exudates and Fatigue

Cancer related fatigue (CRF) is a problem experienced by head and neck cancer patients, especially those who undergo chemoradiation therapy. CRF may persist for years post chemoradiation therapy and significantly impair their quality of life (QOL). Tualang honey is rich in amino acids, vitamins, minerals and enzymes. It is proven to have anti-inflammatory, antioxidant and anti-tumour properties. As CRF is related to inflammatory mediators, the effects of Tualang Honey may improve CRF. The aim of this study is to determine if Tualang honey has a role in improving CRF and quality of life among head and neck cancer patients post chemoradiation.. In this open labelled randomized clinical trial, 40 participants aged between 18 and 65 with head and neck cancer who completed chemotherapy and/or radiotherapy in Hospital USM, Kelantan Malaysia or Hospital Taiping were recruited and randomized into two groups: Tualang honey (experimental) group or Vitamin C (control) group. They were prescribed with either daily oral Tualang honey 20mg or vitamin C tablet 100 mg for 8 weeks. Level of fatigue and quality of life were measured using FACIT-Fatigue and FACT H&N questionnaires at baseline, 4 weeks and 8 weeks. The white cell count and C-reactive protein level were also measured at baseline, 4 weeks and 8 weeks.. After four and eight weeks of treatment with Tualang honey or Vitamin C, the fatigue level for experimental group was better than in the control group, and the differences were statistically significant (p<0.05). Statistically significant improvements were seen on quality of life (p<0.05) for the experimental group at week 8, however, no significant improvements were seen in white cell count and C-reactive protein level between control and experimental group.. Our research provided support for the use of Tualang honey to improve CRF and QOL in head and neck cancer patients post chemotherapy or radiotherapy.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antioxidants; Chemoradiotherapy; Fatigue; Female; Follow-Up Studies; Head and Neck Neoplasms; Honey; Humans; Malaysia; Male; Middle Aged; Prognosis; Quality of Life; Young Adult

This study compares energy expenditure (EE), gait parameters (GP), and level of fatigue (LOF) between 5-minute walking with sharp turning (ST) and corner turning (CT). Data were obtained from 29 community-dwelling elderly (mean age, 62.7 ± 3.54 years). For 5 minutes, in ST task, participants walked on a 3-meter pathway with 2 cones placed at each end (180° turning), while in CT task, participants walked on a 6-meter pathway with 4 cones placed at 4 corners (90° turning). The physiological cost index, pedometer, and 10-point Modified Borg Dyspnoea Scale were used to measure EE (beats/min), GP (no of steps), and LOF, respectively. Data were analyzed by using independent t-tests. EE during ST (0.62 ± 0.21 beats/min) was significantly higher than CT (0.48 ± 0.17 beats/min) (P < 0.05). GP (434 ± 92.93 steps) and LOF (1.40 ± 1.11) in ST were found to be lower compared to GP (463 ± 92.18 steps) and LOF (1.54 ± 1.34) in CT (All, P > 0.05). Higher EE in ST could be due to the difficulty in changing to a 180° direction, which may involve agility and different turning strategies (step-turn or pivot-turn) to adjust the posture carefully. In CT, participants could choose a step-turn strategy to change to a 90° direction, which was less challenging to postural control.

Topics: Aged; Energy Metabolism; Fatigue; Female; Gait; Humans; Malaysia; Male; Middle Aged; Physical Exertion; Task Performance and Analysis; Walking

This study aimed to explore the socio-demographic characteristics, mental health status, and perceived causes of pandemic fatigue with COVID-19 pandemic fatigue among the general population of Malaysia. The data was collected online during the transition from the COVID-19 pandemic phase to the endemic phase in Malaysia from 1 to 30 April 2022. Sociodemographic data, Depression Anxiety Stress Scale-21 (DASS-21), perceived causes of pandemic fatigue, and the Fatigue Assessment Scale (FAS) were included in the survey. The chi-square test and a simple logistic regression analysis were used to identify predictors of pandemic fatigue. The completed survey (

Topics: Anxiety; COVID-19; Cross-Sectional Studies; Depression; Fatigue; Health Status; Humans; Malaysia; Mental Health; Pandemics; SARS-CoV-2

