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Fulltext Disseminated histoplasmosis presenting as a non-healing tongue ulcer

Liam CK, Chua CT, Pathmanathan R

Singapore Med J, 1990 Jun;31(3):286-8.
PMID: 2392708

A 51-year old man presented with a persistent tongue ulcer, fever, cervical lymphadenopathy and hepatomegaly. The diagnosis was initially thought to be tuberculosis. This led to the initiation of antituberculous chemotherapy to which the patient failed to respond. The correct diagnosis of histoplasmosis was made after the detection of Histoplasma capsulatum on further review of the tongue ulcer biopsy specimen. He responded to treatment with amphotericin B.

Matched MeSH terms: Chronic Disease
Fulltext Chronic liver disease in Kuala Lumpur, Malaysia: a clinical study

Kudva MV, Zawawi MM

Singapore Med J, 1990 Aug;31(4):368-73.
PMID: 2255936

This study was undertaken to analyse the clinical spectrum of chronic liver disease (cirrhosis, and others with portal hypertension) in Kuala Lumpur. Eighty patients were diagnosed over a 6-year period. Twenty-two had biopsy proven cirrhosis while 58 others had portal hypertension with clinical and biochemical evidence of chronic liver disease. The commonest aetiology was alcohol (36%), followed by the idiopathic variety and hepatitis B. The male to female ratio was 4.4:1. Indians had a high prevalence of alcohol-associated chronic liver disease. Overall, ascites was the commonest presentation. Eight patients presented with hepatocellular carcinoma. Spontaneous bacterial peritonitis was diagnosed in 13% of patients undergoing abdominal paracentesis. Gallstones were detected in 37% of patients who underwent ultrasonography. Diabetes mellitus and peptic ulcer disease were noted in 22% and 31% of patients respectively.

Matched MeSH terms: Chronic Disease
An ecological study of Paragonimus in Malaysia

Kim JS

Kisaengchunghak Chapchi, 1978 Jun;16(1):47-53.
PMID: 12902783

An ecologic study on Paragonimus in Malaysia was attempted from May to September 1967. Seven streams located in various directions and distances from Kuala Lumpur were surveyed for the study of intermediate hosts, snail and crab. One Malayan village and one aborigine village where infected crabs were found, and two tuberculosis hospitals in K.L. were surveyed for the study of human population. Intradermal tests along with sputum or stool examination to detect human infection by Paragonimus were employed. Wild animals, only a few, were shot in the vicinity of the aborigine village and several domestic cats from the Malayan village were bought. These animals were autopsied and examined for adult Paragonimus. Among five species of crab collected from the study areas, only two species, Potamon jahorenes and Parathelphusa maculata were found to be infected with Paragonimus. P. maculata seemed to be better crab host for the Paragonimus because this species had higher infection rate and metacercarial density than the other in the very same area. Three out of seven streams had infected crabs and the infection rate as well as the infection intensity varied from one stream to another. Only avilable snail in the streams was identified as Brotia costula. The infection rate of the snail was very low, six snails out of 11,898, which is about the same rate reported from other countries. Infected snail, however, had thousands of rediae uncountable containing about twelve microcercocercariae in each redia, sufficient enough to maintain the life cycle of the parasite even with only a few infected snail, the amplifier. This is the first confirmed report on the snail host of Paragonimus from Malaysia where the existence of Paragonimus had been reported in 1923. The first trial to study human population by means of intradermal test, sputum and/or stool examinations in Malaysia showed no evidence of human infection of Paragonimus. The number of animals, wild and domestic, examined for natural infection was too small to draw any statement. These examined animals were all negative for adult Paragonimus. Even though more extensive studies on wild animals and human population may be necessary for the definite conclusion, the facts that infected crabs from jungle stream where human contacts are extreamely rare, and also highly infected crabs from the area where none of humans or domestic animals were infected, strongly suggest the life cycle of Paragonimus in this area may be maintained by wild animal hosts rather than by human host. The morphology of all stages of the parasite, the pattern of penetrating glands, flame cells and excretroy bladder of cercaria, lancet shaped single cuticular spines and 6 branched ovary of adult worm obtained from experimentally infected cat, and the shape of egg including all measurements agree well with the characteristics of Paragonimus westermani.

