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  1. Lekhraj Rampal, G.R., Wong, C.H.
    MyJurnal
    This is a cross»sectional study to determine the nutritional status of Malay children aged 6 to 10 years in Kampongknderam Hilir. A cross sectional study design was used.All households were included in the study. All the 218 Malaysian children aged 6 to 10 years in Kamponglenderam Hilir were included in the study. A pre-tested structured questionnaire was used to collect the data.
    Data were analyzed by using Statistical Package of Social Sciences (SPSS) version 10. The minority of the chihlren were within normal range for weight·for-age, normal height for age status and weight for height status. However in small proportion of children, there was a persistence of protein·energy malnutrition problems. Overall 11% were underweight. There was no significant difference in the prevalence ofunderweight between males and females. The prevalence of overweight and stunting was 5 .3% and 11 .5%. There was no significant difference in the prevalence of sturtting in male compared to females. Although stunting was prevalent in all age groups (4.4% to 19.6%) a significant higher prevalence was observed in the age group 9 - 9.9 years compared to other age groups (p< 0.05). Wasting was present in 7.6% of the respondents. The 6 - 6.9 years age group had the highest wasting prevalence compared to other age groups. The prevalence of wasting was significantly higher in males. ln conclusion the overall nutritional status of children aged 6 to 10 years old in Kampong]enderam Hilir was satnfactory. However, there was still malnutrition in a small proportion of chihlren. Underweight, stunting and overweight were seen in all age groups. As such there is a need to identify these chiMren and improve their nutritional status.
  2. Lekhraj Rampal, G.R., Teh, W.M., Tan, P.H.
    MyJurnal
    Objectives: This study was carried out to determine the nutritional status of primary
    school children aged 6 to 11 years in Sepang District and to compare the results with a
    similar study carried out in 1999. Methods: This cross-sectional study was carried out in
    Sepang District using stratified random cluster sampling technique. A pre-tested, structured
    questionnaire was used to collect the data. Weight was recorded using a digital bathroom
    scale TANITA model HD-309 and height was measured by using a SECA Body meter
    Model 208. Body mass index (BMI) was calculated as weight in kilograms divided by the
    square of height in meters. Classifications of the nutritional status of respondents was
    based on WHO classification 1983 and 1995. Data were analysed using SPSS. Results:
    The overall mean BMI for the 1,910 respondents was 16.8 (95% CI= 16.67 - 16.99;
    SE=0.08). The median BMI was 15 .7 ranging from 9.51 to 36.75 kg/m2. The majority
    (84.4%) had normal weight-for-age status, 7.6% respondents had weight-for-age status
    below -2 SD of the NCHS-WHO median and 8.0% had weight-for-age status above +2 SD
    of the NCHS-WHO median. The prevalence of underweight and overweight was significantly
    higher in the males compared to the females (p< 0.05). There was a significant association
    between underweight and ethnicity (p< 0.05). The majority (90.3%) had normal heightfor-
    age status, 8.8% had height-for-age below - 2 SD of the NCHS-WHO standard median
    and 0.9% had height-for-age above 2 SD from the NCHS median. The prevalence of
    stunting was significantly higher in the male (10.3%) as compared to 7.4% in the females
    (X2 = 5.11, P = 0.02). The majority (81.4%) of the respondents were within the normal
    weight-for-height, 3.4% were wasted (weight-for-height was below - 2 SD of the NCHSWHO
    median) and 15.2% of the respondents were obese (weight-for-height that is more
    than +2 SD of the NCHS-WHO median). The prevalence of wasting was higher in the
    females (4.1 %) compared to males (2.8%). The prevalence of obesity was slightly higher
    in the males (15.4%) compared to females (14.9%). Conclusion: The overall nutritional
    status of primary schools children is good. However, there still exists pockets of population
    in Sepang where chronic and acute forms of undernutrition persist in these children.
  3. Subramanian S, Lekhraj Rampal GR, Wong EFM, Mastura S, Razi A
    Med J Malaysia, 2005 Dec;60(5):535-9.
