MyMedR

Displaying publications 21 - 40 of 71 in total

Abstract:

Sort:

Fulltext Maximizing acceptance of clinical pharmacy recommendations to reduce length of hospital stay in a private hospital from Amman, Jordan

Saadah LM, Khan AH, Syed Sulaiman SA, Bashiti IA

BMC Health Serv Res, 2021 Sep 08;21(1):937.
PMID: 34496856 DOI: 10.1186/s12913-021-06966-4

BACKGROUND: Clinical pharmacy interventions (CPI) usually require prior medical authorization. Physicians approve 80% of CPI and reject 20%. If pharmacists show that physicians should authorize all 100% CPI, the profession will step closer to a fully independent prescriber status. This study used an artificial neural network (ANN) model to determine whether clinical pharmacy (CP) may improve outcomes associated with rejected CPI.
METHOD: This is a non-interventional, retrospective analysis of documented CPI in a 100-bed, acute-care private hospital in Amman, Jordan. Study consisted of 542 patients, 574 admissions, and 1694 CPI. Team collected demographic and clinical data using a standardized tool. Input consisted of 54 variables with some taking merely repetitive values for each CPI in each patient whereas others varying with every CPI. Therefore, CPI was consolidated to one rejected and/or one accepted per patient per admission. Groups of accepted and rejected CPI were compared in terms of matched and unmatched variables. ANN were, subsequently, trained and internally as well as cross validated for outcomes of interest. Outcomes were length of hospital and intensive care stay after the index CPI (LOSTA & LOSICUA, respectively), readmissions, mortality, and cost of hospitalization. Best models were finally used to compare the two scenarios of approving 80% versus 100% of CPI. Variable impacts (VI) automatically generated by the ANN were compared to evaluate the effect of rejecting CPI. Main outcome measure was Lengths of hospital stay after the index CPI (LOSTA).
RESULTS: ANN configurations converged within 18 s and 300 trials. All models showed a significant reduction in LOSTA with 100% versus 80% accepted CPI of about 0.4 days (2.6 ± 3.4, median (range) of 2 (0-28) versus 3.0 ± 3.8, 2 (0-30), P-value = 0.022). Average savings with acceptance of those rejected CPI was 55 JD (~ 78 US dollars) and could help hire about 1.3 extra clinical pharmacist full-time equivalents.
CONCLUSIONS: Maximizing acceptance of CPI reduced the length of hospital stay in this model. Practicing Clinical Pharmacists may qualify for further privileges including promotion to a fully independent prescriber status.

Matched MeSH terms: Hospitals, Private
Fulltext Analysis of Reasons for Orthopaedic Walkouts from the Emergency Department in a Private Tertiary Care Centre

Roy KD, Sharma GM, Qureshi F, Wadia F

Malays Orthop J, 2020 Nov;14(3):137-142.
PMID: 33403074 DOI: 10.5704/MOJ.2011.021

Introduction: A small proportion of patients presenting to the Emergency department (ED) of any hospital tend to take discharge against medical advice (DAMA) due to several patient related or hospital/service related reasons. Amongst these, orthopaedic patients are a special group due to their inability to mobilise independently due to injuries and have treatment needs which involve higher costs. The aim of the current study was to ascertain and analyse the reasons for orthopaedic walkouts at a tertiary care new private hospital.
Materials and Methods: This retrospective telephonic structured interview-based study was carried out on all orthopaedic patients taking DAMA during a one-year period from July 2016 to June 2017. They were telephonically interviewed with a structured questionnaire. Hospital and ED records were analysed for demographic as well as temporal characteristics.
Results: A total of 68 orthopaedic patients walked out of casualty against medical advice out of a total 775 (8.77%) orthopaedic patients presenting during the period as against 6.4% overall rate of DAMA for all specialties. The main reasons for DAMA were financial unaffordability of treatment (36.7%), preference for another orthopaedic surgeon (22%) and on advice of the patient's General Practitioner (16.1%).
Conclusion: Unaffordability of treatment is a significant cause for walkouts amongst orthopaedic patients. Private hospitals need to recognise and implement processes by which these patients can be treated at affordable costs and with coverage either by medical insurance or robust charity programs. Patient education and awareness are important to encourage them to have insurance coverage.

