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@#Introduction: Alcohol is classified as a psychoactive substance, and its dependence is one of the three leading risk factors for death, disability, or disease. Early age alcohol use by the age of 15 is implied to be harmful due to interference in the brain development of adolescents, causing alcohol-related problems later in life. This study aims to determine the prevalence and factors associated with alcohol use among Dayak adolescents in Sarawak, Malaysia. Methods: This was a cross-sectional quantitative research approach. A total of 12 districts within the 12 divisions were selected by multistage stratified cluster sampling. Dayak housing area lists were obtained from district offices and the local councils. The respondents were selected systematically according to male and female respondent houses, and they were interviewed using an interviewer-administered questionnaire. Data were entered into Microsoft Excel and analysed through IBM SPSS Version 27.0. Results: Dayak adolescents’ mean age was 17.31 years. They were either low-risk (50.0 %), hazardous (31.0%), abstainers (11.0%), harmful (5.0%) or alcohol dependant (3.0%) drinkers. Age (p<.001), gender (p<.05), ethnicity (p<.001), religion (p<.05), employment (p<.001), level of education (p<.01), allowance (p<.001), family relationship (p<.05), and family size (p<.05) were the potential predictors of alcohol use disorder. Conclusion: Dayak adolescent alcohol drinking is prevalent and a public health problem, particularly among disadvantaged socio-economic families. The lower proportion of abstainers suggested that alcohol use among adolescents is on the rise. Hence, the results should be utilised to do targeted health promotion regarding harmful alcohol use among adolescents since early use of alcohol among adolescents may lead to more severe health and non-health outcomes in the future.
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The LIM domain-containing proteins are dominantly found in plants and play a significant role in various biological processes such as gene transcription as well as actin cytoskeletal organization. Nevertheless, genome-wide identification as well as functional analysis of the LIM gene family have not yet been reported in the economically important plant sorghum (Sorghum bicolor L.). Therefore, we conducted an in silico identification and characterization of LIM genes in S. bicolor genome using integrated bioinformatics approaches. Based on phylogenetic tree analysis and conserved domain, we identified five LIM genes in S. bicolor (SbLIM) genome corresponding to Arabidopsis LIM (AtLIM) genes. The conserved domain, motif as well as gene structure analyses of the SbLIM gene family showed the similarity within the SbLIM and AtLIM members. The gene ontology (GO) enrichment study revealed that the candidate LIM genes are directly involved in cytoskeletal organization and various other important biological as well as molecular pathways. Some important families of regulating transcription factors such as ERF, MYB, WRKY, NAC, bZIP, C2H2, Dof, and G2-like were detected by analyzing their interaction network with identified SbLIM genes. The cis-acting regulatory elements related to predicted SbLIM genes were identified as responsive to light, hormones, stress, and other functions. The present study will provide valuable useful information about LIM genes in sorghum which would pave the way for the future study of functional pathways of candidate SbLIM genes as well as their regulatory factors in wet-lab experiments.
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@#Introduction: Many factors hinder the effective responses to the HIV/AIDS epidemic. Stigma is one of the major barriers to effective responses to the HIV/AIDS epidemic. It is often considered the main reason for the low response to access proper services for prevention, treatment, and care for HIV/AIDS. In this context, we assessed the perceived level of stigmatisation towards people with HIV/AIDS among rural communities in Sarawak and determined its associated factors. Methods: This cross-sectional community-based study was conducted among the adult population aged 18 years and above among rural communities in Sarawak, Malaysia. A gender-stratified multistage cluster sampling technique was adopted to select the respondents. A total of 900 respondents were successfully interviewed using interviewer-guided questionnaires. Stepwise multiple linear regression with forward and backward selection method was used to determine the HIV/AIDS-related stigma. A p-value of ≤.05 was considered statistically significant. Results: Analysis revealed that females are more stigmatised than males (p<.05). Multivariate analysis showed that those who did not know someone had HIV and Chinese ethnicity were potential predictors in both male and female groups. Having no gainful job, and discussion of HIV/AIDS, household income less than MYR 500, history of HIV testing, knowledge on HIV transmission and exposure to HIV/AIDS information were factors that influenced HIV/ AIDS-related stigma among female respondents. On the other hand, age group 30 to 39, Bidayuh, Chinese ethnicity, and not knowing someone had HIV and media exposure on HIV were factors that influenced HIV/AIDS-related stigma among male respondents. Conclusion: HIV/AIDS-related stigma towards HIV/AIDS existed in rural communities. Enhanced health promotion related to HIV/AIDS activities in rural communities are needed to curb stigmatisation toward people with HIV/AIDS.
