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Displaying publications 21 - 40 of 91 in total

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Fulltext How do health care professionals assess patients when initiating insulin therapy? A qualitative study

Lee PY, Lee YK, Khoo EM, Ng CJ

Prim Care Diabetes, 2014 Apr;8(1):49-55.
PMID: 24315732 DOI: 10.1016/j.pcd.2013.11.003

Aims: To explore how health care professionals (HCPs) assess patients when initiating insulintherapy in type 2 diabetes.
Methods: Focus group discussions and in-depth interviews were conducted with 41 healthcare professionals in Malaysia in 2010–2011. A semi-structured topic guide was used for theinterview. The interviews were transcribed verbatim and analysed using the Nvivo9 softwarebased on a thematic approach.
Results: HCPs were less likely to initiate insulin therapy in patients who were older, withirregular dietary patterns and poor financial status. They also assessed patients’ knowl-edge, views and misconceptions of insulin. However, there was a variation in how doctors assessed patients’ comorbidities before starting insulin therapy. Medical officers were more likely to initiate insulin therapy in patients with comorbidities and complications, whereas family medicine specialists were more cautious. In addition, most HCPs considered patients’ psychosocial status, including self-care ability, social support and quality of life.
Conclusions: HCPs’ assessment of patients’ need to start insulin therapy depends on their perception rather than objective evaluation of patients’ background, knowledge, perception and abilities. The background and the type of practice of HCPs influence their assessment.

Matched MeSH terms: Specialization
Fulltext Rare disease in Malaysia: Challenges and solutions

Shafie AA, Supian A, Ahmad Hassali MA, Ngu LH, Thong MK, Ayob H, et al.

PLoS One, 2020;15(4):e0230850.
PMID: 32240232 DOI: 10.1371/journal.pone.0230850

OBJECTIVE: Rare diseases are often underdiagnosed, and their management is frequently complicated by a lack of access to treatment and information about the diseases. To allow for better policy planning, we sought to examine the current status of managing rare diseases in Malaysia.
METHODS: This study was conducted in two phases. In the first phase, we triangulated information from reviews of journal publications, documents from the Malaysian government and in-depth interviews among selected key healthcare stakeholders in Malaysia. The second phase was designed as a cross-sectional survey to estimate the number of cases and treatment coverage for rare diseases in Malaysia.
RESULTS: Malaysia has no official definition of rare disease yet but currently in the process of reviewing them for Malaysia. There are 13 rare disease specialists and a dozen medical doctors in genetic clinics around Malaysia, mainly in public health facilities. From the survey, 1,249 patients were diagnosed with rare diseases in public hospitals. Only 60% received their medications or supplements, and the rest continued with symptomatic treatment.
CONCLUSION: Generally, Malaysia has made significant progress in the management of rare diseases, but there are still opportunities for development in critical areas. Ultimately, if all healthcare providers, government, society, and politicians work together to manage rare diseases, we will see an improvement in patient outcomes.

Matched MeSH terms: Specialization
Fulltext Automated classification of tropical shrub species: a hybrid of leaf shape and machine learning approach

