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Biosocial Background in the Development of Child Overweight and Obesity among Preschoolers in Putrajaya: An Observational Study

Fatimah Ahmad FAUZI ; Nor Afiah Mohd Zulkefli

Malaysian Journal of Medicine and Health Sciences.2017;13(3):11-20.

Introduction: Childhood obesity becomes a global epidemic with the majority are living in developing countries. Obese children are at risk of becoming obese adults with non-communicable diseases, which may further lead to huge economic burden for the affected countries. The study objectives were to determine the biosocial background contributing overweight and obesity among preschoolers in Putrajaya (2017) - sociodemographic, pre-and perinatal factors, feeding and weaning practices. Methods: Cross-sectional study was performed using cluster random sampling among 897 preschoolers, whose anthropometric body weights and heights were measured. The calculated BMI was used to determine their obese status based on WHO Growth Standards 2006 and Reference 2007. Their mothers were distributed with self-administered, validated, and pre-tested questionnaires regarding their children’s first two-years-of-life experience. Chi Square test was used for bivariate categorical analysis, Independent T-test and Mann Whitney U test for continuous data analysis. Multivariate binary logistic regression was executed to determine predictors of child obesity. Results: The prevalence of obese children was 7.4%, which can be predicted by the increase in child’s age (Adjusted Odd Ratio: 2.619; 95%CI: 1.435 – 4.780), mothers with higher level of education (AOR: 3.896; 95%CI: 1.127 – 13.470), and higher maternal BMI (AOR: 1.132; 95%CI: 1.057 – 1.213). Conclusion: Three predictors of child obesity can be derived from sociodemographic and pre-and perinatal factors. Further application on these predictors in more targeted interventions and policies need to be considered to reduce the prevalence of obesity and related non-communicable diseases in the country.

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Approaches of Learning among Medical Undergraduates of Faculty of Medicine and Health Sciences, Universiti Putra Malaysia in 2016

Nurul Mursyidah ZAKARIA ; Nur Asyiqin Jasman Farok ; Siti Khadijah ADAM ; Syafinaz Amin NORDIN

Malaysian Journal of Medicine and Health Sciences.2018;14(1):1-6.

Introduction: Challenge arises for medical undergraduates as the subject of medicine is intricate and extensive. Although students come from the same pool of excellent academic background, the medical undergraduates are still prone to failure in exams, resulting in them repeating the year of study or even having the thought of changing to other courses. In order to cope with the programme, students may adopt learning approaches that would help them to go through the programme.Therefore, it would be interesting to explore the learning approaches of medical students in Universiti Putra Malaysia. Methods: The purposes of this study were to determine the learning approach of medical undergraduates of Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (FMHS, UPM) together with its associated factors, which were socio-demographic characteristics and learning environment. This research was a cross-sectional study where the sample size calculated was 554. Self-administered questionnaires were given to the respondents chosen by simple random sampling. The socio-demographic characteristics were analysed using descriptive statistics such as frequency and percentage. Chi-square test was used to analyse the association between the variables. Results: The response rate was 83% (460 respondents agreed to participate). The majority of the respondents were females (73.7%), Malay (67%), and in their clinical years of study (58.7%). Overall, most students preferred deep approach (DA) of learning (49.6%), followed by strategic approach (29.1%) and surface apathetic approach (21.3%) of learning. There were statistically significant associations between learning approach and gender (p=0.005), as well as between learning approach and year of study (p=0.037). Conclusion:Our study showed an association between learning approaches and year of study and gender. DA of learning was the preferred learning approach in medical students at FMHS, UPM. This approach of learning, where students learn to understand the subject matter, may result in students become effective learners. Their understanding about the subject matter will be applicable to their clinical practice in the future.

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Development of the Fetal Ureter: A Fetal Metric and Histological Study

Priya. J. MARTIS ; Anne D SOUZA ; Vidya MONAPPA ; Nandini Prashanth BHAT ; Sneha Guruprasad KALTHUR

Malaysian Journal of Medicine and Health Sciences.2018;14(1):15-20.