    PMID: 16515102
    Sinusitis is an important cause of morbidity and one of the major sources of income loss. Anatomical variations of the nose have been reported to predispose to sinusitis. These variations include concha bullosa, nasal septal deviation and oversized bulla. The aim of this study was to determine the proportion and the distribution of concha bullosa in patients with chronic sinusitis and to determine the relationship between concha bullosa and age, sex, ethnicity. A cross-sectional study was conducted at the Department of Ear, Nose and Throat in Kuala Lumpur Hospital (HKL). Data was collected retrospectively using a pretested proforma. All patients who underwent Sino nasal surgery between January 1999 and December 2000 and whose preoperative CT scans were available were included in the study. The CT scans were reviewed. Analysis was carried out using Statistical Package for Social Sciences. Out of 146 patients who underwent sinonasal surgery between January 1999 and December 2000, 101 (69.2% preoperative CT scans of these patients were available and these were reviewed. The proportion of patients with concha bullosa was 49.5%. The results showed that there was significant relationship between presence of concha bullosa and age and sex. The overall mean age of patient with concha bullosa was 35.7 years (95% CI 12.1-39.3) and ranged from 11-years to 56-years. The mean age of respondents with concha bullosa was significantly lower than patients without concha bullosa 41.98 (95% CI 37.6-46.3; t-test = 2.221; df=99; p < 0.05). Concha bullosa was significantly more in females (66.0%) compared to males (chi2 = 4.465, df=1, p < 0.05). There was no significant relationship between presence of concha bullosa and ethnicity.
  4. Abiola, Abdulrahman Surajudeen, Lekhraj Rampal, Norlijah Othman, Faisal Ibrahim, Hayati Kadir@Shahar, Anuradha P. Radhakrishnan
    MyJurnal
    Adherence to antiretroviral therapy (ART) prevents disease progression, and the emergence of resistant mutations. It also reduces morbidity, and the necessity for more frequent, complicated regimens which are also relatively more expensive. Minimum adherence levels of 95% are required for treatment success. Poor adherence to treatment remains a stumbling block to the success of treatment programs. This generates major concerns about possible resistance of the human immunodeficiency virus (HIV) to the currently available ARVs. This paper aims to describe baseline results from a cohort of 242 Malaysian patients receiving ART within the context of an intervention aimed to improve adherence and treatment outcomes among patients initiating ART. A single-blinded Randomized Controlled Clinical Trial was conducted between January and December, 2014 in Hospital Sungai Buloh. Data on socio-demographic factors, clinical symptoms and adherence behavior of respondents was collected using modified, pre-validated Adult AIDS Clinical Trials Group (AACTG) adherence questionnaires. Baseline CD4 count, viral load, weight, full blood count, blood pressure, Liver function and renal profile tests were also conducted and recorded. Data was analyzed using SPSS version 22 and R software. Patients consisted of 215 (89%) males and 27 (11%) females. 117 (48%) were Malays, 98 (40%) were Chinese, 22 (9%) were Indians while 5 (2%) were of other ethnic minorities. The mean age for the intervention group was 32.1 ± 8.7 years while the mean age for the control group was 34.7 ± 9.5 years. Mean baseline adherence was 80.1 ± 19.6 and 85.1 ± 15.8 for the intervention and control groups respectively. Overall mean baseline CD4 count of patients was 222.97 ± 143.7 cells/mm³ while overall mean viral load was 255237.85 ± 470618.9. Patients had a mean weight of 61.55 ± 11.0 kg and 61.47 ± 12.3 kg in the intervention and control groups, respectively. Males account for about 90% of those initiating ART in the HIV clinic, at a relatively low CD4 count, high viral load and sub-optimal medication adherence levels at baseline.
