Many studies have shown that failure in the control of hypertension with oral antihypertensives could be associated with noncompliance. The present study was conducted to assess the compliance rate to antihypertensive therapies and also to determine factors related to any noncompliance. The study was conducted in a teaching hospital in Kuala Lumpur. Data was collected from patients' medical records and via personal interview using a structured questionnaire. Out of a total of 175 respondents recruited in the study, 49.1% missed at least a dose of their antihypertensive agents during a one·month period. The most common reason given by respondents who were not compliant to their antihypertensive therapies was forgetfulness (91.8%), followed by too busy (20.0%) and insufficient medication supplied to them (18.8%). None of the factors analysed, including the demography of the respondents, their knowledge about hypertension and the types of antihypertensive therapies they were on, had any statistically significant influence on the compliance behaviour of the respondents to their antihypertensive therapies. However, more than 80% of the respondents kept their appointment to see their doctor and only this factor appeared to be related to the medication compliance behaviour although it still did not reach any statistical significance. KEYWORDS: Compliance, antihypertensive agent, blood pressure, knowledge
A comparative study was carried out to identify the prevalence of intestinal parasitic infestation among students in 3 different types of primary school localed in Ampang area, Kuala Lumpur. A survey of infection rate was done from April 10 June 2001. Stool samples were randomly collected from one·hundred and eleven schoolchildren aged 9-12 years were examined for intestinal parasites, using a light microscope (or direct smear and after concentration for formol-either method. It was found that an overall prevalence of intestinal parasite infection of schoolchildren was 51%. The infection rate of males and females was (60.3%) and (29.2%) respectively. Prevalence seems to be higher in the younger age groups. Also, the usual intestinal parasites were found more commonly in local and foreign schools than international schooL The local school had the highest prevalence (62%), followed by the foreign school (52%) and international school (38.9%). The prevalence in the international school was much lower compared to the local and foreign schools. KEYWORDS: Intestinal parasites, faecal samples, prevalence, schoolchildren
From August 1999 to January 2001, twelve chemotherapy naive patients with locally advanced and metastatic non-small cell lung cancer (NSCLC) in our hospital received vinorelbine and cisplatin. Ten patients had stage IV disease while two had stage HI disease. Patients' performance status (PS) were as follows: four had PS 1, six had PS 2, and one each PS 3 and 4. A total of 46 cycles were given as scheduled. Only major haematological toxicities were noted; one patient each with Grade 3 anaemia, Grade 3 and Grade 4 leucopenia, two had Grade 3 neutropenia and 5 had Grade 4 neutropenia without associated mortality. Three patients had Grade 3 alopecia and one had Grade 3 phlebitis. After three cycles, three patients demonstrated partial response and two had stable disease. For the four patients who completed 6 cycles, two demonstrated stable disease and two partial response. Symptom improvement was reported in all but one patient. Performance status was better in four, stable in six but declined in two patients. In conclusion, in patients with locally advanced and metastatic NSCLC, vinorelbine/cisplatin is a well-tolerated and active regimen, offering symptom palliation and improved performance status in a significant proportion of patients. KEYWORDS; Vinorelbine, lung cancer, chemotherapy.
In multiethnic countries such as Malaysia more than six different languages are spoken by patients in publicly-funded clinics. Sometimes doctors are unable to speak the patient's language and there are no professional interpreters. Research on doctor-patient communication has rarely included the language variable and its impact on information exchange and patient outcome in consultations where the doctor does not speak the patient's language. The few studies carried out in linguistically plural societies show that doctors and patients can face language barriers and trained interpreters are not always available. This paper illustrates some of the problems of using untrained interpreters in a primary care setting. Consultations were audiotaped and the transcripts were used to show how messages underwent distortion, condensation, and omission in interpreter-mediated consultations. Research needs to be carried out based on a model of doctor-patient communication which reflects the realities of the multilingual consultation.
