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Buccal lichenoid lesions (BLLs) are characterised by a unique, linear whitish striation in the buccal region and can be accompanied by ulcers, plaques, erythemas, atrophies and blisters. They are distinguished from oral lichen planus (OLP) by the association of the administration of a drug or contact with a metal. Herein, we present the case of a 42-year-old woman with underlying hypertension with amlodipine-induced BLLs. She complained of a 1-month history of right buccal whitish streaks and oral ulcers 2 months after taking amlodipine. She visited a private otorhinolaryngology clinic, and a biopsy for the right buccal ulcer was conducted. The biopsy result showed features suggestive of OLP. The patient was then diagnosed with OLP. Her symptoms were persistent despite treatment, so a dental referral was made. Amlodipine was suspected as the cause of her condition and was therefore stopped. Her condition gradually resolved after amlodipine withdrawal. Hence, primary care physicians should be aware of BLLs as one of the adverse drug reactions of amlodipine so that prompt management can be taken to avoid further debilitating impacts on patients. [ABSTRACT FROM AUTHOR]

Background. Pregnancy is one of the risks for severe COVID-19 infection, and receiving a vaccination is one of the effective methods to reduce disease severity. However, COVID-19 vaccine hesitancy among pregnant women remains an issue. This study aims to develop and validate the pregnancy Vaccine Hesitancy Scale (pVHS) toward COVID-19 vaccine for Malaysian pregnant women. Method. An 8-item Malay language pregnancy Vaccine Hesitancy Scale (pVHS-M) for COVID-19 was adapted from the adult Vaccine Hesitancy Scale and validated using Exploratory Factor Analysis. Six expert panels were involved in content validity, and ten pregnant women were involved in face validity. A cross-sectional study on 200 pregnant women was conducted between October 2022 and March 2023 at the Obstetrics and Gynaecology Clinic, Universiti Sains Malaysia, Kelantan. Result. The item-level content validity index is 1.00, demonstrating good relevance of the eight items used to assess COVID-19 vaccine hesitancy. The item-level face validity index obtained is 0.99, indicating that the items were clear and comprehensible. The Cronbach alpha score was 0.944, with factor loadings ranging from 0.79 to 0.89. Conclusion. The pVHS-M demonstrated good internal consistency, indicating that it is a valid and reliable tool for assessing COVID-19 vaccine hesitancy among pregnant women. [ABSTRACT FROM AUTHOR]

Monkeypox is a rare disease originating in Africa and has recently gained the spotlight globally because of the increasing cases reported in Western Europe and North America. However, since July 2022, the World Health Organization has declared this disease a public health emergency of international concern as the cases were rising globally. We report a case of the severe form of rashes of hand-foot-and-mouth-disease to distinguish it from current outbreaks of the monkeypox virus. Hopefully, this case report will aid primary care physicians in their ability to recognize and distinguish between a severe hand-foot-and-mouth-disease rash and an infection with the monkeypox virus. So, effective management and treatment may aid patients in enhancing their quality of life. [ABSTRACT FROM AUTHOR]

Monkeypox is known to be endemic in Africa, but recently, the unusually increasing number of cases of monkeypox in non-endemic countries has caught the attention of the world. The World Health Organization has declared the monkeypox outbreak a public health emergency. The spread pattern is unlikely associated with the previous outbreak outside of Africa, which is related to travelling or contact with exotic animals. The current outbreak is linked to sexual history and presents with atypical localised genital eruptions with an unpredictable onset of viral prodromal symptoms. Although the monkeypox virus is not easily transmittable compared with severe acute respiratory syndrome coronavirus 2, anyone who has been in close contact with a patient with monkeypox is at risk. Most patients will present to a primary care centre for assessment and treatment; therefore, it is important to increase awareness of the infection among primary care providers for early recognition of monkeypox, containment of the outbreak and prevention of healthcare-associated infection. A physician who suspects any patient with monkeypox should notify local or state health authorities immediately. [ABSTRACT FROM AUTHOR]

