The worldwide upsurge of Type 2 Diabetes Mellitus (T2DM) warrants the attention of public health, especially in complications. Diabetic Retinopathy (DR), the commonest ocular complication, contributes to the growing incidence of blindness. Recommendations that the visual acuity (VA) assessment guidelines should be used in DR screening was not routinely practiced. This study aims to model the predictive effect of VA - a simple economic clinical assessment - upon DR in patients with T2DM. A case-control study was conducted in Hospital Universiti Sains Malaysia with subjects recruited from the ophthalmology clinic. The primary variable during analysis was VA, and the outcome variable was DR. Models with eight control variables which included age, gender, and duration of DM were developed. The predictive effect measured by logistic regression showed that when unadjusted; four variables had a significant association with DR, at p-value<0.25; they were the duration of DM, systolic blood pressure, glycosylated haemoglobin and VA. From the eight different predictive models, the estimated adjusted odds ratio produced ranges from 6.09 to 11.64. Our study shows that VA has a predictive effect upon DR in T2DM patients. We suggest VA assessment, to be on par with the monitoring of blood pressure and blood glucose.
Predictive ; Visual acuity ; Diabetic Retinopathy ; Type 2 Diabetes Mellitus

As cognition declines with age, cognitive impairment rates are expected to increase ranging from 100% to 300% in this region. It could be higher among elderly who had any chronic diseases. The aim of the present work was to determine the prevalence and associated factors of cognitive impairment among elderly with hypertension. A clinic-based, cross-sectional study was conducted at several community clinics in Sabak Bernam and Hilir Perak districts from July to December 2015. A total of 480 patients were recruited. The prevalence of cognitive impairment was 13.13% (95%CI: 13.11, 13.15). Factors associated with cognitive impairment among elderly hypertensive were no formal educational level [OR: 3.95 (95%CI: 1.80, 8.67)]; history of high cholesterol [OR: 3.24 (95%CI: 1.15, 9.16)]; underweight [adj. OR: 4.88 (95%CI: 1.34, 17.67)]; and increasing age [OR: 1.03 (95%CI: 1.01, 1.06)]. Public health policy makers and geriatric practitioners should emphasise on early cognitive function assessment among elderlies who are hypertensive, unemployed, poor educational background, males, high cholesterol level and underweight to enhance the quality of geriatric services. Earlier establishment of diagnosis may prevent from greater rate of decline in cognitive functioning among this vulnerable group.

To assess knowledge, practices on cardiovascular disease (CVD) prevention and practices among an urban population in Selangor. A cross-sectional household survey was conducted involving 336 adults in 161 houses randomly selected from three towns in Selangor, Malaysia. The mean knowledge of cardiovascular risk factors was moderately high among participants. Socioeconomic characteristics (SES) significantly associated with higher mean scores were being in middle age, female, high-income group and never smokers. Although the general knowledge on preventing cardiovascular risks among the urban population was moderately high, their lifestyle practices on preventing cardiovascular disease were moderate.

INTRODUCTIONDiabetes mellitus (DM) is a chronic disease that is prevalent in many countries. The prevalence of DM is on the rise, and its complications pose a heavy burden on the healthcare systems and on the patients' quality of life worldwide.

MATERIALS AND METHODSThis is a multicentre, cross-sectional study involving 5 Health Clinics conducted by Family Medicine Specialists in Malaysia. Convenience sampling of 100 respondents with DM were selected. The International Classifi cation of Functioning, Disability and Health (ICF) based measures were collected using the Comprehensive Core Set for DM. SF-36 and self-administered forms and comorbidity questionnaire (SCQ) were also used.

RESULTSNinety-seven percent had Type 2 DM and 3% had Type 1 DM. The mean period of having DM was 6 years. Body functions related to physical health including exercise tolerance (b455), general physical endurance (b4550), aerobic capacity (b4551) and fatiguability (b4552) were the most affected. For body structures, the structure of pancreas (s550) was the most affected. In the ICF component of activities and participation, limitation in sports (d9201) was the highest most affected followed by driving (d475), intimate relationships (d770), handling stress and other psychological demands (d240) and moving around (d455). Only 7% (e355 and e450) in the environmental category were documented as being a relevant factor by more than 90% of the patients.

CONCLUSIONThe content validity of the comprehensive ICF Core set DM for Malaysian population were identified and the results show that physical and mental functioning were impaired in contrast to what the respondents perceived as leading healthy lifestyles.

