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Fulltext A comparison between private clinic in urban and rural area in Selangor, 2009. [Perbandingan klinik swasta di bandar dan luar bandar di negeri Selangor, 2009]

Sharifa Ezat WP, Natrah MS, Khalib AL, Hasni H

Malaysian Journal of Community Health, 2009;15(2):9-16.
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Introduction : Selangor’s private clinic registry system had been introduced in 2006 following gazettment of The Private Healthcare Facilities and Services Act. Through the act, data’s from the private clinics can be obtained and its characteristics can be compared between the urban and rural private clinic. An overview of the services can be known and an appropriate action can be planned.
Methodology : A cross-sectional study was done on private clinics registered in state of Selangor. Using databased known as MedPCs (Medical Practice Control System), a purposive sampling was used to select four districts – two urban and two rural. All private clinics in the selected districts were studied and all details shall be collected online.
Result : District of Gombak and Klang were selected as urban and Sabak Bernam and Kuala Selangor represented rural area. Of a total 625 clinics selected, 90.0% (562) from urban and 10.0% (63) rural. Distributions of clinic were in line with the act. The most prominent services were general treatment (89.4%) and ability to serve more than eight hours daily (89.4%). Medical clinic still dominated at 84.0% compared to dentistry at 16.0%. About 70.6% were operated by male doctors. Though clinic services in rural were relatively as good as urban, the different were significantly observed to the ethnicity of the doctor. Indian doctors more in rural (46.03%), whilst in urban, Malay doctors were more dominant (39.50%). Followed closely by seniority, where rural doctors were much senior (51.02 years old), however, most of the doctors in rural private clinics experienced less exposure in government sectors, compared to those in urban areas.
Conclusion : There were obvious difference in terms of distribution, where more clinics were located in urban compared to rural, but all were still in line to the act and their services were comparable. Most noticeable differences were ethnicity, seniority and past experience working in the public sector. Indian doctors were dominant in rural and Malay in urban. Although rural doctors were more senior, relatively they were less experienced working in the government sector.
Quality of life in Malaysian colorectal cancer patients: a preliminary result

Natrah MS, Ezat S, Syed MA, Rizal AM, Saperi S

Asian Pac J Cancer Prev, 2012;13(3):957-62.
PMID: 22631679

OBJECTIVE: Rapidly increasing colorectal cancer (CRC) incidence in Malaysia and the introduction of cutting edge new treatments, which prolong survival, mean that treatment outcome measures meed to be evaluated, including consideration of patient's quality of life (QoL) assessment. There are limited data on QoL in CRC patients, especially in Malaysia. Therefore, this study was performed focusing on cancer stages and age groups.
METHODS: The cross sectional study was conducted from June to September 2011 at three public tertiary hospitals with the EORTC QLQ C-30 questionnaire in addition to face to face interview and review of medical records of 100 respondents.
RESULTS: The mean age was 57.3 (SD 11.9) years with 56.0% are males and 44.0% females, 62% of Malay ethnicity, 30% Chinese, 7% Indian and 1% Sikh. Majority were educated up to secondary level (42%) and 90% respondents had CRC stages III and IV. Mean global health status (GHS) score was 79.1 (SD 21.4). Mean scores for functional status (physical, emotional, role, cognitive, social) rangeds between 79.5 (SD 26.6) to 92.2 (SD 13.7). Mean symptom scores (fatigue, pain, nausea/vomiting, constipation, diarrhea, insomnia, dyspnoea, loss of appetite) ranged between 4.00 (SD 8.58) to 20.7 (SD 30.6). Respondents role function significantly deteriorates with increasing stage of the disease (p=0.044). Females had worse symptoms of pain (p=0.022), fatigue (p=0.031) and dyspnoea (p=0.031). Mean insomnia (p=0.006) and diarrhea (p=0.024) demonstrated significant differences between age groups.
CONCLUSION: QOL in CRC patients in this study was comparable to that in other studies done in developed countries. Pain, fatigue and dyspnoea are worse among female CRC patients. Given that functions deteriorates with advanced stage of the disease at diagnosis, a systematic screening programme to detect cases as early as possible is essential nationwide.

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