Displaying publications 1 - 20 of 219 in total

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  1. Pirabbasi E, Najafiyan M, Cheraghi M, Shahar S, Abdul Manaf Z, Rajab N, et al.
    Glob J Health Sci, 2013 Jan;5(1):70-8.
    PMID: 23283038 DOI: 10.5539/gjhs.v5n1p70
    Imbalance between antioxidant and oxidative stress is a major risk factor for pathogenesis of some chronic diseases such as chronic obstructive pulmonary disease (COPD). This study aimed to determine antioxidant and oxidative stress status, and also theirs association with respiratory function of male COPD patients to find the antioxidant predictors' factors. A total of 149 subjects were involved in a cross-sectional study. The study was conducted at two medical centers in Kuala Lumpur, Malaysia. Results of the study showed that plasma vitamin C was low in most of the subjects (86.6%). Total antioxidant capacity was the lowest in COPD stage IV compare to other stages (p < 0.05). Level of plasma vitamin A (p= 0.012) and vitamin C (p= 0.007) were low in malnourished subjects. The predictors for total antioxidant capacity were forced vital capacity (FVC) % predicted and intake of ?-carotene (R2= 0.104, p= 0.002). Number of cigarette (pack/ year) and smoking index (number/ year) were not associated with total antioxidant capacity of this COPD population. Plasma oxidative stress as assessed plasma lipid peroxidation (LPO) was only positively correlated with plasma glutathione (p= 0.002). It might be a need to evaluate antioxidant status especially in older COPD patients to treat antioxidant deficiency which is leading to prevent COPD progression.
    Study site: Outpatient clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) and Institute of Respiratory Medicine, Kuala Lumpur, Malaysia
    Matched MeSH terms: Outpatients/statistics & numerical data
  2. Moy FM, Abdul Rahman S
    Malays J Nutr, 2002 Mar;8(1):63-73.
    PMID: 22692440 MyJurnal
    A cross sectional study on Type 2 diabetes patients seeking treatment in the Primary Health Care outpatient clinic of the University Malaya Medical Centre, Kuala Lumpur was undertaken. Two hundred and thirty-three subjects participated. They were asked questions on biodata and dietary intake using face-to-face interview techniques. Dietary intake was assessed using the 24-hour dietary recall. Anthropometric measurements including weight and height were taken and Body Mass Index (BMI) was computed to establish the extent of obesity. Of the 196 subjects, 66.8% were overweight (BMI ≥25 kg/m2) with 15.8% obese (BMI ≥30 kg/m2). The mean BMI of males and females were 25.9±4.3 kg/m2 and 27.2±4.7 kg/m2 respectively. The findings from the dietary survey showed that the mean energy intake of the subjects only achieved about 72% of the Recommended Daily Allowance (RDA) for Malaysia while protein intake of all subjects was adequate. The macronutreint contribution to the total calorie was consistent with the recommendation of the Malaysian Diabetic Association for a healthy diet for diabetes patients. The male subjects were found to meet the RDA requirements for all nutrients while the female subjects did not have sufficient intake of calcium, vitamin A and niacin. No consistent pattern in energy and nutrient intake was observed among different age groups. On the other hand, the Malay subjects seemed to have lower energy and all nutrient intake (except vitamin A and vitamin C) compared to the Chinese and Indian subjects. The Indian subjects seemed to have the highest intake of calcium compared to the others. Advice needs to be given to those who did not have adequate nutrient intake as well as those who need to reduce their weight.