Matched MeSH terms: Hospitals, Chronic Disease
Fulltext Intestinal protozoan infections in Malaysia

Lai KP

Southeast Asian J Trop Med Public Health, 1992 Dec;23(4):578-86.
PMID: 1298065

Intestinal protozoa are found in all communities in Malaysia and among all ethnic groups. Prevalence of intestinal protozoa is not affected by ethnicity but by living conditions. Communities with both basic amenities of safe water supply and proper toilets have lower prevalence than those with one or none of the amenity. Cryptosporidium is an important intestinal protozoon in Malaysia and should be included in future field and laboratory studies and also in laboratory diagnosis for pathogens. Much interest will be centered on Blastocystis hominis in future studies in view that it may be a cause of diarrhea.

Matched MeSH terms: Chronic Disease
Fulltext Clinical nutrition in East Asia and the Pacific

Darnton-Hill I, Cavalli-Sforza LT, Volmanen PV

Asia Pac J Clin Nutr, 1992 Mar;1(1):27-36.
PMID: 24323002

Identifying the nutrition problems of Asia and the Pacific is made difficult by the enormous geographic, socioeconomic and cultural diversity that exists in these areas. With increasing longevity and reduced infant mortality, the more chronic diseases are becoming increasingly important. For almost 90% of the countries that keep such data in the Western Pacific Region of WHO, at least three of the five leading causes of death are noncommunicable diseases. Nevertheless undernutrition is still the most important nutritional problem in the Region. Even though there have been some encouraging declines in the proportion of malnourished under 5-year-olds, increasing populations have meant the actual numbers have not declined. Vitamin A deficiency, iodine deficiency disorders and iron deficiency anaemia remain major public health problems in many countries. There is evidence that vitamin A deficiency is appearing in countries in which it has not previously been a problem. New challenges are occurring, such as childhood obesity, the susceptibility of undernourished populations to the human immunodeficiency virus and the increase in noncommunicable diseases. The three arms of clinical nutrition: therapeutic, research and public health will need to work closely to meet the considerable and continuing threat posed by the nutrition-related diseases.

Matched MeSH terms: Chronic Disease
Fulltext Chronic dacryocystitis--a review of 50 cases in the University Hospital Kuala Lumpur

Jaais F, Chandran S

Med J Malaysia, 1988 Sep;43(3):229-31.
PMID: 3241581
Matched MeSH terms: Chronic Disease
Fulltext Lumbar sympathectomy techniques for critical lower limb ischaemia due to non-reconstructable peripheral arterial disease

Karanth VK, Karanth TK, Karanth L

Cochrane Database Syst Rev, 2016 12 13;12:CD011519.
PMID: 27959471 DOI: 10.1002/14651858.CD011519.pub2

BACKGROUND: Critical lower limb ischaemia (CLI) is a manifestation of peripheral arterial disease (PAD) that is seen in patients with typical chronic ischaemic rest pain or patients with ischaemic skin lesions - ulcers or gangrene - for longer than 2 weeks. Critical lower limb ischaemia is the most severe form of PAD, and interventions to improve arterial perfusion become necessary. Although surgical bypass has been the gold standard for revascularisation, the extent or the site of disease may be such that the artery cannot be reconstructed or bypassed. These patients require other modalities of treatment, for example, vasodilatation by drugs or lumbar sympathectomy to relieve pain at rest and to avoid amputations. A systematic review of randomised controlled trials is required to evaluate the effects of lumbar sympathectomy in treating patients with CLI due to non-reconstructable PAD.
OBJECTIVES: The objective of this review is to assess the effects of lumbar sympathectomy by open, laparoscopic and percutaneous methods compared with no treatment or compared with any other method of lumbar sympathectomy in patients with CLI due to non-reconstructable PAD.
SEARCH METHODS: The Cochrane Vascular Information Specialist (CIS) searched the Specialised Register (January 2016) and the Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 12). In addition, the CIS searched clinical trials databases for details of ongoing and unpublished studies.
SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing any of the treatment modalities of lumbar sympathectomy, such as open, laparoscopic and chemical percutaneous methods, with no treatment or with any other method of lumbar sympathectomy for CLI due to non-reconstructable PAD were eligible. To decrease the bias of including participants that may be incorrectly diagnosed with CLI, review authors defined CLI as persistently recurring ischaemic rest pain requiring regular analgesia for more than two weeks, or ulceration or gangrene of the foot or toes, attributable to objectively proven arterial occlusive disease by measurement of ankle pressure of < 50 mmHg or toe pressure < 30 mmHg. We defined non-reconstructable PAD as a resting ankle brachial index (ABI) < 0.9 when no reasonable open surgical or endovascular revascularisation treatment option is available, as determined by individual trial vascular specialists.
DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies identified for potential inclusion in the review. We planned to conduct data collection and analysis in accordance with the Cochrane Handbook for Systematic Review of Interventions.
MAIN RESULTS: We identified no studies that met the predefined inclusion criteria. To decrease the bias of including participants who may be incorrectly diagnosed with CLI, we based our inclusion criteria on objective tests, as described above. The randomised trials identified by the literature search were performed before such objective criteria for selection were applied and therefore were not eligible for inclusion in the review.
AUTHORS' CONCLUSIONS: We identified no RCTs assessing effects of lumbar sympathectomy by open, laparoscopic and percutaneous methods compared with no treatment or compared with any other method of lumbar sympathectomy in patients with CLI due to non-reconstructable PAD. High-quality studies are needed.

