Mammogram Screening Uptake and Its Associated Factors among Female Staff in Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia.

Background: Breast cancer is among the most common cancers in Malaysia and around the world. Early detection is essential to improve outcomes, increase survival and reduce the death rate. Breast cancer screening via mammography is one of the proven effective methods. Health staff plays an important role to increase awareness and promote mammogram screening in the community. This study aims to determine the prevalence of mammogram screening and its associated factors among the female staff at Health Campus, Universiti Sains Malaysia. Methods: A cross-sectional study was conducted among the female staff aged 50 years old and above in Health Campus, Universiti Sains Malaysia. The data were collected using a self-administered questionnaire and the Viarad online system. The questionnaires include sociodemographic information, medical factors, knowledge regarding breast cancer and health beliefs about breast cancer. The Viarad online system was used to trace data of mammogram findings for those who underwent mammogram screening. Results: Among 260 participants, the prevalence of mammogram screening uptake was only 51.9%. By using statistical analysis simple logistic regression and multiple logistic regression, we found that the most significant associated factors were age, clinical breast examination (CBE), level of knowledge and physician recommendation. The mammogram screening showed that most of the breast cancer findings in Breast Imaging Reporting and Data System (BI-RADS) category 2 were at a rate of approximately 35.6%. Conclusion: This study showed the prevalence of mammogram screening uptake among the female staff was 51.9% although the service is free, readily available and accessible. The older age group, CBE, physician recommendation and knowledge about breast cancer were the main associated factors for mammogram screening uptake in the female staff in this hospital. An education programme aimed at improving the knowledge and role of a physician in promoting mammogram screening among staff should be established.

Elagolix treatment in women with heavy menstrual bleeding associated with uterine fibroid: a systematic review and meta-analysis.

BACKGROUND: Elagolix is effective and safe for treating menorrhagia in women with uterine fibroid. However, it is reported to be associated with hypoestrogenism that can be alleviated by adding estradiol/norethindrone acetate. This systematic review and meta-analysis aimed to determine the effectiveness of elagolix treatment in women with heavy menstrual bleeding associated with uterine fibroid by comparing: elagolix versus placebo and elagolix versus estradiol/norethindrone acetate. METHODOLOGY: The Cochrane Central Register of Controlled Trials (CENTRAL 2021, Issue 3 of 12), MEDLINE databases (1980 to December week 1, 2020), and trial registries for relevant randomized clinical trials were used. All randomized clinical trials were reviewed and evaluated. Random effects models were used to estimate the dichotomous outcomes and mean differences with 95% confidence intervals. Data for risk of bias, heterogeneity, sensitivity, reporting bias and quality of evidence were assessed. RESULTS: Four randomized controlled trials with 1949 premenopausal women from 323 locations were included. Elagolix improved menstrual blood loss of less than 80 ml (RR 4.81, 95% CI 2.45 to 9.45; four trials, 869 participants; moderate quality evidence) or more than 50% reduction from baseline (RR 4.87, 95% CI 2.55 to 9.31; four trials, 869 participants; moderate quality evidence) compared to placebo. There was no difference in menstrual blood loss of less than 80 ml (RR 1.08, 95% CI 1.00 to 1.16; five trials, 1365 participants; moderate quality evidence) or more than 50% reduction from baseline between the elagolix (RR 1.08, 95% CI 1.01 to 1.15; five trials, 1365 participants; high quality evidence) and elagolix with estradiol/norethindrone acetate. In both comparisons, elagolix has reduced the mean percentage change in uterine and fibroid volume, improved symptoms, and health-related quality of life. More patients had hot flush, and bone mineral density loss in the elagolix treatment compared to both placebo and elagolix with estradiol/norethindrone acetate. CONCLUSIONS: Elagolix appeared to be effective in reducing heavy menstrual bleeding caused by uterine fibroid and combination with estradiol/norethindrone acetate was able to alleviate the hypoestrogenism side effects in premenopausal women. Review registration PROSPERO CDR 42021233898.