Matched MeSH terms: Hospitals, Private
Fulltext A second case of diphyllobothriasis in Malaysia

Rohela M, Jamaiah I, Goh KL, Nissapatorn V

Southeast Asian J. Trop. Med. Public Health, 2006 Sep;37(5):896-8.
PMID: 17333730

Diphyllobothriasis was first reported in Malaysia in 2002. We are reporting a second case of diphyllobothriasis in Malaysia. The patient was a 37-year-old Chinese male seen at the outpatient clinic with a complaint of passing strands of white color flat worm in his stool. He had no other abdominal complaints. Laboratory and physical examinations were normal. Diphyllobothrium latum was confirmed by examination of the gravid proglottids passed out and the typical operculated eggs expelled from the ruptured proglottids. The patient had a history of eating raw fish. He was treated with a single dose of praziquantel.
Study site: Outpatient clinic, University Malaya Specialist Center (UMSC), Kuala Lumpur, Malaysia

Matched MeSH terms: Hospitals, Private
Fulltext Diphyllobothriasis: the first case report from Malaysia

Rohela M, Jamaiah I, Chan KW, Yusoff WS

Southeast Asian J. Trop. Med. Public Health, 2002 Jun;33(2):229-30.
PMID: 12236417

Diphyllobothriasis is a disease caused by infection with adult tapeworms of the genus Diphyllobothrium. Humans acquire the infection by consuming the raw or inadequately cooked flesh, roe, liver, or other organs of infected fish. Diphyllobothrium latum infection has not been reported in Malaysia; we are reporting the first case. The patient was a 62 year old Chinese male seen at the outpatient clinic with complaints of watery stools and slight abdominal discomfort for four days. Physical examination was normal. He was treated for diarrhea. Two days after treatment, he passed out intact off-white proglottids in his stool. Diphyllobothriasis was confirmed by examination of these gravid proglottids; typical operculated eggs were seen after rupturing the gravid proglottids. The patient had a history of eating sashimi (Japanese raw fish). He was treated with a single dose of praziquantel and had been well since.
Study site: Gleneagles Intan Medical Centre, Kuala Lumpur, Malaysia

Matched MeSH terms: Hospitals, Private
Fulltext Impact of cytokine storm on severity of COVID-19 disease in a private hospital in West Jakarta prior to vaccination

Ramatillah DL, Gan SH, Pratiwy I, Syed Sulaiman SA, Jaber AAS, Jusnita N, et al.