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Cerebral creatine deficiency syndrome (CCDS) is a disorder where a defect is present in transport of creatine in the brain. Creatine plays an essential role in the energy metabolism of the brain. This is a genetic disorder, autosomal recessive or X linked, characterized by intellectual disability, speech and language delay, epilepsy, hypotonia, etc. Until recently very few number of cases have been reported. Here we report a case of 1.5-year-old boy who had epilepsy (epileptic spasm and generalized tonic clonic seizure), intellectual disability, microcephaly, hypotonia and speech delay. His magnetic resonance imaging of brain showed cortical atrophy and electroencephalography showed burst suppression pattern. The diagnosis was confirmed by clinical exome sequencing which showed novel mutation of SLC6A8+ in exon 9, suggestive of X linked recessive CCDS. The patient was then treated with glycine, L-arginine and creatine monohydrate with multiple antiepileptic drugs.
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Cerebral creatine deficiency syndrome (CCDS) is a disorder where a defect is present in transport of creatine in the brain. Creatine plays an essential role in the energy metabolism of the brain. This is a genetic disorder, autosomal recessive or X linked, characterized by intellectual disability, speech and language delay, epilepsy, hypotonia, etc. Until recently very few number of cases have been reported. Here we report a case of 1.5-year-old boy who had epilepsy (epileptic spasm and generalized tonic clonic seizure), intellectual disability, microcephaly, hypotonia and speech delay. His magnetic resonance imaging of brain showed cortical atrophy and electroencephalography showed burst suppression pattern. The diagnosis was confirmed by clinical exome sequencing which showed novel mutation of SLC6A8+ in exon 9, suggestive of X linked recessive CCDS. The patient was then treated with glycine, L-arginine and creatine monohydrate with multiple antiepileptic drugs.
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@#Introduction: The Coronavirus disease-2019 impacted the governments and public health systems worldwide, with the psychological impact including an increase in the level of stress, anxiety and depression. We determine the prevalence of depression, anxiety and stress using the Depression Anxiety Stress Scales (DASS-21), and to determine the psychological impact of COVID-19 pandemic amongst medical students in Sarawak, Malaysia using the revised Impact of Event Scale (IES-R). Methods: We analysed 355 medical student’s data obtained from an online survey. All the undergraduate medical students were the sample population. IBM SPSS version 22.0 was used for data analysis. A p-value of ≤.05 was considered statistically significant. Results: Analysis indicated that three-fourths of the students had no mental health issues. More than one-tenth of the students were moderately depressed (12.4%) and 4.3% severely depressed. A similar pattern of prevalence of anxiety was noted with 10% reported moderate anxiety, and 6.8% had severe anxiety. 15.8% of the students had mild stress, 4.2% moderately stressed, and 2% severely stressed. A hierarchical multiple linear regression analysis showed that hyperarousal appeared to be a predictor of depression (β=.466, p<.001), anxiety (β=.481, p<.001) and stress β=.508, p<.001). Along with hyperarousal, intrusion (β=.148, p<.05) predicts stress among the students. Conclusion: Our analysis revealed that hyperarousal symptoms related to the global pandemic of COVID-19 led to significant mental health issues among students. Therefore, urgent strategies to support the students’ psychosocial wellbeing and self-care and to strengthen their coping skills and resilience need to be implemented.
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@#Body image is a complex and multifaceted construct with multiple associated factors determining its perception among adolescents. This study aimed to determine the perceived body image and its relationship with body mass index, self-esteem, body change strategy, and social network usage among rural adolescents. This study was a cross-sectional study design using a multistage random sampling technique to select adolescents aged 10 to 19 years. A total of 318 adolescents’ data were collected using a self-administered questionnaire. Data analysis was done using SPSS version 22.0 with a p-value of <0.05 was considered statistically significant. The mean (SD) age of adolescents was 14.6 (2.7) years with a male and female ratio of 1.09:1. The mean score (SD) of perceived body image was 3.63 (0.87). Multiple linear regression analysis revealed that gender, body mass index, and strategy to increase weight could predict perceived body image among adolescents. However, self-esteem did not correlate with perceived body image. Although, the body image dissatisfaction level was low among rural adolescents compared to other studies in Malaysia. However, it can still pose a threat to adolescents’ health if not addressed accordingly.
