Widespread over-prescription of proton pump inhibitors (PPIs) without an appropriate indication has financial and potentially adverse clinical consequences.
Introduction: Long-term survival in beta-thalassaemia major is strongly influenced by adherence to iron chelation therapy. Identifying factors that influence the compliance remains the first step in improving iron chelation therapy. Objective:Due to increase in number of non-compliance to iron chelation therapy for patients in Hospital Keningau, Keningau, Sabah, we aim to evaluate the compliance, identify the factors and assess disease knowledge of patients so that preventive measurement can be formulated. Methodology: This was a cross-sectional study conducted in Hospital Keningau by a combination of self-administered and interviewer-administered survey. The survey consists of 3 domains – knowledge assessment based on 10 items, identifying factors for non-compliance and compliance to treatment. Percentage of compliance was measured based on amount taken reported by patients over the intended therapy. Association between knowledge and compliance was measured using Pearson’s Chi Square. Results: A number of 52 patients completed the survey. The average age was 18 ± 4.77 years. The mean knowledge score was 6.15 out of 10. The percentage of compliance to desferrioxamine was 78.2 ± 30.2% while for deferiprone it was 72.4 ± 32.6%. There were no association between knowledge score and compliance to desferrioxamine (p = 0.893) and deferiprone (p = 0.874). Lazziness and pain were the main reasons for non-compliance chosen by patients on desferrioxamine ABSTRACTCompliance and Barriers of Beta-Thalassaemia Patients towards Iron Chelation Therapy in Hospital Keningau, SabahElfira Cassandra Enderik1*, Syahrizal Azizi bin Shaharudin1, Gan Siaw Yun1, Tan Wei Chong1, Arthur James Adong1, Jackie Ho Chit Khong1, Shamadevi Pasupathi1, Maggie Low May Yee1, Sivaraj Raman1Borneo Journal of Medical Sciences (BJMS), Special Issue, Volume 2, March 2019: 7 – 81 Pharmacy Department, Hospital Keningau, Keningau, Sabah, Malaysia* Corresponding author’s email: elfira_11@yahoo.comBorneo Journal of Medical SciencesBJMSKeywords:thalassaemia, compliance, knowledge, factor NMRR Research ID: NMRR-18-404-39581
8Borneo Journal of Medical Sciences (BJMS),Special Issue, Volume 2, March 2019: 7 – 811 (3): 35 – 38(19.2%) while for deferiprone it was lazziness (23.1%) and side effects (19.2%). The poor compliance was reflected on the high average ferritin levels of respondents (7573 ± 5749). Conclusion: Even though most adolescents had knowledge about their disease, it did not affect patients’ compliance to therapy. Lazziness was the most prominent factor for non-compliance in adolescents in our study. This might be because iron chelation therapy is usually seen as a hindrance to independence. Thus in order to improve compliances, further study is needed to investigate the association between compliance and the affecting factors identified in our study.
Apoptosis is a programmed cell death which occurs following a variety of stimuli. Physiologically the process is important for morphogenesis of organs and homeostasis of different types of cells. Apoptotic cell death is responsible for a variety of pathologic states such as elimination of cell death in mutated cells, infected cells, tumour cells and transplant rejection well as the pathological atrophy. In this review, there is discussion about the control of apoptosis, detection methods of apoptosis, its association with infectious and non-communicable diseases. Intracellular microorganisms survive through inhibition of host cell apoptosis as well as they destroy the parenchymal cells causing impaired functions. It plays important role in tumourigenesis. There are possible therapeutic roles of drugs that modify apoptosis in human diseases.
Ovarian cancer is the fourth most common cancer among women in Peninsular Malaysia. Epithelial ovarian cancer accounts for 90% of all ovarian tumours. Herein, we present a rapidly growing ovarian tumour in a young female patient, following an uneventful vaginal delivery at home. We discuss on the challenges of making said diagnosis in a post-partum patient who presented with abdomen distension. A 19-yearold lady presented to the Emergency Department three days after spontaneous vaginal delivery at home. Her chief complaint was that of a rapidly progressive abdominal distension. Diagnostic and therapeutic emergency laparotomy were done, revealing a huge cystic ovarian mass. Histopathology reported a high grade, serous ovarian carcinoma. There are multiple causes for abdominal distension in post-partum women, however priority should be given into looking for gynaecological origin, given the changes in hormone. Sudden abdominal distension during post-partum period is rare and a systemic approach in its management is vital. There is, inarguably, a role of diagnostic and therapeutic laparotomy in this.