To assess the reliability and validity of two disease-specific questionnaires that assess the quality of life (QoL) among patients with Systemic Lupus Erythematosus (SLE); SLEQoL and LupusQoL in Malay language. This study also identified the factors affecting each domain of the questionnaires.. This cross-sectional study was conducted from June 2021 until April 2022, and SLE patients were recruited to complete the SLEQoL, LupusQoL and Short Form Health Survey (SF-36) in Malay language. Disease activity were recorded using the modified SLE Disease Activity Index (M- SLEDAI) and British Isles Lupus Assessment Group 2004 (BILAG-2004) index. Presence of organ damage was determined using the SLICC Damage index. Cronbach's alpha was calculated to determine internal consistency while exploratory factor analysis was done to determine the construct validity. Concurrent validity was evaluated using correlation with SF-36. Multiple linear regression analysis was deployed to determine the factors affecting each domain of SLEQoL and LupusQoL.. A total of 125 subjects were recruited. The Cronbach's α value for the Malay-SLEQoL (M-SLEQoL) and Malay-LupusQOL (M-LupusQoL) was 0.890 and 0.944 respectively. Exploratory factor analysis found formation of similar number of components with the original version of questionnaires and all items have good factor loading of >0.4. Both instruments also had good concurrent validity with SF-36. M-SLEQoL had good correlations with BILAG-2004 and M-SLEDAI scores. Musculoskeletal (MSK) involvement was independently associated with lower M-SLEQoL in physical function, activity and symptom domains. Meanwhile, MSK and NPSLE were associated with fatigue in M-LupusQoL.. Both M-SLEQoL and M-LupusQoL are reliable and valid as disease -specific QoL instruments for Malaysian patients. The M-Lupus QoL has better discriminative validity compared to the M-SLEQoL. SLE patients with MSK involvement are at risk of poor QoL in multiple domains including physical function, activity, symptoms and fatigue.

Topics: Cross-Sectional Studies; Fatigue; Humans; Language; Lupus Erythematosus, Systemic; Malaysia; Quality of Life; Reproducibility of Results; Severity of Illness Index; Surveys and Questionnaires

Fatigue is an important yet infrequently evaluated component in patients with rheumatoid arthritis (RA) and may have a major impact on quality of life.. To evaluate fatigue, identify factors associated with fatigue and assess the effect of fatigue on health-related quality of life (HRQoL) in a multi-ethnic cohort of RA patients.. A cross-sectional study was performed in patients who fulfilled European League Against Rheumatism/ American College of Rheumatology 2010 criteria for RA. Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) questionnaire was used to assess fatigue. Potential factors for fatigue were categorized into RA-related (gender, seropositivity [rheumatoid factor and/or anti-citrullinated protein antibody], disease duration, visual analog scale pain score, Disease Activity Score of 28 joints - erythrocyte sedimentation rate [DAS28-ESR], ESR, hemoglobin level, functional disability [Health Assessment Questionnaire - Disability Index, HAQ-DI score], EQ-5D-3L, concomitant prednisolone use and number of conventional synthetic disease-modifying anti-rheumatic drugs [csDMARDs] used) and non-RA-related (age, body mass index, ethnicity and number of co-morbidities).. A total of 214 patients (86.9% female) were included; the median age was 62 (25-91) years and 67.3% were seropositive. Seventy-six (33.5%) patients had moderate disease activity, 12 (5.6%) had high disease activity and 152 (71%) patients had mild difficulties to moderate disability HAQ-DI scores. Median of total FACIT-F score was 113.2 (36.3-160.0). Joint factors of younger age, longer disease duration, higher HAQ score (increased functional disability), and lower EQ-5D (poorer HRQoL) were significantly associated with higher levels of fatigue (all P < .02).. Fatigue was associated with functional disability and has a significant impact on HRQoL in RA. Fatigue assessment should be considered in routine clinical practice for RA patients.

Topics: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Blood Sedimentation; Cross-Sectional Studies; Disability Evaluation; Fatigue; Female; Humans; Malaysia; Male; Middle Aged; Pain Measurement; Predictive Value of Tests; Quality of Life; Surveys and Questionnaires

