Tag: pubmed

J Cosmet Dermatol. 2025 Apr;24(4):e70132. doi: 10.1111/jocd.70132.

ABSTRACT

BACKGROUND: Hormonal, metabolic, and immunologic factors may cause several skin changes during pregnancy. Therefore, it is important for pregnant women to be aware of these expected changes in their skin appearance in order to prevent unwanted effects and to choose the appropriate preventive or treatment measures via trustable sources of information.

OBJECTIVE: This study would highlight the most common normal and abnormal physiological skin changes mothers usually complain about before or after pregnancy. The most commonly used skin care products, their sources of knowledge, information, perception, and experiences on these problems and products were also considered. In addition, patient satisfaction levels and their sources and types of knowledge were also investigated.

METHODS: Across sectional survey was distributed among women who met the inclusion criteria and were citizens in the Hashimate Kingdom of Jordan. This survey was composed of a number of questions used for investigating participant’s socio-demographic characteristics, during and post-pregnancy characteristics and medications used, comparison of skin related complains reported by these women, in addition to their use of skin care products. Women’s knowledge, perception, and experience regarding their use of skin care products were also included.

RESULTS: Of the 337 participants in this study, 6.5% and 6.8% of women were using thyroid medications and antihypertensive agents. An increase of around 3% in pregnancy-related skin changes, such as hyperpigmentation, hair loss, cellulite, and wrinkles, was predominant among women. Despite the prevalence of hyperpigmentation, only 4% and 17% of women used depigmentation and sunblock products. Moreover, women declare that their information about the use of skin care products was mainly via social media or self-experience. A low rate of consultation with dermatologists and the reliance on self-diagnosis or non-professional advice were shown.

CONCLUSION: This study suggests a lack of awareness about effective preventive measures for skin-related disorders commonly occurring during pregnancy, potentially exacerbated by reliance on unverified sources of information, such as social media. Therefore, incorporating education about skin changes into routine prenatal care could empower women to make informed decisions and reduce the stigma associated with these changes.

PMID:40145230 | DOI:10.1111/jocd.70132

Disaster Med Public Health Prep. 2025 Mar 27;19:e71. doi: 10.1017/dmp.2025.78.

ABSTRACT

OBJECTIVE: Increase bleeding control knowledge and self-efficacy among middle school students and determine efficacy of health care student-led Stop the Bleed (STB) training.

METHODS: An interprofessional group of health care students led STB trainings at 6 Texas middle schools. Trainings included a presentation plus hands-on skills training and were evaluated using pre- and post-training surveys focused on bleeding control knowledge, self-efficacy, and willingness to assist in emergencies. Paired pre- and post-training survey responses were compared using McNemar’s test for knowledge-based questions and paired t tests for Likert scale responses.

RESULTS: Health care students (N = 103) trained 805 middle school students, aged 10-16 years, of which 447 (55.5%) completed pre- and post-surveys. There was significant improvement in all 7 knowledge-based questions from pre- to post-training. There were significant improvements in comfort using tourniquets (median [interquartile range]: 3 [2-4] vs. 4 [3-5]; P < 0.0001), confidence applying direct pressure (3 [2-4] vs. 4 [3-5]; P < 0.0001), and likeliness to assist someone bleeding (4 [3-5] vs. 4 [4-5]; P = 0.0096). Eighty-four percent of students found this training “useful.”

CONCLUSIONS: While previous studies have demonstrated STB training efficacy, this is among the first to provide evidence that health care student-led STB training significantly increased bleeding control knowledge and self-efficacy among middle school students.

PMID:40145198 | DOI:10.1017/dmp.2025.78

Disaster Med Public Health Prep. 2025 Mar 27;19:e73. doi: 10.1017/dmp.2025.76.

ABSTRACT

The devastating effects of heatwaves and the deficiencies in current response strategies disproportionately affect specific individuals and populations,^1,2 underscoring the urgent need for effective solutions. Lessons from past heat events emphasise the importance of preparedness and effective response strategies.² Understanding the dangers of heatwaves involves recognizing not only individual health impacts but also broader environmental and societal consequences.³ Heat-related illnesses, such as heat exhaustion and heatstroke, can be fatal but are preventable.².

PMID:40145173 | DOI:10.1017/dmp.2025.76

Med J Malaysia. 2025 Mar;80(2):266-274.

