Displaying publications 61 - 80 of 781 in total

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  1. Varma SL, Azhar MZ
    Med J Malaysia, 1995 Mar;50(1):11-6.
    PMID: 7752963
    This study was conducted to find out the psychiatric symptomatology in the patients and their families attending a primary health care facility. The most frequent symptoms found were of depression (13.2%), followed by hypochondriacal symptoms (8.2%), anxiety symptoms (6.1%) and psychotic symptoms. A large proportion (21.5%) of children had psychiatric symptoms. The common symptoms include enuresis, hostility, tantrums, problems of conduct and destructiveness. Surprisingly, concern for these symptoms was lacking in both the patient and their family members.
    Matched MeSH terms: Ambulatory Care Facilities*
  2. Zulkifli A, Rogayah J, Hashim MH, Shukri O, Azmi H
    Med J Malaysia, 1995 Dec;50(4):359-64.
    PMID: 8668057
    A demographic and obstetric profile of pregnant mothers attending antenatal clinics in Kelantan over period of one year was determined by a retrospective study of 10,032 registered pregnant mothers. The prevalence of risk factors related to the age of the mother, parity, weight, haemoglobin level, bad obstetric history and pregnancy related diseases were determined. Prevalence of teenage pregnancy and primigravida accounted for 4.3 and 17.2 percent respectively. Nearly 3.9 percent of the mothers weighed less than 40 kg and 44.5 percent of mothers were found to be anaemic (Hb less than 11g/d) at the first antenatal visit. Only 3.2 percent of the mothers did not have any designated risk factor. Previous bad obstetric history and pregnancy related disease accounted for 17.1 and 3.5 percent of mothers respectively.
    Study site: Antenatal clinics, klinik kesihatan, Kelantan, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  3. Jackson AA, Ismail A, Ibrahim TA, Kader ZS, Nawi NM
    PMID: 9139364
    Typhoid fever remains a common problem in Malaysia, but for its diagnosis both blood culture and the Widal test have drawbacks. A dot enzyme immunoassay (EIA) has been developed which detects IgM and IgG antibodies to a specific 50 kDa outer membrane protein on Salmonella typhi. This study was performed among outpatients attending the university hospital in Kelantan, a state on the east coast of Peninsular Malaysia where typhoid is endemic. The dot EIA was done on 149 outpatients of all ages in whom typhoid was suspected. Of these, 60 were not analysable due to insufficient data. The other 89 were retrospectively classed as typhoid (total = 21), or not typhoid (total = 68). The criteria for diagnosis of typhoid was either, blood culture was positive, or with blood culture negative, temperature was at least 38 degrees C and Widal O and/or H titer greater than or equal to 1/160. We then compared the diagnosis with the EIA result. For the result where either IgM or IgG was positive, sensitivity was 90%, specificity 91% and negative predictive value 97%. For IgM positive, specificity was 100%. But the specificity of IgG positive alone was reduced by six false positives, which were probably due to persistence of IgG after acute infection. Other cases were found where IgG positive alone appeared in the first week of typhoid fever, probably due to rapid response in a second or subsequent infection. We also found that IgM-producing patients were significantly younger than those showing IgG alone positive.
    Study site: Community Medicine clinic, Accident & emergency department, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  4. Chan SC
    Family Physician, 1995;7:3-10.
    This study aimed to established baseline data on patients' demographic and morbidity patterns over three months in the Outpatients Department (OPD) Ipoh Hospital. Entry of the first ten thousand patients into a computerised database for analysis showed that the majority were unemployed and from the low income group. There were more Malays and Indians, less Chinese. Respiratory infections accounted for 18.5 % while major chronic diseases (hypertension, diabetes mellitus, asthma) were common. Overall a wide spectrum of illnesses were seen. A career structure for OPD doctors and incorporation of Family Medicine concepts were proposed to improve primary care in OPD.
    Study site: Outpatients Department (OPD), Hospital Ipoh, Perak, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  5. Lane MJ, Zulkifli A
    Family Physician, 1995;7:16-20.
    The aim of this study was first to analyse the prescribing habits of primary care doctors with a view to providing feedback which may help them to rationalise their prescribing. This analysis was helped by comparing the prescribing practices in two different settings and thus highlighting anomalous differences. The second aim of this study was to obtain data on the diagnoses being made in primary care settings in Malaysia as this information, though available from other countries, is limited here. Lists of the most commonly prescribed drugs and most common diagnoses made are provided, together with tables showing the most commonly prescribed drugs for the ten most common diagnoses. Differences in prescribing habits between the two settings are discussed and possible reasons are suggested.