PLoS One, 2022;17(1):e0262438.
PMID: 35077495 DOI: 10.1371/journal.pone.0262438

BACKGROUND AND AIM: Coronavirus Disease 2019 (COVID-19) has become a worldwide pandemic and is a threat to global health. Patients who experienced cytokine storms tend to have a high mortality rate. However, to date, no study has investigated the impact of cytokine storms.
MATERIALS AND METHODS: This retrospective cohort study included only COVID-19 positive patients hospitalized in a Private Hospital in West Jakarta between March and September 2020. All patients were not vaccinated during this period and treatment was based on the guidelines by the Ministry of Health Indonesia. A convenience sampling method was used and all patients who met the inclusion criteria were enrolled.
RESULTS: The clinical outcome of COVID-19 patients following medical therapy was either cured (85.7%) or died (14.3%), with 14.3% patients reported to have cytokine storm, from which 23.1% led to fatalities. A plasma immunoglobulin (Gammaraas®) and/or tocilizumab (interleukin-6 receptor antagonist; Actemra®) injection was utilised to treat the cytokine storm while remdesivir and oseltamivir were administered to ameliorate COVID-19. Most (61.5%) patients who experienced the cytokine storm were male; mean age 60 years. Interestingly, all patients who experienced the cytokine storm had hypertension or/ and diabetes complication (100%). Fever, cough and shortness of breath were also the common symptoms (100.0%). Almost all (92.3%) patients with cytokine storm had to be treated in the intensive care unit (ICU). Most (76.9%) patients who had cytokine storm received hydroxychloroquine and all had antibiotics [1) azithromycin + levofloxacin or 2) meropenam for critically ill patients] and vitamins such as vitamins C and B-complex as well as mineral. Unfortunately, from this group, 23.1% patients died while the remaining 70% of patients recovered. A significant (p<0.05) correlation was established between cytokine storms and age, the presence of comorbidity, diabetes, hypertension, fever, shortness of breath, having oxygen saturation (SPO2) less than 93%, cold, fatigue, ward of admission, the severity of COVID-19 disease, duration of treatment as well as the use of remdesivir, Actemra® and Gammaraas®. Most patients recovered after receiving a combination treatment (oseltamivir + remdesivir + Antibiotics + Vitamin/Mineral) for approximately 11 days with a 90% survival rate. On the contrary, patients who received oseltamivir + hydroxychloroquine + Gammaraas® + antibiotics +Vitamin/Mineral, had a 83% survival rate after being admitted to the hospital for about ten days.
CONCLUSION: Factors influencing the development of a cytokine storm include age, duration of treatment, comorbidity, symptoms, type of admission ward and severity of infection. Most patients (76.92%) with cytokine storm who received Gammaraas®/Actemra®, survived although they were in the severe and critical levels (87.17%). Overall, based on the treatment duration and survival rate, the most effective therapy was a combination of oseltamivir + favipiravir + hydroxychloroquine + antibiotics + vitamins/minerals.

Matched MeSH terms: Hospitals, Private/statistics & numerical data
Patient satisfaction constructs

Rahman MS, Osmangani AM

Int J Health Care Qual Assur, 2015;28(8):841-54.
PMID: 26440486 DOI: 10.1108/IJHCQA-05-2015-0056

The purpose of this paper is to examine the five-factor structure of patients' satisfaction constructs toward private healthcare service providers.

Matched MeSH terms: Hospitals, Private/economics; Hospitals, Private/organization & administration*
Effectiveness of intradialytic exercise to reduce interdialytic weight gain in patients on hemodialysis at Private Hospital Yogyakarta

Pujiastuti TT, Aima H, Lokonathan S, Chiew L

Enferm Clin, 2020 06;30 Suppl 5:17-20.
PMID: 32713561 DOI: 10.1016/j.enfcli.2020.01.007

Hemodialysis is a treatment for patients with kidney failure. One of the main problems in patients on hemodialysis is increasing of interdialytic weight gain (IDWG) due to decreased kidney excretion function. Increasing of interdialytic weight gain cause dangerous conditions and reduce the function of whole-body systems, especially cardiovascular and respiratory systems. These conditions require appropriate intervention. Various references reported intradialysis exercise can be an alternative intervention to reduce interdialytic weight gain. The purpose of this study was to determine the effectiveness of intradialytic exercise intervention to reduce interdialytic weight gain in patients on hemodialysis. A quantitative descriptive analytic study was conducted. Sixty-four patients on hemodialysis were randomly selected in hemodialysis unit. Patients performed intradialytic exercise twice a week for 8 weeks. Statistical analysis with general linear model repeated measure showed there was decrease in the interdialytic weight gain mean in patients on hemodialysis after 3-8 weeks intervention intradialytic exercise with p value of 0.000; <0.05. The interdialytic weight gain mean decrease between 0.281 and 1.438kg. Performed minimal four weeks intradialytic exercise was effective to reduced interdialytic weight gain in patients on hemodialysis. Based on the results of the study, it is suggested for nurses to educate patient on hemodialysis about intradialytic exercise. Intradialytic exercise can be an alternative independent nursing intervention to reduce interdialytic weight gain in patients on hemodialysis.

Matched MeSH terms: Hospitals, Private
Fulltext Public and private hospitals in Kuala Lumpur and Selangor, Malaysia: how do they fare in terms of accessibility for the physically disabled?

