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The Prevalence of Diabetes Mellitus among Hospitalized Tuberculosis Positive Case Admitted in Hajj Hospital, Surabaya, Indonesia

Een Ika Syah Putri ; Dwi Wahyu Indriati ; Manik Retno Wahyunitisari

Malaysian Journal of Medicine and Health Sciences.2020;16(No.1):235-239.

Introduction: Tuberculosis (TB) is the cause of significant health and death problems worldwide. Indonesia is known as the second highest country with TB burden in the world after India. The incident of TB is further increasing in diabetes mellitus patients. Diabetes mellitus disrupts the body’s immune function; thus, patients are more susceptible to infection, including TB. The purpose of this study was to determine the prevalence of diabetes mellitus history (DM) among newly diagnosed TB patients in Surabaya. Methods: 160 patients were grouped into two groups; the first group (67 patients) was positive for TB and diabetes mellitus, and the second group (93 patients) was positive for TB only. Data were collected from TB patients based on acid-fast bacilli stain (AFB) and positive Xpert MTB/RIFF. Blood glucose level was collected from 2hrPPG, and glycated hemoglobin (HbA1c). Results: The prevalence of TB related with DM history was 42% from 55 ± 9.52 years old. Patients with TB-DM showed poor glucose blood level, their 2hrPPG was 301.43 ± 126.80 mg/dl, and the HbA1c result (> 6.5%) was 82%. The rifampicin resistant level result was not significantly different between TB and TB-DM (4.4% and 3% respectively). Conclusions: Our results highlight the incidence of DM history in TB positive patient that was hospitalized in Hajj Hospital. Therefore, it is important to monitor the prevalence of DM in TB newly diagnosed cases to assist practitioner to choose better treatment while considering the risk of DM interference.

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Urban Health and the Prevalence of Non-Communicable Diseases in Malaysia

Normaz Wana Ismail ; Sudha Sivadas

Malaysian Journal of Medicine and Health Sciences.2020;16(No.2):3-9.

Introduction: Urbanisation is a key determinant of population health. Malaysia’s exemplary economic growth in the early 1990s and the consequent development and urbanisation led to significant changes in health, lifestyle and quality of life. Rising expectations, changing demographics and nutrition and disease transitions were challenges synonymous to an increasingly urban Malaysia. As the Government targets optimal population health, this paper aims to explore one of the many challenges of urbanisation, namely the prevalence of non-communicable diseases or NCDs. For the purpose of this paper, NCD is proxied by Diabetes Mellitus. Methods: This study is based the 2015 National Health and Morbidity Survey, which is a cross-sectional population-based survey, involving 30,000 respondents. Given the binomial nature of the survey variables, the multinomial Probit model was employed using the STATA statistical software. Results: Generally, age, gender and race are significant in determining health outcomes. Socioeconomically, all three variables of income, education and employment are significant. For lifestyle factors, findings show that only the weight and physically active status have a role in determining health outcomes. Finally, the urban variable is also positive and significant. Conclusion: Findings show that the prevalence of Diabetes Mellitus, is rising along with urbanisation and that there is a health penalty for the urban population and also for those who do not embrace healthy lifestyles. Additionally, other factors are equally important as urban health determinants, encompassing both the demographic and socioeconomic factors.

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Perceived Learning Needs Among Coronary Artery Disease Patients: A Study in a Tertiary Hospital

Suriani Yaacob ; Noor Hanita Zaini ; Khatijah Lim Abdullah ; Nor Zehan Ahmad ; Vimala Ramoo ; Nazar Mohd Zabadi Mohd Azahar ; Ahmad Fazli Abdul Aziz

Malaysian Journal of Medicine and Health Sciences.2020;16(No.2):10-15.

Introduction: Determination of learning needs is central for holistic patient education, to sustain behavior changes and to control patient’s risk factor. However, patients often sense that their learning needs are unmet and information provided was too general. Thus, this study aimed to determine the perceived learning needs and their level of importance among Coronary Artery Disease (CAD) patients. Methods: The current investigation is a descriptive, cross-sectional study for which all CAD patients were selected using the cencus method. The data was collected using Cardiac Patients Learning Needs Inventory. The questionnaire was delivered to 140 CAD patients who had their follow-up in a cardiology clinic. The instrument is reliable with a Cronbach’s alpha coefficient of 0.96. The study design followed STROBE cross-sectional design process guideline. Results: Participants’ mean age was 58.96 ± 9.42 years. More than half of the participants were males (62.9%), employed (52.0%) and had attained secondary level education (69.3%). Around two-thirds (60.7%) of the patients perceived to have high learning needs. Gender and highest educational achievement were significantly associated with perceived learning needs. The most significant perceived learning needs were medication information, risk factors for CAD, information on diet, physical activity, anatomy and physiology, and other related information. Conclusion: This study has identified the important domains of learning needs among CAD patients. Findings from the present study will provide important input for future cardiac educational strategies to reduce the rate of hospital readmission and death.

