Factors associated with nonachievement of low density lipoprotein cholesterol target among patients with type 2 diabetes mellitus

Introduction: Dyslipidaemia is a risk factor for cardiovascular disease and Type 2 Diabetes Mellitus is a cardiovascular risk equivalent. Low density lipoprotein cholesterol (LDL-C) is the primary target in the management of dyslipidaemia and achievement of LDL-C target according to National Cholesterol Education Programme (NCEP-ATP III) is crucial. Statins are potents drug to reduce cholesterol especially the LDL-C, however the effectiveness is limited by the poor adherence. Objectives: To determine proportion of patients achieve LDL-C target and factors associated with nonachievers and the adherence to statin therapy among patients with T2DM. Methodology: A cross sectional study involving 234 patients aged 18 years old and above who had comorbid Type 2 Diabetes Mellitus and Dyslipidaemia. Systematic Random Sampling with replacement method was applied to select participants who attended KRK, HUSM from January 2013 to May 2013. Both self-administered and interviewered administered questionnaires were used to obtain the socio demographic characteristics, clinical characteristics and compliance questionnaire. The data was analysed for descriptive statistic and multiple logistic regression. Result: The percentage of LDL-C target achievement was 37.6%. The percentage of patients adhered to statin therapy was 98.3% and 20.5% of patients adhered fully. There was no significant relation between LDL-C achievement and adherence. Sociodemographic data(such as age, marital status, gender, education level and household income) and clinical data (such as smoking status, number of prescribed medications, BMI, SBP, duration on statin therapy and type of statin taken) were not associated with achievement of LDL-C target. HbA1c is the only significant factor that associated with LDL-C target achievement. Conclusion: Achievement of LDL-C target among T2DM patients attended KRK,HUSM was still low. Majority patients were adhered to statin therapy however the relation between adherence and LDL-C achievement was not significant. HbA1c was the only significant factor associated to nonachievement of LDL-C target. Patients with poorly control glycaemic control should more holistically manage including achieving their LDL-C target

Health Literacy: How is it Related to Body Mass Index of Patients with Diabetes Mellitus?

This study aimed to assess the level of health literacy and determines the association between health literacy and BMI among T2DM patients in Hospital Universiti Sains Malaysia (HUSM). A cross-sectional study was conducted among 96 patients with T2DM. Health literacy was measured using the Malay version of the European Health Literacy Survey Questionnaire 16 (HLS–EU–Q16).Information about sociodemographic, weight, height, and body mass index were obtained. The majority of the participants had sufficient health literacy (60.4%), whereas the mean BMI of patients was 28.59 kg/m2. A significant association was found between BMI with health literacy levels. The median BMI value of the sufficient health literacy group was significantly higher, 28.38( 6.02) than the problematic health literacy group, 25.38 (7.52) using Kruskal Wallis test. This indicates that health literacy may be a predictor of BMI. Or maybe, the other way around is true, increased BMI may result in increased awareness on health. Still, other stronger determinants besides health literacy such as income and dietary intake which were not included in this study might influence the BMI of T2DM patients

Validation of a Questionnaire on Knowledge and Barriers of Breast Milk Expression among Mothers of Premature Infants

This study aimed to develop and validate a Malay language questionnaire to assess mothers' knowledge in providing breast milk for premature infants, and barriers to breast milk expression while the infants are in the Neonatal Intensive Care Unit (NICU). Two tertiary hospitals in Kelantan, Malaysia participated in this cross-sectional study. Relevant items of knowledge and barriers were identified through a literature search, clinical observations, and expert opinion. Ten breastfeeding experts validated the content of the knowledge and barriers to breast milk expression questionnaire.The effectiveness of the questionnaires was tested for face validity among ten mothers, followed by reliability tests comprising 50 mothers who gave birth prematurely. The 20 knowledge items and 16 barrier items have an Item-level Content Validity Index (I-CVI) of 0.99, indicating good relevance of the knowledge and barrier items. The knowledge and barrier questionnaires had Item-level Face Validity Indexes (I-FVIs) of 1.00 and 0.99, respectively, suggesting clear and comprehensible items. The questionnaires obtained a Cronbach alpha score of 0.726 for knowledge and 0.736 for barriers, showing that they are reliable tools for assessing knowledge and breast milk expression barriers. The validity and reliability of the newly developed Malay version of the questionnaire have been established for evaluating breastfeeding knowledge and barriers to expressing breast milk among mothers with premature infants

