The Short Form Health Survey SF-36 is a well-known generic health-related quality of life measure that has widely been used worldwide. However, given the cultural, social and ethnic differences in some countries, it might not follow the intended structure of the instrument. Hence, this study aims to determine the psychometric properties of the Malay version of Short Form Health Survey (SF-12) among postpartum mothers. A cross-sectional study was conducted among 1-month postpartum mothers attending Obstetric and Gynecology clinic, Universiti Sains Malaysia Hospital, Kelantan, Malaysia. Reliability was estimated using internal consistency and the factor structure was extracted by performing confirmatory factor analysis using SPSS v. 20 and AMOS v. 20. A total of 108 women responded. The mean (SD) score for the Physical Component Summary (PCS) score and Mental Component Summary (MCS) score were 43.3 (7.08) and 42.4 (6.87) respectively. The Cronbach alpha for PCS-12 was 0.749 and MCS-12 was 0.701. Spearman correlations of individual items and the SF-12 component summary scores showed PF, RP, BP and GH items correlated higher with the PCS score, whereas the VT, SF, RE, and MH items correlated higher with the MCS score lending support to its good convergent validity. The confirmatory factor solution showed final model with two factors structure and six items each with acceptable factor loadings, satisfactory absolute and parsimonious fitness (RMSEA=0.1, x2/df=2.4). The psychometric tests of the Malay version of SF-12 generally showed acceptable validity and reliability among postpartum women.
Factor Analysis, Statistical ; Mothers

Introduction: There is a significant increase in the number of divorce cases among Malay Muslim couples over the past years which serves as a strong signal for the government to take initiatives to understand the current situation. A plethora of literature can be found on marriage satisfaction and the quality of the relationship within marriages. However, exploration on contributing factors to long lasting marriages amongst the Malay Muslim community are lacking. This paper aims to share the initial findings in an effort to explore of the strength of relationship in a lasting marriage amongst Malay Muslim couples in Malaysia. Methods: This paper adopted a quantitative approach utilizing the Eternal Love Instrument (c) 2016 which consisted of 171 items, distributed to 350 respondents based on simple random sampling technique. Results: The findings indicated that there are three main considerations in selecting a spouse which were (1) Religion (95.2%); (2) Character (responsible) (96.1%); well mannered (95.8%); and (3) Race (79.3%). Age, looks and type of jobs were the least considered factors amongst the respondents surveyed. The respondents perceived that the strongest element in their relationship was communication (69.6%), followed by tolerance (62.6%) and responsible towards family wellbeing (56.4%). Conclusion: The initial survey has indicated that a lasting marriage is a consequence of having a responsible partner with good religious background. Also, from all these five constructs, these respondents considered their spouses to be highly responsible.
Marriage wellbeing

We report a case of steroid withdrawal syndrome in a 74-year-old woman who was suspected of having an occult exogenous Cushing’s syndrome secondary to prolonged traditional complementary medicine use. She presented with non-specific symptoms of lethargy, malaise, and poor oral intake with weight loss for 1 month, and investigations showed suboptimal 9 AM cortisol level. She has responded well to steroid replacement.

Background: Breastfeeding is recognized as the optimal form of nutrition for the physical and neurological development of infants and is considered the most significant way to prevent child mortality. This study aimed to assess the effectiveness of metoclopramide for enhancing milk production in lactating women. Methods: We searched the Cochrane Central Register of Controlled Trials and MEDLINE for randomized controlled trials comparing metoclopramide with a placebo, no treatment, or other galactagogue drugs. We included breastfeeding women with term or preterm infants. Results: We retrieved 164 records from our search of the electronic databases and 20 records from other sources. Eight trials involving 342 lactating women that used metoclopramide were included in this review after assessing the eligibility criteria. The meta-analysis of these trials revealed that metoclopramide did not increase the milk volume of the intervention groups compared to that of the control groups. There was a significant increase in the serum concentrations of prolactin when the mothers were administered metoclopramide. No significant adverse events were reported. Conclusion Metoclopramide did not improve milk production in lactating women. Therefore, we do not recommend using metoclopramide to increase milk production in lactating women.

