Displaying publications 1 - 20 of 192 in total

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  1. Fulltext Responding to extremes: managing urban water scarcity in the late nineteenth-century Straits Settlements
    Williamson F
    Water Hist, 2020 Oct 29.
    PMID: 33144897 DOI: 10.1007/s12685-020-00260-6
    In 1877, the major towns of the Straits Settlements-Singapore, George Town, Penang Island and Malacca-suffered a drought of exceptional magnitude. The drought's natural instigator was the El Niño phase of the El Niño Southern Oscillation, a climatic phenomenon then not understood by contemporary observers. The 1877 event has been explored in some depth for countries including India, China and Australia. Its impact on Southeast Asia however is less well-known and the story of how the event unfolded in Singapore and Malaysia has not been told. This paper explores how the contemporary British government responded to the drought, arguing that its impact on hydraulic management was at best minimal yet, it did have impact on other areas, such as forest reservation with the hope of preserving future rainfall. It also highlights how, in contrast to studies on urban water plans in other British Asian colonies, the colonial authorities in the Straits Settlements had a far less coherent and meaningful relationship with water in their town planning schemes. As this paper is part of a special issue, Water History in the time of COVID-19, it has undergone modified peer review.
    Matched MeSH terms: Peer Review
  2. Comparison of Health Care Utilization and Costs for Patients with Asthma by Severity and Health Insurance in Thailand
    Dilokthornsakul P, Lee TA, Dhippayom T, Jeanpeerapong N, Chaiyakunapruk N
    Value Health Reg Issues, 2016 May;9:105-111.
    PMID: 27881251 DOI: 10.1016/j.vhri.2016.03.001
    BACKGROUND: To compare health care utilization and cost by asthma severity and type of health insurance in Thailand.

    METHODS: A retrospective cohort study using an electronic database was conducted in patients with asthma. Patients who were diagnosed with asthma from 2009 to 2011, had at least two subsequent health care encounters for asthma during the first six months after the first asthma diagnosis, and had at least 90 days of follow-up were included. The primary outcome was direct health care costs of inpatient and outpatient care. We compared outcomes between groups on the basis of a proxy of severity (mild/moderate severe asthma vs. high severe asthma) and type of health insurance using a multivariable generalized linear model. Covariates such as Patients' demographic characteristics, comorbidities, and concurrent medications were included in the model.

    RESULTS: Among 1982 patients included, the average age was 40.3 ± 24.0 years, with 60.7% being males. A total of 1936 patients had mild/moderate severe asthma, whereas 46 patients had high severe asthma. There were 1293 patients under the Universal Coverage Scheme, 264 patients under Social Security Insurance, and 626 patients under the Civil Servant Medical Benefit Scheme (CSMBS). The average annual cost per patient was $598 ± $871. In adjusted analyses, the health care cost of patients with high severe asthma was $71 higher than that of patients with mild/moderate severe asthma (95% confidence interval $-131 to $274). The cost of patients under the CSMBS was $110 (95% confidence interval $29-$191) higher than that of patients under Universal Coverage Scheme.

    CONCLUSIONS: Health care costs of patients with asthma were substantial and were higher in patients with high severe asthma and patients under the CSMBS.
    Matched MeSH terms: Utilization Review
  3. A simple pharmacopoeia for out-station skin clinics
    Pettit JHS
    Trop Doct, 1977 Jul;7(3):107-10.
    PMID: 142324
    Matched MeSH terms: Review
  4. Treatment of superficial fungal infections
    Pettit JHS
    Trop Doct, 1986 Jul;16(3):105-12.
    PMID: 3765093 DOI: 10.1177/004947558601600305
    Matched MeSH terms: Review
  5. Fulltext Impact of pharmacist educational intervention on disease knowledge, rehabilitation and medication adherence, treatment-induced direct cost, health-related quality of life and satisfaction in patients with rheumatoid arthritis: study protocol for a randomized controlled trial
    Naqvi AA, Hassali MA, Naqvi SBS, Aftab MT
    Trials, 2019 Aug 09;20(1):488.
    PMID: 31399128 DOI: 10.1186/s13063-019-3540-z
    BACKGROUND: The objective of this study is to evaluate the effectiveness of pharmacist intervention in improving disease knowledge, adherence to treatment, health-related quality of life (HRQoL) and direct cost of treatment. The study also documents patient satisfaction with pharmacist counselling as a quality control measure.

