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
Cleft palate has been recorded for many cenhuies. Until the 16th century attempts at closure were by covering or filling the clefts using artificial materials. By the 18th century sutures were used to close the palate after cauterization. By the 19th century lateral relaxing incisions were used to close the cleft at mid line. In 1861 Von Langenbeck (9,22) introduced his technique for dosing the palate. Veau(9) recommended his technique to elongate the palate and to narrow the velopharyngeal space. Many specialties are involved in rectifying this problem. They comprise maxillofacial, orthodontic. ENT surgeons, as well as speech therapists.(9) However, none of these methods succeeded to provide a satisfactory solution for the problem of complete deft palate. In this study, 618 cases of cleft palate of varying degrees were operated during the period from January 1992 to July 2001. From these 618 cases, 48 cases (7.07%) had complete cleft lip and palate. Only 18 cases (37.5%) had bilateral complete cleft lip and palate, and 30 cases (62.5%), had unilateral complete deft lip and palate. The results of the corrective surgical procedures were very promising. In this series of 618 cases only six cases developed residual fistula. The used technique was simple and similar to the Von Langenbeck technique but differs in some steps. The timing of the surgical intervention was a very important factor which influenced the outcome of the closure. KEYWORDS; New technique and tinling for treating complete cleft palate.
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
Male factor infertility which accounts for 30-50% of infertility is a major problem faced by married couples. Congenital absence of the vas deferens, though uncommon, remains the most common abnormality seen in extratesticular ductal and ejaculatory system, accounting for 1-2% of male infertility. It may be unilateral or bilateral. Association with renal abnormality has also been reported with congenital absence of vas deferens (1). The patients are asymptomatic and the congenital abnormality is usually detected when investigation for infertility is carried out. We present a case of an unusual presentation of congenital bilateral absence of vas deferens (CBAVD).
The aim of this study was to validate the translation of the Overactive Bladder (OAB) Screener (OAB V8) to the Malay language. It was to assess the reliability of the screener in the context of a Malaysian population. The original screener consists of eight symptoms indicative of OAB that has been proven to be highly sensitive and reliable. Translation was done with a modification of the Brislin Method using back translation and a panel of experts as a final review panel. The pilot study had two groups; a symptomatic (n=19 patients) and an asymptomatic group (n=18 patients). All patients performed the test twice at two week intervals once at the clinic and subsequently at home. Test-retest method was used for reliability and Cronbach's alpha for internal consistency. The translated questionnaire demonstrated good internal consistency in both groups of patients for all eight items individually and for the total score. Cronbach's alphas ranged from 0.972 to 0.981 for the symptomatic group and from 0.750 to 0.976 for the asymptomatic group. Testretest correlation for all items was highly significant. Intraclass orrelation (ICC) was high for both the asymptomatic (ICC ranging from 0.600 to 0.953) and the symptomatic group (ranging from 0.944 to 0.989).The Malay OAB V8 showed itself to be suitable for use, reliable in distinguishing symptomatic and asymptomatic patients and a valid instrument.
The beginning of this year, 2020, has been a very challenging one as all over the world, we were caught right in the midst of the Coronavirus (COVID-19) pandemic. This pandemic is a serious global health threat, and its devastating effects are felt in all aspects of life. The World Health Organization (WHO) reported that as of 17th May 2020, we have 4,534,731 confirmed cases of COVID-19, and 307,537 deaths in total, throughout the world. In the WHO Western Pacific region, there were 167,546 confirmed cases, and 6,730 deaths while in the WHO Southeast Region, the COVID-19 accounted for a total of 136,314 confirmed cases, and 4,425 deaths (1). In Malaysia, the figure stood, thus far, at 6,872 confirmed cases, and 114 deaths while in Indonesia, there were 17,514 confirmed cases, and 1,148 deaths (2). Different countries are at different phases of this pandemic. While the curve may have flattened in some countries, there might still be spikes here and there. The COVID-19 pandemic has not disappeared; it is here to stay!
This study is aimed at determining whether there exists a correlation between the relative dimensions of the nose and the face. Through this study, we hoped to give a normal range for the different races in Malaysia. We randomly chose 100 Malay, 50 Chinese and 50 Indian subjects. We chose equal numbers of male and female subjects, mainly in their 20's and 30's. There is a correlation between the length of the nose and the face among Malays, with 78% of the subjects measured having a nose:face ratio of less than 0.27. There is also a correlation between the breadth of the nose and the face among Malays, with 670/0 of the subjects having a ratio of less than 0.28. Similar correlations were found with Chinese and Indian subjects. The length and breadth of the nose in relation to the face is greater in males than in females. Further research is required before conclusive evidence is found for the existence or non existence of a correlation between the length and breadth of the nose and face in the different races in Malaysia. KEYWORDS: Correlation, length, breadth, nose, nace, different races.