Monkeypox is known to be endemic in Africa, but recently, the unusually increasing number of cases of monkeypox in non-endemic countries has caught the attention of the world. The World Health Organization has declared the monkeypox outbreak a public health emergency. The spread pattern is unlikely associated with the previous outbreak outside of Africa, which is related to travelling or contact with exotic animals. The current outbreak is linked to sexual history and presents with atypical localised genital eruptions with an unpredictable onset of viral prodromal symptoms. Although the monkeypox virus is not easily transmittable compared with severe acute respiratory syndrome coronavirus 2, anyone who has been in close contact with a patient with monkeypox is at risk. Most patients will present to a primary care centre for assessment and treatment; therefore, it is important to increase awareness of the infection among primary care providers for early recognition of monkeypox, containment of the outbreak and prevention of healthcare-associated infection. A physician who suspects any patient with monkeypox should notify local or state health authorities immediately. [ABSTRACT FROM AUTHOR]

Aim: Medication non-adherence has remained a common and costly global health issue of growing importance among older adults. This study aims to determine the prevalence and associated factors related to medication non-adherence among older adult stroke survivors in China. Methods and results: In this cross-sectional study, a total of 402 older adult stroke survivors were recruited from three tertiary hospitals in China. The results of the survey showed that 61.4% exhibited medication non-adherence. The chances of medication non-adherence among older adult stroke survivors who had primary school or less educational levels were higher than those who had senior secondary and junior college educational levels [OR (95% CI) = 0.440(0.249, 0.778)] as well as those who had a bachelor's degree or above educational levels [OR (95%CI) = 0.367(0.202, 0.667)]. Moreover, the probability of medication non-adherence with 4-5 and >6 types of total prescription medications per day increased by 1.993 times [OR (95% CI) = 1.993(1.190, 3.339))] and 2.233 times [OR (95%CI) = 2.233(1.159, 4.300)], respectively, as compared to when there were ≤3 types. Furthermore, medication non-adherence decreased with the increase in health literacy scores (β = -0.641 (95% CI; (0.913, 0.965)) and BMQ specific-necessity scores (β = -0.131 (95% CI; 0.806, 0.995)). On the other hand, when the BMQ specific-concerns score increased by one unit, medication non-adherence increased by 11.1% [OR (95% CI) = 1.111(1.044, 1.182)]. Conclusion: The present study found that patient medication adherence among older adult stroke survivors in China is problematic and associated with educational levels, total prescribed drugs per day, beliefs about medication, and health literacy scores. This indicates that measures should be taken to enhance medication adherence among such higher-risk populations. [ABSTRACT FROM AUTHOR]

This case illustrates the rare cause of failure to thrive (FTT) that initially presented with recurrent ear discharge. A five-year-old boy with a history of recurrent ear infections for the past year was treated for acute symptoms during each visit. He later was diagnosed with acute mastoiditis secondary to otitis media by a private otorhinolaryngologist and was referred to a tertiary hospital for admission and parenteral antibiotic commencement. The anthropometric evaluation noted he fell under the group of FTT and had an incidental finding of lower tract respiratory infection that turned out to be tuberculosis infection. Multiple complications occurred during his admission, including candidemia, disseminated tuberculosis, and deep-seated collections. Hence, he was worked up for primary immunodeficiency and was given extensive supportive treatment. [ABSTRACT FROM AUTHOR]

