Citation: Quality of Diabetes Care at MOH Healthcare Facilities: SIQ Investigation Guideline, Fifth Edition. Putrajaya: Ministry of Health, Malaysia; 2011
MeSH terms: Diabetes Mellitus, Type 2; Humans; Malaysia; Medical Audit; Public Sector; Guidelines as Topic
Osteoporosis only became a 'disease' entity in the 20th century. After the initial observations and definitions of osteoporosis based on Caucasian populations, systematic research in Asian populations started in the 1980s. Significant variations between different ethnic groups with respect to the rate of osteoporotic fractures, bone mineral density and disease risk factors emerged from the data; this article highlights some of the earlier important findings and the dissimilarities. Osteoporosis is therefore not a homogeneous disease across the world.
MeSH terms: Asia; Ethnic Groups; Malaysia; Osteoporosis; Risk Factors; Bone Density
In this study, we analysed the genetic polymorphisms present in the third intron region of Interleukin-4 gene in Malaysian patients with Systemic Lupus Erythematosus. Overall, the RP I and II alleles were found evenly distributed in both the SLE patients and control individuals. There was no significant association observed in the distribution of allelic and genotypic frequencies between SLE patients and healthy controls. The result obtained is similar to a previous study carried out on SLE Chinese patients in Taiwan.
Objective: Primary care management of knee osteoarthritis (OA) has received little attention in the scientific literature and the main reason for this survey is to study and explore the variations and patterns of primary care management and assess both conventional and complementary therapy usage in knee OA in the primary care setting.
Methods: A cross-sectional survey of 200 randomly selected general practitioners (GPs) in the peninsular states of Malaysia was undertaken using a questionnaire. The GPs involved were asked about basic knowledge of OA in terms of diagnosis, investigation, and treatment. They were also asked about their usage of conventional and complementary medication.
Results: One hundred and eighty (90%) GPs responded to the questionnaires sent: 77% were in solo practice and 33% in group practice. Most of the GPs surveyed (60%) had been in practice for more than 10 years, 30% for 5-10 years and 10% were in practice for less than 5 years. Of GPs surveyed, 55% saw an average of more than 20 patients per week, 35% about 10-20 patients and 10% less than 10 patients per week. Of GPs surveyed, 65% would arrange an X-ray, 55% would arrange a blood test, mostly serum uric acid, rheumatoid factor and erythrocyte sedimentation rate. Pharmacological management consists of first-line treatment with non-steroidal anti-inflammatory drugs (NSAIDs) (61%), analgesics (35%) or a combination of the two (4%). Non-pharmacological management consisted of advice on exercise (27%), weight reduction (33%) and referral to physiotherapy (10%). Of GPs surveyed, 85% prescribed some form of complementary medications, 60% prescribed glucosamine sulphate, 21% chondroitin sulphate, 11% cod liver oil and 9% evening primrose oil. Only 10% of GPs surveyed perform intra-articular injections.
Conclusion: The data suggest that in the primary care setting, the majority of GPs over-investigate the diagnosis of OA. Pharmacological interventions largely concentrate on analgesics and NSAIDs. The use of physiotheraphy and non-drug approaches were significantly under-utilized. There is a need to further educate GPs in the management of OA.
MeSH terms: Complementary Therapies; Ambulatory Care Facilities; Analgesics; Anti-Inflammatory Agents, Non-Steroidal; Cross-Sectional Studies; Glucosamine; Humans; Malaysia; Osteoarthritis; Physicians, Family; Primary Health Care; Rheumatoid Factor; Uric Acid; Knowledge; General Practitioners
Citation: The first annual report of the National Eye Database 2007. Goh PP, Hussein E, Mustari Z, Ismail M, editors. Kuala Lumpur: Clinical Research Centre; 2008
Aim: This is a rheumatoid arthritis (RA) descriptive study, the first of its kind carried out in Malaysia.
Methods: This descriptive study involved 1084 RA patients' epidemiological and clinical data taken from Selayang, Putrajaya, Taiping and Seremban hospitals from June 2004 to December 2005.
