Displaying publications 481 - 500 of 704 in total

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  1. Paxman JM
    IGCC News, 1979 Apr;4(4):1-3.
    PMID: 12179400
    PIP: A great deal of attention is being devoted to the use of nonphysicians to provide such fertility control services as contraception, sterilization, and abortion. Legal obstacles exist, however, which must be overcome before the role of nonphysicians can be expanded. Such obstacles include medical practice statutes, nursing and midwifery legislation, and laws and regulations directly related to such fertility control measures as the provision of contraceptions and the performance of sterilizations. On the other hand, the following 3 main approaches have been used to permit increased participation of nonphysicians: delegation of tasks by physicians, liberal interpretation of existing laws, and authorization. Thus, the important elements in expanding the roles of nonphysicians are 1) authorization; 2) training; 3) qualification; 4) supervision; and 5) opportunities for referrals to physicians. The ultimate role of paramedicals will depend upon the continued simplification of technology, the results of research on the quality of care which they can provide, the attitudes of the medical profession, and the elimination of the legal ambiguities and obstacles which exist.
    Matched MeSH terms: Physicians*
  2. Rajaratnam K, Xiang YT, Tripathi A, Chiu HF, Si TM, Chee KY, et al.
    J Clin Psychopharmacol, 2016 Dec;36(6):716-719.
    PMID: 27753726
    In this study, we sought to examine factors associated with dosing of antidepressants (ADs) in Asia. Based on reported data and clinical experience, we hypothesized that doses of ADs would be associated with demographic and clinical factors and would increase over time. This cross-sectional, pharmacoepidemiological study analyzed data collected within the Research Study on Asian Psychotropic Prescription Pattern for Antidepressants from 4164 participants in 10 Asian countries, using univariate and multivariate methods. The AD doses varied by twofold among countries (highest in PR China and RO Korea, lowest in Singapore and Indonesia), and averaged 124 (120-129) mg/d imipramine-equivalents. Average daily doses increased by 12% between 2004 and 2013. Doses were significantly higher among hospitalized patients and ranked by diagnosis: major depression > anxiety disorders > bipolar disorder, but were not associated with private/public or psychiatric/general-medical settings, nor with age, sex, or cotreatment with a mood stabilizer. In multivariate modeling, AD-dose remained significantly associated with major depressive disorder and being hospitalized. Doses of ADs have increased somewhat in Asia and were higher when used for major depression or anxiety disorders than for bipolar depression and for hospitalized psychiatric patients.
    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
  3. Said AH, Chia YC
    BMJ Open, 2017 03 01;7(3):e013573.
    PMID: 28249849 DOI: 10.1136/bmjopen-2016-013573
    OBJECTIVES: Dyslipidaemia is one of the main risk factors for cardiovascular disease, the leading cause of death in Malaysia. This study assessed the awareness, knowledge and practice of lipid management among primary care physicians undergoing postgraduate training in Malaysia.

    DESIGN: Cross sectional study.

    SETTING: Postgraduate primary care trainees in Malaysia.

    PARTICIPANTS: 759 postgraduate primary care trainees were approached through email or hard copy, of whom 466 responded.

    METHOD: A self-administered questionnaire was used to assess their awareness, knowledge and practice of dyslipidaemia management. The total cumulative score derived from the knowledge section was categorised into good or poor knowledge based on the median score, where a score of less than the median score was categorised as poor and a score equal to or more than the median score was categorised as good. We further examined the association between knowledge score and sociodemographic data. Associations were considered significant when p<0.05.

    RESULTS: The response rate achieved was 61.4%. The majority (98.1%) were aware of the national lipid guideline, and 95.6% reported that they used the lipid guideline in their practice. The median knowledge score was 7 out of 10; 70.2% of respondents scored 7 or more which was considered as good knowledge. Despite the majority (95.6%) reporting use of guidelines, there was wide variation in their clinical practice whereby some did not practise based on the guidelines. There was a positive significant association between awareness and the use of the guideline with knowledge score (p<0.001). However there was no significant association between knowledge score and sociodemographic data (p>0.05).

    CONCLUSIONS: The level of awareness and use of the lipid guideline among postgraduate primary care trainees was good. However, there were still gaps in their knowledge and practice which are not in accordance with standard guidelines.