  5. Lili Asma Ismail, Lekhraj Rampal, Hejar Abdul Rahman, Nazri Omar, Habshah Midi, Azrin Esmady Ariffin
    MyJurnal
    Microbial keratitis is one of the most challenging complications of contact lens (CL) wear. Proper CL practice plays an important role to reduce the risk for contact lens related microbial keratitis (CLRMK). Methods: This multi-centre case-control study was conducted from January 2008 until June 2009 to determine the risk factors associated with CLRMK. Cases were defined as respondents who were treated for CLRMK, whilst controls were respondents who were contact lens wearers without microbial keratitis. Ninety four cases were compared to 94 controls to determine the risk factors for
    CLRMK. Results: The predictors for CLRMK were: Not washing hands with soap before handling CL (aOR 2.979, CI 1.020, 8.701 p=0.046), not performing rubbing technique whilst cleaning the CL (aOR 3.006, CI 1.198, 7.538 p=0.019) and, not cleaning the lens case with multipurpose solution daily (aOR 3.242 CI 1.463, 7.186 p=0.004). Sleeping overnight with the CL in the eye (aOR 2.864, CI 0.978, 8.386 p=0.049) and overall non-compliance with lens care procedures (aOR 2.590, CI 1.003, 6.689 p=0.049) contributed significantly to CLRMK. Conclusion: Health education and promotion in contact lens care are important and should be conducted by eye care practitioners to reduce the occurrence of CLRMK.
  6. Lekhraj Rampal, G. R., Sanjay, R., Azhar, M. Z., Kamil, M. H.
    MyJurnal
    Introduction: It is estimated that 4.9 million people worldwide died in 2000 as a result of their addiction to nicotine, about half of them prematurely. This huge death toll is rising rapidly, especially in low and middle income countries where most of the world’s 1.2 billion tobacco users live.
    Objectives: This study aimed to determine (i) the prevalence of smoking among the community aged 18 and above in Terengganu state, and (ii) the relationship between smoking and age, sex, educational level, family and peer influence.
    Methods: A cross-sectional study design was used in this study and data was collected using a standardised pre-tested structured questionnaire.
    Results: The overall mean age of the respondents was 38.9 (95% CI= 37.7 – 40.2) years. The majority of the respondents were Malays (99.1%). Of the 653 respondents, 32.2% and 23.6% were ever and current smokers respectively. Of this, 211 ever smokers, 199 (94.3%) were males and only 12 (5.7%) were females. The prevalence of ever and current smokers for males was 73.2% and 53.7% respectively compared to the females (3.1% and 2.1% respectively). There was a significant association between smoking status and sex (p<0.001). The prevalence of ever smokers was lowest amongst respondents with college or university educational level. However, for current smokers, those with college or university education had the highest prevalence. The overall mean initiation age of ever smokers was 19.7 years (95% CI = 18.8 – 20.7). The mean initiation age for the males (19. 1 years) was significantly lower compared to 29.8 years for the females (p<0.001). The mean duration of smoking for the current smokers was 21.6 (95% CI= 19.1 – 24) years. There was also no significant difference in the mean duration of current smoking for males compared to the females (p = 0.5). The majority (93.4%) of the ever smokers started either because their friends asked them to try or they were trying for fun. The quit ratio was 27%.
    Conclusion : The prevalence of ever and current smokers in males is very high (73.2% and 53.7% respectively) compared with the females (3.1% and 2.1% respectively). The mean initiation age for the males (19.1 years) was significantly lower compared to 29.8 years for the females (p<0.001). Key words: Smoking, prevalence, initiation age, duration, Terengganu state
  7. Norlijah Othman, Nor Khamisah, A., Kamarul Azhar, Sinniah, Mangalam, Lekhraj, Rampal
    MyJurnal
    Dengue haemorrhagic fever (DHF) is a severe viral illness with significant morbidity and mortality especially among children in Southeast Asia. The tourniquet test is recommended by the World Health Organisation (WHO) as an initial clinical screening procedure for patients suspected to have DHF, particularly in patients with DHF grade I. The aim of this study was to evaluate the validity of the tourniquet test as a predictor of DHF and also to assess the usefulness of repeated, serial tourniquet testing as a diagnostic indicator of DHF. Individuals included into this study were children from the Institute of Paediatrics, Kuala Lumpur who were admitted on a clinical suspicion of DHF based on the WHO criteria and who had serology for Dengue IgM performed. A standard method of tourniquet was performed on these patients on a daily basis following admission. A total number of 60 patients were considered for analysis and of these the tourniquet test was positive in 50 patients and negative in the remaining 10 patients. Sensitivity of the test was found to be 85.4% and the specificity was 25%. Further assessment of the predictive value of the test showed that the positive predictive value (PPV) was 82% while the negative predictive value (NPV) was 30%. In conclusion, a positive tourniquet test, serially performed on a daily basis was found clinically to be a useful preliminary screening tool for DHF as recommended by WHO. However its specificity was low and consequently led to a high false positive rate.
