Women with an abnormal Pap smear results are susceptible to distress. The objective of this study was to measure the reliability and validity of the Malay version of Psychosocial Effects with an Abnormal Pap Smear Questionnaire 14 Items (PEAPS-Q-14). A cross sectional study was conducted among 70 women with abnormal Pap smear results who were referred to three tertiary hospitals in East Coast Malaysia and completed colposcopy investigation. The self-administered PEAPS-Q-14 comprises of four domains and a total of 14 items. Descriptive analyses, Chronbach’s alpha and exploratory factor analysis were performed to measure the reliability and validity of the Malay version of PEAPS-Q-14. The final model of exploratory factor analysis on the Malay version of PEAPS-Q-14 indicated Bartlett’s Test of Sphericity was significant (Chi-square = 404.640, p value < 0.001) and the Kaiser-Meyer-Olkin (KMO) was 0.561. The items were reduced to four factors based on Eigenvalue exceeding 1 after removing an item. The retained 13 items fit the original PEAPS-Q-14 subdomains well. The model with full items demonstrated acceptable overall internal consistency of 0.724 respectively. The Chronbach’s alpha of each domain in PEAPS-Q-14 range from 0.666 to 0.917 and only an item (Item 7) under the second factor revealed corrected total item correlation of 0.183. Removal of Item 7 has resulted in better reliability of Factor 2 in which its Chronbach’s alpha increased to 0.752. Therefore, the problematic item (Item 7) will be revised and replaced before further confirmatory factor analysis.This study showed the Malay version for PEAPS-Q-14 were reliable and valid to assess the psychosocial burden among women with abnormal Pap smear results based on exploratory factor analysis.

OBJECTIVE: To determine in situ using TEM the balance of apoptosis and necrosis in the articular cartilage of patients with inflammatory (rheumatoid arthritis and seronegative spondyloarthritis) and degenerative (osteoarthritis) joint diseases and to establish possible correlation between the cell death rate and the matrix vesicles formation. METHODS: Cartilage samples of the knee joint were obtained from patients with rheumatoid arthritis (RA, 18 cases), osteoarthritis (OA, 22 cases), Reiter's disease (RD, 9 cases), peripheral form of the ankylosing spondyloarthritis (AS, 6 cases) and psoriatic arthritis (PA, 6 cases) during arthroscopy or knee surgery. Normal samples taken from autopsy cases without a history of joint diseases were used as control. Samples were processed for TEM with subsequent semi-quantitative estimation of the cell death rate in the superficial, middle and deep zone of non-calcified articular cartilage, and computer-aided ultramorphometric evaluation of the matrix vesicles of different types. RESULTS: Both apoptotic and necrotic cell death could be identified in the cartilage of patients with inflammatory joint diseases, including seronegative spondyloarthritides and degenerative arthropathies. Apoptosis dominated over necrosis in all examined arthritides, including RA patients in which necrosis of the chondrocyte was the most frequent among arthropathies, while the highest apoptotic cell death rate was discovered in OA in which it correlated with the volume and numeric density of the matrix vesicles. These data provide evidence that apoptosis may contribute to the cartilage breakdown not only in RA and OA but also in the seronegative spondyloarthritides, which had a significantly higher apoptotic rate than the normal cartilage.
Cell Death ; Osteoarthritis ; Rheumatoid Arthritis ; Cartilage, Articular ; Chondrocytes

Background: The detection and analysis of microsatellites is very important for the mapping of genetic diseases because they are commonly used as genetic markers. Microsatellite marker D19S884 has been associated with polycystic ovary syndrome (PCOS), the most common reproductive endocrine disease of women in their childbearing years. It is responsible for an estimated 70% of cases of anovulatory infertility. In this work, we detected microsatellites in DNA extracted from the blood of PCOS patients. Methods: DNA microsatellites were amplified by polymerase chain reaction (PCR) using a pair of specific primers tagged with fluorescence to yield products of 160–200 base pairs in length. Alleles were separated on 4% low-melting agarose gels; stained with a safe gel staining, GelRed™, which is an alternative to ethidium bromide; and visualised by ultraviolet illumination. Results: Bands were observed, but their base-pairs differences were difficult to distinguish. To identify each allele clearly, the PCR products were also analysed using capillary gel electrophoresis for fragment analysis where it was possible to discriminate even in case of difference between two pairs of bases between the alleles. Conclusion: In this article, we present a protocol that combines the use of gel electrophoresis and fragment analysis in the identification of genetic biomarkers for PCOS.