    Matched MeSH terms: Physicians/statistics & numerical data*
  4. Kruger D, Dlamini NN, Meyer JC, Godman B, Kurdi A, Lennon M, et al.
    Hosp Pract (1995), 2021 Aug;49(3):184-193.
    PMID: 33566710 DOI: 10.1080/21548331.2021.1889213
    OBJECTIVE: Determining antimicrobial utilization patterns in hospitals can be a challenge given personnel and resource constraints with paper-based systems. A web-based application (APP) was developed in South Africa to address this, building on a recent point prevalence survey (PPS) using a paper-based system. Consequently, there was a need to test and evaluate the ease of use of a newly developed app and potential time saving versus paper-based methods for PPS. The findings can be used to further refine the APP.

    METHODS: The developed app was tested in a large academic public hospital in a PPS in South Africa. During data collection, the app was evaluated for functionality on 35 variables and subsequently refined. After data collection, the app was evaluated in terms of its time-saving potential and ease of use.

    RESULTS: 181 patient's files were surveyed across 13 wards in the hospital, with the antimicrobial usage findings similar to the previous paper-based study in the same hospital. The median age for males was 45.5 years and 42 years for females. Overall 80 out of 181 (44%) patients received antibiotics. Whilst 38% (12 out of 31) of patients in the adult surgical ward received antimicrobials, the prevalence was the highest (78%) in the pediatric medical wards. All the data collectors were confident in using the app after training and found the tool is not complex at all to use. In addition, the time taken to plan for the study and to collect data was considerably reduced. Reduced time spent in data collection and analysis is important for timely instigation of quality improvement programs in resource limited settings.

    CONCLUSIONS: All data collectors would recommend the app for future PPSs. Several concerns with data entry were identified, which have now been addressed. The app development has been successful and is now being deployed across South Africa as part of a national PPS as well as wider.

    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*
  5. Xiang YT, Kreyenbuhl J, Dickerson FB, Ungvari GS, Wang CY, Si TM, et al.
    Aust N Z J Psychiatry, 2012 Dec;46(12):1159-64.
    PMID: 22790175 DOI: 10.1177/0004867412453625
    This study examined the prescribing patterns of several first- (FGAs) and second-generation antipsychotic (SGAs) medications administered to older Asian patients with schizophrenia during the period between 2001 and 2009.
    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*
  6. Dhabali AA, Awang R, Zyoud SH
    J Clin Pharm Ther, 2012 Aug;37(4):426-30.
    PMID: 22081958 DOI: 10.1111/j.1365-2710.2011.01314.x
    WHAT IS KNOWN AND OBJECTIVE: Drug-drug interactions (DDIs) cause considerable morbidity and mortality worldwide and may lead to hospital admission. Sophisticated computerized drug information and monitoring systems, more recently established in many of the emerging economies, including Malaysia, are capturing useful information on prescribing. Our aim is to report on an investigation of potentially serious DDIs, using a university primary care-based system capturing prescription records from its primary care services.
    METHODS: We retrospectively collected data from two academic years over 20 months from computerized databases at the Universiti Sains Malaysia (USM) from users of the USM primary care services.
    RESULTS AND DISCUSSION: Three hundred and eighty-six DDI events were observed in a cohort of 208 exposed patients from a total of 23,733 patients, representing a 2-year period prevalence of 876·4 per 100,000 patients. Of the 208 exposed patients, 138 (66·3%) were exposed to one DDI event, 29 (13·9%) to two DDI events, 15 (7·2%) to three DDI events, 6 (2·9%) to four DDI events and 20 (9·6%) to more than five DDI events. Overall, an increasing mean number of episodes of DDIs was noted among exposed patients within the age category ≥70 years (P=0·01), an increasing trend in the number of medications prescribed (P<0·001) and an increasing trend in the number of long-term therapeutic groups (P<0·001).
    WHAT IS NEW AND CONCLUSION: We describe the prevalence of clinically important DDIs in an emerging economy setting and identify the more common potentially serious DDIs. In line with the observations in developed economies, a higher number of episodes of DDIs were seen in patients aged ≥70 years and with more medications prescribed. The easiest method to reduce the frequency of DDIs is to reduce the number of medications prescribed. Therapeutic alternatives should be selected cautiously.

