A survey on smartphone dependence and psychological effects among undergraduate students in a Malaysian University

@#Objective: Problematic smartphone use (PSU) is the development of pathological dependence at the expense of performing activities of daily living, thus having negative health and psychological impact on the users. Previous PSU studies focused on medical students and little is known regarding its effect on students undergoing other courses. The objective of this study is to identify the pattern of smartphone usage and determine the psychological factors affecting PSU among undergraduate students in Malaysia and compare the pattern among students from different fields of study. Method: A prospective cross-sectional study was conducted using the validated Smartphone Addiction Scale–Malay version (SAS-M) questionnaire. One-way ANOVA was used to determine the correlation between the PSU among the students categorised by their ethnicity, hand dominance and by their field of study. MLR analysis was applied to predict PSU based on socio-demographic data, usage patterns, psychological factors and fields of study. Results: A total of 1060 students completed the questionnaire. Most students had some degree of problematic usage of the smartphone. Students used smartphones predominantly to access SNAs, namely Instagram. Longer duration on the smartphone per day, younger age at first using a smartphone and underlying depression carried higher risk of developing PSU, whereas the field of study (science vs. humanities based) did not contribute to an increased risk of developing PSU. Conclusion: Findings from this study can help better inform university administrators about at- risk groups of undergraduate students who may benefit from targeted intervention designed to reduce their addictive behaviour patterns

Prevalence and Factors Associated with Medication Non-Compliance among Patients with Hypertension in a Tertiary Hospital: A Cross-Sectional Study in Malaysia

@#Introduction: Hypertension contributes to major cardiovascular morbidities and mortalities worldwide and medication compliance is crucial in achieving target blood pressure control. This study aimed to determine the prevalence and factors associated with non-compliance towards anti-hypertensive medication in Malaysia. Methods: This is a cross-sectional study among hypertensive patients who were attending the medical outpatient department, Hospital Serdang from March until May 2018. Systematic random sampling was used to recruit patients and a structured self-administered questionnaire was used to collect information. Non-compliance is defined as attaining a score of 26 and below from the Medication Compliance Scale. Data analysis was done using SPSS v. 23. Multiple logistic regression was used to determine the predictors of medication non-compliance among hypertensive patients. Results: A total of 120 respondents were recruited into this study with a response rate of 60.9%. Mean age of the study respondents was 60.82 ± 11.25 years old. They were predominantly female (60.8%), Malay (58.3%) and attained at least secondary educational level (75.0%). The prevalence of non-compliance towards anti-hypertensive medication was 25%. Multiple logistic regression showed that side effects of medication (OR=5.59; 95% CI=1.29-24.21, p=0.021), traditional medications usage (OR=19.19; 95% CI=3.90-94.45, p=<0.001), health advice counsellors (OR=35.31; 95% CI=2.03-35.31, p=0.003) and duration of hypertension (OR=3.38; 95% CI=1.05-10.91, p=0.042) were predictors of non-compliance to anti-hypertensive medications among hypertensive patients Conclusion: Our study reported that those with longer duration of hypertension, suffered from side effect of medication and have experience in usage of traditional medicine are the predictors of medication non-compliance.

The role of social network, social support, religiosity and depression among elderly Malaysians who had experienced major life events

@#Background: Research has found that social network, social support and religiosity are associated with depression in elderly people. However, these predictors of depression have not been fully explored among the high risk elderly population. This study aims to examine the prevalence and factors associated with depression among Malaysian elderly subjects who had experienced major life events. Methods: This is a cross-section study of a subsample of 594 participants from the original sample of 2322 Malaysian elderly respondents, who had experienced major life events. Information on socio-demographic, social network, social support, religiosity and depression were collected through an interviewer-administered questionnaire. A multiple linear regression analysis was used to determine the factors associated with depression among elderly who experienced major life events. Results: Overall prevalence of depression among subsample of Malaysian elderly facing major life events was 9.4%. The results showed that age (p≤0.01), income (p≤0.001) and social network (p≤0.05) were significant associated with depression. In other words, with increasing age, low income as well as small social network associated with high risk of developing depression among elderly who had experienced major life events Conclusion: Other than age and income, social network were also associated with depression among elderly respondents who had experienced major life events. Therefore, professionals who are working with elderly with major life events should seek ways to enhance elderly networking as one of the strategies to prevent depression.

