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  1. Fulltext Dietary supplementation among doctors in Kelantan
    Rohana Abdul Jalil, Zulkifli Ahmad
    Malaysian Journal of Public Health Medicine, 2007;7(1):60-63.
    MyJurnal
    The aim of the study is to describe the usage of dietary supplemenu among doctors working in the hospitals in Kota Bharu, Kelantan. The method used was a postal questionaire survey of the doctors, both specialists and medical officers working in these hospitals. The results showed that
    only 28.7% of the doctors are taking dietary supplements. Significantly more female doctors and doctors on long term medication, were taking these supplements. The dietary supplements commonly used were multivitamins and minerals (92.3%), garlic (26.9%), vitamin C (26.9%) and
    lecithin (15.4%). The majority of the doctors who took dietary supplements (60%) felt their health status have improved. These supplements were mostly obtained from hospital pharmacies. Doctors who puchase their own supplements spend between RMIO to RMIZO per month. The main reasons given for taking these supplements were that the doctors jfelt healthier' and to ‘prevent or as a supplementary treatment’ for conditions like hypercholesterolaemia, hypertension, ischaemic heart disease and cancers. There were four doctors who regularly use traditional dietary supplements. Most doctors will generally advice their patients and children to take dietary supplements regularly, as they felt that it is important for health.
    Matched MeSH terms: Specialization
  2. Fulltext The timing and stability of choice of medical specialty among Malaysian doctors
    Rogayah J, Zulkifli A
    Med J Malaysia, 2001 Sep;56(3):324-30.
    PMID: 11732078
    A total of 356 doctors responded to a survey on the timing and stability of choice of medical specialty. The majority of doctors made their final decision while working as a medical officer. One hundred (48.5%) of the doctors had made an earlier choice as medical students, 63 (30.6%) during their internship and 43 (20.9%) made their final choice while they were medical officers. Working experience in the specialty was the most important factor in determining final choice of specialty. Advice from consultants/seniors, better financial prospects and parental influence were more important for the male doctors while marriage and family considerations were more important for the female doctors in making their final choice.
    Matched MeSH terms: Specialization*
  3. Fulltext Posterior capsule rupture-causes, associations and outcomes: eight year analysis in a Malaysian General Hospital
    Thevi T, Zin MM
    International Eye Science, 2016;16:600-606.
    AIM: To see the causative factors, associations and outcomes of posterior capsule rupture (PCR). METHODS: A retrospective cohort study was done of all patients with PCR from 2007 to 2014 in Melaka Hospital. Associations between ocular comorbidities, lens related complications, surgeon grade, type of cataract surgery, whether done alone or in combination, with the occurrences of PCR were studied. The final visual outcome of cases with PCR was studied. RESULTS: PCR was the commonest intraoperative complication (n=623, 4.8%) among 12 846 patients. Ocular comorbidities and status of the lens did not cause PCR. Experience and seniority of surgeons were significantly associated with PCR. Medical officers had more PCRs than gazetting specialists (P=0.0000), who inturn had more PCRs than specialists (P=0.000). Each type of cataract surgery done was also significantly associated with PCR-phacoemulsification (phaco), phaco convert to extracapsular cataract extraction (ECCE) and intracapsular cataract extraction (ICCE) (P=0.000), lens aspiration (P=0.020), and ECCE (P=0.003). Specialists got good outcomes compared to trainees without PCR occurring (P=0.001) and also with PCR occurring (P=0.013). However, no difference was observed in the occurrence of PCR in complicated cases between specialists and trainees. Vision was compromised mainly by astigmatism following PCR. Impaired vision (P=0.000) and poor vision (P=0.000) were more than good vision. Poor vision was more in PCR compared to other complications.(P=0.000). CONCLUSION: PCR occurs in all types of cataract surgeries and is the main intraoperative complication causing poor vision. Good outcomes were significantly more when specialists got PCR compared to trainees. Junior surgeons should practice in wet labs and be given more cases. Copyright 2016 by the IJO Press.
    Matched MeSH terms: Specialization
  4. Fulltext Smartphones in remote medicine and daily neurosurgery: The Sabah update
    Perumall VV, Sellamuthu P, Harun R, Zenian MS
    Asian J Neurosurg, 2015 Jan-Mar;10(1):1-4.
