PURPOSE: TO DETERMINE: (i) the mammographic parenchymal patterns in Malaysian women and whether the breasts are dense on mammogram; (ii) the effect of age on breast density; (iii) the effect of parity on breast density; (iv) the difference in breast parenchymal patterns among the major races of women in Malaysia.
METHODS: This was a descriptive cross-sectional study of 1,784 patients (981 Malays, 571 Chinese, 214 Indians and 18 others) who had undergone mammography during the 1-year study period. Majority of women (41.7%) were aged between 51 and 60 years and majority (43%) had 3-4 children. The Tabar classification (Pattern I - V) was used to evaluate breast parenchymal patterns on mammogram. Tabar Pattern I was further divided into 3 sub-groups (Pattern IA, IB, and IC). The different patterns were then grouped into dense (IB, IC, IV, V) and not dense (IA, II, III) breasts. The SPSS package was used for statistical analysis.
RESULTS: Majority (59%) of Malaysian women had dense breasts (Pattern IB 29%, IC 20%, IV 5%, and V 5%) and 41% did not have dense breasts (Pattern IA 28%, II 6%, and III 7%). Age and parity were inversely related to breast density (p < 0.0001). Chinese women (65.7%) had the highest percentage of dense breasts (p = 0.69, odds ratio = 1.22), followed by the Indians (57.2%) and the Malays (50.5%).
CONCLUSION: Majority of women had dense breasts but Pattern IV, which has been associated with increased risk of breast cancer, was seen in only 5% of the women. The breast density reduced steadily with increasing age and parity. There was no statistically significant difference in breast density in the three main races.
KEYWORDS: Mammography; breast density; breast parenchymal patterns
Globally, the prevalence of diabetes mellitus and the average life expectancy is on the rise. As diabetes mellitus is commonly associated with old age, it is very important to ensure good glucose control to reduce complications and improve quality of life. A cross sectional study was conducted among elderly diabetics in Kulim with the aim to determine the prevalence of glucose control and its associated factors. Three hundred and twenty nine respondents were chosen through stratified random sampling in all the seven health clinics in Kulim. Respondents were interviewed personally using a structured questionnaire. HbA1c level of 6.5% and below was considered as good glucose control. Prevalence of good glucose control was 22.5%. Being male (Adjusted prevalence odds ratio, APOR = 1.75, 95% CI: 1.02-3.00), age of 70 years and above (APOR = 2.48, 95% CI: 1.40-4.39) and duration of diabetes less than five years (APOR = 2.10, 95% CI:1.21-3.64 ) were found to have significant association with good glucose control. As a conclusion, this study showed that the low prevalence of good glucose control was determined by gender, age and duration of illness.
Introduction : Social problems among adolescents are on the increasing trend. Their involvement in different kinds of high risk behaviours could lead them into juvenile delinquency. Early adolescence is the stage where they are easily influenced. However, this is the period where they should be captured for health prevention enhancement.
Objectives : A cross-sectional study was carried out to identify factors associated with risk taking behaviours involving form one adolescents in selected secondary schools in Johor Bharu.
Methods : Using self administered questionnaires, a total of 280 respondents were recruited via multi-stage sampling.
Results : The prevalence of risk taking behaviour among respondents was 66.8%. Going to video games and karaoke centres was the most popular risk taking behaviour (46.8%) to be followed by truancy (30.7%). Among all the factors studied, being male (AOR=4.5, 95% CI 2.39-8.4), Malay (AOR=7.5, 95% CI 3.30-17.19), and having negative perception towards teachers (AOR 0.3, 95% CI 0.16-0.65) were risk factors for such behaviour among respondents. However, coming from an intact family (AOR=0.1), 95% CI 0.02-0.47) was found to be protective against risk taking behaviour.
Conclusion : Intact family structure and having positive perception towards teachers were found to be protective against risk taking behaviours among adolescents.