Citation: Mohd Ghazali RJ. A study on the adequacy of outpatient management of essential hypertension in MOH hospitals and health centres. Kuala Lumpur: Institute of Health Management, Ministry of Health, Malaysia; 2006
Citation: Buku Panduan Keselamatan Makmal Perubatan Klinik Kesihatan. Putrajaya: Bahagian Pembangunan Kesihatan Keluarga, Kementerian Kesihatan Malaysia; 2009
Translation:
Guideline on medical laboratory safety in health clinic. Putrajaya: Family Health Development Division, Ministry of Health, Malaysia; 2009
Solid waste collection has been a major challenge for local council Municipal workers in urban areas where the population is growing rapidly and the need for local councils to ensure they provide service to clear solid waste in a timely manner without disrupting the existing system. This case study is a review of awareness of health and safety among municipal workers on solid waste collection. The study is an examination of such awareness in Malaysia which involves the Petaling Jaya City Council in the state of Selangor. We review the operating system of the Petaling Jaya City Council and the risks which are being exposed to the municipal workers in their daily operations. Health and Safety of municipal workers in the areas of public health, safety, and industrial hygiene has been a concern for a long time. In most cases the majority of municipal workers exposed are from the contractual aspect of outsourced labour. It is important to understand how large the area of a solid waste is and to identify, evaluate, and eliminate or control risks and hazards across the operation zone of the municipal workers which involves environmental and occupational demands. The data we find provides the latest perspectives on topics of widespread concern such contractors management, ergonomic safety, confined space, motor vehicle safety, machinery safety, fall hazard safety, electrical safety and emergency response. Management of legal requirements is also discovered to be important to ensure any organization conducting business is not in violation of any law, and if there is a change of process how is this being addressed. Finally, we look at the control measures needed to support a operation on a large scale where it will not endanger the health and safety of municipal workers when they are involved in solid waste management. The recommendation we have based on the review are to ensure there is a holistic approach and systems in place to address all the concerns that will be faced by the local municipal council in their daily operations and responsibilities at every level of the organization. Conclusion: Research material and data related to this area is limited and we hope future holistic research can be conducted to future enhance the study of health and safety effecting the municipal workers. Health and Safety management system and procedures are the key elements in ensuring a successful organization.
This paper explores whether middle-income Asian countries are reorienting their health services in response to non-communicable diseases (NCDs). Malaysia, Sri Lanka, and Thailand were selected as case studies of Asian societies experiencing rapid increases both in NCDs and an aging population. While NCD programs, especially those related to diabetes and stroke, are well-established in Thailand, health services struggle to respond to increasing numbers of people with chronic health problems. Health services at all levels must plan ahead for more patients with chronic and often multiple conditions who require better integrated health care.
A descriptive study of full-term neonates with jaundice was carried out to determine factors affecting severity of neonatal jaundice for those infants presenting to the hospital from their homes. Severe jaundice (serum bilirubin >=250 µmol/l) was significantly more likely in infants whose mothers consumed traditional herbs during the postpartum period (p<0.001) and if the jaundice was first detected by the parents or relatives rather than by medical personnel (p<0.05). In addition, the interval between detection of jaundice and presentation to hospital was significantly longer in jaundice that was first detected by parents compared to those detected by medical personnel. In conclusion, factors affecting severity of neonatal jaundice for infants who present from home could be influenced by the socio-cultural practices of maternal postpartum use of herbs, the ability of parents to detect jaundice and the urgency of tlie parents in seeking medical treatment once the jaundice was detected. Further studies need to be done to explore the association of these factors with neonatal jaundice more specifically. KEYWORDS: Hyperbilirubinaemia, socio-cultural practices, herbs.
Study site: Paediatric Institute, Kuala Lumpur Hospital, Malaysia
Parasitological and serological investigations for lymphatic filariasis were performed on 450 immigrants detained at the lmmigration Centre at Semenyih, Selangor, West Malaysia. The country of origin of these immigrants were Indonesia, The Philippines, Myanmar, Bangladesh, India and Pakistan. Brugia malayi adult worm homogenate (BmAH) antigen was used for the detection of antiifilarial IgG. A monoclonal antibody-based ELISA (MAb.XC3-ELISA) specific for filarial circulating antigens and non-phosphorylcholine reactive was used to detect antigenemia in these immigrants. Parasitologically 67 (14.89 %) were positive for W. bancrofti and 54 (12.0%) for Brugia malayi. Serologically 63% had antifilarial IgG titre to the BmAH antigen. While Bancroftian filariasis is now unknown in Peninsular Malaysia, the potential of it to be reintroduced into Peninsular Malaysia by the immigrant population is discussed. KEYWORDS: Lymphatic filariasis, immigratits, antifilarial IgG, antigenemia