Matched MeSH terms: Chronic Disease
Inappropriate secretion of anti-diuretic hormone in chronic obstructive airways disease with chest infection and respiratory failure

Dhanwant SG, Tija J, Poh SC

Med J Malaysia, 1975 Sep;30(1):55-58.
PMID: 1207534
Matched MeSH terms: Chronic Disease
Treatment of 164 patients with chronic pulmonary tuberculosis by pneumonectomy in a developing country

Snelling MR, Kam CM

Tubercle, 1968 Jun;49(2):187-91.
PMID: 5664317
Matched MeSH terms: Chronic Disease
Risk factors for under-immunisation in hospitalised preschool children

Mariana, D., Quah, B.S., Mazidah, A.R.

Malaysian Journal of Paediatrics and Child Health, 2005;14(1):33-40.
MyJurnal

Even though vaccines are effective for prevention of diseases, compliance with recommended schedules of immunisation in early childhood is not always complete. Identification of potential risk factors associated with under-immunisation may help increase vaccination uptake. The objectives of this study were to determine the prevalence and risk factors of under-immunisation in hospitalised preschool children in Universiti Sains Malaysia Hospital (HUSM). Children aged 1 month to 2 years admitted between December 1998 and December 2000 in medical paediatric wards at HUSM were studied. Parents/guardians were interviewed during admission regarding immunisation status and potential risk factors. Children who did not have home-based cards during admission were excluded. Among 401 children, 37.9% had complete immunisation, 43.4% had delayed immunisation and 34.9% had incomplete immunisation. The uptake of BCG, DPT/OPV 1, DPT/OPV2, Hepatitis B3, DPT/OPV3, and measles were 98.5%, 90.7%, 83.2%, 81.4%,79.2% and 72.9% respectively. Vaccines scheduled to be given at later ages were significantly less likely to be taken (p=0.002) compared with vaccines scheduled to be given at an earlier age. Significant independent risk factors for under-immunisation were elderly mothers (3 40 years old) (OR 3.0, 95% CI: 1.2-8.0), low birth weight £2.0 kg (OR 6.2; 95% CI: 1.8-21.4) and presence of chronic illness in the child (OR 4.5; 95% CI: 2.5-7.9). In children whose father's education was low (primary school or no education), low maternal education was significantly associated with lower rate of under-immunisation (p = 0.005, OR 0.11 95%CI 0.02-0.51).
In conclusion this study showed that a large proportion of hospitalised preschool children were under-immunised, and vaccines scheduled to be given at a later age had lower uptakes. The situation can be rectified if every opportunity is taken to immunise all children, who have lapsed in their immunisation schedule.

