Browse publications by year: 2003

  1. Malays J Nutr, 2003;9(2):-.
    A cross-sectional comparative study was conducted to determine the nutritional status among physically active groups in Kota Bharu. The study population comprised 83 adult male athletes from 8 different types of sports (athlete group), 80 active men who exercised a minimum of 30 min per day for at least 3 times per week (exercise group), and 80 inactive men (sedentary group). All the respondents were aged between 18 to 44 years. Measurements taken from the respondents were anthropometric measurements, systolic (SBP) and diastolic (DBP) blood pressure, and serum total cholesterol (TC). The results showed that the combined prevalence of pre-obese (BMI 25.0-29.9) and obese (BMI ¡Ý30.0) was 21.7% in athletes, 29.9% in exercise group, and 47.5% in sedentary group. The mean (± SD) percentage of body fat in athletes was 15.7 ± 5.4%, which was lower compared to the exercise (18.9 ± 5.5%) and sedentary (20.6 ± 5.8%) groups. The incidence of waist-to-hip ratio above 0.9 in athlete, exercise and sedentary groups was 9.6%, 18.7% and 31.3%, respectively. The incidence of hypertension (SBP ¡Ý140 and/or DBP ¡Ý90 mmHg) was 13.2% in athletes, 17.5% in exercise group and 42.5% in the sedentary group. The TC values showed that the prevalence of “high risk” individuals (TC ¡Ý6.20 mmol/l) was also lower in athletes (20.5%), compared to the exercise (36.2%) and sedentary (47.5%) groups. The study revealed that individuals who are actively involved in physical activity, particularly in sport activities have better nutritional status compared to sedentary people. However, the nutritional status in the athlete and exercise groups was still unsatisfactory. The incidence of poor health status related to over nutrition in the active groups was rather high and needs attention from health professionals. Further studies are needed to determine nutritional practices among physically active groups.
    MeSH terms: Adipose Tissue; Adult; Attention; Blood Pressure; Blood Pressure Determination; Cholesterol; Cross-Sectional Studies; Humans; Hypertension; Male; Nutritional Status; Surveys and Questionnaires; Sports; Systole; Exercise; Body Mass Index; Incidence; Prevalence; Waist-Hip Ratio; Athletes
  2. Malays J Nutr, 2003;9(1):-.
    As consumer interest in organically grown vegetables is increasing in Malaysia, there is a need to answer whether the vegetables are more nutritious than those conventionally grown. This study investigates commercially available vegetables grown organically and conventionally, purchased from retailers to analyse â-carotene, vitamin C and riboflavin contents. Five types of green vegetables were selected, namely Chinese mustard (sawi) (Brassica juncea), Chinese kale (kailan) (Brassica alboglabra), lettuce (daun salad) (Lactuca sativa), spinach (bayam putih) (Amaranthus viridis) and swamp cabbage (kangkung) (Ipomoea aquatica). For vitamin analysis, a reverse-phase high performance liquid chromatography was used to identify and quantify β-carotene, vitamin C and riboflavin. The findings showed that not all of the organically grown vegetables were higher in vitamins than that conventionally grown. This study found that only swamp cabbage grown organically was highest in β-carotene , vitamin C and riboflavin contents among the entire samples studied. The various nutrients in organically grown vegetables need to be analysed for the generation of a database on nutritional value which is important for future research.
    MeSH terms: Ascorbic Acid; Carotenoids; Chromatography, High Pressure Liquid; Malaysia; Mustard Plant; Nutritive Value; Riboflavin; Vegetables; Vitamin A; Vitamins; Lettuce; Spinacia oleracea; Amaranthus; Ipomoea; Wetlands; Chromatography, Reverse-Phase