Melioidosis an infectious disease caused by gram-negative bacteria, Burkholderia pseudomallei is highly endemic in Malaysia, Thailand, Singapore and parts of northern Australia. The district of Tuaran which is located on the west coast of Sabah had reported an increasing trend of Melioidosis cases where in 2017, a total of 19 cases were reported, more than doubling the number of cases reported the prior year (7 cases).
The population of Malaysia is estimated in 2018 to be around 32.04 million and 23.5% of the population resides in rural areas. The Ministry of Health has provided healthcare services to the rural areas with the access of modern healthcare facilities based on the two-tier healthcare system. In remote areas, mobile health clinic is the extension of healthcare service by the nearest static health clinic. However, most of the remote areas only covered by a community clinic or Klinik Desa which is limited for mother and child healthcare. There is demand from the people in remote areas for static health clinic or Klinik Kesihatan. Objectives: This study is to evaluate and compare the effectiveness between two health services in remote areas applied in Sabah. This study also determines which type of health services that able to worth the service to people in remote areas. Methods: This is a descriptive study. Data was taken from HMIS report (Per PL 206) under Sabah State Health Department. The data analysed by using Microsoft Excel. Results: This study was conducted based from the data obtained in 2015 till 2017 for the number of patients attended to static health clinics and mobile health clinics on selected remote areas. For example, Jambongan Health Clinic only have an average of 10 – 15 patients per day while the Mobile Health Clinic team under Beluran Health District which covers the adjacent remote areas of Jambongan Island have more than 20 patients per day on a single visit. Another example is from Terian Health Clinic in Penampang, which only have an average of 5 – 10 patients per day. However, on the mobile health team on a single visit to the village next to Terian which is Kg. Buayan, the average patients attended for the service is mo re than 20 patients. Conclusion: From the study, it was noted that people in remote areas prefer the mobile health service to visit their villages. This can be due to financial issue and limitation of transportation service to the nearest static clinic. The density of population and the development of the rural areas play important roles for the healthcare service to be effective in remote areas.
Schools provide an efficient and effective way to reach large numbers of people. In 2013, over 90% children of primary school age and over 80% children of lower secondary school age were enrolled in schools globally. Behaviours and habits are developed in early childhood. The effective way to prevent non-communicable disease (NCD) is from early education as primary prevention. This platform had been in the system since early millennium but the NCD risk factor is still increasing.
There is a strong need to reduce costs of hospital and advocating health economics in countries like the United States of America. The rising cost of healthcare globally especially in the United States of America has interestingly outraged the temper of many citizens about the Obamacare and Trumpcare. The issue about high cost in healthcare is the failure for people globally to recognize that healthcare facility is a 24-hour round-the-clock service. It therefore involves doubling of the utility bills, tripling the manpower due to shifts and rest, wear-and-tear of basic electrical devices is short-lived, breakdown period of huge machine is consistently due to overloaded usages in the government hospitals and poor knowledge of the maintenance programme. Low birth weights (LBW) is a public health concern because it has a well-known predisposition to increased risk for perinatal infections, respiratory distress and ultimately mortality. There is also a higher risk of poor health outcomes throughout the life course of the LBW newborns that includes Type 2 diabetes, high blood pressure, neurodevelopmental disabilities and cardiovascular diseases. The World Health Organization and United Nations Child’s Fund estimate the prevalence of low birth weights in the world ranges from 3% to 32%. Albania in the year 2000 recorded prevalence of low birth weight of 3% whereas Yemen recorded a low birth weight of 32% in 1997. In 2015, the US national vital statistics pointed out that 83.9% of preterm birth (PTB) are LBW. This indicates that prevention of PTB will lead to a decrease in the incidence of LBW.
Dengue fever and its fatal complications have made a comeback since its control in the 1990’s. The Flavivirus has evolved into 4 serotypes DEN 1,2,3,4 which can be passed on by the mosquitoes for 7 generations for each serotype. This communicable disease is predominantly confined to urban areas. Quick control of the spread of the disease will prevent it from becoming an epidemic. The two species mosquitoes involved have different behaviours. The Aedes aegypti is an indoor vector which breeds in clean, clear and calm freshwater. The Aedes albopictus is an outdoor breeding mosquito which breeds in stagnant waters. Surveillance of the areas prone to outbreaks is vital. One of the roles of the entomologist is to monitor the vector for resistance to the insecticides. Localities that have been subjected to recurrent outbreaks will have vector which develop resistance to the insecticides used.
Dengue is a viral infection caused by four types of viruses (DENV-1, DENV- 2, DENV-3, DENV-4) and transmitted through the bite of infected Aedes aegypti and Aedes albopictus female mosquitoes that feed both indoors and outdoors during the daytime (from dawn to dusk). These mosquitoes thrive in areas with standing water, including puddles, water tanks, containers and old tyres. There were a total of 35 dengue outbreaks under PKK KK with four active outbreaks in the year 2017. One uncontrolled outbreak occurred at Ibu Pejabat Kontigen (IPK) Kota Kinabalu from 16 November 2017 to 21 December 2017.
