MEDICINE & Health: abstract of. The Official Journal of The Faculty of Medicine UKM. Volume 2, Number 1, June, ISSN

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1 abstract of MEDICINE & Health: The Official Journal of The Faculty of Medicine UKM Volume 2, Number 1, June, ISSN UKM Medical Centre Library Volume 2, Number 1 - June,

2 table of contents REVIEW ARTICLE Hepatitis B virus genotypes and mutations affecting HBeAg production: a Malaysian perspective. Chee Kent Lim and So Har Ton ORIGINAL ARTICLES Normograms of ovarian volume, uterine size and endometrial thickness in urban midlife Malaysia women. Adeeb N, Nur-Azurah AG, Ong FB, Seri SS, Shamsuddin K, and Noor-aini MY. Female sexual dysfunction among Malaysian women in a primary care setting : does the frequency of sexual activity matter?. Hatta Sidi, Sharifah Ezat Wan Puteh, Marhani Midin, and Norni Abdullah. = Anxiety and depression among patients before and after Percutaneous coronary intervention (PCI) at National Heart Institute. Ho Siew Eng, Syed Zulkifli Syed, Lexshimi R. Gopal, Hamidah Hassan, Santna Lecthmi, Teoh Koi Hong, Razali Omar, and Hanida Mokhtar. Dysmenorrhoea and its effect on school activities among adolescent girls in a rural school in Selangor, Malaysia. I Liliwati, LKM Verna and O Khairani. Prevalence and reason for smoking among upper secondary schoolboys in Hulu Langat, Malaysia. Khairani O, Norazua R, and Zaiton A. Fine needle aspiration (FNA) cytology of the thyroid: a cyto-histopathological study of 361 cases in Hospital Universiti Kebangsaan Malaysia. Nurismah MI, Sharifah NA, Usama AE, Rohaizak M, and Naqiyah Ibrahim. A study on anxiety and depression level among high risk inpatient pregnant women in an obstetric ward. Raja Lexshimi RG, Rohani Mamat, and Syed Zulkifli Syed. Sharps injury in Hospital Universiti Kebangsaan Malaysia (HUKM): experiences of health care workers and students. Santhna Letchumi Panduragan, Samsiah Mat, Raja Lexshimi RG, Roshdinom Razali, Ho Siew Eng, and Hamidah Hassan. Work stress prevalence among the management staff in an International Tobacco Company in Malaysia. WF Swee, Anza E, and Noor Hassim I. CASE REPORTS Kimura s diseases mimicking hodgkin s lymphorma: an unusual cause of parotid swelling. V Shanty, S-A-W Fadilah, and As Goh. Volume 2, Number 1 - June,

3 REVIEW ARTICLE Chee Kent Lim and So Har Ton. (2007). Hepatitis B virus genotypes and mutations affecting HBeAg production: a Malaysian perspective. Medicine & Health, v2 (1), Infection by hepatitis B virus (HBV) is a major global health-care problem. HBV is an accepted factor in the elevated risks for liver disease such as cirrhosis and development of hepatocellular carcinoma. This problem is particularly prevalent in the Asia-Pacific region which includes Malaysia. During infection, the hepatitis B e antigen (HBeAG) is produced in the hosts. This antigen is an important serological marker for diagnosing chronic hepatitis B. Seroconversion to antibody (antihbe) corresponds to the improvement of disease prognosis. However, certain mutations such as the core promoter dual mutations (A 1762 G 1764 to T1762 A 1764 ), the codon 15 variants (C1858 / T1858) and the precore stop codon mutations (TGG to TAG) can affect the HBeAG expression. This has diagnostic and clinical implications. Besides that, the HBV can be grouped into eight genotypes (A to H). Moreover, genotypic subtypes and recombinants have been observes as well. Studies have observed that these can differ in their affiliations with the mutations above as well as with disease prognosis. ORIGINAL ARTICLES Adeeb N, Nur-Azurah AG, Ong FB, Seri SS, Shamsuddin K, and Noor-aini MY. (2007). Normograms of ovarian volume, uterine size and endometrial thickness in urban midlife Malaysia women. Medicine & Health, v2 (1), Cancers of the ovary and corpus uteri afflict 5% and 3.6% Malaysian women respectively. Ovarian cancer (OC) remained the deadliest gynaecological malignancy in perimenopausal women mainly due to the lack of symptoms until the disease had spread. Ultrasonography could provide a preliminary screening allowing the clinician to tailor subsequent management and counseling for these women. To support the basis for selective screening, a study on 517 urban disease free women aged 45 years and above, uterus-intact, non-users of HRT was undertaken. This study presented Normograms of ovary, uterus, and endometrium derived from entry ultrasound assessment. The sample comprised of years old. Over two thirds were Chinese followed by Malays and Indians. The findings indicated that the average uterine size and endometrial thickness (ET) was x cm and mm respectively. Premenopausal women had larger uterus compared to those postmenopausal (p<0.0005), showing a gradual decreased with age. Early postmenopausal women demonstrated ET of <5mm, eventually