DESIGN: Primary and secondary documentary sources in both English and Malay were analysed to illuminate key events and decisions, and the discourse of industry and government. Sources included: speeches by Malaysian political and industry actors; tobacco industry reports, press releases and websites; government documents; World Health Organization (WHO) tobacco control literature; and press reports.
RESULTS: Malays have the highest smoking prevalence among Malaysia's major ethnic groups. The tobacco industry has consistently been promoted as furthering Malay economic development. Malays play the major role in growing and curing. Government-owned Malay development trusts have been prominent investors in tobacco corporations, which have cultivated linkages with the Malay elite. The religious element of Malay ethnicity has also been significant. All Malays are Muslim, and the National Fatwa Council has declared smoking to be haram (forbidden); however, the Government has declined to implement this ruling.
CONCLUSION: Exaggerated claims for the socio-economic benefits of tobacco production, government investment and close links between tobacco corporations and sections of the Malay elite have created a conflict of interest in public policy, limited the focus on tobacco as a health policy issue among Malays and retarded tobacco control policy. More recently, ratification of the WHO Framework Convention on Tobacco Control, regional free trade policies reducing the numbers of growers, concerns about smoking from an Islamic viewpoint, and anxieties about the effects of smoking upon youth have increasingly challenged the dominant discourse that tobacco furthers Malay interests. Nevertheless, the industry remains a formidable political and economic presence in Malaysia that is likely to continue to proclaim that its activities coincide with Malay socio-economic interests.
METHOD: A descriptive cross-sectional study was conducted with a convenience sample of 482 Iranian cancer patients. Participants completed demographic and health, death depression, and religious coping surveys.
RESULTS: After controlling for demographic and health characteristics, positive and negative religious coping behaviors were significantly related to the experience of death depression. There was an interaction effect between negative religious coping and extent of disease with significant positive relationships to the experience of death depression.
CONCLUSIONS: Negative religious coping was found to be more closely associated with death depression in patients with earlier stage disease than those with advanced stages of cancer in this sample of patients with cancer from Iran. Findings support assessing patients for use of religious coping strategies. Muslim patients who are religiously alienated and have existential anguish may be vulnerable and need heightened support following diagnosis and during treatment of early stage cancer.
METHODS: A cross-sectional survey was conducted among clinical-year medical students from a Malaysian private medical college using a self-administered questionnaire.
RESULTS: There were 330 participants with a female preponderance and a mean age of 22.0 ± 1.1 years. The largest proportion of respondents were from Year 3. The vast majority were ethnically Malay (91.8%) and followed Islam (92.4%). Overall, 60.9% of participants had a positive attitude towards vasectomy and 76.0% showed good acceptance. Gender, academic year, ethnicity and religion variables were not associated with attitudes and acceptance (p > 0.05). A significantly higher proportion of male respondents thought that vasectomy was religiously forbidden and would give a bad impression. A significantly higher proportion of Year 5 students agreed to the statement 'I would recommend vasectomy to relatives, friends and people close to me' compared to Year 3 and 4 students.
CONCLUSION: Students' perception of vasectomy as a contraceptive method was encouraging. Our results suggest that their knowledge improved as medical training progressed, and attitudes evolved for the better irrespective of their traditional, cultural and religious beliefs - highlighting the importance of providing students with evidence-based learning about male sterilisation, which is more cost-effective and is associated with lower morbidity than female sterilisation. A qualitative study involving students from different ethnicities and religions would provide a better understanding of this subject.
METHODS: A cross-sectional study was performed at two chemotherapy providers. Patients were questioned about use of three categories of CAM, mind-body practices (MBPs), natural products (NPs) and traditional medicine (TM). PFH was also examined separately from CAM to better characterise the patterns of CAM and PFH used during chemotherapy.
RESULTS: A total of 546 eligible patients participated in the study; 70.7% (n = 386) reported using some form of CAM, and 29.3% (n = 160) were non-CAM users. When PFH was excluded as a CAM, fewer patients reported the use of CAM (66.1%; n = 361). The total number of patients who used MBPs decreased from 342 to 183. The most common CAM use category was NPs (82.8%), followed by MBPs (50.7%), and TM (35.7%). CAM users were more likely to have a tertiary education (OR 2.11, 95% CI 1.15-3.89 vs. primary/lower), have household incomes > RM 3,000 (≈944 USD) per month (OR 2.32, 95% CI 1.40-3.84 vs. ≤RM 3,000 (≈944 USD)), and have advanced cancer (OR 1.75, 95% CI 1.18-2.59 vs. early stage cancer), compared with non-CAM users. The CAM users were less likely to have their chemotherapy on schedule (OR 0.24, 95% CI 0.10-0.58 vs. chemotherapy postponed) than non-CAM users. Most MBPs were perceived to be more helpful by their users, compared with the users of NPs and TM.
CONCLUSION: CAM use was prevalent among breast cancer patients. Excluding PFH from the definition of CAM reduced the prevalence of overall CAM use. Overall, CAM use was associated with higher education levels and household incomes, advanced cancer and lower chemotherapy schedule compliance. Many patients perceived MBP to be beneficial for improving overall well-being during chemotherapy. These findings, while preliminary, clearly indicate the differences in CAM use when PFH is included in, and excluded from, the definition of CAM.
METHODS: All English-language medical literature published from inception till October 2014 which met the inclusion criteria were reviewed and analyzed.
RESULTS: A total of nine papers were included, reviewed and analyzed. The total sample size was 4276 patients. All studies used either of the two DPP4 inhibitors - Vildagliptin or Sitagliptin, vs sulphonylurea or meglitinides. Patients receiving DPP4 inhibitors were less likely to develop symptomatic hypoglycemia (risk ratio 0.46; 95% CI, 0.30-0.70), confirmed hypoglycemia (risk ratio 0.36; 95% CI, 0.21-0.64) and severe hypoglycemia (risk ratio 0.22; 95% CI, 0.10-0.53) compared with patients on sulphonylureas. There was no statistically significant difference in HbA1C changes comparing Vildagliptin and sulphonylurea.
CONCLUSION: DPP4 inhibitor is a safer alternative to sulphonylurea in Muslim patients with type 2 diabetes mellitus who fast during the month of Ramadan as it is associated with lower risk of symptomatic, confirmed and severe hypoglycemia, with efficacy comparable to sulphonylurea.