Background: Breast cancer is one of the most feared diseases among women and it could induce the development of psychological disorders like anxiety and depression. An assessment was here performed of the status and to determine contributory factors. Materials and Methods: A cross-sectional study was conducted among breast cancer patients at University Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur. A total of 205 patients who were diagnosed between 2007 until 2010 were interviewed using the questionnaires of Hospital Anxiety and Depression (HADS). The associated factors investigated concerned socio-demographics, socio economic background and the cancer status. Descriptive analysis, chi-squared tests and logistic regression were used for the statistical test analysis. Results: The prevalence of anxiety was 31.7% (n=65) and of depression was 22.0% (n=45) among the breast cancer patients. Age group (p= 0.032), monthly income (p=0.015) and number of visits per month (p=0.007) were significantly associated with anxiety. For depression, marital status (p=0.012), accompanying person (p=0.041), financial support (p-0.007) and felt burden (p=0.038) were significantly associated. In binary logistic regression, those in the younger age group were low monthly income were 2 times more likely to be associated with anxiety. Having less financial support and being single were 3 and 4 times more likely to be associated with depression. Conclusions: In management of breast cancer patients, more care or support should be given to the young and low socio economic status as they are at high risk of anxiety and depression.

Background: Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC isfast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental andgenetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC. Materials and Methods: Retrospective case review study done on CRC patients at Universiti Kebangsaan Malaysia MedicalCentre (UKMMC), Kuala Lumpur, Malaysia. Patients’ socio-demographic characteristics, modalities oftreatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records. Results:A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%).Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms includingper rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presentedwith Dukes C stage(40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%.Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lowerrecurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinesepatients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment(22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45). Conclusion: Socio-demographicprofile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatmentgives rise to poor overall survival and local recurrence rates.

Background: Patients' delay in the presentation with rectal bleeding had been identified as a factor for late diagnosis of colorectal cancer. This study was conducted to determine the prevalence of delay in consulting a medical practitioner and identifying associated factors. Materials and Methods: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The self-administered questionnaire included data on sociodemographic, concern of rectal bleeding, whether patients sought initial advice, any self treatment prior to medical consultation and patients' opinion on causes of their own rectal bleeding. Results: The prevalence of delay in the presentation of rectal bleeding was 60%. Patients who were less worried (OR 9.6; 95% CI 3.3-27.5), who did not seek anyone's advice (OR 11.8; 95% CI 3.8-36.8) and took some treatment before seeking medical consultation (OR 5.0; 95% CI 1.0-24.1) were significantly more likely to delay. Multiple logistic regression revealed that less worry of rectal bleeding and not seeking anyone's advice were important predictors (p < 0.05). The majority of patients attributed their bleeding to benign causes. Conclusion: A high proportion of patients with rectal bleeding in the high risk group delayed in seeking medical advice. Public education needs to focus on interventions to reduce the delay in presenting and diagnosis of colorectal carcinoma.

Background: Methadone Maintenance Therapy (MMT) is one of the popular choices for drug substitution therapy and is fairly new in Malaysia. Aside from its role in harm reduction against HIV infection, MMT programme may potentially enhances clients' quality of life. This study aims to identify the impact of MMT programme on clients' quality of life after 6 months in treatment and to explore factors that may be associated with changes in their quality of life. Methods: In this retrospective report review, 122 subjects from 2 government MMT clinics were selected from the district of Tampin, Negeri Sembilan, Malaysia. The raw score from the WHO Quality of Life questionnaire (WHOQOL-BREF), at baseline and 6 months after therapy were collected and converted to 0-100 scale form to give quality of life scores for four domains; physical, psychological, social relationships and environment. Other variables of interest were socio-demography, age when joining MMT programme, age and duration of illicit drug use, HIV and Hepatitis C status, and the Opiate Treatment Index (OTI) score on drug use, sexual and social aspect at the baseline. Statistical analysis used the SPSS version 16. Results: There was significant improvement in all four domains of quality of life, after 6 months of MMT. The largest improvement was for psychological domain (mean score difference 15.54 ± 20.81). Multivariable linear regression analysis showed that, for the physical domain, there was no significant predictor. For both the psychological and social domains, having tertiary education is a significant predictor for improvement in both aspects of quality of life. Negative HIV status is associated with improvement for the environment domain. Conclusions: There was a significant short term improvement in the quality of life of MMT clients who stayed in the programme for at least 6 months in the district of Tampin, Negeri Sembilan, Malaysia.

Background: Knowledge is believed to be a driving factor for patients’ early presentation for healthcare. This study was conducted to assess knowledge of colorectal cancer among subjects presenting with rectal bleeding and to determine its association with late presentation. Methods: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The research instruments used in this study was a self-administered questionnaire including data on duration of rectal bleeding, first medical consultation and knowledge of colorectal cancer. Results: Sixty percent of subjects with rectal bleeding delayed seeking medical advice. Subjects were more aware of symptoms of non-colorectal cancers compared to symptoms of colorectal cancer. The majority of subjects (63.8%) correctly identified rectal bleeding as a symptom but were not aware of the best screening method to detect colorectal cancer. Half of the subjects knew increasing age and genetic background to be risk factors for colorectal carcinoma. However, knowledge of colorectal cancer was not found to be significantly associated with delay in seeking help. Conclusion: Findings indicate poor awareness of colorectal cancer among the subjects. Although public education of colorectal cancer is important for early presentation on rectal bleeding, further studies are advocated to evaluate other factors influencing patients’ help seeking behavior other than knowledge. Keywords : rectal bleeding delay in seeking help Knowledge colorectal cancer Malaysia