    Matched MeSH terms: Ambulatory Care Facilities
  6. Suhaimi H, Monga D, Siva A
    Singapore Med J, 1996 Feb;37(1):51-4.
    PMID: 8783914
    OBJECTIVE: To study the knowledge, attitudes and practices on various contraceptive methods among all government health clinic staff in the state of Kelantan.
    DESIGN: Questionnaire-based study.
    SETTING: All government health clinics in the state of Kelantan which are health facilities located outside the general hospital and seven district hospitals.
    SUBJECTS: All 711 nursing staff employed in government health clinics in Kelantan state (sisters, staff nurses, assistant nurses and midwives).
    METHOD: Pretested, prestructured proforma was sent out to all the nursing staff employed in all peripheral health centres to be completed by them and returned the same day via the medical officer in charge of that district.
    RESULTS: Most of the respondents were more than 30 years of age, married, multiparous and working for more than 5 years. Eighty to ninety percent practised contraception, with the majority of midwives preferring pills and the majority of staff nurses preferring condoms. Thirty to forty percent from all groups felt that folk methods are effective, and should be encouraged. Only about 50% of staff nurses are well informed on all contraceptive methods, but among assistant nurses and midwives, this figure is only 33%. A high proportion felt that the nursing curriculum deals inadequately with this subject.
    CONCLUSION: The first step towards achieving success in our family planning programme lies in imparting more information to this target group of health workers, by incorporating more lectures during training and sending them for courses.
    PIP: 711 government health clinic nursing staff in Kelantan state were surveyed about their knowledge, attitudes, and use of various contraceptive methods. 11 sisters, 122 staff nurses, 173 assistant nurses, and 334 midwives returned the questionnaire the same day of receipt. Most respondents were older than age 30 years, married, multiparous, and working for more than 5 years. 80-90% practiced contraception, with the majority of midwives preferring oral pills and the majority of staff nurses preferring condoms. 30-40% from each subgroup of respondents believed folk methods of contraception are effective and worthy of being encouraged. Approximately 50%, 33%, and 33% of staff nurses, assistant nurses, and midwives, respectively, were well informed on all contraceptive methods. A high proportion of staff felt that the nursing curriculum fails to adequately address the subject. The authors stress that in order to realize success in the family planning program, more information must first be imparted to these health personnel. To that end, more lectures could be provided during training, followed by frequent and thorough refresher courses for all nursing staff.
    Matched MeSH terms: Ambulatory Care Facilities
  7. Ho TF, Paramsothy S, Aw TC, Yip WC
    Med J Malaysia, 1996 Mar;51(1):68-74.
    PMID: 10967982
    The serum lipid and lipoprotein levels of 59 obese Chinese children with a mean age of 13.0 years and mean relative weight of 164.2% were analysed. Between 40% to 54% of these children had elevated lipid and lipoprotein levels and about 78% had reduced high density lipoprotein (HDL) level when compared to healthy American and Japanese children. The obese children also had higher mean levels of total cholesterol (TC) and lower HDL compared to male adults in the local population. Those with elevated TC had higher mean relative weight (170% vs 159%, p < 0.05). In view of the close association between hyperlipidaemia and atherosclerosis, obese children should be carefully screened and managed to prevent long term morbidity and mortality of coronary artery disease.
    Study site: Obesity clinic, School Health Services, Ministry of Health, Singapore
    Matched MeSH terms: Ambulatory Care Facilities
  8. Jackson A, Cole C, Esquiro J, Edwards M
    PMID: 9253884
    This study measured the body mass index (BMI), and assessed attitudes and knowledge about obesity, of 197 male and 217 female patients aged 20-59 years attending the primary care clinic of the university hospital in Kelantan, Malaysia. There was no significant difference between the mean BMI of males (23.7) and females (24.2). In the overweight group (BMI 25-29.9) were 60 men (30%) and 66 women (30%). In the obese group (BMI 30 and above) were 12 men (6%) and 22 women (10%). Both diabetes mellitus and hypertension were associated with significantly higher BMI's. Knowledge about obesity was lacking. Sixty-three (15%) failed to recognize that obesity is bad for health. When asked the causes of obesity, 88 (21%) failed to mention either diet or lack of exercise. "Being happy" was suggested as a cause by 32 (8%). When asked if certain foods would cause obesity if eaten in excess, 45 (11%) said "No" for fatty foods, and 164 (40%) said "No" for sweet foods. Concerning appearance, 30 (15%) men regarded an obese man as normal or even handsome, while 49 (23%) women regarded an obese woman as normal or beautiful. Obesity is common among our adult patients, and is associated with some of their common health problems. However, a substantial minority do not regard obesity as unhealthy, do not relate it to diet or lack of exercise, do not recognize important groups of fattening foods, and do not regard obesity as unattractive.