    Study site: Primary health care clinic, University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Outpatients
  3. Sarriff A, Abdul Razzaq HA
    Malays J Med Sci, 2013 Jan;20(1):69-75.
    PMID: 23785257 MyJurnal
    Muslim consumers have special needs in medical treatment that differ from non-Muslim consumers. In particular, there is a growing demand among Muslim consumers for Halal medications. This descriptive exploratory study aims to determine the Halal status of selected cardiovascular, endocrine, and respiratory medications stored in an out-patient pharmacy in a Malaysian governmental hospital. Sources of active ingredients and excipients for each product were assessed for Halal status based on available information obtained from product leaflets, the Medical Information Management System (MIMS) website, or manufacturers. Halal status was based on the products' sources and categorized into Halal, Mushbooh, or Haram. The proportions of Halal, Mushbooh, and Haram products were at 19.1%, 57.1%, and 23.8%, respectively. The percentage of active ingredients for cardiovascular/endocrine products that were assessed as Haram was 5.3%; for respiratory medications, it was only 1.1%. For excipients, 1.7% and 4.8% fall under the category of Haram for cardiovascular/endocrine products and respiratory products, respectively. Ethanol and magnesium stearate were found to be the common substances that were categorized as Haram and Mushbooh.
    Matched MeSH terms: Outpatients
  4. Chua SS, Lee YK, Chua CT, Abdullah MS
    JUMMEC, 2002;7:100-106.
    Many studies have shown that failure in the control of hypertension with oral antihypertensives could be associated with noncompliance. The present study was conducted to assess the compliance rate to antihypertensive therapies and also to determine factors related to any noncompliance. The study was conducted in a teaching hospital in Kuala Lumpur. Data was collected from patients' medical records and via personal interview using a structured questionnaire. Out of a total of 175 respondents recruited in the study, 49.1% missed at least a dose of their antihypertensive agents during a one·month period. The most common reason given by respondents who were not compliant to their antihypertensive therapies was forgetfulness (91.8%), followed by too busy (20.0%) and insufficient medication supplied to them (18.8%). None of the factors analysed, including the demography of the respondents, their knowledge about hypertension and the types of antihypertensive therapies they were on, had any statistically significant influence on the compliance behaviour of the respondents to their antihypertensive therapies. However, more than 80% of the respondents kept their appointment to see their doctor and only this factor appeared to be related to the medication compliance behaviour although it still did not reach any statistical significance. KEYWORDS: Compliance, antihypertensive agent, blood pressure, knowledge
    Matched MeSH terms: Outpatients
  5. Lai CK, Tay KT, Abdullah R
    Med J Malaysia, 2021 03;76(2):233-235.
    PMID: 33742634
    In recognising the palliative care (PC) needs globally and in Malaysia, services were developed to serve the rural area of Kuala Lipis, Pahang. This communication describes the initial a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, stages of development towards achieving a successful implementation. PC services were led by Kuala Lipis district hospital include inpatient referrals, outpatient and community care through home visits. These services involve multi-disciplinary team inclusive of representatives from health clinics and allied health. Referrals and opioid usage have demonstrated an increasing trend since its implementation in October 2018. Implementation of rural PC services is feasible; however, long-term sustainability needs to addressed.
    Matched MeSH terms: Outpatients
  6. Hassan S, Abdullah J, Abdullah B, Jihan Wd S, Jaafar H, Abdullah S
    Malays J Med Sci, 2007 Jan;14(1):18-22.
    PMID: 22593647 MyJurnal
    Juvenile nasopharyngeal angiofibroma (JNA) is a benign but locally invasive tumour. Patients are usually in their adolescent age and present with epistaxis and nasal blockage. Diagnosis is based on clinical evaluation and the C.T. scan findings. Pre-operative superselective embolisation (SSE) and surgical excision is the treatment of choice. The out patient clinic of ORL-HNS hospital of University Science Malaysia received 25 referrals, all male, majority between 9-13 years of age and few adolescents. Clinically the patients were consistent with symptoms of recurrent epistaxis and nasal blockage. They reported from October 1998 to October 2001 from with in the state of Kelantan and the nearby states of Pahang, Kedah and Terenganu. Diagnosis was mostly made on typical radiological findings and the tumours were classified accordingly into four stages. SSE and surgical excision was carried out in all cases. Regular follow-up helped us to identify early recurrences which were treated with salvage surgery or radiotherapy in one case with extensive intracranial extension. A retrospective review of presenting features, diagnostic difficulties, surgical approaches and its outcome is presented. Maxillary swing procedure performed in three cases as a new surgical option in the management of JNA is also discussed.
    Study site: ENT clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Outpatients
  7. Chan KY, Fikri-Abdullah M, Sajjad M, Adeeb SM
    Med J Malaysia, 2003 Oct;58(4):597-9.
    PMID: 15190637
    We report two patients, who have used Pneumostat to replace the conventional underwater seal drainage system for recurrent pneumothorax. Both patients had required repeated chest tube insertion for recurrent pneumothorax and needed a longer hospital stay. Both patients were able to be discharged with the Pneumostat device and were reviewed in outpatient clinic. Both patients had optimal clinical improvement and chest X-ray showed no residual pneumothorax.
    Matched MeSH terms: Outpatients
  8. 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: Outpatients
  9. Ismail A, Gan YN, Ahmad N
    PLoS One, 2020;15(11):e0241082.
    PMID: 33170854 DOI: 10.1371/journal.pone.0241082
    INTRODUCTION: Patient satisfaction is widely used to measure quality of healthcare by identifying potential areas for improvement. Aim of study is to assess patient satisfaction towards pharmacy services and its associated factors using newly developed questionnaire among outpatients attending public health clinics.