Background: Cataract is the second priority eye disease in the world and this case in Indonesia occupies the third-highest position in Southeast Asia. There are two methods for cataract treatment that can be expensive, small incision method (SICS) and Phacoemulsification method, and it is important to know the cost-effective comparison of those two methods.
Objective: This study aims to conduct Cost-Effectiveness Analysis (CEA) between cataract surgery; Small Incision Cataract Surgery (SICS) and Phacoemulsification, at Undaan Eye Hospital Surabaya.
Materials and Method: A prospective study following up patients from before surgery up to 21 days’ post surgery. A total of 155 cataract patients had undergone surgery; 25 patients and 130 patients had SICS and Phacoemulsification, respectively. Quality-Adjusted Life Years (QALYs) was used as the outcome measure. The assessment of utility using ‘Visual Function 25’ (VF-25) was the quality of life regarding visual function before surgery, 7 days, and 21 days post-surgery.
Result: The average cost of Phacoemulsification technique was Rp 10,821,038 and the average cost of SICS technique was Rp 10,443,544. QALYs at day7 post-surgery of Phacoemulsification and SICS was 9.49 and 8.95, respectively. While QALYs at day21 post- surgery of Phacoemulsification and SICS was 10.37 and 10.15, respectively. ICER values for Phacoemulsification versus SICS at day7 post-surgery was Rp 696,360 (USD 49,74) while at day 21 was Rp 1,723,559 (USD 123,11).
Conclusion: Phacoemulsification and SICS are effective ways to improve the quality of life related to visual function. The incremental cost per QALYs obtained via Phacoemulsification from SICS at D7 and day21 post- surgery were less than Indonesia’s GDP per capita income of USD 3,347, means that Phacoemulsification is more cost effective than SICS technique for cataract surgery.
As women with breast cancer are living longer, issues beyond survivorship like the much neglected sexual functioning and issue of quality of life have become increasingly important. Experiences of significant alterations in sexual functioning need to be addressed. However, these sexual issues are often not acknowledged in our traditional medical model of health care delivery. This paper briefly reviews the changes in sexual functioning after a diagnosis of breast cancer, with implication for clinical practice and medical curicula.
Introduction: Dental anxiety is a common problem faced by dental practitioners worldwide. Generally, the management of dental anxiety can be classified as pharmacological and non-pharmacological approaches, in multiple studies and reports available on this subject.
Aims and objectives: This paper will provide a general overview of the pharmacological and nonpharmacological strategies in the management of dental anxiety, supported by dental literature. This would help dental practitioners understand the benefits and limitations of the different methods of treating their anxious patients.
Methodology: This is a narrative review and a summary of the different approaches and methods available in the management of dental anxiety. Relevant articles were searched from the online databases of PubMed, ScienceDirect, and Google Scholar, and the keywords used to identify the papers were ‘Dental Anxiety’, ‘Pharmacological’, and ‘Non-pharmacological’.
Conclusion: Appropriate management of dental anxiety is crucial to ensure a successful dental procedure. The choice of the anxiety management must be based on the complete understanding of the particular patient, identifying the source of anxiety, and working hand-in-hand with the patient for better oral health care.
Prostate cancer is not uncommon amongst the elderly men. Diagnosis is made using histopathology specimens of Transrectal Ultrasound guided biopsy of the prostate gland. However, prostate cancer presenting as a intra-prostatic cysts are rare. We report a case of elderly gentleman who presented with malignant intra-prostatic cysts.
Six groups of adult Sprague-Dawley rats were orally administered with a variety of treatments to elucidate their cytoprotective effects. Absolute ethanol combined with HCl was used to induce gastric lesions in rats. Aqueous and ethanol extracts of Chromolaena odorata, a famous folk herb for treating skin wounds were evaluated to determine their protective effect on gastric mucosa. In this study, aqueous extract and ethanol extract of C. odorata were combined with honey. In addition, honey alone and honey combined with cimetidine were also evaluated. Rat stomachs were examined grossly and histologically. Results were expressed as inhibition percentage. The honey and aqueous extract combination showed the highest inhibition percentage (72.67%) followed by honey and ethanol extract (58.92%), honey and cimetidine (56.55%) and the lowest was honey alone (46.74%). However, there were no significant differences between the effects of aqueous and ethanol extracts of C. odorata and honey in promoting cytoprotective effects and this may be due to the small sample size. Nevertheless, these results suggest that C. odorata and honey may be beneficial in treating induced gastric mucosal injury.