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Correlation of Vitamin D With Bone Mineral Density by Dual Energy X-ray Absorptiometry (DXA) Scan Among Healthy Malay Adult

Tuan Salwani Tuan Ismail ; Siong Hu Wong ; Mohd Hadizie Din ; Zulkarnain Mustapha ; Juhara Haron ; Ahmad Badruridzwanullah Bin Zun

Malaysian Journal of Medicine and Health Sciences.2020;16(No.2):16-22.

Introduction: Scarcity of data found in regard to association of vitamin D level with bone mineral density (BMD). Our study aimed to determine the correlation of vitamin D with BMD and intact parathyroid hormone (iPTH) among healthy Malay adult. Methods: This cross-sectional study recruited 126 healthy Malay volunteers (aged 21–45 years old) from Kota Bharu, Malaysia. Serum total calcium, albumin, phosphorus, 25-hydroxyvitamin D (25(OH)D), and iPTH were measured. BMD was assessed with dual energy X-ray absorptiometry (DXA) scan over left hip (right hip in case of problem with left hip) and lumbar spine (L1 – L4 vertebrae). Results: The mean serum 25(OH)D was 38.91 ± 14.07 nmol/L. Out of 126 study subjects, 104 subjects (82.5%) had insufficient level of vitamin D (< 50 nmol/L). Mean hip and lumbar BMD were 0.952 ± 0.145 g/cm2 and 1.006 ± 0.133 g/cm2 respectively. According to T-score, 93 subjects (73.8%) had normal T-score of ≥ -1, 33 subjects (26.2%) had osteopenia (T-score -2.5 to -1) and none had osteoporosis (T-score ≤ -2.5). Significant positive correlation between serum 25(OH)D and hip BMD (r = 0.234, p = 0.009) was observed, but no correlation was found between serum 25(OH)D and lumbar BMD. Meanwhile, significant inverse correlation between serum 25(OH)D and iPTH was observed (r = -0.324, p < 0.001). Conclusion: High prevalence of vitamin D insufficiency was observed among healthy Malay population, but majority had normal bone density. Nonetheless, serum 25(OH)D was positively correlated with BMD and inversely correlated with iPTH. Our findings support the role of vitamin D for maintaining bone health.

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Plasma and Cell Lysate Proteins Associated With Treatment Outcome in Acute Myeloid Leukaemia

Fatemeh Barantalab ; Pei-Pei Chong ; Cindee Lee ; Stephnie Kang Xian Yiau ; Kian Meng Chang ; Zainina Seman ; Maha Abdullah

Malaysian Journal of Medicine and Health Sciences.2020;16(No.2):23-29.

Introduction: Drug-resistance is a major hindrance to successful treatment of AML. Current predictive biomarkers are mainly genetic aberrations and insufficient in foretelling treatment outcome in all acute myeloid leukaemia (AML) due to its heterogeneous and aggressive nature. Proteins are stable and reliable. Secreted proteins in AML may have predictive or prognostic values for early intervention. Proteomic studies on AML are few and further investigations will benefit in selection of best markers. The aim of the study was to identify differentially expressed plasma proteins in AML with different treatment outcome. Methods: Two-dimensional electrophoresis (2-DE) technique was utilised to identify proteins differentially expressed in chemo-sensitive/chemo-resistant AML. Plasma and peripheral blood mononuclear cell (PBMC) lysate proteome analysis were performed on six chemo-resistant, four chemo-sensitive and six healthy controls and seven chemo-resistant, three chemo-sensitive and six healthy controls, respectively. Each experiment was conducted in duplicate or triplicate. Images were captured and protein spots detected by software. Differentially expressed protein spots were excised from gel and proteins were identified using LC/MS/MS. Proteins spots that were also detected in healthy controls were excluded. Results: Comparing mean % volume of each spot demonstrated significantly enhanced expression of apoliprotein-E (APO-E) and haptoglobin (HP) (p<0.05) in plasma and HNRNP H1 (p=0.049) in cell lysate of chemo-sensitive group. Serotransferrin (STF) from plasma and DNA-PK from cell lysate (p=0.01) were associated with chemo-resistance. Conclusion: This preliminary study identified several potential predictive biomarkers associated with chemo-resistance/chemo-sensitivity to treatment in AML. Further studies with a larger number of samples are required to validate the results.

