Client satisfaction upon health services is important for public especially for those who have to undergo treatment for tuberculosis (TB) noted for its difficult regime. The purpose of this study is to measure client dissatisfaction level towards TB treatment & services among TB patients in government outpatient health services and the factors that influenced it. This study was carried out in all the districts of West Coast Division of Sabah. It was conducted from June 2002 to November 2002. Study design is cross-sectional, with population samples taken on those who are currently receiving outpatient TB treatment in government health facilities. Questionnaires forms were used as study tool and filled by either by respondent or through the help of trained interviewer. The outcome is based on the total score obtained through Likert scales to determine the proportion of dissatisfied group from the respondents. A total of 488 patients took part in this study. Results of study showed overall percentage of 31.8% dissatisfaction level towards TB
treatment & services, while dissatisfaction towards TB treatment and upon health services alone were 54.3% and 24.0% respectively. The predictive factors for client dissatisfaction towards TB treatment and services are those without education, longer waiting time and have opinion of insufficient number of health staff.
Key words: Tuberculosis, client satisfaction, TB treatment, services, Sabah.
Study site: Outpatient clinics, hospitals, Sabah, Malaysia
Objective: This case report highlights the optimum end-of-life care of an adolescent dying of cancer. Method: We report our experience, as part of a multidisciplinary team in managing the cancers of a female student who died an untimely death at the age of 15. Results: Our role of motivating her for chemotherapy of her initial treatable carcinoma, became that of palliative care upon discovery of a second malignancy. We helped the patient “live life to the fullest” during her last days, she helped us realize that helping her master the tasks of adolescence was optimum “end-of-life care” as well. Conclusion: to help an ill adolescent die with dignity is to help her live whatever time she has left of her life. Allowing her to participate in decisions regarding her treatment and in other bio-psycho-social needs of that stage of life is crucial in helping her prepare for the end of life.
A 15-year–old Malay male with congenital insensitivity to pain presented with recurrent septic arthritis of the left knee complicated by osteomylitis. Repeated arthrotomy and wound debridement was done, however, the condition was not resolved. Amputation was suggested as the best method of treatment to eradicate the infection.
This study compared bite force in adults older than 60 years with that of young adults. The participants were 20 healthy adults (9 men) older than 60 years (median age, 66 years) and 44 healthy young adults (22 men; age range, 18-25 years; median age, 22 years) at the International Medical University, Malaysia. All participants had at least 20 teeth, and bite force was measured and evaluated using the Dental Prescale system. Average (SD) bite force was 420.5 (242.0) N for the older adults and 541.4 (296.3) N for the young adults. Although mean bite force was higher for the young adults, the difference was not significant. These findings suggest that bite force is unaffected by age in adults with adequate dentition. (J Oral Sci 58, 361-363, 2016).
The relative age effect (RAE) is the effects of differences between athletes born in the early compared to the later months of the year. This study investigated the presence of RAE among 306 age-group swimmers competing in the 2014 Malaysian Schools Sports Competition (MSSM). Participants’ birthdates were grouped according to four birth quartiles (Q1- Jan to Mar; Q2- Apr to June; Q3 – July to September; Q4 – October to December). Data analyzed using chi-squared goodness-of-fit showed there was a significant difference among overall male but not for the female swimmers. There was a presence of RAE in the U-12 and U-15 but none in the U-18 boys’ category. Further analyses on the medal winners showed no RAEs on both gender. Physical attributes of the male swimmers, especially the early adolescents are suggested to influence the relative age effects in swimming.
BACKGROUND: The main aim of this study is to utilize the geographical information system (GIS) software and perform the spatial analysis in relation to clinical data for road traffic injury (RTI) pediatric cases attending the emergency department.
METHODS: The study sample included pediatric patients (age less than 18 years) with road-related injuries within a district in Malaysia who attended emergency departments of two tertiary hospitals within the district. In addition to injury, pre-hospital care and outcome data, the coordinate of the locations were obtained by the ambulance paramedics by using portable handheld GPS unit brand Garmin(®) model GPS 72 H. The data was transferred into the excel format which in turn underwent GIS analysis by using ARCGIS(®) (by ESRI) software version 10.1 licensed to the study institution.
RESULTS: A total of 102 (24.8%) of all motor vehicle crash (MVC) victims involved the pediatric age group (age 18 years and below). The mean (SD) age of the pediatric victims was 14.30 years (SD 3.830). Male comprised of 68 (66.7%) of the cases. Motorcyclists [88 (88.0%)] were the most common type of victims involved. Interestingly, the majority of the severely injured victims [75 (73%)] sustained the RTI on roads with maximum speed limit of 60 km/hour. The mean (SD) length of hospital stay was 7.83 days (5.59).
CONCLUSION: The pediatric related road traffic injury in Malaysia causes significant health and social burden in the country. This study showed both important clinical and geographical factors that need to be taken into consideration for future preventive action.
