Assessment of prevalence, knowledge and health-related practices of dysmenorrhea among Malaysian women in Kuala Lumpur: a cross-sectional survey.

BACKGROUND: Menstruation is a natural phenomenon considered an important indicator of women's health, reflecting their endocrine function. Women in low middle income countries face substantial menstrual hygiene management challenges. Data on the knowledge of dysmenorrhea and health-related practices among Malaysian women are scarce. The present study aimed to investigate the prevalence of dysmenorrhea among Malaysian women in Kuala Lumpur and its association with socio-demographic factors, knowledge level, and general practices. METHOD: A cross-sectional study was carried out among Malaysian women in Kuala Lumpur. A total of 362 unmarried women, nulliparous and aged between 18 and 25 years old, were included in this study. Participants were conveniently recruited through online platforms as well as face to face using a self-administered questionnaire with five sections consisting of demographics, menstrual characteristics, Working ability, Location, Intensity, Days of pain, Dysmenorrhea (WaLIDD) score for diagnosing and assessing the severity of dysmenorrhea as well as an evaluation of respondents' general knowledge and practices towards dysmenorrhea. The collected data were analysed using the SPSS tool, a descriptive statistic was used to report demographic characteristics. Inferential statistics was used to report the differentiation, association, and correlations of the variables. RESULTS: The prevalence of primary dysmenorrhea was 73.2%. It was found that the majority of the respondents had poor knowledge (60%) and poor practices (61.88%) of dysmenorrhea. The most common preventive practices among the respondents were using dietary supplements, and herbs, taking a rest and exercising. The findings also indicated that dysmenorrhea among the respondents was significantly associated with family history of dysmenorrhea (p = 0.002), monthly income (p = 0.001), and knowledge level (p = 0.001). CONCLUSION: Dysmenorrhea has a high prevalence among women in Malaysia in Kula Lumpur driven by low knowledge and lack of evidence-based practices among these women. Thus, it is critical for Government and healthcare authorities to promote education related to women health among Malaysian women.

Vitamin D Supplementation in Influenza and COVID-19 Infections Comment on: "Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths" Nutrients 2020, 12(4), 988.

There is an ongoing debate on the use of vitamin D supplementation in reducing the risk of influenza and COVID-19 infections and deaths. A recently published article highlights a relationship between vitamin D supplementation and reduced risk of COVID-19 and influenza. This comment aims to discuss the evidence on the use of Vitamin D in people who are at risk of developing COVID-19, focusing on safety issues of the Vitamin D supplementation.

Efficacy and safety of lavender essential oil (Silexan) capsules among patients suffering from anxiety disorders: A network meta-analysis.

A systematic review and network-meta analysis (NMA) were performed to estimate significance of the anxiolytic effect of lavender essential oil taken as silexan capsules versus other comparators (i.e., placebo/paroxetine/lorazepam). The outcome of interest was Hamilton Anxiety Scale (HAMA). Weighted mean differences (WMD) were calculated to estimate the treatment effect at the confidence interval of 95%. League tables were generated using treatment effect, for all pairwise comparisons, where WMD < 0 favors the column-defining treatment. Five studies were identified with a total of 524 participants receiving treatment with silexan 80 mg and 121 participants taking silexan 160 mg. The NMA results indicated that consumption of silexan 160 mg resulted in higher decline of HAMA score [WMD -1.14 (-1.10, 3.39)] in comparison to silexan 80 mg, placebo [-2.20 (-4.64, 0.24)] and paroxetine [-1.24 (-5.34, 2.85)]. The effect of silexan 80 mg was observed to be same as that of paroxetine. Overall, silexan 160 mg was noticed to be a more efficient treatment giving significant decline in HAMA score across other comparators. However, no improvements in HAMA score was observed for the group receiving lorazepam 0.5 mg when compared to silexan 160 mg, silexan 80 mg, paroxetine 20 mg, and placebo.

'Treated as a number, not treated as a person': a qualitative exploration of the perceived barriers to effective pain management of patients with chronic pain.

OBJECTIVES: To identify barriers to effective pain management encountered by patients with chronic pain within the UK's National Health Service (NHS). DESIGN: Secondary analysis of face-to-face, semistructured qualitative interviews using thematic analysis. SETTING: A community-based chronic pain clinic jointly managed by a nurse and pharmacist located in the North of England. PARTICIPANTS: Nineteen adult (>18 years) patients with chronic pain discharged from a pain clinic, with the ability to understand and speak the English language. RESULTS: In general, patients were highly disappointed with the quality of pain management services provided both within primary and secondary care, and consequently were willing to seek private medical care. Barriers to effective pain management were divided into two main themes: healthcare professional-related and health systems-related. Three subthemes emerged under healthcare professionals-related barriers, namely (1) healthcare professionals' lack of interest and empathy, (2) general practitioners' (GP) lack of specialised knowledge in pain management and (3) lack of communication between healthcare professionals. Three subthemes emerged under health system-related barriers: (1) long waiting time for appointments in secondary care, (2) short consultation times with GPs and (3) lack of an integrated multidisciplinary approach. CONCLUSIONS: The patients expressed a clear desire for the improved provision and quality of chronic pain management services within the NHS to overcome barriers identified in this study. An integrated holistic approach based on a biopsychosocial model is required to effectively manage pain and improve patient satisfaction. Future research should explore the feasibility, effectiveness and cost-effectiveness of integrated care delivery models for chronic pain management within primary care.

Effectiveness of a community based nurse-pharmacist managed pain clinic: A mixed-methods study.

BACKGROUND: Chronic pain is predominantly managed in primary care, although often ineffectively. There is growing evidence to support the potential role of nurses and pharmacists in the effective management of chronic pain. OBJECTIVES: To evaluate the effectiveness of a pain clinic jointly managed by a nurse and pharmacist. DESIGN: A mixed-methods design consisting of qualitative interviews embedded within a quasi-experimental study. SETTINGS: A community-based nurse-pharmacist led pain clinic in the north of England. PARTICIPANTS: Adult chronic pain (non-malignant) patients referred to the pain clinic. METHODS: Pain intensity was the primary outcome. Questionnaires (the Brief Pain Inventory, the Hospital Anxiety and Depression Scale, the SF-36 and the Chronic Pain Grade questionnaire) were administered at the baseline, on discharge and at 3-month post-discharge (Brief Pain Inventory and Hospital Anxiety and Depression Scale only). Patient satisfaction was explored using face-to-face, semi-structured qualitative interviews. RESULTS: Seventy-nine patients with a mean age of 46.5 years (SD±14.4) took part in the quasi-experimental study. Thirty-six and nine patients completed the discharge and 3-month follow-up questionnaires respectively. Compared to baseline, statistically significant reductions were noted for two of the outcome measures: pain intensity (P=0.02), and interference of pain with physical functioning (P=0.02) on discharge from the service. Nineteen patients participated in qualitative interviews. The patients were, in general, satisfied with the quality of service. Four contributing factors to patient satisfaction were identified: ample consultation time, in-depth specialised knowledge, listening and understanding to patients' needs, and a holistic approach. CONCLUSIONS: Nurse and pharmacist managed community-based pain clinics can effectively deliver quality pain management services as they offer an interdisciplinary holistic approach to pain management. Such services have the potential not only to reduce the burden on secondary care but also decrease long waiting times for referral to secondary care. Further research is required to support the development of evidence based referral guidelines to such services.