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Fulltext Prevalence and reasons for smoking among upper secondary schoolboys in Hulu Langat, Malaysia

Khairani, O., Norazua, R., Zaiton, A.

Medicine & Health, 2007;2(1):80-85.
MyJurnal

Smoking in adolescence is a great health concern as it is related to many chronic diseases and mortality in later life. It is also associated with other high-risk behaviours among adolescents. The objective of this study was to determine the prevalence and reasons for smoking among upper secondary schoolboys. This was a cross-sectional study conducted among Form 4 and Form 5 students. Three schools in the District of Hulu Langat were identified and students from these schools were selected randomly. The students were given a self-administered questionnaire. A total of 343 students were included in the study. The prevalence of smoking among the schoolboys was 37%. Although the majority of them initiated smoking between 13-15 years old (67%), 21% of them began smoking below 12 years of age (primary school). There was a significant association between adolescent smoking and smoking among family members (p<0.05). The common reasons reported for
initiating smoking were curiosity (69%) and peer pressure (51%). However, the common reasons for continuing smoking were stress (70%) and addiction (49%). Schoolwork was reported as the most important factor which contributed to their stress. Smoking prevention programmes should begin early in primary schools. Adolescents should be educated on effective coping strategies in managing stress and learning to be assertive.
Keywords: smoking, adolescents, secondary school, reasons.
Fulltext Post-traumatic stress disorder and its associated factors among school-going children exposed to a tsunami disaster in Malaysia

Idris, I.B., Shamsudin K., Aniza, I, Khairani, O, Rahmah M.A.

Malaysian Journal of Public Health Medicine, 2015;15(3):112-121.
MyJurnal

Posttraumatic stress disorder (PTSD) is a psychiatric diagnosis made when someone including children who experiences traumatic stressor. Those who are exposed to a more severe trauma have highest level of PTSD. The aim of this study was to measure the prevalence of PTSD and its associated factors among 219 children who were affected by a form of natural disaster which is the tsunami waves in a rural area in Malaysia. A cross sectional study was carried out among children aged 10-12 years 6 months after the traumatic event. Child Posttraumatic Stress Disorder –Reaction Index (CPTSD-RI) was used as a screening instrument which was answered by the affected children through a self-administered questionnaire. Forty six percent of these children had PTSD symptoms; 31.1% of these children had mild, 11.4% had moderate, 3.7% had severe PTSD and none had very severe PTSD. Result also showed that 91.8% had re-experiencing symptoms, 28.3% had numbing/avoidance symptoms and 49.3% had hyperarousal symptoms. Children with low social support (Adj OR = 2.3 (95% CI: = 1.3- 4.2)), and children who experienced deaths among someone close to them (Adj OR = 3.7 (95% CI =1.2 - 11.5)) were more likely to have symptoms of PTSD. This showed that children are at higher risk of developing PTSD as early as 6 months after the event and thus early intervention should be offered to them. Future longitudinal study can be carried out among affected children to assess whether these PTSD symptoms persist over time.
Fulltext The management of an adolescent with conduct problems in a primary care clinic - a case report

Azimah M, Khairani O

Malays Fam Physician, 2009;4(2-3):88-90.
PMID: 25606170

PURPOSE: To describe the management of mild conduct problems in an adolescent at the primary care level.
CASE REPORT: A 16 year old girl presented with conduct problems with impending school suspension. The cause of her behavioural problems was mainly related to poor parenting skills of her parents and anger in herself. She was successfully managed with counselling and improvement of parenting styles in her parents.
CONCLUSION: This case report illustrates the opportunity for family physicians to manage simple conduct problems at primary care level.
KEYWORDS: Conduct problems; adolescents; anger management; parenting skills
Fulltext Drowning in a child: accidental or neglect?

Faridah MN, Khairani O

Med J Malaysia, 2003 Dec;58(5):774-6.
PMID: 15190669

We report the case of an infant who was found dead in the toilet of a nursery. Examination of the scene revealed an element of neglect in the care of the child. Postmortem showed evidence of drowning. Her blood sample showed a toxicologic evidence of alcohol exposure.
Fulltext Comparison Of Family Environmental Scale (FES) Subscales Between Malaysian Setting With The Original Dimension Of FES

Adam, B., Ramli, M., Jamaiyah H., Noor Azimah, M., Khairani, O.