Murat M, Chang SW, Abu A, Yap HJ, Yong KT

PeerJ, 2017;5:e3792.
PMID: 28924506 DOI: 10.7717/peerj.3792

Plants play a crucial role in foodstuff, medicine, industry, and environmental protection. The skill of recognising plants is very important in some applications, including conservation of endangered species and rehabilitation of lands after mining activities. However, it is a difficult task to identify plant species because it requires specialized knowledge. Developing an automated classification system for plant species is necessary and valuable since it can help specialists as well as the public in identifying plant species easily. Shape descriptors were applied on the myDAUN dataset that contains 45 tropical shrub species collected from the University of Malaya (UM), Malaysia. Based on literature review, this is the first study in the development of tropical shrub species image dataset and classification using a hybrid of leaf shape and machine learning approach. Four types of shape descriptors were used in this study namely morphological shape descriptors (MSD), Histogram of Oriented Gradients (HOG), Hu invariant moments (Hu) and Zernike moments (ZM). Single descriptor, as well as the combination of hybrid descriptors were tested and compared. The tropical shrub species are classified using six different classifiers, which are artificial neural network (ANN), random forest (RF), support vector machine (SVM), k-nearest neighbour (k-NN), linear discriminant analysis (LDA) and directed acyclic graph multiclass least squares twin support vector machine (DAG MLSTSVM). In addition, three types of feature selection methods were tested in the myDAUN dataset, Relief, Correlation-based feature selection (CFS) and Pearson's coefficient correlation (PCC). The well-known Flavia dataset and Swedish Leaf dataset were used as the validation dataset on the proposed methods. The results showed that the hybrid of all descriptors of ANN outperformed the other classifiers with an average classification accuracy of 98.23% for the myDAUN dataset, 95.25% for the Flavia dataset and 99.89% for the Swedish Leaf dataset. In addition, the Relief feature selection method achieved the highest classification accuracy of 98.13% after 80 (or 60%) of the original features were reduced, from 133 to 53 descriptors in the myDAUN dataset with the reduction in computational time. Subsequently, the hybridisation of four descriptors gave the best results compared to others. It is proven that the combination MSD and HOG were good enough for tropical shrubs species classification. Hu and ZM descriptors also improved the accuracy in tropical shrubs species classification in terms of invariant to translation, rotation and scale. ANN outperformed the others for tropical shrub species classification in this study. Feature selection methods can be used in the classification of tropical shrub species, as the comparable results could be obtained with the reduced descriptors and reduced in computational time and cost.

Matched MeSH terms: Specialization
Fulltext Delivery of paediatric rheumatology care: a survey of current clinical practice in Southeast Asia and Asia-Pacific regions

Tangcheewinsirikul S, Tang SP, Smith N, Sukharomana M, Charuvanij S, Vilaiyuk S, et al.

Pediatr Rheumatol Online J, 2021 Jan 23;19(1):11.
PMID: 33485337 DOI: 10.1186/s12969-021-00498-1

BACKGROUND: Paediatric rheumatic diseases are a leading cause of acquired disability in Southeast Asia and Asia-Pacific Countries (SE ASIA/ASIAPAC). The aims of this study were to identify and describe the challenges to the delivery of patient care and identify solutions to raise awareness about paediatric rheumatic diseases.
METHODS: The anonymised online survey included 27 items about paediatric rheumatology (PR) clinical care and training programmes. The survey was piloted and then distributed via Survey-Monkey™ between March and July 2019. It was sent to existing group lists of physicians and allied health professionals (AHPs), who were involved in the care pathways and management of children with rheumatic diseases in SE ASIA/ASIAPAC.
RESULTS: Of 340 participants from 14 countries, 261 participants had been involved in PR care. The majority of the participants were general paediatricians. The main reported barriers to providing specialised multidisciplinary service were the absence or inadequacy of the provision of specialists and AHPs in addition to financial issues. Access to medicines was variable and financial constraints cited as the major obstacle to accessing biological drugs within clinical settings. The lack of a critical mass of specialist paediatric rheumatologists was the main perceived barrier to PR training.
CONCLUSIONS: There are multiple challenges to PR services in SE ASIA/ASIAPAC countries. There is need for more specialist multidisciplinary services and greater access to medicines and biological therapies. The lack of specialist paediatric rheumatologists is the main barrier for greater access to PR training.

Matched MeSH terms: Specialization
Fulltext Vitreous loss-causes, associations, and outcomes: Eight-year analysis in Melaka Hospital

Thevi T, Abas AL

Oman J Ophthalmol, 2018 6 23;11(2):113-118.
PMID: 29930443 DOI: 10.4103/ojo.OJO_220_2016

BACKGROUND: Cataract surgery is associated with a variety of complications, one of which is vitreous loss. Doctors and policymakers should be aware about the precipitating factors, associations, and expected outcomes of vitreous loss. This study was, therefore, undertaken to set guidelines to improve the visual outcomes of patients.