This paper describes a case of invasive arnoebiasis in a 72 year old woman. About 1 week prior to admission she had right iliac fossa pain and physical examination suggested perforated appendix or carcinoma of caecum. Laparotomy revealed perforation of caecum. Histopathology of tissue removed showed abundant trophozoites of Entamoeba histolytica. After surgery treatment was instituted and patient had an uneventful recovery. KEYWORDS: Rupture of caecum, amoebiasis
Many tests are available for the diagnosis of H. pylori infection. Broadly they can be divided into invasive- endoscopy biopsy based tests and non-invasive tests. Of the endoscopy biopsy based tests the rapid urease tests (RUT) have been found to be the most convenient, accurate and inexpensive tests and they have therefore been recommended by several consensus panels and working parties as the test of choice during endoscopy. Several RUTS are available; some are commercial: CLO test, Pyloritek, Helicobacter urease test, H. yylori test and others- "homemade". We strongly recommend the "homemade" 1 min rapid urease test using an unbuffered solution as originally described by Arvind et al. This test has been shown to be easy to prepare, inexpensive and accurate on field-testing. Several factors affect the accuracy of the RUT. The larger the size of biopsy samples, the quicker is the postive reaction time. With the CLO test, warming the tests to 37'C has also been shown to hasten the reaction time. The effect of blood on the RUT poses an important problem in testing. It is vitally important to determine the H. yylori status in patients with bleeding peptic ulcers as the recurrence of bleeding has been shown to be markedly reduced or virtually abolished with H. yylori eradication. While the results of studies have not been entirely consistent, it is likely that presence of blood does reduce the sensitivity of the RUT. It is therefore sensible that in patients with bleeding ulcers, the RUT should not be the sole endoscopy biopsy test used and that samples should also be taken for histological examination.
Malaysia is a surplus poultry producing country with well-established commercial slaughtering and processing plants. Immense quantity of heads, feet, viscera, blood and feathers are usually discarded and not optimally utilized. Chicken heads are rich in protein, and could be a potential source of gelatin. The aim of the present work was therefore to find a simpler, faster, cheaper and greener gelatin extraction technology as compared to current available methods of gelatin extraction from poultry heads. A comparison of three different gelatin extraction methods with alkaline-acid pretreatment (E1), single acid pretreatment (E2) and single alkaline pretreatment (E3) were studied to extract gelatin from chicken heads. E1 and E2 produced gelatins of Type A, while E3 produced gelatin of Type B. High bloom gelatin (>300 g) with
This study aimed to isolate, identify, and evaluate the probiotic properties of Bacillus species from honey of the stingless bee Heterotrigona itama. Bacillus spp. were isolated from five different H. itama meliponicultures, and the isolates were characterized through Gram-staining and a catalase test. Tolerance to acidic conditions and bile salt (0.3%), hydrophobicity, and autoaggregation tests were performed to assess the probiotic properties of the selected isolates, B. amyloliquefaciens HTI-19 and B. subtilis HTI-23. Both Bacillus isolates exhibited excellent antimicrobial activity against both Gram-positive and Gram-negative bacteria and possessed significantly high survival rates in 0.3% bile solution for 3 h. Their survival rates in acidic conditions were also comparable to a commercial probiotic strain, Lactobacillus rhamnosus GG. Interestingly, the hydrophobicity and autoaggregation percentage showed no significant difference from L. rhamnosus GG, a commercial probiotic strain. The results from this study suggest that B. amyloliquefaciens HTI-19 and B. subtilis HTI-23 isolated from stingless bee honey have considerably good probiotic properties. Therefore, more studies should be done to investigate the effects of these bacteria cultures on gastrointestinal health.
After oil extraction, palm fruit biomass contains abundant water-soluble phytochemicals (PCs) with proven bioactivity in regulating oxidative stress and inflammation (OSI). For optimal bioefficacy following oral consumption, the pharmacokinetic plasma peak (Tmax) should be bio-matched with the onset of OSI, which can be predicted from the Phytochemical Absorption Prediction (PCAP) model and methodology. Predicted absorption and potential for regulation of OSI by measures of total phenolic content, antioxidant capacity and hydrogen peroxide production capacity, were applied to characterise eight extracts from mesocarp fibre and kernel shells of oil-depleted palm fruits. Results indicated post-consumption absorption Tmax ranges of 0.5-12 h and 2-6 h for intake in liquid and solid forms, respectively, and generally high antioxidant activity of the extracts. The research supports that PC extracts of palm fruit biomass have broad potential uses for human health as dietary antioxidants in foods, supplements or functional beverages.