Malaysian Journal of Psychiatry, 2010;19(1):1-7.
MyJurnal

Introduction: Family Environment Scale (FES) was developed by Moos1, has ten subscales and was categorized into three dimensions.Objective:The objective of this study was to develop factor structure for the Malay-translated version of the FES subscales. Methodology: The study used Malay translated version of FES by Khairani et. al2. This study was a multi centre, cross-sectional study, involving four secondary schools consisted of adolescents, aged between 12-17 years old and a total of 295 participants were enrolled in this study. Exploratory factor analyses was done across two groups of analysis set on the subscales with Cronbach’s alpha more than 0.50 and 0.53 respectively. Results: Two distinct factors were extracted across the four subscales consisted of Cohesion, Conflict and Organization in factor 1 and only Control in factor 2. Conclusion: The finding indicated that element of Cohesion, Conflict and Organization has a good indicator of a good family relationship.
Fulltext Cross-Cultural Adaptation And Validation Of The Bahasa Malaysia Version Of The Eating Disorder Examination Questionnaire (Ede-Q)

Ramli, M., Jamaiyah, H., Noor Azimah, M., Khairani, O., Adam, B.

Malaysian Journal of Psychiatry, 2008;17(2):1-8.
MyJurnal

Introduction: As eating disorders such as anorexia nervosa and others are generally becoming more prevalent, it is essential to have a culturally accepted and locally validated questionnaire that is able to detect abnormal eating habits. Objective: To translate the Eating Disorders Examination Questionnaire (EDE-Q) into Bahasa Malaysia (BM) and to determine the construct validity, reliability and other psychometric properties of the BM version. Method: Two parallel forward and backward translations were done in BM in accordance to guideline. Its validation was determined by using confirmatory factor analysis among 298 secondary school children. Results: The BM EDE-Q had very good internal consistency with global Cronbach’s alpha value of 0.879. For construct validity, majority of the items managed to produce values of more than 0.4 for confirmatory factor analysis with four unforced distinct factors detected. Conclusions: Analyses of reliability and validity of this BM version of EDE-Q yielded satisfactory results. The BM version produced in this study had good psychometric properties and it is applicable to the Malaysian population. Findings indicated that cultural factors in eating habits certainly influences the effort to adapt the questionnaire within a Malaysian setting.
Fulltext Breast feeding practice and knowledge among mothers attending an urban Malaysian maternal and child health clinic

Radzniwan AR, Azimah NM, Zuhra H, Khairani O

Medicine & Health, 2009;4(1):1-7.
MyJurnal

The advantages of breastfeeding have been well established. The objective of this study was to determine the practice and knowledge of breastfeeding in an urban com-munity and identify the influencing factors. This is a cross-sectional study. All mothers attending the Maternal and Child Health Clinic during the study period, who fulfilled the selection criteria, were included in the study. The mothers were interviewed using a self administered questionnaire. A total of 162 mothers participated in the study. The prevalence of initiating breastfeeding during the first week after childbirth was 93.8%. Breastfeeding was found to be higher among Malay mothers (p value

Study site: a Child Health Clinic in Cheras Baru, Kuala Lumpur
Fulltext Prevalence of smoking among secondary school students in Sarawak

Juslina O, Muthupalaniappen L, Khairani O, Iryani T

Malays Fam Physician, 2011;6(2-3):66-7.
PMID: 25606226

Adolescent smoking is an emerging health concern in the developing countries. A cross-sectional study is conducted to determine the prevalence and smoking behaviour of adolescents in Sarawak. The prevalence of smoking is 32.8% with mean age of initiation at 12.8±1.9 years. Most (67.2%) adolescents are experimental smokers and the majority (67.9%) did not smoke on a daily basis. Branded cigarettes are preferred (83.1%) and the cigarettes are obtained either from friends (49.1%) or self purchased (43.6%). Students prefer to smoke at their friend's house (31.0%) or at school (25.3%). Smoking prevalence among adolescents in Sarawak is high and begins early. Early intervention on smoking prevention and risk awareness is perhaps more effective if initiated before the age of 12 years.
Fulltext The prevalence of functional impairment among elderly aged 60 years and above attending Klinik Kesihatan Batu 9 Ulu Langat, Selangor