    METHODS/DESIGN: This is a randomized, single-blind, two-arm, controlled trial in patients with rheumatoid arthritis visiting outpatient rheumatology clinics in Karachi, Pakistan. We will enroll patients with established diagnosis of rheumatoid arthritis over 3 months. The patients would be randomized through a computer-generated list into the control group, i.e., usual care or into the intervention group, i.e., pharmaceutical care, in a ratio of 1:1, after providing signed written consent. The study will take place in two patient-visits over the course of 3 months. Patients in the intervention group would receive intervention from the pharmacist while those in the control group will receive usual care. Primary outcomes include change in mean score from baseline (week 0) and at follow up (week 12) in disease knowledge, adherence to medications and rehabilitation/physical therapy. The secondary outcomes include change in the mean direct cost of treatment, HRQoL and patient satisfaction with pharmacist counselling.

    DISCUSSION: This is a novel study that evaluates the role of the pharmacist in improving treatment outcomes in patients with rheumatoid arthritis. The results of this trial could set the foundation for future delivery of care for this patient population in Pakistan. The results of this trial would be published in a peer-reviewed journal.

    TRIAL REGISTRATION: ClinicalTrials.gov, NCT03827148 . Registered on February 2019.

    Matched MeSH terms: Peer Review
  6. Book review: Rural sanitation in the tropics, being notes and observations in the Malay archipelago, Panama and other lands
    Low GC
    Trans R Soc Trop Med Hyg, 1916;9:157-160.
    Matched MeSH terms: Review
  7. External quality assurance in Malaysia
    Nawawi H, Lim HH, Zakiah I
    Southeast Asian J. Trop. Med. Public Health, 1999;30 Suppl 3:39-45.
    PMID: 10926257
    An activity supportive of the MOH QA Programme, the National EQAS for clinical chemistry monitors for analytical performance in core routine biochemical testing by the pathology laboratories, with unsatisfactory performance scores serving to alert against deficiencies or problems and the scores in subsequent challenges providing the feedback of effectiveness of remedial actions taken. While unacceptable individual analyte performance score (variance index score, VIS) indicated problems in instruments, reagent and calibrators, or the use of inherently poorer methods, repeated occurrence of unsatisfactory OMRVIS was traceable to generally poor laboratory management of usually inadequately-equipment small laboratories. The outcome has been one of slow but gradual improvement in the overall performance of participating laboratories, with a move towards methods upgrading and standardization to achieve greater concordance of results. Presently, the programme is limited to 61 government and 4 private hospital laboratories in the country for 12 commonly assayed clinical biochemistry analytes. It is hoped that the NEQAS could be extended to the other private laboratories and that of academic institutions. However, this is dependent to a large extent on the manpower and financial support obtainable by the organizing body of the programme in the future. Belk and Sunderman, 1947 demonstrated that laboratories participating in an quality assessment scheme could rapidly and dramatically improve their analytical performance. In some countries, participation has become mandatory, and acceptable performance is a requirement in laboratory accreditation. The need and value of the NEQAP is, therefore, evident. While there may be limitations in the national programme. efforts are being made at improving the programme within the means and resources of the organising body. The goals of the NEQAP are not just to monitor performance but also to educate. On this, matters related to and supportive of these goals have also been pursued. The annual workshop/forum on quality controls had allowed exchange of information between representatives of participating laboratories and the organising body. Recently in the 1997 MOH Quality Improvement evaluation, Quality Control has been evaluated together with the other 17 such activities. The study on knowledge, attitude and practice has provided the necessary feedback and will be used for future planning in making efforts at increasing the effectiveness and benefits of the all QC activities including this NEQAP for clinical chemistry. In addition, there is a need to look into areas such as selection of methods and test systems, and improvement of continuing education, training as well as research in quality improvement as suggested by the Quality Improvement evaluation.
    Matched MeSH terms: Peer Review/methods*
  8. Fulltext Health research in Malaysia: overview and future directions
    Jegathesan M, Suleiman AB
    Southeast Asian J. Trop. Med. Public Health, 1992 Dec;23(4):570-1.
    PMID: 1298063
    Matched MeSH terms: Review
  9. Fulltext The chronic care model: Will it work in Malaysia for hypertension?
    Chia YC
    Med J Malaysia, 2013 Apr;68(2):101-2.
    PMID: 23629551
    Matched MeSH terms: Review
  10. Fulltext Critical appraisal of the existing and emerging therapies for smoking cessation
    Bhutani G, Kaushal J, Gupta MC
    Med J Malaysia, 2011 Dec;66(5):526-33.
    PMID: 22390122