ABSTRACT

INTRODUCTION: Stroke is a leading cause of death and disability in Malaysia. This paper provides an overview of the stroke burden, hyperacute stroke services, importance, and challenges of stroke registries. It also details findings from the National Stroke Registry (NSR) Malaysia that have advanced knowledge on local patterns, inequalities and temporal trends in stroke presentation, care processes and outcomes.

MATERIALS AND METHODS: A recent survey that involved all the government (Ministry of Health, MOH) and university hospitals in Malaysia was conducted by a group of neurologists and researchers to provide insights into the hyperacute stroke services in Malaysia from 2012 to 2023.

RESULTS: The results from the survey found that out of 142 MOH hospitals, 29 (20%) hospitals offer only intravenous thrombolysis (IVT) service, and seven (5%) hospitals offer both IVT and mechanical thrombectomy (MT) services. The majority or two-thirds of MOH hospitals still offer office hour services for both IVT and MT. For university hospitals, four (67%) out of six university hospitals provide both IVT and MT services and one (16%) university hospital provides only IVT service. Most university hospitals offer 24-hour services for IVT and MT. The availability of IVT service across MOH hospitals has increased significantly from 2012 to 2023. Thus, there was a substantial increase in the number of IVT cases treated in MOH hospitals. The growth in MT service has been more gradual. Only 22% of the MOH hospitals that provide hyperacute stroke services are equipped with acute stroke unit (ASU). Whereas ASU is available in 80% of the university hospitals that offer hyperacute stroke services. The higher availability of ASU in university hospitals compared to MOH hospitals may be due to better resources, specialised expertise, and advanced facilities in the university hospitals. The National Stroke Registry (NSR) Malaysia was established in 2009 to monitor stroke management practices, patient outcomes and promote quality improvement initiatives.

CONCLUSION: Despite suboptimal adherence on several key performance indicators, the NSR reports recent improvements in thrombolysis rates, reduced mortality, and better functional outcomes. Key recommendations center on promoting greater participation, feedback systems, adequate funding, and governance structures to translate registry findings into national policies and targeted interventions for equitable access to quality stroke care.

PMID:40145171

Med J Malaysia. 2025 Mar;80(2):235-244.

ABSTRACT

INTRODUCTION: To determine the frequency of computer vision syndromes among students during COVID-19 lockdown in Malaysia.

MATERIALS AND METHODS: This is a cross-sectional survey study. A total of 145 subjects studied in secondary school and pre-university programme were involved in this study. An exploratory survey questionnaire was used to assess the symptoms of computer vision syndromes encountered by the students and their electronic device usage behavior before and during fully remote learning started.

RESULTS: Average time spent by students on outdoor activities reduced from one to two hours per day (40.7%) to less than an hour per day (56.6%) after fully remote learning. Average time spent on entertainment activities using electronic devices increased from one to two hours per day (38.6%) to four hours and above per day (40.0%) after fully remote learning. The majority of time spent on school assignments using electronic devices increased from one to two hours (44.8%) to three to four hours per day (33.8%) after fully remote learning. Increased frequency of students experienced eye pain (44.1%), eye fatigue (57.2%), headache (56.6%), eye itchiness (18.6%), glare (31.7%), dry eye (40.0%), blurry vision (31.7%) and double vision (7.6%) after fully remote learning began.

CONCLUSION: An observed increase frequency of computer vision syndrome was noted in relation to the reduction of time spent on outdoor activities and increased usage of electronic devices for entertainment activities and completing school assignment during COVID-19 lockdown in Malaysia.

PMID:40145168

Med J Malaysia. 2025 Mar;80(2):206-211.

ABSTRACT

INTRODUCTION: To evaluate if the Intensive Course in Obstetric Emergencies (ICOE) Shoulder dystocia simulation training module could improve psychomotor and cognitive skills in the management of shoulder dystocia using a Test of Integrated Professional Skills (TIPS).

MATERIALS AND METHOD: This was a prospective observational study involving Malaysian health care professionals participating in ICOE shoulder dystocia simulation, where standardized curriculum was used. Pre and post-test skills assessment were conducted to evaluate the effectiveness of the course content and delivery.