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The Relationship Between Job Burnout and Occupational Cognitive Failures in Nurses at Educational Hospitals of Ardabil University of Medical Sciences, Iran

Mohadese Athar ; Malek Abazari ; Maryam Feiz Arefi ; Azim Karimi ; Mehdi Alinia ; Saba Hosseinzade ; Amin Babaei-Pouya

Malaysian Journal of Medicine and Health Sciences.2020;16(No.2):30-35.

Introduction: Job burnout is a common phenomenon in health care employees who need to deal with and witness people’s problems and expectations. By definition, occupational cognitive failures appear as problems in performing daily tasks like forgetting them or having difficulty in focusing on them. The present study is an attempt to investigate the relationship between job burnout and occupation cognitive failures in nurses of educational hospitals. Methods: This descriptive-analytic study was done in 2018 and consisted of nurses from the Ardebil Hospital (n= 2,250). Using the Cochran formula, 328 hospital nurses were selected from different units by simple random sampling method. The data were collected by two professional health experts through interviewing and completing demographic questionnaires, job burnout questionnaire, and occupational cognitive failure questionnaire. Statistical analyses was performed in SPSS19. Results: A total of 328 nurses participated in the study. The mean age of the subjects was 34±8 years, varying from 22 years to 58 years. Occupational cognitive failures increased with the increase in emotional exhaustion and depersonalization; while it decreased with an increase in individual accomplishment. Conclusion: There was a significant relationship between occupational cognitive failure and different dimensions of job burnout. In addition, different dimensions of job burnout (Emotional Exhaustion, Depersonalization, and Personal accomplishment) could be associated with possible errors in information processing (memory, attention, and functioning).

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Prevalence and Factors Associated with Medication Non-Compliance among Patients with Hypertension in a Tertiary Hospital: A Cross-Sectional Study in Malaysia

Nur Hanani binti Mohamad Yusoff ; Joyce Leong Whye Sook ; Soo Man Jun ; Ching Siew Mooi

Malaysian Journal of Medicine and Health Sciences.2020;16(No.2):36-42.

Introduction: Hypertension contributes to major cardiovascular morbidities and mortalities worldwide and medication compliance is crucial in achieving target blood pressure control. This study aimed to determine the prevalence and factors associated with non-compliance towards anti-hypertensive medication in Malaysia. Methods: This is a cross-sectional study among hypertensive patients who were attending the medical outpatient department, Hospital Serdang from March until May 2018. Systematic random sampling was used to recruit patients and a structured self-administered questionnaire was used to collect information. Non-compliance is defined as attaining a score of 26 and below from the Medication Compliance Scale. Data analysis was done using SPSS v. 23. Multiple logistic regression was used to determine the predictors of medication non-compliance among hypertensive patients. Results: A total of 120 respondents were recruited into this study with a response rate of 60.9%. Mean age of the study respondents was 60.82 ± 11.25 years old. They were predominantly female (60.8%), Malay (58.3%) and attained at least secondary educational level (75.0%). The prevalence of non-compliance towards anti-hypertensive medication was 25%. Multiple logistic regression showed that side effects of medication (OR=5.59; 95% CI=1.29-24.21, p=0.021), traditional medications usage (OR=19.19; 95% CI=3.90-94.45, p=<0.001), health advice counsellors (OR=35.31; 95% CI=2.03-35.31, p=0.003) and duration of hypertension (OR=3.38; 95% CI=1.05-10.91, p=0.042) were predictors of non-compliance to anti-hypertensive medications among hypertensive patients Conclusion: Our study reported that those with longer duration of hypertension, suffered from side effect of medication and have experience in usage of traditional medicine are the predictors of medication non-compliance.

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Advisory Panel Review on the Feasibility of Three Intervention Programmes for Children with Autism Spectrum Disorder

Farahiyah Wan Yunus ; Michelle Bissett ; Stefania Penkala ; Muhammad Hibatullah Romli ; Karen P.Y Liu

Malaysian Journal of Medicine and Health Sciences.2020;16(No.2):43-51.