Adult ; Aged ; Cross-Sectional Studies ; Diabetes Mellitus ; classification ; epidemiology ; Disability Evaluation ; Female ; Health Status ; Humans ; International Classification of Diseases ; Malaysia ; epidemiology ; Male ; Middle Aged ; Physical Endurance ; Quality of Life ; Surveys and Questionnaires ; Young Adult

Burnout among doctors is an alarming issue causing impairment of function among doctors, leading to failure of optimum healthcare delivery. This study aims to improve the knowledge gap of burnout and psychological distress among medical officers. It is a cross-sectional study involving 250 medical officers, using universal sampling. Of the total 250 participants, 63 (25.2%) were burnout. The presence of burnout was significantly associated with psychological distress (p<0.001). Burnout is prevalent among medical officers. It is vital to maintain good psychological wellbeing in the form of good stress management and resilience training.

Introduction: Antibiotic resistance is one of the biggest global threat in modern medicine especially in lower-and middle-income countries (LMIC) as financial limitations and health literacy become barriers to an impactful health policy. The World Health Organization has urge for an improvement in the community antibiotic awareness through effective educational interventions. This study aims to identify the community’s attitude appropriateness, knowledge gaps, the relationship between antibiotic knowledge and attitude as well as factors associated with inappropriate attitude towards antibiotic among outpatients attending a primary care clinic. Methods: This is a cross-sectional study which was conducted among 256 respondents. Data collection was conducted for three months using a self-administered questionnaire which has been validated and translated. Results: It was found that the respondents’ mean attitude and knowledge score were 29.5 ± 4.19 and 5.94 ± 2.4 respectively. The highest inappropriate attitude response was expecting antibiotic from the doctor for common colds and the most frequent incorrect knowledge response was on the domain of role of antibiotics. There is a weak positive relationship between antibiotic knowledge and attitude (r=0.315, n=256, p=0.0001). Respondents with low education level and poor antibiotic knowledge were at least 2.5 times more likely to have inappropriate attitude when handling antibiotics. Conclusion: Antibiotic education should be incorporated in non-pharmacological measures of viral illnesses in primary care that is targeted among those with low education and poor antibiotic knowledge. The weak relationship between antibiotic knowledge and attitude suggest that health campaign should focus on behavioural change rather than a theoretical approach.

Introduction: FertiQoL questionnaire was developed and validated in 2011. It has been widely used and translated into many languages to measure QoL among infertile individuals. The use of translated psychometric tools is often subjected to cross-cultural variations. The objective of this study is to assess the psychometric properties of the Malaysian FertiQoL. Methods: A study was conducted among attendees of a public infertility clinic. Demographic details were collected and respondents answered the Malaysian FertiQoL. The questionnaire consists of 34 items. Factor analysis and internal consistency were analysed using SPSS v24. Results: Data from 175 respondents were analysed. Mean age is 32.1 ±3.8 SD with 56.6% female and 43.4% male. KMO index were 0.826 and significant Bartlett’s test for sphericity. For Treatment domain, factor loadings for items T2 and T5 were < 0.32 but for all other items were acceptable between 0.32 – 0.80 with no cross loadings and Cronbach alpha for environment (0.717) and tolerability (0.660). For Core items, Q4, Q6 and Q14 loaded onto different domains and Q19 had poor factor loading. All other items were acceptable. Cronbach alpha for specific domains were emotional (0.788) mind-body (0.829), relational (0.639) and social (0.666). Cronbach alpha for emotional, relational, social improved to 0.857, 0.643 and 0.732 if Q4, Q6 and Q14 were omitted respectively. Conclusion: The study identified six items that affected the psychometric validity of the questionnaire and maybe explained by language or cross-cultural reasons. However, the Malaysian FertiQoL can still be useful to measure QoL in those with infertility.

Introduction: Mental health-related problems are on the rise among medical doctors, with many house officers (HOs) have quitted training prematurely owing to work and life-related factors. However, the quality of work-life (QOWL) among Malaysian HOs remains unknown. Hence, we aimed to determine the mean score of QOWL and its predictors among HOs working at two tertiary hospitals. Methods: This is a cross-sectional study conducted at two tertiary hospitals in Selangor, between May and August 2019. A stratified random sampling was employed. The Malay version of work-related quality of life scale (M-WRQLS-2) and the patient health questionnaire (M-PHQ-9) were used for data collection. Statistical analysis was performed using the SPSS version 23.0 (IBM, Chicago, IL). Results: A total of 260 (72.9%) respondents completed the questionnaires. The overall score of QOWL was 3.05 ± 0.48 (95% CI: 2.99, 3.11). Depressed HOs had a significantly lower mean score across all subscales (p < 0.005) except for the stress at work (SAW) subscale. Two predictors were inversely associated with QOWL. These were the M-PHQ-9 score [β= -0.049,95% CI: -0.06, -0.04] and being female [β=-0.129,95% CI: -0.24, -0.02]. Conclusion: HOs who worked at the two hospitals in Selangor perceived their overall QOWL as average. However, being female and having depression were found to be associated with lower QOWL. Therefore, early interventions targeting female HOs and those with depressive symptoms are warranted. Further research and strategies aiming to improve the overall quality of work-life and its dimensions for HOs during housemanship training are vital.