Displaying publications 21 - 40 of 70 in total

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  1. Fulltext Factors influencing medical students' choice of future specialization in medical sciences: a cross-sectional questionnaire survey from medical schools in China, Malaysia and regions of South Asian Association for Regional Cooperation
    Kumar A, Mitra K, Nagarajan S, Poudel B
    N Am J Med Sci, 2014 Mar;6(3):119-25.
    PMID: 24741550 DOI: 10.4103/1947-2714.128473
    BACKGROUND: In future, increase in the number of healthcare professionals is dependent on the career interest among present undergraduate medical students. Based on their interest to pursue their specialty, the availability of medical doctors in each specialty could be done.
    AIMS: This study was to find out future career interest and factors that influence undergraduate medical students to choose their future specialization.
    MATERIALS AND METHODS: The study was carried out among first-year medical students from five countries. The students were asked to complete an 8-item questionnaire. Two thousand one hundred fifty three participants were enrolled in the study. Data were analyzed in Microsoft-Excel and Statistical Package for the Social Sciences.
    RESULTS: Of the 2153 participants, only 1470 responded. Among the 1470 participants, 169 participants were excluded due to the ambiguity in responses, finally making it to 1301 participants. Among them, Anatomy (49.3%) followed by Biochemistry (26.7%) and Physiology (24%) were the most preferred subjects.
    CONCLUSIONS: Anatomy was the most preferred basic science subject among the other subjects and the students were interested to pursuing surgery in future. Furthermore, the most preferred future specialties were surgery, internal medicine and pediatrics with gender variations; males preferring surgery and females in obstetrics and gynecology.
    KEYWORDS: China; First year medical students; Malaysia; Medical Education; Post-Graduation; SAARC country
    Matched MeSH terms: Obstetrics
  2. Fulltext Risk factors of gestational diabetes mellitus in the refugee population in Gaza Strip: a case-control study
    AlKasseh AS, Zaki NM, Aljeesh YI, Soon LK
    East Mediterr Health J, 2014 Jan 09;19 Suppl 3:S12-8.
    PMID: 24995734
    To determine the risk factors of gestational diabetes mellitus in refugee populations in the Gaza Strip, a retrospective case-control study was performed between March and June 2011 in the United Nations Relief and Works Agency (UNRWA) primary health care clinics. Data were collected on maternal sociodemographics and the prevalence of diagnosed GDM according to World Health Organization criteria from clinics where postnatal Palestinian refugee women had been diagnosed with GDM during previous pregnancies, and non-GDM women were used as controls. Sociodemographic characteristics, pre-pregnancy body-mass index (BMI), obstetrics history and family history of diabetes were used as study variables. In total, 189 incident cases of GDM were identified. The most significant risk factors for GDM were: history of miscarriage more than once; overweight before pregnancy; history of stillbirth; history of caesarean birth; and positive family history of diabetes mellitus.
    Matched MeSH terms: Obstetrics
  3. Fulltext Factors affecting doctors' and nurses' compliance with standard precautions on all areas of hospital settings worldwide - a meta-analysis
    R. (III) P. Dioso
    ASM Science Journal, 2014;8(2):134-142.
    MyJurnal
    Aim: This study analyses factors affecting SP compliance among doctors and nurses in all areas of hospital settings worldwide.

    Methods: The PICO guide helped put focus on this meta-analysis. Of the 100 studies published from search engines and/or databases from 2009 to 2014, only four were selected. A PRISMA guideline was also used to eliminate other studies. Critique framework helped in analysing the studies selected.