MATERIALS AND METHODS: A retrospective 8-year analysis was conducted from 2007 to 2014 using the national eye database. Demographic features, ocular comorbidities, grade of surgeon, type of surgery, and the associations with the occurrence of vitreous loss, and the final visual outcomes of these patients were studied.

RESULTS: Out of 12,992 eyes, only 3.2% had vitreous loss, mostly aged <40 years. Pseudoexfoliation was the only ocular comorbidity causing vitreous loss. Medical Officers and Gazetting Specialists got more vitreous loss compared to specialists. Intracapsular cataract extraction, phaco convert to extracapsular cataract extraction (ECCE), ECCE, and phaco all had a significant vitreous loss. Vitreous loss was the most significant intraoperative complication causing poor vision and resulted in impaired or poor visual outcome.

CONCLUSION: Vitreous loss occurred in almost all types of cataract surgeries, especially by junior surgeons, among those aged <40 years and significantly caused poor visual outcome compared to other complications. Pseudoexfoliation had higher occurrence of vitreous loss. Vitreous loss patients had impaired/poor visual outcome due to preexisting comorbidity and astigmatism. Patients at risk and junior surgeons should be closely monitored to improve outcomes. Further studies need to be done to see why and when the vitreous loss occurred.

Matched MeSH terms: Specialization
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: Specialization
Response to de Groot 'There is an urgent need for palliative care specialists in MS - Commentary'

Cheong WL, Mohan D, Warren N, Reidpath DD

Mult Scler, 2019 11;25(13):1821-1822.
PMID: 31517592 DOI: 10.1177/1352458519876697
Matched MeSH terms: Specialization*
Retinal imaging analysis based on vessel detection

Jamal A, Hazim Alkawaz M, Rehman A, Saba T

Microsc Res Tech, 2017 Jul;80(7):799-811.
PMID: 28294460 DOI: 10.1002/jemt.22867

With an increase in the advancement of digital imaging and computing power, computationally intelligent technologies are in high demand to be used in ophthalmology cure and treatment. In current research, Retina Image Analysis (RIA) is developed for optometrist at Eye Care Center in Management and Science University. This research aims to analyze the retina through vessel detection. The RIA assists in the analysis of the retinal images and specialists are served with various options like saving, processing and analyzing retinal images through its advanced interface layout. Additionally, RIA assists in the selection process of vessel segment; processing these vessels by calculating its diameter, standard deviation, length, and displaying detected vessel on the retina. The Agile Unified Process is adopted as the methodology in developing this research. To conclude, Retina Image Analysis might help the optometrist to get better understanding in analyzing the patient's retina. Finally, the Retina Image Analysis procedure is developed using MATLAB (R2011b). Promising results are attained that are comparable in the state of art.

Matched MeSH terms: Specialization
Medical school entrance and career plans of Malaysian medical students

Razali SM

Med Educ, 1996 Nov;30(6):418-23.
PMID: 9217903

This study investigates the reasons for entry to medicine and the career perspectives of phase III medical students of the Universiti Sains Malaysia (USM). The majority of the students were Malays from low socio-economic backgrounds who entered medical school after completing a 2-year matriculation course. An interest in medicine and helping people were the two main stated reasons for entry to medical school. A group of students wishing to work in private practice was identified. In comparison to the rest of the study body, students in the group were: not well prepared to enter medical school; dissatisfied with the course; and subject to family influences. A desire for monetary gain motivated their choice of medicine as a career. Overall, 13% of the students wished to change career because they were dissatisfied with their experience of medicine as undergraduates. The study did not find a significant difference in career intentions between female and male medical students. However, women were less likely to seek entrance into private practice or pursue formal postgraduate education. The choice of surgery as a career was confined to men. About 90% of the students had already decided on their future specialty. Four well-established specialties were their most popular choices. The gender of the students had no significant influences of the decision to continue into postgraduate education. The proportion of female students who wished to marry doctors was significantly higher than for male students.