    PMID: 25767567 DOI: 10.4103/1793-5482.151500
    Healthcare costs continue to rise every day as the demand outgrows the supply of surgeons. The application of telephone consultation for immediate management is needed as most neurosurgeons are technology orientated. This enables a specialist at a remote mobile site to receive the necessary information and reduce transmission time, from the second the patient is seen till the management is obtained.
    Matched MeSH terms: Specialization
  5. Fulltext Improvement in documentation of intake and output chart
    Ling, W.W., Ling, L.P., Chin, Z.H., Wong, I.T., Wong, A.Y., Nasef, A., et al.
    Int J Public Health Res, 2011;1(2):152-162.
    MyJurnal
    Intake and Output (I/O) records in hospitals were often found to be incomplete and illegible. The form used to record I/O is not user-friendly - i.e., they feature miniscule boxes, 'total' lines that do not correspond with shift changes and lack of instructions. Complaints often received from Specialists & Doctors regarding calculation errors or no totalling of I/O. Moreover, Nursing Sisters objective rounds often saw incompleteness of I/O chart. This study aims to identify the types of mistakes in recording the existing I/O chart. The second aim is to find out whether shift totalling of I/O chart helps in reducing mistakes. We try to determine whether the identified mistakes were repeated in the new I/O Chart. This study was conducted from October till December 2010 in 9 selected wards in Sibu Hospital. Data collection was divided into 3 phases. A pre-implementation audit using a checklist was carried out. The compliance rate of completeness of documentation of I/O Chart was 63%. A one month trial of new I/O chart was being done in the selected 9 wards. Post implementation audit showed a significant improvement of compliance rate (88%). Feedback from health care workers (N=110) showed that, 89% of doctors (n=17) and 60% of nurses (n=93) in the sample prefer to use the new format as more practical and relevant to the changing shift of nurses and doctors' ward round. It is suggested to implement the new format to increase compliance rate of documentation of I/O charting. Briefing should be given to nurses periodically and the new format should be introduced to nursing students in nursing colleges.
    Matched MeSH terms: Specialization
  6. Fulltext Barriers affecting clubfoot treatment in Sarawak
    Nur Alyana, B.A., Sahdi, H., Rasit, A.H., Zabidah, P.
    JUMMEC, 2018;21(2):15-22.
    MyJurnal
    congenital deformity among paediatric patients. The outcome of starting clubfoot treatment early is very
    promising. Patient retention throughout the treatment programme is challenging in Sarawak. In this study,
    we explored the barriers that parents/caregivers face when seeking clubfoot treatment in Sarawak, Northwest
    Borneo. A better understanding of the barriers will provide us with the information to formulate effective
    programmes for clubfoot treatment in this region.
    Methods: We conducted a questionnaire-based quantitative cross-sectional descriptive survey. We adapted
    a set of closed-ended questionnaires originally designed by Kazibwe and Struthers in a study done in Uganda
    in the year 2006.
    Results: A total of 53 parents/caregivers of children with idiopathic clubfoot were recruited in this study, with
    16 defaulter cases and 37 non-defaulter cases. We found 2 statistically significant barriers to clubfoot treatment
    in Sarawak, with p-value < 0.05, namely the geographical factor (p = 0.019) and logistic factor (p = 0.017).
    Conclusion: Barriers to clubfoot treatment that influence the compliance to treatment identified in this study
    are long distance travel, logistics limitations, uncooperative patients during treatment, parents/caregivers
    having other commitments, unsupportive family members, lack of understanding regarding clubfoot and its
    treatment, inadequate specialists in clubfoot, traditional socio-cultural beliefs and practices and economic
    constraints. Enhanced understanding in this matter will guide us in devising culturally admissible ways to
    increase awareness in parents/caregivers regarding clubfoot and its treatment. A sustainable national clubfoot
    program will be very beneficial in providing a holistic approach to tackle barriers to treatment in our country.
    Matched MeSH terms: Specialization
  7. Fulltext Automated classification of tropical shrub species: a hybrid of leaf shape and machine learning approach
    Murat M, Chang SW, Abu A, Yap HJ, Yong KT
    PeerJ, 2017;5:e3792.