    MATERIALS AND METHODS: Public Health Clinic Patient Satisfaction Questionnaire (PHC-PSQ) towards pharmacy services was developed using exploratory factor analysis and Cronbach's α. A cross-sectional study was conducted among 400 patients visiting the pharmacy in three randomly selected public health clinics recruited via systematic random sampling. Data was collected using a set of questionnaire including PHC-PSQ. Factors associated with patient satisfaction was analysed using multiple linear regression.

    RESULTS: Final PHC-PSQ consisted of three domains (administrative competency, technical competency and convenience of location) and 22 items with 69.9% total variance explained. Cronbach's α for total items was 0.96. Total mean score for patient satisfaction was 7.56 (SD 1.32). Older age and higher education were associated with lower patient satisfaction mean score. Patients who had visited the pharmacy more than once in the past three months, perceived to be in better health status and had a more correct general knowledge of pharmacists expressed higher patient satisfaction mean score.

    CONCLUSIONS: PHC-PSQ is a newly developedtool to measure patient satisfaction towards pharmacy services in public health clinics in Malaysia. Patient satisfaction was relatively high. Age, education, frequency of visit, self-perceived health status and general knowledge of pharmacists were factors significantly associated with patient satisfaction.

    Matched MeSH terms: Outpatients/statistics & numerical data*
  10. Hasan SS, Burud IAS, Kow CS, Rasheed MK, Chan KSC, Tay PK, et al.
    Int J Clin Pract, 2021 Mar;75(3):e13714.
    PMID: 32949074 DOI: 10.1111/ijcp.13714
    BACKGROUND: Older individuals are seemingly having more medical conditions, which predispose them to a greater risk of polypharmacy. Potentially inappropriate medications (PIMs), including those having anticholinergic and sedative properties, are common in their prescriptions, often associated with functional decline and negative health outcomes. Thus, this study reports proportions of inappropriate drugs and drug burden exposures and its correlation with patient-reported outcomes (PROs) among cognitively intact older adults admitted to a ward or visiting the outpatient clinic at a tertiary care hospital in Malaysia.

    METHODS: This cross-sectional study included data from 344 older (173 inpatients and 171 outpatients) patients, aged 60 years and above, through validated questionnaires. Medication appropriateness was assessed via Medication Appropriateness Index (MAI) tool, whereas Beers and Screening Tool of Older Person's Potentially Inappropriate Prescribing (STOPP) criteria were used to evaluate PIMs and potentially inappropriate prescribing (PIP), respectively. The Drug Burden Index (DBI) and polypharmacy, as well as PROs, included Groningen Frailty Indicator (GFI), Katz Index of Independence in Activities of Daily Living (Katz ADL) and Older People's Quality of Life (OPQOL) were also evaluated.