reaching 2mm in women >70 years old. From these findings, a cut-off of <5.0mm was considered clinically acceptable in normal postmenopaused regardless of ethnicity. Likewise, mean ET in the premenopaused was thicker than the postmenopaused (p<0.0005) showing a gradual decrease with age. Early postmenopausal women demonstrated ET of <5mm, eventually reaching 2 mm in women > 70 years old. From these findings, a cut-off of <5.0mm was considered clinically acceptable in normal postmenopaused regardless of ethnicity. Nearly one fifth (18.9%) had uterine fibroids, a quarter (25%) in Premenopausal women as compared to 10% postmenopaused (p<0.0005). the mean right and left ovarian volume (OV) was cm³ and cm³ respectively. There was a gradual decline in OV with age and menopause from about 7cm³ at age years to less than 1.5cm³ at 70 years giving a clinical norm OV of <7.5³ and 3.5³ respectively in pre and postmenopausal Malaysian women. Begin ovarian cysts seen in 2.9% had a mean size of cm³. In conclusion, ET and OV Normograms should be available for the Malaysian population to facilitate screening gynaecological malignancies. Hatta Sidi, Sharifah Ezat Wan Puteh, Marhani Midin, and Norni Abdullah. (2007). Female sexual dysfunction among Malaysian women in a primary care setting : does the frequency of sexual activity matter?. Medicine & Health, v2 (1), The aim of the study was to compare sexual functioning among Malaysian women in a primary care setting between those with a low and high frequency sexual intercourse. Across-sectional study on 230 marries Malaysian women in a primary-care setting was conducted at the Bandar Tun Razak Clinic, Cheras. A validated Malay version of Female Sexual Function Index questionnaire (MVFSFI) was used to access the sexual functioning profile among women with low and high sexual activity. The percentage of women who had sexual intercourse 3-4 times a week. 1-2 times a week and < 1-2 times a month were 13.4%, 44.3 % and 42.4% respectively. Women with a low frequency of sexual intercourse (Low SI) tended to suffer from more sexual dysfunction, (X² = 28.98, p < 0.001) compared to those with a high frequency of sexual intercourse (High SI) group. Women who were less sexually active (having low frequency intercourse, ie. < 1-2 times per week) were found to be less sexually aroused (X² = 25.9, p<0.001), less orgasmic (X² = 19.8, p<0.001), less lubricated during sexual activity (X² = 11.1, p< 0.001), complain of sexual pain (X² = 4.3, p =0.033) and feels satisfied sexually (X² = 12.6, p< 0.001). the problem of female sexual dysfunction (FSD) in the Malaysian primary care population with low sexual activity needs to be addressed. Volume 2, Number 1 - June,

4 Ho Siew Eng, Syed Zulkifli Syed, Lexshimi R. Gopal, Hamidah Hassan, Santna Lecthmi, Teoh Koi Hong, Razali Omar, and Hanida Mokhtar. (2007). Anxiety and depression among patients before and after Percutaneous coronary intervention (PCI) at National Heart Institute. Medicine & Health, v2 (1), Percutaneous coronary intervention (PCI) is an invasive diagnostic investigation that may result in high level of anxiety and fear of the unknown among cardiac patients. An increment in anxiety among PCI patients will augment the level of stress and this extreme stress level will then aggravate depression. The objective of this study was to determine the incidence of anxiety and depression before and after PCI. This was a cross-sectional descriptive study. The Hospital Anxiety and Depression Scale (HADS) was used. It measured two elements, namely, the anxiety and depression levels of patients before and after PCI. This study was conducted in the cardiology wards Anggerik and Dahlia, and Day Care of the National Heart Institute, from January to February A sample of 61 patients before and after PCI who fulfilled the inclusion criteria were recruited in this study. Of these, 40 and 38 patients before and after PCI respectively, had low anxiety levels; while, 47 and 46 patients before and after PCI respectively, had low depression levels. Anxiety and depression levels before and after PCI were not significantly correlated to socio demographic status. However, a significant correlation (p < 0.05) was found between anxiety and depression levels before and after PCI. The low levels of anxiety and depression seen among patients before and after PCI at National Heart Institute could possibly due to the adequate facilities and health education program provided by the physician, nurse and cardiac technician. I Liliwati, LKM Verna and O Khairani. (2007). Dysmenorrhoea and its effect on school activities among adolescent girls in a rural school in Selangor, Malaysia. Medicine & Health, v2 (1), The objective of this study is to determine the prevalence of dysmenorrhoea, its associated factors and its effects on school activities