Health seeking behaviour of menopausal women with urinary incontinence in North east Malaysia.

Urinary incontinence (UI) is common in women in postmenopausal age, but many women delay seeking treatment. The objective of this study is to determine health-seeking behavior of postmenopausal women with UI and its associated factors. This is a cross-sectional study involving 348 postmenopausal women from the outpatient clinic using personal data forms and a validated UI questionnaire. A total of 348 menopausal women were involved in the study. Only 13.17% of patients with UI sought treatment. Factors associated with seeking treatment were age of menopause and severity of UI. More health education needs to be done among these patients.

Diabetes self-care and its associated factors among type 2 diabetes mellitus with chronic kidney disease patients in the East Coast of Peninsular Malaysia.

Introduction: Diabetes self-care among diabetic patients is crucial as it determines how patients care for their illness in their daily routine for better diabetes control. This study aims to calculate the average score for diabetes self-care among patients with type 2 diabetes mellitus and chronic kidney disease and to identify factors that are associated with this score. Materials and Methods: This cross-sectional study enrols patients over 18 years old with type 2 diabetes mellitus and chronic renal disease with an eGFR of less than 60 mL/min/1.73 m2 in a tertiary hospital in Malaysia. The Malay version of the Summary of Diabetic Self-Care Activities (SDSCA) was used to assess diabetes self-care, the Malay version of the diabetes-related distress questionnaire (DDS-17) was used to assess diabetes distress, and the Malay version of the Patient Health Questionnaire-9 (PHQ-9) was used to assess depression. Data analysis was performed using both simple and multiple linear regression models to determine the associations between variables. Result: One hundred and seventy-six eligible patients were recruited for this study. The mean score for diabetes self-care is 3.62. The eGFR (p = 0.002) and diabetes distress (p = 0.004) are the significant associated factors for diabetes self-care among type 2 diabetes mellitus patients with chronic kidney disease. Conclusion: The mean score for diabetes self-care indicated a moderate level of self-care. The eGFR level and diabetes distress were important factors influencing diabetes self-care practices.

Knowledge, attitudes, and associated factors of caregivers towards children with autism spectrum disorder in East Coast Peninsular Malaysia.

Background: Caregivers are directly involved in managing the daily basic needs of children with autism spectrum disorder (ASD). The knowledge and attitudes of these caregivers are important to achieving success in their roles. Thus, this study aimed to determine what constitutes good knowledge, attitudes, and associated factors among caregivers toward children with ASD. Methods: A cross-sectional study was conducted among 128 caregivers of children with ASD in Kota Bharu, Kelantan from May to August 2020, using convenience sampling. Validated questionnaires were used to assess the knowledge and attitudes toward children with ASD. The data were analyzed using SPSS version 24. Descriptive statistics and simple and multiple logistic regression analyses were then performed. Results: The response rate was 100%. The proportion of good knowledge and attitudes toward children with ASD among caregivers was 85.1% and 88.3%, respectively. Factors significantly associated with good knowledge were being female (OR (95% CI) 2.79 [0.99-7.90]) and ASD children being non-first-born children (OR (95% CI) 0.41 [0.15-1.12]). Factors significantly associated with good attitudes were age of 30 years and older (OR (95% CI) 0.13 [0.03-0.62]) and caregiver having other children with other types of learning difficulties (OR (95% CI) 0.15 [0.04, 0.52]). Conclusions: The proportion of caregivers with good knowledge of ASD and good attitudes toward children with ASD was high. The caregiver's age and sex, the position of the ASD child among the siblings, and the presence of other types of learning disorders in the family need to be considered when managing children with ASD.

Written Asthma Action Plan Improves Asthma Control and the Quality of Life among Pediatric Asthma Patients in Malaysia: A Randomized Control Trial.