    Study site: e Universiti Sains Malaysia (USM
    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
  7. Dhabali AA, Awang R, Hamdan Z, Zyoud SH
    Int J Clin Pharmacol Ther, 2012 Dec;50(12):851-61.
    PMID: 23006441 DOI: 10.5414/CP201689
    OBJECTIVES: The objectives of this study were 1) to obtain information regarding the prescribing pattern of nonsteroidal anti-inflammatory drugs (NSAIDs) in the primary care setting at a Malaysian university, 2) to determine the prevalence and types of potential NSAID prescription related problems (PRPs), and 3) to identify patient characteristics associated with exposure to these potential PRPs.
    METHODS: We retrospectively collected data from 1 academic year using the electronic medical records of patients in the University Sains Malaysia (USM) primary care system. The defined daily dose (DDD) methodology and the anatomical therapeutic chemical (ATC) drug classification system were used in the analysis and comparison of the data. Statements representing potential NSAID PRPs were developed from authoritative drug information sources. Then, algorithms were developed to screen the databases for these potential PRPs. Descriptive and comparative statistics were used to characterize DRPs.
    RESULTS: During the study period, 12,470 NSAID prescriptions were prescribed for 6,509 patients (mean ± SD = 1.92 ± 1.83). This represented a prevalence of 35,944 per 100,000 patients, or 36%. Based on their DDDs, mefenamic acid and diclofenac were the most prescribed NSAIDs. 573 potential NSAID-related PRPs were observed in a cohort of 432 patients, representing a prevalence of 6,640 per 100,000 NSAIDs users, or 6.6% of all NSAID users. Multivariate logistic regression analysis revealed that patients with a Malay ethnic background (p < 0.001), members of the staff (p < 0.001), having 4 or more prescribers (p < 0.001) or having 2 - 3 prescribers (p = 0.02), and representing 4 or more long-term therapeutic groups (LTTGs) (p < 0.001) or 2 - 3 LTTGs (p < 0.001) were significantly associated with an increased chance of exposure to potential NSAID related PRPs.
    CONCLUSIONS: This is the first study in Malaysia that presents data on the prescribing pattern of NSAIDs and the characteristics of potential NSAID-related PRPs. The prevalence of potential NSAID-related PRPs is frequent in the primary care setting. Exposure to these PRPs is associated with specific sociodemographic and health status factors. These results should help to raise the awareness of clinicians and patients about serious NSAID PRPs.

    Study site: University Sains Malaysia (USM) primary care system.
    Matched MeSH terms: Practice Patterns, Physicians'*
  8. Lee SL, Azmi S, Wong PS
    Med J Malaysia, 2012 Apr;67(2):190-8.
    PMID: 22822642 MyJurnal
    A cross-sectional study was conducted to explore clincians' baseline knowledge, practice beliefs and acceptance of intravenous (IV)-to-oral antibiotic switching practice in Hospital Pulau Pinang. The factors most highly rated for antibiotic conversion were the ability to maintain oral intake (85.6%) and microbiology etiology (85.0%). Majority of the clinicians (76%) agreed with the traditional clinical rule that "patient should be afebrile for 24 hours before IV-to-oral switch". Specialists and consultants had the highest knowledge score among the clinicians. However, they were generally less positive about a guideline being integrated into practice.
    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*
  9. Aftab RA, Khan AH, Syed Sulaiman SA, Ali I, Khan K
    Am J Med Sci, 2014 Nov;348(5):357-61.
    PMID: 25118657 DOI: 10.1097/MAJ.0000000000000269
    BACKGROUND: The insufficient adoption of internationally accepted clinical guidelines may lead to less than adequate patient care of patients with asthma.
    OBJECTIVE: To evaluate the knowledge and treatment compliance with Global Initiative of Asthma (GINA, 2011) asthma treatment guidelines among emergency physicians (EPs) at a referral hospital in northern Malaysia.
    METHODS: A cross-sectional study was designed in the territory-level referral hospital in northern Malaysia. Twenty-seven EPs were asked to complete an asthma guideline questionnaire to assess their knowledge regarding GINA 2011 asthma treatment guidelines. A total of 810 patients were enrolled, and 30 patients were selected per physician. The authors evaluated the physicians' compliance with GINA 2011 asthma treatment guidelines.
    RESULTS: Of 27 EPs, 20 (74.1%) had adequate knowledge of GINA 2011 asthma treatment guidelines. A total of 615 (75.9%) patients received guideline-recommended emergency treatment. Shortness of breath (n = 436, 53.8%) was the most frequently reported chief complaint. Furthermore, there was a significant but weak association between knowledge of the guideline and treatment compliance among emergency doctors (P = 0.003, φ = 0.110). Moreover, there was no significant change in therapy for patients with comorbid conditions. The mean age of respondents was 27.3 years.
    CONCLUSIONS: Overall, a fair level of guideline knowledge and treatment compliance was noted among EPs. Doctors with adequate guideline knowledge were more likely to comply with GINA 2011 asthma treatment guidelines.
    Matched MeSH terms: Physicians/standards*
  10. Ahmadian M, Samah AA, Saidu MB
    Asian Pac J Cancer Prev, 2014;15(12):5097-105.
    PMID: 24998591
    Knowledge of health and community psychology in health professionals influences psychosocial and community determinants of health and promoting participation in disease prevention at the community level. This paper appraises the potential of knowledge on psychology in health care professionals and its contribution to community empowerment through individual behavior change and health practice. The authors proposed a schematic model for the use of psychological knowledge in health professionals to promote participation in health interventions/disease prevention programs in developing countries. By implication, the paper provides a vision on policies towards supporting breast cancer secondary prevention efforts for community health development in Asian countries.
    Matched MeSH terms: Practice Patterns, Physicians'*
  11. Fatokun O
    Int J Clin Pharm, 2014 Jun;36(3):564-9.
    PMID: 24700341 DOI: 10.1007/s11096-014-9937-6
    BACKGROUND: In Malaysia, antibacterial agents are among the most utilized drugs. There has been an increase in their use in recent years, contributing to an increase of antimicrobial resistance (AMR).

