Objective: This study aims to analyze management of the tuberculosis program at PHCs in Surabaya.
Methods: The research method used is qualitative research. Data collection was done by interviewing tuberculosis officers about TB program and carrying out observations at the PHCs.
Results: The study showed that case finding in the Perak Timur PHC and the Sawahan PHC was passive-active. The Perak Timur PHC has facilities for rapid molecular testing, while the Sawahan PHC have to go to a center for Health Laboratory if rapid molecular testing is needed. In terms of treatment, patients at the Perak Timur PHC would come according to an agreement with TB officer, while at the Sawahan PHC, patients have to come every Monday. Officer at the Perak Timur PHC tended to accommodate the needs of TB patients compared to officer at the Sawahan PHC. The level of adherence to taking medication in two PHCs is good but there are a number of patients who have not really understood the frequency of taking medication.
Conclusion: Generally, both PHCs have good TB program management but the Perak Timur PHC tends to be more flexible towards patients while the Sawahan PHC tends to be stricter towards patients.
AIM: To identify the effect of triage training on the skills and accuracy of triage decisions for adult trauma patients.
METHOD: A randomized controlled trial design was conducted in ten emergency department of public hospitals. A total of 143 registered nurses and medical officer assistants who performed triage roles were recruited for the control group (n = 74) and the intervention group (n = 69). The skill and accuracy of triage decisions were measured two weeks and four weeks after the intervention group were exposed to the intervention.
RESULTS: There was a significant effect on the skill of triage decision-making between the control and the intervention group p
OBJECTIVES: To document the prevalence of atrial fibrillation (AF) in the multiracial population of Malaysia, and to describe the clinical features and management of these patients.
SETTING: Busy city centre general hospital in Kuala Lumpur, Malaysia, over a 1-month period.
SUBJECTS: One-thousand four hundred and thirty-five acute medical admissions, of whom 40 patients (2.8%) had AF.
RESULTS: Of 1435 acute medical admissions to Kuala Lumpur General Hospital over the 4-week study period, 40 had AF (21 male, 19 female; mean age 65 years). Of these, 18 were Malay, 16 Chinese and six Indian. Nineteen patients had previously known AF (seven with paroxysmal AF) and 21 were newly diagnosed cases. The principal associated medical conditions were ischaemic heart disease (42.5%), hypertension (40%) and heart failure (40%). Dyspnoea was the commonest presentation, whilst stroke was the cause of presentation in only two patients. Investigations were under-utilised, with chest X-ray and echocardiography in only 62.5% of patients and thyroid function checked in 15%. Only 16% of those with previously diagnosed AF were on warfarin, with a further three on aspirin. Anticoagulant therapy was started in 13.5% of patients previously not on warfarin, and aspirin in 8%. Records of contraindications to warfarin were unreliable, being identified in only 25%. For those with known AF, 58% were on digoxin. For new onset AF, digoxin was again the most common rate-limiting treatment, initiated in 38%, whilst five patients with new onset AF were commenced on amiodarone. DC cardioversion was not used in any of the patients with new onset AF.
CONCLUSION: Amongst acute medical admissions to a single centre in Malaysia the prevalence of AF was 2.8%. Consistent with previous similar surveys in mainly western (caucasian) populations, standard investigations in this Malaysian cohort were also inadequate and there was underuse of anticoagulation, medication for ventricular rate control and cardioversion to sinus rhythm.