    Outcomes: Four significant factors affected doctors’ and nurses’ compliance with the practice of SPs - health threats, behaviour modifications, systems controls and educations, and health promotions. Of the 33 doctors in the Obstetrics and Gynaecologic department, 30% complied; of the 120 doctors - 60% interns, 34.2% residents and 5.8% consultants - complied by proper hand gloving (56.7%), hand hygiene (39.3%) and wearing aprons (58.3%); of the 32 hospital nurses, 100% complied; and of the 1,444 clinical nurses in the hospital, there is a p
    Matched MeSH terms: Obstetrics
  4. Fulltext Knowledge, attitude and practice of Breast Self- Examination among nurses in tertiary hospitals in Malaysia
    Raja Lexshimi, R. G., Zaleha, M.I., Wahida Daud, Mohd Said Nurumal, Syed Zulkifli, S.Z.
    Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
    MyJurnal
    Breast self-examination (BSE) is recommended globally as one of the methods in early detection of breast cancer. Little is known about nurses screening behavior related to BSE. A cross-sectional study was conducted to examine the knowledge, attitude and practice of Breast Self Examination (BSE) among nurses. A self-administered questionnaire was sent to a total of 114 nurses working in Obstetrics & Gynaecology wards and clinics of two tertiary hospitals. Among the 114 participants, 111(97.4%) practiced BSE. The mean age of the participants was 34.97(±9.104) years. The mean score of knowledge was 11.07(±1.020) and 81.1% had high knowledge of BSE. Majority (98.2%) of respondents showed good attitude towards BSE. Barriers was found to be a significant predictor and self confidence proved to be an influencing factor on BSE performance. Despite practicing BSE, the number of nurses that examined their breast monthly was only 35.1%. Age, working experience and marital status showed no significant relationship with knowledge and practice of BSE. However, BSE taught during their undergraduate programme was found to have a significant relationship with practice of BSE. Majority of nurses in this study were not complying with MOH recommendation for BSE in terms of frequency. Thus, intervention strategies should focus on educating nurses on performing BSE monthly, in accordance with the Ministry of Health guidelines. This is important as nurses play a primary role in promoting health behaviors in BSE practice and breast cancer awareness among women in this country.
    Matched MeSH terms: Obstetrics
  5. Fulltext Favourable outcome after peripartum cardiomyopathy: a ten-year study on peripartum cardiomyopathy in a university hospital
    Chee KH
    Singapore Med J, 2013 Jan;54(1):28-31.
    PMID: 23338913
    INTRODUCTION: Peripartum cardiomyopathy (PPCM) is an uncommon form of congestive heart failure, affecting obstetric patients around the time of delivery. The epidemiology of PPCM is infrequently reported. This study was undertaken to define the prevalence, presentation and outcome of PPCM among women giving birth in a teaching hospital in Malaysia.

    METHODS: A retrospective case record analysis was conducted on all patients admitted and diagnosed with PPCM at the University Malaya Medical Centre, Kuala Lumpur, Malaysia, from 1 January 2000 to 31 December 2009. All deliveries were undertaken in the same hospital.

    RESULTS: A total of 12 patients were diagnosed with PPCM during the ten-year study period. The prevalence of PPCM was 2.48 in 100,000 (1 in 40,322) live births. Nine women were diagnosed with PPCM within five months of delivery. Three women had twin pregnancies. There was one death in the group (mortality rate 8.3%). The mean left ventricular ejection fraction at the time of diagnosis was 28.9% ± 8.5% (range 15%-40%). Following the index event, left ventricular function normalised in six of the nine patients (66.7%) who underwent subsequent echocardiography one year later. All patients were treated with standard heart failure therapy. Two patients with normalised left ventricular function had subsequent pregnancies - one pregnancy was terminated at seven weeks and the other patient delivered uneventfully at full term.

