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  1. Fulltext National healthcare establishments and workforce statistics (primary care) 2008-2009
    Md Gowdh NF, Sivasampu S, Lim TO, Abdullah NH
    Citation: Md Gowdh NF, Sivasampu S, Lim TO, Abdullah NH. National healthcare establishments and workforce statistics (primary care) 2008-2009. Kuala Lumpur: Clinical Research Centre, Ministry of Health, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  2. Factors associated with anxiety among elderly hypertensive in primary care setting
    Ismail Z, Mohamad M, Isa MR, Fadzil MA, Yassin SM, Ma KT, et al.
    J Ment Health, 2015 Feb;24(1):29-32.
    PMID: 25358109 DOI: 10.3109/09638237.2014.971148
    BACKGROUND: There is increasing evidence showing that anxiety is associated with morbidity in the older age group. Factors contributing to anxiety may vary among different diseases and settings.
    AIMS: The aim of this study was to determine the factors associated with anxiety symptoms among elderly hypertensive at the primary care level.
    METHODS: A cross-sectional study and face-to-face interviews using Hospital Anxiety and Depression Scale (HADS) were conducted among elderly hypertensive.
    RESULTS: The mean (SD) age of subjects was 68.8 (6.76) years and comprised of 49.5% and 50.5% of males and females, respectively. The majority of respondents were Malays (76.1%), followed by Chinese (14.3%), and Indians (9.5%). The mean (SD) duration of hypertension was 8.44 (7.29) years and the prevalence of anxiety symptoms was 13.3% (95% CI: 9.9, 16.7). Multiple logistic regression analysis showed that elderly hypertensive with a past history of stroke (adjusted OR: 4.472; 95% CI: 1.754, 11.405; p = 0.002) and depression (adjusted OR: 3.715; 95% CI: 2.009, 6.872; p care
    Matched MeSH terms: Ambulatory Care Facilities
  3. Fulltext Patterns of pre-pregnancy care usage among reproductive age women in Kedah, Malaysia
    Abu Talib R, Idris IB, Sutan R, Ahmad N, Abu Bakar N
    Iran J Public Health, 2018 Nov;47(11):1694-1702.
    PMID: 30581786
    Background: This cross-sectional was aimed to assess the prevalence of pre-pregnancy care services usage and its determinant factors among women of reproductive age in Kedah, Malaysia.

    Methods: Overall, 1347 respondents who attended 24 government health clinics, were chosen using systematic multistage random sampling. A validated self-administered questionnaire which consisted of sections including socio-demographic characteristics, social support, knowledge on pre-pregnancy care, perception on risk of pregnancy, health status, as well as intention and awareness on pre-pregnancy care services were distributed.

    Results: The prevalence of utilization of pre-pregnancy care services was still low i.e. 44.0%. Bivariate and multivariate analysis showed consistent significant level between all factors and pre-pregnancy care usage except for family planning practice. The factors that showed significant difference with the usage of pre-pregnancy care services were age of more than 35 (P<0.001), high education level (P<0.001), non-working mothers (P<0.001), multipara (P=0.001), awareness on the existence of pre-pregnancy care services in government health facilities (P<0.001), intention to use the services (P=0.0030), having medical illness (P=0.005), having social support (P=0.001), high knowledge (P<0.001), and positive perception (P<0.001).

    Conclusion: Low usage of pre-pregnancy care services can be improved through health screening on reproductive-aged women with positive determinant factors at the triage level in integrated clinics. Information and knowledge on pre-pregnancy services should be disseminated among community members through various means including roadshows and pre-wedding workshops.
    Matched MeSH terms: Ambulatory Care Facilities
  4. Fulltext A cross-sectional study comparing customer satisfaction between rural and urban primary care clinics in Hulu Langat district and the influencing factors. [Kajian keratan rentas perbandingan kepuasan pelanggan di antara klinik-klinik kesihatan primer luar bandar dan bandar di daerah Hulu Langat dan faktor-faktor yang mempengaruhi]
    Azimatun, N.A., Salmiah, B., Ahamad, J.