Fear of cancer recurrent, side effects of treatment and belief in food taboos encourage cancer survivors to make changes in their dietary practices after diagnosis of cancer. The objective of this study was to determine the impact of dietary changes on quality of life (QoL) among Malay breast and gynaecological cancer survivors.. Questionnaire of dietary changes was modified from WHEL study and adapted to typical Malay's food intake in Malaysia. A total of 23 items were listed and categorized by types of food and cooking methods.  Four categories of changes "increased", "decreased", "no changes" or "stopped" were used to determine the changes in dietary practices. Score one (+1) is given to positive changes by reference to WCRF/AICR and Malaysia Dietary Guideline healthy eating recommendations. Malay EORTC QLQ-C30 were used to determine the QoL. Sociodemographic, clinical characteristics and anthropometric measurement were also collected.. The mean age of the subjects (n=77) was 50.7±7.8 years old with duration of survivorship 4.0±3.1 years. Subjects mean BMI was 27.8±4.9 kg/m2 which indicate subjects were 31.2% overweight and 32.5% obese. The percentage score of positive dietary changes was 34.7±16.4%. Positive dietary changes were increased intake of green leafy vegetable (49.4%), cruciferous vegetable (46.8%) and boiling cooking methods (45.5%). Subjects reduced their intake of red meat (42.9%), sugar (53.2%) and fried cooking method (44.2%). Subjects stopped consuming milk (41.6%), c 2008-5862 heese (33.8%) and sweetened condensed milk (33.8%). With increasing positive dietary changes, there was a significant improvement on emotional function (rs=0.27; p=0.016) and reduced fatigue symptoms (rs=-0.24; p=0.033).. Positive changes in dietary intake improved emotional function and reduced fatigue symptoms after cancer treatment. By knowing the trend of food changes after cancer treatment, enables the formation of healthy food intervention implemented more effective.

Topics: Adolescent; Adult; Aged; Breast Neoplasms; Cancer Survivors; Combined Modality Therapy; Diet, Healthy; Fatigue; Female; Follow-Up Studies; Genital Neoplasms, Female; Humans; Malaysia; Middle Aged; Prognosis; Quality of Life; Surveys and Questionnaires; Young Adult

This study was conducted to determine the prevalence and severity of menopausal symptoms and their associated risk factors among postmenopausal breast cancer patients receiving adjuvant endocrine therapy.. Postmenopausal breast cancer patients on endocrine therapy were recruited at three hospitals in Malaysia. Presence and severity of menopausal symptoms were determined using the Menopause Rating Scale. Sociodemographic and clinical data were collected from medical records.. A total of 192 patients participated in this study. Commonly reported symptoms were musculoskeletal pain (59.9%), physical and mental exhaustion (59.4%), and hot flushes (41.1%). Multivariate analyses indicated that increasing number of years after menopause until the start of endocrine therapy was significantly associated with less likelihood of reporting menopausal symptoms and musculoskeletal pain. Patients with primary or secondary education levels reported significantly less menopausal urogenital symptoms compared to patients with a tertiary education level. Patients using aromatase inhibitors were twice as likely to experience musculoskeletal pain compared to patients using tamoxifen (odds ratio, 2.18; 95% confidence interval, 1.06-4.50; p < 0.05).. Menopausal symptoms and musculoskeletal pain are common problems encountered by postmenopausal breast cancer patients receiving adjuvant endocrine therapy and should be closely monitored for successful treatment.

Topics: Aged; Antineoplastic Agents, Hormonal; Aromatase Inhibitors; Breast Neoplasms; Chemotherapy, Adjuvant; Cross-Sectional Studies; Fatigue; Female; Hot Flashes; Humans; Malaysia; Mental Fatigue; Middle Aged; Musculoskeletal Pain; Postmenopause; Tamoxifen

Topics: Adaptation, Psychological; Adult; Aged; Aged, 80 and over; Fatigue; Female; Humans; Malaysia; Male; Middle Aged; Neoplasms; Pain; Public Health Surveillance; Sleep; Stress, Psychological; Surveys and Questionnaires

While numerous studies have investigated associations between Ramadan fasting and sports performance, as well as general health, little is known about the experiences of musicians who play while fasting. This exploratory case study aimed to gain a better understanding of the experiences of tertiary-level woodwind players who practice, rehearse, and perform while fasting. Sixteen undergraduate woodwind players from two Malaysian university music faculties completed an 11-item questionnaire, as well as a 7-day food and playing diary, which formed the basis for a semi-structured interview. Their experiences were compared with previous studies of fasting athletes. Many participants stated that practicing from noon to 3:00 pm was difficult due to feeling thirsty, hungry, tired, and exhausted, with some experiencing a dry mouth and/or lips. By 3:00 to 6:00 pm, some had difficulty focusing and felt tired, dizzy, or lacked energy to practice. Many felt more comfortable playing after breaking the fast or after eating sahur. The majority experienced positive impacts such as increased focus and efficiency while practicing. This study suggests that fasting woodwind players would benefit from practicing in the morning and after sunset, limiting their practice time in the afternoon, not skipping sahur, and ensuring adequate hydration during sunset and sunrise.