    CONCLUSION: PPCM is uncommon. The outcome in our series was favourable, with 66.7% of patients with PPCM recovering their left ventricular function. The mortality rate was 8.3%.
    Matched MeSH terms: Obstetrics/methods
  6. Fulltext National HPV immunisation programme: knowledge and acceptance of mothers attending an obstetrics clinic at a teaching hospital, Kuala Lumpur
    Ezat SW, Hod R, Mustafa J, Mohd Dali AZ, Sulaiman AS, Azman A
    Asian Pac J Cancer Prev, 2013;14(5):2991-9.
    PMID: 23803068
    BACKGROUND: Introduction of the HPV vaccine is a forefront primary prevention method in reducing the incidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government has implemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted 13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV, HPV vaccine and National HPV (NHPV) immunisation programme since its' implementation. It also assessed acceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves.
    MATERIALS AND METHODS: A cross sectional study was conducted on 155 respondents using self-administered questionnaires; conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur. Respondents were selected using a multistage sampling technique.
    RESULTS: A response rate of 100% was obtained. Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2% for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regression analyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education was associated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPV immunisation programme; ethnicity (p=0.017), mothers' education (p=0.0005) and number of children (p=0.020). The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by for mothers themselves at 73.5%, and the least is for sons 62.6%.
    CONCLUSIONS: This study found that the overall level of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and the National HPV immunisation programme should be provided to mothers in order to increase acceptance of the HPV vaccine which can reduce the disease burden in the future.
    Study site: O&G clinic, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: Obstetrics
  7. Fulltext Commitment of medical graduates educated with and without community-based medical education towards community health care-A study from Malaysia
    Shahid Hassan
    Education in Medicine Journal, 2013;5(4):42-50.
    MyJurnal
    Context: Community-based medical education (CBME) has become widely accepted as an important innovation in undergraduate medical education. In curriculum featuring CBME, students are acquainted with the community early in their studies however; the impact of this training can be judged best to see them practice the required aspects of CBME. Malaysia is a multiracial country with a very strong community dependant life style. Main national health problems have called for a change in health profession education from traditional hospital based health care to community-based delivery system. Three major university's medical schools that either practice community oriented or community based medical education in undergraduate medical curriculum are evaluated. Universiti Sains Malaysia (USM) has a community based medical education (CBME) curriculum as Community and Family Case Study (CFCS) compared to a community oriented education curriculum (COE) adopted by Universiti Malaya (UM) and Universiti Kebangsaan Malaysia (UKM). However, UM at the time of undertaking this study back in 2005 was though practicing COE has also later opted CBME as CFCS.

    Objective: To determine whether medical graduates from USM with a community-based medical education in its curriculum for more than 25 years are inspired to have stronger commitment towards community health as shown in their on-job practice of medicine compared to other graduates from UM and UKM, who have adopted community-oriented medical education program.

    Method: A questionnaire-based pilot study with 12 items (variables) was designed to obtain supervisor's opinion on commitment of interns towards the health of community they serve. The questionnaire was administered to a randomized group of 85 specialists supervising the internship training program in five major disciplines including internal medicine, surgery, orthopaedic, gynaecology and obstetrics and paediatric medicine. The data received from 62 respondents from five major disciplines was analyzed utilizing SPSS version 12.0.1.

    Result: The responses received from 62 supervisors on an inventory in which 9 out of 12 variables were directly related to community commitments of interns. It was shown that the USM graduates who were taught through a CBME curriculum have performed better than the graduates from UM and UKM who followed a COE curriculum. P-value (< 0.001) was highly significant and consistent with higher mean score in those variables.