    Smoking is a major health problem of the society as it causes a wide variety of health hazards and produces a strong addictive behavior. Various pharmacological and non pharmacological treatments have been tried for smoking cessation from time to time. Some of the pharmacological treatments have been able to achieve the status of first line and second line therapy for smoking cessation by the US Public Health Service Clinical Practice Guideline. Some newer and very promising drugs have come up and are in the clinical trials for establishment of their efficacy. While some other drugs have been tried from time to time but have failed to show any consistent results. Various non pharmacological therapies like behavioural therapy are also of utmost importance in this regard. This article gives a brief review and critical assessment of the existing and the emerging smoking cessation therapies.
    Non-Malaysian publication: India
    Matched MeSH terms: Review
  11. Fulltext Introducing a new series of invited review articles
    Lim KG
    Med J Malaysia, 2008 Dec;63(5):353.
    PMID: 19803288
    Matched MeSH terms: Review Literature as Topic*
  12. Fulltext Managing pelvic inflammatory disease
    Sivalingam N, Vanitha NS, Loh KY
    Med J Malaysia, 2007 Dec;62(5):425-7; quiz 428.
    PMID: 18705484 MyJurnal
    Pelvic inflammatory disease (PID) describes the clinical features of sexually transmitted pelvic infection ranging from acute salpingitis to salpingo-oophoritis and ultimately pelvic abscess. Intra-tubal adhesions and pelvic adhesive disease are the long-term sequelae of PID which may lead to both sub-fertility and tubal ectopic pregnancy. Laparoscopy is the definitive diagnostic modality, but is invasive and not suitable for routine clinical practice especially in the primary care setting. Ascending infection by Neiserria gonorrhoea, Chlamydia trachomatis and less commonly bacterial vaginosis and mycoplasma have been traditionally associated as causative pathogens in PID. As polymicrobial infections are being implicated in PID before culture and sensitivity results are available empirical treatment based on clinical guidelines is justified initially. Pre-emptive testing and treatment for woman at increased risk of chlamydia has been shown to reduce the risk of PID by up to two-thirds. It is imperative that medical practitioners have low thresholds for testing and treatment of both sexually active young women and men.
    Matched MeSH terms: Review
  13. Fulltext Spinal injuries in a level-one trauma centre: a demographic study
    Roohi SA, Naicker AS, Shukur MH, Mohammad AR
    Med J Malaysia, 2006 Feb;61 Suppl A:30-5.
    PMID: 17042226
    The incidence of spinal injuries in Malaysia is on the rise following similar trend of rapid development and increasing number of building constructions sites, and motor vehicles. This epidemiological study was aimed at compiling local data with a view to identifying target areas for preventive measures as well as improvement strategies in the management of these potentially devastating injuries. Seventy eight patients admitted with spine trauma in 1998 in a level-one trauma centre were retrospectively reviewed. All records were traced from the admission and discharge books of the orthopaedic wards, accident and emergency wards, operative registration book, spinal rehabilitation ward and orthopaedic registration data of the Department of Orthopaedics, Hospital Kuala Lumpur. Details on pre-treatment neurological and radiological level of injury and post-treatment outcomes were recorded according to the American Spinal Injury Association (ASIA) impairment scale. Most patients (61.5%) were in the productive ages of less than 34 years with a 4:1 male to female ratio. Majority were due to motor vehicle accidents (57.7%) and fall from a height (28.3%). The thoraco-lumbar junction was the most common site of injury followed by the lower cervical region with 62.5% of which associated with neurological deficit. Neurological deficits: 11 ASIA-A, 1 ASIA-B, 6 ASIA-C, and 3 ASIA-D were detected in 21 (27%) patients with fall from height (50%) particularly landing on the feet (50%) and recreational sports (100%) were the risk factors. Less than 10% of patients were treated surgically and this explains an average 39.4 days of hospitalization (5 times longer in patients treated non-operatively). On discharge, four patients with incomplete neurology recovered to ASIA-E status and the remaining improved to ASIA-C and -D in one and five patients respectively. Only one patient with complete neurology improved to ASIA-B status following surgical treatment. The demographic profiles of our patients were comparable to other series in the literature but still inadequate to provide enough epidemiological data. A multicenter study to provide a larger pool of patients is needed.
    Matched MeSH terms: Utilization Review*
  14. Fulltext The pattern of femoral diaphyseal fractures in children admitted in Sarawak General Hospital
    Rasit AH, Mohammad AW, Pan KL
    Med J Malaysia, 2006 Feb;61 Suppl A:79-82.
    PMID: 17042236
    Trend towards changing the face of management for pediatric femoral fractures tends to advocate operative treatment. This study was undertaken to review our current practice in the wake of recent progress in the management of pediatric femoral fractures. Fifty patients with femoral diaphyseal fracture treated in Sarawak General Hospital were reviewed retrospectively after an average follow-up of 2.6 years. There were 36 boys and 14 girls, with a mean age of 6.2 years (range five months to 14 years). Children under six years of age constituted the majority of the patients. Half of the fractures were caused by road traffic accident. Nine patients had associated injuries. The most common site of fracture was at the middle third (N=31). The treatment regimens were delayed hip spica (DHS) in 16, immediate hip spica (IHS) in 24, plate osteosynthesis (PO) in five, titanium elastic nailing (TEN) in five, and external fixation (EF) in one. The minimum hospital stay was two days, and the maximum 33 days (mean, 9.7 days). Malunion was the commonest complication. Conservative treatment is the preferred option for children under six years of age. It is cost-effective with minimal complication. The other treatment options are reserved for specific indication in older children. Diaphyseal fractures of the femur in children can be adequately managed non-operatively.