Matched MeSH terms: Specialization
Fulltext Coordinating a Postgraduate Orthopaedic Exam During the COVID-19 Pandemic

Mohamed-Haflah NH, Abdullah S, Abdul-Rani R

Malays Orthop J, 2021 Mar;15(1):16-20.
PMID: 33880143 DOI: 10.5704/MOJ.2103.003

The Coronavirus (COVID-19) pandemic and institution of the Movement Control Order (MCO) had resulted in the cancellation of a major orthopaedic exam in April 2020. The exam is known as the Malaysian Orthopaedic Specialist Committee (OSC) Part I Examinations. It is similar to the British Royal Colleges of Surgeons Membership (MRCS) exams and held twice annually in April and October. There are up to 200 candidates involved. With implementation of new guidelines and standard operating procedures (SOP), the OSC Part I exam was successfully held by Universiti Kebangsaan Malaysia (UKM) from 5th-9th October 2020. Here we highlight the challenges we faced whilst coordinating a major exam at a national level during the COVID-19 pandemic with recommendations for future exams.

Matched MeSH terms: Specialization
Fulltext Haematinics for anaemia in the elderly

Khoo SB

Malays Fam Physician, 2011;6(1):7-14.
MyJurnal

Anaemia is the most common haematological problem in the elderly population. Using WHO criteria for anaemia (Hb of <12 g/dL in women and <13 g/dL in men), the prevalence of anaemia in the elderly has been found to range from 8-44% with the highest prevalence in men 85 years and older. Anaemia must not be considered simply as part of ageing because in 80% of cases, there is an underlying cause for Hb
levels of <12 g/dL in the elderly. Anaemia has negative impacts on the quality of life for the elderly and there is evidence of improved morbidity and
mortality after correction of anaemia. Chronic disease and thalassaemia may also cause microcytic anaemia besides iron deficiency and not all vitamin B12 and folate deficiency present with macrocytic megaloblastic anaemia. Nutritional deficiency anaemias are common, easily diagnosed, treatments are simple, inexpensive and effective. Tests for nutritional anaemia have to be given priority in the assessment before a patient is subjected to invasive tests to look for less common causes of anaemia. Serum ferritin which is the best non-invasive test for the diagnosis of iron deficiency anaemia may be increased in the elderly while serum iron and transferrin decrease with ageing. Serum methylmalonic acid (MMA) and homocysteine (HC) levels are sensitive for detecting subclinical vitamin B12 and folate deficiency. Routine iron therapy in non-anaemic elderly or in those without iron deficiency anaemia is of no use and may be detrimental to their health. Folate therapy may improve anaemia but may mask the signs and symptoms of neurological damage due to concomitant
vitamin B12 deficiency. Blood transfusion offers prompt symptom relief of anaemia in patients with terminal malignancy irrespective of the causes for the anaemia.

Matched MeSH terms: Specialization
Fulltext Implementing standard setting into the Conjoint MAFP/FRACGP Part 1 examination - Process and issues

Chan SC, Mohd Amin S, Lee TW

Malays Fam Physician, 2016;11(2-3):2-8.
PMID: 28461851

BACKGROUND: The College of General Practitioners of Malaysia and the Royal Australian College of General Practitioners held the first Conjoint Member of the College of General Practitioners (MCGP)/Fellow of Royal Australian College of General Practitioners (FRACGP) examination in 1982, later renamed the Conjoint MAFP/FRACGP examinations. The examination assesses competency for safe independent general practice and as family medicine specialists in Malaysia. Therefore, a defensible standard set pass mark is imperative to separate the competent from the incompetent.

OBJECTIVE: This paper discusses the process and issues encountered in implementing standard setting to the Conjoint Part 1 examination.

DISCUSSION: Critical to success in standard setting were judges' understanding of the process of the modified Angoff method, defining the borderline candidate's characteristics and the composition of judges. These were overcome by repeated hands-on training, provision of detailed guidelines and careful selection of judges. In December 2013, 16 judges successfully standard set the Part 1 Conjoint examinations, with high inter-rater reliability: Cronbach's alpha coefficient 0.926 (Applied Knowledge Test), 0.921 (Key Feature Problems).

