Prevalence of complementary alternative medicine use among patients with type II diabetes in Negeri Sembilan, Malaysia

The uses of Complementary and Alternative Medicine (CAM) among patients with chronic diseases are becoming increasingly popular. This was a descriptive cross-sectional study conducted in 45 government health clinics across Negeri Sembilan. Respondents at diabetes clinics were selected via systematic random sampling and interviewed using structured questionnaire. CAM usage was divided into three groups; CAM use for diabetes (CAM-DM), CAM use for general health (CAM-G) and Non CAM user. The prevalent use of CAM among type II diabetes mellitus patients in Negeri Sembilan was 58.5% (CAM-DM: 40.6% and CAM-G: 17.9%). For CAM-DM group, bitter gourd (Momordica charantia) was the most popular CAM consumed to help control diabetes, while supplement milk was the most popular choice for the CAM-G group. In conclusion, the use of CAM among type II diabetes mellitus patients in Negeri Sembilan was common. Natural products are the main choice of CAM modality used to help with the management of diabetes. Majority of CAM users never informed their healthcare providers about their CAM use

Faktor Penghalang dan Penggalak Kepatuhan daripada Perspektif Pesakit Tuberkulosis Cicir Rawatan di Kuala Lumpur (Barriers and Motivation Factors towards Treatment Compliance from the Perspective of Defaulted Tuberculosis Patients in Kuala Lumpur)

There is a large volume of published studies describing the adverse relationship between treatment non-adherence with tuberculosis treatment outcome. Non-adherence could result in increased risks of prolonged infectiousness, drug resistance, relapse cases and poor survival among tuberculosis patients. Nevertheless, few studies are to be found providing detailed on the reason of defaulting treatment among tuberculosis patients in Malaysia. Hence the goal of this paper is to find out the barriers and motivations factors that affect patients’ treatment compliance among our local tuberculosis patients. This is a qualitative study which included 12 in-depth interviews with tuberculosis non-compliance patients who were treated at Institute of Respiratory Medicine, Kuala Lumpur. All the conversations were recorded, transcribed and analysed by using thematic analysis. It was found that low knowledge, self-negative attitudes, traditional believes, negative perceptions towards health caregiver, drug side effects, stigma, financial problems, less family support and work commitments are the barriers that prevent the patients from religiously taking their anti-tuberculosis treatment. Meanwhile, factors that encourage them to continue their treatment were the believes of bad effects of the disease onto their lives and health, good relationship between patient and health caregiver and social support from people around them. In conclusion, non-adherence involved a dynamic influence of individual, socio-economic and treatment-related factors on the patients. The results presented here may facilitate improvement in the activities in promoting compliance among tuberculosis patients in the future which tailored to the patients’ specific needs

Faktor penghalang dan penggalak kepatuhan daripada perspektif pesakit tuberkulosis cicir rawatan di Kuala Lumpur

Terdapat banyak kajian yang diterbitkan sebelum ini mengaitkan perhubungan buruk antara ketidakpatuhan terhadap rawatan dengan hasil rawatan tuberkulosis. Ketidakpatuhan boleh mengakibatkan peningkatan risiko kepada kejangkitan yang berpanjangan, resistan ubat, kes-kes berulang, dan peluang kemandirian yang tipis dalam kalangan pesakit tuberkulosis. Namun, masih terdapat kurang kajian yang menyediakan maklumat berkaitan sebab di sebalik ketidakpatuhan dalam kalangan pesakit tuberkulosis di Malaysia. Maka, objektif kajian ini ialah untuk menentukan faktor-faktor penghalang dan penggalak yang mempengaruhi kepatuhan dalam kalangan pesakit tuberkulosis tempatan. Kajian ini merupakan kajian kualitatif yang mana melibatkan 12 temu bual mendalam dengan pesakit tuberkulosis cicir rawatan yang menerima rawatan di Institut Perubatan Respiratori, Kuala Lumpur. Semua perbualan telah direkodkan, ditranskripsi, dan dianalisis dengan menggunakan analisis tematik. Didapati bahawa kurang pengetahuan, sikap negatif diri sendiri, kepercayaan tradisional, persepsi negatif terhadap pemberi rawatan, kesan sampingan ubatan, stigma, masalah kewangan, kurang sokongan keluarga, dan komitmen masa bekerja adalah faktor-faktor yang menghalang pesakit daripada mengambil rawatan anti tuberkulosis dengan sempurna. Sementara itu, faktor-faktor yang menggalakkan mereka untuk meneruskan rawatan adalah kepercayaan terhadap kesan buruk penyakit ke atas kehidupan dan kesihatan, hubungan baik antara pesakit dan pemberi rawatan, dan sokongan sosial daripada orang sekeliling. Kesimpulannya, ketidakpatuhan melibatkan pengaruh yang dinamik antara faktor-faktor individu, sosioekonomi, dan rawatan ke atas pesakit. Hasil kajian ini dapat membantu dalam penambahbaikan aktiviti-aktiviti mempromosi kepatuhan dalam kalangan pesakit tuberkulosis pada masa akan datang disesuaikan dengan keperluan spesifik pesakit

Illness perceptions of Libyans with T2DM and their influence on medication adherence: a study in a diabetes center in Tripoli.