Background. Polycystic ovary syndrome (PCOS) is a disorder in reproductive age women and is characterized by hyperandrogenic anovulation and oligo-amenorrhea, which leads to infertility. Anovulation in PCOS is associated with low follicle-stimulating hormone levels and the arrest of antral follicle development in the final stages of maturation. L-carnitine (LC) plays a role in fatty acid metabolism, which is found to be lacking in PCOS patients. This systematic review and meta-analysis aimed to determine the effectiveness of LC supplementation for patients with PCOS. Methods. Wesearched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information Database (PsycINFO), and the World Health Organization International Clinical Trials Registry Platform for all randomized control trials, comparing LC alone or in combination with other standard treatments for the treatment of PCOS from inception till June 2021. We independently screened titles and abstracts to identify available trials, and complete texts of the trials were checked for eligibility. Data on the methods, interventions, outcomes, and risk of bias from the included trials were independently extracted by the authors. The estimation of risk ratios and mean differences with a 95 percent confidence interval (CI) was performed using a random-effects model. Results. Nine studies with 995 participants were included in this review. Five comparison groups were involved. In one comparison group, LC reduced the fasting plasma glucose (FPG) (mean differences (MD) -5.10, 95% CI [-6.25 to -3.95]; P = 0:00001), serum low-density lipoprotein (LDL) (MD -25.00, 95% CI [-27.93 to -22.07]; P = 0:00001), serum total cholesterol (MD -21.00, 95% CI [-24.14 to -17.86]; P = 0:00001), and serum triglyceride (TG) (MD -9.00, 95% CI [-11.46 to -6.54]; P = 0:00001) with moderate certainty of evidence. Another comparison group demonstrated that LC lowers the LDL (MD -12.00, 95% CI [-15.80 to -8.20]; P = 0:00001), serum total cholesterol (MD -24.00, 95% CI [-27.61 to -20.39]; P D0:00001), and serum TG (MD -19.00, 95% CI [-22.79 to -15.21]; P D0:00001) with moderate certainty of evidence. Conclusion. There was low to moderate certainty of evidence that LC improves Body Mass Index (BMI) and serum LDL, TG, and total cholesterol levels in women with PCOS. [ABSTRACT FROM AUTHOR]

Channa striatus, an indigenous freshwater fish, has been shown to treat knee osteoarthritis, but no study has been done to compare its effectiveness with other oral therapy. This study aimed to compare the effectiveness of oral Channa striatus extract and glucosamine sulphate in knee osteoarthritis symptoms and physical function. This is a double-blind randomised controlled trial, conducted among 78 patients with primary knee osteoarthritis. Patients were assigned to receive either 500 mg/d of Channa striatus or 1,500 mg/d of glucosamine sulphate for 6 months. The main outcome measures were pain, stiffness and physical function, as assessed by the Western Ontario and Mc Master Osteoarthritis Index (WOMAC) at baseline, 3- and 6-months post-randomisation. Seventy-three patients completed the study (Channa striatus, n = 37; glucosamine sulphate, n = 37). There was no significant between-group difference in the WOMAC index. However, the within-group comparison pointed to a significant improvement in all the WOMAC domains in both groups from baseline to 6 months. The effectiveness of Channa striatus shows no difference from that of glucosamine sulphate in reducing the symptoms of knee osteoarthritis. Channa striatus could be a new alternative treatment for the management of knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Adolescent striae are more common in girls. The striae in boys can be misinterpreted as a result of non-accidental injuries such as physical abuses and violence. We reported a case of a 16-year-old boy who presented with multiple linear purplish striae on the upper trunk and both axillae area. The skin lesion was initially interpreted as lesions resulted from physical abuse and bully activities at his school. The parent was concerned about the skin lesions and they thought their son had been assaulted at school. The diagnosis of physiological striae in adolescence was made after excluding other endocrine disorders and related diseases. Further assessment revealed there was no history of recent physical assaulted at his school. This case illustrates that the unfamiliarity with this skin condition can be resulted in misinterpretation of the cases. However, suspiciousness for non-accidental injury is crucial, especially among adolescent groups who are at risk to be involved in the bully activities. The misinterpreted of the adolescent striae may cause stress to the parent or other family members and it has sometimes led to the unnecessary legal acts which might be taken by the protective parent. [ABSTRACT FROM AUTHOR]