Matched MeSH terms: Specialization
Family Physicians' satisfaction with factors affecting the dynamism of the urban family physician program in the Fars and Mazandaran provinces of Iran

Kabir MJ, Hassanzadeh-Rostami Z, Ashrafian Amiri H, Nasrollapour Shirvani SD, Keshavarzi A, Hosseini S

Malays Fam Physician, 2019;14(3):28-36.
PMID: 32175038

Background and objective: A successful family physician program needs ongoing and full cooperation between people and the organizations in charge. Ensuring the satisfaction of family physicians through improvement of the underlying factors could motivate them to provide high-quality services. This study aimed to determine the family physicians' satisfaction level with the factors affecting the dynamism of the urban family physicians program in the Fars and Mazandaran provinces of Iran.
Method: This cross-sectional study was carried out in urban areas in the Fars and Mazandaran provinces in 2016. The sample consisted of 143 and 96 family physicians, respectively, in Fars and Mazandaran provinces and was selected using the stratified random sampling method. Data were collected using a questionnaire and included both sociodemographic variables and factors assessing the family physicians' satisfaction levels. Each factor was scored based on a Likert scale from 0 to 5 points, and any satisfaction level higher than 3 out of 5 was equated with being satisfied.
Results: The overall satisfaction levels among family physicians in Fars and Mazandaran provinces were 2.77±0.53 and 3.37±0.56, respectively, revealing a statistically significant difference between provinces (p<0.001). Moreover, the mean satisfaction scores for the performances of healthcare centers, insurance companies, specialists, healthcare workers, and the population covered were 2.78±0.1, 2.54±0.9, 2.52±0.8, 4.24±0.07, and 2.96±0.8, respectively. The family physicians' levels of satisfaction were significantly correlated with population size (p=0.02, r= -0.106), and willingness to stay in an urban family physician program (p<0.001, r= +0.398).
Conclusion: This study revealed that family physicians exhibited a low level of satisfaction with the urban family physician program. Given the direct association between family physicians' satisfaction levels and retention in the program, it is expected that family physicians will no longer stay in the program, and it is likely to have subsequent executive problems.

Matched MeSH terms: Specialization
Barriers to implementing a national health screening program for men in Malaysia: An online survey of healthcare providers

Ng CJ, Teo CH, Ang KM, Kok YL, Ashraf K, Leong HL, et al.

Malays Fam Physician, 2020;15(1):6-14.
PMID: 32284799

Introduction: This study aimed to determine the views and practices of healthcare providers and barriers they encountered when implementing the national health screening program for men in a public primary care setting in Malaysia.
Methods: An online survey was conducted among healthcare providers across public health clinics in Malaysia. All family medicine specialists, medical officers, nurses and assistant medical officers involved in the screening program for adult men were invited to answer a 51-item questionnaire via email or WhatsApp. The questionnaire comprised five sections: participants' socio-demographic information, current screening practices, barriers and facilitators to using the screening tool, and views on the content and format of the screening tool.
Results: A total of 231 healthcare providers from 129 health clinics participated in this survey. Among them, 37.44% perceived the implementation of the screening program as a "top-down decision." Although 37.44% found the screening tool for adult men "useful," some felt that it was "time consuming" to fill out (38.2%) and "lengthy" (28.3%). In addition, 'adult men refuse to answer' (24.1%) was cited as the most common patient-related barrier.
Conclusions: This study provided useful insights into the challenges encountered by the public healthcare providers when implementing a national screening program for men. The screening tool for adult men should be revised to make it more user-friendly. Further studies should explore the reasons why men were reluctant to participate in health screenings, thus enhancing the implementation of screening programs in primary care.

Matched MeSH terms: Specialization
Fulltext Doctors perception towards implementation of hospital accreditation in state hospitals

Halim, A., Roslan, J.G.