BackgroundThe surrounding environment influences the constitution of illness perceptions. Therefore, local research is needed to examine how Libyan diabetes patients perceive diabetes and how their perceptions influence their medication adherence.MethodsA cross-sectional study was conducted at the National Centre for Diabetes and Endocrinology in Tripoli, Libya, between October and December 2013. A total of 523 patients with type 2 diabetes participated in this study. A self-administered questionnaire was used for data collection; this included the Revised Illness Perception Questionnaire and the eight-item Morisky Medication Adherence Scale.ResultsThe respondents showed moderately high personal control and treatment control perceptions and a moderate consequences perception. They reported a high perception of diabetes timeline as chronic and a moderate perception of the diabetes course as unstable. The most commonly perceived cause of diabetes was Allah's will. The prevalence of low medication adherence was 36.1%. The identified significant predictors of low medication adherence were the low treatment control perception (p=0.044), high diabetes identity perception (p=0.008), being male (p=0.026), and employed (p=0.008).ConclusionDiabetes illness perceptions of type 2 diabetic Libyans play a role in guiding the medication adherence and could be considered in the development of medication adherence promotion plans

Verbal memory test performance in patients with bipolar I disorder attending a psychiatric clinic of a university hospital in Kuala Lumpur, Malaysia

Objective: The study aims to determine pattern of verbal memory and learning impairment and its associated factors among patients with bipolar I disorder in a psychiatric clinic of a university hospital. Methods: A case control study comparing verbal memory test performance in 40 patients with bipolar I disorder to that of 40 healthy normal subjects using Rey Auditory Verbal Learning Test (RAVLT). The association between demographic, clinical characteristics and poor verbal memory performance were examined. Results: Up to 92% of patients with bipolar I disorder have impaired short term working memory in this hospital-based study. They also recalled fewer words in all the RAVLT trials and had difficulties learning the word list in comparison to that of normal healthy individuals. Verbal memory and learning impairment are observed in bipolar illness in the absence of active mood symptoms while duration and severity of illness are not found to have any effect on verbal memory and learning. Conclusion: There is consistent verbal memory and learning problems in individuals with bipolar I disorder and their presence in the absence of mania, depression and mixed symptoms during the course of the illness suggests a trait related deficit

Neuro-cognitive performance in patients with schizophrenia: a cross-sectional study in a psychiatric clinic of a University Hospital

Introduction: Poor neuro-cognitive performance in patients with schizophrenia has been described as a core symptom of the illness and is shown to be associated with poor psycho-social functioning. Management of schizophrenia has shifted its focus to treat this deficit apart from only emphasising on positive and negative symptoms, as it will subsequently improve patient functioning and outcome. Objective: The study aims to determine the proportion of neuro-cognitive impairment in patients with schizophrenia in a psychiatric clinic in Hospital Universiti Kebangsaan Malaysia and factors that are likely to be associated with the impairment. Method: Across-sectional study design was conducted in this hospital-based study and subjects were randomly chosen from the psychiatric clinic. Rey Auditory Verbal Learning Test (RAVLT), Digit Forward and Backward (DF and DB), Trail Making Test (TMT) and Verbal Fluency Test (VF) were used to assess subjects' neuro-cognitive performance that measured their verbal memory and executive functioning of the brain. Results: The proportion of neuro-cognitive impairment is estimated at about 80% in patients with schizophrenia in this hospital-based study. A higher percentages of respondents had abnormal scores for RAVLT1, RAVLT5 and RAVLTB tests(75.6%, 68.3% and 82.9% respectively). The majority of respondents had normal scores for DF, VF tests (80.5% and 73.2% respectively), and about 51.2% of respondents had normal scores for DB test. For TMT, overall performance of respondents in Set A and B was poor. The mean duration of time taken to complete both sets was longer than that of a normal population based on age group: (age group: 18-39 years; TMT A 68.98 vs 40 seconds; TMT B 174.09 vs 90 seconds and age group: 40-49 years; TMT A 58.57 vs 45 seconds; TMT B 162.43 vs 100 seconds). There was a significant association between duration of illness and scores of RAVLT1 and between age of onset of illness and RAVLTB scores (p<0.05). There was no significant association between scores of all tests with the type of treatment received by respondents. Conclusion: The proportion of neuro-cognitive impairment in patients with schizophrenia is very high (80%) and has major implications on the current management of schizophrenia in which this core symptom should also be a focus of treatment. The significant association between clinical factors and neuro-cognitive impairment highlights the importance of modifying those factors in order to minimise the deficit in patients with schizophrenia