    Malaysian Journal of Public Health Medicine, 2012;12(2):52-67.
    MyJurnal
    Improvement in the service quality system of health clinics in Malaysia had increase with the increase of national development. However, customer dissatisfaction towards regular service still has become an issue in the provision of health service in clinics throughout this country. This study aims to identify factors that influence customer satisfaction such as sociodemographic factors of patients, the location of clinic (rural or urban) and the most important SERVQUAL dimensions in determining customer satisfaction. This study conducted in October and November 2008 in Hulu Langat District. SERVQUAL questionnaires were used. Probabilistic sampling was used for the selection of respondents and the number of samples for each clinic was based on the workload of the clinic. Overall, the results showed that there are differences in levels of customer satisfaction between urban clinic (25.8%) and rural (30.7%). The most critical service quality dimensions for urban clinics are the responsiveness and reliability dimensions with a mean value of -0.7018 and -0.7434. Responsiveness, existence and reliability are the weakest quality service dimensions (mean -0.6317, -0.6718 and -0.6028) in rural clinics. It was found that customers’ ethnicity and education affect customer satisfaction in both the urban and rural clinics. Gender and type of work are factors that affect customer satisfaction only in urban clinics. Overall customer satisfaction at health clinics in Hulu Langat District is low. The difference between urban and rural clinics show the customers' needs in the area is different.
    Key words: Customer satisfaction, SERVQUAL, health clinics, services.
    Matched MeSH terms: Ambulatory Care Facilities
  5. Fulltext Tobacco use prevalence, knowledge, and attitudes among newly diagnosed tuberculosis patients in Penang State and Wilayah Persekutuan Kuala Lumpur, Malaysia
    Awaisu A, Nik Mohamed MH, Abd Aziz N, Syed Sulaiman SA, Mohamad Noordin N, Muttalif AR, et al.
    Tob Induc Dis, 2010 Jan 12;8(1):3.
    PMID: 20148105 DOI: 10.1186/1617-9625-8-3
    BACKGROUND: There is sufficient evidence to conclude that tobacco smoking is strongly linked to tuberculosis (TB) and a large proportion of TB patients may be active smokers. In addition, a previous analysis has suggested that a considerable proportion of the global burden of TB may be attributable to smoking. However, there is paucity of information on the prevalence of tobacco smoking among TB patients in Malaysia. Moreover, the tobacco-related knowledge, attitudes, and behaviors of TB patients who are smokers have not been previously explored. This study aimed to document the prevalence of smoking among newly diagnosed TB patients and to learn about the tobacco use knowledge and attitudes of those who are smokers among this population.
    METHODS: Data were generated on prevalence rates of smoking among newly diagnosed TB patients in the State of Penang from January 2008 to December 2008. The data were obtained based on a review of routinely collated data from the quarterly report on TB case registration. The study setting comprised of five healthcare facilities (TB clinics) located within Penang and Wilayah Persekutuan, Kuala Lumpur health districts in Malaysia, which were involved in a larger project, known as SCIDOTS Project. A 58-item questionnaire was used to assess the tobacco use knowledge, attitudes and behaviors of those TB patients who were smokers.
    RESULTS: Smoking status was determinant in 817 of 943 new cases of TB from January to December 2008. Of this, it was estimated that the prevalence rates of current- and ex-smoking among the TB patients were 40.27% (329/817) and 13.95% (114/817), respectively. The prevalence of ever-smoking among patients with TB was estimated to be 54,220 per 100,000 population. Of 120 eligible participants for the SCIDOTS Project, 88 responded to the survey (73.3% response rate) and 80 surveys were analyzed (66.7% usable rate). The mean (+/- SD) total score of tobacco use knowledge items was 4.23 +/- 2.66 (maximum possible score=11). More than half of the participants (51.3%) were moderately dependent to nicotine. A moderately large proportion of the respondents (41.2%) reported that they have ever attempted to quit smoking, while more than half (56.3%) have not. Less than half (47.5%) of the study participants had knowledge about the body system on which cigarette smoking has the greatest negative effect. The majority wrongly believed that smokeless tobacco can increase athletic performance (60%) and that it is a safe and harmless product (46.2%). An overwhelming proportion (>80%) of the patients believed that: smoking is a waste of money, tobacco use is very dangerous to health, and that smokers are more likely to die from heart disease when compared with non-smokers. The use of smokeless tobacco was moderately prevalent among the participants with 28.8% reporting ever snuffed, but the use of cigar and pipe was uncommon.