  3. Abdul Latiff, M., Katiman, E., Abu Hassan, J.
    Ambulatory blood pressure monitoring (ABPM) devices are increasingly being used in the assessment of hypertension. The purpose of the study was to investigate patient’s diurnal BP variation and to further determine the differences of BP readings between male and female patients and the effects of age in patients who attended the clinic with essential hypertension. In addition, evidence of relationship between the parameters recorded by 24-hour ABPM was also investigated. This study was conducted in an outpatient specialist clinic. Two indices were used to demonstrate the diurnal BP variation. Firstly, the diurnal systolic blood pressure (SBP) and diastolic blood pressure (DBP) variations which were calculated as night / day BP ratio for SBP and DBP respectively. Anyone scoring less than 100% were categorised as dippers. Secondly, nocturnal falls in SBP and DBP were calculated as (awake SBP-sleep SBP)/awake SBP x 100 and (awake DBP-sleep DBP)/awake DBP x 100 respectively. The results showed that there was no significant difference in the mean BP between male and female patients. In general, the study sample were categorised as dippers and non dippers. There were more male dippers than female dippers. Finally correlation analysis revealed that age is related to SBP variables whilst night HR showed positive correlation with night time BP. It is concluded that ABPM was shown to be a useful tool to analyse the variation and prevalence of cardiovascular risk markers in hypertensive patients and can easily be done in an outpatient set-up.
    MeSH terms: Accidental Falls; Blood Pressure; Cardiovascular Diseases; Circadian Rhythm; Female; Humans; Hypertension; Male; Outpatients; Risk Factors; Sleep; Prevalence; Blood Pressure Monitoring, Ambulatory
  4. Wan Mohd. Rushidi Wan Mahmud, Amir Awang, Mahmood Nazar Mohamed
    Aim: To reevaluate the psychometric characteristics of the Malay version of the Edinburgh Postnatal Depression Scale among a sample of postpartum Malay women attending the Bakar Bata Health Center in Alor Setar, Kedah, North West of Peninsular Malaysia. Materials and methods: 64 women between 4 to 12 weeks postpartum were recruited for there validation study. They were given questionnaires on socio-demography, the 21-item Malay version of the Beck Depression Inventory II (BDI-II) and the 10-item Malay version of the Edinburgh Postnatal Depression Scale (EPDS). All the participants were later interviewed using the Hamilton Depression Rating Scale (HDRS-17) and the Composite International Diagnostic Interview (CIDI). All diagnoses were made based on the Tenth Edition of the International Classification of Diseases (ICD-10) Results: 9 women (14.1%) were diagnosed to have significant depression (7 mild depressive episodes and 2 moderate epressive episodes according to ICD-10). EPDS was found to have good internal consistency (Cronbach alpha =0.86) and split half reliability (Spearman split half coefficient = 0.83). The instrument also showed satisfactory discriminant and concurrent validity as evidenced by the statistically significant difference in EPDS scores between the depressed group and their nondepressed counterparts (Mann Whitney U test: 2 tailed p value
    MeSH terms: Demography; Depression; Depressive Disorder; Female; Humans; Malaysia; Psychiatric Status Rating Scales; Psychometrics; Surveys and Questionnaires; Reproducibility of Results; Statistics, Nonparametric; Depression, Postpartum; International Classification of Diseases; Postpartum Period
  5. Hasanah Che Ismail
    Quality of life measures are designed to enable patients’ perspectives on the impact of health and healthcare interventions on their lives to be assessed and taken into account in clinical decision-making and research. This paper discusses some approaches, methodological as well as interpretative issues of health related quality of life research.