    OBJECTIVES: This study explores the pattern of antibiotic use and practices in a Malaysian community and identifies the variables associated with a likelihood of non-compliance with a course of antibiotic treatment.

    SETTING: The study was conducted in Cheras, a community located to the south-east of Kuala Lumpur, the capital city of Malaysia.

    METHOD: A cross-sectional survey was conducted with 250 individuals, using an interviewer-administered questionnaire in Cheras, Kuala Lumpur, Malaysia.

    MAIN OUTCOME MEASURES: Frequency of antibiotic use, sources of antibiotics, use of antibiotics without prescription, discontinuation of antibiotic treatment, antibiotic resistance awareness, handling of unused antibiotics, and association between respondents characteristics and compliance with a course of antibiotic treatment.

    RESULTS: Approximately 36 % of the participants (n = 91) had taken antibiotics in the year of the study. The majority (66.8 %) obtained antibiotics from clinics. Almost 80 % of the participants had never obtained antibiotics without a doctor's prescription. Nearly 55 % discontinued the course of antibiotics once symptoms disappeared. The most common method of disposing leftover antibiotics was throwing them into the household rubbish bin (78.8 %). Only 6.4 % of participants returned leftover antibiotics to the pharmacist or doctor. Univariate analysis revealed that male gender (p = 0.04), lack of knowledge of antibiotic functions (p < 0.0001), and lack of awareness of antibiotic resistance (p < 0.0001) were all significantly associated with a greater likelihood of non-compliance with a full course of prescribed antibiotic treatment.

    CONCLUSION: Most individuals in the Malaysian community obtained antibiotics through prescription. Non-completion of a course of antibiotic treatment and improper disposal of unused antibiotics need to be addressed to prevent AMR. Male gender, lack of knowledge and awareness of antibiotics and resistance were significantly associated with a greater likelihood of non-compliance with a full course of prescribed antibiotic treatment. Therefore, patient education and counselling about antibiotics and antibacterial resistance is very important to enhance compliance to antibiotic therapy.