Matched MeSH terms: Chronic Disease
Fulltext The relevant intervention strategies for improving medication adherence of diabetic patients

Akoi C, Rahman MM, Abdullah MS

Int J Public Health Res, 2013;3(1):236-240.
MyJurnal

Medication adherence is very important for the effective treatment or control of various health problems, including chronic disease like diabetes mellitus (DM). However, medication non-adherence among diabetic patients on follow-up treatment is still a global health problem. This study aimed to identify factors associated with medication adherence and to determine methods on how it could be improved. A cross-sectional study was conducted on medication adherence among Malays, Iban and Melanau ethnic groups in Kota Samarahan and Sarikei, Sarawak using the Health Belief Model framework. Interviews with questionnaires, which were tested for its validity and reliability using the Cronbach’s Alpha, were conducted to collect data on the respondent’s socio-demographic and economic characteristics, and health beliefs of 442 respondents. Data was analyzed using SPSS version 17.0 for frequency distribution, measures of central tendencies, significance testing and logistic regression. The medication adherence rates were low in terms of all the treatment indicators such as amount of medication (31.7%), frequency (38.9%), duration (26%), and follow-up treatment (24.2%). The respondent’s socio-economic and economic characteristics have statistically significant association with medication adherence. The respondents adhered towards medication because they believed in its benefits. They also took their medication because they believed in the severity of DM and their susceptibility to its serious complications. The cues to action (medication taking) such as worrying about their socio-economic well-being, effectiveness of medication, and health campaign on diabetic control have influenced medication adherence. However, forgetfulness, distance of clinic, and costs of transport have caused medication non-adherence. The respondent's health beliefs in the benefits of taking medication, perceived severity and susceptibility to DM and its serious complications have contributed towards medication adherence. Their concerns about the socio-economic well-being, effectiveness of medication, and health campaign on diabetic control were positive cues to medication taking behavior. Therefore, modifying the respondent's related health beliefs and reinforcing the positive cues to actions are the relevant intervention strategies that could be used in improving medication adherence among diabetic patients.

Matched MeSH terms: Chronic Disease
Fulltext HPV positivity and its' influencing factors among invasive cervical cancer women in Malaysia

Sharifa Ezat Wan Puteh, Norin Rahayu Samsuddin, Sharifah Noor Akmal Syed Hussain, Shamsul Azhar Shah, Syed Mohamed Aljunid

Int J Public Health Res, 2011;1(1):13-22.
MyJurnal

Accepted 10 August 2011.
Introduction Cervical cancer (CC) is the second most prevalent female cancer in Malaysia. Almost 70% of its’ causal factors are attributable to oncogenic human papillomavirus (HPV) types 16, 18 and other risk factors. HPV genotypes distributions are also noted to differ by geographical area.
Methods This was cross sectional study conducted in 2007, to determine the influencing factors of HPV positivity and prevalence of HPV infections among patients with cervical cancer in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Patients’ paraffin-embedded cervical tissues kept in the Pathology Department from 1999 to 2007 were randomly selected. A total of 81 medical records with complete information were chosen as samples and patients were contacted for consent. Tissue samples were further derived for PCR DNA for HPV genotyping. Analyses included descriptive statistics; bivariate χ2 test and correlation were used to determine relationship between factors and HPV positivity. Significance level of less than 0.05 was taken as statistically significant.
Results Mean age of cancer diagnosis was at 52 ± 12.2 years. Women of Chinese ethnicity was the highest ethnicity to be HPV positive at 65.4% and squamous cell carcinoma was more commonly found (59.3%) compared with other types of cancers. The prevalence of HPV positivity was 92.6% with type 16 being the most common (74.1%), followed by type 33 (30.9%) and 18 (22.2%). Multiple HPV infections were a common finding at 54.3%. Factors thought to influence positivity i.e. age of intercourse, number of sexual partners, number of parity, smoking status of patients and their partners, oral contraceptive usage, presence of chronic illnesses and cancer stage were not significantly associated with HPV positivity. Increased CC severity level was not associated with increased number of HPV infections (Pearson correlation 0.58; p =0.607).
Conclusions High HPV positivity at 92.6% was found among ICC patients. Factors thought to influence HPV positivity were not significant. The top three HPV genotypes were type 16 followed by type 33 and 18. However, local women HPV serotypes findings need to be replicated in a larger population sample.

Matched MeSH terms: Chronic Disease
Fulltext Anxiety and depression in children with epilepsy

Lai, Choo Ong

Neurology Asia, 2013;18(11):39-41.
MyJurnal

Children with epilepsy are at increased risk of behavioral problems and psychiatric disorders compared with the general population and those with other chronic illnesses. Depression and anxiety disorders are the most common and require further attention because they carry the risk of reduced quality of life and have far reaching consequences in later life. The wide range of prevalence quoted in the literature reflects methodologic differences. Risk factors are often multifactorial and include illness severity, coexisting morbidity, and psychosocial factors. Diagnosis remains a challenge, as the presentation is heterogenous and age related. This is complicated by epilepsy issues and associated comorbidity that hamper the use of standardized assessment tools. Multimodal treatment involving psychotherapy and antidepressant therapy currently represents the best approach. The mental health needs of these children are largely unmet; increased awareness and better research are required to determine best practices.