    CONCLUSION: Smoking prevalence rate is high among patients with TB in Malaysia. These patients generally had deficiencies in knowledge of tobacco use and its health dangers, but had positive attitudes against tobacco use. Efforts should be geared towards reducing tobacco use among this population due to its negative impact on TB treatment outcomes.
    Matched MeSH terms: Ambulatory Care Facilities
  6. Fulltext A preliminary study on the specificity and sensitivity values and inter-rater reliability of MINI International Neuropsychiatric Interview (MINI) in Malaysia
    Mukhtar F, Abu Bakar AK, Mat Junus M, Awaludin A, Abdul Aziz S, Midin M, et al.
    ASEAN Journal of Psychiatry, 2012;13(2):157-164.
    MyJurnal
    Objective: The MINI International Neuropsychiatric Interview (MINI) is a short, structured diagnostic interview compatible with the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). It was designed for clinical practice, research in psychiatric, primary care settings and epidemiological surveys. This preliminary study aims to evaluate the reliability and validity of the Malaysian Version of MINI for Major Depressive Disorder and Generalized Anxiety Disorder symptoms criteria only.

    Methods: Six hours of MINI training was given as part of a National Health Morbidity Survey training program for layman interviewers (n=229) and three videos were prepared by an expert psychiatrist for inter-rater reliability purposes. Meanwhile, for validity purposes, the MINI was administered to patients with Major Depressive Disorder (n=30), Generalized Anxiety Disorder (n=20) and to a normal population (n=60), to conform against the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) that was administered by psychiatrists.

    Results: Overall the inter-rater reliability was satisfactory (0.67 to 0.85) and the concordance between the MINI’s and expert diagnoses was good, with kappa values of greater than 0.88.

    Conclusions: The Malay version of the MINI is adjusted to the clinical setting and for the assessment of positive cases in a community setting. Modifications were highlighted to correct any identified problems and to improve the reliability of the MINI for future research and clinical use.
    Matched MeSH terms: Ambulatory Care Facilities
  7. Fulltext Prevalence of depression among women attending a primary urban care clinic in Malaysia
    Mohd Sidik S, Arroll B, Goodyear-Smith F, Ahmad R
    Singapore Med J, 2012 Jul;53(7):468-73.
    PMID: 22815016
    Depression affects more women than men in Malaysia. The objective of this paper was to determine the prevalence of depression and its associated factors among women attending a government primary care clinic.
    Matched MeSH terms: Ambulatory Care Facilities
  8. Fulltext Premature ejaculation and quality of life among men attending Klinik Kesihatan Jaya Gading, Kuantan
    Harun Z, Ahmad S
    Int J Public Health Res, 2018;8(1):878-874.
    MyJurnal
    Introduction: Premature ejaculation (PE) is an important sexual problem among men attending health clinic. Impacts of this condition towards quality of life still require further exploration. Aims of the study is to determine the proportion and determinants for PE and its impact on Quality of Life (QOL) among men attending a public health clinic in Kuantan
    Methods: A cross-sectional study involving 290 respondents was conducted at a public health clinic over the period of five months (Nov 2015-March 2016). A validated self-administrated questionnaire that consisted of sociodemographic questionnaire, clinical characteristics, premature ejaculation diagnostic tool (PEDT) and WHO quality of life (WHOQOL-BREF) were used.