    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data
  12. Karim SA, Ibrahim B, Tangiisuran B, Davies JG
    JPEN J Parenter Enteral Nutr, 2015 May;39(4):482-8.
    PMID: 24590009 DOI: 10.1177/0148607114525209
    Malnutrition is one of the health problems that can be prevented by appropriate nutrition care provided by healthcare providers. However, this practice is still lacking possibly because of the providers' inadequate knowledge. The aim of this study was to evaluate the self-reported knowledge, attitudes, and practices of pharmacists and doctors toward nutrition support in a tertiary care hospital setting.
    Matched MeSH terms: Physicians*
  13. Valayatham V
    Med J Malaysia, 2012 Aug;67(4):399-401.
    PMID: 23082449 MyJurnal
    AIM: We audited indications and outcomes of antiphospholipid syndrome (APS) screening in the pregnant population at our centre.
    METHOD: Prospective and observational. All APS test results returned were audited for validity of indication and subsequent outcome.
    RESULT: 24 of a total of 146 (16%) of requests for the antiphospholipid antibodies and lupus anticoagulant were not indicated. Two positive results returned for a total of 116 "indicated" requests (1.7%).
    CONCLUSION: There needs to be increased awareness among obstetricians on the indications for screening for antiphospholipid syndrome (APS). The prevalence of antiphospholipid syndrome with obstetric manefestations in the study population is lower than rates published in the literature.
    Matched MeSH terms: Practice Patterns, Physicians'/standards*
  14. Tong SF, Low WY, Ismail SB, Trevena L, Willcock S
    Fam Pract, 2011 Jun;28(3):307-16.
    PMID: 21115986 DOI: 10.1093/fampra/cmq101
    BACKGROUND: Although prevalent in primary care settings, men's health issues are rarely discussed. Yet, primary care doctors (PCDs) are well positioned to offer health check-ups during consultations.
    OBJECTIVES: This study aims to develop a substantive theory to explain the process of decision making by which PCDs engage men in discussing health check-ups.
    METHODS: Grounded theory method was adopted. Data source was from 14 in-depth interviews and 8 focus group discussions conducted with a semi-structured guide. Interviews were recorded and transcribed verbatim for analysis. Initial open coding captured the concepts of processes from the data, followed by selective and theoretical coding to saturate the core category. Constant comparative method was used throughout the process to allow emergence of the theory.
    RESULTS: Fifty-two PCDs from private and public settings were interviewed. PCDs engaged male patients in health check-ups when they associated high medical importance with the relevant issues. The decision to engage men also depended on perceived chances of success in negotiations about health check-ups. A high chance of success, associated with minimal negotiation effort, is associated with men being most receptive to health check-ups. When doctors feel the importance of a particular health issue, they place less emphasis on their perceived men's receptivity to discuss that health issue in their intention to engage them in discussing it.
    CONCLUSIONS: Engaging male patients in appropriate health check-up activities requires a series of actions and decisions by the PCDs. The decision to engage the patient depends on the perceived balance between the receptivity of male patients and the medical importance of the issues in mind.
    Matched MeSH terms: Physicians, Primary Care/psychology*
  15. Chow SN, Soon R, Park JS, Pancharoen C, Qiao YL, Basu P, et al.
    Vaccine, 2010 May 14;28(22):3809-17.
    PMID: 20347631 DOI: 10.1016/j.vaccine.2010.03.027
    To determine why HPV vaccination uptake is low in Asia, we surveyed attitudes, knowledge and communication about cervical cancer and HPV vaccination amongst 480 physicians and 1617 randomly selected urban mothers who could afford HPV vaccines in Korea, Malaysia, Taiwan and Thailand. HPV vaccine rejection by mothers was linked with poor knowledge and low perceptions of self-relevance. Physicians' likelihood of raising the subject and/or recommending vaccination was linked to how proactively they advocate preventive health, their attitude to the subject's sensitivity and their knowledge levels. Because most Asian mothers seek doctors' advice and prefer them to take the initiative, physicians should be more proactive in discussing and recommending HPV vaccination.
    Matched MeSH terms: Physician-Patient Relations; Physicians*
  16. Akter SF, Heller RD, Smith AJ, Milly AF
    J Infect Dev Ctries, 2009 Jul 01;3(6):447-51.
    PMID: 19762958
    BACKGROUND: Antimicrobials are often used inappropriately in paediatric wards of medical college hospitals in Bangladesh. Most of the antimicrobials are prescribed based on clinical grounds-signs and symptoms. This intervention study assessed the effectiveness of a training intervention on antimicrobials prescribing by physicians in paediatric wards of tertiary care level hospitals.

    METHODOLOGY: This study was conducted at medical college hospitals in Bangladesh during the period from 1998 through 2000. The pre-intervention survey of antimicrobial use was conducted during 1998 in five hospitals. The post-intervention survey was conducted after the interactive training during the succeeding year in three of the original five hospitals, of which one was the intervention hospital and two control hospitals. A total of 3,466 admitted paediatric patients' treatment charts (2,171 in the pre-intervention and 1,295 in the post-intervention surveys) were reviewed.

    RESULTS: The most commonly used antimicrobials were ampicillin, gentamicin, amoxicillin, cloxacillin and ceftriaxone. Appropriate antimicrobial therapy for the most common infectious diseases, pneumonia and diarrhoea, increased by 16.4% and 56.8% respectively in the intervention hospital compared with the two control hospitals and these improvements were significant (p = < 0.001 and p = 0.002, for pneumonia and diarrhoea respectively).