Psychological Distress and Internet Addiction among Medical Students from a Malaysian Public University: A Comparison between Gender

@#Introduction: Widespread use of the internet is a relatively recent phenomenon that is affecting different cultures worldwide in both positive and negative ways. This study aimed to determine the gender differences in the internet addiction among medical students in public university. Methods: 426 medical students from year one to four were invited to participate in the study. For data collection, we used a self-administered questionnaire consisting of socio-demographic and internet usage questions, the Internet Addiction Test (IAT) and the Depression Anxiety and Stress Scales 21 (DASS-21). Results: There were a total of 426 (270 female and 156 male) medical students included in this study. IA was high in both male and female students. There was a higher proportion of male students (44.9%) found to be addicted compared to female students (32.2%). There were positive correlations between the DASS21 and IAT scores for both male and female students. For female students, longer hours spent online daily (p-value = 0.02), as well as high anxiety (p-value < 0.001) and depression scores (p-value = 0.037) were found to be most strongly associated with IA. Among male students, factors associated with IA were the availability of internet access at home (p-value=0.02) and high anxiety scores (p<0.001). Conclusion: IA was high in both male and female medical students, with higher anxiety raising the risk in both groups. In female students, a higher depression score was also found to be associated with IA

Possible mechanisms of antinociception of methanol extract of Melastoma malabathricum leaves

ABSTRACT Melastoma malabathricum L., Melastomaceae, has been traditionally used to relieve diverse pain-related ailments. The objectives of the present study were to determine the antinociceptive activity of methanol extract of M. malabathricum leaves and to elucidate the possible mechanisms of antinociception involved using various rats' models. The extract (100, 250, and 500 mg/kg) was administered orally 60 min prior to subjection to the respective test. The in vivo acetic acid-induced abdominal constriction, formalin-induced paw licking, and hot plate tests were used as the models of nociception to evaluate the extract antinociceptive activity. Further studies were carried out to determine the role of opioid and vanilloid receptors, glutamate system and nitric oxide/cyclic guanosine phosphate (NO/cGMP) pathway in modulating the extract antinociceptive activity. From the results obtained, M. malabathricum exhibited significant (p < 0.05) antinociceptive activity in all the chemical- and thermal-induced nociception models. Naloxone (5 mg/kg), a non-selective opioid antagonist, failed to significantly affect the antinociceptive activity of MEMM when assessed using the abdominal constriction-, hot plate- and formalin-induced paw licking-test. M. malabathricum also significantly (p < 0.05) reversed the nociceptive response in capsaicin- and glutamate-induced paw licking test. Furthermore, only L-arginine (a nitric oxide precursor) alone, but not, NG-nitro-L-arginine methyl esters (L-NAME; an inhibitor of NO synthase), methylene blue (MB; an inhibitor of cGMP), or their combination thereof, significantly (p < 0.05) block the antinociceptive activity of M. malabathricum. In conclusion, M. malabathricum exerted a non-opioid antinociceptive activity at the central and peripheral levels partly via the inhibition of vanilloid receptors and glutamatergic system, and activation of the NO-mediated/cGMP-independent pathway.

A Clinical Audit on the care of Adult Tuberculosis Contacts In a Public Primary Care Clinic, Malaysia

Introduction: The National Clinical Practice Guideline in Tuberculosis (TB) was designed to improve the quality of tuberculosis care. However, it remains unknown whether primary care doctors adhere to it well. This audit aims to assess the quality of care in the process of TB contact tracing in a primary care setting. Methods: Data on TB contact tracing from 1st February 2013 to 15th February 2013 was obtained retrospectively from all medical records of diagnosed pulmonary TB in a public primary care clinic. All patients who fulfilled the inclusion and exclusion criteria were included in the study. Results: A total of 102 medical records of adult TB contacts were recruited. The median age of the TB contact was 34 (IQR=10) years and 65 % were male. Seventy two percent of the adult TB contact had a TBIS 10C3 form created, and 95% of the medical records were fully documented. History taking and physical examination were recorded on 97% and 99% of patients respectively during the first follow-up at the polyclinic. Eighty five percent and 100% of the patients had a chest-x-ray and sputum direct smear for acid-fast bacilli done respectively. The turn-up rate for the first, second, third and fourth visit was 100% to 32%, 10% and 2% respectively. Conclusion: The quality of care for adult TB contacts tracing in this clinical audit was found to be suboptimal. There is a difference between the current national guidelines and practice in the clinic. Certain measures to improve the quality of care for adult TB contact tracing are urgently needed.

A Rare Case of Acute Psychosis as an Isolated Manifestation of Extrapontine Myelinolysis.

Aims and Background: Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are recognized as osmotic demyelination syndrome (ODS). ODS is pathologically characterized by non-inflammatory demyelination of several brain structures with sparing of axons. This condition is usually associated with overzealous correction of hyponatraemia. Acute psychosis as the sole clinical manifestation is extremely rare. Presentation of Case: Hence, we report an interesting case of a middle-aged man who was diagnosed with EPM, following rapid correction of hyponatraemia and subsequently developed acute psychosis. He made a good recovery with supportive treatment alone. Discussion and Conclusion: The possibility of psychosis as a manifestation of ODS, particularly in patients with recent correction of hyponatraemia. The rate of correction of plasma sodium level is the key point for preventing ODS and its complications.