Introduction: Providing adequate and equal access to healthcare is a key goal towards achieving universal health coverage. However, social and demographic inequalities in accessing health care services exist in both developed and developing countries. This study examined the demographic and socio-economic factors associated with the lack of access to public clinics in the Greater Kuala Lumpur area.
Materials and Methods: The study employed a survey involving 1032 participants. Data were collected using self- administered questionnaires distributed between October and December 2015 in the Greater Kuala Lumpur area.
Results: Of the 1032 participants, 535 were public clinic users. A quarter (25.8%) of the users stated that they did not have access to public clinics in their residential area. A multiple logistic analysis showed that the elderly, the women, those from ethnic minority groups, those of lower family income, and the private sector workers were more likely not to have access to public clinics than their counterparts.
Conclusions: The existing level of accessibility to public clinics could be improved by increasing the number of clinics. Clinics should be established to focus more on reaching the elderly, the women, the ethnic minority groups, the poorer families, and the private sector employees.
Dengue is one of the highest occurring vector-borne diseases. It is caused by dengue viruses 1- 4. Currently, the disease is classified into dengue with or without warning signs and severe dengue based on WHO 2009 dengue classification. As of today, neither specific drugs nor commercial vaccine exist for dengue. The best treatment yet would be support, management and proper medical care. With no pathognomonic features that could differentiate it from other febrile illnesses, clinical diagnosis alone is insufficient. Yet, despite the current advances and existence of various laboratory diagnostic methods of dengue, a consensus singular method has not been established. There are several hypotheses or theories regarding the vaguely understood immunopathogenesis of dengue. Amongst these are the viral factors, host-immune factors and host-genetic factors. In addition to these, the occurrence of asymptomatic dengue has further complicated the disease. However, these individuals provide opportunities in the search for protective factors against dengue.
Dengue virus infection has been endemic in Malaysia and in the region for decades and the disease caused by the virus has led to increased morbidity and mortality each year. Dengue is now endemic in more than 110 countries worldwide with two-fifths of the world's population at risk. Dengue fever is a flu-like illness and clinical features vary with the age of the patient. Dengue haemorrhagic fever on the other hand, is characterized by high fever, haemorrhagic phenomena and in severe cases, circulatory failure. There is no specific treatment for dengue fever but careful clinical management frequently saves the lives of these patients. Vaccine development has been difficult as protection against one or two dengue viruses could actually increase the risk of more serious diseases. At present, the only method of preventing dengue is to combat the vector mosquitoes. Dengue is diagnosed by viral isolation and or serology. Current methods, some in-house and others commercial, are far from satisfactory. My laboratory has developed, evaluated and validated tests for dengue that now enable detection on the first day of illness in most cases. At the same time an important aspect of dengue prevention is protection. To this end, we have been investigating the various immune parameters such as T-cells, cytokines and antibody neutralizing activities to show that specific immune responses do occur in a selected Malaysian population which are HLA restricted, cytokine mediated and directed specifically at certain regions of the virus.
Recent innovations in the treatment of schizophrenia reflect a growing trend towards community-based care. Malaysia had in the past few years attempted to deinstitutionalise mental patients in the mental hospitals. Therefore it is important to conduct research to compare the two groups of schizophrenia patients (community-based patients against chronic hospitalised patients) to ascertain if deinstitutionalisation has been beneficial. The main objective of the study was to compare levels of depression and function in community-based patients against chronic hospitalised patients as depression is prevalent among schizophrenia patients. This study was cross sectional in nature where data was collected from 51 inpatients in Hospital Bahagia Ulu Kinta (HBUK) and 23 community-based patients. Calgary Depression Scale for Schizophrenia (CDSS) and Global Assessment of Functioning scale (GAF) were the assessment tools used. Community-based patients were found to have significantly lower scores in the CDSS scale (1.96) as compared to chronic hospitalised patients (4.04); p < 0.01). They also showed higher functional capability between community-based and hospitalised patients respectively (74.04 vs 57.92) respectively. (p < 0.001). Community services appeared to be more effective than long stay in-patient services in preventing depression and promoting better functional levels.