Introduction: This study provides a description of development of various components of the human ureter at different gestational ages. Methods:Measurements of the length of the ureter from pelvi-ureteric junction to vesico-ureteric junction, length of its intravesicular portion and angle made by the ureter at the entry into the bladder with respect to the internal ureteric orifice were taken. Transverse sections of the ureter were taken at the upper end, close to the pelvi-ureteric junction, and at the midpoint between the pelvis of the kidney and the vesico-ureteric junction. These were subjected for processing and stained with Haematoxylin Eosin and Masson’s Trichrome. They were then studied under the light microscope. Results: The length of the ureter from the pelvi-ureteric junction to the vesico-ureteric junction showed a highly positive correlation with the gestational age (GA). The angle of entry of the ureter to the bladder decreased as the GA increased. The microstructure of the ureter in both the sections showed development of transitional epithelium with an increase in layers by 33 weeks. At 18 weeks, the smooth muscle layer was in a single layer with an abundance of interspersed collagen fibers. By 33 weeks, the thickness of the wall increased significantly with a decrease in collagen. There was no trace of longitudinal muscle fibers even upto 33 weeks. Conclusion: Epithelial, muscular and connective tissue components displayed significant changes during intra uterine development.

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Pap Smear Uptake and Its Associated Factors among Orang Asli Women in Selangor

Iis Sulastri INDRA ; Mohamad Zahari MAHAMUD ; Ng Zhi LING ; Rosliza Abdul MANAF ; Suriani ISMAIL

Malaysian Journal of Medicine and Health Sciences.2017;13(3):3-10.

Introduction: Pap smear screening may increase the quality of women’s health through early detection of cervical cancer thus providing a better prognosis for women with cervical cancer. While the benefit of Pap smear screening is well documented, the screening uptake among Malaysian women in general was unsatisfactory with only 47.3% being screened. This study aimed to determine the prevalence of Pap smear uptake and its associated factors among Orang Asli women who lives in rural areas in Selangor. Methods: A cross sectional study was conducted in Hulu Langat and Kuala Langat districts from April to July 2017. Through cluster sampling, five Orang Asli settlements in the two districts were chosen. All women in the selected village aged between 18 to 65 years were invited to participate and interviewed using a structured, pretested questionnaire. Data were analysed using SPSS Version 22. Univariate and bivariate analysis were conducted to identify factors associated with Pap smear uptake among the participants. All hypotheses tests were two-sided and level of significance was set at 0.05. Results: Out of the 147 respondents, 114 (77.6%) had undergone Pap smear for at least once in the past. Women aged more than 35 years (p=0.013) were shown to be significantly more likely to take Pap smear compared to women who were 35 years old and less. There were significant associations between marital status (p<0.001), knowledge (p<0.001), attitude (p<0.001) and use of oral contraceptive (p=0.001) with Pap smear uptake. Conclusion: This study showed a high prevalence of Pap smear uptake among Orang Asli women in Selangor.

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Predictors of Preventive Practices towards HFMD among Mothers of Preschool Children in Klang District

Qudsiah SULIMAN ; Salmiah Md. SAID ; Nor Afiah Mohd. Zulkefli

Malaysian Journal of Medicine and Health Sciences.2017;13(3):21-32.

Introduction: During which HFMD epidemic has kept on recurring worldwide, effective vaccine and specific treatment for HFMD are still not available, calling attention to on preventive practices as the mainstay of the management. Therefore, it is timely to renew the assessment on maternal preventive practices and its predictors in Klang District, Selangor wherein the endemicity and upsurge of HFMD cases has been demonstrated. Methods: A cross-sectional study was conducted from 1st April 2017 until 15th May 2015 among mothers of Community Development Department (KEMAS) preschool children in Klang District. Respondents were selected based on probability proportional to size sampling, whereas data collection was facilitated by validated, and reliable self-administered questionnaire, that examine on the preventive practices towards HFMD. Results: A total of 353 mothers responded to questionnaire, resulting response rate of 80.2%. Most of the respondent were housewife, married and obtained educational level up to secondary school. Insufficient knowledge score (13.61 ± 4.04) was demonstrated, with health belief highlighted on low mean score for perceived severity and perceived barrier, which was 8.30(SD=1.36) and 7.80(SD=2.14) respectively. Simple linear regression revealed significant linear relationship between preventive practices with knowledge and all health belief subscales. Hierarchical multiple linear regression reported predictors of preventive practices towards HFMD, which include knowledge, (perceived susceptibility)2, perceived severity, and perceived barrier, with the group of variables was significantly predicting the (preventive practice)3 and accounted for 13.1% variance in the (preventive practices)3 (F[5,347]=11.588, p value=<0.001, adjusted R2=0.131). Conclusion: The four predictors derived from this study should be given further attention in planning for future HFMD intervention

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Prevalence and Predictors of Pap Smear Practice among Staff of a Public University in Nilai, Negeri Sembilan

Nuurain Amirah Mohd Razi ; Rosliza Abdul MANAF ; Suriani ISMAIL

Malaysian Journal of Medicine and Health Sciences.2017;13(3):33-42.

