concern in breast cancer involves changes in weight which may adversely affect the prognosis of patients. This study intended to evaluate weight changed uring chemotherapy and its association with prognostic outcome measured as event-free survival (EFS)among breast cancer patients. A total of63 women diagnosed with breast cancer and have been treated by anthracycline-based chemotherapy between 2005 and 2011were included.A weight change (WC) was calculated based on relative percentage of weight changes from baseline to post-chemotherapy and categorized into either weight change (WC >5%) or stable (±5% WC).Survival probabilities were estimated using the Kaplan-Meier (SPSS 20). Upon treatment completion, 42.9% of the women experienced weight changes. A small weight reduction was observed (61.1 ± 11.6kg to 60.2 ± 11.9kg; -0.8 ± 4.0kg; p=0.106). The median EFS of women who experienced weight change was shorter (median 61.0 months) compared to those who maintained their weight (median 89.0 months) (p=0.044). In this study, weight changes during breast cancer chemotherapy were associated with poorer prognosis in comparison to women who maintained their weight.

Objectives: This paper mainly intended to review the experiences and challenges encountered particularly in mental health issues and to additionally analyze the methodologies used in studies involving HIV/AIDS informal caregivers. Methods: Four electronic databases; Science Direct, EBSCOhost, Ovid and Springer Link were searched for articles published in the past 10 years (2002 – 2012). Only full-text English articles related to research on care giving of HIV-infected adult patients were selected. Results: Twenty two out of 293 articles (7.5%) were reviewed, involving 2,765 caregivers in the USA (n=1,610), Africa (n=253), Asia (n=838) and Oceania (n=64) regions. A variety of age categories was involved in care giving with the youngest carer being 12 years old and the oldest, 60 years on average. Females and whites appeared to be dominant and 603 caregivers themselves were HIVpositive. The main outcomes measured were care giving burden, challenges and coping. Stress and depression, stigma and discrimination, insufficient support, role overload and extreme poverty were the main challenges experienced in care giving. Both qualitative (n=11) and quantitative (n=9) were the equally preferred types of study. Purposive sampling emerged as the most preferred sampling technique. Various instruments were utilized, but the Beck Depression Inventory (BDI) was the most popular particularly in quantitative studies. Conclusion: A variety of life aspects were negatively affected in the process of care giving for HIV/AIDS patients and studies of such nature commonly focused on caregivers’ psychosocial burden.

Objective: The relationships between awareness, knowledge and attitudes (AKA) and coping mechanisms among people with epilepsy (PWE) have not been well-explored particularly in Asia. This study aimed to: identify preferred coping strategies, correlate between AKA and coping mechanisms and compare coping strategies of PWE with different AKA levels. Methods: A cross-sectional sample of epilepsy out-patients was recruited from the Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu. The participants completed the Malay AKA Epilepsy and the Malay Brief COPE instruments. The data was analysed using non-parametric statistics. Results: Sixty out of 72 patients (response rate = 83.3%) consented participation (median age = 27.5 years; male = 53.3%; unmarried = 63.3%; Malay = 90.0%; SPM education = 54.2%; unemployed = 35.0%; rural residents = 70.0%). Religion was the most preferred coping strategy (93.3%), followed by Emotional Support (86.7%) and Instrumental Support (81.7%). Awareness was negatively correlated with Instrumental Support (rs = -0.268; p<0.05) while Knowledge was positively linked to Humour (rs = +0.267; p<0.05). Positive associations between Attitudes versus Active Coping and Positive Reframing were also detected (rs = +0.284 to +0.331; p<0.05). Patients with good AKA levels coped significantly better through Self Distraction, Positive Reframing and Humour (p<0.01). Conclusion: AKA levels seemed to influence the type of coping strategies adopted by PWE in dealing with their illness suggesting that, efforts in improving AKA level should be combined with appropriate coping strategies to provide better health outcomes in epilepsy management.

