The objective of this cross -sectional study is to determine the prevalence and pattern of herbal medicines use during pregnancy among women in Tumpat district, Kelantan. A total of 210 mothers were interviewed using a structured questionnaire. There were 108 mothers (51.4%) who used at least one type of herbal medicines during pregnancy. The most common herbal medicines used (63.9%) was coconut oil which was ingested during the third trimester of pregnancy only. The most common indication was (89.8%) to facilitate labour. The majority of users (79.6%) used herbal medicines during the third trimester of pregnancy only. Many of them (81.5%) believed that herbal medicines were effective to solve their health problems and fulfilled the indications for use. The older generation like parents and in laws (63.9%) were the most common persons who suggested using herbal medicines. The majority of them used the herbs only once (56.5%) and one type (87.0%) throughout the pregnancy. Further research focusing on local commonly used herbal medicines is to be carried out to evaluate the safety and efficacy of the herbs.

Background: The objective of this study was to determine the effectiveness of MMT program among injecting drug users (IDUs) in Kota Bharu , Kelantan. Methods: The study was a retrospective study based on the records of injecting drug users (IDUs) involved in the MMT program from November 2005 to 31st January 2008, registered at the Psychiatric Clinic of Hospital Raja Perempuan Zainab II. Opiate Treatment Index (OTI) was used as the research instrument. Repeated measures ANCOVA was used to compare the mean scores during the entry period and after completing twelve months of MMT program after adjusted for age, marital status and level of education. Results: A total of 117 file records were reviewed. There was significant reduction in the mean scores after 12 months of heroin Q score , HIV Risk-taking Behavior Scale and health scale after adjusted for age, marital status and level of education. For Heroin Q score, mean difference was 2.01 (95% CI: 1.45, 2.56), for HIV Risk-taking Behavior Scale, mean difference was 7.64 (95% CI: 6.03, 9.26); and for health scale, mean difference was 5.35(95% CI: 3.90, 6.79). Conclusion: This study supports the evidence that MMT program is effective in treating heroin and opiate dependence.

Interleukin 31 (IL-31)is one of the cytokines which appears to be an important regulator of Th2 responses. Previous study has been done to determine IL-31 serums levels in atopic dermatitis (AD). However, the serum levels of IL-31 in allergic rhinitis (AR) and atopic asthma (AA) is not many reported and still unclear. The objective of this cross sectional study is to determine an association between IL-31 and other predisposing factors with allergic diseases in HRPZ II (Hospital Raja PerempuanZainab II) and HUSM (Hospital UniversitiSains), Kelantan, Malaysia. This study involved 70 patients of AD, 70 patients of AR, 70 patients of AA and 70 healthy controls from staffs and people in HUSM.Five milliliters of blood were withdrawn and centrifuged for 5 minutes at 2000 rpm to obtain the serum and analyzed for IL-31 levels by using enzyme-linked immunosorbent (ELISA) kits (Human IL 31 Duoset, R&D System). Simple and multiple logistic regressions were used to analyze the association between IL-31 levels and predisposing factors among allergic diseases. The levels of IL-31 and other predisposing factors showed significant associations in smoking status, occupational exposure and area of living for AD and AR, however in AA, the significant association only found in smoking status and occupational exposure. In conclusion, we found that there were associations between IL-31 serum levels and other predisposing factors with AD, AR and AA. The findings can be the pilot study to determine IL-31 levels in allergic diseases in Malaysia.

Parents or caregivers of children with learning disabilities have been shown to experience increases in stress and greater negative caregiving consequences than those with typically developing children. The current study sought to assess the perceived stress among Malay caregivers of children with learning disabilities in Kelantan. The Malay version of Perceived Stress Scale 10 items was administered to a sample of 40 caregivers of children with learning disabilities who were registered to five Pusat Pemulihan Dalam Komuniti (PDK) in Kelantan. Higher scores indicate higher levels of stress. The caregivers had mean age of 47.68 (SD = 9.18) years old, of whom 90% were fathers or mothers. Ninety percent of them were married, majority were unemployed or housewives and had secondary school education. The majority of children with learning disabilities were males and half of them were Down Syndrome children. The mean total Perceived Stress Scale score of the caregivers was 16.77 (SD = 5.74). There were no significant associations between total perceived stress score and any of the independent variables. The mean total perceived stress score showed that the perceived stress level was in the category of slightly higher than average and health concern level was high, while the average stress level was between score of 12 to 15. In conclusion, this result indicated that the caregivers had slightly higher levels of stress than the average score, and might increase susceptibility to stress-induced illness.
Stress ; Caregivers

Background: The need for client feedback in assessing healthcare services is widely recognized. However, little is known about the satisfaction of adolescent clients utilizing healthcare services in Malaysia. To the best of our knowledge, there is no validated instrument to measure the satisfaction of adolescent clients attending health clinics in Malaysia. This cross-sectional study aimed to determine the reliability of the Malay version of the Malaysian Ministry of Health’s Adolescent Client Satisfaction Questionnaire among adolescents attending health clinics in northeastern Malaysia. Methods: A cross-sectional study was conducted in January 2019 among adolescents aged 10–19 years attending four designated health clinics in the northeastern state of Peninsular Malaysia. The test for Cronbach’s α was performed to determine the internal consistency reliability. Results: There were a total of 85 adolescent clients involved in this study. The mean age of respondents was 15.6 years. The majority of respondents were female, Malay, students, and had attained a secondary level of education. The mean total satisfaction score was 78.35. The internal consistency reliability according to the Cronbach’s α of the domain was 0.854, which is considered highly reliable. The corrected item-total correlation for the domain was acceptable as it was ≥0.4. Conclusion The Malay version of the Malaysian Ministry of Health’s Adolescent Client Satisfaction Questionnaire has excellent internal consistency reliability. Therefore, it may be recommended as a tool to measure the satisfaction level among adolescents attending health clinics in Malaysia.