  8. Lili Asma Ismail, Lekhraj Rampal, Nazri Omar, Hejar Abdul Rahman, Habshah Midi, Azrin Esmady Ariffin
    MyJurnal
    Introduction: A hospital based case control study was
    conducted in government hospitals on contact lens patients
    diagnosed with microbial keratitis. Methods: The objective of
    this study is to determine the visual outcomes of contact lens
    related microbial keratitis. The visual outcomes which
    comprised of visual acuity, keratometry readings, corneal
    topography findings and contrast sensitivity examinations was
    determined after three months from the first presentation at the
    hospitals. Results: The mean LogMAR visual acuity during
    presentation was 0.96 ± 0.73 or a Snellen equivalent 6/60 (n=76)
    and mean LogMAR visual acuity after three months was 0.10 ±
    0.48 or a Snellen equivalent 6/7.5 (n=76) with a significant
    difference (t=11.22, df=78, p=0.001). Best fit curve for the cases
    had a regression coefficient, r=0.350 ± 0.063 (95% CI = 0.224,
    0.447, df=78, p=0.001. The visual acuity in cases and controls
    was 0.10 ± 0.48 and -0.10 ± 0.14 respectively (t= -3.61, df=154
    p=0.001) after three months which showed improvement. There
    was a reduction in the corneal uniformity index and corneal
    asphericity in the cases. The Corneal Uniformity Index (CU
    index) in cases was 63.03 ± 26.38 (n=76) and in controls, 80.13
    ± 11.30 (n=77), (t= -5.22, df=151, p=0.001). There was also a
    reduction in the contrast sensitivity function at all spatial
    frequencies in the cases which was significantly different.
    Conclusion: Microbial keratitis reduced the vision, corneal
    uniformity index, asphericity and contrast sensitivity after three
    months in eyes of patients diagnosed with the condition.
  9. Siew Tin, Tan, Mohd-Sidik, Sherina, Lekhraj, Rampal, Normala, Ibrahim, Kit-Aun, Tan, Zuriati, Ibrahim
    MyJurnal
    As reported by the World Health Organisation (2014), Malaysia is the fattest country among the Southeast Asia. Among others, obesity is a leading contributor of non-communicable diseases (e.g., type II diabetes, metabolic syndrome, and cancer). This article aims to review the exiting weight management programmes targeting overweight and obesity in Malaysia from 2005 to 2015. The findings from this review could be useful for future intervention efforts in an attempt to address such issues in Malaysia.