Phua, K.L., Chong, J.C., Elangovan, R., Liew, Y.X., Ng, H.M., Seow, Y.W.

Malaysian Journal of Medicine and Health Sciences, 2014;10(1):43-50.
MyJurnal

Public and private hospitals in Kuala Lumpur and Selangor were evaluated in terms of their accessibility for the physically disabled. The research hypotheses for this study included the following: (1) Both types of hospitals are accessible for the physically disabled as measured by specific criteria but (2) the degree of accessibility is higher in the case of private hospitals as compared to public hospitals. A total of 23 private hospitals and 11 public hospitals in Kuala Lumpur and Selangor were invited to participate in the study. The 5 private hospitals and 5 public hospitals that agreed were evaluated for adequacy of facilities for the physically-disabled. For this purpose, 13 specific criteria were assessed and scored for each hospital. These criteria were also grouped into 5 categories, namely, parking, toilet, door and lift, corridor and ramp. Scores were compared between each hospital and then aggregated and compared for private hospitals versus public hospitals. It was found that none of the 5 private hospitals and 5 public hospitals studied satisfied 100% of the criteria evaluated. Looking at each hospital individually, the overall scores range from 32% to 92% for the criteria set. Only 4 of the 10 hospitals in our sample achieved overall scores of 80% or higher in terms of the evaluation criteria we used. With the exception of availability of ramps where public hospitals scored slightly higher ,for most of the individual criterion, private hospitals scored higher than public hospitals. Looking at each criterion across all hospitals, the scores range from 59.2% (adequacy of parking) to 85% (adequacy of corridors). The median score obtained by private hospitals and by public hospitals for all 13 criteria were analysed for any difference. The difference between private hospitals and public hospitals is not statistically significant (Mann-Whitney U = 6.5, p-value = 0.099). There is no significant difference between Kuala Lumpur/Selangor private and public hospitals in terms of accessibility for physically disabled people. However, some hospitals are more accessible for the physically disabled than other hospitals. These findings indicate that there is room for improvement.

Matched MeSH terms: Hospitals, Private
Fulltext Urologic Services in Public Hospitals Suffered a Greater Detriment Than Private Hospitals During the Battle of COVID-19

Ong WLK, Lechmiannandan S, Loeb S, Teoh JY

Urology, 2020 10;144:269-270.
PMID: 32687841 DOI: 10.1016/j.urology.2020.07.010
Matched MeSH terms: Hospitals, Private*
Fulltext Reliability of computerised electrocardiographic reports

Ong HT, Kuah SH, Chew SP

Singapore Med J, 1993 Feb;34(1):53-4.
PMID: 8266130

The aim of this study is to assess the reliability of computerised reporting of electrocardiograms (ECG). Fifty ECG performed consecutively at the outpatient department of the Penang Adventist Hospital on the Marquette 12SL-SC were studied. Two physicians independently reviewed the ECG and the manual readings were compared with each other and to the computer reports. There was no significant difference in the measurement of rate. The PR and QT intervals measured by the two physicians were similar but each was significantly different from the computer reading. The QRS duration assessed by Physician 1 was similar to the computer reading but each was significantly different from that of Physician 2. The overall diagnosis was the same between the two physicians in 76%, between Physician 1 and the computer in 68%, and between Physician 2 and the computer in 78%. No ECG was reported as normal by the computer and said to be abnormal by either physician. Thus, the computer programme is reasonably reliable in ECG reporting with computer-physician variability being comparable to inter-physician variability.

Study site: outpatient department of the Penang Adventist Hospital

Matched MeSH terms: Hospitals, Private
Fulltext Rethinking health care commercialization: evidence from Malaysia

Nwagbara VC, Rasiah R

Global Health, 2015;11:44.
PMID: 26582159 DOI: 10.1186/s12992-015-0131-y

Against the backdrop of systemic inefficiency in the public health care system and the theoretical claims that markets result in performance and efficiency improvement, developing countries' governments have been rapidly commercializing health care delivery. This paper seeks to determine whether commercialization through an expansion in private hospitals has led to performance improvements in public hospitals.