    Results: The proportion of PE was 33.9% with PE 18.1% (49/271) and probable PE 15.8% (43/271). Multivariate analysis showed that level of education (p=0.002, OR 3.281/95% CI 1.183, 9.101) and hypertension (p=0.047, OR 1.788/95% CI 1.008, 3.170) were the only significant predictors for PE after controlling self-reported erectile dysfunction, pulmonary and neurological disorder. PE patients had lower median scores QOL in all four domain namely physical health, psychological, social relationship, environment (all domains with p<0.001).
    Conclusions: The proportion of men diagnosed with premature ejaculation in this study is high and possibly associated with level of education and hypertension. Men with PE had lower quality of life in domains of physical health, psychological, social relationship and environment. Hence, it is
    recommended for PE screening among male attendees to primary health clinic especially those with hypertension and moderate level of education.
    Keywords Premature ejaculation - Quality of life - Sexual dysfunction.
    Study site: Klinik Kesihatan Jaya Gading, Kuantan, Pahang, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  9. Fulltext Clinical and Sociodemographic Predictors of the Quality of Life among Patients with Type 2 Diabetes Mellitus on the East Coast of Peninsular Malaysia
    Jusoh Z, Tohid H, Omar K, Muhammad NA, Ahmad S
    Malays J Med Sci, 2018 Feb;25(1):84-95.
    PMID: 29599638 MyJurnal DOI: 10.21315/mjms2018.25.1.10
    Background: The quality of life (QoL) describes the multidimensional self-perceived well-being of a person, which is an important diabetes outcome. This study aimed to measure the QoL scores among patients with type 2 diabetes mellitus (T2DM), as well as their clinical and sociodemographic predictors.

    Methods: This cross-sectional study involved 180 randomly sampled patients at a primary care clinic on the East Coast of Peninsular Malaysia. A self-administered questionnaire containing the Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) was used.

    Results: Most of the respondents (96.7%) were Malay, with a median (interquartile range, IQR) age of 54.0 (14.0) years old. The majority of them were females (60.0%), married (81.1%) and from low-income families (63.3%), who attained a secondary education or lower (75.6%). Only 49.4% of them were employed. The mean (standard deviation, SD) ADDQoL-18 average weighted impact score was -4.58 (2.21) and all 18 domains were negatively affected, particularly the living condition, family life and working life. The multiple linear regression analysis showed that the age (adjusted B = 0.05,P= 0.004) and insulin use (adjusted B = -0.84,P= 0.011) were QoL predictors.

    Conclusion: T2DM negatively impacts the patient's QoL in all aspects of their life. The QoL improvement with age suggests that the older patients had accepted and adapted to their illness. The need to improve the QoL among insulin users was also highlighted.
    Study site: Klinik Kesihatan, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  10. Fulltext Weight perception among non-pregnant urban Malaysian women: is it reliable?
    Fadzil F, Shamsuddin K, Wan Puteh SE, Ahmad S, Abdul Hayi NS, Abdul Samad A, et al.
    Int J Public Health Res, 2015;5(2):637-642.
    MyJurnal
    Introduction: In maternal healthcare, pre-pregnancy weight is used to predict pregnancy outcomes. Since no recorded data on pre-pregnancy weight, perceived weight is used alternatively. This study examines the relationship between perceived and actual weight among non-pregnant urban Malaysian women of childbearing age and identifies differences in perceived and actual weight by selected socio-demographic characteristics.
    Methods: A cross-sectional study was conducted between April and June 2013 among urban Malaysian women attending public health clinics in the Klang Valley. Information on height, perceived current weight and time when their weight was last taken were obtained and actual weight was the average of two measurements (TANITA-HD-323-digital-scale). Socio-demographic data collected were age, ethnicity, education level, marital and employment status and total household income.
    Results: Mean age of 371 women in this study was 28.81±5.65, 82.2% were Malays, 62.8% had tertiary education, over 75% were married and employed, with more than half from middle-income households. Overall, the mean perceived and actual weight was 59.29±11.59 and 59.20±11.90 respectively. Pearson‟s Correlation test showed a very strong positive correlation between perceived and actual weight (r=0.957;p<0.0001), ranging between 0.852 to 0.994 among subgroups; 258 (69.5%) perceived their weight accurately (±2.0 kg of actual weight), 49 (13.2%) under and 64 (17.3%) overestimated their weight.Main outliers were among younger women, Malays, tertiary educated, employed, middle-income and had weight last measured a month or more ago.
