Background Back pain is a common presenting complaint during pregnancy and it is often being considered as part of the pregnancy process. The purpose of the study is to investigate the prevalence of back pain in pregnancy, risk factors and its impact on the quality of life in pregnant women. Materials and methods Three hundred and fifty-eight pregnant women who attended the antenatal clinic in Universiti Kebangsaan Malaysia (UKM) Medical Centre were recruited in this cross-sectional study from October 2011 until April 2012. The back pain was further classified into lumbar pain and posterior pelvic pain. The severity of back pain was assessed using visual analoque scale (VAS) and the functional limitation was assessed using the Oswestry Disability Questionnaire (ODQ). Result The prevalence of back pain in pregnancy was 84.6%. Occupation and previous history of back pain were associated with back pain in pregnancy. In terms of functional limitation disability, total ODQ score was statistically significant correlate with severity of pain (VAS score). Personal care, sitting, standing, sex life and social life were significantly affected. Conclusion The risk factors for back pain in pregnancy were type of occupation and history of back pain. The higher VAS score, the more ODQ will be affected. Personal care, sitting, standing, sex life and social life were significantly affected.
Background Malaysia has introduced the free Pap smear as the primary cervical cancer screening program since the 1960s but has only achieved the national coverage of 22%. The coverage would be much lower in the rural communities especially in Sarawak where many villages are still inaccessible by road, and communities are living in low resource settings. In this study, we have evaluated Qiagen’s careHPV system as a point-of-care HPV diagnostic test together with the visualization using acetic acid (VIA) in the isolated community in the Highland of Bario which are predominantly from the Kelabit ethnicity. Methods Women attending the cervical cancer outreach program were recruited. Consent was obtained and a cervical swab was clinician-collected and screened for High-risk HPV DNA using the careHPV system. Cervical examination using VIA was offered to all women age <50-year. hrHPV positive women were recruited during their follow-up session and the second cervical swab was collected for HPV genotyping using consensus primer-nested PCR to elucidate the infecting HPV genotypes. Results Seventy-five women from the age of 27-83 (mean age 55) attended the cervical cancer screening clinic and 8% (n=6/75) of them were positive for hrHPV. Only 33 women were screened using VIA and 21.2% (n=7/33) were found to be positive. A majority of the women (58.6%) were above the age of 50-year and not recommended for VIA to be performed. Thus, it was not feasible to correlate the results obtained from the HPV DNA test and VIA. Only four hrHPV positive women returned for follow-up and genotyping revealed HPV52 in 2 of four women tested suggesting that HPV52 may be the predominant genotype in Bario. Conclusions The careHPV system is portable and can be used in low resource settings as long as reliable electricity is available. We found that careHPV DNA test is more objective compared to VIA and can be used to screen women outside the recommended eligible age. This is especially true for older women in the rural who have never had any form of cervical cancer screening before.
Background Malaysia has introduced the free Pap smear as the primary cervical cancer screening program since the 1960s but has only achieved the national coverage of 22%. The coverage would be much lower in the rural communities especially in Sarawak where many villages and communities are still living in low resource settings and inaccessible by road. In this study, we have evaluated Qiagen’s careHPV system as a point-of-careHPV diagnostic test together with the visualization using acetic acid (VIA) in the isolated communities in the Highland of Bario, Sarawak, East Malaysia. Methods Women attending the cervical cancer outreach program were recruited. Consent was obtained and a cervical swab was clinician-collected and screened for High-risk HPV DNA using the careHPV system. Cervical examination using VIA was offered to all women age <50-year. hrHPV positive women were recruited during their follow-up session and the second cervical swab was collected for HPV genotyping using consensus primer-nested PCR to elucidate the infecting HPV genotypes. Results Seventy-five women aged 27-83 (mean age 55) attended the cervical cancer screening clinic and 8% (n=6/75) of them were positive for hrHPV. Only 33 women were screened using VIA and 21.2% (n=7/33) were found to be positive. A majority of the women (58.6%) were above the age of 50-year and not recommended for VIA to be performed. Thus, it was not feasible to correlate the results obtained from the HPV DNA test and VIA. Only four hrHPV positive women returned for follow-up and genotyping revealed HPV52 in 2 of four women tested suggesting that HPV52 may be the predominant genotype in Bario. Conclusions The careHPV system is portable and can be used in low resource settings as long as reliable electricity is available. We found that careHPV HPV DNA test is more objective compared to VIA and can be used to screen women outside the recommended eligible age. This is especially true for older women in the rural who have never had any form of cervical cancer screening before.
Introduction: Cervical cancer is common cancer and ranked in fourth place in both incidence and mortality worldwide. It is 3rd most common female cancer in Malaysia with a lifetime risk of 1 in 116. Infection with high-risk oncogenic human papillomavirus (HPV) is recognized as one of the substantial risk factors for the development of cervical cancers. Methods: It was a cross-sectional study conducted to determine the prevalence of HPV infection and its subtypes among women with various degrees of abnormal smears, who were seen in the colposcopy clinic of Sarawak General Hospital within six months’ period from January to June 2018. We recruited 56 participants. There were 23 each for an atypical squamous cell of undetermined significance (ASC-US) and low-grade squamous intraepithelial lesion (LSIL) and 10 high- grade squamous intraepithelial lesion (HSIL). DNA was extracted, and HPV genotypes were determined via polymerase chain reaction (PCR) using two primer pairs MY09/MY11 and GP5+/GP6+. Results: The age ranged from 23 to 56 years, with a mean age of 42.96 years. HPV was detected in 20 out of 56 (35.7%). There were 6 high-risk oncogenic HPVs (18, 51, 52, 56, 58, 68) detected in participants and the most prevalent subtypes were 18, 52, and 58 (20% each). Four low-risk HPVs detected were 6, 53, 70, and 84. There was a significant association between the severity of cervical lesions and HPV positivity (P < 0.004). HSIL had the highest positive predictive value to have HPV infection as 70% compared to 43.4% of LSIL and 9.3% of ASC-US. Conclusion: Distribution of HPV subtypes from women with abnormal smears from Sarawak indicated a high prevalence of HPV 18, 52, and 58. We also identified HPV 70, which has never been reported in West Malaysia. These findings could contribute valuable information for HPV vaccination strategies, particularly for Sarawakian women.
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