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Health seeking behaviour of menopausal women with urinary incontinence in North east Malaysia

Yaacob LH, Abdul Mokti S, Muhammad J

J Women Aging, 2019 04 09;32(5):537-545.
PMID: 30967095 DOI: 10.1080/08952841.2019.1593799

Urinary incontinence (UI) is common in women in postmenopausal age, but many women delay seeking treatment. The objective of this study is to determine health-seeking behavior of postmenopausal women with UI and its associated factors. This is a cross-sectional study involving 348 postmenopausal women from the outpatient clinic using personal data forms and a validated UI questionnaire. A total of 348 menopausal women were involved in the study. Only 13.17% of patients with UI sought treatment. Factors associated with seeking treatment were age of menopause and severity of UI. More health education needs to be done among these patients.
Severe Dengue with Hemophagocytosis Syndrome

Ishak SH, Yaacob LH, Ishak A

Malays Fam Physician, 2020;15(1):47-49.
PMID: 32284805

Dengue is known to cause high morbidity and mortality worldwide. In recent years, there have been increasing cases of dengue fever associated with a rare complication: hemophagocytic syndrome (HPS), which is a dangerous disorder that carries high mortality. It is associated with infections, autoimmune disorders, and malignancies. Prolonged duration of fever and cytopenia together with multi-organ dysfunction out of proportion to the plasma leakage phase should alert clinicians to consider this condition. In this case study, we highlight a 45-year-old woman with underlying diabetes who was admitted due to dengue fever with warning signs. Her conditions deteriorated quickly: she had spontaneous bleeding, evidence of plasma leakage, severe hepatitis, and coagulopathy on the 11th day of illness. With the support of other blood results, such as raised serum ferritin and lactate dehydrogenase, she was diagnosed with severe dengue with hemophagocytosis syndrome. She responded well to intravenous dexamethasone and recovered on the 19th day of illness.
Fulltext Type 2 Diabetes Mellitus with HbJ trait: A management conundrum

Wan Yaacob WN, Yaacob LH, Draman N

Malays Fam Physician, 2022 Mar 28;17(1):86-89.
PMID: 35440968 DOI: 10.51866/cr1288

Optimal glycaemic control is crucial in patients with diabetes mellitus (DM) to avoid episodes of hypoglycaemia and both micro- and macrovascular complications. Diabetic control relies mainly on the evaluation of haemoglobin A1c (HbA1c), which is unfortunately unreliable in patients with haemoglobinopathies. This case report describes a patient with type 2 DM and haemoglobin J (HbJ) trait, which resulted in erratic HbA1c values throughout her follow-up. Other approaches, such as self-blood glucose monitoring, are needed to evaluate glycaemic control instead of relying on HbA1c alone to guide the management DM in these patients.
Fulltext Dumping syndrome after bariatric surgery in a pregnant woman: A case report

Cheah KL, Yaacob LH, Abdul Rahman R

Malays Fam Physician, 2023;18:24.
PMID: 37292225 DOI: 10.51866/cr.257

Dumping syndrome after bariatric surgery is common. However, it is rarely seen during pregnancy because patients are usually advised to avoid pregnancy immediately after surgery. This case highlights the importance of avoidance of pregnancy after bariatric surgery. We report a case of unplanned pregnancy in a 35-year-old woman with a history of subfertility for 8 years who conceived spontaneously 3 months after gastric bypass surgery. This occurred because there was no contraception offered to her after the procedure. The pregnancy was complicated with recurrent episodes of hypoglycaemia secondary to dumping syndrome. Primary care providers need to be vigilant and have a high index of suspicion for dumping syndrome in pregnant obese women who have undergone bariatric surgery.
Prevalence and associated factors of internet addiction among adolescents during the COVID-19 pandemic in Kota Bharu, Kelantan, Malaysia: A cross-sectional study