Matched MeSH terms: Hospitals, Private/economics; Hospitals, Private/standards*
Fulltext Neuroendocrine tumour of the lung: a diagnostic challenge

Nur Hidayah Bahrom, Anis Safura Ramli, Nor Suraya Samsudin, Norliana Dalila Mohamad Ali, Nor Salmah Bakar

Journal of Clinical and Health Sciences, 2019;4(2):97-104.
MyJurnal

This is a case of a 62-year-old Indian man who was diagnosed with a rare type of lung
neuroendocrine tumour (NET) of atypical carcinoid (AC) subtype which comprises only 0.1%–
0.2% of pulmonary neoplasms. He initially presented to a private hospital in May 2018 with a
6-month history of chronic productive cough and haemoptysis. Chest X-Ray (CXR), CT scan,
bronchoscopy, biopsy and broncho-alveolar lavage were conducted. At this stage, imaging and
histopathological investigations were negative for malignancy. Diagnosis of bronchiectasis was
made and he was treated with antibiotic and tranexamic acid. Due to financial difficulties, his
care was transferred to a university respiratory clinic in June 2018. His condition was monitored
with CXR at every visit and treatment with tranexamic acid was continued for 6 months.
However, due to persistent haemoptysis, he presented to the university primary care clinic in
Dec 2018. Investigations were repeated in January 2019 where his CXR showed increased
opacity of the left retrocardiac region and CT scan revealed a left lower lobe endobronchial
mass causing collapse with mediastinal lymphadenopathy suggestive of malignancy.
Bronchoscopy, biopsy and histopathology confirmed the presence of NET. Although the Ki-67
index was low, the mitotic count, presence of necrosis and evidence of liver metastases
favoured the diagnosis of AC. A positron emission tomography Ga-68 DONATOC scan showed
evidence of somatostatin receptor avid known primary malignancy in the lungs with suspicions
of liver metastasis. He was subsequently referred to the oncology team and chemotherapy was
initiated. This case highlights the challenge in diagnosis and management of patients with AC.
Physicians ought to be vigilant and have a high index of suspicion in patients who present with
persistent symptoms on multiple visits. Early diagnosis of NET would prevent metastasis and
provide better prognosis. Continuous follow-up shared care between primary care and
secondary care physicians is also essential to provide ongoing psychosocial support for
patients with NET, especially those with metastatic disease

Matched MeSH terms: Hospitals, Private
Fulltext Factors deterring registered nurses from pursuing post graduate nursing degree in a private hospital in Penang, Malaysia

Ng, Mei Foong, Ooi, Bee Yean, Siew, Wei Fern

International e-Journal of Science, Medicine & Education, 2015;9(3):38-46.
MyJurnal

Background: In Malaysia the percentage of diploma registered nurses outnumber the percentage of degree registered nurses. Internationally, most registered nurses earn associate degrees or bachelor’s degrees in nursing. Malaysia is in the pipeline of ensuring that its registered nurses are professionally qualified with nursing degree by year 2020. Registered nurses with diploma qualification are feeling the pressure to upgrade their qualification to degree. There are concerns as to why these nurses are not pursuing their post registration nursing degree. Objective: To determine factors that are deterring the registered nurses of a private hospital in Penang from pursuing the post registered nursing degree. Methods: This descriptive study utilised a convenient sample of 150 registered nurses from Lam Wah Ee Hospital in Penang. The instrument of this study was developed based on literature search and the conceptual framework of Force Fields Analysis developed by Kurt Lewin in 1952. Results: The deterring factors for registered nurses not pursuing post registration nursing degree from this hospital were determined through negative mean score, which was valued at less than 2.5. The top 3 deterring factors identified were: high educational cost, with a score of 1.92; financial commitment, with a score of 2.22 and time constraints and high workload, with a score of 2.27. Conclusions: High educational cost, financial commitment, time constraint and high workload were the main factors deterring the registered nurses from this hospital from pursuing their post registration nursing degree. Thus it is timely for the organisational management to consider workable measures to assist and motivate their nurses to upgrade themselves with nursing degree in line with Malaysia’s vision to meet the increasing challenges and complex needs in the care of clients in health services.