Loh KY, Khairani O, Norlaili T

Med J Malaysia, 2005 Jun;60(2):188-93.
PMID: 16114159

The aim of this study was to determine the prevalence of functional impairment and its associated factors among patients aged 60 years and above attending Klinik Kesihatan Batu 9 Ulu Langat, Selangor. This is a cross sectional community health clinic based study. A total of 260 elderly patients attending the community health clinic were interviewed. They were clinically assessed for functional impairment by using the 9 item Instrumental Activities of Daily Living (IADL) scale. There were 118 (45.4%) elderly male and 142 (54.6%) elderly female with age ranging from 60 years to 92 years with the mean age of 67.5 and 65.5 years for male and female respectively. Chinese form the largest population (42.3%) followed by Malay (36.5%), Indian (19.2%) and others (2.0%). The overall prevalence of functional impairment among elderly aged 60 years and above in this study was 33.5%. Among the functionally impaired, two patients (0.8%) were totally dependent. There were significant associations between functional impairment and older age (p = 0.025), lower income group (p = 0.010), lower education level (p = 0.030) and history of chronic medical illness (p = 0.020). Functional impairment had no significant association with ethnic group, gender, occupation and living arrangement. For daily activities that were assessed, the commonest impairment was inability to perform shopping (40%) followed by impairment in climbing up staircase (36.6%) and impairment in taking medication (35%). Advanced age, lower income, lower education and history of medical illness are associated with functional impairment. Functional impairment is an important consideration in caring for the elderly patients in the community. These findings have implications in caring of the elderly in which attention need to be paid to activities such as shopping, climbing stairs and taking medication. The use of the IADL scale is feasible for screening of functional impairment among the elderly population in the community.
Fulltext Do adolescents attending Bandar Mas primary care clinic consult health professionals for their common health problems?

Khairani O, Zaiton S, Faridah MN

Med J Malaysia, 2005 Jun;60(2):134-9.
PMID: 16114152

The aims of the study were to determine the prevalence of the common health problems namely acne, overweight, smoking and depressive symptoms among adolescents attending a primary healthcare clinic, whether they seek treatment for these problems and the reasons for not consulting health professionals. It was a clinic-based, crosssectional study. All adolescents aged 13 to 20 years who attended the clinic during the study period were included in the study. The respondents were given self-administered questionnaires and their weights were measured to assess if they had the above disorders. A total of 215 adolescents were included in the study. The proportion of adolescents who had acne were 70.7%, overweight 8.9%, smoking 41.9% and depressive symptoms 9.8%. Only 25% of those who had acne, 47% of those who were overweight, 9.5% who had depressive symptoms and none of those who smoked had ever sought treatment for these problems. The common reasons given for not consulting the health professionals were 'did not consider it as a problem', 'shy' and 'thought there was no treatment available'. The majority of the adolescents who attended the clinic did not consult health professionals the above common health problems. It is important to educate them on these disorders and encourage health-seeking behaviour in adolescents.
Fulltext Have we done enough with diabetic education? A pilot study

Azimah M, Radzniwan R, Zuhra H, Khairani O

Malays Fam Physician, 2010;5(1):24-30.
PMID: 25606182 MyJurnal

BACKGROUND: Patients' education and empowerment are essential parts of a disease management. Patients have to be educated on the disease as well as lifestyle changes that they need to practise for a holistic and consistent improvement in their disease status. This study examined patients' knowledge on diabetes and nutrition as well as the role of dietician in the patient education.
METHODS: This was a cross-sectional study of patients aged more than 18 years, in a primary care centre in Kuala Lumpur. Patients responded to a pre-tested self-administered questionnaire which contains socio-demographic profiles of patients, knowledge on diabetes and nutrition. Patients were also asked on dietician consultation and the number of dietician visits. Patients were conveniently selected on the data collection days. Only consented patients and those who could understand Malay or English language were selected.
RESULTS: There were 110 patients who participated in the study. Overall the patients had good knowledge on diabetes and nutrition. The mean total knowledge score was 71.2% ± 9.34. Domains such as diabetes complications, exercise, meal practice, food sources and proportion need reinforcement. Only 60 (54.9%) patients had seen a dietician. Patients who had seen dietician showed significantly higher level of knowledge score (p=0.04). However frequent meeting with the dietician did not show any significant improvement in the knowledge (p=0.10). Factors such as patients' gender, ethnicity, level of education, employment status, glycaemic level, duration of illness and body mass index did not show any significant association with the overall diabetic and nutrition knowledge.
CONCLUSION: There is still a need to improve the overall diabetic education particularly in areas that patients were lacking such as diabetes complications, exercise, meal practice, food sources and proportion. It is equally necessary to encourage all diabetics to see a dietician since it helps to improve their level of knowledge as shown in this study.
Fulltext Coping styles of mothers with disabled children at rural community rehabilitation centres in Muar, Malaysia