Introduction: The practice of Pap smear has long been an issue worldwide especially in the developing countries. Malaysia National Health and Morbidity Survey IV reported an uptake of 12.8% in 2011. It was found that Malay women has the lowest prevalence of uptake compared to other major ethnicities in the country. The objective of this study is to determine the prevalence of Pap smear practice and its predictors among staff in a public university with majority of Malay ethnicity. Methodology: A cross-sectional study was conducted among female staff in a public university in Nilai, Negeri Sembilan using a self-administered and validated questionnaire. All female staff from the seven faculties and the library were invited to participate. Data were analysed using SPSS version 22 for descriptive and inferential statistics, whereby Multiple Logistic Regression were performed to identify the predictors. Results: One-hundred-and eighty-seven respondents participated this study. The prevalence of Pap smear practice was 65.2%, of which, two-thirds (65.6%) had done it within the past three years. Predictors of the practice were higher parity, attending annual medical check-up, husband’s support and positive attitude towards the test. Conclusion: The prevalence of Pap smear uptake among this population is higher than other studies in Malaysia, however, not all of them have done it regularly within 3 yearly interval as suggested by the World Health Organisation.

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The Correlation of Two Nicotine Dependence Measurement Methods: Fagerstrom Test for Nicotine Dependence (FTND) and Saliva Cotinine among a Group of Muslim Smoker in Malaysia

Nuraisyah Hani ZULKIFLEY ; Suriani ISMAIL ; Rosliza Abdul MANAF ; Zulkifley HAMID

Malaysian Journal of Medicine and Health Sciences.2017;13(3):43-50.

Introduction: One of the known factors that hindered smoking cessation is nicotine dependence. Measurement of the nicotine dependence is important to better understand cigarette smoking addiction dependence and ways to overcome it. Among methods of nicotine dependence measurement are self-reported Fagerstrom Test for Nicotine Dependence (FTND) and biochemical assessment such as saliva cotinine. Biochemical assessment can be used to measure the accuracy of the self-reported measurement of nicotine dependence. Objective: To explore the correlation between the FTND and the saliva cotinine of the smokers in three different timeline. Methods: A total of 61 male smokers who currently smoke cigarette on daily basis were recruited. The study used the one-group pretest-posttest study design and the data were collected three times. The self-reported measurement were measured by using FTND and the biochemical assessment measured by using saliva cotinine from Saliva Bio oral swab (SOS) with the sensitivity of 0.15ng/ml. Data analysis was conducted by using Pearson correlation. Results: There was a significant association between the FTND score and saliva cotinine level of the smokers at baseline, second and third data collection (p=0.014, p=0.003, p<0.001). Conclusion: Both the self-reported measurement of nicotine dependence and biochemical assessment of the smokers are correlated and it could provide reliable information of the nicotine dependence.

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Inadequate Health Literacy on Childhood Immunization and Its Predictors among Antenatal Mothers

Nazatul Yusrina Mohamad Yusof ; Nor Afiah Mohd Zulkefli ; Suriani ISMAIL ; Mohammad Faid Abd Rashid

Malaysian Journal of Medicine and Health Sciences.2017;13(3):51-59.

Introduction: Outbreak of vaccine preventable disease still persists despite good coverage of immunization in Malaysia. Health literacy on childhood immunization is one of essential factor for the outbreak to happen. Thus, this study determined the predictors of health literacy on childhood immunization among antenatal mother in Seremban, Negeri Sembilan. Methodology: A cross sectional study was conducted among 424 antenatal women using a cluster sampling approach. Antenatal women who were Malaysian and not illiterate were chosen in this study. A self-administered, validated and pretested questionnaire was used to collect data on sociodemographic, socio economic, awareness on immunization, utilization of health care services and health literacy on childhood immunization. The data was analyzed using SPSS version 22.0. Chi Square test was used in bivariate analysis and multiple logistic regression was used to determine the predictors of inadequate health literacy on childhood immunization. Result: Out of 362 respondents, 81.2% were inadequate health literacy. The predictors were maternal education (AOR= 2.608, 95% CI 1.477-4.604), parity (AOR= 1.067, 95% CI 1.103-3.876), residential area (AOR= 2.344, 95% CI 1.184-4.641) and utilization of government hospital (AOR= 2.344, 95% CI 1.184-4.641). Conclusion: Accessibility of health education with regard to immunization need to be strengthen among primigravida, low education and those staying in rural area. In addition, health education also needs to emphasize on the individual that is employed and low economic status with underutilization of government hospital. A simplified education material with interesting pictures and using visual aids help illiterate people for better understanding.