Background. Chronic constipation is a common symptom among the elderly, and it may affect their quality of life (QoL). A lack of available research focused on the elderly means that this effect is not well understood. This study aimed to develop and validate a new scale (Elderly-Constipation Impact Scale (E-CIS)) to measure the impact of chronic constipation on QoL among the elderly. Methods. A pool of items was generated from a qualitative study, literature reviews, and expert reviews. Exploratory factor analysis (EFA) was performed on the original 40 items of the E-CIS and followed by 27 items for confirmatory factor analysis (CFA). A total of 470 elderly people with chronic constipation were involved. Results. The mean age of the participants was 68.64 ± 6.57. Finally, only 22 items were indicated as appropriately representing the E-CIS, which were grouped into seven subscales: 'daily activities', 'treatment satisfaction', 'lack of control of bodily function', 'diet restriction', 'symptom intensity', 'anxiety' and 'preventive actions'. The scale was confirmed as valid (root mean square error of approximation (RMSEA) = 0.04, comparative fit index (CFI) D 0.961, Tucker-Lewis index (TLI) D 0.952 and chi- square/degree of freedom (chiSq/df)D1.44) and reliable (Cronbach's alpha: 0.66-0.85, composite reliability (CR) D 0.699-0.851) to assess the impact of chronic constipation on the elderly's QoL. Conclusions. The E-CIS is useful to measure the impact of chronic constipation on the elderly's QoL. A further test is needed to determine the validity and reliability of this scale in other elderly population. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the prevalence, symptoms, and factors associated with chronic constipation among community-dwelling older people in the East Coast region of Peninsular Malaysia. Methods: A cross-sectional study was conducted in four selected health clinics using stratified cluster sampling. A face-to-face interview was carried out among the elderly outpatients, in order to complete a structured questionnaire. Results: A total of 400 participants were included in the study. The mean age was 68.7 ± 6.4 years, and 55% of the cohort were women. The prevalence of chronic constipation was 32.3% among the sample population. The most common symptom was "sensation of incomplete evacuation" (63.6%), and none of the participants reported having "less than three defecations per week," "straining," or "lumpy or hard stool." Educational level (p = 0.005), number of defecations per week, stool form, time spent for defecation, and abdominal bloating were significantly associated with chronic constipation (p < 0.001). Conclusion: Chronic constipation was common in older people and associated with a low educational level. Recognition of symptoms was predominantly based on clinical features of constipation and will require the healthcare providers to consider these factors in their routine assessment of older people. [ABSTRACT FROM AUTHOR]

Pregnancy in patients with end-stage renal disease (ESRD) is considered a very high-risk and is not recommended as it might cause fatal consequences for both the mother and the fetus. Even though chronic kidney disease affects the physiological components of fertility, decreasing the possibility of spontaneous conceptions, unwanted pregnancies still happen, and a small percentage of women with ESRD become pregnant. All women with kidney disease should have access to specialists in renal disease and pregnancy who can support, care for, and monitor them during their pregnancy. We reported a case of a 37-year-old primigravida who has ESRD on hemodialysis. The pregnancy journey was uneasy, but eventually she successfully passed through it. The most challenging issues to treat and manage throughout this pregnancy are anemia, the risks of eclampsia, and uncontrolled hypertension. The management of this patient requires multidisciplinary and shared care monitoring by the nephrologist, obstetrician, and primary care doctor. [ABSTRACT FROM AUTHOR]

Background: The Emotion Thermometer is a quick visual analogue scale for assessing emotional distress originally designed for cancer patients. To date, there is no visual analogue scale available for the quick assessment of emotional distress post-disaster. Objectives: This study aimed to validate the Malay version of Emotion Thermometer among flood disaster survivors for local use Design: It was a cross sectional study. Materials and Methods: The Emotion Thermometer (ET) scale was translated into the Malay language and validated among 150 flood survivors. The content validity of Malay version of Emotion Thermometer (MET) was checked by a group of psychiatrists, linguists, and epidemiologists. The final version MET was compared with the Malay version of the Depression, Anxiety and Stress Scale 21 (DASS-21-M). Results: The domains of depression, anxiety, and distress of the MET correlated well with the respective domains of the DASS-21-M. The overall coefficient alpha for the MET was 0.65. Pearson's correlations ranged from r = 0.25 to r = 0.34. All MET domains showed good sensitivities and acceptable area under the curve values. At the optimal cut-off scores of > 2 for distress, > 3 for anxiety, and > 1 for depression, the sensitivities were 0.66, 0.78, and 0.79, respectively Conclusion: The Malay version of the Emotion Thermometer (MET) is the first visual analogue scale (VAS) validated to Malay and administered in disaster survivors. It is quick and easy to be administered for emotional distress screening in disaster situation. [ABSTRACT FROM AUTHOR]