    Conclusion: Strong correlation between perceived and actual weight among women in this study reassured weight perception can be used more confidently in patients‟ history taking and future research among urban Malaysian women using public health services.
    Matched MeSH terms: Ambulatory Care Facilities
  11. Factors associated with suicidal ideation among older people in medical outpatient clinic
    Syed Elias SM, Makhtar A, Ahmad Tarmidi NH
    Enferm Clin, 2021 04;31 Suppl 2:S356-S360.
    PMID: 33849199 DOI: 10.1016/j.enfcli.2020.09.026
    This study aimed to determine the prevalence of suicidal ideation and the associated factors with suicidal ideation among older people. This was a cross-sectional study. The present study was carried out from March 2018 to May 2018. In total, 200 older people aged 60 years and over were recruited from a medical outpatient clinic in Malaysia. The older people completed a self-administered questionnaire on sociodemographic background, depression, and suicidal ideation. The data analysis involved descriptive and inferential analysis using IBM SPSS Statistics version 23.0. The prevalence rate of suicidal ideation was 3%. There were significant associations between ethnicity (p<0.00), marital status (p=0.008), depression (p<0.00) and suicidal ideation. Risk factors for suicidal ideation in older people are ethnicity, marital status, and depression. Future studies should focus on these factors in any intervention aimed to reduce suicidal ideation among older people in Malaysia.
    Matched MeSH terms: Ambulatory Care Facilities*
  12. Fulltext Cross-cultural adaptation of the reliable and valid Malay version of alcohol use disorder identification test
    Ali, N., Abdul Mutalip, M.H., Kamaruddin, R., Manickam, M.A., Ahmad, N.A.
    Malaysian Journal of Psychiatry, 2017;26(2):19-31.
    MyJurnal
    Background: Early detection of alcohol abuse and associated risk(s) is necessary. It requires easy and reliable screening tools that are culturally
    adapted to the local context.
    Objectives: The aims of this study were to cross culturally adapt, test for its reliability and validity of the Malay version of Alcohol Use Disorder Identification Testing (AUDIT-M).
    Methods: The cross-cultural adaptation process involved four stages: translation, synthesis, back translation and field pre-testing. The final version of AUDIT-M was pre-tested and post-tested within a 10-day interval among 37 respondents at the Tampin Health Clinic. Analysis of reliability and validity testing were done using SPSS version 21.
    Results: There were 37 participants in this study. The Intra-Class Correlation (ICC) with single measures of the test-retest scores was 0.93 (Cronbach alpha = 0.97), while the internal consistency reliability yielded (Cronbach alpha=0.92). Validity testing for the Pre-test and Post-test analysis with the Pearson correlation analysis was r=0.938.
    Conclusion: The translated Malay version of the AUDIT-M was found to be easy to understand and adaptable in the Malaysian context.
    Matched MeSH terms: Ambulatory Care Facilities
  13. Fulltext A tale of two boys: case report on nonconsanguineous siblings with cerebral palsy
    Leelavathi, M., Lim, J.L., Ahmad, S.
    Medicine & Health, 2014;9(1):74-79.
    MyJurnal
    Cerebral palsy is a common cause of childhood disability. It has a great impact on parents and caregivers, especially when it reoccurs in the same family. Although familial cerebral palsy is relatively uncommon, cases have been reported among children from consanguineous, non-consanguineous marriages and multiple pregnancies suggesting a possible complex genetic mode of inheritance. Physicians need to be aware of the possibility of familial cerebral palsy for early detection and counseling. We describe a rare case of two male siblings from a non-consanguineous marriage affected by cerebral palsy.