  10. Chindo Ibrahim Bisallah, Lekhraj Rampal, Sherina Mohd Sidik, Zubairu Iliyasu, Munn-Sann Lye, Michael Ochigbo Onyilo
    MyJurnal
    Introduction: Tuberculosis is the commonest cause of death among HIV patients in Nigeria. Though tuberculosis is common among HIV patients, their knowledge about transmission and prevention is poor. Objective: To determine knowledge, attitude and preventive practices regarding tuberculosis and its predictors among HIV patients receiving treatment. Methods: A cross sectional study was carried out involving 226 randomly selected HIV patients receiving care at General Hospital, Minna. Study duration was from June 2015 to July 2017. Data on socio-demographic characteristics, psychosocial factors, knowledge, attitude and preventive practices regarding tuberculosis was collected using a self-administered, WHO modified, pretested and validated questionnaires. Data collected was analysed using SPSS version 22. Results: Out of 226 respondents, 60(26.5%) had poor knowledge, 123(54.4%) had negative attitude and 48(21.2%) had poor preventive practices regarding tuberculosis. The predictors of knowledge were age (B=0.087, 95%CI=0.031, 0.143, p=0.002), depression (B=-0.444, 95%CI=-0.673,-0.214, p
  11. Lekhraj Rampal GR, Mohd Sidik S, Rampal S, Daniel Wong YJ, Chow PL, Liew JS, et al.
    Malays J Nutr, 2007 Mar;13(1):1-8.
    PMID: 22692184 MyJurnal
    Overweight and obesity place children and adolescents at increased risk of significant health problems, both during their early life and adult life. A cross sectional study was carried out to determine the prevalence of overweight among secondary school students aged 13-17 years in the Klang district and to determine the association between overweight and age, sex, ethnicity, religion and blood pressure. Random cluster proportionate to size sampling technique was used to select the respondents. Weight was recorded using TANITA model HD-309 and height was measured using SECA Body meter Model 208. A mercury sphygmomanometer was used to measure blood pressure manually. Statistical analysis was carried out using SPSS version 13. Out of the 3,333 respondents, 11.4% were found to be at risk of overweight and 8.2% were overweight. The prevalence of overweight was significantly higher in the males (10.6%) as compared to females (6.0%). Prevalence of overweight was highest in Malays (10.7%) followed by the Indians (7.1%) and the Chinese (5.9%). Prevalence of 'risk of overweight' was highest in the Indians (13.7%) followed by Chinese (12.0%) and Malays (9.8%). There was a moderate direct significant relationship between overweight and systolic blood pressure (r=0.5, r2=0.25, p<0.001) and also diastolic blood pressure (r=0.42, r2=0.18, p<0.001). The relationship between BMI and overweight was very weak (r=0.11, r2=0.01 and df=3331, p<0.001). In conclusion the prevalence of overweight among the secondary school students is high and there is a need for a comprehensive integrated population-based intervention program.
  12. Mohd-Sidik S, Lekhraj R, Foo CN
    PMID: 33498401 DOI: 10.3390/ijerph18030868
    BACKGROUND: The pervasiveness of obesity is a growing concern in the world. This study aims to determine the prevalence of obesity among a segment of the Malaysian population, as well as investigate associated factors and psychological determinants of obesity.

    METHODS: A cross-sectional study design was carried out in Selangor, Malaysia. A total of 1380 Malaysian adults (≥18 years old) participated in a structured and validated questionnaire survey. TANITA body scale and SECA 206 body meter were used to measure the respondents' weight and height, from which measurements of their body mass index (BMI) were calculated.

    RESULTS: The overall prevalence of obesity (BMI ≥ 30 kg/m2) among adults in Selangor, Malaysia, was 18.6%. Factors significantly associated with increased risk of obesity were: being female (OR = 1.61, 95% CI [1.20-2.17]), aged between 30 to 39 years old (OR = 1.40, 95% CI [1.04-1.88]), being Indian (OR = 1.55, 95% CI [1.13-2.12]), married (OR = 1.37, 95% CI [1.03-1.83]), and having only primary school education (OR = 1.80, 95% CI [1.17-2.78] or secondary school education (OR = 1.37, 95% CI [1.04-1.81]). In the multiple linear regression analysis (stepwise method), perceived stress (B = -0.107, p = 0.041), suicidal ideation (B = -2.423, p = 0.003), and quality of life in the physical health domain (B = -0.350, p = 0.003) inversely and significantly contributed to BMI among males. Among females, stressful life events contributed positively to BMI (B = 0.711, p < 0.001, whereas quality of life in the psychological domain had a negative effect (B = -0.478, p < 0.001) in this respect.