Objective: Channa striatus or Haruan was found to have beneficial effect for wound healing and anti-inflammatory due to its' amino acids and fatty acids content. The objective of this study was to determine the effect of C.striatus supplementation on inflammatory markers which are high sensitive C-reactivc protein (hsCRP), total white cell counts (TWCC) and platelet counts in post Lower Segment Caesarean Section (LSCS) patients. Design: This was a randomized; double blinded, placebo-controlled study among post LSCS women conducted in Hospital Universiti Sains Malaysia from March 2010 to December 2012. Material and Methods: A Total of 33 patients from C.striatus and 27 patients from placebo group were included in this study. Participants in the treatment group consumed 500 mg of freeze dried C.striatus extract daily while the participants in placebo group consumed 500 mg of placebo daily for 3 days. Venous bloods for hsCRP, TWCC and platelet counts were taken from each participant postoperatively at day 1 and day 3. Results: Within C. striatus group, there were significant reduction in hsCRP (P < 0.001) and TWCC (P < 0.001), with significant increase in platelet count (P < 0.001) from day 1 to day 3. Similar pattern of changes were observed within control group. Between group comparison at day 3 post operatively indicates no significant difference in hsCRP (P = 0.275), TWCC (P = 0.983) and platelet count (P= 0.206) between the two groups. Conclusion: In conclusion, there is no significant difference in the inflammatory markers during wound healing in post LSCS women. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effectiveness of health education program on cardiovascular risk factors among perimenopausal women in Kelantan, Malaysia. Design: A randomized control trial study. Materials and methods: A randomized control trial based on two arm parallel study was conducted from June 2011 until June 2013. Eligible 64 perimenopausal women aged 45-55 years old were selected in Kelantan, Malaysia. They were randomized to intervention and control groups. The intervention group received health education program consisted of Women Wellness Workshop, lectures, exercise session, counseling and monthly phone call. The control group received routine advice on healthy lifestyle. Results: There were significant reductions in systolic blood pressure (p = 0.008) and diastolic blood pressure (p = 0.003) between intervention and control groups. There was no significant difference in sociodemographic data, including age, income, level of education and employment status. Conclusion: Health education program in primary care setting has a clinical value in improving cardiovascular risks among perimenopausal women. [ABSTRACT FROM AUTHOR]

Channa striatus has been consumed for decades as a remedy to promote wound healing by women during postpartum period. The objectives of this study were to compare postoperative pain, wound healing based on wound evaluation scale (WES), wound cosmetic appearance based on visual analogue scale (VAS) scores and patient satisfaction score (PSS), and safety profiles between G striatus group and placebo group after six weeks of lower segment caesarean section (LSCS) delivery. A randomised, double-blind, placebo-controlled study was conducted. Subjects were randomised in a ratio of 1:1 into either the C. striatus group (500 mg daily) or placebo group (500 mg of maltodextrin daily). 76 subjects were successfully randomised, with 38 in the C. striatus group and 35 in the placebo group. There were no significant differences in postoperative pain (p = 0.814) and WES (p = 0.160) between the C. striatus and placebo groups. However, VAS and PSS in the C. striatus group were significantly better compared with the placebo group (p = 0.014 and p < 0.001, resp.). The safety profiles showed no significant differences between the groups. In conclusion, six-week supplementation of 500 mg of C. striatus extract showed marked differences in wound cosmetic appearance and patient's satisfaction and is safe for human consumption. [ABSTRACT FROM AUTHOR]