In this data article we present the determinations of the diet preference and growth of a pair of the giant panda, Ailuropoda melanoleuca (David, 1869) from Zoo Negara Malaysia. Once considered as endangered, the captive giant pandas were given with nine species of local bamboo in separate indoor enclosures. We recorded data between May 25, 2014 and December 31, 2016 and analysed it based on food preference, the pattern toward food consumption and body weights using SPSS v25.0 (IBM, USA). Data on the bamboo preference, daily average bamboo provided and consumed, and factors predicting of body weight per individual are reported in this article. The data highlight correlation between panda growth (kg) to the part of bamboo consumed (kg) and exhibit the pattern of preferred part of food (i.e.: either the leaf, culm or shoots of bamboo variety) for panda consumptions. The food consumption toward the body weight was modelled using logistic regression analysis to help determine the pattern of food consumption and body weight of giant panda in the future and based on regression model 1, only consumed variable is significance to the model.
The Asia-Pacific region is known as a favorite destination for global medical travelers due to its medical expertise, innovative technology, safety, attractive tourism destination and cost advantage in the recent decade. This study contributes to propose an approach which effectively assesses performance of medical tourism industry based on considering the economic impact factors as well as provides a conceptual framework for the industry analysis. Grey system theory is utilized as a major analyzing approach. According to that, factors impact on the sustainable development of medical tourism in Asia-Pacific region could be identified. The performance of each destination in this region was simultaneously revealed. The results presented an overall perspective of the medical tourism industry in the scope of the Asia-Pacific region, and in Taiwan particularly. Data was collected on six major destinations including Singapore, Thailand, India, South Korea, Malaysia and Taiwan. The results proved that tourism sources and healthcare medical infrastructures play a crucial role in promoting the healthcare travel industry, while cost advantage and marketing effectiveness were less considered. In addition, performance analyse indicated that Thailand has a good performance and stands in the top ranking, followed by Malaysia, India, Singapore, South Korea and Taiwan, respectively. The revenue of Taiwan has increased slowly in the last six years, with a market worth approximately NT$20.5 billion, and the number of medical travelers is expected to increase to 777,523 by 2025. The findings of this study are expected to provide useful information for the medical tourism industry and related key players in strategic planning.
The recent expansion of oil palm (OP, Elaeis guineensis) plantations into tropical forest peatlands has resulted in ecosystem carbon emissions. However, estimates of net carbon flux from biomass changes require accurate estimates of the above ground biomass (AGB) accumulation rate of OP on peat. We quantify the AGB stocks of an OP plantation on drained peat in Malaysia from 3 to 12 years after planting using destructive harvests supported by non-destructive surveys of a further 902 palms. Peat specific allometric equations for palm (R2 = 0.92) and frond biomass are developed and contrasted to existing allometries for OP on mineral soils. Allometries are used to upscale AGB estimates to the plantation block-level. Aboveground biomass stocks on peat accumulated at ~6.39 ± 1.12 Mg ha-1 per year in the first 12 years after planting, increasing to ~7.99 ± 0.95 Mg ha-1 yr-1 when a 'perfect' plantation was modelled. High inter-palm and inter-block AGB variability was observed in mature classes as a result of variations in palm leaning and mortality. Validation of the allometries defined and expansion of non-destructive inventories across alternative plantations and age classes on peat would further strengthen our understanding of peat OP AGB accumulation rates.
Agricultural activities have been arising along with the use of pesticides. The use of pesticides can impact not only on vector or other pest but also able to harm human health. Pesticide may leach from the irrigation of plant into the groundwater and in surface water. These waters could be sources of drinking water in a pesticides polluted area. This study aims to determine the occurrence pesticides in surface water and pesticides removal efficiency in a conventional drinking water treatment plant (DWTP) and the potential health risk to consumers. The study was conducted in Tanjung Karang, Selangor, Malaysia. Thirty river water samples and eighteen water samples from DWTP were collected. The water samples were extracted using solid phase extraction (SPE) before injected to the ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS). Five hundreds and ten respondents were interviewed using questionnaires to obtain information for health risk assessments. The results showed that propiconazole had the highest mean concentration (4493.1 ng/L) while pymetrozine had the lowest mean concentration (1.3 ng/L) in river water samples. The pesticides removal efficiencies in the conventional DWTP were 77% (imidacloprid), 86% (propiconazole and buprofezin), 88% (tebuconazole) and 100% (pymetrozine, tricyclazole, chlorantraniliprole, azoxystrobin and trifloxystrobin), respectively. The hazard quotients (HQs) and hazard index (HI) for all target pesticides were <1, indicating there was no significant chronic non-carcinogenic health risk due to consumption of the drinking water. Conventional DWTP was not able to completely remove four pesticide; thus, advanced treatment systems need to be considered to safeguard the health of the community in future.