    CONCLUSION: There is an urgent need to integrate psychological approaches to enhance the effectiveness of obesity prevention strategies and weight-loss programs.

  13. Ab Ghaffar SF, Mohd Sidik S, Ibrahim N, Awang H, Gyanchand Rampal LR
    PMID: 31817328 DOI: 10.3390/ijerph16244913
    Anxiety is one of the most common mental health disorders in childhood, and children with anxiety have an increased risk of psychiatric disorders during adulthood. This study aimed to evaluate the effectiveness of a school-based anxiety prevention program for reducing anxiety among primary school students relative to a school-as-usual control group. Secondary to this, the current study aimed to examine the effect of a school-based prevention program on worry coping skills and self-esteem. A two-group parallel cluster randomized controlled trial of a single-blinded study was conducted to evaluate the effectiveness of the program, with schools as the unit of allocation and individual participants as the unit of analysis. The intervention program was conducted between May 2016 and December 2017. The primary outcome was anxiety, whereas the secondary outcomes were worry coping skills and self-esteem measured at three months post-intervention. Data were analyzed by using a generalized linear mixed model, accounting for the clustering effect. Subgroup analyses were performed for children with anxiety. A total of 461 students participated in this study. At baseline, there was no significant difference between groups for anxiety score, worry coping skills score, and self-esteem score (p > 0.05). The intervention was effective in reducing anxiety for the whole sample (p = 0.001) and the anxiety subgroup (p = 0.001). However, it was not effective in improving worry coping skills and self-esteem. These findings suggest that the program could be effective for reducing symptoms of anxiety when delivered in schools and provide some support for delivering this type of program in primary school settings.
  14. Blin J, Ahmad Z, Rampal LR, Mohtarrudin N, Tajudin AK, Adnan RS
    Genes Genet Syst, 2013;88(3):199-209.
    PMID: 24025248
    Identifying susceptible genes associated with the pathogenesis of atherosclerosis (ATH) may contribute toward better management of this condition. This preliminary study was aimed at assessing the expression levels of 11 candidate genes, namely tumor protein (TP53), transforming growth factor, beta receptor II (TGFBR2), cysthathionenine-beta-synthase (CBS), insulin receptor substrate 1 (IRS1), lipoprotein lipase (LPL), methylenetetrahydrofolate reductase (MTHFR), thrombomodulin (THBD), lecithin-cholesterol acyltransferase (LCAT), matrix metallopeptidase 9 (MMP9), low density lipoprotein receptor (LDLR), and arachidonate 5-lipoxygenase-activating protein (ALOX5AP) genes associated with ATH. Twelve human coronary artery tissues (HCATs) were obtained from deceased subjects who underwent post-mortem procedures. Six atherosclerotic coronary artery tissue (ACAT) samples representing the cases and non-atherosclerotic coronary artery tissue (NCAT) samples as controls were gathered based on predetermined inclusion and exclusion criteria. Gene expression levels were assessed using the GenomeLab Genetic Analysis System (GeXP). The results showed that LDLR, TP53, and MMP9 expression levels were significantly increased in ACAT compared to NCAT samples (p < 0.05). Thus, LDLR, TP53, and MMP9 genes may play important roles in the development of ATH in a Malaysian study population.
  15. Kandiah N, Lekhraj R, Paranjothy S, Gill AK
    Med J Malaysia, 1980 Mar;34(3):211-20.