    MeSH terms: Clinical Decision-Making; Paper; Quality of Life; Research
  6. Faudziah Abd Manan, Jenkins, T.C.A., Kaye, N.A.
    The characteristics of foveal suppression (FS) in fixation disparity (FD) due to visual stress were investigated and their relationship’s between, age, symptoms, and the effect of temporary elimination of FD using prisms on the degree of the FS were analysed. Forty-five presbyopic subjects (15 without FD and 30 with stress related FD) participated in the study. The subjects underwent comprehensive optometric examination prior to the study. Their FS and FD were measured. The FD was later corrected with ophthalmic prisms, the power of which was equally divided between the eyes, and the FS was later verified. Age and FS had no significant correlation for subjects without FD (Spearman’s rs = 0.17, p = 0.55,NS) and in subjects with FD (rs = 2.49, p = 0.19, NS), respectively. Correlation between the degree of FS and FD was weak (rs=0.38, p=0.07), however the magnitude of FD significantly increased with age (r=0.27, p=0.04). Subjects with FD had significantly larger degree of FS compared with subjects without FD (Wilcoxon’s Z =-0.25, p=0.01). There was no significant difference in the magnitudes of FD (t = -0.38, p=0.07) and in their degrees of FS (Mann-Whitney U = 1.5, p=0.71) between subjects with and without symptoms. Correcting the FD with prisms generally reduced the degree of FS (Wilcoxon’s Z =1.96, p=0.04), however, significant change in FS only occured in subjects with symptoms (Z=-1.97, p=0.03), but was not significant in subjects without symptoms (Z=-0.70, p=0.48).
    MeSH terms: Fovea Centralis; Optometry; Vision Disparity
  7. Abdul Kareem
    Road accident is ‘a global tragedy’ with ever-rising trend. The goal of this article includes review of the causes and nature of accidents, statistical data regarding road accidents and the economical impact. 1.17 million deaths occur each year worldwide due to road accidents 70 % of which occur in developing countries. 65% of deaths involve pedestrians, 35 % of which are children. Estimates suggest that 23-34 million people are injured worldwide every year in road crashes - a value almost twice that previously estimated. It is estimated that more than 200 U.S. citizens die each year due to road accidents abroad. Every year in Europe, more than 50,000 peoples are killed in road accidents, and more than 150,000 remain disabled. It is a sad fact that the total number of road accidents in Malaysia exceeded 223,000 in 1999. On the average, 16 persons died from these road accidents, every single day in 1999. Lack of attention, reckless driving, lack of proper protection, speeding, bad personal habits, social and behavioral misconduct and inconsiderate drivers of larger vehicles are some of the problems that cause accidents. In Malaysia, motorcycle fatal accidents (60%) warrant a high degree of concern. Young children and senior citizens are found to be in the vulnerable age group. In Malaysia, in 1999 alone, general insurers paid RM1.67 billion or an average of RM4.6 million a day on motor claims. It is now recognized that road traffic accidents represent a major public health problem, because of the high number of victims involved and because of the seriousness of the consequences for themselves and for their families.
    MeSH terms: Accidents, Traffic; Pedestrians; Attention; Child; Death; Developing Countries; Europe; Goals; Habits; Disabled Persons; Homicide; Humans; Insurance Carriers; Malaysia; Motorcycles; Public Health
  8. Raymond Azman Ali
    Diabetes mellitus is the commonest cause of neuropathy worldwide. Diabetic neuropathy (DN) develops in about 4-10% of diabetic patients after 5 years and in 15% after 20 years.Four main mechanisms have been postulated to underlie the pathogenesis of DN. Diabetic neuropathy can be divided into symmetrical and asymmetrical neuropathies. Diabetic Autonomic Neuropathy (DAN) parallels the severity of DSN, and affects primarily the cardiovascular, gastrointestinal, genitourinary and integumentary systems. The cornerstone of treatment of diabetic neuropathy is optimization of glycaemic control. Future treatments for diabetic neuropathy should address the underlying pathogenesis.