    CONCLUSIONS: An interactive, focussed educational intervention, targeted at physicians, appears to have been effective in improving appropriate antimicrobial prescribing for the most common paediatric infectious diseases in a medical college hospital in Bangladesh.

    Matched MeSH terms: Physicians*
  17. Han GS, Davies C
    Ethn Health, 2006 Nov;11(4):409-30.
    PMID: 17060035 DOI: 10.1080/13557850600824054
    This paper investigates the use and provision of biomedicine among Korean-Australian men on the basis of interview data from all of the eight Korean-speaking doctors practising in the Korean community in Sydney in 1995. From the viewpoint of these general practitioners, an analysis is made of the processes Korean men go through in adjusting to a new country, being involved in constant hard manual work and long working hours, and explores how they make use of all available resources to stay healthy. The Korean men have fully utilized the 'freely' available medical services under government-subsidized Medicare, bearing in mind that health is a capacity to work under the current environment, although illegal migrants restrained themselves from using it until they obtained legal status. Korean-speaking medical practitioners have been able to provide their fellow Koreans with 'culturally appropriate' health care, with the key factor being the absence of a language barrier. The level of patient satisfaction is high, possibly due to the excellent understanding the doctors have of the social aspects of illnesses, although the doctors do not go beyond curative medicine in their practice. However, the increasing number of Korean-speaking doctors in the small Korean community means that there is competition for patients. Consequently, the medical care is highly entrepreneurial. Referral by Korean doctors to practitioners of Korean herbal medicine is also a notable feature of the health care sector of the Korean community, especially as this offers Korean patients 'satisfactory' health relief for problems that are not easily relieved by doctors in the biomedical system.
    Matched MeSH terms: Physicians, Family/psychology*
  18. Balachandran R, Philip R, Avatar S, Simon R, Mann GS, Benedict CT, et al.
    Eur Arch Otorhinolaryngol, 2012 Feb;269(2):649-58.
    PMID: 21691719 DOI: 10.1007/s00405-011-1665-0
    Nasopharyngeal carcinoma (NPC) is among the commonest cancers in Malaysia. The prognosis for NPC like most other head and neck cancer is dependent on its staging. Majority of patients in Malaysia at the time of diagnosis are either at stage III or IV (27 and 47%, respectively). The lack of knowledge among primary care medical doctors regarding NPC may contribute to this delay in diagnosis. The aim of this study was to assess the knowledge of the primary care doctors in the state of Perak on the various aspects of NPC. The doctors at the primary care level in the state of Perak were recruited to take part in this study on a voluntary basis. A total number of 154 out of 198 doctors participated in this survey. They were given a questionnaire to fill in to test their knowledge on different aspects of NPC and its treatment. The overall respondents' score was poor with a score of 67.5% on all sections. The doctors appear to be able to identify common presenting features of NPC with a mean score of 85.3% but for the uncommon presentations of NPC, the scores were poorer with 61.8%. In addition, 54.1% of the participants answered that they would refer a patient with symptoms suspicious of NPC after a period of 1 month from the onset of symptom. However, only 34% would refer within 2 weeks. Based on the results of this study, the authors feel that it is clear that the doctors posted in the primary care hospitals and clinics appear to have inadequate knowledge to diagnose and refer patients with suspected NPC. As early diagnosis can often lead to a better prognostic outcome, steps must be taken to raise the awareness among these doctors.
    Matched MeSH terms: Physicians, Primary Care/education*
  19. Kanchanachitra C, Lindelow M, Johnston T, Hanvoravongchai P, Lorenzo FM, Huong NL, et al.
    Lancet, 2011 Feb 26;377(9767):769-81.
    PMID: 21269674 DOI: 10.1016/S0140-6736(10)62035-1
    In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues.
    Matched MeSH terms: Physicians/statistics & numerical data
  20. Poh KK, Tan HC, Yip JW, Lim YT
    Singapore Med J, 2005 Aug;46(8):407-13.
    PMID: 16049611
    The pattern of use of abciximab in real-life clinical patients undergoing percutaneous coronary intervention (PCI) in 11 high-volume centres in Singapore, Malaysia, Thailand, Philippines, India, Pakistan and Korea was prospectively examined.
    Matched MeSH terms: Practice Patterns, Physicians'/statistics & numerical data*
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