Objective: The objective of this paper was to determine the prevalence of overactive bladder syndrome (OABS) and its risk factors among patients with other gynaecological problems. Methods: This study was conducted on women aged more than 18 years who attended the gynaecology clinic for various diagnoses other than urinary problems at a tertiary hospital in Negeri Sembilan, Malaysia, for a period of 6 months. Data on patient’s profile, symptoms and risk factors for overactive bladder (OAB) were prospectively collected using a structured questionnaire adapted from ICIQ (international consultation on incontinence questionnaire). Exclusion criteria included patients with confirmed diagnosis of stress incontinence or OAB, neurological impairment, gynaecological malignancy and those with a previous history of pelvic radiation. Chi-square test and logistic regression test were used in the statistical analysis. We presented the odds ratio (OR) and 95% confidence interval for each of the OAB symptoms with p-value of 0.05. Results: The prevalence of OAB among the patients (n = 573) in this study was 19.1%. History of giving births to macrosomic babies and presence of utero-vaginal prolapse (UVP) were shown to be significantly associated with OAB in the multivariate analysis. Other factors were advanced age, high parity and menopausal for more than 5 years. More than half of the patients with the symptoms of OAB did not seek treatment, as they did not think it is necessary. Conclusion: It is found that the prevalence of OAB is similar with many other studies conducted elsewhere. It was found to be multifactorial, but was highly significantly related with the presence of UVP, especially cystocoele and history of giving births to macrosomic babies.

Background: The incidence of diabetes mellitus is ever increasing. Individuals with diabetes mellitus may have concurrent mental health disorders and are shown to have poorer disease outcomes. The objectives of this study were to determine the prevalence of depression, anxiety and stress (DAS) in diabetes patients aged 20 years or more in the primary care setting. Methods: This was a cross-sectional study involving the use of self-administered questionnaire conducted in eight primary care private and government clinics in Pulau Pinang and Melaka, Malaysia. The validated DASS-21 questionnaire was used as a screening tool for the symptoms of DAS. Prior permission was obtained from the patients and, clearance from ethical committee was obtained before the start of the study. Data analysis was done using SPSS statistical software. Results: A total of 320 patients with diabetes from eight centres were enrolled via convenience sampling. Sample size was calculated using the Kish’s formula. The prevalence of DAS among patients with diabetes from our study was 26.6%, 40% and 19.4%, respectively. Depression was found to be significantly associated with marital status and family history of DAS; anxiety was significantly associated with monthly household income, presence of co-morbidities and family history of DAS; and stress was significantly associated with occupation and family history of DAS. Conclusions: The prevalence of DAS was higher in patients with diabetes compared with the general community. We recommend to routinely screen all patients with diabetes using the DASS-21 questionnaire because it is easy to perform and inexpensive.

Introduction: Diabetes-related distress (DRD) refers to patient’s concerns about diabetes mellitus, its management, need of support, emotional burden and access to healthcare. The aim of this study was to translate and examine the psychometric properties of the Malay version of the 17-item Diabetes Distress Scale (MDDS-17) in adult patients with type 2 diabetes mellitus (T2D). Methods: A standard procedure was used to translate the English 17-items Diabetes Distress Scale into Malay language. We used exploratory factor analysis (EFA) with principal axis factoring and promax rotation to investigate the factor structure. We explored reliability by internal consistency and 1-month test-retest reliability. Construct validity was examined using the World Health Organization quality of life-brief questionnaire, Morisky Medication Adherence Scale, Patient Health Questionnaire and disease-related clinical variables. Results: A total of 262 patients were included in the analysis with a response rate of 96.7%. A total of 66 patients completed the test–retest after 1 month. EFA supported a three-factor model resulting from the combination of the regimen distress (RD) and interpersonal distress (IPD) subscales; and with a swapping of an item between emotional burden (EB; item 7) and RD (item 3) subscales. Cronbach’s α for MDDS-17 was 0.94, the combined RD and IPD subscale was 0.925, the EB subscale was 0.855 and the physician-related distress was 0.823. The test– retest reliability’s correlation coefficient was r = 0.29 (n = 66; p = 0.009). There was a significant association between the mean MDDS-17 item score categories (<3 vs ≥3) and HbA1c categories (<7.0% vs ≥7.0%), and medication adherence (medium and high vs ≥low). The instrument discriminated between those having diabetes-related complication, low quality of life, poor medication adherence and depression. Conclusion: The MDDS-17 has satisfactory psychometric properties. It can be used to map diabetes-related emotional distress for diagnostic or clinical use.