    RESULTS: Overall, inpatients received significantly higher medications (6.90 ± 2.70 vs 4.49 ± 3.20) than outpatients. A significantly higher proportion of inpatients received at least one PIM (65% vs 57%) or PIP (57.4% vs 17.0%) and higher mean MAI score (1.76 ± 1.08 and 1.10 ± 0.34) and DBI score (2.67 ± 1.28 vs 1.49 ± 1.17) than outpatients. Inpatients had significantly higher total OPQOL (118.53 vs 79.95) and GFI score (5.44 vs 3.78) than outpatients. We only found significant correlations between GFI and DBI and total OPQOL and the number of PIMs.

    CONCLUSIONS: Proportions of PIMs and DBI exposure were significantly higher in an inpatient setting. No significant correlations between exposures to inappropriate medications or drug burden and PROs were observed.

    Matched MeSH terms: Outpatients
  11. Albackr HB, Al Waili K, Almahmeed W, Jarallah MA, Amin MI, Alrasadi K, et al.
    Curr Vasc Pharmacol, 2023;21(4):285-292.
    PMID: 37431901 DOI: 10.2174/1570161121666230710145604
    AIM: To assess the current dyslipidemia management in the Arabian Gulf region by describing the demographics, study design, and preliminary results of out-patients who achieved low-density lipoprotein cholesterol (LDL-C) goals at the time of the survey.

    BACKGROUND: The Arabian Gulf population is at high risk for atherosclerotic cardiovascular disease at younger ages. There is no up-to-date study regarding dyslipidemia management in this region, especially given the recent guideline-recommended LDL-C targets.

    OBJECTIVE: Up-to-date comprehensive assessment of the current dyslipidemia management in the Arabian Gulf region, particularly in view of the recent evidence of the additive beneficial effects of ezetimibe and proprotein convertase subtilisin/kexin-9 (PCSK-9) inhibitors on LDL-C levels and cardiovascular outcomes.

    METHODS: The Gulf Achievement of Cholesterol Targets in Out-Patients (GULF ACTION) is an ongoing national observational longitudinal registry of 3000 patients. In this study, adults ≥18 years on lipidlowering drugs for over three months from out-patients of five Gulf countries were enrolled between January 2020 and May 2022 with planned six-month and one-year follow-ups.

    RESULTS: Of the 1015 patients enrolled, 71% were male, aged 57.9±12 years. In addition, 68% had atherosclerotic cardiovascular disease (ASCVD), 25% of these patients achieved the LDL-C target, and 26% of the cohort were treated using combined lipid-lowering drugs, including statins.

    CONCLUSION: The preliminary results of this cohort revealed that only one-fourth of ASCVD patients achieved LDL-C targets. Therefore, GULF ACTION shall improve our understanding of current dyslipidemia management and "guideline gaps" in the Arabian Gulf region.

    Matched MeSH terms: Outpatients
  12. Fei CM, Zainal H, Ali IAH
    Malays J Med Sci, 2018 Sep;25(5):103-114.
    PMID: 30914867 MyJurnal DOI: 10.21315/mjms2018.25.5.10
    Background: The use of multi-drug regimens in tuberculosis (TB) treatment has been associated with undesirable adverse drug reactions (ADRs). This study aims to assess the incidence and impact of ADRs on TB treatment in Hospital Pulau Pinang.

    Methods: This cross-sectional study was conducted via retrospective review of outpatients' medical records. Details regarding ADRs were identified by a pharmacist and verified by a consultant respiratory physician.