among adolescent girls in a secondary school in a rural district of Selangor, Malaysia. This is a cross-sectional study conducted in a public secondary school. A stratified random sampling of 300 female students (12 to 17 years old) from Form one to Form five classes were selected. A selfadministered questionnaire consisting of 20-items was used to collect sociodemographic and menstrual data. Pain intensity of dysmenorrhoea was measured by numerical rating scale. The prevalence of intensity for dysmenorrhoea was 62.3%. It was significantly higher in the middle adolescence (15 to 17 years old) and group (p=0.003), girls with regular menstrual cycle (p=0.007) and positive family history (p<0.05). There was no significant association with mean age of menarche and duration of menstruation. The number of school and class absences increased with increasing severity of dysmenorrhoea (p<0.05). The mean pain score was significantly higher in girls who reported to be unable to participate in sports (p=0.008) and with poor concentration in class (p<0.05). Dysmenorrhoea among the adolescent girls was common in this rural school. It had significant negative impact in their school performance and activities. Khairani O, Norazua R, and Zaiton A. (2007). Prevalence and reason for smoking among upper secondary schoolboys in Hulu Langat, Malaysia. Medicine & Health, v2 (1), Smoking in adolescence is a great health concern as it is related to many chronic diseases and mortality in later life. It is also associated with other high-risk behaviors among adolescents. The objective of this study was to determine the prevalence and reason for smoking among upper secondary schoolboy. This was a cross-sectional study conducted among Form 4 to 5 students. Three schools in the District of Hulu Langat were identified and student from these schools were selected randomly. The students were given a selfadministered questionnaire. A total of 343 students were included in the study. The prevalence of smoking among the schoolboys was 37%. Although the majority of them initiated smoking between years old (67%), 21% of them began smoking below 12 years of age (primary school). There was a significant association between adolescent smoking and smoking among family members (p<0.05). the common reasons reported for initiating smoking were curiosity (69%) and peer pressure (51%). However, the common reasons for continuing were smoking were stress (70%) and addiction (49%). Schoolwork was reported as the most important factor which contributed to their stress. Smoking prevention programmes should begin early in primary schools. Adolescent should be educated on effective coping strategies in managing stress and learning to be assertive. Nurismah MI, Sharifah NA, Usama AE, Rohaizak M, and Naqiyah Ibrahim. (2007). Fine needle aspiration (FNA) cytology of the thyroid: a cyto-histopathological study of 361 cases in Hospital Universiti Kebangsaan Malaysia. Medicine & Health, v2 (1), Thyroid nodules are common but thyroid malignancies are not. Fine needle aspiration (FNA) cytology is a diagnostic tool used to screen patients with thyroid nodules who require surgery. We study the diagnostic accuracy of FNA as the initial diagnostic modality, in the clinical assessment of thyroid nodules. Between January 1995 until December 2000, 2131 FNA of thyroid nodules were performed. 441 (20.7%) of these were unsatisfactory and 1960 (79.3%) cases were satisfactory for cytological evaluation. Histopathological diagnoses were available for 361 cases. Cyto-histopathological correlation was carried out for these cases. Our results showed a diagnostic accuracy of 96.2% with sensitivity Volume 2, Number 1 - June,

5 and sensitivity and specificity rates 87.7% and 98.4% respectively. Our positive predictive value is 93.4% and our negative predictive value is 96.8%. from this study, we conclude that fine needle aspiration is an important initial screening diagnostic tool for the investigation of thyroid nodules. Raja Lexshimi RG, Rohani Mamat, and Syed Zulkifli Syed. (2007). A study on anxiety and depression level among high risk inpatient pregnant women in an obstetric ward. Medicine & Health, v2 (1), Pregnancy is perceived by many mothers as a period of happiness in anticipation of motherhood. Not all pregnant mothers experience cheerfulness as some may experience a high anxiety and depression level of unknown reasons. The purpose of this study was to determine the level of anxiety and depression among high risk pregnant women and the factors that contribute to their level of anxiety and depression. A descriptive cross-sectional study was conducted on 38 high risk mothers whose stay in hospital exceeded more than three days in obstetric wad of Hospital University Kebangsaan Malaysia. A self assessment questionnaire Hospital Anxiety Depression