RESULTS: 609 Malaysian health care professionals attended ICOE training; 400 midwives, 128 medical officers, 55 specialist and 26 consultants. Participants were derived from 25 consecutive courses, from 2014 to 2019 and tested on predetermined skills in the management of shoulder dystocia. Their mean TIPS pre-test vs post-test score were (2.55 vs 6.77) midwives, (3.78 vs 7.25) medical officers, (5.16 vs 7.82) specialists & (3.62 vs 6.88) consultants. All four group of participants showed statistically significant improvement (51-165%) in their skills (p<0.001). The mean post test score in noting time of dystocia and call for help were significantly higher among midwives than others. All four groups statistically improved their delivery skills in McRoberts manoeuvre and directed suprapubic pressure. Pre-skills for delivery of the posterior arm was suboptimal and post skills test showed statistically significant improvement in all four groups.

CONCLUSION: ICOE shoulder dystocia simulation training module improved the psychomotor and cognitive skills in the management of delivery of shoulder dystocia.

PMID:40145164

Med J Malaysia. 2025 Mar;80(2):199-205.

ABSTRACT

INTRODUCTION: Cardiopulmonary resuscitation (CPR) is indeed a basic skill that should be acquired by everyone in the community. Early CPR is an important element in the chain of survival and home-based child daycare (HBCD) caregivers play a vital role as early responders in case of out-of-hospital cardiac arrest (OHCA). The study aims to determine the level of knowledge and attitude of CPR among HBCD caregivers in Kelantan and the factors that contribute to them. This study covers a research gap in Kelantan, Malaysia, evaluating HBCD caregivers’ knowledge and attitudes towards CPR.

MATERIALS AND METHODS: This was a quantitative crosssectional study conducted from November 2020 until March 2021 which involves 139 HBCD caregivers in Kelantan. Validated questionnaire was used which consisted of 27 questions based on demography, knowledge and attitude towards CPR. The data was keyed in and analysed using software SPSS version 26.

RESULTS: A total of 139 respondents participated in the study. The mean attitude score obtained by the caregivers was 16.67 with SD = 4.22. There were 89 caregivers (64%) with poor knowledge among the 139 HBCD caregivers in the study compared to 50 HBCD caregivers (36%) who had good knowledge. Caregivers who were exposed with CPR training had 5.91 higher odds of having good CPR knowledge compared to those without being exposed to CPR training (Wald-statistic (df) = 21.12 (1), OR (95% CI) = 5.91 (2.77, 12.61), p<0.001). Caregivers with experience in handling CPR were 5.91 of higher odds in having good CPR knowledge compared to those without the experience in handling CPR when adjusted for the duration of caregiver’s experience (Wald-statistic (df) = 21.12 (1), OR (95% CI) = 5.91 (2.77, 12.61), p<0.001). HBCD caregivers’ experience was the only variable that had a significant p-value when tested in the regression model (p = 0.023).

CONCLUSION: The findings revealed that HBCD caregivers in Kelantan had inadequate CPR knowledge, potentially increasing the risk of OHCA. Planned and regular training for them is mandatory. Exposure to CPR was the associated factor that contributes to knowledge level among HBCD caregivers whereas years of experience as HBCD caregivers influence attitude towards CPR.

PMID:40145163

Med J Malaysia. 2025 Mar;80(2):191-198.

ABSTRACT

INTRODUCTION: Statins are one of the most commonly used drugs in primary care. Both hyperlipidaemia and diabetes have independently shown statistically significant association with depression. Conversely, patients with depression have also been shown to have increased comorbidity with and poorer control of both diabetes and hyperlipidaemia.

MATERIALS AND METHODS: A retrospective cross-sectional study was conducted for about 7 months (from 23 January 2024 to 9 August 2024) among adult Type 2 diabetic patients in the non-communicable disease section of Seremban Health Clinic to determine the association between statin use and depression. The data was collected via interviewerguided questionnaire that consisted of 5 sections: Section A (Participant Information), Section B (Depression, Anxiety and Stress Scale 21 [DASS-21]), Section C (Beliefs about Medicines Questionnaire [BMQ]), Section D (Malaysia Medication Adherence Assessment Tool [MyMAAT]) and Section E (Patient Health Questionnaire-9 [PHQ-9]). Consecutive patients that met inclusion and exclusion criteria who consent to be involved in the study were sampled. Although the ideal sample size that was required is 242, only 82 participants were enrolled in this study. These participants were also part of the Seremban Diabetes cohort study.

