Introduction: Various initiatives and medications have been introduced to achieve better control of bronchial asthma. However total control according to Global Initiative for Asthma (GINA) remains elusive even at tertiary referral hospitals. Our study is to determine the level of asthma control (according to GINA 2009), Asthma Control Test (ACT) scores and the types of medications used among patients with bronchial asthma in a large tertiary hospital.
Methods: A cross-sectional study of all patients with bronchial asthma who attended the Chest Clinic at Hospital Tengku Ampuan Afzan (HTAA) from 2009 to 2011. Patient demographics, self-administered ACT scores, GINA-defined level of asthma control and medications were documented.
Results: 208 patients were recruited. There were 23.2%, 46.3% and 30.5% of patients with controlled, partly controlled and uncontrolled asthma respectively. The median ACT scores was 19 [inter quartile range (IQR) 6]. The most frequently used preventer therapy was inhaled long-acting β-agonist/corticosteroids (LABA/ICS) fixed-dose combination (61.7%), and 9.6% were not on preventer therapy. 75% of patients with controlled asthma were on LABA/ICS compared to 58.5% of the partly controlled and uncontrolled groups (p=0.039).
Conclusion: The majority of the asthmatic patients attending the Chest Clinic at HTAA did not have GINA-defined controlled asthma. Patients with higher ACT scores had better control of asthma. There were more patients with controlled asthma who were on LABA/ICS combination.
KEYWORDS: Bronchial asthma, level of control, Asthma Control Test
Study site: Chest Clinic, Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
Device, Questionnaire & Scale: Asthma Control Test (ACT)
Hypertension is one of the major risk factors for coronary heart disease and the most important factor for cerebrovascular diseases. Adherence to treatment is a fundamental pre-requisite for therapeutic benefit in hypertensive patients. Adherence is a complex behavioural process that is strongly influenced by the way in which patients live, as well as the psychological and social support system.
Aim: To understand and conceptualize the experience of people on long-term antihypertensive treatment Method: Qualitative analysis using semi-structured interviews with ten hypertensive patients from the medical clinic of Kuala Lumpur General Hospital.
Results: Although the participants were aware of having high blood pressure they declined receiving any treatment at the early stage of the disease. Fear of death and disease complications are reinforcements for participants to adhere to medication. They perceived the label of “hypertension” will affect their self-identity and social role. Positive thinking regarding medication assists participants to adhere to treatment. Conversely, participants who perceived medication negatively also adhere to a medication regime, as adherence behaviour satisfies the family. Participants justified modifying their regimen or taking Complementary and Alternative Medicine (CAM) as they believe know the their body best. However, participants wished to obtain more information regarding hypertension and its treatment from the doctors.
Conclusion: In finding the fine balance between stepping in and holding back treatment and care, health professionals need to know their clients in context. This balance can only be achieved by establishing processes of negotiation within an ongoing therapeutic relationship.
Study site: medical clinic of Kuala Lumpur General Hospital.
Living with epilepsy is equally demanding for both patients and their caregivers. The caregivers’ tasks are not limited to caring for the patients only but also the need to improve their awareness, knowledge and attitude (AKA) level as lack of understanding has a major impact on health-related quality of life (HRQoL). Little is known about the influence of AKA on family caregivers’ HRQoL. Objective: Therefore, this study aimed to assess and relate the AKA and HRQoL profiles of epilepsy carers. Methods: This prospective, cross-sectional study included a sample of 32 epilepsy family caregivers who were recruited from the Neurology and Paediatric Clinics of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu. Results: Majority were Muslims (93.8%), married (65.6%), housewives (31.2%), who earning monthly income of not more than RM 1000 (34.4%) and was the patients’ mothers (40.6%). The Total AKA score was generally good (mean=123.4±16.8, median 122.5) with awareness being good, knowledge moderate and attitude positive whereas HRQoL score for Disruptiveness was the highest (good) compared to other domains. There were significantly higher scores for Sexual Functioning (p = 0.039) among Poor AKA group and Pain Management (p = 0.040) among Good AKA. Conclusion: The overall outcomes signified that family caregivers with Good AKA experienced better well-being compared to those with Poor AKA while carrying out their roles as caregivers. Consequently, carers clearly require constant epilepsy education to enhance skill-building in order to understand and keep updates with the disease, thus indirectly sustaining their desired HRQoL status from time to time.