    Results: A total of 91 cases, out of 210 patients enrolled in this study, were detected with 75 patients (35.7%) experienced at least one ADR. The three most common ADRs detected were cutaneous adverse drug reactions (CADRs) (21.0%), drug-induced hepatitis (DIH) (7.1%) and gastrointestinal disturbance (4.8%). Pyrazinamide was the most common causative agent and 15.7% of all TB patients required treatment modification due to ADRs. Females were shown to have a higher tendency to develop ADRs than the males in this study (P = 0.009). The development of ADRs was shown not to affect the TB treatment outcomes (P = 0.955).

    Conclusion: The incidence of ADRs in this study was high so it is important to identify the risk factors for ADRs and the individuals who have those risk factors when initiating anti-TB drugs. These individuals require special attention when anti-TB drugs are initiated.

    Matched MeSH terms: Outpatients
  13. Mohd-Dom TN, Wan-Puteh SE, Muhd-Nur A, Ayob R, Abdul-Manaf MR, Abdul-Muttalib K, et al.
    Value Health Reg Issues, 2014 May;3:117-123.
    PMID: 29702916 DOI: 10.1016/j.vhri.2014.04.012
    OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease.
    METHODS: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs.
    RESULTS: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively.
    CONCLUSIONS: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.
    Matched MeSH terms: Outpatients
  14. Abdul Aziz AF, Tan CE, Ali MF, Aljunid SM
    Health Qual Life Outcomes, 2020 Jun 20;18(1):193.
    PMID: 32563246 DOI: 10.1186/s12955-020-01450-9
    BACKGROUND: Satisfaction with post stroke services would assist stakeholders in addressing gaps in service delivery. Tools used to evaluate satisfaction with stroke care services need to be validated to match healthcare services provided in each country. Studies on satisfaction with post discharge stroke care delivery in low- and middle-income countries (LMIC) are scarce, despite knowledge that post stroke care delivery is fragmented and poorly coordinated. This study aims to modify and validate the HomeSat subscale of the Dutch Satisfaction with Stroke Care-19 (SASC-19) questionnaire for use in Malaysia and in countries with similar public healthcare services in the region.

    METHODS: The HomeSat subscale of the Dutch SASC-19 questionnaire (11 items) underwent back-to-back translation to produce a Malay language version. Content validation was done by Family Medicine Specialists involved in community post-stroke care. Community social support services in the original questionnaire were substituted with equivalent local services to ensure contextual relevance. Internal consistency reliability was determined using Cronbach alpha. Exploratory factor analysis was done to validate the factor structure of the Malay version of the questionnaire (SASC10-My™). The SASC10-My™ was then tested on 175 post-stroke patients who were recruited at ten public primary care healthcentres across Peninsular Malaysia, in a trial-within a trial study.

    RESULTS: One item from the original Dutch SASC19 (HomeSat) was dropped. Internal consistency for remaining 10 items was high (Cronbach alpha 0.830). Exploratory factor analysis showed the SASC10-My™ had 2 factors: discharge transition and social support services after discharge. The mean total score for SASC10-My™ was 10.74 (SD 7.33). Overall, only 18.2% were satisfied with outpatient stroke care services (SASC10-My™ score ≥ 20). Detailed analysis revealed only 10.9% of respondents were satisfied with discharge transition services, while only 40.9% were satisfied with support services after discharge.

    CONCLUSIONS: The SASC10-My™ questionnaire is a reliable and valid tool to measure caregiver or patient satisfaction with outpatient stroke care services in the Malaysian healthcare setting. Studies linking discharge protocol patterns and satisfaction with outpatient stroke care services should be conducted to improve care delivery and longer-term outcomes.

    TRIAL REGISTRATION: No.: ACTRN12616001322426 (Registration Date: 21st September 2016.