KEYWORDS: Geographical information system; Geospatial; Injury; Pediatric; Road safety
The objective of this research is to develop an “energy” snack bar supplying energy and
electrolytes in one bar by utilizing local Malaysian ingredients. The local ingredients used to make
this snack bar were banana, glutinous rice flour, and coconut milk. It is a wholesome nutritious
food for different age groups from adolescents to elderly people. Proximate composition, total
carbohydrate, energy value, and sensory quality of prototype were determined. The developed
snack bar contains 13.23% of moisture, 1.13% of ash, 6.36% of crude protein, 22.39% of
crude fat, 1.16% of crude fibre, 56.89% of total carbohydrate, and 454.51 kcal of energy. The
“energy” snack bar was highly acceptable with desirable sensory quality by all consumers.
Missed Monteggia fracture leading to chronic radial head dislocation is a known complication. The surgical treatment options remain challenging. The aim of treatment is to reduce the radial head and to maintain the stability of the elbow in all ranges of motion. A few surgical techniques have been described with complications. We report the case of a 13 years old boy with chronic radial head dislocation as a result of an unrecognised Monteggia fracture-dislocation for eight years. We successfully reduced the radial head and corrected the cubital valgus from 45 degrees to 10 degrees with a proximal ulna osteotomy and gradual distraction with 2-pin Monotube external fixator. The correction was uneventful with good functional outcome.
This paper examines relationship between media literacy and the Theory of Planned Behavior (TPB) variables focusing on consumption of soft drink among adolescents in Klang Valley, Malaysia. In addition, this paper also determines soft drink consumption, level of media literacy and the influences of the TPB variables on the intention of soft drink consumption. A cluster sampling method was used in collecting data within the Klang Valley area. The sample consisted of 436 adolescents from secondary school, aged between 13 to 18 years old. Two main scales utilized were Media Literacy (ML) scale and TPB scale. The descriptive, multiple linear regression and Pearson product-moment correlation analyses were carried out to answer the research objectives. Results revealed that 36% of respondents drank a minimum of 1 can, bottle or glass of soft drink for the past seven days and possess good level of media literacy (35%). Meanwhile, 14% of variance in adolescents’ intention of soft drink consumption is explained by TPB variables. Additionally, the total media literacy score towards soft drink advertisement was significantly positively correlated with attitude (r = 0.250, p
Juvenile hypertrophy of the breast (JHB) is a rare and relentless disease affecting women in the peripubertal period. We present a 13-year-old girl with massive bilateral JHB, successfully treated with a breast reduction and free nipple graft technique. A total of 7300 grams of breast tissue had been removed, accounting for 14.9% of the patient's total body weight. Prophylactic hormonal therapy was not commenced. During the 5-year follow-up period, there was no recurrence and the patient remains satisfied with the aesthetic outcome. A recent meta-analysis study indicates that subcutaneous mastectomy is associated with reduced risk of recurrence, but it is more deforming and the aesthetic result is inferior to a reduction mammaplasty. In patients treated with the latter technique, some evidence exists suggesting that the use of a free nipple graft is associated with a less frequent risk of recurrence than a pedicle technique. This present case is unique as it demonstrates the clinical course of this patient at a considerably longer follow-up period than most reported studies. We adhered to the limited available evidence and highlight the long-term reliability of breast reduction with free nipple grafting as the first line surgical option in JHB, eliminating the need for repeated surgeries.
Giant cell tumour in the metatarsal of a skeletally immature person is uncommon. Adequate surgical resection in this region can be difficult to achieve as there is little space between the rays of the foot. Furthermore, there is the challenge of restoring the metatarsophalangeal articulation after resection of the tumor. We describe a technique using non-vascularised fibular graft for reconstructing the 2nd metatarsal after en-bloc resection for giant cell tumour in a 14 year old adolescent female.
Introduction: Family Environment Scale (FES) was developed by Moos1, has ten subscales and was categorized into three dimensions.Objective:The objective of this study was to develop factor structure for the Malay-translated version of the FES subscales. Methodology: The study used Malay translated version of FES by Khairani et. al2. This study was a multi centre, cross-sectional study, involving four secondary schools consisted of adolescents, aged between 12-17 years old and a total of 295 participants were enrolled in this study. Exploratory factor analyses was done across two groups of analysis set on the subscales with Cronbach’s alpha more than 0.50 and 0.53 respectively. Results: Two distinct factors were extracted across the four subscales consisted of Cohesion, Conflict and Organization in factor 1 and only Control in factor 2. Conclusion: The finding indicated that element of Cohesion, Conflict and Organization has a good indicator of a good family relationship.
A late adolescent patient presented with a Class III malocclusion on a skeletal Class III base, complicated by severe upper arch and moderate lower arch crowding, reverse overjet, anterior and bilateral posterior crossbites with displacement, proclined upper incisors, retroclined lower incisors, distally tipped lower canines and non-coincident centrelines. Treatment was undertaken on an extraction basis by employing the use of an upper removable appliance with Z-springs and posterior bite blocks to correct the anterior crossbite, quad helix and jockey arch for arch expansion, and pre-adjusted edgewise fixed appliance to level and align, space closure and achieve a mutually protective functional occlusion. This paper discussed the rational and evidences behind the treatment employed.