    Matched MeSH terms: Ambulatory Care Facilities
  9. Ong BL
    Sains Malaysiana, 1996;25(3):13-18.
    A retrospective study of the incidence of Giant Papillary Conjunctivitis (GPC) seen in the Optometry clinic in Universiti Kebangsaan Malaysia from 1989 to 1994 was carried out. In the period of the 6 years, 37 contact wearers were diagnosed to have GPC. Of the 37 patients, 21 were Malays (57%), 12 were Chinese (32%) and the remaining 4 patients were Indians (11%). 18 or 48% of those with GPC were soft lens wearers, 46% of the wearers (17 patients) were rigid gas permeable lens wearers and 1 of the patients seen was a hard (PMMA) wearer (3%) and the other one was a disposable lens wearer (3%). Thirty patients were female (81%) and 7 (19%) were male. The age range of those with GPC were between 9 to 60 years old.
    Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  10. Wong KC, Teng CL, Krishnan R
    Family Physician, 1996;9(3):3-6.
    A quality assurance exercise for non-insulin dependent diabetes mellitus in the Family Practice Clinic, University Hospital Kuala Lumpur, was conducted using HbA1c as an indicator. We found that about 60% of the 163 patients with non-insulin dependent diabetes mellitus had fair to optimal control. The HbA1c correlated well with fasting and post-prandial blood glucose level (r=0.79 and r=0.54, respectively, p<0.001). The mean HbA1c was significantly higher in Malay compared to the other races, in those with longer duration of diabetes and in patients on two types of oral hypoglycaemic agent.
    Study site: Family Practice Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  11. Lane MJ
    Family Physician, 1996;8(1&2):21-24.
    985 medical certificates issued by primary care doctors at the Klinik Perubatan Masyarakat and the staff health clinic at Universiti Sains Malaysia were analysed. Most common diagnoses were URTls, conjunctivitis, and gastro-enteritis. Mean duration of absence ranged from 1.3 to 3.4 days. HUSM staff with skin infections were given certificates nearly twice more often than the public. Backache earned more time off for the staff compared to the public. There is a need to formulate guidelines for medical certificates.

    Study site: Klinik Perubatan Masyarakat and the staff health clinic at Universiti Sains Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  12. Aljunid SM, Zwi AB
    Med J Malaysia, 1996 Dec;51(4):426-36.
    PMID: 10968029
    A cross-sectional study, comparing the nature of services in 15 private clinics and 6 public health facilities, was undertaken in a rural district of Malaysia. Semi-structured interviews and observations using check-lists were employed. Public health facilities were run by younger doctors (mean age = 31.1 years), supported mostly by trained staff. The private clinics were run by older doctors (mean age = 41.2 years) who had served the district for much longer (8.9 years vs 1.5 years) but were supported by less well trained staff. The curative services were the main strength of the private clinics but their provision of preventive care was less comprehensive and of inferior quality. Private clinics were inclined to provide more expensive diagnostic services than the public facilities. 'Short hours' private clinics had very restricted opening hours and offered limited range of services.
    Comment in: Hee HW. Differences in public and private health services in a rural district of Malaysia. Med J Malaysia. 1997 Sep;52(3):296-8
    Matched MeSH terms: Ambulatory Care Facilities
  13. Chan SC
    Med J Malaysia, 1997 Mar;52(1):53-9.
    PMID: 10968053
    The Well Man & Well Woman's Clinic in Ipoh Hospital provides screening for coronary risk factors and early detection of cancer. This retrospective review of 1095 patients screened between April and December 1995 showed 48% had one or more coronary risk factors--1 risk (29%), 2 risks (14%), 3 or more risks (5%). Modifiable risks included hypertension (10%), obesity (9%), diabetes mellitus (8%) and smoking (7%). Sixteen abnormal Papanicolaou smears and six cancers (three cervical, two breast and one ovarian) were detected. Public response was good. There is a need for clinics offering comprehensive screening in Malaysian primary health care.