Background: Alternative and complementary medicines are widely used to treat migraine headaches. This review aimed to determine the effectiveness of essential oils as an alternative treatment approach. Methods: A structured search was conducted to identify randomized trials comparing essential oils with a placebo for migraine headaches, using databases (MEDLINE and CENTRAL) to search for articles published between 1966 and 2021. We included trials involving adult males and females diagnosed with migraine headaches according to the International Headache Society. The outcomes included number of attacks, headache severity, associated symptoms, number of days of limited activity, headache duration, use of analgesics, and adverse effects. Seven trials were included with a total of 558 participants. Results: No difference was observed in the number of migraine headache attacks compared to placebo (mean difference [MD], -1.34; 95% confidence interval [CI], -3.31 to 0.64; I2=94%; P=0.190; four trials, 242 participants; moderate- quality evidence). There was no difference in this outcome between the essential oils treated group and the placebo (MD, -0.38; 95% CI, -1.76 to 0.99; I2 statistics=86%; P=0.580; five trials, 240 participants; moderate-quality evidence). Conclusion We found no significant difference between the use of essential oils and placebo in managing migraine headaches.

Background: Vitamin D may enhance immune system function and provide a protective effect against infections. Feto-maternal circulation plays an important role in supplying the developing fetus with nutrients and antibodies for its development and health during pregnancy and for its early years of life after birth. This meta-analysis aimed to determine the effectiveness of maternal vitamin D supplementation in preventing respiratory tract infections (RTIs) in children. Methods: We searched the Central and MEDLINE databases and went through all the reference lists in the related articles. We also searched for ongoing trials at http://www.who.int/ictrp/en/ and www.clinicaltrials.gov. Randomized controlled trials comparing vitamin D supplementation with a placebo or no treatment in pregnant women published in the English language up to March 2019 were included. Two reviewers extracted data independently using a predefined protocol and assessed the risk of bias using the Cochrane risk of bias tool, with differences agreed upon by consensus. The predefined primary outcome was the number of offspring who had RTIs. The secondary outcome was the presence of measurable serum immunoglobulin E levels. Results: Three trials involving 3,224 participants (mother–child pairs) met the inclusion criteria and were included in this review. The present analysis reported that maternal supplementation with vitamin D had no effect on RTIs among children (n=1,486 offspring; risk ratio, 0.95; 95% confidence interval, 0.82–1.11; random effects; I2 statistics, 0%). Conclusion Maternal vitamin D supplementation had no effect on RTIs in children. Therefore, consideration of other prevention methods in this regard is recommended.

Introduction: cAMP Response Element Binding (CREB) and Brain Derived Neurotrophic Factor (BDNF) protein levels tend to be a critical mediator for the beneficial effects of diet on neurogenesis and cognitive function. Increased fruit intake has been associated with improved cognitive function. However, in Malaysia, most adolescents still haven't met the recommended intake of fruits and far less is known on how their adequacy of fruit intake can be affected to their protein levels of CREB and BDNF. Methods: A cross sectional study was done on 352 students aged 14 and 16 years old involving 11 secondary schools in Kuala Terengganu, Marang and Hulu Terengganu Districts. A validated MyUM adolescent FFQ was used for fruit intake assessment. Blood sample to determine the level of CREB and BDNF proteins. Results: A total of 53.7% of adolescents consumed an adequate intake (≥ 2 servings/day) of fruits. Serum level BDNF was significantly (p<0.001) higher in the adolescent with adequate fruit intake (389.05±204.96 pg/mL) compared with inadequate (< 2 servings/day) group (118.60 ± 49.04 pg/mL) and was correlated positively with fruit intake (r=0.62, p<0.001). The median of CREB protein level was significantly (p<0.021) higher among inadequate intake of fruits (19.85±23.60 ng/mL) relative to adequate group (14.71± 17.9 ng/mL) and was negatively correlated with fruit intake (rs (8) =-0.07, p<0.001). Apple, papaya, watermelon, orange, pear, guava, mango, banana and durian were significant factors for BDNF protein level. Conclusion: High serum protein level of BDNF in the adolescent with adequate intake of fruit could have a role in controlling neuronal survival, and synaptic function in the central nervous system.