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Adherence towards Different Vaccines of Childhood Immunization of Under Five Year Old Children

Zamzaireen Zainal ABIDIN ; Muhamad Hanafiah JUNI ; Faisal IBRAHIM

Malaysian Journal of Medicine and Health Sciences.2017;13(3):61-69.

Introduction: Adherence towards childhood immunization (completeness and timeliness), with consideration of age-dependent-seroconversion, is the basis for children protection. Despite high global and national immunization coverage, vaccine preventable diseases’ are rising. This study aimed to determine adherence (completeness and timeliness) towards different vaccines of childhood immunization and associated factors among mothers of under five children. Methods: Cross-sectional study design was conducted at a health clinic in Seremban. Total of 320 mothers of under five children attending child health clinic selected via systematic random sampling. Data collection was via validated self-administered questionnaires and proforma, analysed using SPSS version 22. Associations between categorical variables determined by chi-square tests. Results: Consented respondents were 314; resulting in response rate of 98.1%. Adherence (completeness) was 98.09% but only 56.5% - 97.1% of respondents adhered in terms of timeliness. Types of transportation was significantly associated with adherence (completeness), p=0.041. Employment status was significantly associated with adherence (timeliness) towards BCG (p=0.008), Hepatitis B dose one (p=0.018) and dose two (p=0.040) vaccines. Education level was significantly associated with adherence (timeliness) towards DTaP/IPV/HiB dose four (p=0.019). Maternal age and usage of government clinic were significantly associated with adherence (timeliness) of MMR dose one, p=0.030 and p=0.017 respectively. Conclusion: Adherence (completeness) was high but varying adherence towards vaccine timeliness. Transportation types associated with completeness. Employment status associated with BCG, first and second doses of Hepatitis B vaccines’ timeliness. Education level associated with fourth dose of DTaP/IPV/HiB. Maternal age and usage of government clinic associated with timeliness of first dose MMR.

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A Cross-sectional Study of Ovarian Cancer Knowledge and Its Determinants among Female Employees in a Public University, Malaysia

Najat Milad ELMAHDI ; Latiffah A LATIFF ; Mehrnoosh AKHTARI-ZAVARE ; Maimunah ISMAIL ; Rosliza Abdul MANAF ; Azrin Shah Bin Abu Bakar

Malaysian Journal of Medicine and Health Sciences.2017;13(3):71-79.

Introduction: Ovarian cancer is recognizable as the fourth leading cancer in Malaysia. Knowledge on ovarian cancer is low among Malaysian women, which may affect their interpretation of early symptoms and delay presentation of ovarian cancer cases. The aim of this study was to determine the level of ovarian cancer knowledge and its determinants among female nonacademic staff in Universiti Putra Malaysia, Serdang, Malaysia. Methods: Across- sectional study was designed to collect the data from 366 participants via a validated self-administered questionnaire, from April to July 2015. Results: The mean age of participants was 34 ± 7.89. Most of the sample was Malay (96.4%), married (61.5%). A total of 51.4% of respondents reported low knowledge level. Knowledge of ovarian cancer was significantly associated with marital status (p<0.001), age (p=0.03), interest to know about ovarian cancer (p<0.001) and level of education (p= 0.02) . Participant’ age and having heard or read about ovarian cancer were predictors to low knowledge, with the odds ratios of (OR=1.031, 95% CI= 1.002-1.061, P=0.03) and (OR=0.549, 95% CI= 0.356-0.846, P < 0.00) respectively. Conclusion: Our findings showed that more than half of female nonacademic staff in UPM was not well knowledgeable about ovarian cancer, which needs an educational intervention to improve knowledge among this group.

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