Matched MeSH terms: Hospitals, Private
Fulltext The incidence of deep venous thrombosis following arthroscopic knee surgery

Ng WM, Chan KY, Lim ABK, Gan EC

Med J Malaysia, 2005 Jul;60 Suppl C:14-6.
PMID: 16381276

A prospective cohort study was undertaken at two centers to look for the incidence of deep vein thrombosis (DVT) following knee arthroscopic surgery. Eighty-four patients who had 90 arthroscopic procedures were reviewed. The relevant risk factors: past or family history of DVT, smoking, oral contraceptives, body weight, haemoglobin level, platelet count, tourniquet time and type of anaesthesia were documented. All patients were subjected to preoperative and post-operative duplex ultrasound. Only one patient (1.2 %) was noted to have DVT involving the peroneal vein. We concluded that the incidence of DVT after knee arthroscopy was very low in this study population.

Matched MeSH terms: Hospitals, Private
Anti-hypertensive prescription practices in private hospitals in Malaysia: a prospective, non-interventional, observational study

Ng WK, Philip AZ, Lim TT, Wong M, Goh EL, Tengku Ismail TS, et al.

Med J Malaysia, 2023 May;78(3):350-356.
PMID: 37271845

INTRODUCTION: In managing hypertension, monotherapy and sometimes a combination of more than one agent are used to achieve blood pressure (BP) control. The objective of this prospective, observational, multi-centre study was to assess the level of BP control in patients receiving one or more anti-hypertensive drugs in private medical centres in Malaysia according to the treatment regimens (monotherapy, free drug combinations and single pill combinations).
MATERIALS AND METHODS: Data were collected through medical records and interview sessions with patients on current pharmacotherapy for hypertension management at baseline and 2-3 months later. Results are expressed as mean ± SD for continuous data and as frequencies and percentages for categorical data.
RESULTS: Among 182 recruited patients, 89 (49%) achieved BP control by the end of the study. Majority (62/89) patients were on single-pill (monotherapy or SPC) antihypertensives. Majority (63/89) required more than two antihypertensives to achieve BP control.
CONCLUSION: Both SPC and free drug combination antihypertensives reduced BPs, but physicians preferred SPC to improve BP control and increase treatment compliance.

Matched MeSH terms: Hospitals, Private
Fulltext A descriptive cross sectional study on patient satisfaction in a private hospital in Selangor

Narimah, A.H.H., Shahril Rizwan, O., N Nadhrah, N.R., Adlina, S., Hakimi, Z.A., Nuraliza, A.S.

Malaysian Journal of Public Health Medicine, 2006;6(2):6-12.
MyJurnal

This descriptive cross sectional study was conducted to assess patient's satisfaction by evaluating the waiting time experienced by 27 (54%) inpatients and 23 (46%) outpatients who sought treatment at a private hospital in Selangor from 15th of May 2006 until 3rd of]une 2006. Majority of the patients (78%) were in the range between Z 1 - 40 years old and well»educated. Almost half (48%) were in the human resources employment category, 20% were in administration and marketing and 10% were professionals. Majority of them earned from RM1000-1999 (34%) and RMZ000-3999 (32%). Almost all of them (96%) agreed that the medical care that they had been receiving in the hospital was just about perfect. 98% agreed that the doctors treated them in a very friendly and courteous manner and 96% rated the care given by nurses as g0od/ excellent. 88% to 92% said that their communication with the doctors, nurses and other staff were good/ excellent. 80% waited less than 15 minutes at the registration counter, 52% waited less than 15 minutes to see the doctor and 44% waited less than 15 minutes at other places such as pharmacy and x-ray. Overall, 94% rated the level of services in the hospital as good/ excellent, Almost all (90%) would like to recommend the hospital to their friends and relatives. Our study demonstrated that the majority of the patients were satisfied with the doctors, nurses and environment of the private hospital. The average waiting time of patient before being attended to by a doctor was less than 30 minutes.

Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Hospitals, Private
Fulltext Lifestyle practices and its influence on quality of life among breast cancer survivors

Najwa Haneem Mohamad, Zoharah Omar, Nor Aina Emran

Int J Public Health Res, 2014;4(1):376-383.
MyJurnal

Introduction Breast cancer is ranked number one from the ten most frequent cancers in
female, Peninsular Malaysia. Various studies provide negative evidence on
malignancies and one of the end results is impaired quality of life (QOL).
Studies show lifestyle approaches are key factors in enhancing the QOL
among cancer survivors. The purpose of this study is to describe the lifestyle
practices (LP) among breast cancer survivors (BCS) which consist of dietary
intake, exercise habits, and stress management and to determine whether
these practices have influence on the QOL among Malaysian BCS.

Methods This study adopts a cross-sectional study design using a self-administered
questionnaire. A total of 280 BCS from public and private hospitals
throughout Peninsular Malaysia had participated. The questionnaire covers
QOL and LP items which consist of dietary intake (consumption of high-fat
food, high-fibre food, fruits and vegetables), exercise habits, and stress
management. Descriptive statistics and one-way ANOVA were used to
determine the relationship between LP and QOL.

Results Mean age of the study sample was at 41 (SD=7.37). Majority of them were
Malay (74%), 53% were diagnosed with breast cancer between 1 to 2 years
whereas 54% were presented with stage 2 at diagnosis. There was a
statistically significant difference (p

Matched MeSH terms: Hospitals, Private
Fulltext Classical varicose vein surgery in a diverse ethnic community

Murli NL, Navin ID

Med J Malaysia, 2008 Aug;63(3):193-8.
PMID: 19248688 MyJurnal

Chronic venous disorders range from telangiactasia or spider veins to varicose veins, venous swellings, skin changes and venous ulcerations. The aim of this study is to assess outcome of varicose vein surgery in the ethnically diverse population of Penang, Malaysia. This study is a retrospective analysis of patients seen from 1999 to 2004. All patients who presented to the outpatient clinic of our surgical department with saphenofemoral junction (SFJ) and/or saphenopopliteal junction (SPJ) reflux associated with incompetence of the great saphenous vein (GSV) or small saphenous vein (SSV) respectively underwent classical varicose varicose vein surgery. A single surgeon at a single institution performed the surgeries. Data from pre-operative, post-operative and follow-up procedures were recorded in case report forms. A total of 202 cases were treated. Of these, 200 were qualified by the inclusion criteria and follow-ups, with 23 who were treated bilaterally. Of those treated, Chinese comprised 47.5%, Indians 27.0%, Malays 12.5% and foreigners 13.0% (largely Indonesian Chinese, British and Americans). The average age was 52.1 years. Indians had the highest average BMI of 29.2, compared to the Chinese who had the lowest of 24.6. Based on occupation, housewives (43.0%), blue collar workers (19.0%), salespersons (12.0%) and factory workers (9.5%) were among those afflicted with varicose veins. While local Chinese predominated in the business groups (salespersons and food-related workers), the Indians and Malays in this study were mainly factory workers and/or blue collar workers. Symptomatology in descending order of severity included pain in 80.0% of cases, swelling in 65.5%, heaviness in 53.5%, cramps in 53.0%, lipodermatosclerosis in 39.0%, superficial thrombophlebitis in 33.5%, venous ulceration in 32.0%, eczema 22.0% and cellulitis in 12.5% of patients. Post surgery pains dropped to 9.9%, cramps 6.4%, heaviness 5.5% and swelling 5.3% (p<0.0001 in all groups). Indians had the highest rate of venous ulcers (35.2% of all Indians treated) possibly due to their high BMI and low socioeconomic background. In cases of venous ulcers, gram negative infections (49.8%) were more common than gram positive infections at 18.8%. Operative procedures performed included great saphenous vein high ligation in 96.5% of cases, stripping 93.5% and multiple avulsions in 98.5%, saphenous popliteal junction ligation with multiple avulsions in 13.0% and subfascial ligation in 10.5%. Operative complications included induration (40.0% of cases), bruising in 49.5%, pains in 15.0%, paraesthesia in 3.5%, wound infection in 4.0%, deep venous thrombosis in 3.0% and ulcer recurrence in 7.5%. A total of 96.2% of patients treated expressed satisfaction with varicose vein surgery. Late presentations of chronic venous insufficiency, possibly as a result of poor understanding and inadequate education on diet, weight control, use of stockings and change in lifestyle by patients, employers and general practitioners are probably the cause of high rates of severe chronic venous disease especially venous ulcerations in the local community. However, classical varicose vein surgery is widely applicable across diverse ethnicities with a high rate of success.
Study site: Surgical clinic, Penang Adventist Hospital, Pulau Pinang, Malaysia