    PMID: 28924506 DOI: 10.7717/peerj.3792
    Plants play a crucial role in foodstuff, medicine, industry, and environmental protection. The skill of recognising plants is very important in some applications, including conservation of endangered species and rehabilitation of lands after mining activities. However, it is a difficult task to identify plant species because it requires specialized knowledge. Developing an automated classification system for plant species is necessary and valuable since it can help specialists as well as the public in identifying plant species easily. Shape descriptors were applied on the myDAUN dataset that contains 45 tropical shrub species collected from the University of Malaya (UM), Malaysia. Based on literature review, this is the first study in the development of tropical shrub species image dataset and classification using a hybrid of leaf shape and machine learning approach. Four types of shape descriptors were used in this study namely morphological shape descriptors (MSD), Histogram of Oriented Gradients (HOG), Hu invariant moments (Hu) and Zernike moments (ZM). Single descriptor, as well as the combination of hybrid descriptors were tested and compared. The tropical shrub species are classified using six different classifiers, which are artificial neural network (ANN), random forest (RF), support vector machine (SVM), k-nearest neighbour (k-NN), linear discriminant analysis (LDA) and directed acyclic graph multiclass least squares twin support vector machine (DAG MLSTSVM). In addition, three types of feature selection methods were tested in the myDAUN dataset, Relief, Correlation-based feature selection (CFS) and Pearson's coefficient correlation (PCC). The well-known Flavia dataset and Swedish Leaf dataset were used as the validation dataset on the proposed methods. The results showed that the hybrid of all descriptors of ANN outperformed the other classifiers with an average classification accuracy of 98.23% for the myDAUN dataset, 95.25% for the Flavia dataset and 99.89% for the Swedish Leaf dataset. In addition, the Relief feature selection method achieved the highest classification accuracy of 98.13% after 80 (or 60%) of the original features were reduced, from 133 to 53 descriptors in the myDAUN dataset with the reduction in computational time. Subsequently, the hybridisation of four descriptors gave the best results compared to others. It is proven that the combination MSD and HOG were good enough for tropical shrubs species classification. Hu and ZM descriptors also improved the accuracy in tropical shrubs species classification in terms of invariant to translation, rotation and scale. ANN outperformed the others for tropical shrub species classification in this study. Feature selection methods can be used in the classification of tropical shrub species, as the comparable results could be obtained with the reduced descriptors and reduced in computational time and cost.
    Matched MeSH terms: Specialization
  8. Fulltext Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 2: management
    Park DI, Hisamatsu T, Chen M, Ng SC, Ooi CJ, Wei SC, et al.
    Intest Res, 2018 Jan;16(1):17-25.
    PMID: 29422794 DOI: 10.5217/ir.2018.16.1.17
    Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 2 of the statements comprised 3 parts: management of latent TB in preparation for anti-TNF therapy, monitoring during anti-TNF therapy, and management of an active TB infection after anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.
    Matched MeSH terms: Specialization
  9. Fulltext Asian Organization for Crohn's and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessment
    Park DI, Hisamatsu T, Chen M, Ng SC, Ooi CJ, Wei SC, et al.
    Intest Res, 2018 Jan;16(1):4-16.
    PMID: 29422793 DOI: 10.5217/ir.2018.16.1.4
    Because anti-tumor necrosis factor (anti-TNF) therapy has become increasingly popular in many Asian countries, the risk of developing active tuberculosis (TB) among anti-TNF users may raise serious health problems in this region. Thus, the Asian Organization for Crohn's and Colitis and the Asia Pacific Association of Gastroenterology have developed a set of consensus statements about risk assessment, detection and prevention of latent TB infection, and management of active TB infection in patients with inflammatory bowel disease (IBD) receiving anti-TNF treatment. Twenty-three consensus statements were initially drafted and then discussed by the committee members. The quality of evidence and the strength of recommendations were assessed by using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Web-based consensus voting was performed by 211 IBD specialists from 9 Asian countries concerning each statement. A consensus statement was accepted if at least 75% of the participants agreed. Part 1 of the statements comprised 2 parts: risk of TB infection Recommendaduring anti-TNF therapy, and screening for TB infection prior to commencing anti-TNF therapy. These consensus statements will help clinicians optimize patient outcomes by reducing the morbidity and mortality related to TB infections in patients with IBD receiving anti-TNF treatment.
    Matched MeSH terms: Specialization
  10. Accreditation of medical training in Australia and New Zealand
    Simpson I, Lockyer T, Walters T
    Med J Malaysia, 2005 Aug;60 Suppl D:20-3.
