Objectives: To study Malaysian dengue clinical practice guideline (CPG) warning signs (WS) in predicting severe dengue (SD) and its associated factors among confirmed cases presented to a teaching hospital in north-eastern Malaysia in 2014. Methods: A cross-sectional study was performed in February 2015 using secondary data acquired from the hospital records. There were 2607 confirmed dengue cases presented to Hospital Universiti Sains Malaysia (HUSM) in 2014. Seven hundred patients were selected after proportionate stratified random sampling conducted according to the number of cases in 12 different months in 2014. Data were collected and analysed using SPSS version 22.0. Results: Severe dengue outcomes represented 4.9% of cases. The prevalence of any of WS in SD was 91.2%. The most common WSs prior to SD were persistent vomiting (55.9%), and abdominal pain/tenderness (52.9%). The most sensitive warning sign in detecting SD was abdominal pain (59%). Specificity of individual WS were generally good, especially of clinical fluid accumulation (99%), hepatomegaly (98%) and mucosal bleeding (93%). Factors associated with SD were persistent vomiting (Adjusted odds ratio (aOR)): 2.41), mucosal bleeding (aOR: 4.73) and haematocrit rise with rapid platelet drop (aOR: 2.74). Conclusion: A focus on sensitivity, specificity, predictive values and association of a number of particular WS should be emphasized in order to better predict severe dengue outcomes.
Background: The positive smoker identity construct, which was based on West’s PRIME Theory, affected the smoking prevalence, quit attempts and cessation success. A validated questionnaire which could measure this rich and complex construct may facilitate prediction models of successful cessation. We aimed to develop and validate a questionnaire that assesses positive smoker identity based on West’s PRIME Theory. Method: The initial item pool was developed based on a theoretical framework, empirical literature, existing scales and expert review. The questionnaire was conveniently distributed to 100 smokers. Exploratory factor analysis was utilized to explore domains in the questionnaire. Construct and criterion validity, internal consistency and reliability of the domains were analyzed. Results: The final positive smoker identity questionnaire (PSmoQi) has 26 items under four internally-consistent and reliable domains: Contributory factors, contextual and temporal patterning, identity related to smoking, and behaviour in relation to smoking. The full scale demonstrated good internal consistency (∝ = 0.78), acceptable convergent and divergent validity, and good concurrent validity with the smoker self-concept scale. Conclusion: The current study provides fundamental evidence for the PSmoQi as a valid instrument in research related to smoking cessation and interventional strategy. The PSmoQi contained validated domains which could measure almost a full spectrum of smoking cessation components.
Background: COVID-19 has a varied clinical presentation and may progress to severe form which could be fatal. Determination of risk factors for severe infection would be beneficial in averting COVID-19 mortality in Terengganu setting.Materials and Methods: A casecontrol study between mild and severe COVID-19 groups was conducted in Terengganu state from 1st March 2020 until 31st January 2021 based on retrospective record review. Individuals with laboratory RT-PCR confirmed positive test for COVID-19 were included as study samples. Descriptive statistics, simple and multiple logistic regression analyses were employed for statistical analysis.Results: There were 2142 COVID-19 cases in Terengganu during the studied period. The proportion of severe COVID-19 infection was 2.1% (95%CI: 0.01, 0.03). Among the severe COVID-19 cases, their mean (±SD) age was 52 (±16) and majority of them were male (59.1%) and had comorbidity (56.8%). The common symptoms among severe COVID-19 cases included fever (68.2%), cough (63.6%), coryza (22.7%), sore throat (13.6%) and anosmia (11.4%). Multiple logistic regression revealed older age, presence of comorbidity, having symptoms of fever, cough and anosmia as the significant associated factors for severe COVID-19 with adjusted odds ratio (AOR) of 1.07 (95%CI: 1.03, 1.11), p<0.001; AOR 5.97 (95%CI: 2.09, 17.01), p=0.001; AOR 4.78 (95%CI: 1.63, 14.05), p=0.004; AOR 4.81 (95%CI: 1.70, 13.60), p=0.003; and AOR 8.39 (95%CI: 1.39, 50.33), p=0.020,respectively.Conclusion: Knowing the predictive factors for severe COVID-19 would facilitate clinicians in timely identification of high-risk cases for delivering prompt treatment and intervention.International Journal of Human and Health Sciences Vol. 06 No. 03 July’22 Page: 269-274
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Positive smoker identity (PSI) is a construct that evaluates the degree of smokers’ positive thoughts, images and feeling about smoking behavior and culture. PSI encompasses the indicators related to tobacco denormalization strategy, which is one of the four WHO tobacco endgame strategies. PSmoQi is a newly validated instrument which could reliably assess PSI. This study’s objectives were to determine the prevalence of positive smoker identity and its associated factors using PSmoQi. A sample of 253 smokers from government agencies in Kota Bharu City, Malaysia were recruited using invitation letters sent to their head of agencies. Data collection was done in a briefing session voluntary attended by the smokers. Factors associated with PSI were analyzed using Multiple Logistic Regression. The prevalence of smokers with positive smoker identity was 72.3%. Factors associated with positive smoker identity were older age (Adjusted Odds ratio; AOR: 1.042; 95% confident interval; CI: 1.004, 1.081); p = 0.028), higher smoking self-concept scale Malay version (SSCS-M) score (AOR: 1.216; 95% CI: 1.112, 1.329; p < 0.001), higher heaviness index (AOR: 1.002; 95% CI: 1.001, 1.004; p = 0.011) and lower educational attainment (AOR: 0.458; 95% CI: 0.233, 0.900; p = 0.024). This study shows a high prevalence of PSI among smokers from government agencies in Kota Bharu City. Factors such as age, SSCS-M score, heaviness index and educational attainment influenced the level of positive smoker identity in a smoker. The finding would contribute an evidentiary guideline in screening smokers for smoking cessation clinic enrollment to achieve the best interventional outcome, as well as it would provide an objective indicator for tobacco denormalization status in a population.
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