    Matched MeSH terms: Ambulatory Care Facilities
  14. Perceptions among general medical practitioners toward implementation of medication reconciliation program for patients discharged from hospitals in Penang, Malaysia
    Hassali MA, Al-Haddad M, Shafie AA, Tangiisuran B, Saleem F, Atif M, et al.
    J Patient Saf, 2012 Jun;8(2):76-80.
    PMID: 22561848 DOI: 10.1097/PTS.0b013e31824aba86
    OBJECTIVE: This study aims to explore the perceptions of general practitioners (GPs) from the state of Penang toward the feasibility of implementing the medication reconciliation program in Malaysia.
    METHODS: A cross-sectional descriptive study using a validated, self-completed anonymous 18-item questionnaire was undertaken over a period of 2 months in 2010. The study was conducted in the state of Penang, Malaysia. A letter consisting of survey questionnaires and prepaid return envelope were mailed to 429 GPs identified from the Private Medical Practice Control Department Registry.
    RESULTS: A total of 86 responses were received with response rate of 20.1%. Majority (90.1%) of the respondents agreed that medication reconciliation can be a feasible strategy to improve medication safety, and 97.7% confirmed that having an accurate up-to-date list of the patient's previous medication will be useful in the rational prescribing process. However, about half (56.9%) of them felt that standardization of the medication reconciliation process in all clinics will be difficult to achieve. Three quarters (73.2%) of the respondents believed that the involvement of GPs alone is insufficient, and 74.5% agreed that this program should be expanded to community pharmacy setting. More than 90% of the respondents agreed upon the medication reconciliation card proposed by the researchers.
    CONCLUSIONS: General practitioners in Penang are generally in favor of the implementation of medication reconciliation program in their practice. Because medication reconciliation has been shown to reduce many medicine-related problems, it is thus worth considering the feasibility of nationwide implementation of such program.
    Matched MeSH terms: Ambulatory Care Facilities
  15. Fulltext A comparative analysis of reflection in a primary care outpatient setting in two learning environments
    Abdul Rahman NF, Albualy R
    Education in Medicine Journal, 2018;10(2):41-47.
    MyJurnal
    Situated learning characterises the learning that takes place in the clinical environment. Learning in the workplace is characterised by transferring classroom knowledge into performing tasks and this may take various forms. In the medical education field, the cognitive apprenticeship instructional model developed by Collins (2016) supported this learning in the workplace setting due to its common characteristics of apprenticeship. This paper analysed two concrete learning situations in a Malaysian undergraduate and an Omani postgraduate learning environment. Both learning situations occurred in the primary healthcare outpatient setting. The cognitive apprenticeship model was used to identify characteristics of the individual learning environments and discusses factors that stimulate learning. Attention was paid to the role of reflection in stimulating learning in the described settings. The paper provided the context in both institutes, described the learning situation and provided an analysis based on the theoretical framework. Based on the analysis of the situations, solutions to problems in the two settings were suggested.
    Matched MeSH terms: Ambulatory Care Facilities
  16. Fulltext Refractive error, visual acuity, and corneal-curvature changes in high and low myopes with orthokeratology treatment: A Malaysian study
    Liong SL, Mohidin N, Tan BW, Ali BM
    Taiwan J Ophthalmol, 2015;5(4):164-168.
    PMID: 29018692 DOI: 10.1016/j.tjo.2015.07.006
    BACKGROUND/PURPOSE: The effect of orthokeratology (OK) on low myopia is well known, but there are a few reports on its effect on high myopia. In this study, the parametric changes in high and low myopia as results of wearing OK lenses for a period of 6 months have been analyzed.
    METHODS: Records of schoolchildren (age 7-17 years) undergoing OK treatment from an optometry clinic were retrospectively reviewed. Data involving refractive errors, uncorrected visual acuity, and corneal curvatures at baseline and after 1 day, 1 week, 1 month, 3 months, and 6 months of OK treatment from 25 patients who fulfilled the inclusion criteria were examined. For the analysis, the participants were arbitrarily divided into two groups comprising high myopia (< -6.00 D) and low to moderate myopia (from -1.00 D to -6.00 D).