    PMID: 16315618
    The Australian Medical Council (AMC) accredits both Australian and New Zealand (NZ) medical courses and also college specialist training programmes. The common accreditation process allows mutual recognition of basic medical training and vocational training between Australia and New Zealand. The ultimate purpose of accreditation assure stakeholders including medical registration boards, health departments, students/trainees and the general community of the quality of the programs and the competence of those completing such training. AMC revised its own accreditation guidelines using the WFME standards as the model around which the new AMC standards were developed. The College Accreditation Process is similar to and builds on AMC experience in the medical school accreditation process. In conclusion, AMC accreditation has been successful in improving medical education in Australia and New Zealand and has been able to do so without the imposition of any exclusive educational model or philosophy.
    Matched MeSH terms: Specialization
  11. Fulltext Urban tinkering
    Elmqvist T, Siri J, Andersson E, Anderson P, Bai X, Das PK, et al.
    Sustain Sci, 2018;13(6):1549-1564.
    PMID: 30546487 DOI: 10.1007/s11625-018-0611-0
    Cities are currently experiencing serious, multifaceted impacts from global environmental change, especially climate change, and the degree to which they will need to cope with and adapt to such challenges will continue to increase. A complex systems approach inspired by evolutionary theory can inform strategies for policies and interventions to deal with growing urban vulnerabilities. Such an approach would guide the design of new (and redesign of existing) urban structures, while promoting innovative integration of grey, green and blue infrastructure in service of environmental and health objectives. Moreover, it would contribute to more flexible, effective policies for urban management and the use of urban space. Four decades ago, in a seminal paper in Science, the French evolutionary biologist and philosopher Francois Jacob noted that evolution differs significantly in its characteristic modes of action from processes that are designed and engineered de novo (Jacob in Science 196(4295):1161-1166, 1977). He labeled the evolutionary process "tinkering", recognizing its foundation in the modification and molding of existing traits and forms, with occasional dramatic shifts in function in the context of changing conditions. This contrasts greatly with conventional engineering and design approaches that apply tailor-made materials and tools to achieve well-defined functions that are specified a priori. We here propose that urban tinkering is the application of evolutionary thinking to urban design, engineering, ecological restoration, management and governance. We define urban tinkering as:A mode of operation, encompassing policy, planning and management processes, that seeks to transform the use of existing and design of new urban systems in ways that diversify their functions, anticipate new uses and enhance adaptability, to better meet the social, economic and ecological needs of cities under conditions of deep uncertainty about the future.This approach has the potential to substantially complement and augment conventional urban development, replacing predictability, linearity and monofunctional design with anticipation of uncertainty and non-linearity and design for multiple, potentially shifting functions. Urban tinkering can function by promoting a diversity of small-scale urban experiments that, in aggregate, lead to large-scale often playful innovative solutions to the problems of sustainable development. Moreover, the tinkering approach is naturally suited to exploring multi-functional uses and approaches (e.g., bricolage) for new and existing urban structures and policies through collaborative engagement and analysis. It is thus well worth exploring as a means of delivering co-benefits for environment and human health and wellbeing. Indeed, urban tinkering has close ties to systems approaches, which often are recognized as critical to sustainable development. We believe this concept can help forge much-closer, much-needed ties among engineers, architects, evolutionary ecologists, health specialists, and numerous other urban stakeholders in developing innovative, widely beneficial solutions for society and contribute to successful implementation of SDG11 and the New Urban Agenda.
    Matched MeSH terms: Specialization
  12. Fulltext Tramadol: a valuable treatment for pain in Southeast Asian countries
    Vijayan R, Afshan G, Bashir K, Cardosa M, Chadha M, Chaudakshetrin P, et al.
    J Pain Res, 2018;11:2567-2575.
    PMID: 30425567 DOI: 10.2147/JPR.S162296
    Background: The supply of controlled drugs is limited in the Far East, despite the prevalence of health disorders that warrant their prescription. Reasons for this include strict regulatory frameworks, limited financial resources, lack of appropriate training amongst the medical profession and fear of addiction in both general practitioners and the wider population. Consequently, the weak opioid tramadol has become the analgesic most frequently used in the region to treat moderate to severe pain.

    Methods: To obtain a clearer picture of the current role and clinical use of tramadol in Southeast Asia, pain specialists from 7 countries in the region were invited to participate in a survey, using a questionnaire to gather information about their individual use and experience of this analgesic.

