The need to deliver teaching material in medical education using the internet is compelling in view of the many advantages that the internet provides. The internet has enabled organizations, in particular institutions of higher education to conduct various courses entirely electronically and without regard to physical geographical boundaries. The term CAL is used to denote the employment of the Internet for the delivery of teaching material, conduct of discussion, as;sessment of performance and interaction between students and teachers. This study reviews reports of the use and evaluation of Computer-Aided-Learning (CAL) in teaching various major disciplines in medicine.
Haematologic abnormalities are found in patients who develop acute ischaemic syndromes including acute myocardial infarction (AMI). A coronary care unit population of 660 consecutive patients were studied for their haematologic parameters on admission. There were 263 patients who had AMI, 207 who had non-infarct acute ischaemic syndromes (CAD), and the other 190 non-coronary patients served as controls. Overall patients with AMI had signijicantly higher haemoglobin (145 ± 2.2 vs 12.9 ± 3.0 g/dl, p<0.0001), haematocrit (45.4 ± 5.8% vs 41.2 ± 8.8%. P < 0.001). red cell count (5.0 ± 0.7 vs 4.5 ± 10^12 p<0.001), but there were no significant differences in their leucocyte count, platelet count or mean corpuscular volume. Patients with CAD had higher haemoglobin and red cell counts (p<0.002, p<0.02 respectively). Although infarct women tended to have lower counts (p<0.001), they still had significantly higher haemoglobin (p<0.01), haematocrit (p<0.02) and red cell count(p<0.002) when compared with controls. Interestingly, there were no ethnic differences at all with regard to haematologic values for infarct patients; haemoglobin, haematocrit, and red count were each significantly higher than controls. Our results suggest that a relatively high baseline Hb, haematocrit or RBC count may be associated with increased likelihood of acute ischaemic syndromes including AMI among Malaysians. Increased viscosity and abnormal haemorheological characteristics may contribute to the development and subsequent outcome of unstable coronary syndromes. Keywords: acute myocardial infarction, coronary artery disease, haemoglobin, haematocrit, haemorheology.
A survey of laws and regulations governing the practice of radiology by general practitioners in Malaysis and ten other selected countries wascarried out. It showedvaryingdegrees oflegal restrictions on the use of x-ray machines in the countries studied. Most regulations reflected the concern of radiation protection forpatients andstaff. Only some countries provide training for non-medical persons in the use of x-ray machines. Radiology has an important role in primary care. Undergraduate and post-graduate education should ensure competence in basic radiological practice. KEYWORDS: X-ray, general practice, regulations.
The morbidity patterns of elderly patients presenting to a family physician clinic was studied by the attending physician completing a questionnaire on all elderly patients aged 60 and above attending the clinic between 1st January to 31st March 2000. 612 elderly patients registered during the study period. The most common presentations included upper respiratory tract infections (21.6%), hypertension and diabetes mellitus (18%), gastritis/dyspepsia (5.0%) and injuries (5.0%), Musculoskeletal complaints (backache, gout, osteoarthritis) and anxiety were also among the top 10 most common presenting complaints. Injuries were mainly soft tissue injuries and sprains sustained at home. Some were preventable.
This study aimed to established baseline data on patients' demographic and morbidity patterns over three months in the Outpatients Department (OPD) Ipoh Hospital. Entry of the first ten thousand patients into a computerised database for analysis showed that the majority were unemployed and from the low income group. There were more Malays and Indians, less Chinese. Respiratory infections accounted for 18.5 % while major chronic diseases (hypertension, diabetes mellitus, asthma) were common. Overall a wide spectrum of illnesses were seen. A career structure for OPD doctors and incorporation of Family Medicine concepts were proposed to improve primary care in OPD.
Study site: Outpatients Department (OPD), Hospital Ipoh, Perak, Malaysia
Between 2/10/2000 and 30/1/2001, the organizational structure and management in 4 general practice (GP) clinics & 2 health centers (HC) in Kinta District were studied by 14 Level 4 medical students of Perak College of Medicine. Data collected from work process files and staff interviews / shadowing showed that GPs in the study had more working experience with postgraduate qualifications than HC doctors. All HC nurses but only one GP clinic nurse had formal training. HC organization was more complex with documentation. GP organization was simple and lacked documentation. HC management was by a group while GPs handled all management aspects. This study enhanced students' understanding of Malaysian primary care system.
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.
A study was done in 1987 to find out the attitudes and perceptions of patients toward treatment in the Hospital Universiti Sains Malaysia (HUSM). A similar study was repeated five years later covering both patients and relatives of patients. In 1987, 17% of patients were not satisfied with the treatment mainly because of poor patient-staff relationship. In 1991, 5% of the patients were dissatisfied. The reasons attributed for their dissatisfaction were rudeness of staff, the presence of medical students and attitude of the patients and public of the nurses. There was a positive change of attitude of the aptients and public towards the hospital services after five years. Factors that lead to this improvement like education and better public relations is discussed.
The cultural and socioeconomic determinants (including the accessibility, costs and perceived effectiveness of medical care) of why and how individuals engaged in health-improving behaviours are essential information for policy makers in designing strategies towards increasing the efficient utilisation of public health services and interventions. Studies on such determinants are particularly needed for urban populations given their socioeconomic and cultural heterogeneity.
This study was carried out on 30 patients to: i) determine the efficacy of low dose captopril as monotherapy (with or without a diuretic) in the treatment of various grades of hypertension. ii) assess the quality of life of these patients 12 weeks after commencement of therapy. Our results showed that there was a sustained and significant fall in both mean systolic and diastolic blood pressure from 171.9 ± 24 to 150.5 ± 25 mm Hg and 109.0 ± 14 to 93.6 ± 15mmHg respectively (p<0.001). Improvement in quality of life was however not statistically significant (p<0.05). We concluded that low dose captopril used alone or in combination with a diuretic can be considered for the initial therapy of mild to moderate hypertension. The optimal dosage and the longterm benefits on quality of life need further evaluation in a larger series.