Sangaran LN, Kadir AA, Yaacob LH

Malays Fam Physician, 2024;19:59.
PMID: 39534764 DOI: 10.51866/oa.469

INTRODUCTION: The study aimed to determine the prevalence and associated factors of internet addiction (IA) among early adolescents during the COVID-19 pandemic in Kota Bharu, Kelantan, Malaysia.
METHODS: A cross-sectional online survey was conducted from February to April 2021 among adolescents in Kota Bharu, Kelantan. Participants completed the Malay Version of the Internet Addiction Test, the Depression, Anxiety and Stress Scale-21 and a sociodemographic information form. A multiple logistic regression analysis was performed to determine the associations between variables.
RESULTS: A total of 535 adolescents participated in this study. Among them, 65.9% were girls. The prevalence of IA among the participants was 48.6%. Male sex [adjusted odds ratio (AOR)=2.15, 95% confidence interval (CI)=1.30-3.57], internet usage at home (AOR=6.17, 95% CI=1.94-19.58), internet usage to watch/download music (AOR=2.50, 95% CI= 1.52-4.12), internet usage to engage in social networking (AOR=2.29, 95% CI=1.19-4.40), inadequate parental/guardian bonding (AOR=2.19, 95% CI=1.31-3.65), depression (AOR=2.03, 95% CI=1.07-3.85), anxiety (AOR=2.79, 95% CI=1.64-4.76) and stress (AOR=4.67, 95% CI=2.00-10.91) were significantly associated with IA.
CONCLUSION: IA was prevalent among Malaysian adolescents during the COVID-19 pandemic. Sex, internet usage profile and psychological factors were significant predictors of IA.
Fulltext Parental Knowledge on Thalassaemia and Factors Associated with Refusal to Screen Their Children

Mat MAC, Yaacob LH, Zakaria R

Malays J Med Sci, 2020 Feb;27(1):124-133.
PMID: 32158352 MyJurnal DOI: 10.21315/mjms2020.27.1.13

Introduction: Acceptance of a screening programme for thalassemia is important in managing the disease and its associated complications. The objective of this study was to determine the knowledge of thalassemia and factors associated with thalassemia screening refusal among parents of secondary school children.
Methods: This cross-sectional study was carried out from May 2017 to October 2017 among parents of fourth form students in three schools in Besut, Terengganu, Malaysia. Parents who are able to read and understand Malay and consented to the study were required to answer a validated questionnaire on their knowledge regarding thalassemia. They were also asked the reason for their acceptance or refusal of the thalassemia screening of their children.
Results: In total, 273 participants took part in the study. The mean thalassemia knowledge score was 11.8 out of a maximum score of 21. Low knowledge scores (adjusted odds ratio [adj OR] 0.87; 95% confidence interval [CI]: 0.79, 0.95; P = 0.002) and female sex (adj OR 2.60; 95% CI: 1.04, 6.53; P = 0.040) had significant associations with parental thalassemia screening refusal. The main reason for screening refusal was that parents perceived that their children were not at risk for the disease since they did not have a family member with thalassemia.
Conclusion: The mean thalassemia knowledge score among parents remains unsatisfactory. A high knowledge score is important since it is associated with parental acceptance of thalassemia screening for their children.
Knowledge of Pre-Pregnancy Care Among Men Attending the Outpatient Clinics of Hospital Universiti Sains Malaysia

Ishak SH, Yaacob LH, Ishak A

Malays J Med Sci, 2021 Apr;28(2):119-127.
PMID: 33958966 DOI: 10.21315/mjms2021.28.2.11

Background: Men's involvement in pre-pregnancy care is important to ensure a positive pregnancy outcome. The objective of this study is to determine the level of knowledge of pre-pregnancy care among men and the factors associated with poor knowledge.
Methods: This work is a cross-sectional study conducted at the outpatient clinics of Hospital Universiti Sains Malaysia involving 235 married men. A self-administered questionnaire was used and it consisted of four sections: socio-demographic data, reproductive characteristics of couples, clinical characteristics and knowledge of pre-pregnancy care.
Results: More than half of the men (51.9%) had poor knowledge of pre-pregnancy care, mostly on high-risk pregnancy, consequences of poor birth spacing and effect of maternal anaemia on a baby. The mean (SD) knowledge was 11.86 (3.85). Poor knowledge of pre-pregnancy care was significantly associated with age (adjusted odds ratio [AOR] = 0.96; 95% CI: 0.94, 0.99, P = 0.002) and education level (AOR = 2.61; 95% CI: 1.49, 4.57; P = 0.001).
Conclusion: The men in our study had poor knowledge of pre-pregnancy care. Further health promotion and education are needed to be focused on men to increase their knowledge and share the responsibilities in maternal health.
Fulltext Behind the Scenes of Parents Nurturing a Child with Autism: A Qualitative Study in Malaysia