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@#Health literacy has shown to have some influence in preventive behaviour, including on colorectal cancer. Such a relationship, however, is not well established in Malaysia, particularly Sarawak. This study is aimed to estimate the level of health literacy and preventive practice against colorectal cancer and factors associated with it. This was a cross-sectional study conducted in Sarawak, among adults aged 50 years and above. Data was collected by face to face interviews using a validated questionnaire. Descriptive statistics were used to determine the health literacy and preventive behaviour on colorectal cancer. Multiple linear regression was used to determine the factors associated with preventive behaviour on colorectal cancer and also to examine its relationship with health literacy. A p-value of ≤0.05 was considered as statistically significant. A total of 829 respondents were included in the analysis. Mean age (standard deviation) of the respondents was 55.78 (5.01) years. A large proportion had an educational background of upper secondary school and above (41%) and from Iban ethnicity (32.4%). Only 1.1% of them had a family history of colorectal cancer. Multiple linear regression analysis revealed that gender (p<0.01), ethnicity (p<0.05), functional health literacy (p<0.05), and knowledge on colorectal cancer (p<0.05) appeared to be significant predictors for preventive behaviour on colorectal cancer. Health literacy has a positive effect on preventive behaviour on colorectal cancer. The findings assist in designing and developing targeted informational campaigns to promote preventive behaviour, particularly among low health literate group.
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@#Background: Undernutrition among children has become a major public health issue due to the high risk of morbidity and mortality involving this vulnerable age group. This study focused on the rural population, especially among the Dayak children in Sarawak, Malaysia. Methodology: This community-based cross-sectional study was conducted in Sarawak’s rural areas using a multistage stratified cluster sampling technique. Data were collected through face-to-face interviews using an interviewer-guided questionnaire. The nutritional status of the under-five children was measured according to the World Health Organization guidelines. The nutritional indicators were calculated as z-scores. Multivariate logistic regression analyses were performed using SPSS to identify the factors associated with nutritional status. Results: The prevalence of undernutrition among the under-five Dayak children in the rural areas of Sarawak was 39.6%. The analysis suggested that wasting was predominantly associated with parental education levels of primary and below, poor wealth index, environmental and sanitation issues, children with history of low birth weight, shorter duration of exclusive breastfeeding, and poor appetite. Stunting was high within the age group of <3 years old and was associated with parents’ occupation and household wealth index. Low parental education, poor wealth index, environmental and sanitation issues, poor appetite, and the children’s recent illness predicted underweight. Conclusion: These findings imply that a multi-sectoral and multi-dimensional approach is essential to address undernutrition in rural settings. Improvement on households’ socioeconomy, environment and sanitation should be emphasised to reduce undernutrition among the children.
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Background: The internet has become an indispensable tool for communication, academic research, information and entertainment. However, heavy users of the internet lead to less confidence in social skills and the tendency to be isolated. The study aimed to assess the pattern of internet use and factors affecting problematic internet use among university students.Methods: This cross-sectional study conducted among the students of a university in Sarawak, Malaysia. A multistage cluster sampling technique was adapted to select the participants. Data were collected from 463 students by self-administered questionnaire. Hierarchical binary logistic regression analysis was done to determine the potential factors for problematic internet use.Results: The mean age of the students was 22 years, with a standard deviation of 1.6 years. Two-fifths (61.8%) of the students had no problematic internet use. However, 35.4% had moderate and 2.8% had severe problematic internet use. Hierarchical binary logistic regression analysis found that age of the students, year of study, duration of daily internet use and use of social networking like Skype appeared to be potential predictors of problematic internet use (p<0.05).Conclusions: This study was conducted in only one university, thus did not depict the overall scenarios of the country. The implications of the findings are still worth noting in the process of designing internet addiction studies among university students. Overall, this study has unearthed some useful insights which can serve as a guide to more elaborate studies.