    Results: Fifteen completed questionnaires were returned and the responses analyzed. Tramadol is used to manage acute and chronic pain caused by a wide range of conditions. Almost all the specialists treat moderate cancer pain with tramadol, and every one considers it to be significant or highly significant in the treatment of moderate to severe non-cancer pain. The reasons for choosing tramadol include efficacy, safety and tolerability, ready availability, reasonable cost, multiple formulations and patient compliance. Its safety profile makes tramadol particularly appropriate for use in elderly patients, outpatients, and for long-term treatment. The respondents strongly agreed that tighter regulation of tramadol would reduce its medical availability and adversely affect the quality of pain management. In some countries, there would no longer be any appropriate medication for cancer pain or the long-term treatment of chronic pain.

    Conclusions: In Southeast Asia, tramadol plays an important part in the pharmacological management of moderate to severe pain, and may be the only available treatment option. If it were to become a controlled substance, the standard of pain management in the region would decline.
    Matched MeSH terms: Specialization
  13. Fulltext An audit of paediatric dental patient assessment and recall in faculty of dentistry UiTM Sungai Buloh
    Aimi Shafiqah Shukri, Muhammad Syazwan Hassan, Venkiteswaran, Annapurny
    Compendium of Oral Science, 2019;6(1):26-34.
    MyJurnal
    Objective: To assess if the recall appointments and the use of radiographs for paediatric dental patients at Faculty of Dentistry, UiTM comply with current guidelines. Materials and Method: A retrospective study was conducted using patients’ dental records that were registered at the Faculty of Dentistry UiTM. The sample consisted of 350 randomly chosen treatment records of paediatric patients aged between birth and 16 years of age at the time of data collection which was in the year 2016. Data collection included demographic details, whom the cases were treated by, caries risk assessment, radiographs taken and time taken for the patient’s review appointments. Results: An initial sample size of 350 records were assessed. The mean age of patients seen when they were first seen is 6.3 years old. Caries Risk Assessment was not reported in majority of the cases (58%,). Baseline radiographs were taken in 44.6% of the cases. For the assessment of recall attendance, only samples with data on CRA was analysed (n=145). The review appointments at 3 months interval was 70% whereas at 6 months was 6.2% and one year recall was 6.7%. A chi-square test showed significant difference (p=0.013) between the category of operators for the 1-year review whereby review was higher among students and specialists as compared to dental officers. Conclusion: This study shows poor adherence to the recommended recall protocol as suggested by NICE and AAPD guidelines. Further studies need to be done to assess the patients’ and clinicians awareness regarding the recall protocol and determine the problems causing poor recall attendance.
    Matched MeSH terms: Specialization
  14. Fulltext Multicentre study of preoxygenation practices by anaesthesia providers
    Wong AK, Sushila S, Thomas H, Tong JMG
    Med J Malaysia, 1999 Mar;54(1):102-9.
    PMID: 10972012
    A total of 155 consecutive anaesthetics in three public Malaysian hospitals were prospectively studied to assess preoxygenation practices by their anaesthesia providers. Preoxygenation was practised in 96.1% of patients. Specialist and non-specialist anaesthesiologist did not preoxygenate 8.8% and 2.3% of their patients, respectively. Overall incidence of arterial oxygen desaturation during induction was 15.5%. Arterial oxygen desaturation occurred more frequently with emergency surgery (30.2%) in comparison to elective surgery (9.8%). Arterial oxygen desaturation occurred more frequently with non-specialist (18.9%) than specialist anaesthesia providers (3.0%).
    Matched MeSH terms: Specialization
  15. Fulltext Outcome of Various Pterygium Excision Techniques in Tertiary Ophthalmic Centre in East Coast Malaysia
    Khairidzan, M.K., Fatimah, S.S., Thangasamy, V.K.
    International Medical Journal Malaysia, 2006;5(1):1-2.