    MeSH terms: Blood Glucose; Diabetic Neuropathies; Humans; Integumentary System
  9. Singh, Rabindarjeet
    Major sporting events in Asia are commonly staged in hot environments where the average daytime temperature is generally 29-31°C with the average relative humidity ranging from 80-95%. Exercise capacity and exercise performance are reduced when the ambient temperature is high and it has major implications for competitors as well as for spectators and officials. Prolonged exercise leads to progressive water and electrolyte loss from the body as sweat is secreted to promote heat loss. The rate of sweating depends on many factors and increases in proportion to work rate and environmental temperature and humidity. Sweat rates are highly variable and can exceed 2L.h-1 for prolonged periods in high heat. Since dehydration will impair exercise capacity and can pose a risk to health, the intake of fluid during exercise to offset sweat losses is important. Carbohydrate-electrolyte fluid ingestion during exercise has the dual role of providing a source of carbohydrate fuel to supplement the body’s limited stores and of supplying water and electrolytes to replace the losses incurred by sweating. The composition of the drinks to be taken will be influenced by the relative importance of the need to supply fuel and water which, is in turn depends on the intensity and duration of exercise activity, the ambient temperature and humidity. Carbohydrate-electrolyte solutions appear to be more effective in improving performance than plain water. There is no advantage to fluid intake during exercise of less than 30-minute duration. Complete restoration of fluid balance after exercise is an important part of the recovery process and becomes even more important in hot, humid conditions. If a second bout of exercise has to be performed after a elatively short interval, the speed of rehydration becomes of crucial importance. Rehydration after exercise requires not only replacement of volume losses, but also replacement of some electrolytes, primarily sodium. Studies show that rehydration after exercise can be achieved only if sweat electrolyte losses as well as water are replaced. Drinks with low sodium content are ineffective at rehydration and they will only reduce the stimulus to drink. Addition of small amount of carbohydrate to the rehydrating drinks may improve the rate of intestinal uptake of sodium and water and will improve palatability. The volume of the rehydration beverage consumed should be greater than the volume of sweat lost to provide the ongoing obligatory urine losses and palatability of the beverage is a major issue when a large volume of fluid has to be consumed.
    MeSH terms: Asia; Beverages; Body Temperature Regulation; Carbohydrates; Dehydration; Drinking; Fluid Therapy; Hot Temperature; Humidity; Sodium; Sweat; Sweating; Temperature; Water; Water-Electrolyte Balance
  10. Ashraf, M., Abdullah, J., Abdul Rahman Ariff, Biswal, B. M., Mokhtar, I., Othman, N.H.
    Solitary plasmacytoma of the head and neck is a rare disease entity. Its description in the literature consist of some case reports. Solitary plasmacytoma presenting with exophthalmos are rare. We report a case of intracranial solitary plasmacytoma in an elderly lady with involvement of the right orbitocranial region presenting with severe exophthalmos. The tumour was debulked and radiotherapy was given.
    MeSH terms: Aged; Bone Neoplasms; Exophthalmos; Head; Humans; Neck; Plasmacytoma; Rare Diseases
  11. Abdul Rahman Omar, Aini Ideris, Abdul Manaf Ali, Fauziah Othman, Khatijah Yussoff, Jafri Malin Abdullah, et al.
    Newcastle disease virus (NDV) is one of the most economically important avian virus which affects the poultry industry worldwide. Although NDV is being very actively studied in Malaysia, there are still no studies on its potential as an anticancer agent, a new approach to treating cancer known as virotherapy. Currently, a collaborative research is being undertaken between Universiti Putra Malaysia (UPM), Universiti Sains Malaysia (USM) and Majlis Kanser Nasional (MAKNA) in characterising various local NDV isolates as anticancer agent. This paper describes an overview of the research that have been carried out worldwide in the use of NDV for cancer treatment and also some of our findings in characterising local NDVs with oncolytic properties.