Introduction: The prevalence of children with autism spectrum disorder is increasing each year. Intervention programmes towards improving the occupational needs such as daily activities of these children are limited. This study aimed to collect opinions from advisory panel for the content validation of the three developed intervention programmes to be implemented among children with autism spectrum disorder aged between 6 to 12 years. The intervention programmes are; i) self-regulated learning, ii) sensory integration intervention and iii) activity-based intervention. Methods: A cross-sectional study was conducted. Twenty occupational therapists with more than three years’ experience working with children with autism spectrum disorders were recruited as advisory panel members. Researchers-developed questionnaire was used. The questionnaire consists of nine to eleven items. Each item consists of a five-point Likert scale for quantitative responses and open-ended questions for qualitative responses. Results: Advisory panel ratings of ‘Good’ to ‘Excellent’ was reported across most items in all three intervention programmes. Overall results suggested that the intervention programmes content was rated to be suitable for children with autism spectrum disorder. Constructive comments were adopted to clarify the activities and structure of the intervention programmes. Final development of the intervention programmes is presented. Conclusion: This study provides confidence for the interventions to be incorporated into the future randomised controlled trial.

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Critical Factors in Quality of Life: A Qualitative Explorations into the Experiences of Malaysian with Heart Failure

Nor Firdous Mohamed ; Nor Azwany Yaacob ; Aizai Azan Abdul Rahim ; Oteh Maskon ; Mohamed Hatta Shaharom ; Othman Lebar

Malaysian Journal of Medicine and Health Sciences.2020;16(No.2):52-62.

Introduction: Heart failure (HF) prevalence is increasing in Malaysia and brings about significant poor outcomes especially on the patients’ wellbeing. Despite the devastating physical symptoms of HF experienced by patients, other social consequences on patients are often not discussed by their health care professionals. Hence, this qualitative study aims to explore and understand the quality of life (QOL) for patients in Malaysia of various ethnicity who have been diagnosed with heart failure. Methods: Nineteen (n = 19) patients with recurrent HF were recruited via purposive sampling. One-to-one semi-structured interviews were conducted after patients’ informed consent was obtained. The aforementioned sessions were audio-recorded and transcribed verbatim. Finally, the transcribed data was analysed through Braun and Clarke’s framework for thematic analysis. Results: The findings revealed that Malaysians with HF reported either positive or negative experiences related with QOL which had an effect on their well-being. Four main themes emerged included physical, psychological, social, and spirituality. Interestingly, cultural and beliefs consideration were important to understand these QOL themes of HF patients as a whole, especially in Malaysia’s multi-ethnic communities. Conclusion: Informants were able to give vivid descriptions of living with HF experiences and the way it affected their QOL due to the disruptive and uncertain nature of HF in four major themes. However, the individual themes of QOL in HF patients need to be comprehended in detail including the local cultural perspectives, particularly by health professionals who deal with HF patients of minority ethnicities, in order to improve treatment and health outcomes.

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The Effectiveness of Non-dominant Hand in Performing Oral Hygiene Care

Normaliza Ab Malik ; Aws Hashim Ali Al-Khadim ; Muhammad Syafiq Alauddin ; Siti Nur Farhanah Mohd Desa ; Azlan Jaafar

Malaysian Journal of Medicine and Health Sciences.2020;16(No.2):63-68.

Introduction: This study aimed to assess the effectiveness of dental plaque removal and to determine factors that could influence its efficacy when using the non-dominant hand. Methods: A quasi-experimental study was performed on a group of dental students. Dominant hands were determined using Edinburg Handedness Inventory questionnaire, and the dental plaque scores were examined using Quigley-Hein (Turesky) index. All of the participants were examined twice for dental plaque index scores. Data obtained was analyzed using a paired t-test and an independent t-test. Factors which influenced the dental plaque removal were listed and categorized accordingly. Results: A total of 62 dental undergraduates participated in the study. A high percentage of them, (71%, n = 44) were found to be right-handed. There was a significant increase in the dental plaque score for the left-handed participants, from baseline (use of the dominant hand) to follow-up appointment (after brushing their teeth with non-dominant hands) (p< 0.01). A significant change was found between the right- and left-handed participants in the first quadrant of the buccal side (p<0.05). Factors identified to be beneficial in dental plaque control were; using a mirror while brushing, extending brushing time, increasing brushing frequency, using additional tooth aids and powered toothbrushes. Conclusions: This study revealed that left-handed participants have less ability to remove dental plaque with their non-dominant hands. The right-handed participants, showed better controls in plaque removal with their non-dominant hands, compared to their left-handed peers on the buccal side of the first quadrant.

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