BACKGROUND: A written asthma action plan (WAAP) is one of the treatment strategies to achieve good asthma control in children. METHODS: This randomized controlled trial was conducted to observe the effect of WAAP on asthma control and quality of life using the Asthma Control Questionnaire and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) at baseline and after 3 months. A repeated measure analysis of variance was used to analyze the mean score difference between the two groups. RESULTS: There was no significant difference in mean score for asthma control at baseline between groups (F[degree of freedom (df)]=1.17 [1, 119], P=0.282). However, at 3 months, a significant difference in mean scores between groups was observed (F[df]=7.32 [1, 119], P=0.008). The mean±standard deviation (SD) scores in the intervention and control groups were 0.96±0.53 and 1.21±0.49, respectively. For the analysis of the PAQLQ, no significant difference was observed in the mean score for the quality of life baseline in both groups. There were significant mean score changes for the quality of life (F[df]=10.9 [1, 119], P=0.001) at 3 months follow-up, where those in the intervention group scored a mean±SD score of 6.19±0.45, and those in the control group scored 5.94±0.38. A time-group interaction analysis using repeated-measures analysis of variance showed significant differences in mean score changes (F[df]=5.03 [1, 116], P=0.027) and (F[df]=11.55 [1, 116], P=0.001) where a lower mean score was observed in the intervention group, indicating better asthma control and quality of life, respectively. A significant (P<0.001) negative Pearson correlation between asthma control and quality of life (-0.65) indicated a moderate correlation. CONCLUSION: WAAP, along with standard asthma treatment, improves asthma care.

Effect of yoga on anthropometry, quality of life, and lipid profile in patients with obesity and central obesity: A systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to determine the effectiveness of yoga on anthropometry, quality of life, and lipid profiles in patients with obesity and central obesity. METHODOLOGY: The Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed (1985-January 2022) and trial registries for relevant randomised clinical trials were used. Relevant and published randomised clinical trials were reviewed and evaluated. The primary outcomes were anthropometry measurements, which were weight, waist circumference, body mass index (BMI), and body fat percentages. The secondary outcomes were changes in quality of life, psychological impact, lipid profile measurement, presence of adverse events, and changes in blood pressure and blood glucose. We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. RESULTS: 15 studies are included, involving 1161 participants. The analysis performed is based on three comparisons. For the first comparison between yoga and control, yoga reduces the waist circumference (MD -0.84, 95% CI [-5.12 to 3.44]), while there is no difference in body weight, BMI, or body fat percentages. In the second comparison between yoga and calorie restriction, yoga reduces body weight (MD -3.47, 95% CI [-6.20 to -0.74]), while there is no difference in waist circumference, BMI, or body fat percentage. In the third comparison between yoga and exercise, yoga reduces the body weight (MD -7.58, 95% CI [-11.51 to -3.65]), while there is no difference in waist circumference or BMI. For the secondary outcomes, yoga intervention reduces total cholesterol (MD -17.12, 95% CI [-32.24 to -2.00]) and triglycerides (MD -21.75, 95% CI [-38.77 to -4.73]) compared to the control group, but there is no difference compared to the calorie restriction and exercise group. There is no difference in the rest of the outcomes, which are LDL, HDL, quality of life, psychological impact, adverse events, blood pressure, and blood glucose. However, findings are not robust due to a high risk of bias and low-quality evidence. CONCLUSION: From our review, there were methodological drawbacks and very low to moderate quality of evidence across all comparisons, and hence, it is inconclusive to say that yoga can significantly improve anthropometric parameters. More well-designed trials are needed to confirm and support the beneficial effects of yoga.

Quality of Life and Its Associated Factors among Patients with Psoriasis in a Semi-Urban Northeast Malaysia.