Dental students’ perception, attitude, and willingness to interact with mental illness patients: a multicentre cross-sectional study

Mental illness is a psychological impairment involving emotions, cognitions, and behaviors, and its prevalence is increasing worldwide. Dental students may encounter patients with underlying psychological problems during their training. Objective : To evaluate dental students’ perception, attitude, and willingness to interact with patients with mental illness. Methods: A multi-center cross-sectional study was conducted involving undergraduates at three dental institutions in Malaysia using an online self-administered questionnaire. Descriptive data analysis was conducted and statistical analysis using chi-square test was done for associations (p < 0.05). Results: The response rate was 63% (225); the majority of respondents were female (77.8%) and of Malay ethnicity (88.4%). Our study found that positive attitudes are independent of respondents’ sociodemographic profiles. No significant differences in attitudes were portrayed by gender, race, or history of mental illness. Our findings suggest that respondents’ place of study, gender, and previous encounter with mental illness are associated with willingness to interact with patients (p < 0.05). Conclusions: Dental students displayed positive attitudes and willingness to interact with patients with mental illness. However, to further improve students’ attitudes and enhance their readiness to interact with patients with mental illness, more mental health-related educational programs should be introduced in the dental curricula

Lived experience after bariatric surgery among patients with morbid obesity in east coast Peninsular Malaysia: a qualitative study

Living with morbid obesity is challenging since it affects various dimensions of life. Sustainable weight loss via bariatric surgery helps people suffering from morbid obesity to lead a healthy and meaningful life. This study highlights the challenges before bariatric surgery and the impact on one’s life. A phenomenological approach was employed using in-depth interviews with 21 participants (15 females and 6 males) who had undergone surgery at least 6 months prior to the study with the mean age of 42.6 years. Due to excess body weight, the physical limitation had a serious negative impact on their social life, making them targets of bias and stigmatisation. Surgery was the best option for them to attain sustainable weight loss and to lead a new life. However, a few participants struggled with the side effects of surgery. Five themes were discovered, namely, (1) social restraint; (2) experiencing bias and stigmatisation; (3) bringing new life; (4) boosting self-esteem; and (5) facing the negative side of surgery. This study serves as a platform to explore the difficulties faced by people with morbid obesity and the changes that the participants experienced after the surgery for future intervention to curb the rising number of people with morbid obesity

&ldquo;Providing Sex Education Is Challenging&rdquo;: Malay Mothers&rsquo; Experience in Implementing Sex Education to Their Children with Intellectual Disabilities

Sex education (SE) is still a controversial and sensitive topic in Malaysia. Thus, individuals with intellectual disability receive less information about SE formally as Malaysian culture believes that students with disabilities should be shielded from everything connected to sexuality owing to their paucity of maturity and intellectual comprehension of the topic. Due to that reason, non-formal education by the parent is very important to fill that needful gap. This study aimed to explore the experience of mothers on the meanings of sexuality, and implementing sex education for their children with ID. We adopted a phenomenological framework and social cognitive theory to increase understanding of the phenomenon and conducted it using in-depth interviews. Twenty mothers with children aged 10&ndash;19 who were diagnosed with mild to moderate ID and/or other cognitive disabilities were involved. Almost all mothers acknowledged the influence of socio-cultural factors and religion on meanings of sexuality and practicing SE. They realized their children&rsquo;s emerging sexual behavior as they go through the adolescence period. However, how they confronted sexuality and sex education with their vulnerable children was different. Three themes emerged: (1) Sexuality as an erotic experience in life, which enlightens mothers&rsquo; views on sexuality, relying mainly on sexual intimacy and sexual being; (2) Perceived their children&rsquo;s sexual maturity is different, which reflects the mothers&rsquo; attitude toward their children&rsquo;s sexual development; (3) Caution/hesitance in providing sexuality education, which summarizes mothers&rsquo; ways of delivering SE, either following physicality or through sociocultural ways. Our findings exemplify the need for strategies to increase parents&rsquo; understanding and awareness regarding sexuality and appropriate delivery of SE. To ensure its success, it should be a shared responsibility among all relevant stakeholders

