Sexual dysfunction among post-partum women and its associated risk factors in Primary Care Clinics in Kuantan, Pahang

Introduction: Childbirth is one of the recognized risk factors for female sexual dysfunction (FSD). Despite high prevalence of female sexual dysfunction worldwide, there is very limited data concerning sexual dysfunction in postpartum women. The aim of our study is to determine the prevalence of FSD and its subtypes among postpartum women in primary health clinics in Kuantan, Pahang. Materials and method: This cross-sectional study was conducted at 9 primary health clinics located at urban and suburban areas in Kuantan, Pahang from February to June 2018. A validated Malay version of Female Sexual Function Index (MVFSFI) was used to assess FSD. A total of 372 women who have given livebirth within 6 weeks to 6 months were invited to participate in this study. Results: The prevalence of FSD among postpartum women in the primary care population was 35.5%. The most common reported sexual dysfunction was lubrication disorder (85.6%), followed by desire disorder (69.7%), pain disorder (62.9%), arousal disorder (11.0%), orgasmic disorder (9.7%) and satisfaction disorder (7.3%). Our results showed that level of education (aOR= 1.71 95% CI 1.04, 2.84) and use of contraception (aOR= 0.58 95% CI 0.36, 0.95) were associated with postpartum sexual dysfunction. Conclusion: The prevalence of FSD among postpartum women in primary care clinics in Kuantan, Pahang was high. Thus, it is important for the healthcare providers to address this issue during postpartum consultation at primary care level

Difference between Alar ligament of male and female: MRI perspectives

Background: Road traffic accidents have caused serious public health concerns; which include whiplash-associated disorders involving cervical spine. MRI is often required to supplant diagnosis of this condition. Nevertheless, alar ligament of the cervical spine may show variability in MR appearance; most profoundly signal hyperintensity easily mistaken as injury. Purpose: The main purpose of the study is to compare the normal anatomy of alar ligament on MRI between male and female in terms of its course, shape, orientation and signal homogeneity, despite determining the association between the heights of respondents with alar ligament dimensions. Methodology: 50 healthy volunteers were studied on 3.0T MR scanner Siemens Magnetom Spectra using 2-mm proton density, T2 and fat-suppression sequences. Alar ligament is depicted in 3 planes and the visualization and variability of the ligament courses, shapes and signal intensity characteristics were determined. The alar ligament dimensions were also measured. Results: Male respondents were 70% more likely to exhibit alar ligament signal inhomogeneity which is statistically significant (p = 0.02). No significant difference in alar ligament shape, size and orientation was seen between both genders. However positive correlation between height and the craniocaudal diameter of the alar ligament as well as the anteroposterior diameter, regardless of gender; which were statistically significant (r = 0.25, n = 100, p = 0.01 and r = 0.201, n = 100, p = 0.045 respectively). Conclusion: Presence of gender variability of alar ligament MR signal intensity as depicted in our data shows that caution needs to be exercised when evaluating alar ligament, especially during circumstances of injury. Acknowledgement: Radiology Department, Sultan Ahmad Shah Medical Centre (SASMEC

Characterization of alar ligament on 3.0T MRI: a cross-sectional study in IIUM Medical Centre, Kuantan

INTRODUCTION: The main purpose of the study is to compare the normal anatomy of alar ligament on MRI between male and female. The specific objectives are to assess the prevalence of alar ligament visualized on MRI, to describe its characteristics in term of its course, shape and signal homogeneity and to find differences in alar ligament signal intensity between male and female. This study also aims to determine the association between the heights of respondents with alar ligament signal intensity and dimensions. MATERIALS & METHODS: 50 healthy volunteers were studied on 3.0T MR scanner Siemens Magnetom Spectra using 2-mm proton density, T2 and fat-suppression sequences. Alar ligament is depicted in 3 planes and the visualization and variability of the ligament courses, shapes and signal intensity characteristics were determined. The alar ligament dimensions were also measured. RESULTS: Alar ligament was best depicted in coronal plane, followed by sagittal and axial planes. The orientations were laterally ascending in most of the subjects (60%), predominantly oval in shaped (54%) and 67% showed inhomogenous signal. No significant difference of alar ligament signal intensity between male and female respondents. No significant association was found between the heights of the respondents with alar ligament signal intensity and dimensions. CONCLUSION: Employing a 3.0T MR scanner, the alar ligament is best portrayed on coronal plane, followed by sagittal and axial planes. However, tremendous variability of alar ligament as depicted in our data shows that caution needs to be exercised when evaluating alar ligament, especially during circumstances of injury