    MyJurnal
    Pterygium is a common external eye problem. It is more frequently seen in tropical areas regions where exposure to ultraviolet sunlight is high. Clinically, a pterygium is a wing shaped fibrovascular growth arising from the bulbar conjunctiva onto the superficial cornea. Complications of pterygium include decreased in visual acuity, dryness, foreign body sensation and persistent redness. Surgical management is the mainstay of treatment for this condition. Numerous surgical techniques have been described in the treatment of pterygium. They include the bare sclera technique, simple direct conjunctival closure, rotational conjunctival graft and conjunctival autograft. Additional treatment to some of these techniques may include the use of beta particle therapy and antimetabolite therapy. Despite the wide range of surgical procedures described for its treatment, the main concern from these procedures has been the recurrence, which could be as high as 30% to 70%. Recurrent pterygium is often accompanied by increased conjunctival inflammation and accelerated corneal involvement. Repeated surgical procedures often only worsen the situation, as loss of conjunctival tissue and scarring can result in obliteration of the fornices and mechanical restriction of extraocular movements, with clinically significant diplopia. In Hospital Tengku Ampuan Afzan, pterygium excision is the most common surgical procedure after cataract extraction. We reviewed patients who had undergone pterygium surgery in HTAA in order to determine the most effective surgical method that could minimize recurrence. PURPOSE: To compare success rates of various excision techniques performed for primary and recurrent pterygium in Hospital Tengku Ampuan Afzan, Kuantan, Pahang.
    METHODS: The outcome of 47 cases of pterygia (44 primary and 3 recurrent) excised with various techniques between January 2004 to September 2004 was retrospectively reviewed. Six clinical specialists and four trainees performed the surgical procedures. Outcome was evaluated in terms of recurrence of pterygia onto the cornea. RESULTS: The mean follow up was 3.04 months (range, 1-7 months). All pterygia were morphologically graded as intermediate or fleshy type except one. Four types of pterygium excision techniques were performed. Twenty-four cases had bare sclera, seventeen cases had conjunctival autograft transplantation, six cases had direct conjunctival closure and one had amniotic membrane transplantation done. Recurrence of pterygia occurred in thirteen eyes. Twelve cases from primary pterygia group and one case from recurrent group recurred. Recurrence rate was noted to be higher in direct conjunctival closure (4 out of 6 cases) and lowest in conjunctival autograft transplantation (2 out of 17 cases). Recurrence rate for bare sclera technique was noted to rank second in this study (6 out of 24 cases). In five cases of recurrence, subconjunctival tissue invasions were more than 1 mm but further surgical interventions were not needed at the time of this review was done. CONCLUSIONS: Conjunctival autografting was found to have less recurrent rate when compared with other techniques. The bare sclera technique was quoted to be associated with higher recurrence rate in other literatures. Interestingly in our series, recurrence rate for direct conjunctival closure technique was higher when compared to the former technique. This may be related to inadequate excision of pterygia tissue, which led to direct apposition of abnormal tissue to the cornea in the direct conjunctival closure technique. Even though the bare sclera technique is associated with a higher recurrence rate, it is still the preferred excision technique. This could be because it is less time consuming and technically easier to perform. Based on this study, conjunctival autografting should be the surgical procedure of choice for pteryigum in order to minimise the risk of recurrence.
    Matched MeSH terms: Specialization
  16. Fulltext Psychiatrists in malaysia: the ratio and distribution
    Lee, Toh Chin, Ng, Chong Guan, Benedict Francis, Tan, Shean Yen
    Malaysian Journal of Psychiatry, 2018;27(1):0-0.
    MyJurnal
    We are aware of the shortage of psychiatrists in Malaysia.
    However, there is no formal report on the distribution and ratio of
    psychiatrists in each state in Malaysia. We aim to do a detailed count of the
    number of psychiatrists in the country. Methods: We obtained the figures for
    the psychiatrists practicing in the government, private and university settings
    by accessing the Ministry of Health database, information from the
    Malaysian Psychiatric Association, Malaysian Mental Health Association,
    National Specialist Register and websites of the respective Universities. The
    total number and ratio of psychiatrists per 100,000 population are calculated.
    Results: There was a total of 410 registered psychiatrists in Malaysia in the
    private universities, private clinics, public universities and government
    hospitals. The state with the highest number of psychiatrists is Wilayah
    Persekutuan Kuala Lumpur with a total of 94 psychiatrists which has a ratio
    of 5.24 per 100, 000 population followed by Wilayah Persekutuan Putrajaya
    with 3.38 per 100,000 population. The states with the least ratio of
    psychiatrists are Sabah with 0.54 and Kedah with 0.55 per 100, 000
    population. Conclusion: There is a discrepancy in the geographical
    distribution of psychiatrists in Malaysia. People living in larger, urban states
    have better access to mental health care whereas the smaller states face a
    serious lack of psychiatrists. More effort should be taken to improve mental
    healthcare in Malaysia as recommended by WHO with one psychiatrist for
    every 10, 000 population.