Study site: Neurology and Paediatric Clinics of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu
Objective: To evaluate the health-related quality of life (HRQOL) of patients with chronic depression. Methods: The study involved patients with chronic depression being followed-up at an outpatient clinic at a local hospital in Malaysia. HRQOL was assessed using the Sheehan Disability Scale (SDS); while symptom severity was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS). Results: 104 patients of Malay, Chinese and Indian ethnic groups met the selection criteria. Mean total SDS and MADRS scores was 9.36 ± 7.92 and 13.99 ± 11.58 respectively. There were no significant differences of HRQOL scores between the different ethnicities and between males and females. Symptom severity significantly influenced total and component HRQOL scores. Conclusions: The HRQOL of patients with chronic depression was found to be significantly influenced by symptom severity. Data obtained in this study can be used in the design and implementation of therapeutic and preventive interventions.
Patients are increasingly dissatisfied with the “waiting time” and “duration of consultation” at outpatient clinics. A cross sectional study was carried out to measure waiting time and duration of consultation and to examine patients’ level of satisfaction towards waiting time and duration of consultation at the Orthopedic Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This study also examined patient’s satisfaction towards the overall clinic services. Data was collected using a self-administered questionnaire. A total of 81 patients participated in this study with a response rate of 100 percent. Findings indicated a significant difference in the mean between expected waiting time level II (from the time the patient is given the calling number till the time patient is called into the doctor’s room) and the actual waiting time level II experienced. A significant difference in the mean between the expected duration of consultation and the actual duration of consultation experienced was also noted. However, no significant difference was found between the mean of expected waiting time level I (the time patient register at the counter till the patient is given the calling number) and the actual waiting time (p>0.05). Overall, patient satisfaction towards waiting time was low (29.6%) and duration of consultation was of moderate level (41.9%). The overall satisfaction towards the clinic services were of average level (56.8%). Findings also indicated that patient satisfaction was not influenced by socio-demographic factors of respondents such as age, ethnic, education level, occupation and income level. Important findings from this study may help staff managing the clinic in addressing patients’ complaint on waiting time and improve patients’ satisfaction on the overall services of the Orthopedic clinic in UKMMC.
Study site: Orthopedic clinc, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Background: The aim of this study was to explore the predictors of QOL and health state and examine the relationship with glycemic control among type 2 diabetes mellitus (T2DM) patients.
Methods: A randomized cross-sectional case-control study was conducted among n = 600 T2DM patients of Malaysia. Study population was distributed into three groups as: controls: patients with HbA1c ≤ 7 (n = 199), cases arm 1: with HbA1c 7-7.9 (n = 204) and cases arm 2 (n = 197): with HbA1c ≥ 8 consecutively last 3 times.
Results: Participants with diabetes history > 10 years exhibits higher mean QOL score among all the three groups. In contrast mean health status score significantly (p
Objective The objective of this paper is to determine photoprotection awareness, knowledge, practices, and its relationship with disease activity and damage in patients with systemic lupus erythematosus (SLE).
Methods A cross-sectional study was performed. Data were acquired from in-person interviews and medical records.
Results A total of 199 (89.6%) females and 23 (10.4%) males were recruited. Median age was 39.00 (interquartile range (IQR) 18) years, disease duration 12.12 (IQR 8) years, Fitzpatrick skin phototype III 119 (53.6%) and IV 81 (36.5%). Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) was 2.95 (IQR 4) while Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC-ACR DI) was 1.20 (IQR 2). The majority 205 (92.3%) were aware of sun exposure effects on SLE. Photoprotection methods were shade seeking 209 (94.1%), sun avoidance 212 (95.5%), long pants 168 (75.7%), long sleeves 155 (69.8%), sunscreen 116 (52.3%), sunglasses 114 (51.4%) and head cover 103 (46.4%). Significantly higher photoprotection practice scores (PPS) were observed in females, Malays, and individuals with higher education level and internet accessibility. PPS were not significantly correlated with SLICC-ACR DI and SLEDAI-2 K. Independent predictors for good photoprotection practice (GPP) were ethnicity (OR = 3.66, 95% CI 1.78-7.53), awareness (OR = 3.77, 95% CI 1.09-13.08) and cutaneous involvement (OR = 2.43, 95% CI 1.11-5.28). Photoprotection methods and GPP were not predictors for disease activity or damage.