    Conclusion: The graduates taught through a CBME curriculum performed better in community commitments towards patients care compared to graduates from COE curriculum.
    Matched MeSH terms: Obstetrics
  8. Fulltext Association between maternal food group intake and birth size
    LOY S, MARHAZLINA M, HAMID JAN J
    Sains Malaysiana, 2013;42(11):1633-1640.
    Maternal nutrition is one of the dominant factors in determining fetal growth and subsequent developmental health for both mother and child. This study aimed to explore the association between maternal consumption of food groups and birth size among singleton, termed newborns. One hundred and eight healthy pregnant women in their third trimester, aged 19 to 40 years who visited the Obstetrics and Gynecology Clinic of Hospital Universiti Sains Malaysia completed an interviewed-administered, validated semi-quantitative food frequency questionnaire. The maternal socio-demographic, medical and obstetric histories and anthropometry measurements were recorded accordingly. The pregnancy outcomes, birth weight, birth length and head circumference were obtained from the medical records. The data were analyzed using multiple linear regression by controlling for possible confounders. Among all food groups, fruits intake was associated with higher birth weight (p=0.018). None of the food intake showed evident association with respect to birth length while only fruits intake was associated positively with head circumference (p=0.019). In contrast, confectioneries and condiments were associated with lower birth weight (p=0.013 and p=0.001, respectively). Also, condiments appeared to associate inversely with ponderal index (p=0.015). These findings suggest the potential beneficial effects of micronutrient rich food but detrimental effects of high sugar and sodium food on fetal growth. Such an effect may have long term health consequences to the lives of children.
    Matched MeSH terms: Obstetrics
  9. Perinatal Care Manual, Third Edition
    Matched MeSH terms: Obstetrics
  10. Fulltext Abstracts of the RCOG (Royal College of Obstetricians and Gynaecologists) 10th International Scientific Congress. June 5-8, 2012. Kuching, Sarawak, Malaysia
    BJOG, 2012 Jun;119 Suppl 1:2-250.
    PMID: 22672235 DOI: 10.1111/j.1471-0528.2012.03375.x
    Matched MeSH terms: Obstetrics*
  11. Differences in physician attitudes towards patient-centredness: across four medical specialties
    Chan CM, Ahmad WA
    Int J Clin Pract, 2012 Jan;66(1):16-20.
    PMID: 22171901 DOI: 10.1111/j.1742-1241.2011.02831.x
    Aims: There is limited study on patient-centred attitudes with regards to the patient–physician relationship in physicians. The objective of this study was to examine and compare physician attitudes toward patient-centredness in four different medical settings.
    Methods: The present study utilised a cross-sectional survey design and purposive sampling to recruit physicians from a single academic medical centre via face-to-face interviews. Patient-centred attitudes of physicians specialising in surgery, oncology, obstetrics and gynaecology and primary care
    (N = 78) were compared on the Patient–Practitioner Orientation Scale (PPOS) using an independent one-way analysis of variance (ANOVA). The four medical
    specialties comprised the four levels, with role orientation (patient-centred orientation vs. doctor-centred orientation) as the dependent measure.
    Results: A significant level of difference (p < 0.001) was found between the four specialisations:
    oncologists were found to have the highest level of patient-centeredness, followed by obstetricians & gynaecologists and primary care physicians, with surgeons being the least patient-centred among specialisations sampled.
    Conclusion: These data are the first from the South-East Asian region to demonstrate differences in
    physician attitudes between medical specialties. Our findings prompt further investigation and confirmation as to whether physicians with particular attitudinal traits are attracted to any particular specialties of medicine, or if physician attitudes are acquired through professional experience and training. In addition, this study offers better insight into the attitudinal differences of physician between medical specialities.
    Questionnaire: Patient–Practitioner Orientation Scale; PPOS
    Matched MeSH terms: Obstetrics
  12. Contemporary approaches to hyperemesis during pregnancy
    Tan PC, Omar SZ
    Curr Opin Obstet Gynecol, 2011 Apr;23(2):87-93.
    PMID: 21297474 DOI: 10.1097/GCO.0b013e328342d208
    PURPOSE OF REVIEW: Nausea and vomiting of pregnancy (NVP) affects 90% of pregnant women and its impact is often underappreciated. Hyperemesis gravidarum, the most severe end of the spectrum, affects 0.5-2% of pregnancies. The pathogenesis of this condition remains obscure and its management has largely been empirical. This review aims to provide an update on advances in pregnancy hyperemesis focusing on papers published within the past 2 years.

    RECENT FINDINGS: The cause of hyperemesis is continuing to be elaborated. Recent data attest to the effectiveness of the oral doxylamine-pyridoxine in NVP. Follow-up data of children exposed in early pregnancy to doxylamine-pyridoxine for NVP are reassuring. Evidence is increasing for ginger as an effective herbal remedy for NVP. Metoclopramide is effective in NVP and hyperemesis gravidarum, with a good balance of efficacy and tolerability. A recent large-scale study on first trimester exposure to metoclopramide is reassuring of its safety. Evidence is emerging for the treatment of acid reflux to ameliorate NVP. The role of corticosteroids for hyperemesis gravidarum remains controversial. Transpyloric feeding may be warranted for persistent weight loss, despite optimal antiemetic therapy.