Nor Zaidah AH, Khairani O, Normah CD

Med J Malaysia, 2004 Aug;59(3):384-90.
PMID: 15727385 MyJurnal

Chronic disability in children imposes great strains on a family. The responsibility of mothering disabled children may be detrimental to the well-being of mothers. This study aims to assess the different types of coping styles of mothers with disabled children and its influencing factors. It is a cross-sectional study using Coping Inventory Stressful Situation (CISS) scale to determine the mothers' coping styles. A sample of 81 mothers with disabled children attending two rural Community Rehabilitation Centres, were included in the study. Overall, the mothers were using a mixture of coping strategies. However, they scored more in the task-oriented (mean T score = 52.88) and emotion-oriented (mean T score = 50.52) coping styles, while the other subscales of coping styles, namely avoidance, distraction and social diversion were below average (mean T score < 50). Divorced mothers (p=0.04) and those with low educational level (p=0.00) were more inclined to use emotion-oriented coping strategies while mothers with younger children (< 5 years old) used more avoidance coping strategies (p=0.01). There were no significant difference of coping styles in association with the mothers' age, ethnicity, duration of marriage, number of siblings, child's birth order or gender. By understanding the mothers' coping styles, health care workers would be able to educate the mothers with effective coping strategies and consequently reduce their psychological distress.
Fulltext Clinical features of acute febrile thrombocytopaenia among patients attending primary care clinics

Tong SF, Abd Aziz NA, Chin GL, Khairani O

Malays Fam Physician, 2006;1(1):15-8.
PMID: 26998201 MyJurnal

Identifying clinical features that differentiate acute febrile thrombocytopaenia from acute febrile illness without thrombocytopaenia can help primary care physician to decide whether to order a full blood count (FBC). This is important because thrombocytopaenia in viral fever may signify more serious underlying aetiology like dengue infection.
Fulltext Parental concerns and control in feeding of 9 to 12-year-old children in a primary school in Kuala Lumpur, Malaysia

Noor AM, Muthupalaniappen L, Shamsul AS, Hizlinda T, Khairani O, Fatimah A

Malays J Nutr, 2012 Apr;18(1):47-55.
PMID: 23713229 MyJurnal

Body weight of children is affected by many factors including food habits which are influenced by their parents. Studies in the West have shown that parents tend to control child feeding in response to their child's weight status. The aim of this study was to assess Malaysian parental concerns about child weight and the control they exert on child feeding.
Fulltext Palliative care for a child: role of a primary care doctor

Tan CE, Md Radzniwan R, Khairani O, Ednin H

Malays Fam Physician, 2011;6(1):26-28.
PMID: 25606216 MyJurnal

A 7-year-old boy with a diagnosis of advanced medulloblastoma refractory to treatment was discharged from hospital for further palliative care at home. During this short and eventful period, the child developed spinal cord compression with progressive weakness of upper and lower limbs, neck pain, faecal and urinary incontinence. This case highlights the important roles of a primary care doctor in the provision of palliative care for a child in the community.
Fulltext Prevalance of smoking among secondary school students in Sarawak

Juslina O, Leelavathi M, Khairani O, Tuti Iryani MD

Malays Fam Physician, 2011;6(2):66-67.
MyJurnal

Adolescent smoking is an emerging health concern in the developing countries. A cross-sectional study is conducted to determine the prevalence and smoking behaviour of adolescents in Sarawak. The prevalence of smoking is 32.8% with mean age of initiation at 12.8±1.9 years. Most (67.2%) adolescents are experimental smokers and the majority (67.9%) did not smoke on a daily basis. Branded cigarettes are preferred (83.1%) and the cigarettes are obtained either from friends (49.1%) or self purchased (43.6%). Students prefer to smoke at their friend’s house (31.0%) or at school (25.3%). Smoking prevalence among adolescents in Sarawak is high and begins early. Early intervention on smoking prevention and risk awareness is perhaps more effective if initiated before the age of 12 years.
Fulltext A study on pregnant adolescents residing in a government home: common characteristics and their views on the pregnancy

Tan P, Tohid H, Su X, Tan K, Azimah M, Khairani O

Malays Fam Physician, 2012;7(1):11-5.
PMID: 25606239 MyJurnal DOI: 10.4066/MFP.2012.1710