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@#Caring for stroke survivors is inevitably a burden to caregivers. It is not uncommon for stroke survivors who are discharged from the hospital and found themselves at home without any help and care from the supposed caregivers. However, in instances where there are available and willing caregivers, a sudden and unpredictable task of caring for stroke survivors require the stroke caregivers to apply their coping strategies due to the demanding nature of looking after a survivor. This study aimed to determine coping strategies undertaken by stroke caregivers in caring for stroke survivors. This was an exploratory qualitative study and data was collected from the caregivers of stroke survivor using a semi-structured guided questionnaire. A total of 18 caregivers were included in the study. The data were collected from November 2015 until June 2016 at a selected community rehabilitation centre in Kuching, Sarawak. The qualitative data analysis revealed that the coping strategies undertaken by stroke caregivers include change of role in life, self-motivation, sharing with other people, crying, trying to forget things that happen, hoping survivors will get better, emotion suppression and self-blame. The study highlighted the experiences by the caregivers for caring for stroke patients and focused on the coping strategies undertaken by the caregivers. Better ununderstanding of these experiences does help the service providers to provide better support and resources for caregivers in caring for stroke survivors.
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@#problems from extended usage of electronic devices areissues among primary school children. This study is aimedto investigate the prevalence of physical and behaviouralcomplaints arising from the electronic device usage and toidentify the potential factors that predicted the complaints.Methods: This was a primary school-based cross-sectionalstudy using multistage cluster sampling, conducted at Baudistrict in Sarawak, Malaysia in 40 primary schools. Aquestionnaire was used to collect information of usagepattern in insufficient lighting, timing and position. Thephysical and behavioural complaints were traced. Dataanalysis was performed using SPSS version 22. A p-value <0.05 with 95% CI was considered as statistically significant. Results: About 52.8% of the 569 students used digitaldevices in a bright room, 69.8% in the day time and 54.4% insitting position. The physical complaints were headache(32.9%), neck, shoulder and back pain (32.9%) followed by byeye strain (31.8%). Regarding behavioural problems, 25.7% ofthe students had loss of interest in study and outdooractivities (20.7%), skipped meals (19.0%) andarguments/disagreements with parents (17.9%). After logisticregression analysis, the lying position (OR=1.71, 95% CI:1.096, 2.688) and darkroom lighting (OR=2.323 95% CI: 1.138,4.744) appeared to be potential predictors of the complaint.Conclusion: One-quarter of the students studiedexperienced physical complaints, and one-fifth hadbehavioural problems associated with the use of electronicdevices. Lying position and darkroom lighting are thepotential predictors of complaints. Therefore, we suggestthat the children should use electronic devices in the sittingposition with adequate room lighting.
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@#Since December 2019, a novel coronavirus disease (COVID-19) creates a global threat. Medical students are more susceptible to be infected by the virus. This study aimed to assess COVID-19 related knowledge, attitude towards COVID-19, and preventive behaviours against COVID-19 among medical students within the first month of the onset of the outbreak in Malaysia. We collect data from medical students using an online Google survey form. Out of 696 students, 467 responded to the questionnaire. The analysis revealed that the mean percentage of knowledge was (85.04), attitude (84.12), and preventive practice (77.75) respectively. Hierarchical multiple linear regression analysis revealed that living with family (p<0.01) and knowledge of COVID-19 (p<0.001) appeared to be important predictors of attitude toward COVID-19. However, gender (p<0.001), living status (p<0.001), frequency of travel during movement control order (p<0.01), attitude towards COVID-19 (p<0.001) have appeared significant predictors for preventive practice against COVID-19. But knowledge of COVID-19 had no impact on preventive practice against COVID-19 (p>0.05). We found a high level of COVID-19 related knowledge, attitude, and preventive practice against COVID-19 among medical students. A sustained knowledge, attitude, and preventive behavioural strategy could play an ingredient in upholding the student’s learning and practice against any disease like COVID-19.