In Malaysia nasopharyngeal carcinoma (NPC) is ranked as number fourth (5.2%) from all cancer and third (8.4%) most common cancer among male population. Nasopharyngeal carcinoma in Malaysia mostly occurs among Chinese (49%), followed by natives of Sabah and Sarawak (28%) and Malay (22%). There were multiple researches done to determine the risk factors for nasopharyngeal carcinoma and most of them from western pacific region. Prevalence of nasopharyngeal carcinoma in Sabah in 2013 is about 106 cases while in 2012 is 75 cases. It shows almost 30% increment from previous year. A total of 53 patients were diagnosed NPC in 2013 from Kota Kinabalu locality and it contributes more than 50% from total prevalence NPC in 2013. NPC is common in local Sabahan, especially in Kadazan and Dusun ethnicity. In 2013, the youngest are 11 years old and the eldest are 84 years old. The upward trend of NPC cases in younger age group is worrisome for us. Thus it is very important to determine the risk factors associated with NPC and this would help the health provider and other stakeholders to do planning in prevention of NPC such as awareness programme or cancer screening for the target high risk group especially for Sabah population.
Since 1996, World Health Organisation (WHO) and member countries, through the World Health Assembly Resolution 49.25 acknowledged violence (including violence against women) (VAW) as a serious public health issue. The United Nations, at its Sixty-second General Assembly on 7 February 2008 not only reiterated the health impact of VAW but also the rights dimension of VAW and sees it “…as an offence against the dignity and integrity of the victim… and that all forms of violence against women seriously violate and impair or nullify the enjoyment of women of all human rights and fundamental freedoms and constitute a major impediment to the ability of women to make use of their capabilitiesâ€.
Infectious disease remains a public health concern in Malaysia. Efficient public health infectious disease surveillance is needed in order to address the issues posed by infectious disease. The main goal of public health infectious disease surveillance is to facilitate the control and prevention of the infectious diseases. For that, infectious disease surveillance needs involvement of multidiscipline either in government or non-government/private to ensure its success. General practitioners (GPs) have an important role in public health infectious disease surveillance considering their role and position as one of the main front liner medical personnel.
Over the last few years, Universiti Malaysia Sabah (UMS) as part of its global marketing initiative opened its doors to international students to take up elective as well full time programmes. In September 2017, 36 nursing students from a university in China completed a 12-week elective /mobility programme in UMS.
Melioidosis is a tropical infectious disease cause by gram-negative bacterium, Burkholderia pseudomallei. It is predominantly in tropical climate especially Southeast Asia and Northern Australia. This disease is associated with significant mortality due to early onset of sepsis.
Some call it climate change and some global warming, regardless of the term used, it has been deemed the biggest global health threat of the 21st century. It is the 13th goal of United Nations Sustainable Developmental Goals (SDG). Multiple factors contribute to this global phenomenon including the anthropogenic causes which are man-made. The repercussions of this crisis are vast and bring effect environmentally and socioeconomically. These then ultimately lead towards an effect on individual as well as population health.
Since the 1970s, people’s understanding of life has gradually deepened into the basic material nucleic acid and protein levels of life. The life sciences have entered the era of “molecules†and produced a large number of new and interdisciplinary subjects. An important direction has had a major and profound impact on the development of epidemiology itself and on disease control.
PHC services particularly the ambulance call is traditionally a hospital-based system. Within the Kota Kinabalu area, there are 3 tertiary hospitals that provide the ambulance call service; and also provide the interfacility transfer, disaster management and medical team standby. How about the health clinics? Health clinics play a major role for primary healthcare and the interfacility transfer of patient from the health clinics to the hospital.
Community and nosocomial-associated methicillin-resistant Staphylococcus aureus (MRSA) infections in Malaysian healthcare setting are terrifically increasing in recent years. There is an urgent need for an effective antibacterial agent to cope with this important issue. Due to the development of new antibiotics is not parallel with the increase of cases of infections, researchers have initiated isolation of compounds from natural resources to develop new potent therapeutic agent. Meanwhile, Ganoderma boninense is an oil palm devastating pathogen, which has been known to contain many bioactive compounds that might be potential to be developed as a new source of therapeutic agent.
Fascioliasis is a major parasitic disease caused by the liver flukes, Fasciola hepatica and Fasciola gigantica in Malaysia. On 31st May 2016, three cases of fasciolasis among humans were notified in Tuaran involving two localities.