Conclusion Photoprotection awareness and knowledge was good. Shade seeking and sun avoidance were the common photoprotection methods practised. The use of sunscreen requires improvement. Photoprotection awareness and cutaneous manifestation were predictors for GPP. Neither photoprotection methods nor GPP were associated with disease activity or damage.
Study site: Nephrology, Rheumatology and Dermatology clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Objective: Sexual problems are common among patients who are on antidepressants treatment. The objective of this study is to determine the prevalence of PE and ED, and their potential risk factors that may impair their sexual function in a TH
Methods: A cross-sectional study using simple random sampling was conducted among adult male patients who are on antidepressant treatment in the TH psychiatric outpatient clinic. Respondents’ sociodemographic data were obtained. Participants were interviewed using a structured self-report questionnaire with 15-item International Index of Erectile Function (IIEF-15)where the scores lesser than 25 were indicative for having an ED. A validated Malay Premature Ejaculation Diagnostic Tool (MAPET) was used to assess PE and those with a score ≥ 23 were considered to have PE.
Results: Hundred respondents were participated, and the prevalence of PE and ED was 66% and 85%, respectively. Using multivariate binary logistic regression, the potential risk factors of PE were race, i.e. being non-Malay (p=0.044), lesser in the frequency of sexual activity (p=0.03) and also an ED (p=0.03), respectively. The only risk factor for ED was PE (p=0.026). No significant association was noted for the other factors, including type of the antidepressant, dose and duration of antidepressant used (p>0.05). There was a strong correlation of MAPET and IIEF-15 (r=-0.345, p < 0.01) signifying patient with more severe PE had more severe ED.
Conclusions: Due to very high rate of ED and PE in this group of respondents, it is pivotal to screen for sexual problem among patients who are taking an antidepressant in a psychiatric setup.
Study site: Psychiatric clinic, Pusat Perubatan University Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia.
Objectives: We sought to determine the prevalence of traditional and complementary medicine (TCM) use for knee osteoarthritis and its associated factors among patients attending a referral hospital in an eastern coastal state of Malaysia.
Methods: This cross-sectional study included 214 patients with knee osteoarthritis. A universal sampling method was applied to patients who attended the outpatient clinic in Hospital Universiti Sains Malaysia from May 2013 to October 2013. Participants were given a questionnaire to determine their sociodemographic information and a validated Bahasa Malaysia version of the Western Ontario and McMaster Universities Arthritis Index (WOMAC). This questionnaire was used to assess the severity of knee osteoarthritis (i.e., pain, stiffness, and disturbances in daily activity).
Results: Over half (57.9%) of patients reported using TCM to treat knee osteoarthritis. Factors associated with TCM use were gender (odd ratio (OR) = 2.47; 95% confidence interval (CI): 1.28-4.77), duration of knee osteoarthritis (OR = 1.51; 95% CI: 1.03-2.23), and the severity of knee pain (OR = 2.56; 95% CI: 1.71-3.86).
Conclusions: The prevalence of TCM use among eastern Malaysian patients with knee osteoarthritis was high. Physicians caring for these patients should be aware of these findings so that inquiries regarding TCM use can be made and patients can be appropriately counseled.
Study site: Primary care clinic, Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Aim: To evaluate doctors' knowledge, attitude, and practices and predictors of adherence to Malaysian hypertension guidelines (CPG 2008).
Methods: Twenty-six doctors involved in hypertension management at Penang General Hospital were enrolled in a cross-sectional study. Doctors' knowledge and attitudes towards guidelines were evaluated through a self-administered questionnaire. Their practices were evaluated by noting their prescriptions written to 520 established hypertensive outpatients (20 prescriptions/doctor). SPSS 17 was used for data analysis.
Results: Nineteen doctors (73.07%) had adequate knowledge of guidelines. Specialists and consultants had significantly better knowledge about guidelines' recommendations. Doctors were positive towards guidelines with mean attitude score of 23.15 ± 1.34 points on a 30-point scale. The median number of guidelines compliant prescriptions was 13 (range 5-20). Statistically significant correlation (rs = 0.635, P < 0.001) was observed between doctors' knowledge and practice scores. A total of 349 (67.1%) prescriptions written were guidelines compliant. In multivariate analysis hypertension clinic (OR = 0.398, P = 0.008), left ventricular hypertrophy (OR = 0.091, P = 0.001) and heart failure (OR = 1.923, P = 0.039) were significantly associated with guidelines adherence.
Conclusion: Doctors' knowledge of guidelines is reflected in their practice. The gap between guidelines recommendations and practice was seen in the pharmacotherapy of uncomplicated hypertension and hypertension with left ventricular hypertrophy, renal disease, and diabetes mellitus.
Study site: Cardiology, nephrology, diabetic, and hypertension clinics of Hospital Pulau Pinang, Malaysia
Early detection and prompt treatment of eye diseases can prevent visual disability. To our knowledge, there is no published data on factors associated with delayed presentation of eye diseases in Malaysia. Our objective is to determine the proportion of patients with eye disease who had a delayed presentation to an ophthalmologist after an initial screening, as well as the factors associated with delay in seeking treatment. This was a retrospective cohort study of patients with eye diseases detected during a Community Eye Survey (CES) program from September 2004 to December 2012 who were referred to the ophthalmologist in Hospital Universiti Sains Malaysia (USM). Delayed presentation of eye disease was defined as patients who came to the eye clinic more than six months after eye screening. Multiple logistic regression was used for analyses. A total of 434 patients who were referred to Hospital USM, Kubang Kerian were included in the study. Their mean (standard deviation) age was 55.65 (21.62) years. The majority of patients (76%) had delayed presentation of eye disease post screening. Type of ocular diseases was not associated with delayed presentation. The factors associated with delayed presentation were unemployment (adjusted odds ratio (OR): 2.51, 95% CI (1.36, 4.64), p
Study site: Hospital Universiti Sains Malaysia (HUSM)
AIM: To validate the accuracy of estimated glomerular filtration rate (eGFR) equations in Malay population attending our hospital in comparison with radiolabeled measured GFR.
METHODS: A cross-sectional study recruiting volunteered patients in the outpatient setting. Chromium EDTA (51Cr-EDTA) was used as measured GFR. The predictive capabilities of Cockcroft-Gault equation corrected for body surface area (CGBSA), four-variable Modification of Diet in Renal Disease (4-MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations were calculated.
RESULTS: A total of 51 subjects were recruited with mean measured GFR 42.04 (17.70-111.10) ml/min/1.73 m(2). Estimated GFR based on CGBSA, 4-MDRD, and CKD-EPI were 40.47 (16.52-115.52), 35.90 (14.00-98.00), and 37.24 (14.00-121.00), respectively. Higher accuracy was noted in 4-MDRD equations throughout all GFR groups except for subgroup of GFR ≥ 60 ml/min/1.73 m(2) where CGBSA was better.
CONCLUSIONS: The 4-MDRD equation seems to perform better in estimating GFR in Malay CKD patients generally and specifically in the subgroup of GFR < 60 ml/min/1.73 m(2) and both BMI subgroups.
Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
INTRODUCTION: This is a cross-sectional study of 1 year duration (August 2013 to August 2014). The objective of the study was to investigate the diagnostic accuracy of single channel cystometry (SCC) for confirmation of neurogenic bladder following spinal cord injury.
MATERIALS AND METHODS: The study was conducted in both out-patient and in-patient services of Department of Rehabilitation Medicine, Hospital Sungai Buloh, Malaysia. Subjects in the study include sixteen patients with a clinical diagnosis of neurogenic bladder following spinal cord injury aged between 15 and 62 years. Patients with a clinical diagnosis of neurogenic bladder were subjected to cystometric evaluation using SCC in our hospital. Confirmation of the diagnosis was made by urodynamic study (UDS) in another hospital. SCC procedure involved manual intra-vesical pressure assessment using a 12F Nelaton catheter. Cystometric parameter measurement taken in this study was detrusor pressure (cm H2O) done at regular intervals from baseline, throughout bladder filling phase and voiding/leaking phase. The relationship between detrusor pressure to bladder volume from initial bladder filling until voiding or leaking phase was recorded, analyzed and graph plotted. Maximum detrusor pressure (cm H2O) during bladder filling, voiding or leaking and the maximum cystometric capacity (mls) was recorded.
RESULTS: SCC was found to have 100% sensitivity, 50% specificity, 93.33% positive predictive value and 100% negative predictive value for neurogenic bladder diagnosis. Only 55.55% patients with SCC suspicion of detrusor sphincter dyssynergia (DSD) had comparable UDS findings.
DISCUSSION: The use of SCC may be considered for objective confirmation of neurogenic bladder diagnosis following spinal cord lesion in centers with limited access to UDS. However, we are not able to establish its clinical application for confirmation of DSD.
Study site: Department of Rehabilitation Medicine, Hospital Sungai Buloh, Malaysia
Background: The Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) developed by the World Health Organization is designed to identify individuals at risk for alcohol use problems and provide brief intervention.
Objectives: To evaluate the validity and reliability of the ASSIST in Malaysia’s official language, the Bahasa Malay, among a group of alcohol users. The study also aimed to assess the impact of alcohol on the quality of life of patients.
Methods: The final version of ASSIST-M was administered to 51 patients who were identified as alcohol users and attended the outpatient psychiatric clinic during a three-month period from September to November of 2012. Patients completed ASSIST, ASSIST-M, Mini-International Neuropsychiatric Interview (M.I.N.I.), Malay version of The Alcohol Use Disorders Identification Test (AUDIT-M), CAGE Assessment for Alcohol Abuse (CAGE), and the World Health Organization Quality of Life Scale-Brief-Malay version (WHOQoL-Brief-M). Statistical procedures were performed to assess the reliability and validity of the ASSIST-M.
Results: Factor analysis of ASSIST-M yielded one factor similar to the factor structure of the English version. The Cronbach’s α coefficient of ASSIST-M was 0.80. The parallel reliability of the ASSIST-M was high with the intra-class correlation (ICC) of 0.96 (P< 0.01). The test–retest reliability of the ASSIST-M after the 1-week interval was high with the ICC of 0.94(P< 0.01). The ASSIST-M was positively correlated with the AUDIT-M (r =0.67, p <0 .01) and the CAGE (r=0. 57, p < 0.01). ASSIST-M score showed a negative and statistically significant relationships with the physical (r= -0 .28, p < 0.01) and social relationship (r= -0.37, p<0.01) subscales of the WHOQoL-Brief-M. The optimal cutoff point for ASSIST-M for alcohol use disorder was more than 14 with the with a sensitivity of 84.21 %, specificity of 84.38 %, positive predictive value (PPV) of 76.19% and negative predictive value (NPV) of 90%.
Conclusions/Importance: The ASSIST-M displayed a fair psychometric performance in assessing alcohol use disorder in Malaysia.
Keywords: Alcohol Dependence, ASSIST, ASSIST-M, M.I.N.I., CAGE, WHOQoL
Study site: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Stroke is a causal factor that commonly caused physical impairments and activity limitations among patients to perform daily activities until at certain level stroke patients will experience disability. The aim of this study is to examine the relationship of each demographic and clinical factors that is believed to associate with physical functioning of patients
those who experienced stroke. This present study also try to compare physical functioning of patients with associated factors and then examine the correlation between those factors with physical functioning. A total of 147 respondents that pass for cognitive screening test involved in this study. Barthel Index (ADL) was administered to the respondents after 6 weeks of stroke attack in order to measure their physical functioning status. Results found that there was a significant difference [F(3, 143) = 4.06; p < 0.01] between level of educations with physical functioning of patients. With respect to clinical factors also showed a significant difference (p < 0.01) was higher in physical functioning when stroke attack
occurred at right hemisphere of brain. There was a significant difference (p < 0.01) in physical functioning with respect to belief of recovery. Furthermore, number of stroke attack also showed a significant difference [F(1, 145) = 11.19; [p < 0.01] in physical functioning of patients. Correlation test that was carried out found a positive significant correlation
(r = 0.24; p < 0.01) between physical functioning with respect to the affected lesion side. In conclusion, demographic and clinical factors also played the roles to determine level of physical functioning among stroke patients and thus these factors should be considered in any studies that intended to enhance physical functioning of patients in future.