Matched MeSH terms: Chronic Disease
Fulltext Cost-effectiveness of antihypertensive treatment in Malaysia

Qais Alefan, M. Izham M. Ibrahim, Tariq Abdul Razak, Azizi Ayub

Malaysian Journal of Pharmaceutical Science, 2009;7(2):137-152.
MyJurnal

Hypertension is a prevalent chronic disease, which is strongly related to the development of cerebrovascular and cardiovascular diseases. The prevalence of hypertension in Malaysia in subjects aged 15 years and above was estimated to be 27.8%. Cost-effectiveness analysis (CEA) compares treatment options with different effectiveness and safety profiles. The utilisation of antihypertensive drugs has raised some concerns about the balance between its costs and benefits. This study was conducted to describe the healthcare costs for hypertensive subjects and to examine the cost-effectiveness of different classes of antihypertensive drugs used in Malaysia. Retrospective and prospective data analysis of a cohort of uncomplicated hypertensive patients was conducted to determine ambulatory health care costs among hypertensive patients groups. The total direct and
indirect costs of controlled and uncontrolled blood pressure (BP) were described. The health care
costs ($) / clinical outcome (AC/E ratio) was calculated. Mean total direct costs per patient per month was higher in uncontrolled blood pressure groups compared to the controlled blood pressure groups. The cost-effectiveness relationship was more favourable for diuretics (1.9), angiotensin converting enzyme inhibitors (ACEIs) (2.0), prazosin (2.4) and beta blockers (2.5), more than the diuretics and beta blockers combination theraphy (3.0), calcium channel blockers (CCBs) (3.4) and other combinations (6.1). Antihypertensive drugs used to treat hypertensive patients were different
in their cost-effectiveness ratios. Such results will allow health care professionals and/or decision
makers to make better decisions on how to select treatment options for hypertensive patients in
Malaysia and how to distribute and allocate scarce health care resources. Pharmacoeconomic
evaluations can help in making difficult choices rationally and allocate scarce resources efficiently.

Matched MeSH terms: Chronic Disease
Fulltext A community health screening conducted at Sungai Pinang township, state of Pulau Pinang, Malaysia

Chai Fung Kiew, Chee Ping Chong

Malaysian Journal of Pharmaceutical Science, 2013;11(1):59-68.
MyJurnal

Non-communicable diseases are raising much concern in Malaysia due to changing lifestyles which is parallel to the economic development. Intervention program like community health screening (CHS) allows early detection, prevention and reduction of chronic diseases and its risk factors. This study aimed to assess the obesity level, risk factors for chronic diseases and blood cholesterol level among the Malaysian public. A health screening program was conducted on April 2012 at Sungai Pinang township, in the state of Pulau Pinang, Malaysia. A convenient sample of the general public was recruited. Screening tests consisted of measurements of blood pressure, body mass index (BMI), body fat percentage, visceral fat accumulation (VFA) and blood cholesterol. Chi-square analysis was used to determine the difference between prevalence of obesity among subjects with different age groups and gender. Out of 76 recruited subjects, 23.7% had systolic blood pressure of 140 mmHg or greater and 7.9% had diastolic blood pressure of 90 mmHg or greater. Approximately 51% of the subjects were obese (BMI ≥ 27.5 kg/m2). Body fat percentage was high in 63.6% and 63.0% of male and female subjects, respectively. High VFA (≥15) was found in 19.8% of subjects. There were three newly discovered hypercholesterolemia cases (total cholesterol ≥ 5.2 mmol/L). Counselling was given during the health screening program to help the public to take necessary measures to reduce risk factors while preventing complication resulting from these chronic diseases. In conclusion, prevalence of obesity found to be high in the present screened population.