Matched MeSH terms: Hospitals, Private
Fulltext The Relationship between Type of Music and Anxiety Level among Malaysian Women during Mammography

Mohd Zain, N., Ab Malek, N. N. F., Che Mut, N. A. I., Mohd Norsuddin, N., Abdullah Suhaimi, S. A., Ahmad Dahari, M., et al.

Physics and Technology in Medicine, 2020;1(2):7-12.
MyJurnal

Music is one of the suggested interventions that can reduce stress caused by pain from mammography procedures. The different types of music might affect the anxiety level during a mammogram screening. Thus, the study aimed to determine the anxiety level of women who underwent mammogram screening according to different types of music. A cross-sectional study was conducted on 60 women by using the purposive sampling technique in the radiology department at randomly selected private hospitals in Klang Valley from November 2018 to November 2019. Respondents were randomly divided based on the day of mammogram screening into two groups; namely slow and upbeat music. Descriptive analysis was used to determine the anxiety level for each group and T-test analysis was used to compare the significance of anxiety level between both groups. A total of 60 respondents had participated in this study with a total of 30 (50.0%) respondents allocated in slow music, while another 30 (50.0%) respondents were allocated in upbeat music. Patients who underwent mammography screening while listening to slow music had a high anxiety level (70.0%) as compared to upbeat music group (63.3%). There was no significant effect for music, t (60) = -0.54, p = 0.59, despite slow music (M = 1.70, SD = 0.47) attaining higher anxiety level than the upbeat music (M = 1.63, SD = 0.49). Upbeat music has the potential in reducing the anxiety level of women undergoing mammography screening.

Matched MeSH terms: Hospitals, Private
A comparison of human elements and nonhuman elements in private health care settings: customers' perceptions and expectations

Mohd Suki N, Chwee Lian JC, Suki NM

J Hosp Mark Public Relations, 2009;19(2):113-28.
PMID: 19827322 DOI: 10.1080/15390940903041567

In today's highly competitive health care environment, many private health care settings are now looking into customer service indicators to learn customers' perceptions and determine whether they are meeting customers' expectations in order to ensure that their customers are satisfied with the services. This research paper aims to investigate whether the human elements were more important than the nonhuman elements in private health care settings. We used the internationally renowned SERVQUAL five-dimension model plus three additional dimensions-courtesy, communication, and understanding of customers of the human element-when evaluating health care services. A total of 191 respondents from three private health care settings in the Klang Valley region of Malaysia were investigated. Descriptive statistics were calculated by the Statistical Package for Social Sciences (SPSS) computer program, version 15. Interestingly, the results suggested that customers nowadays have very high expectations especially when it comes to the treatment they are receiving. Overall, the research indicated that the human elements were more important than the nonhuman element in private health care settings. Hospital management should look further to improve on areas that have been highlighted. Implications for management practice and directions for future research are discussed.

Matched MeSH terms: Hospitals, Private/standards*

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links