Introduction: Hill-Bone compliance to high blood pressure therapy scale (HBTS) is one of the useful scales in primary care settings. It has been tested in America, Africa and Turkey with variable validity and reliability. The aim of this paper was to determine the validity and reliability of the Malay version of HBTS (HBTS-M) for the Malaysian population. Materials and methods: HBTS comprises three subscales assessing compliance to medication, appointment and salt intake. The content validity of HBTS to the local population was agreed through consensus of expert panel. The 14 items used in the HBTS were adapted to reflect the local situations. It was translated into Malay and then back-translated into English. The translated version was piloted in 30 participants. This was followed by structural and predictive validity, and internal consistency testing in 262 patients with hypertension, who were on antihypertensive agent(s) for at least 1 year in two primary healthcare clinics in Kuala Lumpur, Malaysia. Exploratory factor analyses and the correlation between HBTS-M total score and blood pressure were performed. The Cronbach’s alpha was calculated accordingly. Results: Factor analysis revealed a three-component structure represented by two components on medication adherence and one on salt intake adherence. The Kaiser–Meyer–Olkin statistic was 0.764. The variance explained by each factors were 23.6%, 10.4% and 9.8%, respectively. However, the internal consistency for each component was suboptimal with Cronbach’s alpha of 0.64, 0.55 and 0.29, respectively. Although there were two components representing medication adherence, the theoretical concepts underlying each concept cannot be differentiated. In addition, there was no correlation between the HBTS-M total score and blood pressure. Conclusion: HBTS-M did not conform to the structural and predictive validity of the original scale. Its reliability on assessing medication and salt intake adherence would most probably to be suboptimal in the Malaysian primary care setting.

Juvenile recurrent respiratory papillomatosis (JRRP) is a rare condition. The varied presentation of this condition predisposes to misdiagnosis and potential life-threatening airway obstruction. In this paper, we have reported a case of JRRP presenting as severe respiratory distress and consequently mistreated as asthmatic attack culminating in a near fatal acute airway obstruction.

Dengue infection is highly endemic in many tropical countries including Malaysia. However, neurological complications arising from dengue infection is not common; Gullain–Barre syndrome (GBS) is one of these infrequent complications. In this paper, we have reported a case in which a 39-year-old woman presented with a neurological complication of dengue infection without typical symptoms and signs of dengue fever. She had a history of acute gastroenteritis (AGE) followed by an upper respiratory tract infection (URTI) weeks prior to her presentation rendering GBS secondary to the post viral URTI and AGE as the most likely diagnosis. Presence of thrombocytopenia was the only clue for dengue in this case.

Introduction: In Malaysia, the prevalence of menstrual disorders among adolescents and young adults is high. However, most of them are not aware of the signs and symptoms of menstrual disorders in terms of medical issue as well as Islamic ruling. Awareness of the menstrual disorder symptoms is important so that early and appropriate treatment can be given. Objectives: The objective of the study was to compare the knowledge and attitude of premarital men and women on menstrual disorders. Methods: This was a comparative cross sectional study conducted in Kota Bharu, Kelantan. Selfadministered questionnaires were given for data collection. The questionnaires consisted of 3 parts that required information on the women’s and men’s socio-demographic data, women’s menstrual history and information in knowledge and attitude of men and women on menstrual disorders. Results: A total of 460 respondents were involved in this study with a response rate of 93.5%. The prevalence of good knowledge was higher among women compared to men with 73.2% and 26.8%, respectively. There was a significant difference on knowledge and attitude on menstrual disorders between premarital men and women.

Background: Diabetic ketoacidosis (DKA) is a late presentation of newly diagnosed type 1 diabetes mellitus (DM) in children. The aim of this study was to determine the clinical characteristics of type 1 DM at presentation so that appropriate actions can be taken to promote early diagnosis. Methods: This was a retrospective cohort review from a patient registry database. Data on all patients younger than 20 years old diagnosed with type 1 DM who had been registered with the Malaysian Diabetes in Children and Adolescents Registry (DiCARE) from its inception in 2006 until 2009 were analysed. Results: The study included 490 children and adolescents, out of which 57.1% were female. The mean (SD) age at diagnosis was 7.5 (3.7) years, which increased from year 2000 to 2009 [6.6 (3.3) years to 9.6 (3.5) years; p = 0.001]. An increasing percentage of DKA at diagnosis was observed from year 2000 (54.5%) to year 2009 (66.7%), which remained high and leveled between 54.5% and 75.0%. DKA was more common in patients with normal weight (p = 0.002) with no significant association with age, gender, ethnicity and status of family history of diabetes mellitus. Conclusion: An increasing trend of age at diagnosis of patients with type 1 DM was observed. Besides that, proportion of DKA at diagnosis had remained high over the past decade. This study found that normal weight was associated with status of DKA, thus more detailed investigations are required to determine the risk factors for DKA.