Matched MeSH terms: Chronic Disease
Fulltext Dietary intake of adolescents in a rural fishing community in Tuaran District, Sabah

Foo LH, Khor GL, Tee, E. Siong ES, Prabakaran D

Malays J Nutr, 2006;12(1):11-21.
MyJurnal

Dietary intakes and lifestyle habits during adolescence may predict the occurrence of obesity and other diet-related chronic diseases later in life. The purpose of this study was to determine dietary intake of adolescents in a fishing community in Tuaran District, Sabah. A total of 199 apparently healthy adolescents comprising 94 male and 105 female subjects were purposively selected for the study. The mean age of the subjects was 15.2 f 2.2 years with female subjects having a higher mean age of 15.7 f 2.4 years compared to the males (14.6 k1.8 years). The mean BMI of the subjects was 18.4 f 2.9 kg/m2 with females having a significantly higher BMI (18.9 f 2.8 kg/m2) than the males (17.8 f 3.0 kg/m2). Based on the WHO classification (WHO, 1995), 19.6% of the subjects could be classified as thin while 4.5% were at risk of overweight. Overall for both sexes, intake of energy and most nutrients were below the Malaysian recommended nutrient intake (RNI) levels for adolescents, with the exception of vitamin C and niacin. The male subjects showed higher mean intake for vitamin A, thiamine, niacin and vitamin C than the females. Calcium and iron intake ranked among the lowest levels, at 33.4% and 47.2% respectively of the RNI values for both sexes. The main sources of energy were rice, flour products and tubers while fish and seafood were the chief sources of protein. Majority of the subjects (84%) reported taking breakfast daily, which often consisted of fried noodles, fried banana, doughnuts and coffee. Consumption of snacks was popular and commonly consumed snacks were bread, biscuits, and fried banana. The present study revealed that 25.5% and 14.3% of the male and female adolescents respectively were thin, with majority of them consuming inadequate levels of energy and several key nutrients. The results underscore the need for adolescents to be targeted for nutrition and health education as they go through a period of marked physical, physiological and psychological changes.

Matched MeSH terms: Chronic Disease
Spectrum of flood-related diseases encountered during flood disaster in Johore, Malaysia

Badrul Hisham, A.S., Nor Azian Shaharom, C.M.D., Marzukhi, M.I., Norli, R., Fatimah, O., Kee, KF, et al.

Malaysian Journal of Community Health, 2009;15(3):15-23.
MyJurnal

The state of Johore, Malaysia had been hit by the worst flood in the Malaysian modern history on the 19th December 2006 (first wave) and the 12th January 2007 (second wave) affecting all the eight districts. A total number of 157,018 and 155,368 Johore population had been displaced by the first and the second wave event respectively. The Johore State Health Department activated the Flood Action Plan which include mobilising medical teams to conduct daily clinical examinations on the flood victims and health teams to inspect flood relief centres, food premises and homes at flood-hit areas with regard to prevent and control communicable diseases. The spreadsheet format was used to collect data on diseases, injury and death throughout the Johore flood disaster period starting from the 19th December 2006 until 19th February 2007. Analyses showed that 19,670 flood victims (36.3%) had communicable diseases and 34,530 (67.0%) had non-communicable diseases. As for the communicable diseases and symptoms/syndromes related to communicable disease, 41.3% were acute respiratory infections (ARI) followed by 25.9% skin infections, 19.1% fever, 10.1% acute gastroenteritis (AGE) and 3.0% acute conjunctivitis. Other infectious diseases include 61 notifiable diseases (46 food poisoning, 14 dengue fever and one tuberculosis), 20 leptospirosis (with two deaths), 20 chicken pox and two melioidosis cases. The Batu Pahat district had the highest incidence for the majority of the communicable diseases because of the prolonged flooding period. No cholera, typhoid, malaria, measles or hand-foot-mouth disease (HFMD) cases were detected among the Johore flood victims. Trends of disease incidence follow the number of evacuees placed in the relief centres corresponding to respective wave. A total of 507 flood victims had physical injuries related to flood mostly due to fall onto wet floor at the relief centres. Fifteen deaths due to drowning were mainly caused by accidental fall into the flood water. The incidence of communicable diseases encountered had been appropriately anticipated and managed attributed to enhanced public health control programmes augmented by syndromic and laboratory surveillance on potentialy fatal infectious diseases. Equal emphasis should be given to the surveillance and control of chronic diseases.

Matched MeSH terms: Chronic Disease
Fulltext Challenges in managing uncontrolled hypertension cases at relief centre in Kota Tinggi District, Johore

Hanihaselah, M.S., Norasikin, M.