Yaacob WNW, Yaacob LH, Muhamad R, Zulkifli MM

Int J Environ Res Public Health, 2021 08 12;18(16).
PMID: 34444280 DOI: 10.3390/ijerph18168532

Many parents have experienced difficulties in parenting children with autism. We, therefore, consider a more in-depth understanding that is necessary to explore the challenges facing parents and families to provide a better outcome for both. We interviewed 21 parents of 24 children with autism spectrum disorder (ASD) to qualitatively explore the challenges they experienced through a phenomenological framework. Four main aspects emerged as challenges to the parents: inadequate knowledge, psychological distress and stigma, lack of support, and barriers to services. These four themes reflect a lack of balance between the needs of caregivers and the services and resources or support available in the community to meet those needs. Our study contributes to an understanding of how parents perceive challenges, making it easier to take necessary action to meet their needs and ease their burden of stress. A concerted effort is needed to coordinate services across all disciplines to address these challenges.
Fulltext Traditional and complementary medicine use in knee osteoarthritis and its associated factors among patients in northeast peninsular Malaysia

Nik Shafii NAH, Yaacob LH, Ishak A, Kadir AA

Oman Med J, 2018 Mar;33(2):148-153.
PMID: 29657684 DOI: 10.5001/omj.2018.27

Objectives: We sought to determine the prevalence of traditional and complementary medicine (TCM) use for knee osteoarthritis and its associated factors among patients attending a referral hospital in an eastern coastal state of Malaysia.
Methods: This cross-sectional study included 214 patients with knee osteoarthritis. A universal sampling method was applied to patients who attended the outpatient clinic in Hospital Universiti Sains Malaysia from May 2013 to October 2013. Participants were given a questionnaire to determine their sociodemographic information and a validated Bahasa Malaysia version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). This questionnaire was used to assess the severity of knee osteoarthritis (i.e., pain, stiffness, and disturbances in daily activity).
Results: Over half (57.9%) of patients reported using TCM to treat knee osteoarthritis. Factors associated with TCM use were gender (odd ratio (OR) = 2.47; 95% confidence interval (CI): 1.28-4.77), duration of knee osteoarthritis (OR = 1.51; 95% CI: 1.03-2.23), and the severity of knee pain (OR = 2.56; 95% CI: 1.71-3.86).
Conclusions: The prevalence of TCM use among eastern Malaysian patients with knee osteoarthritis was high. Physicians caring for these patients should be aware of these findings so that inquiries regarding TCM use can be made and patients can be appropriately counseled.
Study site: Primary care clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Fulltext A Case Report of Steroid Withdrawal Syndrome

Wahab F, Rahman RA, Yaacob LH, Noor NM, Draman N

Korean J Fam Med, 2020 Sep;41(5):359-362.
PMID: 32961047 DOI: 10.4082/kjfm.18.0181

We report a case of steroid withdrawal syndrome in a 74-year-old woman who was suspected of having an occult exogenous Cushing's syndrome secondary to prolonged traditional complementary medicine use. She presented with non-specific symptoms of lethargy, malaise, and poor oral intake with weight loss for 1 month, and investigations showed suboptimal 9 AM cortisol level. She has responded well to steroid replacement.
Fulltext Predisposing Factors and Impact of Child Victimization: A Qualitative Study

Wahid Satar SNA, Norhayati MN, Sulaiman Z, Othman A, Yaacob LH, Nik Hazlina NH

Int J Environ Res Public Health, 2021 09 05;18(17).
PMID: 34501964 DOI: 10.3390/ijerph18179373