Objective: This interventional study was aimed to investigate the effects of dark chocolate consumption on anxiety, depression, and stress (ADS) among trainee nurses. Methods: A parallel and open-label experimental study was conducted. Of the 128 nurses enrolled, only 47 participated in the intervention study (mean age = 20.32 years; ranging from 19 to 22 years old). They were randomly assigned to an intervention group (IG, n = 25) or a control group (CG, n = 22). The IG consumed dark chocolate and CG ingested mineral water for 3 consecutive days. The validated Malay Hospital Anxiety and Depression Scale (HADS) and Depression, Anxiety and Stress Scale (DASS-21) were utilised for measuring ADS levels. Data were analysed descriptively and score comparisons were conducted using non-parametric tests. Results: No significant differences between IG and CG in ADS scores were detected at baseline (all p > 0.05). At post-consumption, ADS score were significantly reduced in IG (all p < 0.01) compared with CG (all p < 0.05). Larger effect sizes among these respondents had also revealed that there were mood-elevating effects of dark chocolate consumption. Conclusion: This study has discovered that 3-day consumption of dark chocolate may alleviate ADS status among trainee nurses suggesting that dark chocolate may have a more prominent role in improving emotional and mood generally. Further investigations are however warranted to confirm this finding.

Objectives: This review aims to compile and evaluate all available randomised controlled trials (RCTs) of auricular acupuncture (AA) treatment in drug addiction population with emphasis on the length of treatment course, needle-points, outcome measures, reported side-effects and overall outcomes. Methods: Science Direct, Medline and EBSCOhost databases were searched. From the year 1990 until 2010, only full-length English articles incorporating RCTs related to AA studies (needlebased only) in drug addiction such as heroin, morphine, methamphetamine and cocaine were included. Studies involving the usage of various methods of electroacupuncture and investigations relating to cigarette-smoking or alcohol addiction were excluded. Results: Eight RCTs met all inclusion criteria comprising of 1,594 respondents (age = 19 - 46 years; male = 57% - 76%). Most were involved in cocaine addiction. Overall, trials were designed with brief periods of treatment course and utilised three to five standard National Acupuncture Detoxification Association (NADA) points (Sympathetic, Lung, Liver, Kidney and Shenmen), but inconsistent sham points. All trials included urine toxicology test as the main outcome measure while data on side-effects incidence was insufficient. Conclusions: Overall, four of the RCTs reported positive outcomes although at this point, AA’s effectiveness and safety could not be substantially confirmed. For the future, high-quality RCTs of AA are urgently required to provide a clearer understanding on the usefulness of this complementary therapy in drug addiction treatment.

The educational needs of epilepsy family caregivers vary depending on their relationship to the patients, their role in providing care and their emotional needs. Carers often have lack of confidence in their ability to seek information, resulting in barriers to receive information. Various educational programmes / materials about epilepsy were designed to improve the awareness, knowledge and attitudes (AKA) of patients and their families. Therefore, this study aimed to assess the feasibility, acceptability and practicality of Animated Epilepsy Educational Video (AnEEV) and AKA of family caregivers (FCGs). This part of a randomized, controlled study included a sample of 32 epilepsy FCGs who were recruited from the Neurology and Paediatric Clinics of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu. Descriptive statistics were employed for data analyses (SPSS 17.0). Most were women (59.46%), married (65.6%), earning between RM1001 - RM2000 (34.4%), receiving secondary level education (65.6%) and were patients’ parents (65.6%). The AnEEV was highly acceptable (97.0%), easy to understand (90.9%), attractive (93.9%) and useful (87.9%). Almost all carers recommended AnEEV to other carers (97.0%) and were hoping to receive such educational materials in the future (93.9%). The Total AKA score was generally good (median=125.0; range=75.0-155.0) with awareness being moderate (median=30.0; range=0.0-50.0), knowledge was good (median=60.0; range=40.0-75.0) and attitudes were positive (median=35.0; range=10.0-40.0). The overall outcomes signified that AnEEV were well-received by the family caregivers and these favourable findings suggested that AnEEV could help in improving AKA for carers, which could ultimately assist epilepsy treatment, management and rehabilitation process

Inappropriate use of medicine could lead to harmful effects on the user. In some cases it results in unnecessary adverse drug reactions and drug interactions. Knowledge about possible side effect and drug interaction may ensure better self-medication practices. This study aimed to explore the prevalence of self-medication practices among undergraduate students of a public university in Terengganu, Malaysia, and to identify the most common group of medicine used. Knowledge on adverse drug reactions (ADRs) and drug interactions was also explored. A structured questionnaire asking about self-medication, therapeutic classes, knowledge of ADRs and drug interactions was administered to 363 final year students of UniSZA. Statistical analyses were performed using SPSS version 20.0. Nearly half (46.6%) practised self-medication in the previous week and about 84.0% were aware of ADRs and drug interactions. Pain relievers were the most common group of medicines consumed (63.4%). Self-medication practices were moderately common among the undergraduates and they were aware of ADRs and drugs interactions. More awareness should be given to the students for continuous safe self-medication.