Background: No previous study has assessed the impact of childhood disability on parents and family in the context of Malaysia, and no instrument to measure this impact has previously been available. The objective of this cross-sectional study was to determine the reliability of a Malay version of the PedsQL™ Family Impact Module that measures the impact of children with disabilities (CWD) on their parents and family in a Malaysian context. Methods: The study was conducted in 2009. The questionnaire was translated forward and backward before it was administered to 44 caregivers of CWD to determine the internal consistency reliability. The test for Cronbach’s alpha was performed. Results: The internal consistency reliability was good. The Cronbach’s alpha for all domains was above 0.7, ranging from 0.73 to 0.895. Conclusion: The Malay version of the PedsQL™ Family Impact Module showed evidence of good internal consistency reliability. However, future studies with a larger sample size are necessary before the module can be recommended as a tool to measure the impact of disability on Malay-speaking Malaysian families.

INTRODUCTIONThis retrospective review aimed to examine the relationship between preoperative pulmonary function and the Cobb angle, location of apical vertebrae and age in adolescent idiopathic scoliosis (AIS). To our knowledge, there have been no detailed analyses of preoperative pulmonary function in relation to these three factors in AIS.

METHODSA total of 38 patients with thoracic or thoracolumbar scoliosis were included. Curvature of spinal deformity was measured using the Cobb method. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were used to evaluate preoperative pulmonary function. Statistical methods were used to analyse the relationship between preoperative pulmonary function and the factors that may contribute to poor pulmonary function.

RESULTSThe mean age of the patients was 16.68 ± 6.04 years. An inverse relationship was found between the degree of the Cobb angle and FVC as well as FEV1; however, the relationships were not statistically significant (p = 0.057 and p = 0.072, respectively). There was also a trend towards a significant negative correlation between the thoracic curve and FVC (p = 0.014). Patients with larger thoracic curves had lower pulmonary function. A one-year increase in age significantly decreased FVC by 1.092 units (p = 0.044). No significant relationship between age and preoperative FEV1 was found. The median FVC was significantly higher in patients with affected apical vertebrae located at levels L1-L3 than at T6-T8 or T9-T12 (p = 0.006).

CONCLUSIONLung function impairment was seen in more severe spinal deformities, proximally-located curvature and older patients.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Forced Expiratory Volume ; physiology ; Humans ; Kyphosis ; diagnosis ; physiopathology ; surgery ; Lumbar Vertebrae ; Lung ; physiopathology ; Male ; Preoperative Period ; Respiratory Function Tests ; Retrospective Studies ; Scoliosis ; diagnosis ; physiopathology ; surgery ; Severity of Illness Index ; Spinal Fusion ; methods ; Thoracic Vertebrae ; Young Adult

Introduction: The aim of the study is to determine the prevalence of burnout and correlation between burnout score and stressor domain score and to determine the association between sociodemographic and occupational related factors with overall burnout among nurses caring for children in Hospital Universiti Sains Malaysia (Hospital USM). Methods: This was a cross-sectional study using bilingual validated questionnaire; the General Stressor Questionnaire (GSQ) and Copenhagen Burnout Inventory (CBI) conducted among nurses providing medical service for children in Hospital USM particularly in wards and clinics. All 159 eligible nurses were recruited and 157 completed questionnaires were analysed. Pearson’s correlation analysis was applied to study the correlation while simple logistic regression and multiple logistic regressions were applied to study the association. Results: The prevalence of burnout among nurses caring for children in Hospital USM was 28.7% (95% CI = 21.6, 35.7) with the majority of them experienced personal burnout (49.7%, 95% CI = 41.9, 57.5). There was a significant moderate positive correlation between different stressor domain score with overall burnout score with p-value < 0.05. Work placement and bureaucratic constraints were identified as the main contributory factor leading to overall burnout. Conclusion: Burnout among nurses providing medical services for children in Hospital USM is of concern especially involving personal burnout. The main stressor related factors of burnout were work placement and bureaucratic constraints. Therefore, burnout among nurses providing care for children must be addressed in order to enhance their psychological well-being.

Introduction: Age-related macular degeneration (ARMD) is an ocular degenerative disorder that associated with impairment of central vision. Oxidative stress plays an important role in the pathogenesis of ARMD. The aim of this study was to determine the level of antioxidant enzymes (catalase and glutathione peroxidase) in tears among Malay ARMD patients. Methods: A cross sectional study was conducted between September 2015 and November 2017 among Malay ARMD patients. Schirmer paper was used to collect the tear samples. The level of catalase and glutathione peroxidase level in tears was evaluated using commercially available oxidative stress marker kits. Results: A total of 136 Malay ARMD patients were recruited into the study with 68 controls. Mean tear catalase and glutathione peroxidase levels were significantly lower in ARMD patients (1348.97 SD 109.11 µM and 453.87 SD 41.96 U/L respectively) as compared to the control group (1453.38 SD 38.87 µM and 502.28 SD 34.29 U/L respectively) (P<0.001 and P<0.001 respectively). Late ARMD has lower mean of catalase level in tears as compared to early ARMD (P=0.044). Based on subtypes of neovascular late ARMD, neovascular ARMD has lower mean catalase level in tears compared to idiopathic polypoidal choroidal vasculopathy (IPCV) (P=0.031). Conclusion: This study showed that antioxidant enzyme might play an important factor in the pathogenesis of ARMD.