Prevalence and factors associated with internet addiction among adolescents in Malaysia: a cross-sectional study

Introduction: Internet is important to university students, especially for medical students who use it to search for literature and relevant information. However, some of the users are experiencing a gradual loss of the ability to reduce the duration and frequency of their internet activities, despite the negative consequences. The literature on internet usage among Malaysian medical students is limited. This study aims to determine the prevalence and factors associated with internet usage among medical students in a public university in Malaysia. Methods: This cross-sectional study was performed among all the medical students (Year 1-5). Students were assessed on their internet activities using the internet addiction questionnaires (IAT). A Multiple Logistic Regression was used for data analysis. Results: The study was conducted among 426 students. The study population consisted of 156 males (36.6%) and 270 females (63.4%). The mean age was 21.6 ±1.5 years. Ethnicity distribution among the students was: Malays (55.6%), Chinese (34.7%), Indians (7.3%) and others (2.3%). According to the IAT, 36.9% of the study sample was addicted to the internet. Using the multivariate logistic regression analysis, we have found that the use of internet access for entertainment purposes (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.05-12.00), male students (OR 1.8, 95% CI 1.01-3.21) and increasing frequency of internet usage were associated with internet addiction (OR 1.4, 95% CI 1.09- 1.67). Conclusion: Internet addiction is a relatively frequent phenomenon among medical students. The predictors of internet addiction were male students using it for surfing and entertainment purposes

Prevalence and Factors Associated with Smartphone Addiction among Adolescents–A Nationwide Study in Malaysia

Smartphone ownership among adolescents is getting common in this decade especially in Malaysia; Adolescent are strongly devoted to their smartphone and this may lead to smartphone addiction. Studies have reported that smartphone addiction has become an emerging social and health problem especially among the youth in many countries however there is lack of study among adolescents in Malaysia. This study aimed to examine the prevalence and factors associated with smartphone addiction among adolescents in Malaysia. This was a cross-sectional study involving adolescents from 15 primary care clinics throughout the country. Respondents were assessed on their smartphone activities using the Malaysian short version of the Smartphone addiction scale (SAS-M-SV). Multiple logistic regression was used to determine the predictors of smartphone addiction among adolescents. The study was conducted among 921 adolescents with 49.6% male (n = 457). The mean age of adolescents was 16.4 ± 2.4 years. The ethnicity distribution were 74.6% Malay, 7.3% Chinese, 4.7% Indian and 13.4% other ethnicities. The prevalence of smartphone addiction was 37.1% (342/921); 37.4% in male and 36.9% in female. Based on multiple logistic regression analysis, longer duration of smartphone use per week was associated with higher odds of smartphone addiction among adolescent (odd ratio = 1.005%, 95% confidence interval = 1.000–1.009, p-value = 0.039). Smartphone addiction is present in nearly four in ten adolescents in Malaysia. Adolescents who spend longer duration in smartphone usage per week were associated with higher odds of having smartphone addiction. Parents should be more alert and vigilant about this finding. Hence, parents should limit their children from spending too much of time with smartphone in order to prevent their children from getting smartphone addiction

Prevalence and Factors Associated with Smartphone Addiction Among Adolescents-A Nationwide Study in Malaysia

Smartphone ownership among adolescents is getting common in this decade especially in Malaysia; Adolescent are strongly devoted to their smartphone and this may lead to smartphone addiction. Studies have reported that smartphone addiction has become an emerging social and health problem especially among the youth in many countries however there is lack of study among adolescents in Malaysia. This study aimed to examine the prevalence and factors associated with smartphone addiction among adolescents in Malaysia. This was a cross-sectional study involving adolescents from 15 primary care clinics throughout the country. Respondents were assessed on their smartphone activities using the Malaysian short version of the Smartphone addiction scale (SAS-M-SV). Multiple logistic regression was used to determine the predictors of smartphone addiction among adolescents. The study was conducted among 921 adolescents with 49.6% male (n = 457). The mean age of adolescents was 16.4 ± 2.4 years. The ethnicity distribution were 74.6% Malay, 7.3% Chinese, 4.7% Indian and 13.4% other ethnicities. The prevalence of smartphone addiction was 37.1% (342/921); 37.4% in male and 36.9% in female. Based on multiple logistic regression analysis, longer duration of smartphone use per week was associated with higher odds of smartphone addiction among adolescent (odd ratio = 1.005%, 95% confidence interval = 1.000–1.009, p-value = 0.039). Smartphone addiction is present in nearly four in ten adolescents in Malaysia. Adolescents who spend longer duration in smartphone usage per week were associated with higher odds of having smartphone addiction. Parents should be more alert and vigilant about this finding. Hence, parents should limit their children from spending too much of time with smartphone in order to prevent their children from getting smartphone addiction

Acute Urinary Retention – It Is Not about the Bladder

Chronic cyclical abdominal pain in an adolescent female is indeed a rare occasion. Nevertheless, concomitant presence of acute urinary retention in the background history delayed menarche will give clues towards possibility of imperforate hymen (IH). Nevertheless, adequate physical examination, especially abdominal and gynaecological assessment in the adolescent female is indeed important in making the conclusion. We shared a case of a 12-year-old girl who came to us with recurrent lower abdominal pain for three months associated with inability to pass urine on the day of presentation. Perineum inspection showed bulging hymen with inability to catheterize the urethral opening. Bedside ultrasound was performed and revealed a fluid filled lesion in her vagina showing features of hematocolpos. A diagnosis of imperforate hymen was made clinically, and she was referred urgently to the gynaecology team for surgical intervention. Hymenotomy was done and she was saved from further morbidity. This case highlights the importance of identifying gynaecological causes in a female patient with acute urinary retention especially if the patient had prior episodes of recurrent cyclical symptoms that may be highly associated with imperforate hymen.   Keywords: Hematocolpos, Bladder, Acute Urinary Retentio

