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Fulltext The association between health literacy and quality of life and its associated factors among adults with type 2 diabetes mellitus in public primary care clinic

Shibraumalisi NA, Mat Nasir N, Md Yasin M, Isa MR

Journal of Clinical and Health Sciences, 2020;5(1):60-74.
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Introduction: Low health literacy (HL) is one of the contributing factors that leads to negative diabetic outcome. Quality of life (QOL) is a state of complete physical, mental and social wellbeing. There is limited evidence on association of HL and QOL among type 2 diabetes mellitus (T2DM), therefore the objectives of this study were to identify the HL and QOL status, to determine the association between HL and QOL and factors associated with QOL among T2DM patients.
Methods: This was a cross sectional study involving patients with T2DM from two public primary care clinics. HL and QOL were measured using translated and validated HLS – Asia Q16 and DQoL-BCI questionnaires respectively among T2DM patients.
Results: The mean HL score was 12.39 (3.34), 17.7 % had “inadequate HL”, 25.7% had “problematic HL” and 56.6% had “sufficient HL”. The mean DQoL-BCI score was 32.09 (6.51). Lower QOL level was negatively associated with age (b -0.140; CI: -0.190, - 0.090; p<0.001), not obese (b -1.476; CI: -2.605, - 0.347; p<0.011), and HL level (b -0.425; CI: -0.59, - 0.259; p<0.001). Lower QOL level was positively associated with uncontrolled glycaemic status (HbA1c >6.5%) (b 1.308; CI: -0.042, 2.659; p<0.058), treatment with insulin (b 4.163; CI:1.538, 6.788; p<0.002) and combination treatment of insulin and oral hypoglycaemic agents (OHA) (b 2.450; CI:1.145, 3.756; p<0.001).
Conclusions: This study demonstrated that age, body mass index, HL, glycaemic control, treatment with OHA and insulin were significantly associated with QOL. This suggest the importance of identifying high risk patients with poor QOL for targeted intervention.
KEYWORDS: Health Literacy, Quality of Life, Type 2 Diabetes Mellitus, Primary Care, Malaysia
Study site: Two public primary care clinics (klinik kesihatan), Gombak district, Selangor, Malaysia
Fulltext Isolated Pancreatic Tail Injury in Paediatrics; A Case Report and Literature Review

Al Kuddoos NM, Ismail AK, Shen KWC, Shibraumalisi NA, Yunus AY

Bull Emerg Trauma, 2020 Oct;8(4):249-252.
PMID: 33426141 DOI: 10.30476/beat.2020.85719

Pancreatic injury in paediatrics is a rare condition and can be difficult to diagnose. The diagnostic challenge is due to its symptom of vague abdominal pain which usually results in late presentation. Elevated biochemical markers such as amylase and lipase can aid in the evaluation of pancreatic injury, however, it is not specific and is only evident after several hours of trauma. Ultrasound is commonly used as a primary modality to evaluate abdominal organ injuries, but its role in detecting pancreatic injury is limited due to low sensitivity. High index of suspicion is needed to avoid undiagnosed pancreatic injury which could be lethal to children. We herein report a case of delayed presentation of isolated pancreatic tail injury in a child who was sufficiently diagnosed with ultrasound and treated conservatively. Proper initial assessment and diagnosis will allow appropriate management of pancreatic injury. Conservative management should include serial imaging to look at the evolution of pancreatic injury and detect complications such as pseudocyst or abscess formation.
Fulltext A Hidden Condition: Multiple Tarlov Cysts Unveiled in a Young Woman Seeking Primary Care for Debilitating Low Back Pain

Abu Hussain SM, Shibraumalisi NA, Miptah HN, Mohamad Ali ND, Yahaya MY, Ramli AS

Am J Case Rep, 2023 Jul 30;24:e940600.
PMID: 37516905 DOI: 10.12659/AJCR.940600

BACKGROUND Tarlov cysts are rare, with a prevalence of 3.3% in the Asian population, and symptomatic cases are even rarer. Here, we report a case of a young woman with multiple Tarlov cysts presenting in primary care with severe low back pain. CASE REPORT A 23-year-old Malay woman presented to a primary care clinic with sudden-onset, severe, and persistent low back pain for 1 week, affecting her activities of daily living (ADL), especially as a medical student, as she could not stand for more than 10 minutes. There were no other associated symptoms or recent trauma prior to the onset of back pain. Examinations revealed para-vertebrae muscle tenderness and restricted movements at the L4/L5 lumbosacral spine. A plain radiograph of the lumbosacral spine showed sclerosis and erosion of the right pedicle at the L4/L5 levels. Tuberculosis and haematological tests were normal. A lumbosacral MRI of the spine was ordered and the patient was urgently referred to the orthopaedic spine team. The MRI confirmed the diagnosis of multiple Tarlov cysts, with the dominant cyst located at the S2 level. Her symptoms and ADL improved with conservative management. She is being monitored closely by the orthopaedic team and primary care physician. CONCLUSIONS This case highlights red flag symptoms, ie, sudden-onset, severe, and persistent low back pain, that warrant further investigation. Tarlov cysts should be considered as a differential diagnosis. Close monitoring is vital and early surgical intervention is indicated if symptoms worsen, to prevent potential irreversible nerve damage.
Fulltext A Review of Polychlorinated Biphenyls (PCBs) Pollution in the Air: Where and How Much Are We Exposed to?