Results: One thousand and eighty-four RA patients'data were analysed; 960 (88.6%) patients were female and 124 (11.4%) were male, approximately 8 : 1 M : F ratio. The majority of the patients were Indian (591; 54.5%), followed by the Malays (340; 31.4%), Chinese (126; 11.6%), indigenous (13; 1.2%) and others (14; 1.3%). Mean age was 49.6 ± 11.8 years with the youngest being 15 years and the oldest 88 years of age. Mean age for males was 52.0 ± 12.0 and females 49.3 ± 11.7 years (P =; 0.017). Most of these patients were housewives (565; 52.1%), followed by paid workers (266; 24.5%), retired patients (80; 7.4%), unemployed (76; 7.0%) and others (97; 8.9%). Mean duration of illness was 8.4 ± 6.7 years; 805 (74.3%) patients were relatively new patients (≤ 2 years illness duration) and 279 (25.7%) patients had illness duration > 2 years. Eight hundred and six (74.4%) were seropositive RA patients and 385 (35.5%) had presence of deformity. The majority of patients were treated with methotrexate (178; 16.4%), followed by combination of methotrexate, sulfasalazine and hydroxychloroquine (143; 13.2%), leflunomide (140; 12.9%), sulfasalazine (133; 12.3%) and combination of methotrexate and sulfasalazine (108; 10%).
Conclusion: In the above study, the majority of patients were female (960; 88.6%), Indian (591; 54.5%), had a mean age of 49.6 ± 11.8 years, most were housewives with a mean duration of illness of 8.4 ± 6.7 years and were treated with methotrexate (178; 16.4%). The results of the study may help Malaysian rheumaologists to understand their patients better and treat RA holistically.
Comment in: Yeap SS. Comment on: Multicentre survey of rheumatoid arthritis patients from Ministry of Health rheumatology centres in Malaysia. Int J Rheum Dis. 2009 Jul;12(2):177-8; author reply 179. doi: 10.1111/j.1756-185X.2009.01403.x. PubMed PMID: 20374340.
Citation: Buku Panduan Penggunaan Khidmat Doktor Swasta Untuk Perkhidmatan Kesihatan di Klinik Kesihatan. Putrajaya: Kementerian Kesihatan Malaysia; 2008
Translation:
Guideline on utilisation of private doctors in public primary care clinics. Putrajaya: Ministry of Health, Malaysia; 2008
MeSH terms: Ambulatory Care Facilities; Malaysia; Private Sector; Guidelines as Topic; General Practitioners
Tris(1-carboxyl-2-phenyl-1,2-ethylenodithiolenic-S,S’) tungsten complex is one of the most promising photocatalyst to be used in photolysis of water to produce hydrogen. The first step of the synthesis involves a metathesis reaction of tetrapropylammonium bromide [{(C3H7)4N}Br] and ammonium tetrathiotungstate [(NH4)2WS4] to form a tetrapropylammonium tetrathiotungstate [{(C3H7)4N}2WS4] (precursor). Then, the precursor was reacted with phenylacetylenecarboxylic acid (C9H6O2) to form tris(1-carboxyl-2-phenyl-1,2-ethylenodithiolenic-S,S’) tungsten complex (C27H18O2S6W). The infra-red, ultra violet/visible (UV/Vis) spectrum, nuclear magnetic resonance (NMR) and elemental micro-analysis of C, H, N and S agreed with the characteristic of the tris(1-carboxyl-2-phenyl-1,2-ethylenodithiolenic-S,S’) tungsten complex. The (W-S), (C-S) and (C=O) stretching frequencies were detected at 511, (1470 and 1035) and 1655 cm-1, respectively. The 1H NMR spectrum showed six protons in the complex. The 13C NMR showed only 7 signals for carbon atom in the benzene ring, ethylene groups and carboxylic acid pendant group due to the symmetry of the molecules. The reaction yield was about 50 percent. Photolysis of acetone spiked H2O showed that the catalyst was able to produced 1.8µmol/h hydrogen.