    Study site: The Well Man & Well Woman's Clinic in Ipoh Hospital
    Matched MeSH terms: Ambulatory Care Facilities
  14. Ahmad Z, Jaafar R, Mohd Hassan MH, Othman MS, Hashim A
    Malays J Nutr, 1997 Mar;3(1):83-90.
    PMID: 22692237 MyJurnal
    A retrospective study of anaemia in pregnancy in rural Kelantan was conducted. The study sample consist of 9,860 mothers who had antenatal care at one of the 102 rural health clinics selected and had delivered a live baby. Anaemia in pregnancy was determined by reviewing the antenatal records for the haemoglobin level recorded at the first and last antenatal visit. Estimation of haemoglobin was done either by photocalorimetric methods or the Sahli's method in these rural clinics. At the time of booking, 47.5% of the mothers were anaemic by WHO criteria (Hb < 11.0 g/dl), with 1.9% having less than 9.0 g/dl. Age of mother, parity and late gestational age at the first antenatal visit were associated with anaemia during pregnancy at the time of booking. However, practise of contraception by the mother did not show any association with anaemia in pregnancy. There were 594 mothers (6.0%) who delivered a baby weighing less than 2.5 kg. There was no association between the low birth weight of the child and the status of anaemia in the mother at the last antenatal visit.
    Matched MeSH terms: Ambulatory Care Facilities
  15. Chan SC, Tan OH, Tee AS
    Med J Malaysia, 1997 Dec;52(4):382-9.
    PMID: 10968115
    Adequacy of diabetic management in 5 Perak outpatient departments was studied in April 1996. Two hundred diabetic patients' records were analysed. All doctors and 100 patients answered questionnaires on diabetes. Fifty five percent of doctors had adequate knowledge. Patients' knowledge varied between centres (13% to 80% adequacy). Most records had insufficient data to determine adequacy of early detection. Centres with screeners had adequate weight and blood pressure measurement. Overall control and monitoring of diabetes were inadequate. Referral of complications were delayed in 2 centres. Refresher courses for doctors, patient health education, protocols, screeners and physician visits are recommended.
    Study site: Klinik kesihatan, outpatient clinics, hospitals, Perak, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  16. Teng CL
    Family Physician, 1997;10(1):25-27.
    Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  17. Ariff KM, Schattner P
    Med J Malaysia, 1998 Mar;53(1):82-6.
    PMID: 10968143
    A survey of domestic childhood accidental injuries was conducted at a rural general practice in Arau, Perlis. Data was collected from parents or other caregivers of 171 children, aged 12 years and below, using a pretested questionnaire. Male children between the ages of 6 and 12 years were the most common group affected, with a male to female ratio of 1.7:1. The three most common accidents were injuries from falls (28%), cuts, lacerations, bruises and puncture wounds not resulting from falls (26%), and thermal injuries (22%). The most commonly affected parts of the body were the limbs. Most injuries to children between ages 4 to 12 years occurred in the house compounds, while those to children below 4 years occurred in the kitchen and other locations within the house. Major contributing factors to the injuries were the existence of unsafe home environments, the risk taking activities of the children, the presence of hazardous products in the household and unrealistic parental attitudes to injury prevention.
    Matched MeSH terms: Ambulatory Care Facilities
  18. Omar, K.
    MyJurnal
    A cross-sectional study using structured questionnaires was conducted to determine the level of knowledge, attitude and practice on breast-feeding among working mothers. A total of 200 working mothers who attended the Child Health Clinics in Temerloh, for their chil-dren's third DPT/Polio vaccination were interviewed. Eighty-nine percent of the mothers successfully initiat-ed breast-feeding. However, there was a rapid decline in breast-feeding each month especially during the period when the mothers returned to work. Only 33.5% of the mothers had at least one experience in expressing and feeding expressed breast milk to their babies and only 47% reported that they had been taught by health work-ers. The mothers scored highest on the 'benefits of breast-feeding' with a mean knowledge score of 77.9% and lowest on "storage of expressed breast milk" (35.4%). Overall the mothers showed a positive attitude towards breast-feeding. The two main reasons given for stopping breast-feeding were "work" (61.4%) and "insufficient milk" (57.9%). In conclusion, other areas of breast-feeding besides benefits such as "expressing and storing breast milk" and "how" to practise breast-feeding while working away from home are also impor-tant for working mothers.
    Matched MeSH terms: Ambulatory Care Facilities
  19. Fredericks C
    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.
    Matched MeSH terms: Ambulatory Care Facilities
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