients had better physical functioning. Meningioma patients had more symptoms of insomnia compared with other patients. All the findings were with p value less than 0.05. Conclusion: The quality of life of patients with brain pathology is affected by socio-demographic factors and clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients