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Fulltext Usefulness of newly acquired commercial dengue NSI antigen test kit for early detection of dengue in a general practice clinic in Batu Gajah, Perak

Chan, S.C., Teoh, L.C.

Asian Journal of Medicine and Health Sciences, 2018;1(1):1-8.
MyJurnal

The non-structural protein 1 (NS1) of the dengue viral genome has been found useful for diagnosis of acute dengue infections, being detected from one day and up to 18 days post onset of symptoms (1). Rapid Dengue NS1 antigen test was made available in commercial test kits for private clinics in Perak in 2014. This study aimed to determine the use usefulness of dengue NS1 test kits in suspected dengue cases in a general practice clinic in Perak and the period in which positive test results were obtained after the onset of symptoms. Clinic records of all suspected dengue cases seen in the ten months from October 2014 to July 2015 were traced. Patients’ demographic characteristics, presenting symptoms and the use of One Step Dengue NS1 Antigen test (Avo Diagnostics) were analyzed using SPSS version 17. Seventy one suspected dengue fever cases were seen in the study period, the highest number in July 2015 (25%). Majority were Chinese (80%), female (63%), and aged 40 years and above (51%). Most patients presented with fever (99%), body-ache (51%), gastrointestinal symptoms (51%) and headache (44%). Dengue NS1 antigen test was done in 94% of the suspected cases with 61% testing positive. The majority of the cases presenting one day to five days after onset of symptoms tested positive i.e. 59% (1 day), 90% (2 days), 54% (3-4 days) and 89% (5 days). Using dengue NS1 antigen test, positive results can be obtained as early as one day after the onset of symptoms. This test is a useful tool to aid primary care physicians detect dengue fever early.

Matched MeSH terms: Ambulatory Care Facilities
A retrospective study of the incidence of giant papillary conjunctivitis seen in the Optometry clinic UKM. [Kajian retrospektif insidens konjunktivitis papillari gergasi di Klinik Optometri UKM]

Ong BL

Sains Malaysiana, 1996;25(3):13-18.

A retrospective study of the incidence of Giant Papillary Conjunctivitis (GPC) seen in the Optometry clinic in Universiti Kebangsaan Malaysia from 1989 to 1994 was carried out. In the period of the 6 years, 37 contact wearers were diagnosed to have GPC. Of the 37 patients, 21 were Malays (57%), 12 were Chinese (32%) and the remaining 4 patients were Indians (11%). 18 or 48% of those with GPC were soft lens wearers, 46% of the wearers (17 patients) were rigid gas permeable lens wearers and 1 of the patients seen was a hard (PMMA) wearer (3%) and the other one was a disposable lens wearer (3%). Thirty patients were female (81%) and 7 (19%) were male. The age range of those with GPC were between 9 to 60 years old.
Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Patient appointment compliance at UKM optometry. [Kepatuhan temujanji oleh pesakit di klinik optometri UKM]

Hairol MI, Arif N, Mohd Shariffudin SH

Jurnal Sains Kesihatan Malaysia, 2018;16(1):103-108.
MyJurnal

Patient’s appointment compliance refers to the willingness and ability of a patient to attend to their scheduled clinical appointment. Failure to do so have various consequences, especially so for a teaching clinic such as the Optometry Clinic, Universiti Kebangsaan Malaysia (UKM). The percentage of appoinment compliance at the Optometry Clinic was analysed from September to December 2015. Compliance rate was categorised based on clinic type and session, and on patient’s gender and ethnicity. Attendance compliance was around 60% for the Primary Care Clinic. It increased to 70% for patients with vision problems who where referred to specialty clinics i.e. Low Vision and Paediatric Clinics. Clinic day and session did not influence compliance significanly (p > 0.05). Patient’s gender and ethnicity did not influence compliance significantly as well but those of Indian ethnicity consistently showed the lowest appointment compliance rates. A protocol should be developed to increase the rate of patients’ appoinment compliance. This would then maximise productivity of students and clinic staff and optimise the clinic’s resources. The cost of each clinical session could be informed to the patients, even when the cost is not borne by them.
Keywords: Appointment compliance; Optometry Clinic; appointments; clinical teaching and learning; public health
Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Musculoskeletal disorders presenting to the primary care department at University Malaya Medical Centre

Chow SK, Yew KC, Yeap SS

Family Physician, 2003;12(1):33-34.

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.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Comparing morbidity patterns in two government health centers and four private GP clinics in the Kinta district

Ding HJ, Chan SC

Family Physician, 2003;12(2&3):25-29.

The morbidity patterns and demographics of patients presenting to two government health centers and four private general practice clinics were studied over one week. Results showed little difference in the morbidity patterns but a significant difference in the demographics of the patients. The commonest illnesses seen were minor ones like upper respiratory tract infection and chronic ones like hypertension and diabetes mellitus. A wide spectrum of illnesses was seen in all the clinics. Both places handled few emergencies and referred only occasionally. There was an equal percentage of patients from both sexes. Ages of the patients varied from place to place and the racial distribution was influenced by several factors, including the existing patient population and the race of the doctor.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext A survey of medical certificates issued by primary care doctors at Universiti Sains Malaysia

Lane MJ

Family Physician, 1996;8(1&2):21-24.

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

Matched MeSH terms: Ambulatory Care Facilities
Management problems of insomnia in primary care

Sidek Nontak MA, Hamzah N, Salleh MO

Family Physician, 1993;5:28-34.

There is increasing evidence that insomnia is a common complaint. Furthermore, physicians tend to institute treatment without adequate assessment of the patients with insomnia. For the purpose of management, cases are presented on the basis of classification. A survey of doctor's knowledge and practice in the primary care department is discussed. Management principles and problems are outlined.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Drug Utilization in the Treatment of Diabetes Mellitus in the Ministry of Health Facilities

Abdul Aziz AM, Manan MM, Bahri S, Md Yusof FA, Kamarruddin Z, Said S, et al.

ISBN: 978-967-5570-45-2

Citation: Abdul Aziz AM, et al. Drug Utilization in the Treatment of Diabetes Mellitus in the Ministry of Health Facilities. Petaling Jaya: Pharmaceutical Services Division, Ministry of Health, Malaysia; 2013

Diabetes Mellitus (DM) is a costly disease to manage because of its chronic nature and severity of complications. Treatment of DM incurred high healthcare cost in both developed and developing countries. In Malaysia, treatment of DM is provided by all Ministry of Health (MOH) healthcare facilities and treatment may vary according to types of facilities. These differences may be associated with the utilization pattern and patient’s adherence to therapy and it is important to link actual medication therapy and the direct medical cost in the management of Malaysian DM patients. Thus, this study is to describe the utilization of medications in the treatment of DM in the MOH healthcare facilities and DM patient’s adherence towards their medication. This is a cross-sectional study in 94 MOH health facilities from November 2010 to December 2011. The healthcare facilities were categorized as National Referral Hospital, State Hospitals, Hospitals with Specialist, Hospitals without Specialist and Health Clinics. Patients were selected by the method of systematic random sampling and screened based on the inclusion and exclusion criteria. Face-to-face interview and retrospective data retrieval of patients’ medical record were conducted. The questionnaire and Morisky’s four questions adherence scale were utilized during the interview. A total of 2,509 (88.2%) patients were included in the study. The findings showed that variables for age, gender, race, marital status, household income, and occupation were essential components in examining its impact towards DM care. Most of the patients were between 45 to 55 years old and were burdened with co-morbidities. The observed trend in disease status showed that DM is closely related to co-morbidities such as hypertension, cardiovascular diseases, and hyperlipidaemia; more commonly in patients with more than 5 disease years. A total of 14.6% of DM patients have yet to be initiated with insulin while 84% and 78.9% of patients had poor control of HbA1c and fasting blood glucose. In terms of drug utilization and medication cost, there was no significant difference in the pattern of medication used for the first-line treatment of DM among type of facilities. Biguanides, sulphonamides, urea derivatives, and insulin are the top three DM medications. Insulin usage ranges from 25.6% at Hospitals without Specialist to 57.8% at State Hospitals and this corresponds to 2.5 to 7.0 times increment from National Health and Morbidity Survey (NHMS) III. Use of non-antidiabetic agents (ADA) corresponds with the top 10 co-morbidities. These include platelet aggregating inhibitors, ACE-inhibitors and statins. The pattern of treatment for co-morbidities showed significant differences among facilities and may be due to the degree of severity of DM patients. Also, the policies of categorizing A*/A/KK has led to these medications being less commonly prescribed in Hospitals without Specialist and Health Clinics. Adherence is an issue that DM patients need to improve. This study found that race, household income, and age were significant indicators for poor adherence. The odds ratio (OR) for age showed it contributed to almost one time lower in adherence. The OR for inter-racial differences found that both Chinese and Indian patients were about 0.7 times more likely to be non-adherence than Malays. Household income of less than RM1,000 per month similarly showed a 0.8 times less adherence compared to households earning between RM1,000 to RM3,000 per month. Pharmacists had been giving counselling to patients and the personalized approach by pharmacist had shown positive impact on Diabetic Medication Therapy Adherence Clinic (DMTAC) patients. The study findings, however, showed no improvement in adherence between those who attended DMTAC and those who have not. These findings might not be generalizable since most facilities had a very small percentage of DM patients and they are usually the problematic or difficult patients; this could have led to the rather uneventful findings. Finally, this study showed that there is no significant difference in the utilization of medication among health facilities in the treatment of DM. Adherence is still an area of concern and collaboration between healthcare professionals is vital for better treatment outcome.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Using TelePrimary Care to monitor immunization status in Sarikei Health Clinic, Sarikei, Sarawak

Lai BF, Safii R, Nyulang L, Dunggau C, Riffin MA, Khu FM, et al.

Int J Public Health Res, 2011;1(2):237-241.
MyJurnal

Introduction The purpose of this paper is to demonstrate the effectiveness of using TelePrimary Care (TPC) to monitor immunization programmed in a clinic. Japanese Encephalitis (JE) vaccination was selected as an example because its coverage has not been satisfactory when compared to that of other vaccinations, which generally exceed 90%.
Methods Data for all children who were eligible for JE vaccination (age range from 9 months to 30 months) who attended Sarikei Health Clinic between 1 January 2007 till 31 June 2008, was extracted from the TPC database and analyzed for completeness and timeliness of JE vaccination.
Results The analysis showed that although 1,243 children were eligible to receive their first dose of J vaccine at 9 months of age, only 560 (45%) received it. 15 (3%) received on time, and 545 (97%) received it late (age range from 10 months to 20 months). Out of the 560 who were scheduled to receive their second dose of JE vaccine four weeks after the first, 382 (88%) received it on time, and 55 (12%) received it late. Only 78 (18%) out of 429 children aged between 18 months to 24 months received their booster dose; 52 (67%) received it on time and 26 (33%) received it late.TPC not only enables health staff to monitor immunization coverage and timeliness accurately, but it also helps them to identify defaulters quickly so that these children can be traced and immunized. Doing these tasks manually is time-consuming and tedious, leading to delays in tracing defaulters.
Conclusions TPC provides an effective system for staff to easily access real time child health data to monitor and audit their immunization programme and take remedial action where necessary.
Study site: Klinik Kesihatan Sarikei, Sarawak, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Disposal practices of unused and unwanted medications among patients in a tertiary hospital

Lim MT

Education in Medicine Journal, 2016;8(3):49-59.
MyJurnal

There is a growing concern of unintended consequences of inappropriate medications disposal on the environment and public health. Objective: The aims of this study are to determine patients’ medications disposal methods and their awareness of the pharmacy medications take back program.
Method: A cross sectional survey using a self-administered closed-ended questionnaire on information, medications disposal and views, awareness of medications take back program and reasons for their unwillingness to return the unused and unwanted medication to pharmacy or doctor. A convenient sample of 438 patients at Out Patient Pharmacy and Patient Registration areas in the hospital was collected and completed within three months.
Results: Only 44.5% had ever received information about medications disposal and were significantly more likely to return to pharmacy or doctor (29.2% versus 6.0%, p < 0.001). There were significant differences between tertiary and nontertiary with regard to not returning to pharmacy or doctor (22.8% versus 42.0 %, p = 0.004). Some common medications disposal methods were throwing medications away with household garbage, 38.3% (n = 168), returning to pharmacy or doctor, 35.1% (n = 154) and flushing medications down the toilet or sink 11.0% (n = 48). About 50.2% (n = 220) knew about medications take back program and were significantly more willing to return the medication to the assigned location (34.7 % versus 20.1%, p < 0.001). The main reasons for unwillingness were availability of time, not convenient or a bother and out-of-vicinity location.
Conclusion: There is a clear need to create public awareness about issues on safe medication disposal and medications take back program,
Study site: Outpatient pharmacy, and patient registration area in Sultanah Aminah Hospital, Johor, Malaysia

Matched MeSH terms: Ambulatory Care
Fulltext Diabetes literacy and knowledge among patients with type 2 diabetes mellitus attending a primary care clinic in Seremban, Malaysia

Lee CL, Chee WSS, Arasu K, Kwa SK, Mohd Ali SZ

Malays J Nutr, 2019;25(4):435-444.
MyJurnal DOI: 10.31246/mjn-2019-0031

Introduction: Good health literacy and knowledge are associated with improved outcomes in diabetes. The purpose of this study was to determine diabetes-specific literacy and knowledge levels, and its associated socio-demographic factors, among adults with type 2 diabetes mellitus (T2DM).
Methods: This cross-sectional study was conducted among 196 adults from the Indian, Chinese, and Malay ethnic groups with T2DM who attended a primary care clinic in Seremban, Malaysia. The Literacy Assessment for Diabetes and Diabetes Knowledge Test 2 were used to assess diabetes-specific literacy and knowledge, respectively.
Results: The majority of participants (75.0%) had literacy scores that corresponded to Ninth Grade Level but only 3.6% of participants had a good knowledge of diabetes. Literacy scores explained up to 19.8% of the variance in knowledge scores (r=0.445, p<0.01). Indian participants had the lowest literacy and knowledge scores when compared to Chinese and Malays (p<0.05). Participants with higher education had better literacy
and knowledge scores (p<0.05). Educational level was more likely than ethnicity to predict both literacy and knowledge scores (p<0.001), while gender and age did not significantly predict either score. The majority of participants could answer general questions about physical activity, diabetes-related complications and healthy eating. Knowledge of diabetes and its relation to specific foods and the effect of diet on glucose control were limited among the participants.
Conclusion: Education and ethnicity were associated with literacy and knowledge on diabetes. There existed a deficit of diabetes-related nutrition knowledge among the participants. These findings may help healthcare providers tailor individualised patient educational interventions.
Keywords: Diabetes literacy, diabetes knowledge, type 2 diabetes

Matched MeSH terms: Ambulatory Care Facilities
Fulltext The association between health literacy and quality of life and its associated factors among adults with type 2 diabetes mellitus in public primary care clinic

Shibraumalisi NA, Mat Nasir N, Md Yasin M, Isa MR

Journal of Clinical and Health Sciences, 2020;5(1):60-74.
MyJurnal

Introduction: Low health literacy (HL) is one of the contributing factors that leads to negative diabetic outcome. Quality of life (QOL) is a state of complete physical, mental and social wellbeing. There is limited evidence on association of HL and QOL among type 2 diabetes mellitus (T2DM), therefore the objectives of this study were to identify the HL and QOL status, to determine the association between HL and QOL and factors associated with QOL among T2DM patients.
Methods: This was a cross sectional study involving patients with T2DM from two public primary care clinics. HL and QOL were measured using translated and validated HLS – Asia Q16 and DQoL-BCI questionnaires respectively among T2DM patients.
Results: The mean HL score was 12.39 (3.34), 17.7 % had “inadequate HL”, 25.7% had “problematic HL” and 56.6% had “sufficient HL”. The mean DQoL-BCI score was 32.09 (6.51). Lower QOL level was negatively associated with age (b -0.140; CI: -0.190, - 0.090; p<0.001), not obese (b -1.476; CI: -2.605, - 0.347; p<0.011), and HL level (b -0.425; CI: -0.59, - 0.259; p<0.001). Lower QOL level was positively associated with uncontrolled glycaemic status (HbA1c >6.5%) (b 1.308; CI: -0.042, 2.659; p<0.058), treatment with insulin (b 4.163; CI:1.538, 6.788; p<0.002) and combination treatment of insulin and oral hypoglycaemic agents (OHA) (b 2.450; CI:1.145, 3.756; p<0.001).
Conclusions: This study demonstrated that age, body mass index, HL, glycaemic control, treatment with OHA and insulin were significantly associated with QOL. This suggest the importance of identifying high risk patients with poor QOL for targeted intervention.
KEYWORDS: Health Literacy, Quality of Life, Type 2 Diabetes Mellitus, Primary Care, Malaysia
Study site: Two public primary care clinics (klinik kesihatan), Gombak district, Selangor, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Examining diabetes distress, medication adherence, diabetes self-care activities, diabetes-specific quality of life and health-related quality of life among type 2 diabetes mellitus patients

Jannoo Z, Wah YB, Lazim AM, Hassali MA

J Clin Transl Endocrinol, 2017 Sep;9:48-54.
PMID: 29067270 DOI: 10.1016/j.jcte.2017.07.003

AIMS: Health-Related Quality of Life (HRQoL) has been increasing attention in health outcome studies. Factors that individually influence HRQoL, diabetes self-care behaviors, and medication adherence have been widely investigated; however, most previous studies have not tested an integrated association between multiple health outcomes. The purpose of this study was to formulate a hypothetical structural equation model linking HRQoL, diabetes distress, diabetes self-care activities, medication adherence and diabetes-dependent QoL in patients with Type 2 Diabetes Mellitus (T2DM).
METHODS: A cross-sectional study design was employed, and 497 patients with T2DM were recruited from outpatient clinics in three public hospitals and one government clinic. The patients completed a series of questionnaires. The hypothetical model was tested using Structural Equation Modeling (SEM) analysis.
RESULTS: The values of the multiple fit indices indicated that the proposed model provided a good fit to the data. SEM results showed that medication adherence (MMAS) had a significant direct effect on diabetes distress (PAID) (Beta = -0.20). The self-care activities (SDSCA) construct was significantly related to PAID (Beta = -0.24). SDSCA was found to have a significant relationship with HRQoL (SF-36) (Beta = 0.11). Additionally, diabetes distress had a significant effect (Beta = -0.11) on HRQoL of patients. Finally, ADDQoL had a significant effect on HRQoL (Beta = 0.12).
CONCLUSIONS: The various health outcome indicators such as self-care behaviors, diabetes distress, medication adherence and diabetes-dependent QoL need to be considered in clinical practice for enhancing HRQoL in those patients.
Study site: Hospital Tuanku Ampuan Rahimah, Hospital Sungai Buloh and Hospital Serdang; Klinik Kesihatan Botanic, Kelang, Selangor, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Prevalence of hypertension and glycaemic control in adult type-2 diabetes patients: A preliminary retrospective cohort study in Kuantan, Pahang, Malaysia

Abdullah F, Han TM, Mat Nor MB, Mohd Aznan MA, Ismail IZ

International Medical Journal Malaysia, 2017;16(1):115-122.
MyJurnal

Introduction: Hypertension (HPT) is the most common co-morbidity among type-2 diabetes mellitus (T2DM) patients which ominously increased their morbidity and mortality from cardiovascular diseases (CVD). We aimed to determine the prevalence and control status of HPT, and also the glycemic control among T2DM patients in a primary care clinic in Kuantan, Pahang. Methods: It was a retrospective study of 154 T2DM patients’ records, aged ≥18 years selected by random sampling. The statistical analysis is done by using Chisquare test, paired sample “t” test and ANOVA “F” test. Results: Among T2DM patients; 47% were Malay, 45% Chinese and 9% Indian. The prevalence of HPT was 72.1% and majority of T2DM patients were women (60%). Out of 82 T2DM aged >60 years, 80.5% were hypertensive. 67.2% of T2DM patients between the age of 40-60 years and 25% age <40 years were also hypertensive (p= 0.003). BP-controlled status were classified into controlled, uncontrolled, systolic and diastolic HPT. All patients were compared between the last visit and one year before, which reported 55.8% versus 33.1%, 14.9% versus 51.9%, 20.1% versus 10.4% and 9.1% versus 4.5% respectively. There were significant rises in percentage of systolic BP (by 9.7%) and diastolic HPT (by 4.6%) p<0.0001, from the first visit. BP controlled status for aged group >60 years showed increments in systolic HPT and diastolic HPT which were significant (p<0.0001). Regarding glycemic parameters, 71.4% T2DM patients had poor controlled level of Hb1Ac (≥6.5) and only 20.1% remained controlled after one year (p<0.0001). Conclusions: This pilot study found high prevalence of HPT, increasing prevalence of systolic HPT and diastolic HPT in older age group as well as poor glycemic control among T2DM patients.

KEYWORDS: Controlled blood pressure, systolic hypertension, diastolic hypertension, HbA1C difference, primary care clinic

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Differences in public and private health services in a rural district of Malaysia.

Aljunid SM, Zwi AB

Med J Malaysia, 1996 Dec;51(4):426-36.
PMID: 10968029

A cross-sectional study, comparing the nature of services in 15 private clinics and 6 public health facilities, was undertaken in a rural district of Malaysia. Semi-structured interviews and observations using check-lists were employed. Public health facilities were run by younger doctors (mean age = 31.1 years), supported mostly by trained staff. The private clinics were run by older doctors (mean age = 41.2 years) who had served the district for much longer (8.9 years vs 1.5 years) but were supported by less well trained staff. The curative services were the main strength of the private clinics but their provision of preventive care was less comprehensive and of inferior quality. Private clinics were inclined to provide more expensive diagnostic services than the public facilities. 'Short hours' private clinics had very restricted opening hours and offered limited range of services.
Comment in: Hee HW. Differences in public and private health services in a rural district of Malaysia. Med J Malaysia. 1997 Sep;52(3):296-8

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Nutraceutical Use among Patients with Chronic Disease Attending Outpatient Clinics in a Tertiary Hospital

Mahmood NA, Hassan MR, Ahmad S, Mohd Nawi H, Pang NTP, Syed Abdul Rahim SS, et al.

Evid Based Complement Alternat Med, 2020;2020:9814815.
PMID: 33224262 DOI: 10.1155/2020/9814815

Food-drug interphase products, referring to nutraceuticals in this study, are a category of health products containing a combination of food ingredients with active substances for oral consumption. Many of these products are marketed as an alternative to prescription medicine to treat various ailments despite the lack of scientific evidence, influencing patients with chronic diseases to consume nutraceutical products. This study aimed to determine the prevalence and factors associated with knowledge, attitude, and practice of nutraceutical use among patients with chronic disease attending to the outpatient clinic. This is a cross-sectional study involving patients with chronic disease at the outpatient specialist clinic. Samples were recruited from the outpatient clinic using convenience sampling. Data was collected using a self-administered questionnaire, which was self-constructed and validated. We found that the use of nutraceuticals was prevalent among 17.9% of respondents. More than half (60.9%) of the respondents have poor knowledge of nutraceutical and 53.1% of respondents have a positive attitude towards nutraceutical. Gender and morbidities were the factors associated with the practice of nutraceutical usage. Female patients are more likely to have increased use of nutraceutical than male patients and patients with multiple morbidities have higher odds of using nutraceutical than patients with single morbidities. There is a high number of patients who consume nutraceutical products and public knowledge of nutraceutical needs to be improved further. The government should develop appropriate regulation and monitoring of nutraceutical products.

Matched MeSH terms: Ambulatory Care Facilities
Iron deficiency in healthy, term infants aged five months, in a pediatric outpatient clinic: a prospective study

Adnan NA, Breen E, Tan CA, Wang CC, Jalaludin MY, Lum LCS

BMC Pediatr, 2024 Jan 23;24(1):74.
PMID: 38263022 DOI: 10.1186/s12887-023-04277-7

BACKGROUND: Iron deficiency (ID) is prevalent in Malaysian children. The incidence of ID in infants under 6 months of age is unknown. Our aim was to determine the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in healthy, term infants aged below 6 months in our hospital population.
METHODS: A prospective longitudinal pilot study of mother-infant pairs was conducted on infants receiving routine immunizations in a mother and child clinic at a university hospital, in Kuala Lumpur, Malaysia. Mothers completed standardized questionnaires at 3- and 5-month postnatal visits. Maternal and infant full blood count, ferritin, and C-reactive protein (CRP) levels were measured at 3 months and for the infants repeated at 5 months. Infant anthropometric measurements were obtained at both visits. We conducted a univariate analysis to identify factors associated with ID and IDA.
RESULTS: Altogether, 91 mother-infant pairs were enrolled, with 88 completing the study. No infant had ID or IDA at 3 months; the lowest ferritin level was 16.6 µg/L. At 5 months, 5.9% (5/85) of infants had ID, and 2.4% (2/85) had IDA. Median (interquartile range) infant ferritin levels significantly declined from 113.4 (65.0-183.6) µg/L at 3 months to 50.9 (29.2-70.4) µg/L at 5 months, p

Matched MeSH terms: Ambulatory Care Facilities
Fulltext The changing characteristics of a cohort of children and adolescents living with HIV at antiretroviral therapy initiation in Asia

Sornillo JB, Ditangco R, Kinikar A, Wati DK, Du QT, Nguyen DQ, et al.

PLoS One, 2023;18(9):e0291523.
PMID: 37708128 DOI: 10.1371/journal.pone.0291523

Despite improvements in HIV testing and earlier antiretroviral therapy (ART) initiation in children living with HIV through the years, a considerable proportion start treatment with advanced disease. We studied characteristics of children and adolescents living with HIV and their level of immunodeficiency at ART initiation using data from a multi-country Asian cohort. We included children and adolescents who were ART-naïve and <18 years of age at ART initiation from 2011 to 2020 at 17 HIV clinics in six countries. Incidence rates of opportunistic infections (OIs) in the first two years of triple-drug ART (≥3 antiretrovirals) was also reported. Competing risk regression analysis was performed to identify factors associated with first occurrence of OI. In 2,027 children and adolescents (54% males), median age at ART initiation increased from 4.5 years in 2011-2013 to 6.7 in 2017-2020, median CD4 count doubled from 237 cells/μl to 466 cells/μl, and proportion of children who initiated ART as severely immunodeficient decreased from 70% to 45%. During follow-up, 275 (14%) children who received triple-drug ART as first treatment and had at least one clinic visit, developed at least one OI in the first two years of treatment (9.40 per 100 person-years). The incidence rate of any first OI declined from 12.52 to 7.58 per 100 person-years during 2011-2013 and 2017-2020. Lower hazard of OIs were found in those with age at first ART 2-14 years, current CD4 ≥200 cells/μl, and receiving ART between 2017 and 2020. The analysis demonstrated increasing number of children and adolescents starting ART with high CD4 count at ART start. The rate of first OI markedly decreased in children who started ART in more recent years. There remains a clear need for improvement in HIV control strategies in children, by promoting earlier diagnosis and timely treatment.

Matched MeSH terms: Ambulatory Care
Fulltext Validity and Reliability of Questionnaire on Knowledge, Attitude and Dietary Practices Related to Colorectal Cancer

Norsa'adah B, Aminu AR, Zaidi Z

Malays J Med Sci, 2020 Feb;27(1):115-123.
PMID: 32158351 MyJurnal DOI: 10.21315/mjms2020.27.1.12

Introduction: Colorectal cancer (CRC) is one of the leading cancers in Malaysia where new cases are increasing every year. The aim of this study was to test the reliability and validity of a newly developed questionnaire on knowledge, attitude and dietary practices (KAP) related to CRC for the Malay population.
Methods: The respondents were conveniently selected among visitors attending an outpatient clinic in a tertiary hospital. We excluded those with any cancers, chronic diseases and those that were illiterate. The exploratory factor and reliability analyses were conducted.
Results: A total of 108 respondents were recruited of which 67.7% were males and the mean age was 54.59 years (standard deviation 8.93). The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy values for KAP were 0.64, 0.66 and 0.67, respectively (P < 0.001). The 17 items of knowledge formed five domains with loading factors ranging from 0.54-0.89. The six items of attitude formed two domains with loading factors ranging from 0.64-0.80 and the 15 practices had four domains with loading factors ranging from 0.52-0.83. The total variances explained for each KAP were 61.02%, 56.41% and 53.12%, respectively. The internal consistency Cronbach alpha values on KAP were 0.61, 0.60 and 0.70, respectively.
Conclusion: The final questionnaire is suitable for measuring KAP related to CRC among the Malay population.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Profile of clients attending a methadone clinic

Jacob SA, Mohammed F, Hassali MA

Malays J Med Sci, 2015 Jan-Feb;22(1):58-69.
PMID: 25892951 MyJurnal

BACKGROUND: Client characteristics provide useful information for designing programs that target individuals with risk factors for substance use and for determining client retention. Therefore, this study examined the profiles of clients attending a methadone clinic.
METHODS: A cross-sectional analysis of clients of a methadone clinic was conducted through a survey to obtain a profile of methadone clients.
RESULTS: Of the 51 patients who responded (response rate: 66.2%), the mean (SD) age at which they started substance use was 19.8 (5.1) years. Friends were cited as the most regular source of drugs (82.4%), and heroin was the most commonly used drug (98%). Daily substance use was reported by 72.5% of the respondents; 23.5% admitted to having stolen money to purchase drugs; 92.2% tried quitting substance use on their own and 98% stated that the main reason for registering at the clinic was that they wanted to stop their drug dependence. Approximately 60% of clients were receiving methadone doses of less than 60 mg/day.
CONCLUSION: Heroin is still the most popular drug of abuse and most clients still receive methadone doses below the recommended level, despite evidence of poor patient retention rates associated with these low doses.
KEYWORDS: Malaysia; methadone; patient appointments; profile; substance use
Study site: Methadone clinic, hospital, Malaysia.

Matched MeSH terms: Ambulatory Care Facilities

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