Othman N, Ismail Z, Selamat MI, Sheikh Abdul Kadir SH, Shibraumalisi NA

Int J Environ Res Public Health, 2022 Oct 26;19(21).
PMID: 36360801 DOI: 10.3390/ijerph192113923

Polychlorinated biphenyls (PCBs) were widely used in industrial and commercial applications, until they were banned in the late 1970s as a result of their significant environmental pollution. PCBs in the environment gained scientific interest because of their persistence and the potential threats they pose to humans. Traditionally, human exposure to PCBs was linked to dietary ingestion. Inhalational exposure to these contaminants is often overlooked. This review discusses the occurrence and distribution of PCBs in environmental matrices and their associated health impacts. Severe PCB contamination levels have been reported in e-waste recycling areas. The occurrence of high PCB levels, notably in urban and industrial areas, might result from extensive PCB use and intensive human activity. Furthermore, PCB contamination in the indoor environment is ten-fold higher than outdoors, which may present expose risk for humans through the inhalation of contaminated air or through the ingestion of dust. In such settings, the inhalation route may contribute significantly to PCB exposure. The data on human health effects due to PCB inhalation are scarce. More epidemiological studies should be performed to investigate the inhalation dose and response mechanism and to evaluate the health risks. Further studies should also evaluate the health impact of prolonged low-concentration PCB exposure.
Fulltext Self-system and mental health status among Malaysian youth attending higher educational institutions: A nationwide cross-sectional study

Mohd Azlan S, Mohamad F, Dahlan R, Ismail IZ, Kadir Shahar H, Kamaruddin KN, et al.

Malays Fam Physician, 2024;19:12.
PMID: 38496770 DOI: 10.51866/oa.34l

INTRODUCTION: Mental health disorders (MHDs) are a global health burden with an increasing prevalence. During the COVID-19 pandemic, depression was the commonest MHD, followed by anxiety and stress. This nationwide study aimed to determine the prevalence and associated factors of depression, anxiety and stress among Malaysian students attending higher educational institutions.
METHODS: A cross-sectional study was conducted from June to December 2021. Institutions were selected via stratified random sampling and students via convenience sampling. A self-administered questionnaire comprising questions on socio-demographic characteristics, academic background, substance abuse, childhood abuse, religiosity and the Depression Anxiety Stress Scale-21 was used. Data were analysed using SPSS version 27; descriptive, point-biserial correlation, chi-square and multiple binary logistic regression analyses were conducted.
RESULTS: Sex and adverse childhood experiences significantly predicted all three MHDs (P<0.05). The students from public institutions (odds ratio [OR]=0.71, 95% confidence interval [CI]=0.56-0.90, P=0.004) had a lower risk of depression than those from private institutions. The smokers/vapers (OR=1.43, 95% CI=1.02-2.02, P=0.041) a higher risk of depression than the non-smokers/non-vapers. The social science students (OR=1.29, 95% CI= 1.01-1.65, P=0.039) had a higher risk of anxiety than the science students. The students who highly engaged in organisational religious activity (OR=0.91, 95% CI=0.84-0.98, P=0.015) had a lower risk of anxiety than their counterparts.
CONCLUSION: Anxiety is the commonest MHD among Malaysian youth, followed by depression and stress. Childhood abuse is a crucial related factor requiring further attention. Screening, surveillance, preventive measures and comprehensive interventions for MHDs should be initiated among youth.
Fulltext Factors associated with usability of the EMPOWER-SUSTAIN Self-management mobile app© among individuals with cardiovascular risk factors in primary care

Abu Hussain SM, Miptah HN, Shibraumalisi NA, Mohamed-Yassin MS, Baharudin N, Badlishah-Sham SF, et al.

Digit Health, 2024;10:20552076241242795.
PMID: 38571876 DOI: 10.1177/20552076241242795

OBJECTIVE: This study aimed to determine the usability of the EMPOWER-SUSTAIN Self-Management Mobile App© and evaluate the factors associated with its usability among patients with cardiovascular risk factors in primary care.
METHODOLOGY: This was a cross-sectional study, conducted among patients aged ≥ 18 years with cardiovascular risk factors attending a university primary care clinic. Patients were given the app to use for at least three months. Those who fulfilled the eligibility criteria were recruited. Data gathered were on sociodemographic, clinical characteristics, self-management support by doctors, utilisation of the app at home and social support in using the app. The previously translated and validated Malay version of the mHealth App Usability Questionnaire was used to measure usability. The mean usability score was calculated and linear regressions analysis was conducted to determine the factors associated with the usability of the app.
RESULTS: A total of 247 patients with at least one cardiovascular risk factor(s) were recruited. The mean age was 60.2 (±8.2). The majority were Malays (86.2%) and half of them were males (52.2%). The total mean (±SD) usability score was 5.26 (±0.67) indicating a high usability of the app. Usability of the app declined with increasing age in the simple linear regressions analysis. The multiple linear regressions yielded that being Malay (b = 0.31, 95% CI 0.08,0.54), using the app at home to understand their medications (b = 0.33, 95% CI 0.12,0.53) and having social support from family members and friends (b = 0.28, 95% CI 0.07,0.49) were significantly associated with higher usability of the app.
CONCLUSION: The usability of the EMPOWER-SUSTAIN Self-Management Mobile App© was high among patients with cardiovascular risk factors in our primary care clinic. This finding supports the widespread use of this app among our patients. Involvement of family members and friends should be encouraged to improve the usability of the app.