Aim of study: To describe the residents of nursing home for the elderly in relation to their socio-demographic, physical and mental profiles. Method: A cross-sectional study design was carried out. The elderly in two selected nursing homes in Kuantan, Pahang were interviewed. The respondents were interviewed using a structured questionnaire which included the biodata, social background, and medical illness, presence of cognition, depression and ability to perform basic activities of daily living (ADL). Results: Results are available for 36 respondents out of 41 residents, giving a response rate of 87.8%. Chinese (77.8%), male (63.9%), single or divorced (50%), and low income (69.4%) was consisted the majority. Most respondents (86.1%) suffered from chronic illness, 61.1% were functional dependent (according to Barthel index), 33.3% have cognitive impairment (according ECAQ) and 22.2% have depression (according to GDS-14). The most common functional dependence was mobility on level surface (47.2%), followed by climbing stairs (38.9%).Conclusion: This study had identified chronic illness, cognitive impairment, depression, and functional decline as major health problems of the elderly in nursing homes that require greater attention and intervention.
INTRODUCTION: One of the most important and debilitating complication of diabetes mellitus is foot
problem such as ulcers, infections and amputations. However, these complications are preventable by simple
intervention such as regular foot care practice. This study aims to assess the foot care practice and its
associated factors among type 2 diabetes mellitus patients attending primary health clinics in Kuantan.
MATERIALS AND METHODS: This was a cross-sectional study conducted at four primary health clinics in
Kuantan involving 450 study participants who were selected by using universal sampling method. Level of
awareness and practice toward diabetic foot care was assessed using validated self-administered
questionnaire. Multiple logistic regressions were performed to identify factors associated with poor foot care
practice among the respondents. RESULTS: About 59.6% of respondents had poor foot care practice and
50.9% had poor awareness level. Multivariate logistic regression analysis identified that, increasing age
(OR 0.97, 95% CI: 0.955-0.993) and good awareness towards foot problem (OR 0.43, 95%CI: 0.289-0.643)
were less likely to have poor foot care practice. However, Malay ethnicity (OR 1.81, 95% CI: 1.002-3.271) and
obesity (OR 1.9, 95% CI: 1.225-2.976) were associated with poor foot care practice after controlling other
variables. CONCLUSION: Majority of the respondents had poor foot care practice and poor awareness.
Respondents who are older and have better awareness are less likely to have poor foot care practice.
Diabetic patients who are Malays and/or obese are predicted to have poor diabetic foot practice and hence
must be prioritized for a sustainable patient education and compliance towards foot care practice at primary
care level.
Obstructive sleep apnoea (OSA) is a sleep related breathing disorder with recurrent episodes of apnoea or hypopnoea occurring during sleep. It is associated with increased risk of cardiovascular disease and prone to accidents. However, there is no applicable study that assess the risk for OSA at the primary care level. Objective: This study aims to assess the prevalence of risk for OSA and OSA symptoms and its associated risk factors among adults attending primary care clinics. Materials and method: This cross-sectional study was conducted among 252 adults attending four Klinik Kesihatan in Kuantan, Pahang. The inclusion criteria was adults age 30 years old and above. The exclusion criteria were a known case of Hypothyroidism, Depression and pregnancy. A self-administered validated Malay version of Berlin Questionnaire(BQ) was used to screen for high risk of OSA. The statistical analyses were done using IBM SPSS version 23.0. Results: Majority of the respondents were male (54%), Malay (87.7%), and married (79.4%). The prevalence of High Risk for OSA was 32.9%. Among these, 94% of them presented with snoring and 16.9% presented with excessive daytime sleepiness. Among male, Malay and married; 48%, 32.6% and 36.5% respectively was shown to be High Risk for OSA. The risk factors that were found significantly associated with High Risk of OSA includes younger age (AOR=0.951 CI=0.923-0.980); higher BMI classification with obese type 1 (AOR=2.604 CI=1.278-5.308), obese type 2 (AOR=3.882 CI=1.078-13.975) and obese type 3 (AOR=6.800 CI=1.164-39.717); higher neck circumference (AOR=1.109 CI=1.007-1.221); hypertension (AOR=2.297 CI=1.122-4.702); and hypercholestrolaemia (AOR=2.040 CI=1.050-3.965). Conclusions: This study shows that nearly one third of the adults attending primary health clinic are at High Risk for OSA and nearly 17% of them presented with excessive daytime sleepiness. Further study need to be carry out particularly among those of younger age, higher BMI classification, and with co-morbidities.
Introduction: Clinical resolution of periodontitis (CRP) of type-2 diabetic patients with chronic periodontitis (T2DM-PD) after receiving non-surgical periodontal treatment (NSPT) has been reported in the previous studies. This study aimed to evaluate CRP of T2DM-PD under medicaldental coordinated care (M-DCC). Materials and Methods: A 6-months follow-up quasi-experimental study was conducted among 20 subjects who received M-DCC in 2016. M-DCC included standard diabetic care provided by medical professional from 3 health clinics and NSPT provided by periodontal specialists from two periodontal specialist clinics. Target glycemic control achievement (TGCA) HbA1c 6.5% was assessed at baseline and 6 months after NSPT. Clinical resolution of PD was measured in terms of BPE, BOP %, CAL(mm), PPD(mm), PPD 4mm, PPD =4 mm and PPD 6mm at baseline, 3 and 6 months. Paired simple t test and ANOVA F test were applied to infer clinical resolution of periodontitis and its relation to TGCA.
Results: Mean (SD) of average BPE at baseline, 3- and 6-months were 3.52(0.34), 3.12(0.33) and 3(0.45) with (p<0.05); average PPD(mm) were 3.33(0.5), 3.23(0.75) and 2.73(0.57) with (p<0.05); PPD(%) 4mm were 71.03(12.33), 82.77(9.9) and 85.85 (8.9) with (p<0.05); PPD(%) =4 mm were 27.94(11.9), 16.97(10.01) and 13.71(9.1) with (p<0.05); PPD(%) 6mm were 8.04(4.32), 2.66(2.3) and 1.87(2.32) with (p<0.05). Significant resolution of BPE, CAL(mm) and PPD(mm) was noticed among two subjects who has changed from uncontrolled TGCA to controlled TGCA.
Conclusion(s): CRP and TGCA results have verified the effectiveness of M-DCC. A further clinical control trial with adequate sample size needs to confirm the results of the present study.
KEYWORDS: clinical resolution, chronic periodontitis, periodontal therapy, target HbA1C%, Type-2 Diabetic Patients with chronic periodontitis