Malaysian Journal of Community Health, 2009;15(3):24-34.
MyJurnal

Background : The management of chronic disease during flood seems to be one of the main challenges to the health care service. Chronic disease becomes worst during flood. Poor condition at the relief centres, loss of assets, fear, and lack of functional health facilities contribute to the morbidity and mortality during and after flood. Poor chronic disease management, especially on severe and uncontrolled hypertension, may threaten lives of victims during flood. In addition, comprehensive treatment cannot be delivered due to destroyed infrastructure, shortage of doctors on duty and delay in getting drug supply. Therefore, all aspects of chronic disease management shall be reviewed and included in the disaster preparedness in order to control and prevent acute incidence and complications of the chronic diseases. Previous Action Plan did not address this issue effectively which had caused many patients not getting their treatment adequately. The aim of this writing is to share experiences in managing chronic disease patients particularly hypertensive patients.
Methodology : A retrospective study based on data collection by health personnel while conducting health screening, clinical examination and giving treatment to flood victims at the relief centres. Hypertensive patients were identified when the victims came for treatment and while the medical team conducting medical rounds. New hypertensive cases as well as uncontrolled cases with no complication were treated and monitored at the relief centres.
Result : It was found that 34,530 cases of non communicable disease (11.1% of the total number of the flood victims) including hypertension and diabetes mellitus were reported in Johor. Kota Tinggi reported a total number of 5,317 cases of chronic disease. There was no data collection on specific chronic diseases collected at the state level during the floods thus the findings representing Kota Tinggi cases only. In retrospective search of 150 flood victims with hypertension in Kota Tinggi, only 95 cases had complete data. Among them 71.6% (68 cases) were hypertensive cases already on treatment and 28.4% (27 cases) were new cases. Also it has been found that 67.4% (64 cases) were uncontrolled hypertension and 32.6% (31 cases) were controlled hypertension. Four cases had been found diagnosed as uncontrolled hypertension with complications and have been referred to hospital.
Conclusion : Comprehensive health strategy for flood victims shall not be focused only on saving lives and giving emergency treatment to patients but also to update and strengthen an overall chronic disease management. Many factors contributed to increase in blood pressure during flooding. Good hypertensive treatment at the relief centres is needed to minimise morbidity and mortality. Information on care and treatment received by flood victims having chronic disease is vital in assessing their health needs during disaster and in formulating disaster preparedness in the future.

Matched MeSH terms: Chronic Disease
Fulltext Chronic kidney disease stage 3B among Malaysian diabetics in primary care and its associated factors: a pilot 5-year case control study

Tan CE, Tohit N, Shamsul Azhar S, Lee CC, Mohd Ridzuan AR, Siti Rahimah S, et al.

Medicine & Health, 2013;8(2):55-63.
MyJurnal

The present study aimed to determine the factors associated with CKD stage 3b among type 2 diabetics attending primary care follow-up, specifically the role of angiotensin blockade dosage. This was a pilot unmatched case-control study conducted in a teaching primary care centre. Clinical data of 25 cases of diabetic patients with CKD stage 3b (GFR 30-45ml/min/1.73m2) in 2012 were selected for this study, as well as 103 controls who were diabetic patients with GFR more than 45ml/min/1.73m2 in 2012. Systematic random sampling was employed. Data was obtained from patients’ diabetic records, computerised clinical medical information system and medical case notes. Univariate analysis was done using Chi-square, t-test, Fisher’s exact test and Mann-Whitney U-test. Multiple logistic regression was used to determine the associated factors for development of CKD stage 3b. Cases and controls were different in terms of age, duration of diabetes, use and dosage of angiotensin blockade medications, systolic blood pressure and baseline GFR. Multiple logistic regression revealed that systolic blood pressure (Adjusted OR= 1.08, 95% CI= 1.02-1.14, p=0.013) and baseline GFR (Adjusted OR= 0.90, 95% CI= 0.85-0.95, p

Matched MeSH terms: Chronic Disease
Fulltext Independent hospital dialysis in Brunei

Chin SS, Hart PL

Br Med J, 1971 Sep 11;3(5775):629-31.
PMID: 5569986

In establishing a chronic haemodialysis unit in Brunei the difficulties encountered were less insuperable than had been expected. Quite unsophisticated patients successfully dialysed unattended in some cases, or with minimal supervision in others.

Matched MeSH terms: Chronic Disease

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