Topics: Adaptation, Physiological; Fasting; Fatigue; Female; Holidays; Humans; Islam; Malaysia; Male; Music; Surveys and Questionnaires; Young Adult

There are few studies on rhinitis and sick building syndrome (SBS) among students in tropical countries. We studied associations between levels of five fungal DNA sequences, two mycotoxins (sterigmatocystin and verrucarol) and cat allergen (Fel d 1) levels in schools and rhinitis and other weekly SBS symptoms in the students. Fungal DNA was measured by quantitative PCR and cat allergen by ELISA. Pupils (N = 462) from eight randomly selected schools in Johor Bahru, Malaysia participated (96%). Dust samples were collected by cotton swabs and Petri dishes exposed for one week. None of the schools had a mechanical ventilation system, but all classrooms had openable windows that were kept open during lectures and indoor CO2 levels were low (mean 492 ppm; range 380-690 ppm). Weekly nasal symptoms (rhinitis) (18.8%), ocular (11.6%), throat (11.1%), dermal symptoms, headache (20.6%) and tiredness (22.1%) were common. Total fungal DNA in swab samples was associated with rhinitis (p = 0.02), ocular symptoms (p = 0.009) and tiredness (p = 0.001). There were positive associations between Aspergillus versicolor DNA in Petri dish samples, ocular symptoms (p = 0.02) and tiredness (p = 0.001). The level of the mycotoxin verrucarol (produced by Stachybotrys chartarum) in swab samples was positively associated with tiredness (p = 0.04). Streptomyces DNA in swab samples (p = 0.03) and Petri dish samples (p = 0.03) were negatively associated with tiredness. In conclusion, total fungal contamination, measured as total fungal DNA) in the classrooms, Aspergillus versicolor and verrucarol can be risk factors for rhinitis and SBS symptoms among students in the tropical country Malaysia.

Topics: Adolescent; Allergens; Animals; Cats; DNA, Fungal; Dust; Eye; Fatigue; Female; Headache; Humans; Malaysia; Male; Models, Theoretical; Mycotoxins; Pharynx; Prevalence; Rhinitis; Schools; Skin; Students

The purpose of this study was to investigate whether there were gender-specific depressive symptom profiles or gender-specific patterns of psychotropic agent usage in Asian patients with depression.. Clinical data from the Research on Asian Psychotropic Prescription Patterns for Antidepressant study (1171 depressed patients) were used to determine gender differences by analysis of covariates for continuous variables and by logistic regression analysis for discrete variables. In addition, a binary logistic regression model was fitted to identify independent clinical correlates of the gender-specific pattern on psychotropic drug usage.. Men were more likely than women to have loss of interest (adjusted odds ratio = 1.379, p = 0.009), fatigue (adjusted odds ratio = 1.298, p = 0.033) and concurrent substance abuse (adjusted odds ratio = 3.793, p = 0.008), but gender differences in other symptom profiles and clinical features were not significant. Men were also more likely than women to be prescribed adjunctive therapy with a second-generation antipsychotic (adjusted odds ratio = 1.320, p = 0.044). However, men were less likely than women to have suicidal thoughts/acts (adjusted odds ratio = 0.724, p = 0.028). Binary logistic regression models revealed that lower age (odds ratio = 0.986, p = 0.027) and current hospitalization (odds ratio = 3.348, p < 0.0001) were independent clinical correlates of use of second-generation antipsychotics as adjunctive therapy for treating depressed Asian men.. Unique gender-specific symptom profiles and gender-specific patterns of psychotropic drug usage can be identified in Asian patients with depression. Hence, ethnic and cultural influences on the gender preponderance of depression should be considered in the clinical psychiatry of Asian patients.