    RESULTS: Significant reductions of refractive error, improvement in visual acuity, and corneal-curvature flattening were found in all participants after 6 months of OK lens wear compared to the baseline. No significant changes were found in corneal toricity in both high and low to moderate myopic groups. Almost all of these occurred after one night of lens wear in both the high- and low-myopia groups.
    CONCLUSION: The OK lens wear significantly reduced the refractive error and corneal curvature that results in the improvement in visual acuity in both high- and low-myopia groups, and the reduction seemed to occur nearly at the same time despite the difference in initial myopic power. High myopes with refractive power up to -8.25 D would benefit significantly from OK lenses.
    Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  17. Fulltext Risk factors for diabetic nephropathy among non insulin dependent patients who attended city hall’s staff clinic in Kuala Lumpur
    Ahmad U, Mohd Nor MI, Ali O
    Malaysian Journal of Public Health Medicine, 2001;1(1):16-21.
    MyJurnal
    Diabetes mellitus and its main complication, nephropathy, ajjbcts the economic wellbeing and quality of Iife of the sufferers and the population. A matched case control study was conducted in September 1998 to investigate the factors involved with nephropathy such as diabetic control, smoking, hypertension, familv history of diabetes and diabetic duration. Respondents were classyied based on the presence of microalbuminuria or macroalbuminuria, Seventy-two pairs of case and control were studied Duration of diabetes Q2 = 0.005), presence of lethargy and weakness prior to diabetes diagnosis @7 = 0.019), duration of smoking @7 = 0.014), duration of hypertension @2: 0.000), systolic hypertension Qu= 0e 025), uncontrolled diabetes with poor HbA1c level (v= 0.02Q and lack of diabetes knowledge Q2 = 0.037) were jbctors which related signyicantlv to nephropathy by univariate anahrsis. In multivariate anahrsis, systolic hypertension (p = 0.0015), lack of diabetes knowledge (17 = 0.0197), presence of lethargy symptom Q7 = 0.0027), prolonged diabetic duration @ = 0.0301) and higher body mass indices (p = 0. 0213) were predictors to diabetic nephropathy.
    Matched MeSH terms: Ambulatory Care Facilities
  18. Prevalence and determinants of restless leg syndrome in type 2 diabetes mellitus (T2DM) in Pakistan
    Nawaz MS, Nawaz MS, Shah KU, Mustafa ZU, Ahmed A, Sajjad Ahmed H, et al.
    Diabetes Metab Syndr, 2021 Feb 13;15(2):525-528.
    PMID: 33668002 DOI: 10.1016/j.dsx.2021.02.013
    BACKGROUND AND AIMS: Restless legs syndromes (RLS) are intrinsic sleeping disorder and its prevalence rate is 10-15% in general population but it is observed that prevalence rate is different in diabetes patients. Current study aims to find prevalence and determinants of RLS in people living with type 2 diabetes mellitus in Pakistan.

    METHOD: A multicenter cross-sectional observational study was conducted in 388 diabetes patients attending daily diabetes clinics and teaching hospitals in Pakistan's twin city between August 2019 and February 2020. The chi-square test and linear regression were used to detect RLS-related factors in type 2 diabetes mellitus.

    RESULTS: The prevalence of RLS found was; 3.1% patients with diabetes were suffering from very severe RLS, 23.5% from severe RLS, 34% from moderate RLS, 21.1% from mild RLS and 18.3% from non-RLS. Gender, age, education, blood glucose fasting (BSF), blood glucose random (BSR) and HBA1c were found to be significant predictors of RLS in patients with diabetes.

    CONCLUSION: Policy makers can develop local interventions to curb the growing RLS prevalence by keeping in control the risk factors of RLS in people living with type 2 diabetes.

    Matched MeSH terms: Ambulatory Care Facilities
  19. Fulltext Proportion of women with history of gestational diabetes mellitus who performed an oral glucose test at six weeks postpartum in Johor Bahru with abnormal glucose tolerance
    Fatin A, Alina TI
    Malays Fam Physician, 2019;14(3):2-9.