    SUMMARY: Women with significant NVP should be identified so that they can be safely and effectively treated.

    Matched MeSH terms: Obstetrics/methods
  13. Fulltext Development, validity and reliability of a pregnancy symptoms questionnaire (PSQ)
    Marhazlina Mohamad, Loy, See-Ling, Nik Mohamed Zaki Nik Mahmood, Nor Azwany Yaacob, Hamid Jan Jan Mohamed
    Jurnal Sains Kesihatan Malaysia, 2011;9(2):15-21.
    MyJurnal
    This study aimed to develop and examine the validity and reliability of a pregnancy symptoms questionnaire. A total of 214 pregnant women aged 19 to 40 years old were purposive randomly recruited from December 2009 to January 2010 in Antenatal Clinic, Hospital Universiti Sains Malaysia. Pregnant mothers at second and third trimesters were interviewed to complete the Pregnancy Symptoms Questionnaire (PSQ). The PSQ was developed by experts in nutrition, obstetrics and statistics. The PSQ consists of 38 items on frequency and severity of pregnancy symptoms. Factor analysis was done using Promax rotation method to check for construct validity. A total of 16 items which had poor correlation (<0.3) and less important content were removed during the final revise. The 22 remaining items were found to be loaded on the three components (general, constitutional and somatic pain). The overall Cronbach’s alpha coefficient was 0.93 and for each three components ranges from 0.70–0.87. The results suggest that the final PSQ consisting of 22 items is valid and reliable for measuring the frequency and severity of the symptoms experienced during pregnancy. It can be used in nutritional studies related to pregnancy and its outcome.
    Keywords: Pregnant mothers; Pregnancy symptoms; Questionnaire; Validation
    Study site: Antenatal Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Obstetrics
  14. Fulltext Morbidly adherent placenta at extreme prematurity: can major haemorrhage and hysterectomy be prevented?
    Shafiee, M.N., Rahana, A.R., Lim, P.S., Nor Azlin, M.I., Wan Faraliza, Z.A., Isa, M.R., et al.
    Journal of Surgical Academia, 2011;1(1):56-60.
    MyJurnal
    Morbidly adherent placenta with spontaneous rupture of membrane at extreme prematurity poses poor pregnancy outcome. Various issues on different management modalities still remain perplexed and individual consideration is vital. Two cases of morbidly adherent placenta with symptomatic per vaginal bleeding and spontaneous rupture of membrane at severe prematurity were reviewed and discussed. We found that, active intervention by termination of pregnancy and methotrexate therapy at early gestation can prevent the need of hysterectomy following major obstetrics haemorrhage.
    Matched MeSH terms: Obstetrics
  15. Fulltext Building capacity for evidence generation, synthesis and implementation to improve the care of mothers and babies in South East Asia: methods and design of the SEA-ORCHID Project using a logical framework approach
    McDonald S, Turner T, Chamberlain C, Lumbiganon P, Thinkhamrop J, Festin MR, et al.
    BMC Med Res Methodol, 2010;10:61.
    PMID: 20594325 DOI: 10.1186/1471-2288-10-61
    Rates of maternal and perinatal mortality remain high in developing countries despite the existence of effective interventions. Efforts to strengthen evidence-based approaches to improve health in these settings are partly hindered by restricted access to the best available evidence, limited training in evidence-based practice and concerns about the relevance of existing evidence. South East Asia--Optimising Reproductive and Child Health in Developing Countries (SEA-ORCHID) was a five-year project that aimed to determine whether a multifaceted intervention designed to strengthen the capacity for research synthesis, evidence-based care and knowledge implementation improved clinical practice and led to better health outcomes for mothers and babies. This paper describes the development and design of the SEA-ORCHID intervention plan using a logical framework approach.
    Matched MeSH terms: Obstetrics and Gynecology Department, Hospital/organization & administration; Obstetrics and Gynecology Department, Hospital/standards
  16. Perinatal Care Manual
    Section 1: Pre-pregnancy Section 2: Antenatal Care Section 3: Intrapartum Care Section 4: Postpartum Care Section 5: Neonatal Care