Topics: Adult; Aged; Antidepressive Agents; Antipsychotic Agents; Asian People; China; Depression; Depressive Disorder, Major; Fatigue; Female; Hong Kong; Humans; India; Indonesia; Japan; Logistic Models; Malaysia; Male; Middle Aged; Odds Ratio; Republic of Korea; Sex Distribution; Sex Factors; Singapore; Substance-Related Disorders; Suicidal Ideation; Suicide, Attempted; Taiwan; Thailand

This was an analysis of the impact of somatic symptoms on the severity and course of depression in Chinese patients treated for an acute episode of major depressive disorder (MDD).. Data were extracted from a 3-month prospective observational study which enrolled 909 patients with MDD in psychiatric care settings; this analysis focused on the Chinese patients (n=300). Depression severity was assessed using the Clinical Global Impression of Severity (CGI-S) and 17-item Hamilton Depression Rating Scale (HAMD-17); somatic symptoms were assessed using the patient-rated 28-item Somatic Symptom Inventory (SSI). Cluster analysis using baseline SSI scores grouped patients into three clusters with no/mild, moderate, or severe somatic symptoms. Four SSI factors (pain, autonomic symptoms, energy, and central nervous system) were defined, and regression analyses identified which factors were associated with remission at 3 months.. More than 70% of the patients had moderate or severe somatic symptoms. Baseline depression severity (HAMD-17 and CGI-S scores) was associated with more severe somatic symptoms. Remission rates differed between clusters of patients: 84.1%, 72.0%, and 55.3% for no/mild, moderate, and severe somatic symptoms, respectively (P=0.0034). Pain symptoms were the somatic symptoms more strongly associated with lower remission rates at 3 months.. Somatic symptoms are associated with greater clinical severity and lower remission rates. Among somatic symptoms, pain symptoms have the greatest prognostic value and should be taken into account when treating patients with depression.

Topics: Adult; Autonomic Nervous System Diseases; Central Nervous System Diseases; China; Comorbidity; Depressive Disorder, Major; Fatigue; Female; Follow-Up Studies; Hong Kong; Humans; Malaysia; Male; Middle Aged; Outcome Assessment, Health Care; Pain; Republic of Korea; Severity of Illness Index; Singapore; Taiwan

Vena cava compression is a relatively rare initial manifestation of underlying malignancy. The superior vena cava syndrome, which is characterized by facial plethora, jugular venous distension, and arm swelling, is a well-known entity associated with bronchogenic carcinoma. Less common is the compression of the inferior vena cava. To the best of my knowledge, this is the first reported case of newly diagnosed gastric adenocarcinoma presenting initially as the inferior vena cava syndrome. The unique aspect about this case is that it highlights a rare presentation before diagnosis of gastric adenocarcinoma.. A 56-year-old Malaysian woman with a past medical history of iron deficiency anemia presented with lower extremity edema and progressive fatigue of 1 month's duration. She had significant worsening of leg swelling after standing for short periods of time. She also reported epigastric discomfort, which led to an additional workup, including computed tomography of the abdomen and pelvis. This revealed a 3cm×2.9cm mass in the stomach, extensive hepatic metastasis, and severe inferior vena cava compression. The patient was examined further with esophagogastroduodenoscopy, and a biopsy showed gastric adenocarcinoma.. This report describes a case of a patient with inferior vena cava syndrome as a unique presentation of previously undiagnosed stage IV gastric adenocarcinoma. Patients presenting with inferior vena cava syndrome should undergo prompt evaluation for underlying malignancies that have a predilection for hepatic metastasis. This case is important because earlier recognition of this syndrome can lead to earlier workup and thus detection of malignancy. Prompt initiation of treatment, including chemotherapy or vena cava stent placement, can result in improved patient outcome.

Topics: Adenocarcinoma; Anemia, Iron-Deficiency; Antineoplastic Combined Chemotherapy Protocols; Budd-Chiari Syndrome; Disease Progression; Edema; Endoscopy, Gastrointestinal; Fatigue; Female; Humans; Lower Extremity; Malaysia; Middle Aged; Neoplasm Staging; Paclitaxel; Stomach Neoplasms; Syndrome; Tomography, X-Ray Computed; Trastuzumab; Treatment Outcome; Vena Cava, Inferior

