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Fulltext Dandy-walker syndrome in a child at rural Kelantan, Malaysia

Low, Qin Jia, Huan, Nai Chien, Tan, Wei Lun

Borneo Journal of Medical Sciences, 2018;12(2):41-45.
MyJurnal

Dandy-Walker syndrome is a rare congenital malformation of the brain that involves the cerebellum and the fourth ventricle. It is characterised by a classical triad of hydrocephalus, cystic dilatation of the fourth ventricle and complete or partial agenesis of the vermis. Majority of cases are diagnosed during neonatal or early infantile period. In this case report, a seven-year-old boy complained of recurrent headaches for the past one year. Physical examination was unremarkable. Examination of the fundus on the same day revealed bilateral papilloedema. His subsequent computed tomography scan of the brain done at a major district hospital demonstrated features in keeping with Dandy-Walker malformation. Our case highlighted the importance of embarking on a detailed and thorough approach when dealing with a child with chronic headache, especially in rural settings where advanced medical equipment is not readily available.

Matched MeSH terms: Hospitals, District
Fulltext Clinical phenotypes and heath-related quality of life of COPD patients in a rural setting in Malaysia - a cross-sectional study

Chai CS, Mos SB, Ng DL, Goh GM, Su AT, Ibrahim MAB, et al.

BMC Pulm Med, 2020 Sep 29;20(1):254.
PMID: 32993591 DOI: 10.1186/s12890-020-01295-4

BACKGROUND: The Spanish chronic obstructive pulmonary disease (COPD) guideline phenotypes patients according to the exacerbation frequency and COPD subtypes. In this study, we compared the patients' health-related quality of life (HRQoL) according to their COPD phenotypes.
METHODS: This was a cross-sectional study of COPD patients who attended the outpatient clinic of the Serian Divisional Hospital and Bau District Hospital from 23th January 2018 to 22th January 2019. The HRQoL was assessed using modified Medical Research Council (mMRC), COPD Assessment Test (CAT), and St George's Respiratory Questionnaire for COPD (SGRQ-c).
RESULTS: Of 185 patients, 108 (58.4%) were non-exacerbators (NON-AE), 51 (27.6%) were frequent exacerbators (AE), and the remaining 26 (14.1%) had asthma-COPD overlap (ACO). Of AE patients, 42 (82.4%) had chronic bronchitis and only 9 (17.6%) had emphysema. Of the 185 COPD patients, 65.9% had exposure to biomass fuel and 69.1% were ex- or current smokers. The scores of mMRC, CAT, and SGRQ-c were significantly different between COPD phenotypes (p

Matched MeSH terms: Hospitals, District
Prevalence of depression among diabetic patients in an outpatient clinic in Hospital Sik: A rural hospital in Malaysia

Ng TK

Asian J Psychiatr, 2010 Jun;3(2):76-7.
PMID: 23051195 DOI: 10.1016/j.ajp.2010.03.008

Study period: 1 February 2008 till 1 August 2008
Study participants: 110 type 2 diabetes patients, 40% male, 96% malay
Study design: Cross-sectional study
Questionnaire: Beck depression inventory II (BDI-II) in Malay version
Prevalence of depression: 22%
Study site: Outpatient clinic, Hospital Sik, Kedah, Malaysia

Matched MeSH terms: Hospitals, District
Key quality aspect: a fundamental step for quality improvement in a resource-poor setting

Su TT, Sax S

Asia Pac J Public Health, 2009 Oct;21(4):477-86.
PMID: 19666950 DOI: 10.1177/1010539509342433

The objective of the study is to identify user's perception of key quality aspects of the hospital and its influence on willingness to pay. The study was conducted in 2001 in Dhading District Hospital, Nepal. This was a descriptive, cross-sectional study design using quantitative and qualitative methods: questionnaire exit interview and focus group discussions with inpatients and outpatients, focus group discussion with service providers, and key informant interviews. The research identified attitude, technical and interpersonal skills of health personnel, availability of drugs and services as important quality aspects to be improved. Users were motivated to use this hospital and were ready to pay if they received proper treatment from skilled and communicative staff. This study highlights the importance of identifying the quality factors important to service users as a first step in improving quality. For the users within this study, this meant improving attitude, interpersonal skills, and technical skills of service personnel.