    Matched MeSH terms: Outpatients
  15. Yusoff K, Roslawati J, Almashoor SH
    Med J Malaysia, 1992 Sep;47(3):194-9.
    PMID: 1491645
    One hundred consecutive patients attending the UKM (Universiti Kebangsaan Malaysia) Cardiology Clinic completed a questionnaire enquiring about their own assessment of their knowledge about their illness, their awareness of cardiac risk factors and their expectations in their management. Only 11% of our patients had graduated from tertiary education. 59% of our patients were being treated for ischaemic heart disease. Although only 28% of our patients considered having considerable knowledge of their illness, a majority of our patients were aware of cardiac risk factors. This was independent of the formal education achieved. However this awareness did not necessarily result in appropriate behaviour; 32% of patients admitted to smoking despite being aware of the harmful effects of smoking. 74% of our patients expected a cure from their doctors; only 37% of our patients thought they required medication indefinitely. Thus, patients could be made aware of their illness regardless of their formal educational status. However this may not necessarily result in appropriate behaviour. The high expectations which the patients have of their doctors is unrealistic and may be detrimental to appropriate long-term management of their chronic illness.

    Study site: Cardiology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Outpatients/psychology*
  16. Shim YW, Chua SS, Wong HC, Alwi S
    Ther Clin Risk Manag, 2018;14:1115-1125.
    PMID: 29942134 DOI: 10.2147/TCRM.S146218
    Background: The elderly population is the largest consumer of medications as this age group is at high risk for developing chronic diseases. However, medication use among elderly people is complicated by an increased risk of drug-related problems. Therefore, the present study was conducted to investigate the effects of collaborative interventions between pharmacists and physicians on health-related outcomes of elderly patients.
    Patients and methods: This was a randomized controlled trial (RCT) conducted on elderly outpatients who sought treatment in the Medical Outpatient Department of a public tertiary hospital in Malaysia and who were taking at least five medications. The participants were randomly allocated to the intervention and control groups. The intervention group received pharmaceutical care from a pharmacist in collaboration with physicians and was followed-up for 6 months, while the control group received usual care in the outpatient pharmacy.
    Results: A total of 73 participants in the intervention group and 79 participants in the control group completed the study. Participants in the intervention group had significantly better medication adherence (median =7.0 vs 5.0, U=1224.5, p<0.001, r=0.503) and better Medication Appropriateness Index (MAI) score (median =8.0 vs 20.0, U=749.5, p<0.001, r=0.639).
    Conclusion: Collaborative interventions between pharmacists and physicians improved medication adherence and MAI scores of the elderly patients. Therefore, such services should be implemented in all hospitals, especially in countries where pharmacists are still not playing a substantial role in patient care.
    Trial registration: NMRR-12-958-13020.
    Study site: Outpatient clinic (MOPD), Duchess of Kent Hospital, Sandakan, Sabah, Malaysia
    Matched MeSH terms: Outpatients
  17. Ade Suzana Eka Putri, Syed Mohamed Aljunid, Amrizal Muhammad Nur
    MyJurnal
    Indonesian government secures the access of the poor towards health services through subsidised schemes. This study is aimed to describe the pattern of health expenditure by households and to describe the pattern of health service utilisation across household’s socioeconomic level in the city of Padang after seven years of the introduction of subsidised schemes. A household survey was conducted involving 918 households, with multistage random sampling method. The proportion of out-of-pocket (OOP) health spending as a share of household’s capacity to pay was regressive across consumption quintiles. The proportion of households with catastrophic health expenditure was 1.6% while 1.1% faced impoverished health expenses. Among those who need health care, the utilisation among the rich was higher than the poor. Health insurance schemes in Padang provides financial protection, however with regards to household’s capacity to pay, the poor has the higher burden of health payment. The gap on health service utilisation between the poor and the better-offs was still apparent for outpatient services and it has been narrowed for inpatient care. This study suggests that the subsidised schemes for the poor are highly needed and the possibility of the leakage of subsidies to the rich should be considered by the government.
    Matched MeSH terms: Outpatients
  18. Charles APT, Shukrimi BA, Zamzuri BZ, Ardilla HBAR
    J Orthop Case Rep, 2021 5 7;10(3):108-113.
    PMID: 33954149 DOI: 10.13107/jocr.2020.v10.i03.1772
    Introduction: The prevalence of knee osteoarthritis is on the raise. This raise has been a huge financial burden to developed countries in treating the disease. Transcutaneous electrical nerve stimulation (TENS) is a cost-effective, easily available, and self-applicable mode of non-pharmacological pain relieve technique. Despite these advantages, the use, settings, and effectiveness of portable TENS are still poorly understood. The aim of this study is to determine the effectiveness of portable TENS at different frequencies in treating knee osteoarthritis.