Keywords: stroke; physical functioning; disability; physical impairment
Patients with chronic heart failure suffer from undesirable effects in their daily activities. Effective self-care management in conjunction with social support gives improved the wellbeing of patients with chronic heart failure. This study determines social support and self-care management among patients with chronic heart failure. A cross-sectional study was conducted at the Cardiology Clinic in Hospital Serdang, Selangor from April 2014 to June 2014. A questionnaire consisting of demographic characteristics, MOS Social Survey and Self-Care Heart Failure Index (SCHFI) was distributed to a total of 113 respondents. The results show moderately high level of social support (3.51±0.89) and level of self-care management (160.49±44.39). For instance, social support and self-care management were not statistically significant with the demographic characteristics (p>0.05). There was a positive correlation between social support and self-care management (r=0.263, p<0.05) and the findings suggest that social support should be considered a predictor in self-care management of patients with chronic heart failure.
Keywords: social support, self-care management, patient(s), chronic heart failure
Study site: Cardiology Clinic in Hospital Serdang, Selango
Purpose: The objective of this study was to explore the experiences and side-effects of breast cancer patients on chemotherapy in Malaysia.
Participants and methods: Purposive sampling of 36 breast cancer patients who have completed chemotherapy and agreed to participate in semi-structured in-depth interviews. A constant comparative method and thematic analysis were used to analyze the interviews.
Results: Data were categorized into six main themes: know nothing of chemotherapy; fear of chemotherapy; patients' beliefs in alternative treatments; symptom management; staying healthy after chemotherapy; and concerns of patients after chemotherapy.
Conclusion: Despite complaints about the bad experiences of their chemotherapy-induced side-effects, these patients still managed to complete the entire course of chemotherapy. Moreover, there is a need for a clinical pharmacy service in the oncology clinic setting in Malaysia in order to provide relevant information to help patients understand the chemotherapy received.
Study site: two tertiary care hospitals in Malaysia as well as the National Cancer Society Malaysia.
Rising risk of falls has been associated with injury and dysfunction among the elderly. Therefore, this study was conducted to determine the prevalence of falls and association with nutritional status among 143 elderly patients from medical ward and clinic in Hospital Kuala Lumpur. Anthropometric indicators and bone health status using quantitative ultrasound (QUS) were also assessed. History of falls, functional status and dietary intake based on dietary history was assessed
through questionnaire which was administered by face-to-face interview with the subjects. Data were analyzed using SPSS software version 16.0 and Foodworks. The past-year prevalence of falls (falls at least once in the previous 12 months) in this study was 32.9%. The past year prevalence of falls in women (40.2%) was higher than in men (17.4%) (p<0.01). Women who had calcium intake less than 300 mg/d (adjusted OR = 3.07, 95% CI = 1.02-9.24) and protein intake < 1 g/kg body weight (adjusted OR = 3.68, 95% CI = 0.98-13.84) were more likely to have a higher risk of falls. In conclusion, one third of the subjects, especially women in this study had a history of falls. Elderly people should be assessed for calcium and protein intake and those with calcium intake less than 300 mg/day and protein intake less than 1 g/kg body weight should be given intervention to reduce falls risk factor and subsequent fall-related co-morbidity.
Keywords: Elderly patients; falls; nutritional status
Musculoskeletal complaints are one of the most common presenting symptoms to primary care physicians. However, in Malaysia, there has been no prospective survey to look at this problem. This was a descriptive study to look at the prevalence of non-traumatic musculoskeletal complaints presenting to the primary care clinic at University Malaya Medical Center, Kuala Lumpur. Over a 3-week period, there were 408/4201 patients (9.7%) with non-traumatic musculoskeletal disorders. The most common regional problem was backache and the most commonly made diagnosis was non-specific musculoskeletal pain. In conclusion, musculoskeletal disorders form a significant proportion of primary care consultations and thus should be included in the curriculum for the primary care physician training. Keywords: musculoskeletal disorders, arthritis, primary care
Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia.
985 medical certificates issued by primary care doctors at the Klinik Perubatan Masyarakat and the staff health clinic at Universiti Sains Malaysia were analysed. Most common diagnoses were URTls, conjunctivitis, and gastro-enteritis. Mean duration of absence ranged from 1.3 to 3.4 days. HUSM staff with skin infections were given certificates nearly twice more often than the public. Backache earned more time off for the staff compared to the public. There is a need to formulate guidelines for medical certificates.
Study site: Klinik Perubatan Masyarakat and the staff health clinic at Universiti Sains Malaysia