    MeSH terms: Animals; Antineoplastic Agents; Malaysia; Neoplasms; Newcastle disease virus; Parainfluenza Virus 2, Human; Poultry; Research; Oncolytic Virotherapy
  12. Chen, Ai Hong, Abdul Aziz Md Dom
    The purpose of this study was to investigate the relationship between heterophoria and refractive error. Thirty-six subjects (11 myopes, 25 emmetropes) participated in this study. Heterophoria was measured with the Free-Space Phoria Card at five different viewing distances (25cm, 33cm, 50cm, 100cm and 300cm). Regardless of the types of heterophoria, the amount of heterophoria reduced towards orthophoric position with increasing viewing distance. Emmetropes and myopes did not show any significant difference in the degree of heterophoria at different viewing distances (F = 0.30, p>0.05) or in the type of heterophoria (c2 = 2, p>0.05).Thirty-six optometry students, aged from 19 to 24 years, participated in this study. All subjects had complete optometric examination within the last two years and did not show any clinical signs of accommodative, fusion, stereopsis or strabismic problems. Written consents were obtained prior to examination. Eleven (8 females, 3 males) of them were myopes (spherical range: -0.25DS to – 10.00DS; cylindrical range: -0.25DC to –0.75DC). Twenty-five (14 females, 11 males) of them were emmetropes (Refraction range: plano - +1.00DS). The majority (10 out of 11) of our myopic subjects. In general, exophores (69%) were most common in this study. Regardless of the type of heterophoria, the amount of heterophoria decreased towards orthophoric position with increasing viewing distances. Our finding are also consistent with the report of fixation disparity at different viewing distance (24).viewing distance. We too report an exo-shift of the heterophoria with decreasing viewing distance 97% of our subjects. One subject however showed an eso-shift for closer distance.
    MeSH terms: Depth Perception; Female; Humans; Male; Myopia; Optometry; Refractive Errors; Strabismus; Students; Vision Disparity
  13. Ooi, Foong Kiew, Singh, Rabindarjeet, Sirisinghe, Roland G., Ang, Boon Suen, Syed Mohsin Sahil Jamallulail
    In this study, we examined the effects of acute ingestion of a herbal drink (H) or a coloured water placebo (P) on physiological responses and performance during cycling exercise. Eight healthy and trained male young cyclists (age: 16.0±0.5years) exercised on a cycle ergometer at 72.0±0.8% of the maximal oxygen consumption (VO2max) until exhaustion in a room maintained at 23.9±0.2 oC and 64.2±1.6% relative humidity on two occasions, 1-week apart. During each exercise bout, subjects received body weight of H or P every 20 minutes in a doubleblind randomised study design. There was no significant difference between H and P trials in the total work time to exhaustion (84.5±5.1 and 82.3±5.6 min respectively). Changes in heart rate, oxygen consumption, plasma glucose concentrations, plasma lactate concentrations, rectal temperature, respiratory exchange ratio and energy expenditure were similar with both type of drinks. Loss of plasma volume was also similar with both drinks. Herbal drink elicited similar physiological responses, thermoregularity responses and exercise performances during endurance cycling when compared to the placebo ingestion. Thus, it can be concluded that the ingredient in the herbal drink did not provide any added advantage to cycling endurance performance. In both the herbal (H) drink and placebo (P) trials, time taken for exhaustion to occur were similar, and they were 84.5 ± 5.1 min and 82.3 ± 5.6 min respectively (p>0.05). The total volume of fluid consumed during exercise was also similar in both drinks, 751.0± 49.6 ml and 727.6 ± 42.7 ml in the H and P trials respectively. As a result of exercise, subjects’ body weight decreased 0.7 ± 0.2 kg (2.6 ± 0.5%) and 0.8 ± 0.2 kg (2.8 ± 0.5%) in the H and P trials respectively, and these values were corrected for the fluid ingested during cycling. The decrease in body weight as expressed both in kg and percentage change of body weight with P did not differ statistically from H. Similar hemoglobin concentrations and hematocrit were noted at each time point during the H trial when compared with P trial. The percentage change of plasma volume relative to the preexercise level is shown in Figure 1. Plasma volume declined significantly (p
    MeSH terms: Blood Glucose; Body Temperature; Body Weight; Energy Metabolism; Heart Rate; Hematocrit; Hemoglobins; Humidity; Male; Oxygen Consumption; Plasma Volume; Temperature; Water; Exercise; Lactic Acid