    PMID: 7412661
    A pilot study on the epidemiology of hypertension was carried out in 3 out of the 8 districts in the state of Selangor, namely Klang, Sabak Bernam and UIu Langat. stratified random sampling, 435 households were selected for the study. Eventually 312 (72%) households were surveyed: 963 (94%) out of the 1,030 persons aged 15 years and above living in the selected households were interviewed, and 957 of them were examined. The mean age of the respondents was 33 years. Taking a systolic pressure of more than 140 mmHg and/or diastolic pressure of more than 90 mmHg as hypertension, 1 in every 7 of those equal and mor.e than 15 years of age had hypertension, i.e. 140/0. 5.40/0 had a systolic pressure of equal and more than 160 mmHg, and 4.7% had a diastolic pressure of equal and more than 95 mmHg. The study showed that there was a significant rise in the prevalence rates with age in both sexes. There was no significant difference in the prevalence rates among. the sexes, ethnic groups (Malays, Chinese and Indians) and urban and rural areas. The mean systolic pressure ranged from 112-147 mmHg and diastolic from 69 - 73 mmHg. Hypertension was significantly more common among smokers (18.1%) than nonsmokers. There was no significant relationship between hypertension and tea, coffee and alcohol consumption. Hypertension was significantly more common among those with no physical activity (34.8%) as compared with those with physical activity (13.5%). 67% of the hypertensives were aware of their illness but only 36.1% of them were under treatment.
  16. Soleymani S, Abdul Rahman H, Lekhraj R, Mohd Zulkefli NA, Matinnia N
    Reprod Health, 2015;12:77.
    PMID: 26318873 DOI: 10.1186/s12978-015-0070-3
    BACKGROUND:
    The main sexual and reproductive health issues among young people are premarital sexual intercourse, unwanted pregnancies, unsafe abortions and sexually transmitted diseases including Human Immunodeficiency Virus. The aim of this study was to determine the knowledge related to sexual and reproductive health among Malaysian postgraduate students in a public university in Malaysia.

    METHODS:
    A cross-sectional study was carried out among postgraduate students by systematic random sampling technique. A pre-tested self administered questionnaire was used to collect the data.

    RESULTS:
    Out of 434 respondents, the majority of students were female (78.6 %) and single (78.3 %). The overall mean age of respondents was 27.0 ranging from 20 to 46 years of age. The main sources of information for sexual and reproductive health awareness were the internet (78.6 %) and newspaper (61.8 %). The majority (97.9 %) of the students knew that AIDS is a sexually transmitted disease. Most of them believed that the spread of sexually transmitted diseases was through shaking hands (92.1 %). Use of condoms was perceived to be the best way to avoid sexually transmitted diseases (88.4 %). Sexual and reproductive health knowledge was significantly associated with the students' age, marital status and faculty. The socio-demographic factors and current educational status accounted for a significant 9 % of the variability in sexual and reproductive health knowledge, f (7, 426) = 11, p <0.001.

    CONCLUSIONS:
    The postgraduate students' level of knowledge on sexual and reproductive health was not satisfactory. Sexual and reproductive health knowledge was associated with the students' marital status and faculty. Intervention programs related to sexual and reproductive health are recommended.
  17. Foo CN, Arumugam M, Lekhraj R, Lye MS, Mohd-Sidik S, Jamil Osman Z
    PMID: 32858791 DOI: 10.3390/ijerph17176179
    BACKGROUND: Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia.

    METHODS: A parallel-group unblinded randomized controlled trial involving 300 patients was conducted in two hospital orthopedics clinics in Malaysia. Patients were randomly assigned to receive cognitive behavioral-based group therapy (n = 150) or no further intervention (n = 150). The primary outcome was the change from baseline in knee pain as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 months. The data collected were analyzed by covariate-adjusted mixed design repeated measures analysis of variance. All analyses were performed under the terms of intention-to-treat.

    RESULTS: At 6 months, mean change from baseline in the KOOS knee pain score was 0.6 points (95% CI -1.73 to 2.94) in the control group and 8.9 points (95% CI 6.62 to 11.23) (denoting less knee pain intensity) in the intervention group (significant treatment effect p < 0.0001). Patients treated with such an approach also experienced significant improvement in functional ability when performing activities of daily living and had improved ability to cope with depression, anxiety and pain catastrophizing.

    CONCLUSION: The intervention module delivered by healthcare professionals had a sustained effect on knee OA pain and functionality over 6 months, thereby leading to an overall improvement in psychological well-being, thus benefitting most of the Malaysian knee OA patients.

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