Sexual abuse of children is increasing at an alarming rate. This study aims to describe the risk factors and the effects of sexual abuse on children. This unobtrusive qualitative study was conducted on children aged 10 to 18 years old who experienced sexual abuse and followed-up at a psychiatric clinic between the years 2019 and 2021. The information from case records was transcribed. Thematic analysis was performed. Thirty case records were reviewed. The mean age of the victims was 14.6 years; 94% of the victims had experienced vaginal penetration, and 23% of the cases involved incest. The results indicated that socio-psychological predisposing factors involving family structure and dynamic dysfunction, low intrapersonal strength, social influence, and low family socioeconomic status could lead to sexual victimization. This sexual victimization can then lead to emotional turmoil, negative effects on cognitive, academic and social function, negative parental reactions toward the incident, the creation of baby-mother relationships and love-hate relationships, and a lack of goals and hope for the future. Children who experienced sexual abuse may show rape or pregnancy symptoms but may also show entirely non-specific ones. A thorough examination of their history, including biopsychosocial aspects, is necessary to appropriately care for them.
Fulltext Achievement of LDL Cholesterol Goal and Adherence to Statin by Diabetes Patients in Kelantan

Yudin ZM, Yaacob LH, Hassan NB, Ismail SB, Draman N, Yusoff SSM

Malays J Med Sci, 2017 May;24(3):44-50.
PMID: 28814932 MyJurnal DOI: 10.21315/mjms2016.24.3.6

BACKGROUND: Statins are a class of potent drugs that can be used to reduce cholesterol, especially low-density lipoprotein cholesterol (LDL-C). However, their effectiveness is limited if adherence to treatment is poor. The objectives of the study are to estimate the proportion of diabetic patient who has achieved LDL-C goal and to determine the association of LDL-C achievement with socio demographic factors and statin therapy adherence.

METHODS: This is a cross-sectional study involving 234 patients with type 2 diabetes mellitus (T2DM) and dyslipidaemia attending an outpatient clinic in a hospital in Kelantan. Interviews and self-administered questionnaires were used to determine their sociodemographic and clinical characteristics. Adherence to therapy was assessed using the Medication Compliance Questionnaire (MCQ). The associations between the achievement of LDL targets and sociodemographic/clinical factors, including adherence, were analysed with simple logistic regression.

RESULTS: About 37.6% of patients achieved their LDL-C target. The percentage of patients who adhered to statin use was 98.3%, and 20.5% of these patients reported full adherence. There was no significant association between achievement of LDL-C targets with adherence or any other sociodemographic factors, such as age, gender and educational or economic status (all P-value < 0.05).

CONCLUSION: Despite a high level of adherence, the majority of patients failed to achieve LDL-C targets. More concerted efforts are needed to improve this.

Study site: primary
care clinic in Hospital Universiti Sains Malaysia,
Fulltext Identification of psychosocial factors of noncompliance in hypertensive patients

Hassan NB, Hasanah CI, Foong K, Naing L, Awang R, Ismail SB, et al.

J Hum Hypertens, 2006 Jan;20(1):23-9.
PMID: 16177812 DOI: 10.1038/sj.jhh.1001930

This cross-sectional study was aimed to identify the predictors of medication noncompliance in hypertensive patients. The study was conducted at the Family Medicine Clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia, which is a university-based teaching hospital. All hypertensive patients aged 40 or over-registered from January to June 2004, who had been on treatment for at least 3 months, were screened. Previously validated self-administered questionnaires were used to assess the compliance and psychosocial factors. A total of 240 hypertensive patients were recruited in the study. Of these, 55.8% were noncompliant to medication. Logistic regression showed that age (adjusted odds ratio (OR): 0.96; 95% confidence interval (CI): 0.92-0.997; P: 0.035), patient satisfaction (adjusted OR: 0.97; 95% CI: 0.93-0.998; P: 0.036) and medication barrier (adjusted OR: 0.95; 95% CI: 0.91-0.987; P: 0.009) were significant predictors of medication noncompliance. Therefore, younger age, poor patient satisfaction and medication barrier were identified as independent psychosocial predictors of medication noncompliant in hypertensive patients.

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