RESULTS: Since only 82 participants consented to be part of this study, the response rate was 33.9%. About 25% of patients had depression. As the statin dosage intensity increased, the prevalence of depression also increased but this was not statistically significant. Based on Pearson’s chi square test, only stress (p<0.001), anxiety (p=0.002), beliefs about medicines (p=0.010) and marital status (p=0.039) had a statistically significant association with depression. Upon adjusted logistic regression of the 4 factors (marital status, stress, anxiety and belief about medicines), only stress (OR 14.000, 95% CI 2.682 – 73.076, p=0.002) was statistically significant.

CONCLUSION: The association between depression and statin use among patients with Type 2 diabetes mellitus is not statistically significant. Further studies are needed to confirm the cause of depression in this group of patients.

PMID:40145162

Med J Malaysia. 2025 Mar;80(2):183-190.

ABSTRACT

INTRODUCTION: Young adults’ engagement in sexual risk behaviour (SRB) is a growing concern worldwide. Addressing this issue is crucial as it can lead to various detrimental effects on individuals, including psychological, behavioural, and, in severe cases, suicidal tendencies and mortality. This nationwide study aimed to determine the mediating roles of depressive, anxiety, and stress symptoms in the relationship between adverse childhood experiences (ACE), religiosity, knowledge on sexuality, attitude towards premarital sex, and SRB among young Malaysian adults using structural equation modelling (SEM).

MATERIALS AND METHODS: A quantitative, cross-sectional design was employed in this study. Respondents were recruited from June to December 2021 among students attending higher education institutions in Malaysia. Institutions were sampled using stratified random sampling and the respondents were selected via convenience sampling. Data were collected via an online survey that inquired about respondents’ socio-demographic characteristics, ACE, religiosity, knowledge on sexuality, attitude towards premarital sex, mental health status (MHS), and engagement in SRB. The data were analysed using SPSS version 27 for descriptive analysis, and SPSS AMOS version 27 for structural equation modelling (SEM) analysis.

RESULTS: A total of 1171 respondents were recruited in this study. From the SEM analysis, the proposed model indicated a good fit, and it explained 26% of the SRB variance. There was a partial mediation effect of the relationship between ACE on SRB through MHS (p<0.05), as well as religiosity on SRB through MHS (p<0.05). There was no significant mediation effect was found for the other variables.

CONCLUSION: This study highlighted the mediation effect of MHS between ACE on SRB, as well as between religiosity and SRB. Apart from addressing ACE and religiosity of the young adults, MHS should also need to be explored when dealing with SRB issues and vice versa. Preventive measures should be considered at younger stage to prevent high risk behaviour among young adults.

PMID:40145161

Med J Malaysia. 2025 Mar;80(2):161-167.

ABSTRACT

INTRODUCTION: Dengue is a major public health issue, with 3,900,000 people living in 129 dengue-endemic countries globally facing a risk of contracting dengue fever. Dengue incidence in Sabah is among the highest in Malaysia. In 2022, Kota Kinabalu District reported 22% of the total number of dengue cases in Sabah. The objective of this study was to develop a prediction model for dengue incidence using meteorological, entomological, and environmental parameters in Kota Kinabalu, Sabah.

MATERIALS AND METHODS: An ecological study was conducted from 2016 to 2021 using the dengue database and meteorological data. The forecasting model for dengue incidence was performed with R software using the seasonal autoregressive integrated moving average (SARIMA) model. The model was fitted based on the reported weekly incidence of dengue from 2016 to 2020 and validated using data collected between January and December 2021.

RESULTS: SARIMA (1,1,1) (1,1,0)52 with the external regressor maximal temperature, Aedes index, and vacant lot were the models with minimal measurement errors, as indicated by the Mean Absolute Error (MAE) values of 3.04, Root Mean Squared Error (RMSE) of 4.43, and Akaike Information Criterion (AIC) of 1354.82.

CONCLUSIONS: The predicted values in 2021 accurately forecasted the capability to serve as an early warning system for proactive dengue measures. This information is deemed valuable to healthcare administrators for enhancing the level of preparedness.

PMID:40145157