Major depressive disorder in the adolescent – barriers to managing adolescent mental health problems at primary care

Aims/Background: Major Depressive Disorder (MDD) among adolescents is increasing, and it is an important health problem leading to high-risk behaviors and suicide. Therefore, early identification is vital for immediate intervention. The primary care team acts as an intermediator in managing major depression, whereby parents and school officials play an essential role in achieving optimum recovery. This case report aims to acknowledge the importance of biopsychosocial support and unveil the barriers faced in managing adolescent MDD in primary care. \ud Methodology: This was a case of a female adolescent aged 14 years old, diagnosed with MDD after a comprehensive psychological assessment. She had visited the clinic a few times prior to the diagnosis for other acute problems, but MDD has never been picked up. She has been co-managed by specialists at the primary care and hospital psychiatry clinics. Her initial management included two weekly clinic follow-ups for clinical monitoring and counselling sessions with trivial improvement. Following an intensive approach comprising patient-family counselling, frequent school visits, patient self-empowerment, and regular hospital psychiatric clinic follow-ups for psychotherapy sessions has shown a significant improvement in her mental health condition. Her mood is elevated; she shows interest in daily activities and can focus on classes. Results: This case exhibited a high commitment to dealing with MDD in adolescents. We found four critical challenges in managing her: 1) To pick up the diagnosis of MDD earlier for immediate intervention. 2)Poor compliance with medication and defaulted follow-up. 3)Psychosocial issues related to the illness, such as personal and social stigma, lead to embarrassment and despair. 4)Poor family support with high academic expectations and inadequate school monitoring. Conclusion: This case highlighted the importance of a multidisciplinary team approach and good psychosocial support, primarily parental care, school officials’ assistance, and peer group acceptance, to overcome barriers such as early diagnosis, patient compliance, personal and social stigma, and psychosocial support in managing mental health illness among adolescents toward achieving optimum care and recover

It is tuberculosis or melioidosis? a clinical diagnostic dilemma

Pulmonary Tuberculosis (PTB) is an endemic disease in Malaysia and continues to cause great morbidity and mortality. However, the diagnosis and treatment may pose a challenge to the attending physician since other diseases such as melioidosis can mimic tuberculosis. Hence, the final diagnosis should be done thorough history of illness, physical examination, investigations, and interpretation of findings. We present here a case of a 27-year-old man who presented at our primary care clinic with underlying diabetes mellitus whose symptoms were suggestive of PTB, and who was treated with anti-tuberculosis but later his sputum grew culture Burkholderia pseudomalle

Major Depressive Disorder in the adolescent – barriers to managing adolescent mental health problems at primary care

Major Depressive Disorder (MDD) among adolescents is an important health problem among adolescents and leads to high-risk behaviours and suicide. Given the increasing prevalence of MDD among adolescents, early identification is vital for immediate intervention. The primary care team is an important intermediator in managing MDD, whereby parents and school officials play pivotal roles in achieving optimum recovery. This case report aims to acknowledge the importance of biopsychosocial support and unveil the barriers faced in managing adolescent MDD in primary care. This was a case of a female adolescent aged 14 years old, diagnosed with MDD after a comprehensive psychological assessment. She had previously visited the clinic several times for other acute problems before MDD was diagnosed. She has been co-managed by primary care and hospital psychiatry clinic specialists. Her initial management included two weekly clinic follow-ups for clinical monitoring and counselling sessions with trivial improvement. Her mental health condition was significantly improved after an intensive approach comprising patient-family counselling, school visits, patient self-empowerment, and hospital follow-ups for psychotherapy sessions. Furthermore, her mood improved, evident in her interest in daily activities and focus on classes. Despite the busy schedules of primary care doctors, a high commitment is required for the successful management of MDD in adolescents and overcoming its challenges. Primary care plays an important role in employing a multidisciplinary team approach to coordinate care with the family and school and improve psychosocial support and peer group acceptance. Barriers could be addressed to catalyse the diagnostic process, reduce personal and social stigma, and enhance self-empowerment and compliance in achieving the most favourable care and recovery

Prevalence and factors associated with internet addiction among adolescents in Malaysia : a cross-sectional study

Background: Internet addiction (IA) among adolescents has become an important health problem due to its association with many negative consequences if not prevented early. However, there were no data on IA among adolescents in Malaysia. Aim: The objective of this study was to determine the prevalence and factors associated with IA among adolescents aged 10 to 19 years of age in Malaysia. Methods: A cross-sectional study was done in 15 primary care clinics throughout Malaysia using the validated Malay version of the Internet Addiction Test. A standardized, self-administered questionnaire on socio-demographic data and questions assessing IA were given to the participants. Data analyses were done using Statistical Package for Social Sciences (SPSS) 21. The findings were described in terms of frequencies, percentages, means, and standard deviations. The association between socio-demographic factors and IA was determined by using univariate analysis. Multivariate logistic regressions were used to identify predictors of IA Results: A total of 921 participants were included in this study. The male population was 49.5% (n=456), with a mean age of 16.38±2.38 years. The prevalence of internet addiction was 56.4% (n=519). The significant predictors of internet addiction were age, mother's high education level, and having a smartphone. Conclusion: This study showed that there is a high prevalence of internet addiction among adolescents in Malaysia