Validity and reliability of an instrument assessing the associated factors for preventive behavior towards dengue

Dengue is one of the most important vector-borne diseases in Malaysia. Government efforts alone are not sufficient in preventing the disease if people continue to allow the widespread mosquito breeding in their housing compound. Individual or community behavior is an important factor in the prevention of dengue. However, there is no standard instrument to measure the associated factors of dengue preventive behavior. This study commenced to validate and assess the reliability of a newly developed instrument for the constructs measuring factors associated with dengue preventive behavior. Methods: A total of 327 respondents involved in this pilot study, which is a preliminary study to a larger scale study. Exploratory factor analysis (EFA) was employed to explore underlying constructs of the latent variables. Results: From the EFA, 10 factors (knowledge regarding dengue, behavior toward dengue prevention, fear and awareness toward dengue, motivation to adopt preventive behavior, medical practices for dengue fever, cooperation in dengue prevention, perceived susceptibility of dengue, perceived severity of dengue, perceived benefit from practicing dengue preventive behavior, and perceived barrier toward dengue preventive behavior) emerged contributing 63.1 percent of the total variance with the reliability of 0.791. Conclusions: The questionnaire is valid and reliable to measure the associated factors of preventive behavior toward dengue

Obesity among urban primary schoolchildren

Three urban public primary schools in the district of Petaling, Selangor were surveyed for obesity amongst the schoolchildren and factors related to it. The prevalence of obesity amongst primary schoolchildren, with the mean age of 8.91 years was 9.5%. In addition, it was more prevalent among the boys (p<0.05) as compared to the girls. However, there was no difference with regards to ethnicity, being breastfed, physical activity, time spent watching television or fast food intake in relation to obesity among these primary schoolchildren. A larger community study is required to determine if other specific factors and dietary energy intake are associated with obesity amongst primary schoolchildren, especially in rural or less urbanised regions

Environmental factors associated with Sarcopenia: a systematic review

Elderly is a vulnerable population that is prone for sarcopenia which is associated with the loss of muscle mass, strength and function which are one the diseases that affects elderly. Association between environmental factors with sarcopenia should be explored as it has the potential to influence the health and disability of a person. At present, limited research is conducted to investigate the association which could be attributed to the complex interaction between the human and environmental interactions. Hence this review is conducted to identify the environmental factors associated with sarcopenia. A systematic review was conducted using PubMed, SCOPUS, Web of Science and manual search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We used articles that have been written in English and relevant articles were then screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords environmental factors, pollutants food environment, neighbourhood environment, locality and sarcopenia were included. Initial search generated 934 publications and 12 articles were included after inclusion and exclusion criteria for this review. In this review, environmental factors associated with sarcopenia are divided into 3 themes that comprises of food environment (availability and physical access, economic access and food quality and safety), neighbourhood environment and pollutants. This systematic review revealed association between the food environment, neighbourhood environment and pollutants with sarcopenia. The findings are salient as it could aid the the policy makers to formulate the necessary strategy to reduce the morbidity and mortality associated with sarcopenia especially with the increase in ageing population globally

Internal consistency study of EORTC QLQ-C30 and QLQ-PR25 questionnaires for quality of life assessment among prostate cancer patients in a University Hospital, Kuala Lumpur, Malaysia

Introduction Prostate cancer is forth most common diagnosed tumors in Malaysian male. The use of a self-reported, quality of life assessment is important for clinical practice, care taker and researcher to evaluate the level of quality of life. The aim of this study was to measure the internal consistency of the translated Malay Language EORTC QLQ-C30 and EORTC PR-25 questionnaires among prostate cancer patient at National University of Malaysia hospital in Kuala Lumpur, Malaysia. Methods This was a cross sectional study conducted between July 2017 and Dec 2017. The respondent comprised of 110 Malaysian prostate cancer patients who were under follow up at Urology and Oncology Clinic. Sets of translated Malay language EORTC QLQ C30 and EORTC PR-25 consisted of functional, symptom and global health status domains were administered to assess their quality of life. Results The translated questionnaires were acceptable by 110 respondents. Cronbach`s α coefficient result were 0.913 (EORTC QLQ-C30) and 0.829 (EORTC PR-25) respectively suggested that this instrument had good internal consistency. Conclusions Our study confirmed that translated Malay language EORTC QLQ-C30 and QLQ-PR25 questionnaires are acceptable, reliable and valid instrument to be used among Malaysian prostate cancer patients