Background: This study aims to determine the hazard ratio of having any complication from diabetes mellitus, and the associations between comorbidities and risk of having any complications from diabetes mellitus among diabetic patients who have attended government primary care clinics. Methods: Secondary data were retrieved from the Malaysian National Diabetic Registry which included all patients who received care. The data from the study on the socio-demographic, diabetes complications, clinical and treatment characteristics were analyzed using descriptive statistics. Cox regression was performed to estimate the hazard ratio for comorbidities, tobacco use, duration of diabetes and socio-demography characteristics upon time to diabetic complications. Results: Adjusted for other covariates, increase number of comorbidities contributed the highest hazard ratio risk: 1 comorbid (aHR: 2.47, 95% CI: 2.39, 2.55), 2 comorbidities (aHR: 4.34, 95% CI: 4.22, 4.47), 3 comorbidities (aHR: 6.56, 95% CI: 6.31, 6.81) and 4 comorbidities (aHR: 9.13, 95% CI: 8.20, 10.17). Other factors: age > 40 years (8%) Malays (27%) and smokers (10%) have hazard risks to develop diabetic complications. Conclusions: Increase in number of comorbidities will increase the risk of getting diabetes complications. Other factors such as age, gender, race, smoking status and duration of diabetes are also noted to contribute to increase risk for diabetes complications.

Background: Iodine deficiency disorder (IDD) is a public health issue in Sarawak. This study aimed to determine the present status of IDD among first trimester pregnant women in Sarawak after a decade of implementation of USI. Materials and Methods: A cross-sectional study of IDD involved 30 Maternal and Child Health Clinics throughout Sarawak with 750 pregnant women in the selected clinics were randomly selected via systematic sampling. Socio-demographic data, urinary iodine sample, thyroid size examination, and household salt were also collected. Further associations and odds were analysed using Krusskal-Wallis, Chi square and Logistic regression. Result: The prevalence of goiter rate (TGR) was found to be 1.0% (n=10). The median urinary iodine concentration (UIC) for Sarawak was 123.9μg/L (IQR 56.5-192.1μg/L) which indicates an iodine deficiency. Median UIC for both Sri Aman and Mukah had achieved adequacy of iodine intake which were 150.7 (IQR 128.2-235.8) and 170.2 (IQR 119.1-264.7) respectively. Sarawak divisions and ethnicity were found significant association with UIC. Conclusion: USI programme should be continue as has improved IDD in Sarawak despite majority of pregnant women in Sarawak still having iodine insufficiency. Programme manager should anticipate to location who has UIC lower than <100 μg/L.

Background: Chronic periodontitis has been recognised as one of the complications of diabetes mellitus. Individuals with diabetes are at higher risk of destructive periodontal disease. The objective of this study was to examine the oral health seeking behaviour of diabetic patients in Malaysia in order to improve their oral health condition. Methods: A cross-sectional study on Type II diabetes patients was conducted at selected public sector health clinics across four states, using self-administrated questionnaires. Descriptive data analysis was performed using SPSS version 19. Results: Of the 4,017 respondents, only 35.5% (95% CI: 34.10-37.10) acknowledged the association of diabetes and oral health. Less than half [48.4% (95% CI: 46.90-50.00)] had dental check-up since their diagnosis of diabetes. Of these, only 35.3% (95% CI: 33.10- 37.40) had their last dental visit within the past one year. This accounted for only 16.7% of all respondents. Among those who had dental check-up, majority of them [95.4% (95% CI: 94.30-96.30)] were self-motivated while the remaining [4.6% (95% CI: 3.70-5.70)] were referred by healthcare staff. About 79.2% (95% CI: 77.90-80.40) claimed that dental check-up is important for diabetes patients. However, only 59.9% (95% CI: 58.30-61.40) wanted to be referred for dental care. Three main reasons for not wanting a referral were perceived lack of necessity for a dental check-up, the absence of dental problems and the perception that dental problems were not serious. Conclusion: Despite majority of diabetes patients claiming the importance of dental check-up (79.2%), the demand for dental referral (59.9%) and actual oral healthcare utilisation (48.4%) were low. Referral of diabetes patients for oral healthcare by healthcare workers was very low. There is a need to increase the oral health awareness of diabetes patients and to improve their utilisation of oral healthcare. Healthcare workers need to routinely refer diabetes patients for a dental check-up.

Introduction: An estimated 13% of women in the postnatal period suffer from postnatal depression (PND) worldwide. In addition to underprivileged women, women who are exposed to violence are at higher risk of PND. This study aimed to investigate the relationship between intimate partner violence (IPV) and PND in Malaysia. Methods: This survey was conducted as a nationwide cross-sectional study using a cluster sampling design. Probable PND was assessed using a self-administered Edinburgh Postnatal Depression Scale (EPDS). Demographic profiles and IPV were assessed using a locally validated WHO Multicountry Study on Women’s Health and Life Events Questionnaire that was administered in a face-to-face interview. An EPDS total score of 12 or more and/or a positive tendency to self-harm were used to define PND. Results: Out of 6669 women, 5727 respondents were successfully interviewed with a response rate of 85.9%. The prevalence of probable PND was 4.4% (95% CI 2.9 to 6.7). The overall prevalence of IPV was 4.9% (95% CI 3.8 to 6.4). Among the women in this group, 3.7% (95% CI 2.7 to 5.0), 2.6% (95% CI 1.9 to 3.5) and 1.2% (95% CI 0.9 to 1.7) experienced emotional, physical and sexual violence, respectively. Logistic regression analysis revealed that women who were exposed to IPV were at 2.3 times the risk for probable PND, with an adjusted OR (aOR) of 2.34 (95% CI 1.12 to 4.87). Other factors for PND were reported emotional violence (aOR 3.79, 95% CI 1.93 to 7.45), unplanned pregnancy (aOR 3.32, 95% CI 2.35 to 4.69), lack of family support during confinement (aOR 1.79, 95% CI 1.12 to 2.87), partner’s use of alcohol (aOR 1.59, 95% CI 1.07 to 2.35) or being from a household with a low income (aOR 2.99; 95% CI 1.63 to 5.49). Conclusions: Exposure to IPV was significantly associated with probable PND. Healthcare personnel should be trained to detect and manage both problems. An appropriate referral system and support should be made available.