  14. Zain Hamid, R., Ismail, Z., Mahendra Raj, S., Shuaib I.L., Mohsin S.S.J.
    The pharmacodynamics of propranolol were studied in 12 cirrhotic Malay patients. Fifteen healthy Malay volunteers were selected and several clinical parameters were obtained. The effects of three doses of propranolol in reducing the heart rate (HR) of these patients were observed to be significantly different. These differences were seen at dosing of 10 mg vs 20 mg and 10 mg vs 30 mg (P
    MeSH terms: Blood Pressure; Heart Rate; Humans; Liver Cirrhosis; Propranolol; Research; Healthy Volunteers
  15. MyJurnal
    Prostate cancer is not common in south-east asia and in particular there are only scarce reports on the characteristics of Malaysian men with prostate cancer. A retrospective study where all prostate specimens sent to the pathology department during the period 1st January 1996 to 30th June 1998 were reviewed. A total of 131 prostate specimens were reviewed and these consisted of prostatectomy specimens, transurethral resection specimens and trucut biopsy specimens. Only 114 patients’ case notes were evaluated. Data reviewed were age, race, presenting symptoms, clinical findings and prostate-specific antigen (PSA) level. Overall incidence of carcinoma of the prostate was 19.0%. The incidence of carcinoma of the prostate with serum prostate-specific antigen (PSA) of 4.1 to 20.0 ng/ml was only 10% and 60.5% of patients had evidence of subclinical histological prostatitis. The mean age of men with carcinoma of the prostate was 71.3 years and there was no differences in the incidence of carcinoma of the prostate among the 3 major ethnic groups (Malays, Chinese and Indian). About three-quarter of the patients with carcinoma of the prostate presented with lower urinary tract symptoms, a third had haematuria and about a tenth of patients presented with urinary retention. The majority of patients presented with metastatic disease (66.7%) with a mean PSA of 1476.8 ng/ml. A significant proportion of men with prostatic diseases attending the University of Malaya Medical Center had prostate cancer (19.0%). A small proportion of men with serum PSA in the range of 4.1 to 20.0 ng/ml had prostate cancer and this is thought to be due to the background histological prostatitis. The majority of patients presented late.
    MeSH terms: Asia; Biopsy; Ethnic Groups; Hematuria; Humans; Male; Prostatectomy; Prostatic Diseases; Prostatic Neoplasms; Prostatitis; Retrospective Studies; Incidence; Urinary Retention; Prostate-Specific Antigen; Lower Urinary Tract Symptoms
  16. MyJurnal
    The truth often hurts, but only by knowing the truth can proper solutions be found. It has long been recognised that adequate epidemiological data is crucial for the planning and development of cancer programmes. In the First Report of the National Cancer Registry, 26,089 cases were registered among the population in Peninsular Malaysia. Taking into account the estimated 10,656 unregistered cases and the 3750 cases registered in Sabah and Sarawak, the total number of new cancer patients in Malaysia in 2002 would be approximately 40 500. This means that the cumulative lifetime risk of getting cancer was 1 in 4 in Malaysia, a fact which hit the headlines in many of the daily newspapers of the country. Cancer is indeed a serious national health problem. Correlating these registry findings with existing findings from studies on lifestyles, presentation of disease, diagnostic tests, interventions in cancer prevention, treatment, palliation and rehabilitation will be the way to go in defining and refining the strategy against cancer in this country.
    MeSH terms: Delivery of Health Care; Diagnostic Tests, Routine; Humans; Life Style; Malaysia; Medicine; Neoplasms; Palliative Care; Registries
  17. MyJurnal
    A cross-sectional study to determine the prevalence of Human Immunodeficiency Virus (HIV) and HIV associated risk behavior was conducted in February 1998 among 6,324 drug users in 26 drug rehabilitation centres in Malaysia. The majority of respondents were males (97.3%) and Malays (77.8%), administered drugs intravenously (64.6%) and of these 65.4% shared needles. About 78.1% had sexual exposure, of which 55.1% had sex with girl friends, 31.3% with prostitutes and 4.6% with male partners. The HIV prevalence rate in the group was 12.1% and significantly high among injecting drug users (IDU); those sharing needles; those who started addiction at a young age (10-15 years); those who had sexual exposures and had sex with prostitutes.
