The Aging Male Symptoms Scale (AMS) measures health-related quality of life in aging men. The objective of this paper is to describe the translation and validation of the AMS into Bahasa Melayu (BM). The original English version of the AMS was translated into BM by 2 translators to produce BM1 and BM2, and subsequently harmonized to produce BM3. Two other independent translators, blinded to the English version, back-translated BM3 to yield E2 and E3. All versions (BM1, BM2, BM3, E2, E3) were compared with the English version. The BM pre-final version was produced, and pre-tested in 8 participants. Proportion Agreement, Weighted Kappa, Spearman Rank Correlation Coefficient, and verbatim responses were used. The English and the BM versions showed excellent equivalence (weighted Kappa and Spearman Rank Coefficients, ranged from 0.72 to 1.00, and Proportion Agreement values ranged from 75.0% to 100%). In conclusion, the BM version of the AMS was successfully translated and adapted.
Purpose of the present study was to assess effect of work-family conflict (along with its four dimensions) on physical health status. In particular, we examined the mediating role of health related behaviors on the linkage between all dimensions of work-family conflict and physical health status. The current cross-sectional research was conducted among 567 women who were working in the public departments of Malaysia. Self-administrated questionnaire was used for data collection. Our findings showed that work-family conflict (along with its four dimensions) significantly and negatively correlated with physical health status. The findings from mediational analysis showed that all dimensions of work-family conflict indirectly deteriorate physical health status via increasing the chance of not using food strategies. However, our results did not support the mediating function of physical activity on the proposed relationship. Results of the current study indicated that women with greater level of work-family conflict are more likely to suffer from poor physical health status. Having multiple strategies for managing food and eating reduce the adverse effect of work-family conflict on physical health. Organizations may benefit from Family Friendly Policies (FFP) that can alleviate level of conflict and eventually avoid or decrease rate of engagement in unhealthy behavior that have detrimental effect on health status.
Caring practice is one of the three core values of Corporate Culture of Ministry of Health Malaysia, initiated in 1991. A cross sectional study was conducted to determine the extent of hospital healthcare personnel practicing the element of caring. Self-administered questionnaires were mailed to all staff working in public hospitals followed by reminder letters and telephone calls. A total of 37,267 responded out of 69,385 personnel working in the hospitals with a response rate of 53.7%. Results showed that about half of the respondents perceived that they practice caring value of the corporate culture (49.5%) and only 33.3% perceived that their colleagues practiced it. The practice of caring value was highest among clinical specialists (65.4%) and lowest among the clerks (22.1%). Nurses perceived that 40.4% of their colleagues practiced caring values while the clerks perceived only 17.0% of their colleagues practice it. In conclusion, caring value is not being well practiced by healthcare staff especially among the support staff. There is a need for further research to study the reasons for poor caring practice by healthcare personnel and develop strategies to improve the situation.
This is a cross sectional study to assess the performance of Putrajaya Health Clinic in meeting the client's expectation among 403 clients who came to seek medical treatment through a systematic random sampling in the month of July 2006. Our aim is not only to reduce dissatisfaction among clients but also try to meet their expectations; we have adopted SERVQUAL method which defined satisfaction as the difference between perceptions and expectations. We would also like to refer this dissatisfaction as not able to meet clients' expectations. It was found that there were only 6.9% of clients dissatisfied in Putrajaya Health Clinic, but they had not been able to meet 81.5% of clients' expectation. As for demographic characteristics, there appeared to be a significant association between client's satisfaction and age, gender, ethnicity and educational level. For outpatient's, the greatest dissatisfaction is in the dimension of Reliability. Clients were not happy with the waiting time at the clinic. Apart from recruiting more staff, management should develop a comfortable waiting environment to reduce the agony of waiting.
Dengue is a serious mosquito borne disease common in tropical and sub-tropical countries including Malaysia. There is at present a lack of specific treatment and an effective tetravalent vaccine against dengue. The control of dengue depends solely on the suppression of the two most important vectors namely, Aedes aegypti and Ae albopictus. Despite intensive and extensive control efforts by health agencies, the disease continues to spread. This paper updates various innovations on control of dengue vectors. Gene-based sterile insect technique using the RIDL technology for both Aedes aegypti & Ae albopictus control has now been actively researched and field trials are pursued to evaluate the effectiveness of the technology. The release of Wolbachia-infected Ae aegypti is another dengue control innovation. The infected mosquito cannot support development of dengue virus and has shorter life span. Other innovations include: auto-dissemination of insect control agents using ovitrap, autocidal adult and larva trap, outdoor residual spraying, insecticidal paint and biocontrol agent. In other innovation, outbreak prediction capability is enhanced by developing model based on environmental data and analysis utilising neural network.