The identification of psychosocial burden and general health among women with abnormal Pap smear results was fundamentally important because women play the significant role in the family and community. The purpose of this study was to determine the level of psychosocial burden, level of general health and relationship between psychosocial burden with general health among women with abnormal Pap smear after colposcopy. This crosssectional study was done towards 218 women with abnormal Pap smear after colposcopy. Universal sampling at gynecology clinic from three tertiary hospitals in the East Coast of Malaysia was conducted. Respondents selfanswered the validated Malay version of Psychosocial Effect of Abnormal Pap smear Questionnaire and General Health Questionnaire-12 in Malay version. Data were analyzed by using statistical software IBM-SPSS version 22, descriptive statistical method, Pearson and Spearman Correlation coefficient analysis were used. The results revealed that 43.1% and 16.5% of women with psychosocial burden were having distress due to abnormal Pap smear after colposcopy. The correlation coefficient showed a significant moderate correlation between psychosocial burden and general health (r = 0.41 and p=0.000). The women are facing psychosocial burden and distress in life after being diagnosed with abnormal Pap smear, because it is related to physical and psychological aspects. This shown that psychological aspect is important in health, therefore health care needs to perform the assessment of the psychosocial burden and general health among women with abnormal Pap smear in Malaysia.
women&rsquo ; s health ; psychosocial burden ; abnormal Pap smear ; general health ; distress

Family planning is an important practice for women as it can help to improve financial and social status. Unwanted pregnancy has negative effects for husband and financial. However, couples married at a late age may not practice family planning because they want to have kids. The aims of this study were to determine the prevalence, factors associated with husband’s socio demography and decision making in family planning practices among women in reproductive age who attended a polyclinic in Serdang, Malaysia. A cross sectional study was conducted on 245 women with a systematic random sampling. Descriptive analysis, Fisher exact and Chi-square tests were conducted to identify the influence of husband’s socio demographic factors and decision making in family planning practices. The prevalence of family planning practices among married women was moderate (53.9%). Family planning practices among women showed significant relationship with the husband’s socio demography which were husband’s race (p = 0.018), religion (p = 0.008) and making decision in family planning (p = 0.002). The husband’s socio demography showed a significant relationship with the prevalence of the wife practicing family planning. This clearly indicates that the husband is the individual that influence the wife to use contraceptive method. Decision making in family planning by both the husband and wife is important in choosing to use contraceptive method. Health promotion in the concept of health education for male contraceptive method such as pamphlet and booklet is important to promote husband involvement in family planning.
Family Planning Services ; Contraception

Background: Mitragyna speciosa (MS) or ketum is primarily found in Southeast Asia, particularly in northern Malaysia and Thailand. The medicinal value of this plant has attracted significant attention from both herbal medicine practitioners and scientists worldwide. Despite having illegal consumption status, the plant merits study. We conducted a series of experiments to test our hypothesis that ketum impairs both learning and memory in rats. Methods: Ketum leaves were extracted using methanol and standardised for the amount of its pure compound, mitragynine. Rats were divided into groups for a passive avoidance task and long-term potentiation (LTP) extracellular recording. In the extracellular recording condition, rats were grouped into control, MS100 (100 mg/kg of ketum extract), MS200 (200 mg/kg of ketum extract), and MS500 (500 mg/kg of ketum extract) groups. An additional group that received morphine was included in the passive avoidance task (10 mg/kg), and there were six animals per group. Rats received daily treatments orally for 28 days for both experiments. Result: Using a passive avoidance task, our data revealed that the rats' memory significantly increased with increasing doses of MS compared to the morphine-treated group. Our findings from LTP recordings showed that LTP was fully blocked by the higher doses of MS. Conclusion: We speculate on the possibility that additional factors were involved in the passive avoidance task because it was an in vivo animal study, while the LTP experiment solely involved brain slices.