This is a randomized, double-blind, placebo-controlled study comparing the effects of a water extract of Labisia pumila var. alata at 280 mg/day with placebo, given for 6 months in postmenopausal Malay women. There were 29 patients treated with Labisia pumila and 34 patients in the placebo group. Menopausal symptoms were assessed at baseline and at 6 months. The blood pressure, body mass index, waist circumference, fasting blood sugar, lipid profile, and hormonal profile (follicle stimulating hormone/luteinizing hormone/estradiol) were measured during visits every two months. ANCOVA model analysis showed significantly lower triglycerides levels in LP subjects at 6 months after treatment as compared to placebo (1.4 versus 1.9 mmol/L; adj. mean difference 0.5, 95% CI: 0.02, 0.89 after adjusted for the baseline values, age, B MI, and duration of menopause placebo). Other parameters in both groups did not differ significantly. In conclusion, daily intake of Labisia pumila at 280 mg/day for six months was found to provide benefit in reducing the triglyceride (TG) values. [ABSTRACT FROM AUTHOR]

Objectives: To determine the proportion of patients with metabolic syndrome using both International Diabetes Federation (IDF) and Asian Modified National Cholesterol Education Program - Third Adult Treatment Panel (NCEP - ATP III) criterias, and its associated factors among patients undergoing coronary angiogram in Hospital Universiti Sains Malaysia. Materials and Methodology: A cross-sectional study was conducted from September 2006 to April 2008 on 236 patients undergoing elective coronary angiogram in Hospital Universiti Sains Malaysia, Malaysia. Demographic, anthropométrie, biochemical parameters and coronary angiography result were reviewed. Results: A total of 228 patients underwent coronary angiograms. The proportion of persons with metabolic syndrome using IDF and Asian modified NCEP ATP III criteria were 50.0% and 76.8% respectively. There was a significant association between metabolic syndrome (Asian modified NCEP ATP III criteria) with age (OR = 2.20, 95%CI: 1.04, 4.68), female sex (OR = 3.99, 95%CI: 1.28, 12.3) and smoking (OR = 7.0, 95%CI: 3.05, 16.0). Conclusion: The proportion of metabolic syndrome patients was higher using Asian modified NCEP ATP III vs. IDF criteria. Age more than 60 years old, female sex and smoking were significantly associated with metabolic syndrome. [ABSTRACT FROM AUTHOR]

Background: Amongst the most important issues in women's health are the risks and benefits of estrogen replacement therapy. However, continual uncertainty and lack of consensus of standard estrogen replacement therapy has driven many women to seek alternative sources of estrogen, including herbal remedies. To date, there has been no clinical study to look at the effects of Labisia pumila var. alata (Kacip Fatimah) on post- menopausal women. In view of the initial evidence from animal studies that the plant contains phytoestrogens and exert androgenic and estrogenic activities, it is postulated that Labisia pumila may be beneficial to these women. BioLabisia™ is a water extract of Labisia pumila var. alata, produced using a patented technology developed by a group of Malaysian scientists. The objectives of this study were to determine the effects of varying doses of BioLabisia™ a standardized sprayed-dried water extract of Labisia pumila var. alata on the safety profiles such as haematological indices, liver and renal function and the cardiovascular effects from body mass index, waist hip ratio, the effects on blood pressure, chest x-ray and ECG changes. Methodology: This is a randomized, double-blind, placebo-controlled study comparing the effects of BioLabisia™, at 140, 280 or 560 mg/day, given for 6 months, in a group of post-menopausal, but otherwise healthy, Malay women aged 48-55 years old. Ethical approval from participating hospitals were obtained prior to the study. 70 eligible participants were divided into four groups. Group 1 received 140 mg/day BioLabisia™, Group 2 received 280 mg/day BioLabisia™, Group 3 received 560 mg/day BioLabisia™ and group 4 received placebo (maltodextrine). Pre study screening and assessment was done and if the subject was eligible, informed consent was taken and baseline investigations including hematological, liver and renal function tests, chest x-ray and electrocardiography (ECG) were performed. Those respondents with normal baseline investigations were invited to participate in this study. The study duration was six months and all participants were required to come to the clinic for clinical examination two monthly. During each visit the participants were asked regarding any side effects of medication. The participants were also required to come for a supply of medication each month and the investigator team had to ensure that all participants complied with the medication and scheduled visits. On visit 4, all blood investigations, blood pressure, chest x-ray and ECG were repeated again. Results: There was no significant difference seen in demographic profile between the four groups of post-menopausal women. No significant changes were seen in the measurement of body mass index and the waist hip ratio at the end of study period. In terms of haematological indices, liver and renal function, no significant changes were seen in each of the four groups. Other investigations such as blood pressure, chest x-ray and ECG were all normal. Conclusion: In summary, based on the clinical and laboratory evidence, daily intake of BioLabisia™ up to 560 mg/day for 6 months, was found to be safe and has not been shown to cause any adverse effect to the body. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of depressive symptomatology in early postnatal period and its relationship with obstetric risk factors. Material and Methodology: This is a cross sectional study involving 293 women from postnatal ward Hospital Universiti Sains Malaysia (HUSM), Malaysia. They were screened for depression at day 1 to day 5 postpartum and 4 to 6 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). At the first visit, the women completed questionnaires on socio-demography and obstetric risk factors and Brief Patient Health Questionnaire (BPHQ-9). At the second visit which is 4-6 weeks postpartum, they only completed EPDS. Results: Two hundred and ninety-three women successfully completed the study (100% response rates). The prevalence of PND at 4-6 weeks postpartum using the EPDS score of 12 or more was 27.3%. Women with the history of abortion (p < 0.05) and early postnatal depression (p < 0.05) was significantly associated with PND. Conclusion: Postnatal depression among women in Hospital USM was more common compared to previously reported series in Malaysia. Women with the history of abortion and early postnatal depression were significantly associated with PND. [ABSTRACT FROM AUTHOR]