Muslim doctors are those qualified doctors who practise their professional knowledge and skills in line with Islam and upholds the highest standards of ethical and professional behaviour. The medical curriculum of the Faculty of Medicine and Health Sciences of Universiti Sains Islam Malaysia (USIM) was designed with the integration of Islamic input which aims at producing doctors who are able to practise medicine that is integrated with Islamic, moral and ethical values. Halaqah Studies and Fundamental Islamic Knowledge (FIK) courses such as History of Medicine in Islam, Science and Medicine in Quran and Sunnah, Akhlak and Tasawuf, Islamic Jurisprudence and Medical Ethics and Fiqh Issues are taught to students during the pre-clinical and clinical phases. Memorization of selected Quranic verses throughout the programme aim to get the students to apply the verses of the al-Quran into practice in everyday life and especially in their clinical practice. Islamic values are emphasised during doctor-patient interactions in all clinical postings. Islamic knowledge and values integrated in the curriculum are assessed in written and clinical examinations. The outcome of the integration of the Naqli component in the medical curriculum has been demonstrated positively by the students in the patient management problems and clinical consultations. Studies on the outcome of the integrated Islamic input in the medical curriculum among the clinical students and graduates are being carried out.
Introduction: In Malaysia, medical specialisation training is mainly carried out by the public universities. Methods: A survey was carried out to explore the views of medical specialists in the country on issues such as structure of medical specialty training, availability of human resource, public/private sector competition, competency and apprenticeship, and its impact on assurance and quality of medical specialty training. Results: Altogether 238 medical specialists from 30 hospitals and medical institutions in the country participated in the survey. Conclusion: Among the findings, competition for human resource between public and private sector and lack of uniformity on medical specialty training across universities in the country are among the issues found to be of concern. There is also a need to address governance issue which necessitates to clearly delineating what constitutes medical specialty and what constitutes a subspecialty so that an agreed uniformed nomenclature is exercised across all stakeholders. The respondents also strongly agreed on the need to ensure competence in medical specialist training.
Leaves of Thottea dependens have been used as folk medicine in Malaysia for the treatment of
several conditions involving pain and inflammation with accompanying pyrexia. However, there is no scientific
evidence for its effectiveness to treat fever. Hence, the purpose of this study was to evaluate the anti-pyretic
activity of methanol (MeOH) and aqueous (Aq) extracts of T. dependens leaves in albino mice (ICR strain).
Purpose: To evaluate the usefulness of ultrasound guidance in percutaneous needle biopsy for musculoskeletal tumours.
Methods: Forty-five consecutive patients underwent ultrasound-guided needle biopsy. An additional group of 50 patients who underwent needle biopsy without ultrasound guidance was retrospectively selected as historical control. The sample was considered adequate when a diagnosis can be made, and diagnostic when the diagnosis is similar to the final report based on the excised tumour.
Results: Adequacy of the biopsy samples was 84% in ultrasound-guided group as compared 76% in the group with no ultrasound guidance. Diagnostic accuracy was 64% in the ultrasound-guided group and 52% in the group without ultrasound guidance. Both of these differences were not statistically significant.
Conclusions: Ultrasound guidance did not provide a significant advantage in the biopsy of musculoskeletal tumours. Diagnostic accuracy seems to improve with the use of larger 14 gauge biopsy needle but further evaluation is necessary.
In 1977, a female patient, aged 31y, presented with histiocytosis X in the right pelvis and was treated with radiotherapy. She presented again in 1999 at the age of 53y with a similar problem at the same location this time also involving the acetabulum. The affected right hip was treated with cemented total hip replacement. Two years postoperatively, the patient was pain free with no evidence of local recurrence or loosening of implant, thus demonstrating that total hip replacement is a viable treatment option for histiocytosis involving the hip.
Palmaris longus is a dispensable muscle with a long tendon which is very useful in reconstructive surgery. It is absent 2.8 to 24% of the population depending on the race/ethnicity studied. Four hundred and fifty healthy subjects (equally distributed among Malaysia's 3 major ethnic groups) were clinically examined for the presence or absence of palmaris longus. This tendon was found to be absent unilaterally in 6.4% of study subjects, and bilaterally in 2.9% of study participants. Malays have a high prevalence of palmaris longus absence at 11.3% followed closely by Indians at 10.7% whilst Chinese had a low absence rate of 6.0%.