    Matched MeSH terms: Utilization Review
  15. Fulltext Inappropriate utilization of emergency department services in Universiti Sains Malaysia hospital
    Selasawati HG, Naing L, Wan Aasim WA, Winn T, Rusli BN
    Med J Malaysia, 2004 Mar;59(1):26-33.
    PMID: 15535332
    Inappropriate utilization of Emergency Departments (ED) services may result in compromised management of patients requiring true emergency treatment. Significant attendance of non-emergency cases in ED was found in several countries. A cross-sectional study was conducted in Universiti Sains Malaysia Hospital (HUSM) to determine the proportion of the inappropriate cases and the utilization pattern by time (over 24 hours and within a week) and by diagnoses. A sample of 350 cases was randomly selected from ED-HUSM register of the year 2000. A decision flowchart, which was adopted from 4 guidelines, was applied to classify appropriate and inappropriate cases. There were 55% inappropriate cases in this study. The inappropriate cases increased considerably in early morning, late evening, during the weekend and early part of the week. Most common diagnoses of inappropriate cases were upper respiratory tract infections, mild acute gastroenteritis and urinary tract infections. Considerable attendance of inappropriate cases calls for interventions.
    Matched MeSH terms: Utilization Review*
  16. Fulltext Appropriate utilisation of emergency upper gastrointestinal endoscopy in a tertiary referral centre
    Gul YA, Jabar MF, Mo'min N, Hon SK
    Med J Malaysia, 2004 Mar;59(1):65-71.
    PMID: 15535338
    A retrospective cross-sectional study was carried out in a tertiary referral centre to determine the appropriateness of usage of emergency upper gastrointestinal endoscopy (EUGIE) with reference to the guidelines set by the American Society of Gastrointestinal Endoscopy (ASGE). EUGIE was defined as early, non-elective endoscopy performed for in-patients within 48 hours of acute hospital admission. The median age of the 668 patients was 55 years (age range 12- 90), 31% of whom had a previous upper gastrointestinal endoscopy. Bleeding in the form of haematemesis, melaena or anaemia was the most common indication (40.7%) for EUGIE. Eighty one percent of the procedures were judged appropriate by the ASGE guidelines. There was a statistically significant relationship between appropriateness and significant diagnostic yield (P<0.05). Procedures performed for melaena, symptomatic anaemia and haemetemesis led to greater significant diagnostic yield (P<0.05) and there was no difference in the yield between working-hours and after-hours EUGIE.
    Matched MeSH terms: Utilization Review*
  17. Proceedings in a disciplinary action at the Malaysian Medical Council
    Mahmud MN
    Med J Malaysia, 2005 Aug;60 Suppl D:32-4.
    PMID: 16315621
    Members of the medical profession are expected to be well aware and abide by the revised code of ethics adopted by the Malaysian Medical Council on 9th December 1986. Under the Act Council may, in the exercise of its disciplinary jurisdiction, impose punishments related to misconduct or malpractices. When a complaint or information is made against any practitioner, the President shall forward such complaint to the Chairman of the Preliminary Investigation Committee. The procedure of the disciplinary inquiry is not exactly like those in the court of law but the same principle of justice is adhered to and all evidence used to make a decision must only be those that are admissible in accordance with the rule of evidence.
    Matched MeSH terms: Peer Review, Health Care/methods
  18. Managing liver metastases: myth or reality?
    Primrose JN
    Med J Malaysia, 2005 Jul;60 Suppl B:67-9.
    PMID: 16108177
    Matched MeSH terms: Review Literature as Topic
  19. Surrogate markers for liver fibrosis
    Poynard T
    Med J Malaysia, 2005 Jul;60 Suppl B:39-40.
    PMID: 16108172
    Matched MeSH terms: Review Literature as Topic
  20. Fulltext Helicobacter pylori and peptic ulcer disease--a causal link
    Goh KL
    Med J Malaysia, 1997 Jun;52(2):161-8.
    PMID: 10968075
    The link between Helicobacter. pylori and peptic ulcer disease in 1997 is an irrefutable one. The association between infection and ulcerogenesis has been shown to be biologically plausible with induction of epithelial inflammation and cell damage and its effect on gastrin/acid homeostasis. The association of H. pylori infection and peptic ulcer disease is a close and consistent one. There is ample evidence indicating that H. pylori eradication results in virtual abolition of ulcer relapse. Several studies have demonstrated that eradication of H. pylori results in ulcer healing and there is evidence showing a temporal relationship between infection and development of peptic ulcer disease.
    Matched MeSH terms: Review
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