Breast cancer is the leading cause of cancer-related death among women in Malaysia. A diagnosis is very stressful for women, affecting all aspects of their being and quality of life. As such, there is little information on quality of life of women with breast cancer across the different ethnic groups in Malaysia. The purpose of this study was to examine the quality of life in Malay and Chinese women newly diagnosed with breast cancer in Kelantan.. A descriptive study involved 58 Malays and 15 Chinese women newly diagnosed with breast cancer prior to treatment. Quality of life was measured using the Malay version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and its breast-specific module (QLQ-BR23). Socio-demographic and clinical data were also collected. All the data were analyzed using SPSS version 20.0.. Most of the women were married with at least a secondary education and were in late stages of breast cancer. The Malay women had lower incomes (p=0.046) and more children (p=0.001) when compared to the Chinese women. Generally, both the Malay and Chinese women had good functioning quality-of-life scores [mean score range: 60.3-84.8 (Malays); 65.0-91.1 (Chinese)] and global quality of life [mean score 60.3, SD 22.2 (Malays); mean score 65.0, SD 26.6 (Chinese)]. The Malay women experienced more symptoms such as nausea and vomiting (p=0.002), dyspnoea (p=0.004), constipation (p<0.001) and breast-specific symptoms (p=0.041) when compared to the Chinese.. Quality of life was satisfactory in both Malays and Chinese women newly diagnosed with breast cancer in Kelantan. However, Malay women had a lower quality of life due to high general as well as breast-specific symptoms. This study finding underlined the importance of measuring quality of life in the newly diagnosed breast cancer patient, as it will provide a broader picture on how a cancer diagnosis impacts multi-ethnic patients. Once health care professionals understand this, they might then be able to determine how to best support and improve the quality of life of these women during the difficult times of their disease and on-going cancer treatments.

Topics: Adult; Breast Neoplasms; China; Constipation; Cross-Sectional Studies; Diarrhea; Fatigue; Female; Humans; Malaysia; Middle Aged; Nausea; Pain; Quality of Life; Sleep Initiation and Maintenance Disorders; Socioeconomic Factors; Stress, Psychological; Surveys and Questionnaires; Vomiting; Young Adult

Fatigue-related crashes have long been the topic of discussion and study worldwide. The relationship between fatigue-related crashes and time of day is well documented. In Malaysia, the possibility of banning express buses from operating during the early-hours of the morning has emerged as an important consideration for passenger safety. This paper highlights the findings of an impact assessment study. The study was conducted to determine all possible impacts prior to the government making any decision on the proposed banning. This study is an example of a simple and inexpensive approach that may influence future policy-making process. The impact assessment comprised two major steps. The first step involved profiling existing operation scenarios, gathering information on crashes involving public express buses and stakeholders' views. The second step involved a qualitative impact assessment analysis using all information gathered during the profiling stage to describe the possible impacts. Based on the assessment, the move to ban early-hour operations could possibly result in further negative impacts on the overall road safety agenda. These negative impacts may occur if the fundamental issues, such as driving and working hours, and the need for rest and sleep facilities for drivers, are not addressed. In addition, a safer and more accessible public transportation system as an alternative for those who choose to travel at night would be required. The proposed banning of early-hour operations is also not a feasible solution for sustainability of express bus operations in Malaysia, especially for those operating long journeys. The paper concludes by highlighting the need to design a more holistic approach for preventing fatigue-related crashes involving express buses in Malaysia.

Topics: Accidents, Traffic; Adult; Automobile Driving; Decision Making; Fatigue; Humans; Malaysia; Middle Aged; Motor Vehicles; Policy; Safety Management; Sleep; Sleep Deprivation; Work Schedule Tolerance

The fatigue that is observed in patients who are undergoing dialysis is usually associated with an impaired quality of life. The present cross-sectional study was conducted from January to April 2009 in three hemodialysis units in Kuala Lumpur, Malaysia. In this study, the Multidimensional Fatigue Inventory and Depression Anxiety and Stress Score 21 were used to determine the level of fatigue, depression, anxiety, and stress of patients who were undergoing dialysis. The data were obtained from a calculated sample of 116 and a total of 103 respondents participated in the study. A total of 56 (54.4%) and 47 (45.6%) respondents experienced a high level and a low level of fatigue, respectively. There was a significant relationship between the duration of treatment and the level of fatigue. The respondents who had been receiving treatment for > 2 years experienced more fatigue, compared to the respondents who had been undergoing hemodialysis for > 2 years. There was a significant difference in relation to the age of the participants regarding the level of fatigue. No significant relationship between the sex of the participants, anemia, depression, anxiety, stress, and the level of fatigue was observed. Special attention needs to be paid to both the younger and older adults who are receiving treatment. In addition, proper planning is needed for the patients regarding their daily activities in order to reduce fatigue. Nurses who work in hemodialysis units are recommended to provide exercise classes or group therapy in order to boost the energy levels among patients who are undergoing dialysis. Health professionals should provide appropriate treatment for patients who are experiencing fatigue in order to prevent any other complications that could arise.