Thyroid enlargement is one of the common surgical presentations in the Department of Surgery, Hospital Universiti Sains Malaysia (HUSM). Among them, benign non-toxic multinodular goiter constitutes one third (30%) of patients who underwent thyroidectomy. Common complications of thyroidectomy include recurrent laryngeal nerve (RLN) injury, hypocalcaemia, and recurrence of the thyroid lesion. Objective & Methods: This is a retrospective study of patients diagnosed with multinodular goiter treated in HUSM between January 1996 and December 2005. A total of 111 patients were studied and 52 of them underwent subtotal thyroidectomy while 59 underwent total thyroidectomy. The outcome in terms of RLN injury, hypocalcaemia and mass recurrence were analyzed. Results: Post operative complications were studied in both groups. Permanent recurrent laryngeal nerve injury occurs in 2.4% (1 case) in subtotal thyroidectomy group compared to total thyroidectomy group (3.6%, 2 cases). Five cases from total thyroidectomy group suffered from permanent hypocalcaemia but none in the other group. 70.7% (29 cases) from subtotal thyroidectomy group have functional remnant of thyroid tissue. Recurrence rate post subtotal thyroidectomy after 5 years is only 4.9% (2 cases). Conclusion: The post operative outcome in patients who underwent subtotal thyroidectomy in HUSM from January 1996 to
December 2005 was better than total thyroidectomy with significant functional thyroid remnant.
Background: The present study describes the morphology of sparganum (larva) of the Malaysian Spirometra spp. collected from naturally infected frogs (Rana cancrivora) from rice fields in Tanjung Karang, Malaysia.
Materials and Methods: Spargana of Spirometra spp. collected from naturally infected frogs (Rana cancrivora) were used for the morphological studies. Stretched on a metal ruler, measurements of the worm were recorded. Specimens were stained in Alum-carmine.
Results: The length of the body ranged from 11-50 mm and the width ranged from 0.5-1.5 mm. Specimens stained with Alum-carmine showed ridges (formation of segments) on the surface of the body, and no sexual organs in the body.
Conclusion: The Malaysian Spirometra spp. are similar in measurement and morphology to Spirometra erinacei but further studies are required for confirmation.
Spinal Muscular Atrophy (SMA) is a heredity neuromuscular disorder and is one of the most common genetic causes of childhood fatality. SMA is classified into three groups based on age of onset and achieved motor milestone. Survival Motor Neuron (SMN) gene has been identified as the responsible gene for SMA. From August 2003 until Feb 2007 we have received 93 samples for SMN1 gene deletion analysis from various hospitals in Malaysia. All the patients except for 3 patients were Malaysian (71 Malays, 5 Indians, 9 Chinese and 5 patients are mixed ethnicity). DNA were extracted from blood samples using DNA extraction kit and subjected to SMN/ gene deletion analysis by PCR-RE. Forty nine out of 93 samples (20 type I, 21 type II, and 8 type III) were found to have homozygous deletion of at least exon 7 of the SMN1 gene. Twelve patients (7 type I, 4 type II, 1 type III) showed the presence of the SMN1 gene and the rest were excluded as they did not fulfill the criteria of International SMA Consortium. Deletion analysis of exon 7 of the SMN gene can be an alternative to the existing diagnostic modalities of SMA.
Basal stem rot (BSR) caused by species Ganoderma, is one of the most serious disease of oil palm in Malaysia. As far as the disease problem to oil palm in Malaysia is concerned, BSR is the only disease requiring urgent solution. The BSR is not new to Malaysia, it has been known to attack oil palm since the early years when the crop was introduced into this country. There is an indication that there are differences in susceptibility to basal stem rot between germplasm materials from different genetic origin [2]. This provides hope in generating oil palm varieties with reduced level of susceptibility using existing genetic materials. There is also interest in developing diagnostic tools such as using PCR primers for detection of the pathogen in oil palms [1]. Altered expression of several classes of genes was observed in plants in response to fungal infection. These include genes associated with cell maintenance and development, genes involved in biosynthesis of lignin and phenolics and genes implicated in oxidative burst, programmed cell death or hypersensitive response [5].
The multi-racial, multi-lingual, multi-religious, and multi-cultural Malaysia is situated at the crossroads of Southeast Asia. It has a total population of about 23 million, comprising of more than fifty ethnic groups: Malays, Chinese, Indian, and the minorities of Orang Asli in Peninsular; Iban, Bidayuh, Melanau, Kenyah Kayan, Ukit, Penan, Sekapan, Lahanan, Lun Bawang, Kelabit, Berawan, Punan Bah etc. in Sarawak; and Kadazan, Bajau, Murut, Paitan, Suluk Bonggi, Illanun, Bengkahak Tidung etc. in Sabah. The origin of the multi-ethnic character of this country traces back to decades of human migration from various regions of Southeast Asia. With her rich human biodiversity, a study of the human population genetics is imperative, either for forensic database purposes, or as the stepping stone for medical applications.