    Matched MeSH terms: Obstetrics
  17. The application of empirical mode decomposition for the enhancement of cardiotocograph signals
    Krupa BN, Mohd Ali MA, Zahedi E
    Physiol Meas, 2009 Aug;30(8):729-43.
    PMID: 19550027 DOI: 10.1088/0967-3334/30/8/001
    Cardiotocograph (CTG) is widely used in everyday clinical practice for fetal surveillance, where it is used to record fetal heart rate (FHR) and uterine activity (UA). These two biosignals can be used for antepartum and intrapartum fetal monitoring and are, in fact, nonlinear and non-stationary. CTG recordings are often corrupted by artifacts such as missing beats in FHR, high-frequency noise in FHR and UA signals. In this paper, an empirical mode decomposition (EMD) method is applied on CTG signals. A recursive algorithm is first utilized to eliminate missing beats. High-frequency noise is reduced using EMD followed by the partial reconstruction (PAR) method, where the noise order is identified by a statistical method. The obtained signal enhancement from the proposed method is validated by comparing the resulting traces with the output obtained by applying classical signal processing methods such as Butterworth low-pass filtering, linear interpolation and a moving average filter on 12 CTG signals. Three obstetricians evaluated all 12 sets of traces and rated the proposed method, on average, 3.8 out of 5 on a scale of 1(lowest) to 5 (highest).
    Matched MeSH terms: Obstetrics
  18. Fulltext Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia
    Martis R, Ho JJ, Crowther CA, SEA-ORCHID Study Group
    BMC Pregnancy Childbirth, 2008;8:34.
    PMID: 18680603 DOI: 10.1186/1471-2393-8-34
    Evidence-based practice (EBP) can provide appropriate care for women and their babies; however implementation of EBP requires health professionals to have access to knowledge, the ability to interpret health care information and then strategies to apply care. The aim of this survey was to assess current knowledge of evidence-based practice, information seeking practices, perceptions and potential enablers and barriers to clinical practice change among maternal and infant health practitioners in South East Asia.
    Matched MeSH terms: Obstetrics
  19. Fulltext Optimising reproductive and child health outcomes by building evidence-based research and practice in South East Asia (SEA-ORCHID): study protocol
    Henderson-Smart DJ, Lumbiganon P, Festin MR, Ho JJ, Mohammad H, McDonald SJ, et al.
    BMC Med Res Methodol, 2007;7:43.
    PMID: 17892586
    Disorders related to pregnancy and childbirth are a major health issue in South East Asia. They represent one of the biggest health risk differentials between the developed and developing world. Our broad research question is: Can the health of mothers and babies in Thailand, Indonesia, the Philippines and Malaysia be improved by increasing the local capacity for the synthesis of research, implementation of effective interventions, and identification of gaps in knowledge needing further research?
    Matched MeSH terms: Obstetrics and Gynecology Department, Hospital/standards*
  20. Fulltext "Postpartum morbidity--what we can do"
    Zainur RZ, Loh KY
    Med J Malaysia, 2006 Dec;61(5):651-6.
    PMID: 17623974
    Postpartum is a crucial period for a mother. During this period a mother is going through the physiological process of uterine involution and at the same time adapting to her new role in the family. Many postpartum complications occur during this period. Among the important obstetric morbidities are postpartum hemorrhage, pregnancy related hypertension, pulmonary embolism and puerperal sepsis. Common surgical complications are wound breakdown, breast abscess and urinary fecal incontinence. Medical conditions such as anemia, headache, backache, constipation and sexual problems may also be present. Unrecognized postpartum disorders can lead to physical discomfort, psychological distress and a poor quality of life for the mothers. Providing quality postnatal care including earlier identification of the problems (correction) and proper intervention will help the mother to achieve full recovery and restore her functional status back to the pre-pregnancy state sooner.
    Matched MeSH terms: Obstetrics/methods
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