Psoriasis is a chronic relapsing dermatological disorder that significantly affects the patients' psychosocial well-being and quality of life (QOL). This study aimed to determine the proportion of severely impaired QOL, the factors associated with severely impaired QOL, and its correlation with depression among semi-urban populations on the Northeast Coast of the Peninsular Malaysia. A cross-sectional study was conducted among 257 patients with psoriasis at the Dermatology Clinic of Hospital Sultanah Bahiyah via a self-administered questionnaire that included sociodemographic profiles, the validated Malay version of the Dermatology Life Quality Index (DLQI), and the Malay version of the Beck depression scale. The data were analysed using logistic and linear regression models. About 20.5% of the patients had severely impaired QOL quality of life, while 79.5% of the patients had non-impaired QOL. Multiple logistic regression analysis showed that the psoriatic severity [Adjusted OR = 1.91, 95% CI: 1.76, 9.93; p < 0.001] and exposed area [Adjusted OR 2.93, 95% CI: 0.38, 2.29; p = 0.050] had a significant association with severely impaired QOL. Among the patients, 18.7% had a positive result in the screening for depression, which revealed a significant association between QOL and depression scores [r = 0.47, 95% CI: 0.35, 0.56, p < 0.001]. Psoriasis can impair QOL and have a relation with mental health. Regular screening for depression among patients with psoriasis is a beneficial strategy for the early detection of depression, especially in semi-urban areas.

A Case Report of Male Systemic Lupus Erythematous with Antinuclear Antibodies-Negative: A Challenging Diagnosis.

Systemic lupus erythematosus (SLE) is a connective tissue disease of unknown etiology that predominantly affects women of childbearing age. We report a case of male systemic lupus erythematous with antinuclear antibodies and typical clinical presentations of multiple skin lesions, polyarticular joint pain, fatigue, anorexia, and hair loss. Full evaluations were used to establish a diagnosis of SLE. The lower prevalence of SLE among males and antinuclear antibody-negative patients poses a great challenge for diagnosis. Therefore, as primary care doctors, we need to have a high suspicion of systemic lupus erythematous even in male and antinuclear antibody-negative patients. Thus, early treatment may help patients improve their quality of life.

A Systematic Review and Meta-Analysis of the Efficacy of Evening Primrose Oil for Mastalgia Treatment.

Mastalgia, or breast pain, is common among women which can lead to significant impairment in daily living. Hence, finding an effective treatment that can alleviate the symptom is very important. Thus, we carry out this study to determine the efficacy of evening primrose oil (EPO) for mastalgia treatment in women. The review included published randomised clinical trials that evaluated EPO used for treating mastalgia against a placebo or other treatments, irrespective of the blinding procedure, publication status, or sample size. Two independent authors screened the titles and abstracts of the identified trials; full texts of relevant trials were evaluated for eligibility. Two reviewers independently extracted data on the methods, interventions, outcomes, and risk of bias. The random-effects model was used for estimating the risk ratios and mean differences with 95% confidence intervals. Thirteen trials with 1752 randomised patients were included. The results showed that EPO has no difference to reduce breast pain compared to topical NSAIDS, danazol, or vitamin E. The number of patients who achieved pain relief was no different compared to the placebo or other treatments. The EPO does not increase adverse events, such as nausea, abdominal bloating, headache or giddiness, increase weight gain, and altered taste compared to a placebo or other treatments. EPO is a safe medication with similar efficacy for pain control in women with mastalgia compared to a placebo, topical NSAIDS, danazol, or vitamin E.

Unsuccessful Exclusive Breastfeeding and Associated Factors among the Healthcare Providers in East Coast, Malaysia.