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Background: Multiple true-false tests (MTF), a component of our assessment system, have consistently generated low scores and many failures. This was attributed to the negative marking scheme. However, no study was conducted to explore the issue further. Item analysis revealed that students omitted false options more frequently and answered them wrongly more frequently than true options. The aim of this study was to determine the performance discrepancy between true and false options of MTF tests and the reasons for such discrepancy and the poor performance of MTF in general.Methods: The student performance of past 7 years of year-3 medicine end-of-posting examinations was analysed. The item analysis reports of 23 MTF tests were used to determine the significance of the differences in omission rates, correct-answer rates and the discrimination index of true and false options.Results: There were statistically significant differences in the omission rates, correct-answer rates and discrimination index values of true and false options. This study revealed that the false options consistently let down student performance. Although negative marking could be partly blamed for the situation, no justification could be found for the use of false options to test knowledge.Conclusions: Some publications endorse MTF, but many highlight its drawbacks. The use of false options in MTF was seen as an inherent defect in this instrument. As viable alternatives like VSAQ and Constructed Response Tests are in the horizon, we conclude that MTF ought to be discarded as an assessment instrument.
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Objective: In this study our main goal is to evaluate thedifference between conventional lateral internal sphincterotomyvs one step controlled sphincterotomy as a treatment forchronic anal fissure.Method: This quasi experimental study was carried out atdifferent Private Hospital, in Dhaka City from November 2008to October 2010 where 85 patients were included in this study.Grouping was done non randomly. Informed consent wasobtained from all patients after explanation of the nature of analfissure and possible treatment.Result: During the study, bleeding per rectum was found in 35(77.8%) in Group A (conventional group) and 30 (75.0%) inGroup B (one step controlled group).In Group A (conventionalgroup) pain was relived in mean 5.0(SD 3.8) (range 2-14) daysand in Group B (one step controlled group) pain was relived inmean 1.9(SD 1.2) (range 1-7) days. Which was statisticallysignificant (p<0.05).Conclusion: From our results; we can conclude that, one stepcontrolled lateral internal sphincterotomy is comparativelybetter than conventional technique which serves much moreconvenient treatment for chronic anal fissure. Further study isneeded for better outcome.
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@#Pre-pregnancy Clinic (PPC) services is one the plausible efforts towards achieving the Millennium Development Goals. However, various issues still need to be addressed for improvement of the services. Considering this view, an attempt was made to explore the barriers, strength and weakness of current practice of pre-pregnancy clinic services in Sarawak, since the programme has been implemented in this state from the year 2011. This cross-sectional study was conducted at nine selected health care facilities throughout Sarawak. A multistage sampling procedure was adapted to select the health care facilities. An unstructured open-ended questionnaire was administered to get the in-depth perceived views and current practice of pre-pregnancy clinic services. A total of 322 health care providers from nine selected health care facilities gave their feedback. In the present paper, a qualitative analysis was done for the open-ended questions to get in-depth views of barriers, strength and weakness of pre-pregnancy clinic services. The results of the study were narrated in textual form and a thematic analysis was done manually. The identified themes for perceived barriers to the provision of pre-pregnancy care were perception, attitude and acceptance of PPC services, socio-economic issues, services and client factors. The perceived weaknesses of the services are listed under two main themes: working environment and service factors, while, the strength of services produced three thematic areas which are preparation for pregnancy, prevention of mortality and morbidity and comprehensive services. Though pre-pregnancy services are beneficial for society wellbeing, various issues still need to be considered for the improvement of the quality of services. Lack of awareness, no ministerial guidelines or Standard Operating Procedures (SOP) and knowledge pertaining to the services were few of the main areas which need to be pondered upon. Promotional activities and campaigns should be geared up ensuring availability the services to the general population.
Subject(s)
Perception , MalaysiaABSTRACT
@#Achieving smoking cessation is an arduous process, where smokers try different methods or approaches to achieve cessation. Quit smoking attempts play an important role in smoking cessation.Thus, this study was conducted to determine the factors associated with attempt-to-quit smoking among the currentsmokers in Sarawak.This cross-sectional study was conducted among adult smokers in Sarikei, Sarawak by face-to-face interview using an adapted and validated questionnaire. Non-probability sampling method was used to select the study place. An adult smoker was selected systematically from each selected household. A total of 482 smoker households were identified with a response rate of 92.3%. Data was analysed using IBM SPSS Version 22.0. A p-value of <0.05 was considered statistically significant. The mean (SD) age of the smokers was 36.3(13.3) years. However, the mean (SD) age of smoking initiation was 18.5(4.8) years. Majority of the smokers were male (91.5%), with the male to female ratio being 1:0.1. Mean (SD) score on The Fagerström Test for Nicotine Dependence was 4.75(2.4), while motivation to quit smoking score was 3.04(1.0). Majority of the smokers (83.1%) hadever seen pictorial health warnings on cigarette packs. More than half of the smokers (54.8%) had ever tried to quit smoking. Binary logistic regression analysis revealed that marital status, religion, ethnicity, pictorial health warnings on cigarette packs and motivation to quit smoking appeared to be the significant predictors of attempt-to-quit smoking (p<0.05). Understanding the attempts to quit smoking will assist inclinical expectations. Thus, a smoking cessation programme should be designed in line with these factors, to aid quit smoking attempts.