Aim Validation of the Malay version of the Edinburgh Postnatal Depression Scale (EPDS) Methods A validation study was done involving 52 mothers who were at 4-12 weeks post-delivery. The women completed the Malay versions of EPDS and the 30-item General Health Questionnaire (GHQ). They were then assessed with the Hamilton Depression Rating Scale (HDRS) and Clinical Interview Schedule (CIS). Psychiatric diagnoses were made based on ICD-10 criteria. The validity of EPDS was tested against this clinical diagnosis and the concurrent validity against the Malay version of 30-item GHQ and HDRS scores was also evaluated. Results The best cut-off score of the Malay version of EPDS was 11.5 with the sensitivity of 72.7% and specificity of 92.6 %. Conclusion The Malay version of EPDS is a valid and reliable screening tool for PND. [ABSTRACT FROM AUTHOR]

Introduction: One of the most serious non-communicable diseases is diabetes kidney disease (DKD) which will progress to end-stage renal failure if not managed properly. Thus, the patient must be given proper educational and self-management information in managing their disease. Therefore, in line with the current trend and the convenience of using smartphones, a mobile application will be developed for this purpose. The objective of this study was to determine the main content and sub-contents for the educational and self-management features of mobile apps specifically designed for DKD patients. Methods: A modified nominal group technique (mNGT) has been used with five experts related to DKD management and two potential mobile apps consumers gathered face to face physically and virtually for about 3 hours. The e-booklet of the proposed mobile apps’ main contents and sub-contents was given to participants a week prior to mNGT meeting. Results: During the meeting, the participants generated and discussed their ideas resulting in no changes for 8 items of main content, but 4 items were added on top of the original proposed 46 sub-contents. After six days, the participant’s most voted mobile apps sub-content was “diabetes medication”, “co-morbidities medication” and “checking blood glucose at home” with a 100% score for each. Two items under the sub-contents of the patient’s data, namely “email” and “address” were rated below 70%, with scores of 65.71% and 68.57% respectively. A voting score of other items are in between 77.14% - 97.14%. All the main content and sub-content items that have been rated more than 70% will be included in the mobile apps for DKD patients. Two sub-content items that rated below 70% were removed. Conclusion: The mNGT is very useful in gathering experts and consumers to generate ideas and perform a group discussion to determine the items that qualify for inclusion in the content and sub-content of mobile apps. The individual voting and ranking finally concluded the eight items of main contents and 48 sub-content items proposed will be used for an educational and self-management mobile apps for DKD patients. [ABSTRACT FROM AUTHOR]