Aloi aluminium tempaan terawat haba siri 6XXX perlu melalui pelbagai proses termomekanik sebelum sedia digunakan sebagai badan luar kereta. Penuaan tabii yang lama pada suhu bilik memberi kesan yang tidak baik terhadap pengerasan tuaan. Ramai pengkaji telah memperkenalkan langkah tambahan seperti pra-penuaan untuk mengatasi masalah tersebut. Kajian ini bertujuan untuk meningkatkan respons pengerasan tuaan aloi Al-1.2Si-0.5Mg-0.25Fe berbentuk kepingan melalui penambahan Zr antara 0.02 hingga 0.30% bt. Aloi yang dikaji dilindap kejut air ke suhu bilik dan dibiarkan mengalami penuaan tabii selama 14 hari sebelum rawatan haba pada suhu 180ºC selama 30 minit dan juga 11 jam. Mikrokekerasan aloi Al-1.2Si-0.5Mg-0.25Fe tanpa Zr ialah 80.2 VHN untuk rawatan haba 30 minit dan 105.0 VHN untuk rawatan haba 11 jam. Mikrokekerasan, kekuatan tegangan dan kekuatan alah aloi yang mengandungi Zr dan dirawat haba pada 180ºC selama 11 jam adalah jauh lebih tinggi berbanding dengan set aloi yang sama tetapi dirawat haba selama 30 minit. Namun begitu, aloi yang mengandungi 0.30% bt. Zr dan dirawat haba selama 30 minit mempunyai mikrokekerasan, kekuatan tegangan dan kekuatan alah yang lebih tinggi daripada aloi tanpa Zr tetapi dirawat haba selama 11 jam. Peningkatan sifat mekanik yang dilaporkan dikaitkan dengan fenomena penghalusan butiran.
Oleic acid (OA) capped wolfram (VI) oxide, WO3 nanoparticles were chemically synthesized and characterized by means of Fourier Transform-Infrared spectroscopy (FT-IR) and transmission electron microscopy (TEM). The tribological properties of the capped WO3 nanoparticles as an additive in base oils were investigated using a four-ball machine. Results show that OA-capped WO3 nanoparticles are able to prevent water adsorption and capable of being dispersed stable in organic solvents which is base oils. The as-prepared capped WO3 nanoparticles have an average size of 15 nm. In addition, OA-capped WO3 nanoparticles as an additive in base oils perform good anti-wear (AW) and anti-friction (AF) properties owing to the formation of a boundary film.
Offset curves arise in a variety of industrial applications such as robot’s path planning and numerical control machining in the textile, shoe and automobile industries. Rational curves, in particular the rational cubics, are widely accepted as a standard representation for design problems and geometric modellers but their offset curves are in general not rational. Given a rational cubic or quartic spline, we present two local methods to approximate its offset curve using a rational Bézier spline of the same degree. This approximate offset curve interpolates the positions and unit tangents at both ends of the exact offset curve segments and its curvatures at these endpoints are consistent with the offset distance and the corresponding curvatures of the given curve. It has second order geometric continuity if the given curve is so. The accuracy of the approximation can be refined by a local iterative subdivision process.
This article study the influences of structural break to the fractionally integrated time-varying volatility model in Malaysian stock markets from year 1996 to 2006. A fractionally integrated autoregressive conditional heteroscedastic (FIGARCH) model combines with sudden changes of volatility is develops to study the possibility of structural change in Asian financial crisis and currency crisis. Our empirical results evidence substantially reduction in long memory clustering volatility after the inclusion of sudden changes in the volatility. Finally, the estimation, diagnostic and model selection evaluations indicate that the fractionally integrated model with structural change is out-performed compared to the standard model.
A gradient of neutron flux distribution in an irradiation channel in research reactor is considered to have effect on the k0-instrumental neutron activation analysis (k0-INAA) measurement. A study has been carried out to determine: (1) the variation of the thermal to epithermal neutron flux ratio (f); (2) the epithermal neutron flux shape factor (!), and; (3) the neutron flux in an irradiation container at four selected irradiation channels, use being made of an Au-Cr-Mo monitor set. In this work, f was found to range from 15.5 – 16.3, while ! was found to range from 1.52 × 10-2 – 5.58 × 10-2. Additionally, within the selected irradiation channels the variation in calculated thermal neutron flux within one irradiation container was found to vary from 11.8% - 26.7%. The results of analysis have provided a determination of variation in the neutron parameters, f and !, and neutron flux between the irradiation channels and within the irradiation container.