BACKGROUND: Adolescent pregnancy has emerged to be a significant public health and social issue in Malaysia as its prevalence is increasing in our population.
OBJECTIVES: This study aimed to identify the common characteristics of pregnant adolescents residing in a government shelter home. Their reasons for pregnancy, sources of information on contraception, and views on abortion and future care of the baby were explored.
METHODS: A cross-sectional study was performed on 26 universally sampled pregnant adolescents in the centre. The adolescents responded to a set of self-administered questionnaire on their socio-demographic profiles, reasons of their pregnancy, contraception and future plans including abortion as well as care of the newborn.
RESULTS: Almost all (92%) of the adolescents were unmarried. Majority of them were in late adolescence, age between 16 to 19 years (73.1%), from urban areas (73.1%) and of low income families (53.8%). There were 69.3% of the adolescents who were school dropouts. The reasons for pregnancy were consensual sexual activity (63.0%), coercion by boyfriend (18.5%), and rape (11.5%). The main sources of information on contraception were friends (50%), partners (50%) and the internet or mass media (42.3%). 54% had considered abortion earlier, but majority (92.0%) disagreed that abortion should be legalised in Malaysia. Most of the adolescents planned to parent their child with or without help from significant others and only 42.3% planned to relinquish their child for adoption.
CONCLUSION: To curb teenage pregnancy-related problems, efforts on educating the adolescents about sexual reproductive health and assertive communication skills should be implemented, especially to the late adolescents, school dropouts and those from poor urban families. Parenthood support may be necessary to the pregnant adolescents who opted to care for their own child.
Fulltext Barriers to the utilization of primary care services for mental health prolems among adolescents in a secondary school in Malaysia

Aida J, Noor Azimah M, Mohd Radzniwan AR, Tuti Iryani MD, Ramli M, Khairani O

Malays Fam Physician, 2010;5(1):31-5.
PMID: 25606183

OBJECTIVE: To study the barriers toward the utilization of primary care services for mental health problems among adolescents in a secondary school in Hulu Langat, Selangor, Malaysia.
METHODS: This was a cross-sectional study conducted in July 2008 at a secondary school in Hulu Langat, Selangor. The respondents were selected using randomised cluster sampling among Form Four and Form Five students. Students were given self-administered questionnaire, consisting socio-demographic data and questions on their help-seeking barrier and behaviour. Help-seeking behaviour questions assess the use of medical facility and help-seeking sources. The formal help-seeking sources include from teachers, counsellors and doctors. The informal help-seeking sources include from friends, parents and siblings.
RESULTS: A total of 175 students were included in the study. None of the students admitted of using the primary health care services for their mental health problems. Majority of the students were not aware of the services availability in the primary health care (97.1%). More than half of them thought the problems were due to their own mistakes (55.4%) and the problems were not that serious (49.1%). With regard to perception of the primary health care services, (43.2%) of the students were worried about confidentiality, half of them were concerned about other people's perception especially from their family members (44.6%) and friends (48.6%). Minority of them (10.8%) thought that nobody can help them. Few of them thought smoking (3.4%), alcohol (3.4%) and recreational drugs (1.1%) can solve their emotional problems.
CONCLUSION: One of the major barriers identified in the students' failure to use the health care facilities was their unawareness of the availability of the service for them in the community. Thus there is a need to promote and increase their awareness on this issue.
Fulltext Reasons for choosing medicine and career suitability among medical students

Khairani O, Mohamed NA, Ismail Z, Shalinawati R, Chamhuri NH, Rahim NS

Medicine & Health, 2018;13(1):97-105.
MyJurnal

Choosing a course to pursue is an important decision for students to make. A suitable career should correspond to the students’ personalitiy for future work satisfaction and success. The objectives of this study were to determine the students’ reasons for choosing medicine, their personality traits and aptitude (suitability). This was a cross-sectional study involving all third-year medical students at Universiti Sains Islam Malaysia. A self-administered questionnaire was used, which included questions on demographic data, Sidek Career Interest Inventory and reasons for choosing medicine. The inventory was used to measure the students’ personality traits and career suitability. A total of 80 students participated in the study. Majority of them were females (n=56, 70.0%). The findings showed that 45.7% (n=44) of the repondents chose medicine because of ‘passion and interest’, while 24.7% (n=20) and 19.8% (n=16) because of ‘parental influence’ and ‘to help the society’, respectively. For medicine, two personality traits are essential which are investigative and social personality traits. Approximately, 47.5% (n=38) of the respondents had high scores in investigative personality trait. However, only 13.8% (n=11) of them had high scores in social personality trait. Only 12.5% (n=10) of the students had high scores when combining both of the traits. Majority of the students chose medicine for altruistic reasons. However, only a few of them had suitable aptitude for this course namely investigative and social skill. Therefore, the students and the teachers need to be aware of these issues and cultivate the required skills in the students for better career outcome.
Fulltext An adolescent with anorexia nervosa - a case report

Khairani O, Majmin SH, Saharuddin A, Loh SF, Noor Azimah M, Hizlinda T

Malays Fam Physician, 2011;6(2):79-81.
PMID: 25606230 MyJurnal

This case report illustrates an adolescent with clinical presentation of moderate anorexia nervosa with no significant co-morbidities. It highlights the management of anorexia nervosa in the outpatient setting by a multi-disciplinary health care team which includes a family physician, a dietician, a psychologist and a child psychiatrist.

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