Increasing number of motoring industries can contribute to air pollution which increase in turn the respiratory symptoms amongst schoolchildren. This study was done to explore the associations between respiratory symptoms and exposures to traffic related air pollution amongst schoolchildren. Cross-sectional study (schoolbased) of 10, 11 and 12 years old children would be done in two schools in Kota Bharu, Kelantan with reference to Sekolah Kebangsaan Langgar dan Sekolah Kebangsaan Demit. The total sample size in this study are 124 (n = 124). Sampling procedure employed was the probability sampling method of simple. Respondents were to answer questions by using the adaptation questionnaires from International Study of Asthma and Allergies in Childhood (ISAAC). Data were analysed by using Statistical Package For Social Sciences (SPSS). The finding shows that there are associations between respiratory symptoms and exposures to traffic-related air pollution amongst schoolchildren in two schools in Kota Bharu (p <0.05). The exposure to the traffic-related air pollution increased the respiratory symptoms amongst schoolchildren in studies area.

Introduction: Essential thrombocythaemia (ET) is a chronic myeloproliferative neoplasm (MPN) characterised by persistent thombocytosis. It is an indolent disorder but transformation to myelofibrosis (MF), acute myeloid leukaemia (AML) or myelodyplastic syndrome (MDS) has been reported. Case Report: We described a patient with ET whose disease evolved into MDS with fibrosis and complex karyotype after 15 years of stable disease. She was asymptomatic and was on hydroxyurea (HU) treatment until recently when she presented with worsening anaemia. Physical examination showed mild splenomegaly. Full blood picture showed leukoerythroblastic picture with presence of 3% circulating blasts and background of dysplastic features such as hypogranular cytoplasm and nuclear hyposegmentation of neutrophils. The bone marrow aspiration was haemodiluted but revealed presence of 6% blast cells, trilineage dysplasia and predominant erythroid precursors (60%). Trephine biopsy showed no excess of blast cells and normal quantity of erythroid precursors, but there was increased in fibrosis (WHO grade 2) and presence of dysmegakaryopoeisis such as nuclear hypolobation, multinucleation and micromegakaryocytes. Cytogenetic study showed complex karyotype; monosomy of chromosome 2, chromosome 5, chromosome 18 and presence of a marker chromosome (42~44, XX,-2,-5,-18,+mar). Fluorescence in situ hybridisation (FISH) showed 5q deletion (CSF1R and EGR1). Conclusion: The findings were consistent with transformation of ET to MDS with fibrosis and complex karyotype. ET progression to MDS is considered rare. The presence of complex karyotype and fibrosis in MDS are associated with unfavourable outcome.
myelodysplastic syndrome

Introduction: Mandated counselling is usually associated with forced participation. Therefore, there is considerably higher likelihood of involuntary participation resulting in client’s dissatisfaction toward the counselling session. However, there exists literature that shows satisfaction and positive outcomes among mandated clients. Mandated counselling is widely practised, especially in the case of Malaysia. Thus, an instrument to measure client’s satisfaction was developed to capture the client’s perception, attitude and factors that contributed to the mandated counselling satisfaction. Methods: The respondents involved in this study were adolescents in rehabilitation centres under the supervision of the Department of Social Welfare (Jabatan Kebajikan Masyarakat) aged 13 to 19 who had attended mandated counselling at least twice. The study was divided into four phases. Initially, in the first phase, the items were developed based on themes narrated by mandated clients and from the counsellor’s perspectives. Next, the initial measurement developed was tested to identify dimensions conceptualized in the instrument. Then, the reliability of the instrument was tested. In the final phase, a confirmatory factor analysis was conducted to confirm the model. Results: Findings showed a 52% of total variance was explained in the exploratory factor analysis, with an internal consistency of .919. The findings also showed a 16-item measurement with four dimensions: (a) alliance-system; (b) counselling efficacy; (c) therapeutic change; (d) counsellor-counselling effect. Conclusion: : In summary, this study had identified significant factors essential in influencing satisfaction of mandated counselling clients in the Malaysian context. It is thus beneficial for counselling practitioners in their counselling work involving mandated clients.
Mandated counselling

Pulmonary embolism is the obstruction of the pulmonary artery or its branches, commonly by thrombus or fat. We report an unusual case of double pathology - both pulmonary thromboembolism and fat embolism syndrome in a patient with bilateral femur and bilateral tibia fractures. This highlights the importance of a high index of suspicion of these conditions while managing patients with multiple long bone fractures. Morbidity and mortality can be significantly reduced with prompt and appropriate prevention strategies.
Thromboembolism ; Pulmonary Embolism ; Embolism, Fat