Objective: This study aimed to assess the concurrent validity of the Malay version of the Perceived Stress Scale (PSS-10) PSS-10 item.
Methods: A cross-sectional study was conducted among all students in a medical faculty in Malaysia. The questionnaire included three parts; socio-demographic correlates, PSS-10 and the validated Malay version of Depression Anxiety and Stress Scale-21 item (DASS-21). Spearman's correlation coefficient was used in the analysis.
Results: Stress subscale of DASS -21 correlated positively with the total score of PSS-10 (r= +0.50, p<0.001), positively with the negative subscale of PSS-10 (r=+0.36, p<0.001) and negatively with the positive subscale of PSS-10 (perceived coping) (r= -0.33, p<0.001).
Conclusion: The Malay Version of PSS-10 has fair correlation with the stress subscale of DASS-21. This confirmed the concurrent validity of this scale, which further strengthened the previous evidence that the Malay version of PSS-10 was a valid tool to measure stress in Malaysian university students.
Keywords: Malay, Version, Stress, Medical, Students, Psychological Distress
Community and family case study (CFCS) is a community based educational (CBE) programme commenced in 1980 at School of Medical Sciences, Universiti Sains Malaysia. It serves to help and resolve health needs of the individual patients, family and their community. This will help to develop generic skills such as organization, communication and problem solving in relation to local norms, beliefs and socio-cultural influences. Students should have good awareness, sensitivity and empathic response based on health needs and environment that they are living in. Knowledge, skills, attitudes, emotions and values are repeatedly exposed to inculcate optimal learning environment with the community, as well as triggered response by the student to give back to the community by volunteerism. CFCS activism can be revitalized within the individual and group context. This can be achieved by multi-dimensional learning, collaborative effort, effective leadership and supervision, creative programme initiation, effectual research activities and sustainable service to the community. It is hopeful with active community engagement, life experiences learning process, self-directed and reflective learning, students are able to acquire refined attributes such as skills, behaviour, knowledge and attitudes, towards successful personal growth and advancement.
Introduction: Appropriate professional conduct of clinical teacher is vital in their medicine practice. In UKM medical centre Malaysia, personal and professional development (PPD) of future medical professionals is greatly emphasized. The objective of this study was to determine the medical students' perception about the professional conduct of their clinical teachers at UKM medical centre. Methods: It was an online questionnaire survey conducted among the clinical students enquiring about the professional conduct of their clinical teachers. There were five statements and one open ended question which described students' preference about PPD teaching- learning method, expectation on PPD session, need of teachers training and experience about the excellent and inappropriate professional conduct of clinical teachers. The open ended question described what students had observed regarding the 'doctor-patient relationship' medical ethics and 'student-teacher relationship. A total of 77 questionnaires were returned after complete evaluation. The data were compiled and analysed using SPSS version 20 and the answers to the open ended questions were transcribed. Result: Role modelling was the preferred teaching-learning method for PPD as stated by 38% respondents; subsequent preferred methods were small group (30%), role play (24%), large group (7%) and reflective writing (1%). Majority (67.5%) respondents indicated that professional conduct of their clinical teachers was frequent enough as they had expected while 29.9% claimed that professional conduct was infrequently emphasized. Excellent professional conduct of clinical teachers was witnessed by 73% respondents while 27% indicated that they had never seen excellent conduct. When asked about inappropriate professional behaviours by clinical teachers, 53% indicated to have witnessed. Qualitative data also revealed both positive and negative experiences as reflected in open comments. According to 70% respondents clinical teachers required training to apply PPD in their daily practices. Conclusion: Professional conduct of clinical teachers as perceived by the students was excellent and frequents enough with experience of inappropriate behaviour too. Role modeling was the preferred teaching method while attention needed on reflective assignment. Educators must emphasize on role modelling in their daily practices and curriculum planners should give due importance on training needs of clinical teachers to apply PPD in their daily practices.
This paper discusses the ethical issues of patient autonomy based on a case of a patient who refused medication during Ramadhan fasting period. Issues on patient autonomy include the right of a patient to refuse medication, informed decision making, the importance of effective communication and the physician roles and responsibilities are discussed. In conclusion, patient autonomy must be respected and valued. However, the need of effective communication in facilitating informed decision making to improve doctor-patient relationship, should not be overlooked and compromised.