Matched MeSH terms: Hospitals, District/economics*
Fulltext Post motor vehicle accident with multiple jagged laceration wound

Irfan Mohamad, Arumugam, Puvan Arul, Nik Fariza Husna Nik Hassan

Archives of Orofacial Sciences, 2011;6(2):86-88.
MyJurnal

An 11-year-old Malay boy was allegedly involved in motor vehicle accident. He sustained left lung contusion and pneumothorax which necessitate chest tube insertion at a district hospital. On arrival at Accident & Emergency Unit, general physical examination was performed. Neck examination revealed multiple jagged lacerations wound on the left side of the neck (Panel 1). (Copied from article).

Matched MeSH terms: Hospitals, District
Comparison of the effectiveness of trauma services provided by secondary and tertiary hospitals in Malaysia

Sethi D, Aljunid S, Saperi SB, Clemens F, Hardy P, Elbourne D, et al.

Ann Emerg Med, 2007 Jan;49(1):52-61, 61.e1.
PMID: 17084938

STUDY OBJECTIVE: The trauma services provided by 6 hospitals operating at 2 levels of care (4 secondary or district general hospitals and 2 tertiary care hospitals) in Malaysia are compared in terms of mortality and disability for direct admissions to emergency departments to test the hypothesis that care at a tertiary care hospital is better than at a district general hospital.
METHODS: All cases were recruited prospectively for 1 year. The hospitals were purposefully selected as typical for Malaysia. There are 3 primary outcome measures: death, musculoskeletal impairment, and disability at discharge. Adjustment was made for potential covariates and within-hospital clustering by using multivariable random-effects logistic regression analysis.
RESULTS: For direct admissions, logistic-regression-identified odds of dying were associated with older age (>55 years), odds ratio (OR) 1.9 (95% confidence interval [CI] 1.3 to 2.8); head injury, OR 2.7 (95% CI 1.9 to 3.9); arrival by means other than ambulance, OR 0.6 (95% CI 0.4 to 0.8); severe injuries (Injury Severity Score >15) at a district general hospital, OR 45.2 (95% CI 27.0 to 75.7); severe injuries at a tertiary care hospital, OR 11.2 (95% CI 7.3 to 17.3); and admission to a tertiary care hospital compared to a district general hospital if severely injured (Injury Severity Score >15), OR 0.2 (95% CI 0.1 to 0.4). Admission to a tertiary care hospital was associated with increased odds of disability (OR 1.9; 95% CI 1.5 to 2.3) and musculoskeletal impairment (OR 3.5; 95% CI 2.7 to 4.4) at discharge.
CONCLUSION: Care at a tertiary care hospital was associated with reduced mortality (by 83% in severe injuries), but with a higher likelihood of disability and impairment, which has implications for improving access to trauma services for the severely injured in Malaysia and other low- and middle-income settings.

Matched MeSH terms: Hospitals, District/standards*
Infant feeding practices among nursing personnel in Malaysia

Sinniah D, Chon FM, Arokiasamy J

Acta Paediatr Scand, 1980 Jul;69(4):525-9.
PMID: 7446101

Concerned by the alarming decline in breast feeding in the urban and rural areas of Malaysia, we conducted a critical review of infant feeding practices among nursing personnel from representative centres using questionnaires. It was found that although 75% of mothers breast-fed their babies at birth only 19% did so at 2 months and 5% at 6 months respectively. Chinese mothers initiated breast feeding less frequently compared with Indian or Malay mothers. The prevalence of breast feeding was higher among lower category nurses, lower income groups and those from health centres. Decision for breast feeding was based in most instances on conviction derived from reading, lectures or advice from relatives. The vast majority of mothers listed "work' as the main reason for termination of breast feeding followed by "insufficient breast milk' and satisfactory past experience with bottle feeding. The ramifications of these findings and measures to improve the prevalence and duration of breast feeding are discussed.

Matched MeSH terms: Hospitals, District