Barriers and Concerns in Providing Sex Education among Children with Intellectual Disabilities: Experiences from Malay Mothers

Though sex education (SE) may benefit the sexual development and overall well-being of children with intellectual disabilities (IDs), obstacles to its implementation remain. This study highlights barriers and concerns of SE for children with IDs based on their mothers&rsquo; experiences. We employed a phenomenological approach and in-depth interviews with twenty Malay mothers of children with mild-to-moderate IDs or/and other neurodevelopmental disorders. Four primary hurdles to SE were discovered: (1) mother (2) children (3) family value, and (4) socio-cultural environment. Inadequate knowledge, mothers&rsquo; perceptions that SE is less necessary at this stage of their children&rsquo;s development, and time constraints were among their main barriers. Another source of hardship was the communication barrier because children with ID have cognitive impairment in their capacity to understand the topic being addressed and more time should be spent throughout the discussion. Family value and socio-cultural elements also had an impact on mothers&rsquo; intention to deliver SE to their children. Our findings suggest that mothers recognize the importance of SE for their children&rsquo;s well-being. However, the dynamic interaction between the barriers complicates SE. This study emphasizes the necessity for future interventions to overcome hurdles at each level to effectively implement the recommended strategies

Sugar level modeling among Kelantanese using structure equation techniques: a case study

Sugar control in patients with type 2 diabetes mellitus is a crucial part of managing the disease to ensure the progress of further complication of the cardiovascular disease. The aim of this case study is to look into the factors which have a relationship with sugar level among our study sample using a structural equation technique. The sugar level was assessed as fasting blood sugar and Hemoglobin A1c. We examined four main factors which consist of physical factor, biochemistryfactor, cholesterol factor and enzyme factor. From this study, we evaluated factors which significantly have a relationship with the sugar level and these factors were uric acid creatinine urea weight BMI, and tryglicerides There were multidirectional effect and relationship between few factors with their underlying items and the fasting blood sugar or Hemoglobin A1c

Validation of the questionnaire “Pregnancy Vaccine Hesitancy Scale (pVHS)” toward COVID-19 vaccine for Malaysian pregnant women

Background Pregnancy is one of the risks for severe COVID-19 infection, and receiving a vaccination is one of the effective methods to reduce disease severity. However, COVID-19 vaccine hesitancy among pregnant women remains an issue. This study aims to develop and validate the pregnancy Vaccine Hesitancy Scale (pVHS) toward COVID-19 vaccine for Malaysian pregnant women. Method An 8-item Malay language pregnancy Vaccine Hesitancy Scale (pVHS-M) for COVID-19 was adapted from the adult Vaccine Hesitancy Scale and validated using Exploratory Factor Analysis. Six expert panels were involved in content validity, and ten pregnant women were involved in face validity. A cross-sectional study on 200 pregnant women was conducted between October 2022 and March 2023 at the Obstetrics and Gynaecology Clinic, Universiti Sains Malaysia, Kelantan. Result The item-level content validity index is 1.00, demonstrating good relevance of the eight items used to assess COVID-19 vaccine hesitancy. The item-level face validity index obtained is 0.99, indicating that the items were clear and comprehensible. The Cronbach alpha score was 0.944, with factor loadings ranging from 0.79 to 0.89. Conclusion The pVHS-M demonstrated good internal consistency, indicating that it is a valid and reliable tool for assessing COVID-19 vaccine hesitancy among pregnant women