Subject(s)
Smoking , Motivation , MalaysiaABSTRACT
Menthol brand cigarette has been found to be linked with early initiation of smoking and addiction of nicotine. This study was designed to find out the factors associated with smoking menthol brand cigarettes among adult population in Sarawak. This was a cross-sectional study conducted among the adult population in Sarawak. Data were collected from ten villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Non-probability purposive sampling method was adopted to select the villages. All the households of the villages were visited, and an adult member was selected randomly from each household irrespective of sex. After missing value imputation, 1000 data sets were analysed using statistical software SPSS 19.0 version. Analysis showed that 28.8% of the respondents were current smokers, and 7.8% were past smokers. Among the smokers, 56.3% were habituated with menthol brand cigarette. Logistic regression analysis revealed that age at initiation of smoking before 15 years of age (OR=11. 68, 95% CI: 4.25, 32.10), smoking within five minutes of wake up from sleep (OR=3. 20, 95% CI: 1.35, 7.54), nature of job as business (OR=4. 81, 95% CI: 2.13, 10.86) and service holders (OR= 3.85, 95% CI: 2.07, 7.16) and family size 5 and above (OR=2. 22, 95% CI: 1.25, 3.94) appeared to be important determinants of smoking any menthol brand cigarette (p<0.05). Menthol is a prominent design feature to attract and retain younger smokers. It does not necessarily make the transition from experimenting with cigarettes, but to encourage early smokers to become a confirmed smoker. So, anti-tobacco public health programme should focus on age-specific community approach.
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Adult , Smoking , Tobacco ProductsABSTRACT
BACKGROUND: The current study aims at evaluating the analgesic, anti-pyretic and anti-inflammatory properties of methanolic extract of the stem, bark and leaves of Launaea sarmentosa and Aegialitis rotundifolia roxb. RESULTS: The AELS and AEAR extract presented a significant (***p < 0.001) dose dependent increase in reaction time in writhing method and showed inhibition of 63.1% and 57.1% respectively at the doses of 400 mg/kg body weight while standard drug showed (P < 0.001) inhibition of 69.23%. In tail immersion method, AELS and AEAR showed maximum time of tail retention at 30 min in hot water i.e. 6.93 sec and 6.54 sec respectively at highest doses of 400 mg/kg body weight than lower dose while standard pentazocine showed reaction time of 7.62 sec. The AELS and AEAR extract also exhibited promising anti-inflammatory effect as demonstrated by statistically significant inhibition of paw volume by 32.48% and 26.75% respectively at the dose of 400 mg/kg body weight while the value at the dose of 200 mg/kg body weight were linear to higher dose at the 3rd hour of study. On the other hand, Standard indomethacin inhibited 40.13% of inflammation (***P < 0.001). In Cotton-pellet granuloma method, AELS and AEAR extract at the dose of 400 mg/kg body weight exhibited inhibition of inflammation of 34.7% and 29.1% respectively while standard drug showed (P < 0.001) inhibition of 63.22%. Intraperitoneal administration of AELS and AEAR showed dose dependent decrease in body temperature in brewer's yeast induced hyperthermia in rats at both doses. However, AELS significantly decreased body temperature (***p < 0.001) at 400 mg/kg compared to control. CONCLUSIONS: Present work propose that the methanolic extract of Launaea sarmentosa and Aegialitis rotundifolia roxb possesses dose dependent pharmacological action which supports its therapeutic use in folk medicine possibly mediated through the inhibition or blocking of release of prostaglandin and/or actions of vasoactive substances such as histamine, serotonin and kinins.