    Matched MeSH terms: Specialization
  17. Is the Singapore-Malaysia Congress of Medicine relevant in an age of specialisation?
    Tan WC
    Ann Acad Med Singap, 1999 May;28(3):315.
    PMID: 10575512
    Matched MeSH terms: Specialization*
  18. Knowledge of Acute Stroke Management Among Healthcare Professionals: Development and Validation of Acute Stroke Management Questionnaire (ASMaQ)
    Sim CY, Wan Zaidi WA, Shah SA, Wan Yahya WNN, Tan HJ
    J Stroke Cerebrovasc Dis, 2021 Jan;30(1):105421.
    PMID: 33160125 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105421
    BACKGROUND: Around 15.0% of all strokes occurred in hospitalised patients and studies showed significant delay in the stroke recognition and lack of awareness on thrombolytic therapy for acute ischaemic stroke (AIS) which lead to higher mortality for in-hospital stroke. We aimed to develop and validate a new instrument known as acute stroke management questionnaire (ASMaQ) to evaluate the awareness of healthcare professionals in managing acute ischaemic stroke cases.

    METHODS: This study consisted of 3 steps; the formulation of ASMaQ draft, content validation and construct validity. A total of 110 questions were drafted with 5-point Likert scale answers. From the list, 31 were selected and subsequently tested on 158 participants. The results were analysed and validated using exploratory factor analysis on SPSS. Components were extracted and questions with low factor loading were removed. The internal consistency was then measured with Cronbach's alpha.

    RESULTS: Following analysis, 3 components were extracted and named as general stroke knowledge, hyperacute stroke care and advanced stroke management. Two items were deleted leaving 29 out of 31 questions for the final validated ASMaQ. Internal consistency showed high reliability with Cronbach's alpha of 0.82. Our respondents scored a total cumulative mean of 113.62 marks or 66.6%. A sub analysis by occupation showed that medical assistants scored the lowest in the group with a score of 57% whilst specialists including neurologists scored the highest at 79.4%.

    CONCLUSION: The ASMaQ is a newly developed and validated questionnaire consisting of 29 questions testing the respondents' acute stroke management knowledge.

    Matched MeSH terms: Specialization
  19. Are our staff in Public Hospitals Caring
    Roslinah, A., Roslan, J.M.G., Aravalzi, K., Nuriza, Z., Hong, L.C., Tahir, A.
    Journal of Health Management, 2008;4(1):20-26.
    MyJurnal
    Caring practice is one of the three core values of Corporate Culture of Ministry of Health Malaysia, initiated in 1991. A cross sectional study was conducted to determine the extent of hospital healthcare personnel practicing the element of caring. Self-administered questionnaires were mailed to all staff working in public hospitals followed by reminder letters and telephone calls. A total of 37,267 responded out of 69,385 personnel working in the hospitals with a response rate of 53.7%. Results showed that about half of the respondents perceived that they practice caring value of the corporate culture (49.5%) and only 33.3% perceived that their colleagues practiced it. The practice of caring value was highest among clinical specialists (65.4%) and lowest among the clerks (22.1%). Nurses perceived that 40.4% of their colleagues practiced caring values while the clerks perceived only 17.0% of their colleagues practice it. In conclusion, caring value is not being well practiced by healthcare staff especially among the support staff. There is a need for further research to study the reasons for poor caring practice by healthcare personnel and develop strategies to improve the situation.
    Matched MeSH terms: Specialization
  20. Fulltext Utilisation of specialist medical manpower in Malaysia
    Wong SL, Mohan AJ, Suleiman AB
    Med J Malaysia, 1998 Sep;53(3):245-50.
    PMID: 10968161
    One hundred and twenty specialists from the Ministry of Health, the Universities and the private sector provided information on 4,802 patients seen over a total of two hundred and forty working days. This information was used to classify the patients into four categories based on a disease complexity classification. Each specialist's perception on the appropriateness of utilisation of his expertise was obtained. Complex cases requiring specialist expertise in management made up 69.8%, 73.5% and 19.1% of the cases of the Ministry of Health, University and private sector specialists respectively. Underutilisation was most marked with paediatricians and obstetricians in the private sector. The Specialist Register, the Programme for Accreditation of Hospitals and a National Health Financing Plan can be used to influence positively the case-mix of specialists.
    Matched MeSH terms: Specialization*
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