Lipid control and its associated factors among patients with type 2 diabetes mellitus attending government health clinics in Kuantan, Pahang

Studies have shown that type 2 diabetes mellitus (T2DM) and dyslipidaemia were strong predictors of the likelihood that an individual will develop cardiovascular (CV) disease. The main aim of this study was to ascertain the attainment of the primary target in lipid control specifically LDL-cholesterol (LDL�C) among patients with T2DM in primary care settings based on their individualised CV risk according to the latest local guideline. Materials and method: This multicentre cross-sectional study was conducted among patients with T2DM attending government health clinics in Kuantan using simple random sampling. The data were collected from the participants’ diabetes records. They were also asked to answer two validated questionnaires, International Physical Activity Questionnaire (IPAQ) and Malaysian Medication Adherence Assessment Tool (MyMAAT) to assess for the associated factors. Results: A total of 418 participants completed the study. Alarmingly, only 34 (8.1%) achieved the LDL-C target across all CV risk categories. Notably, those who were adherent to lipid-lowering medications and engaged in moderate physical activity were more likely to achieve the lipid target after multiple logistic regression analysis. Conclusion: The proportion of lipid control among participants was very low, emphasizing the urgent need for improvement. Promoting the importance of both physical activity and medication adherence is imperative to enhance these outcomes

Mental health and early adolescent: a prevalence study

Prevalence of mental health problems among children and adolescent is increasing in trend as reported in the National Health Morbidity Survey (NHMS). Male, younger age group and from low socioeconomic status were at higher risk to develop this problem. This study aimed to measure the prevalence of mental health problems and their associated factors among young adolescent in Kuantan, Pahang

Nutritional knowledge, attitude and practice among antenatal and postnatal mothers in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang 2016

Background: Balanced and sufficient maternal nutritional intake ensures not only the wellbeing of pregnant mother, fetus and newborn (protection of life), but also her future health and her three generations (protection of progeny). Nutritional inadequacies during pregnancy have been reported and several factors were attributed. The objectives were to measure nutritional knowledge, attitude and practice (KAP) during pregnancy and the relationship with socio-demographic characteristics. Methods: Cross-sectional study was conducted among 320 antenatal and postnatal mothers in Hospital Tengku Ampuan Afzan (HTAA), Pahang, Malaysia from 18th July to 27th August 2016. A pre-tested self-constructed, interview-guided questionnaire was used. Independent variables were age, ethnicity, educational level, marital status, and monthly household income. Outcomes were nutritional KAP level with median used for the categorization. Relationship between independent variables and outcomes obtained by logistic regression with significance at p<0.05. Results: Sixty-five percent aged from 25 to 34, 84% Malays, 37% completed secondary education with SPM/Olevel, 96% married, 48% from middle-income family, 52% had good nutritional knowledge, 67% with positive attitude and 55% with good practice. Age and educational level were significantly related to knowledge. Only educational level was significantly related to practice. Less than 70% of respondents have good nutritional KAP, reflected by educational level with more than half of them received up to secondary education. Hence, the rights of mothers in getting necessary and adequate education should be fulfilled. Conclusion: Results emphasize on the importance of empowering girls and women with adequate educations and to strengthen the nutritional and health education of our educational system. It is for them to be knowledgeable with good attitude and practicing healthy nutritional lifestyle as they entering reproductive life, maintaining and transferring at least optimum healthy life to their progenies

Prevalence of physical activity and its association with body mass index among late adolescents in Kuantan, Malaysia