Malaysian Journal of Public Health Medicine, 2002;2(1):47-49.
MyJurnal

The Ministry of Health had instructed all state hospitals to go for Accreditation. Accreditation is considered to be a more appropriate tool forquality assurance in a hospital setting than ISO 9000.The objective of this research was to study doctors perception towards the implementation of Accreditation in state hospital. Self-administered questionnaires were sent through mail to doctors in eight clinical departments of all state hospitals. From 832 questionnaires sent, 297 responded (36%),i.e. 84 specialists and 2/2 medical officers. The study showed that 69% doctors knew that their hospital was implementing Accreditation. There were more clinical specialist (9I%) who were involved in accreditation as compared to Medical Ojicers (73%). 83% of doctors believed that accreditation can assist in assuring quality in their hospital. Those who do not, thought that quality can be assured stajfing was adequate (67%) and accreditation does not assess patient care
(33%). The study also showed that 7I% of doctors knew that their hospital was implementing MS ISO 9000. A 77% of doctors believed that ISO 9000 can assist in assuring quality in their hospital. Those who do not, thought that quality can onhi be assured Jstajfng was adequate (27%) and ISO 9000 was only meant for industry (8%). In conclusion, doctors believed that Accreditation and MS ISO 9000 can assist in assuring quality in their hospitals. Amongst, those who do not, majority thought that quality can only be assured staffing was adequate.

Matched MeSH terms: Specialization
Fulltext A cross sectional study on job satisfaction level and the influencing factors among public health specialists in the Ministry of Health Malaysia, September 2004 - October 2004

Aniza, I., Syed Mohamed Al Junid, Sharifa Ezat

Malaysian Journal of Public Health Medicine, 2005;5(2):25-31.
MyJurnal

Job satisfaction level of workers is among the important factors influencing the performance and productivity of an organization. A cross sectional study was conducted among Public Health Specialists in the Ministry of Health of Malaysia to identify their job satisfaction level and the factors influencing it. The respondents are from the Association of Public Health Specialists of Malaysia. A working in Ministry of Health. Focus group discussions were conducted in four states to develop a relevant and comprehensive questionnaire. Survey questionnaires were then mailed to the respondents. The response rate was 7 2.3%. In measuring the job satisfaction level seven aspects were studied. The study showed that ‘job and workload` is the main contributor to job dissatisfaction followed by ’management and policy aspect’, 'salary and remuneration: aspect’ and resources and facilities aspect. Most of the respondents (94.0%) were dissatisfied with their job. Gender and income were the predictors of general job satisfaction. As a conclusion, the management, policy and remuneration shouM be revised in order to overcome the problems identified and subsequently increase job satisfaction levels among Public Health Specialists in the Ministry of Health, Malaysia.

Matched MeSH terms: Specialization
Fulltext Factors affecting motivation level among public health specialists in the Ministry of Health Malaysia

Aniza, I., Syed Mohamed Al Junid, Sharifa Ezat

Malaysian Journal of Public Health Medicine, 2006;6(1):17-22.
MyJurnal

Employee motivation affects productivity and need to be channeled towards the accomplishment of organizational goals. A cross sectional study was conducted among Public Health Specialists (PHS) in the Ministry of Health Malaysia to study their motivation level and the factors influencing this. The respondents were from the Association of Public Health Specialists of Malaysia working in the Ministry of Health. Quantitative Technique self-administered questionnaires were used in this study and the questionnaires were mailed to the respondents. The response rate for this study was 72.3%. In measuring the motivation level, five (5) aspects were studied. The social aspect, self -achievement aspect and autonomy aspect were found to be the main aspects that motivated the respondents. With regard to motivation level, 55.8 % respondents had low motivation level. In order to improve the motivation level among PHS, the aspect of self actualization and autonomy required serious attention. In the future, PHS are expected to play a major role in controlling, promoting, preventing, maintaining, restoring and solving problems in order to enhance the health of the Malaysian population.