Topics: Anxiety; Confidence Intervals; Cross-Sectional Studies; Fatigue; Female; Health Surveys; Hemodialysis Units, Hospital; Humans; Iatrogenic Disease; Malaysia; Male; Middle Aged; Psychometrics; Renal Dialysis; Risk Factors; Surveys and Questionnaires; Time Factors

To document the common menopausal symptoms and quality of life in indigenous women of Sarawak in Malaysia.. A face-to-face interview using the Menopause-specific Quality of Life questionnaire was conducted with 276 indigenous Sarawakian women aged 40-65 years to determine the mean age of menopause and common symptoms (divided into vasomotor, psychosocial, physical and sexual domains) associated with menopause.. The mean age at menopause of postmenopausal women was 50.78 +/- 2.47 years (range 47.3-58.2 years). The most common symptoms reported were aching in muscles and joints (82.6%), lack of energy (77.5%) and low backache (77.2%). The typical menopausal symptoms of hot flushes, night sweats, sweating and vaginal dryness were experienced by 42.4%, 34.8%, 29.7% and 49.3%, respectively of the women studied. Perimenopausal women (n = 114) experienced the most physical and psychosocial symptoms, while postmenopausal women (n = 102) experienced most sexual symptoms. Perimenopausal and postmenopausal women were reported to suffer more than premenopausal women (p < 0.001) within the four domains of symptoms (vasomotor, psychosocial, physical and sexual).. The menopausal symptoms in this study correspond to those in other studies on Asian women but the prevalence of typical and classical menopausal symptoms was lower compared to studies on Caucasian women. The perimenopausal women had the most significant decrease in quality of life, followed by postmenopausal women and premenopausal women. Vasomotor symptoms had a predominant influence on the quality of life.

Topics: Adult; Aged; Arthralgia; Cross-Sectional Studies; Educational Status; Fatigue; Female; Hot Flashes; Humans; Low Back Pain; Malaysia; Menopause; Middle Aged; Postmenopause; Quality of Life; Sexual Dysfunction, Physiological; Surveys and Questionnaires; Sweating

Between July 1999 to November 2000, 115 patients undergoing radiotherapy were evaluated for the development of treatment-related fatigue, using a modified Piper's fatigue scale. The above scale determines 4 dimensions of fatigue ie behavioral severity (6 items), affective meaning (5 items), sensory (5 items), and cognitive mood (6 items). Radiotherapy was delivered to the head and neck, breast, pelvis, and miscellaneous sub-sites. The area of the radiation field ranged from 25 to 480 cm2 (median 156 cm2). Forty-three percent of patients experienced significant fatigue, which altered their work environment. The individual components of fatigue were behavioral severity 25%, affective meaning 21%, sensory 18%, and cognitive mood 16%. Significant radiotherapy-related fatigue was higher in patients treated with advanced-stage disease, large radiotherapy field area, and low pre-radiotherapy hemoglobin level.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Fatigue; Female; Humans; Malaysia; Male; Middle Aged; Neoplasms; Prevalence; Radiotherapy; Sickness Impact Profile; Surveys and Questionnaires

As part of an organizational review of safety, interviews and questionnaire surveys were performed on over 700 commercial goods drivers and their managers within a series of related companies operating across 17 countries. The results examine the reported incidence of fatigue-related problems in drivers and their associations with near miss and accident experience as well as work and organizational factors. Experience of fatigue problems while driving was linked to time of day and rotation of shifts, though most associations were small. There were significant associations found between fatigue experiences and driver and management systems of break taking and route scheduling. The quantitative combined with qualitative information suggested that, where feasible, more flexible approaches to managing the scheduling and sequencing of deliveries assisted drivers in managing their own fatigue problems through appropriate break-taking. The results are interpreted within the overarching principles of risk assessment and risk control.

Topics: Accidents, Traffic; Adult; Africa; Australia; Automobile Driving; Decision Making; Europe; Fatigue; Health Knowledge, Attitudes, Practice; Health Surveys; Humans; Incidence; Internationality; Malaysia; Middle Aged; New Zealand; Occupational Health; Personnel Staffing and Scheduling; Regression Analysis; Risk Assessment; Risk Factors; Workload