Introduction: Geriatric Giants are the impairment that appear in older people. It comprises of impaired cognition, urinary incontinence, instability, fall and immobility. The aim of this study is to determine the prevalence of Geriatric Giants among older people living in three different living environment; own home, pondok and old folks home. Methods: This comparative study involved 471 respondents from Kelantan. There were 157 participants each from own home, pondok and old folks home. The prevalence of Geriatric Giants were determine by 10 minutes comprehensive screening which was developed to diagnose and manage the Geriatric Giants (WHO, 2007) and prevalence were compared using chi-square tests or Fisher exact test. Results: Prevalence of dementia among respondents of old folks home (11.5%), pondok (6.4%) and own home (0.6%). Prevalence of urinary incontinence among respondents of own home (22.3%), old folks home (16.6%) and pondok (14.0%). Prevalence of instability among respondents of old folk home (31.2%), pondok (27.4%) and own home (14.0%). Prevalence of fall among respondents of pondok (33.1%), old folks home (24.25) and own home (19.7%). Old folk home respondents had the highest prevalence of moderate and severe immobility There were significant difference in prevalence of dementia ((Fisher exact p value <0.001), instability (χ2(2)=13.957,p=0.001), fall (χ2(2)=7.629,p=0.022) and mild and moderate immobility. Conclusion: Old folks home respondents had more prevalence of Geriatric Giants compared to their other counter parts. [ABSTRACT FROM AUTHOR]

Aim and design: L-carnitine supplementation combined with exercise may enhance metabolic responses and improve exercise performance. Thus, this systematic review article aims to identify the effects of the L-carnitine supplement on biochemical markers, and exercise performance when combined with exercise. Data Sources: The articles are screened and reviewed based on titles, abstracts and keywords. Only peer-reviewed studies written in the English language, dated January 2000 to March 2021, were considered in this review. Review Methods: The PRISMA method is used for this study. PubMed, EBSCOHost, SpringerLINK, and Scopus databases were used to systematically search. Results: From a search 731 articles, 12 articles were identified related to effect of L-carnitine intake with exercises on biochemical markers and exercise performance. Studies showed that L-carnitine supplementation can be consumed daily during aerobic or anaerobic exercises by different population including patients. Its combination could improve serum lipid profiles, antioxidant properties, markers of metabolic, oxidative stress, and inflammatory, and exercise performance. Conclusion and Impact: This review provides information regarding the beneficial effects of L-carnitine supplement with recommended dosages and exercise prescriptions on overall body health in human. [ABSTRACT FROM AUTHOR]

Objectives: We sought to determine the prevalence of traditional and complementary medicine (TCM) use for knee osteoarthritis and its associated factors among patients attending a referral hospital in an eastern coastal state of Malaysia., Methods: This cross-sectional study included 214 patients with knee osteoarthritis. A universal sampling method was applied to patients who attended the outpatient clinic in Hospital Universiti Sains Malaysia from May 2013 to October 2013. Participants were given a questionnaire to determine their sociodemographic information and a validated Bahasa Malaysia version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). This questionnaire was used to assess the severity of knee osteoarthritis (i.e., pain, stiffness, and disturbances in daily activity)., Results: Over half (57.9%) of patients reported using TCM to treat knee osteoarthritis. Factors associated with TCM use were gender (odd ratio (OR) = 2.47; 95% confidence interval (CI): 1.28-4.77), duration of knee osteoarthritis (OR = 1.51; 95% CI: 1.03-2.23), and the severity of knee pain (OR = 2.56; 95% CI: 1.71-3.86)., Conclusions: The prevalence of TCM use among eastern Malaysian patients with knee osteoarthritis was high. Physicians caring for these patients should be aware of these findings so that inquiries regarding TCM use can be made and patients can be appropriately counseled.