Matched MeSH terms: Specialization
Fulltext Dietary supplementation among doctors in Kelantan

Rohana Abdul Jalil, Zulkifli Ahmad

Malaysian Journal of Public Health Medicine, 2007;7(1):60-63.
MyJurnal

The aim of the study is to describe the usage of dietary supplemenu among doctors working in the hospitals in Kota Bharu, Kelantan. The method used was a postal questionaire survey of the doctors, both specialists and medical officers working in these hospitals. The results showed that
only 28.7% of the doctors are taking dietary supplements. Significantly more female doctors and doctors on long term medication, were taking these supplements. The dietary supplements commonly used were multivitamins and minerals (92.3%), garlic (26.9%), vitamin C (26.9%) and
lecithin (15.4%). The majority of the doctors who took dietary supplements (60%) felt their health status have improved. These supplements were mostly obtained from hospital pharmacies. Doctors who puchase their own supplements spend between RMIO to RMIZO per month. The main reasons given for taking these supplements were that the doctors jfelt healthier' and to ‘prevent or as a supplementary treatment’ for conditions like hypercholesterolaemia, hypertension, ischaemic heart disease and cancers. There were four doctors who regularly use traditional dietary supplements. Most doctors will generally advice their patients and children to take dietary supplements regularly, as they felt that it is important for health.

Matched MeSH terms: Specialization
Fulltext Development of clinical pathway for Mild Cognitive Impairment and Dementia to quantify cost of age-related cognitive disorders in Malaysia

Syed Mohamed Aljunid, Namaitijiang Maimaiti, Zafar Ahmed, Amrizal Muhammad Nur, Norashidah Mohamed Nor, Normazwana Ismail, et al.

Malaysian Journal of Public Health Medicine, 2014;14(3):0-0.
MyJurnal

As the Malaysian population ages, the burden of age-related cognitive disorders such as dementia and Alzheimer’s disease will increase concomitantly. This is one of the sub-study under a research project titled by quantify the cost of age-related cognitive impairment in Malaysia, which was undertaken to develop a clinical pathway for Mild Cognitive Impairment (MCI) and Dementia. The clinical pathway (CP) will be used to support the costing studies of MCI and Dementia. An expert group discussion (EGD) was conducted among selected experts from six (6) government hospitals from different states of Malaysia, Ministry of Health, and United Nations University, International Institute for Global Health, UKM and UPM. The expert group includes psychiatrist specialists and public health medicine specialists. A total of 15 participants took part in the EGD. The group was presented with the different approach in managing MCI and Dementia. Finally, the group came to the consensus agreement on the most appropriate and efficient ways of managing the two conditions. In the EGD, an operational definition for MCI and Dementia was agreed upon and a pathway was developed for the usual practice in the Malaysian health system. A typical case used, as a reference is a 60-year-old patient referred to a memory clinic with complaint of “forgetfulness”. After three outpatient visits in the clinic, the diagnosis of MCI and Dementia could be clinically established. The clinical pathways covered all active clinical and non-clinical management of the patient over a period of one year. The experts identified the additional resources required to manage these patients for the whole spectrum of lifetime based on the expected life expectancy. The Clinical pathway (CP) for MCI and Dementia was successfully developed in EGD with strong support from practitioners in the health system. The findings will help the researchers to identify all-important clinical activities and interventions that will be included in the costing study.

Matched MeSH terms: Specialization
Fulltext Should hospital directors in public hospitals perform clinical work?

Roslan Johari, M.G., Teng, S.C., Rosidah, S.S., Haliza, A.M., Tahir, A., Nadhirah, R., et al.

Malaysian Journal of Public Health Medicine, 2005;5(1):44-50.
MyJurnal

A cross sectional study was conducted to determine the perception of Hospital Directors in performing clinical duties. This was done through a postal survey which was conducted covering all public hospitals in Malaysia. The majority of Hospital Directors had read the circular at the time of the study and agreed to do clinical work besides managerial duties. Before the issuance of the directive, the majority of those directors were already doing some clinical work. However they disagreed that by doing clinical work they could help overcome the problem of shortage of doctors. They agreed that the duration of 10 hours per week is suitable to do clinical duties. In term of confidence in giving curative treatment, the Hospital Directors especially those from district hospitals without specialists were confident in giving curative care to individuals. As for the clinicians, the majority felt that the implementation of the directive for Hospital Directors to do clinical work will not disrupt the clinicians' routine duties.
Study site: University Malaya, Universiti Kebangsaan Malaysia; Hospital Kuala Lumpur, Malaysia

Matched MeSH terms: Specialization

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