scale was used to measure the level of anxiety and depression among high risk pregnant women. Of the 38 participants, 16 (42.1%) women experienced a mild level of anxiety and 22 (57.9%) experienced a severe level of anxiety. Seventeen (44.7%) women was classified as having mild depression and 21 (55.3%) severe depression. The factors contributing to the level of anxiety and depression, include those related with lack of information on diseases, family matters, and finance. High risk pregnant women in this study experienced a significant level of anxiety and depression during stay in hospital. It is therefore important for nurses and doctors to be aware and sensitive to the influencing factors that cause anxiety and depression as to enable high risk pregnant mothers to enjoy their pregnancy and childbirth. Santhna Letchumi Panduragan, Samsiah Mat, Raja Lexshimi RG, Roshdinom Razali, Ho Siew Eng, and Hamidah Hassan. (2008). Sharps injury in Hospital Universiti Kebangsaan Malaysia (HUKM): experiences of health care workers and students. Medicine & Health, v2 (1), Sharps injury among health care workers in HUKM has received serious attention lately due to the possible transmission of diseases like HIV, Hepatitis B and Hepatitis C, which can cause serious consequences for the victim. The aim of the study was to gain a deeper understanding of the emotional problem experienced by health care workers who had incurred a sharps injuries and the coping strategies adopted by them to overcome the researcher as there was no existing questionnaire to be adopted, as no research had been carried out in this area prior to this. The target group consisted of 64 health care workers of different categories working in HUKM. Data was collected over a period of five months from November 2000 to March The results of the study revealed that the most frequently injured were the staff nurses, nearly 90% of whom were emotionally upset and were worried that they might contract a disease. There was no significant different in the emotional stress experienced by the different categories of the health care workers, all were equally upset about the injury but each category of staff adopted different methods to management of the sharps injury in HUKM as given by the respondents here are taken into account. Several views given by the participants were explored and discusses. Finally, several implications for nursing and recommendations have been presented. WF Swee, Anza E, and Noor Hassim I. (2008). Work stress prevalence among the management staff in an International Tobacco Company in Malaysia. Medicine & Health, v2 (1), A cross sectional study on work stress prevalence was carried out among 185 executives and managers in the headquarter of an international tobacco company. The aim of the study was to identify work stress prevalence in this company and work stressors that were associated with stress experienced by the workers. A questionnaire based on the Personal Stress Inventory by O Donell (1984) was used. Data collected from participants included socio-demographics factors, symptoms of stress and work stressors related to organizational policy, organizational structure, organizational process, and work environment. The study showed that the prevalence of stress among executives was 68.1% and managers were 67.9% respectively. There was no significant difference in the level of stress between the executives and the managers in the company. The sociodemographic factors that were significantly associates with stress were salary, number of children and personal factors. The significant stressors in the workplace were lack of job recognition, over focusing on quality of work, heavy workload and long working hours. CASE REPORTS V Shanty, S-A-W Fadilah, and As Goh. (2008). Kimura s diseases mimicking hodgkin s lymphorma: an unusual cause of parotid swelling. Medicine & Health, v2 (1), Kimura s disease (KD) is a rare, benign chronic inflammatory disease of unknown aetiology, typically presents in the Orientals as subcutaneous masses in the head and neck region that could be easily misdiagnosed as a maglinant tumor, leading to unnecessary radical surgery or intensive cytotoxic therapy. It has been mainly reported in the Chinese and Japanese literature. It is difficult to diagnose before tissue biopsy and fine needle aspiration cytology (FNAC) Volume 2, Number 1 - June,

6 has limited value. Hence, unless the pathologists are aware of this entity, it might be mistaken as a malignant lesion. We encountered a case of KD in a Malay patient presenting as a period mass that was initially diagnosed as Hodgkin,s lymphoma (HL). This disorder should be suspected in young male Asian patients presenting with a painless unilateral mass in the head and neck region with associated hypereosinophilia. Volume 2, Number 1 - June,