    MeSH terms: Cross-Sectional Studies; Female; Humans; Malaysia; Male; Needles; Surveys and Questionnaires; Risk-Taking; Sexual Partners; HIV Infections; Prevalence; Substance Abuse Treatment Centers; Needle Sharing; Friends; Drug Users; Sex Workers
  18. MyJurnal
    The profile of admissions staying less than 24 hours admitted to the paediatric wards of University Malaya Medical Center, Kuala Lumpur, over a period of six weeks was reviewed to ascertain the need of a short-stay ward. Ninety-three (22%) of the 428 admissions admitted during the study period were discharged within 24 hours, 56 (60%) were discharged within 12 hours. Major categories of admissions were: elective investigative procedures (43%), and emergency admissions (44%). Reasons for emergency admissions: infections 42%, minor trauma/cerebral concussion 25% and febrile/afebrile seizures 11%. Only 20% required percutaneous oximetry monitoring and 2% required observations more frequently than 2 hourly. There may be a case for a short stay ward in a big paediatric unit in Malaysia.
    MeSH terms: Brain Concussion; Child; Seizures, Febrile; Fever; Hospitalization; Humans; Malaysia; Oximetry; Patient Discharge; Seizures; Universities
  19. MyJurnal
    Identification of pregnancies that are at greater than average risk is a fundamental component of antenatal care. The objective of this study was to assess the level of appropriate management and outcomes among mothers with hypertensive disorders of pregnancy, postdates and anemia in pregnancy, and to determine whether the colour coding system had any effect on the maternal mortality ratios. A retrospective follow-through study confined to users of government health services in Peninsular Malaysia was carried out in 1997. The study areas were stratified according to their high or low maternal mortality ratios. The study randomly sampled 1112 mothers out of 8388 mothers with the three common obstetric problems in the selected study districts. The study showed that the prevalence of anemia, hypertensive disorders in pregnancy and postmaturity among mothers with these conditions were according to known international standards. There was no significant difference in the colour coding practices between the high and low maternal mortality areas. Inappropriate referrals were surprisingly lower in the areas with high maternal mortality. Inappropriate care by diagnosis and by assigned colour code were significantly higher in the areas with high maternal mortality. The assigned colour code was accurate in only 56.1% of cases in the low maternal mortality areas and in 55.8% of the cases in the high maternal mortality areas and these two areas did not differ significantly in their accurate assignment of the colour codes. The colour coding system, as it exists now should be reviewed. Instead, a substantially revised system that takes cognisance of evidence in the scientific literature should be used to devise a more effective system that can be used by health care personnel involved in antenatal care to ensure appropriate level of care and referrals.
    MeSH terms: Anemia; Color; Female; Government; Humans; Hypertension; Malaysia; Maternal Mortality; Mothers; Pregnancy; Prenatal Care; Referral and Consultation; Retrospective Studies; Risk; Prevalence
  20. Teng, Sang-Chong, Esah Bahaman, Tang, Wen-Yen
    Although only 6.3% of the 221 respondents in this crass-sectional study stated outright that the hospital food served to them was not good, a high proportion of respondents ( 62.0%) supplemented ltaspimlfoad with outside food. When the reasons for supplementation were considered, it is likely that 53.8% ( $5.5%; 95% CI ) of the patients in this study were dissatisfied with hospimlfoudfar some reasons or when particularly with regards t0 variety, attractiveness and sewing lime. The pl‘0]701’l‘i011 of respondents wha were dissatisfied with hospital faud was significantly higher (p
    MeSH terms: Humans; Oxides; Surveys and Questionnaires; Calcium Compounds; Dietary Supplements
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