    PMID: 32175035
    Introduction: Glucose testing at six weeks postpartum has been recommended by the World Health Organization as the earliest period in which to detect abnormal glucose tolerance among women with a history of gestational diabetes mellitus (GDM). This study aimed to determine the outcomes of six weeks postpartum glucose testing and its associated factors among women with a history GDM who attended government primary health clinics in Johor Bahru.
    Methods: The study was a cross sectional study which was conducted among women with a history of GDM who registered from January to June 2016 at primary health clinics in Johor Bahru and underwent an oral glucose tolerance test at six weeks postpartum. Secondary data were obtained from Maternal Health Records (clinic copy). Data were analyzed using SPSS Version 23.0. Descriptive statistics and simple logistic regression analysis were used.
    Results: One hundred and twenty-two women with a history of GDM completed the postpartum glucose testing. Approximately 12% of these women were reported to have abnormal glucose tolerance. Insulin usage (OR:5.44; 95% CI:1.53, 19.43; p=0.009), abnormal glycated hemoglobin (OR:8.70; 95% CI:2.68,26.27; p<0.01), hospital follow-up (OR:3.38; 95% CI: 1.11, 10.34; p=0.033) and neonatal intensive care unit admission (OR:3.96; 95% CI: 1.16, 13.54; p=0.028) were found to have significant associations with abnormal glucose tolerance at six weeks postpartum.
    Conclusion: The proportion of women with a history of GDM and abnormal glucose tolerance at six weeks postpartum in Johor Bahru was 12% and was associated with insulin usage, abnormal glycated hemoglobin, hospital follow-up and neonatal intensive care unit admission. Screening during the postpartum period offers a window of opportunity for early identification of diabetes and prediabetes, as women with history of GDM are at increased risk of future glucose intolerance.
    Matched MeSH terms: Ambulatory Care Facilities
  20. Fulltext Care for post-stroke patients at Malaysian public health centres: self-reported practices of family medicine specialists
    Abdul Aziz AF, Mohd Nordin NA, Abd Aziz N, Abdullah S, Sulong S, Aljunid SM
    BMC Fam Pract, 2014;15:40.
    PMID: 24580779 DOI: 10.1186/1471-2296-15-40
    BACKGROUND: Provision of post stroke care in developing countries is hampered by discoordination of services and limited access to specialised care. Albeit shortcomings, primary care continues to provide post-stroke services in less than favourable circumstances. This paper aimed to review provision of post-stroke care and related problems among Family Medicine Specialists managing public primary health care services.
    METHODS: A semi-structured questionnaire was distributed to 121 Family Physicians servicing public funded health centres in a pilot survey focused on improving post stroke care provision at community level. The questionnaire assessed respondents background and practice details i.e. estimated stroke care burden, current service provision and opinion on service improvement. Means and frequencies described quantitative data. For qualitative data, constant comparison method was used until saturation of themes was reached.
    RESULTS: Response rate of 48.8% was obtained. For every 100 patients seen at public healthcentres each month, 2 patients have stroke. Median number of stroke patients seen per month is 5 (IQR 2-10). 57.6% of respondents estimated total stroke patients treated per year at each centre was less than 40 patients. 72.4% lacked a standard care plan although 96.6% agreed one was needed. Patients seen were: discharged from tertiary care (88.1%), shared care plan with specialists (67.8%) and patients who developed stroke during follow up at primary care (64.4%). Follow-ups were done at 8-12 weekly intervals (60.3%) with 3.4% on 'as needed' basis. Referrals ranked in order of frequency were to physiotherapy services, dietitian and speech and language pathologists in public facilities. The FMS' perceived 4 important 'needs' in managing stroke patients at primary care level; access to rehabilitation services, coordinated care between tertiary centres and primary care using multidisciplinary care approach, a standardized guideline and family and caregiver support.
    CONCLUSIONS: Post discharge stroke care guidelines and access to rehabilitation services at primary care is needed for post stroke patients residing at home in the community.
    Matched MeSH terms: Ambulatory Care Facilities
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