Objectives: Accurate medical information is essential among health care professionals to aid dissemination of information to the public. This study aimed to determine the level of knowledge about breast cancer and to identify related factors among undergraduate health sciences students in a public university in Terengganu, Malaysia. Methods: The respondents included students aged 18 years old or older who were enrolled in nursing, medical laboratory technician (MLT) and radiography diploma programmes. A Breast Cancer and Chemotherapy Questionnaire (BCCQ) was administered; higher scores on it indicated better knowledge. The reliability and validity of the BCCQ was considered adequate. Descriptive statistics, independent t test, one-way analysis of variance (ANOVA) and multiple logistic regressions were employed (SPSS 16). Results: A total of 239 respondents participated (mean age = 19.8 ± 0.1 years; females = 83.7%). The knowledge level was moderate. Females, nursing, and final-year students possessed significantly better knowledge. After adjusting for covariates, significant factors determining good breast cancer knowledge include being in the nursing discipline and years of study. Conclusion: This study has generally ascertained that knowledge related to breast cancer and chemotherapy among this sample population remains moderate and is not uniformly disseminated. An increase in knowledge is required to ensure an optimal level of knowledge, particularly for the junior students and those from courses other than nursing.

The objective of this study was to compile and analyse existing scientific evidences reporting the effects of objectively measured physical activity on the levels of adiponectin and leptin. Articles related to the effects of objectively measured physical activity on the levels of adiponectin and leptin were searched from the Medline and PubMed databases. The search was limited to ‘objectively measured’ physical activity, and studies that did not objectively measure the physical activity were excluded. Only English articles were included in the search and review. A total of 18 articles encompassing 2,026 respondents met the inclusion criteria. The eligible articles included all forms of evidence (e.g., cross-sectional and intervention). Seventeen and 11 studies showed the effects of objectively measured physical activity on adiponectin and leptin, respectively. Five and four cross-sectional studies showed the effects of objectively measured physical activity on adiponectin and leptin, respectively. Two out of five studies showed a weak to moderate positive association between adiponectin and objectively measured physical activity, while three out of four studies showed a weak to moderate inverse association between leptin and objectively measured physical activity. For intervention studies, six out of 12 studies involving adiponectin and five out of seven studies involving leptin showed a significant effect between the proteins and objectively measured physical activity. However, a definitive conclusion could not be drawn due to several methodological flaws in the existing articles and the acute lack of additional research in this area. In conclusion, the existing evidences are encouraging but yet not compelling. Hence, further well-designed large trials are needed before the effectiveness of objectively measured physical activity in elevating adiponectin levels and in decreasing leptin levels could be strongly confirmed.

Objective: This study was aimed to determine the prevalence of anxiety and depressive symptoms , to examine their association with health-related quality of life (HRQoL) profiles and to determine the predictors on overall HRQoL. Methods: This was a cross-sectional study conducted in Hospital Sultanah Nur Zahirah, Kuala Terengganu, Malaysia. The Malay Hospital Anxiety and Depression Scale (HADS) and McGill Quality of Life Questionnaire (MMQoL) were administered to a sample of 150 cancer patients (mean age = 50.4 years). Chi-square test, correlation and multiple regression were utilised for data analysis. Results: The prevalence for mild anxiety and depressive symptoms was 30.7% and 23.3% respectively. The HADS-A correlated strongest with Total MMQoL Score (r = - 0.578) and Psychological Well-Being (r = -0.526). Only HADS-A (beta = - 0.486), and HADS-D (beta = -0.173) were significant in predicting overall health-related quality of life. Conclusion: Findings in our study indicated that the prevalence of anxiety and depressive symptoms in Terengganu cancer patients are moderate. If anxiety and depression are identified and treated, health-related quality of life among oncology patients appropriately could significantly be improved.