BACKGROUND: Breastfeeding is widely recognized as the optimal and natural method of feeding infants. However, there are obstacles that can limit exclusive breastfeeding practices during the first 6 months of an infant's life. This study aimed to determine the prevalence of unsuccessful exclusive breastfeeding and its associated factors among mothers who work as healthcare providers at Universiti Sains Malaysia Hospital. METHODS: A cross-sectional study was conducted among 295 medical doctors and staff nurses from June to December 2015. Simple random sampling was applied. The data were collected using a self-administered questionnaire and analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics and logistic regression analysis were performed. RESULTS: The prevalence of unsuccessful exclusive breastfeeding among the study participants was 58.3%. Mothers who preferred formula milk (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.45-13.31) delivered via lower segment cesarean section (OR, 2.31; 95% CI, 1.07-4.98) and produced inadequate breast milk (OR, 4.06; 95% CI, 2.40- 6.89) were significantly associated with unsuccessful exclusive breastfeeding. CONCLUSION: The prevalence of unsuccessful exclusive breastfeeding among the study participants was high. Maternal characteristics such as preference towards formula milk, mode of delivery and adequacy of breast milk must be assessed to prevent unsuccessful exclusive breastfeeding among healthcare providers.

Home Blood Pressure Monitoring Has Similar Effects on Office Blood Pressure and Medication Compliance as Usual Care.

BACKGROUND: Home blood pressure monitoring is recommended to achieve controlled blood pressure. This study evaluated home blood pressure monitoring-improvement of office blood pressure control and treatment compliance among hypertensive patients. METHODS: A randomized controlled trial was conducted from December 2014 to April 2015. The home blood pressure monitoring group used an automatic blood pressure device along with standard hypertension outpatient care. Patients were seen at baseline and after 2 months. Medication adherence was measured using a novel validated Medication Adherence Scale (MAS) questionnaire. Office blood pressure and MAS were recorded at both visits. The primary outcomes included evaluation of mean office blood pressure and MAS within groups and between groups at baseline and after 2 months. RESULTS: Mean changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) and MAS differed significantly within groups. The home blood pressure monitoring group showed greater mean changes (SBP 17.6 mm Hg, DBP 9.5 mm Hg, MAS 1.5 vs. SBP 14.3 mm Hg, DBP 6.4 mm Hg, MAS 1.3), while between group comparisons showed no significant differences across all variables. The adjusted mean difference for mean SBP was 4.74 (95% confidence interval [CI], -0.65 to 10.13 mm Hg; P=0.084), mean DBP was 1.41 (95% CI, -2.01 to 4.82 mm Hg; P=0.415), and mean MAS was 0.05 (95% CI, -0.29 to 0.40 mm Hg; P=0.768). CONCLUSION: Short-term home blood pressure monitoring significantly reduced office blood pressure and improved medication adherence, albeit similarly to standard care.

Pelvic Floor Muscle Exercise Education and Factors Associated with Implementation among Antenatal Women in Hospital Universiti Sains Malaysia.

BACKGROUND: Pelvic floor muscle exercise is effective for pelvic floor muscle dysfunction. Despite the high prevalence of pelvic floor muscle dysfunction in women in the community, pelvic floor muscle exercise recognition is low in Malaysian society; thus, this intervention is not frequently used . This study assessed the knowledge of, attitudes towards, and use of pelvic floor muscle exercise among antenatal women before and after educational classes. The study also determined factors associated with exercise practice. METHODS: An interventional study was conducted in 121 antenatal women selected through systematic random sampling between June and December 2010. Baseline knowledge of, attitude towards, and practice of pelvic floor muscle exercise were assessed using self-administered validated questionnaires at first visit and at 2 months postpartum. All participants attended two exercise education classes on their next two visits before delivery. A paired ttest and multivariate analysis were used for data evaluation. RESULTS: The mean pre-intervention scores for knowledge, attitudes, and practice were 24.98, 24.25, and 3.51, respectively, with statistically significant mean score increments after intervention (P<0.001). The mean differences were 4.67 (95% confidence interval [CI], 3.86-5.49), 3.77 (95% CI, 3.05-4.50) and 3.45 (95% CI, 2.90-4.00) for knowledge, attitudes, and practice, respectively. Lack of baseline information on pelvic floor muscle exercise was significantly associated with practice change following an educational class. CONCLUSION: Education is effective in improving knowledge of, attitude towards, and practice of pelvic floor muscle exercise. There is a need for greater effort to increase exercise awareness in our community, especially during antenatal class.