A national data reported more than half of school going adolescents in Malaysia were physically inactive. This study aimed to describe the prevalence of physical activity among late adolescent in Kuantan, Malaysia and to determine factors associated with their physical activity level. A cross sectional study among late adolescents aged 17 - 19 from seven governmental higher learning institutions in Kuantan, Malaysia was conducted from April to October 2018. A validated, selfadministered International Physical Activity Questionnaire (IPAQ) questionnaire was used to measure the level of physical activity among participants. Weight and height of the participants were measured and the body mass index (BMI) was calculated. Chi-square test was used to test for association between physical activity level and BMI of the participants. The association between physical activity and socio-demographic profile was tested using logistic regression analysis. One third of the participants (37.6 %) have high physical activity level while 29.0% of them only practiced low physical activity level. Non-smokers were 0.4 times more physically active than smokers (aOR 0.39, 95% CI 0.19-0.78) while male gender was 2.46 times more active than female (aOR 2.46, 95% CI 1.55-3.92). There was no statistically significant association between physical activity level with BMI of the participants (2 = 0.93, p = 0.63). Only one third of late adolescents in our study practiced high level of physical activity. This is worrying as it may leads to increased number of morbidity and mortality related to low physical activity. Furthermore, physical activity level during adolescence-age group may influenced their physical activity level during adulthood. Therefore, continuous health education focused on the important of physical activity is undoubtedly crucial. Smokers were found to be less physically active than non-smokers. Hence, health education focused on the important of physical activity and the harm of smoking should be targeted simultaneously. Clinica

Level of physical activity and it’s associated factors among pregnant women during pregnancy.

Co-morbidities such as obesity, gestational diabetes and pregnancy induced hypertension during pregnancy can be dangerous to mother and fetus. Regular physical activity during pregnancy not only maintains maternal and fetal wellbeing, but it also maintains physical fitness and brings various health benefits. However, many women reduced their physical activities during pregnancy. The objective of this study was to measure the prevalence, level and factors contributing to physical activity among pregnant women during pregnancy and identify the barriers that could prevent a pregnant woman from doing physical activities. This was a cross-sectional study involving 168 pregnant women aged 18-35 years between 12-35 weeks of gestation attended a primary health clinic in Kuantan, Pahang. Their socio- demographic characteristics were recorded, and three sets of questionnaires were used; validated Malay version of IPAQ (short-form) for assessing physical activity, DASS -21 Malay version for evaluating psychological symptoms and a pre-tested questionnaire for assessing barriers for physical activity. Chi-square test, Fishers exact test, Independent t-test and multiple logistic regression were conducted using IBM SPSS Statistics version 23.0. Significant level was set at p value <0.05. The mean (SD) age was 28.0(3.6) and majority of them were Malay ethnicity from B40 group. Two third (74.4%) had tertiary education and 66.7% were working mothers. More than half (53.0%) of the participants were overweight and obese. Among 168 respondents, 24.4% had moderate level of physical activity, but the majority (76.0%) had low- level physical activity. Likewise, about 78.6% were physically inactive and only 22.0% physically active during pregnancy. For the barriers, we found that 58.0% of the participants had leg cramp, 63.1% felt fatigue, 80.4% had backache and 46.4% had epigastric discomfort. We have not found any significant factors associated with physical activity level. Majority of the pregnant women conducted low level of physical activity and less than quarter of the pregnant women were physically active. Physical barriers such as leg cramp, backache, fatigue and epigastric discomfort could prevent pregnant women from conducting physical activities

Knowledge and practices on i-Ta'aleem and other educational technologies among International Islamic University Malaysia Kulliyyah of Medicine lecturers

Technologies in the classroom require teacher’s knowledge and skills in utilizing it. Teaching for medical student can be different in some areas. To date, no studies has been conducted on the use of technologies among medical lecturer in International Islamic University Malaysia (IIUM). Thus, the objective of this survey is to determine the level of awareness, practice and perception of learning management system (i-Ta’aleem) and educational technologies among Kulliyyah of Medicine (KOM) lectures. Materials and Methods: This cross-sectional study was conducted among all IIUM KOM lecturers. Only 26.1% responded to the self-administered questionnaire which was distributed via google form for one month. Descriptive analysis was used to analyze the background information and their awareness, practice and perception. Results: Majority of the respondents were male (56.8%), permanent staff (94.6%) with mean years of service at IIUM was6.7. Most of them owned technology tools [smartphone (100%), personal computer (73.0%), tablet (54.1%) and laptop (97.3%)]. All of them heard about i-Ta’aleem. However, 78.4% never use i-Ta’aleem and only a small percentage of them always uses other technologies for their teaching and learning (2.7% to 5.4%) except the usage of laptop (48.6%) and projector (59.5%). Conclusion: Although the lecturers were aware about i-Ta’aleem and owned high technology tools and gadget, only a small percentage of them use it in teaching activities