    Materials and Methods: This is a single-center quasi-experimental study involving 100 patients seen in the outpatient department with knee osteoarthritis. They were randomly (computer generated) allocated into two arms (high frequency [H-F] or low frequency [L-F]). H-F is set at 100 Hz and L-F is set at 4 Hz. A baseline assessment is taken with the visual analog score (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Oxford Knee Score, and Lequesne index. They were instructed to self-administer the TENS therapy as per protocol and followed up at the 4th and 12th week to be reevaluated on the above scores.

    Results: The final results show that both H-F and L-F groups showed improvement in all parameters of the VAS, WOMAC index, Oxford Knee Score, and Lequesne index (73%). Only the pain component of Lequesne index, activities of daily living component of Lequesne index, total Lequesne index, and pain component of WOMAC index shows a statistically significant difference, favoring the H-F group. The H-F group yields a faster result; however, with time the overall effect remains the same in both groups.

    Conclusion: Both H-F and L-F groups show improvement in all the component of Lequesne index, Oxford Knee Score, WOMAC index, and VAS with no statistical difference between the two groups. Although H-F yields a faster result, not everyone is able to tolerate the intensity. Therefore, the selection of H-F or L-F should be done on case basis depending on the severity of symptoms, patient's expectation, and patient's ability to withstand the treatment therapy. Based on this 12th week follow-up, both groups will continue to improve with time. A longer study should be conducted to see it this improvement will eventually plateau off or continue to improve until the patient is symptom free.

    Matched MeSH terms: Outpatients
  19. Lim BK, Sivalingam N, Aza Mirandan AR
    Family Physician, 1996;8:11-14.
    A prospective case controlled study was conducted to determine the incidence of asymptomatic bacteriuria in pregnancy (ASB), causative organisms and fetal outcome. Out of 510 antenatal mothers screened, 46 (9%) had ASB. The main organisms isolated were E. coli (16%), Staphylococcus aureus (15%) and Beta-Haemolytic Streptococcus (11%). Oral Nitrofurantoin and Cefuroxime axetil achieved sensitivity levels of 96%. There was no significant difference in period of gestation at birth and birthweight between the control and study groups. The reasons for routine antimicrobial therapy for ASB are discussed.
    Matched MeSH terms: Outpatients
  20. Hasyimah, R., Aniza, I., Ahmad Taufik, J., Jamsiah, M., Azimatun Noor, A.
    MyJurnal
    The level of patient satisfaction is important for service quality in hospitals. This study aims to measure the level of patient satisfaction at University Kebangsaan Malaysia Medical Centre (UKMMC) and the factors affecting it. A cross-sectional study was conducted on 520 respondents at the outpatient department in four clinics in UKMMC by using self-administered questionnaires. Respondents were selected using a systematic sampling method based on the list of patient appointments. The level of patient satisfaction was measured using the PSQIII domain. Less than half of the respondents were satisfied with the overall service provided (41.0%), while the others (59.0%) were not satisfied. Based on the domain studied, the level of satisfaction varies widely: the highest satisfaction were interpersonal relationships (75.8%) followed by the registration process (73.8%), technical quality (71.3%), communication (66.7%), physical facilities (64.6%), accessibility (60.2%), and financial (47.3%). The level of patient satisfaction was low and financial domain should be given more attention to in order to ensure an increase in patient satisfaction levels.
    Study site: Surgery, Orthopaedic, Obstetric and Gynaecology, and Medical clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Outpatients
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