Depressive illness is common among the aged population. A case control study was conducted, focusing on risk factors influencing depression among the elderly. This study involved 130 elderly patients diagnosed to have depressive illness from the psychiatric clinics of Kuala Lumpur Hospital (HKL) and Universiti Kebangsaan Malaysia Hospital (HUKM). Another group of 130 elderly patients with no history of depressive illness were recruited from the medical specialist clinics. The majority of cases were female (75.4%), aged 60-74 years (92.3%) and from Chinese ethnic group (59.2%). Non-Malay elderly has three times risk (AOR 2.537, 95% CI 1.439-4.471) of suffering the depressive illness compared to the Malay elderly, the elderly with chronic health problems are more likely to be depressed compared to those who do not suffer from any chronic illness (p trend <0.001). Other risk factors identified were family history of depression with four times risk (AOR 4.225, 95% CI 2.017-8.848) and lower social support with eight times risk (AOR 7.949, 95% CI 2.588-24.417). Social support is not only important in encouraging the elderly to practice healthy life style but proven to influence the risk of getting depression among them. Hence, it is very crucial that the elderly is given total attention, respect and love from all parties to ensure prosperity and meaningfulness in life.
Introduction: Anemia in pregnancy is still a public health problem in developing countries including Malaysia. Early screening of pregnant mothers who have risk factors of anemia could help identifying these potential anemic mothers and hence targeted for intervention.
Methodology: A cross sectional study IN 2008 was conducted among pregnant women who attended government health clinics in Johor Bahru district to assess the prevalence of anemia in pregnancy and factors associated with it using a structured questionnaire.
Result: Prevalence of anemia in pregnancy (Hb<11.0 g/dl) was 36.6% and majority in mild category (Hb 9-<11 g/dl). The associated factors of anemia in pregnancy were birth spacing, dietary intake with high iron content and iron pill consumption. Multivariate analyses revealed that iron pill intake was the most important factor influencing anemia in pregnancy.
Discussion and conclusion: Even though Johor Bahru is a big town with good health facilities, the prevalence of anemia in pregnancy was quite high. Results were compared with previous studies. Emphasis on compliance to iron pills is very important in prevention and treating anemia in pregnancy
Key Words: anemia in pregnancy, birth spacing and iron pill intake
Study site: Four urban and two rural klinik kesihatan, Johor, Malaysia
Delay in help-seeking behaviour which is potentially preventable has a major effect on the prognosis and survival of patients with breast cancer. The objective of this study was to explore reasons for delay in seeking help among patients with breast cancer from the East Coast of peninsular Malaysia. A qualitative study using face- to-face in-depth interview was carried out involving 12 breast cancer patients who had been histo-pathologically confirmed and were symptomatic on presentation. Respondents were selected purposely based on their history of delayed consultation, diagnosis or treatment. All were of Malay ethnicity and the age range was 26-67 years. Three were in stage ll, seven in stage lll and two in stage lV. At the time of interview, all except one respondent had accepted treatment. The range of consultation time was 0.2-72.2 months with a median of 1.7 months, diagnosis time was 1.4-95.8 months( median 5.4 months )and treatment time was 0-33.3 months (median 1.2 months). The themes derived from the study were poor knowledge or awareness of breast cancer, fear of cancer consequences, beliefs in complementary alternative medicine, sanction by others, other priorities, denial of disease, attitude of wait and see and health care system weakness. Help-seeking behaviour was influenced by a complex interaction of cognitive, environmental, beliefs, culture and psycho-social factors. Breast cancer awareness and psychological counselling are recommended for all patients with breast symptoms to prevent delay in seeking clinical help.
Breast cancer is the leading cause of cancer mortality among women in Malaysia. Delayed diagnosis is preventable and has major effects on patients' prognosis and survival. The objectives of our study were to identify the magnitude of delayed diagnosis and its associated factors in women with breast cancer in Malaysia.