Displaying publications 81 - 100 of 290 in total

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  1. Chandrasekaran PK, Jambunathan ST, Zainal NZ
    Ann Gen Psychiatry, 2005 Apr 15;4(1):9.
    PMID: 15876360
    BACKGROUND: Organic Brain Syndromes (OBS) are often missed in clinical practice. Determining their varied presentations may help in earlier detection, better management, and, assessing prognosis and outcome. We described the in-patient referrals of patients suffering from the psychiatric effects of organic states and compared the symptomatology and mortality between those with the Acute and Chronic varieties. METHODS: 59 patients referred to our Consultation-Liaison (C-L) Psychiatry services and given a clinical diagnosis of OBS were selected over a 6-month period. Psychiatric and cognitive abnormalities and treatment regimes were recorded and fatality rates determined. Information regarding their condition 24 months after their index hospitalization was recorded. All data were entered into a proforma and analyzed after exclusion. RESULTS: The mean duration of detecting the symptoms by the physician was 3.52 days. The presence of a premorbid psychiatric illness had no influence on the clinical presentation but did on the mortality of patients with OBS (p = 0.029).Patients with the Acute syndrome had significantly more symptom resolution as compared to those with the Chronic syndrome (p = 0.001) but mortalityrates did not differ. Elderly patients and those with symptom resolution upon discharge did not show statistically significant higher mortality rates. The most popular combination of treatment was that of a low-dose neuroleptic and a benzodiazepine (34.7%). The need for maintenance treatment was not significantly different in any group, even in those with a past history of a functional disorder. CONCLUSION: Other than the Acute group having a significantly better outcome in terms of symptom resolution, our findings suggest that there was no significant difference in the clinical presentation between those with Acute or Chronic OBS. Mortality-wise, there was also no difference between the Acute and Chronic syndromes, nor was there any difference between the elderly and the younger group. There was also no significant difference in the need for continued treatment in both groups.
    Matched MeSH terms: Referral and Consultation
  2. Florentino R, Tee ES, Poh BK
    Asia Pac J Clin Nutr, 1999 Dec;8(4):291-9.
    PMID: 24394232
    The 3-day seminar-workshop on 'Food-based Dietary Guidelines and Nutrition Education' was held from 22-24 July 1998 in Kuala Lumpur, Malaysia to present the latest scientific information on nutrition and health and to discuss its impact on the rationale and process for the development of food-based dietary guidelines (FBDG). The first two sessions were devoted to a review of the current information on the relation between lifestyle factors and chronic diseases, particularly obesity; the present health status and food consumption patterns in Malaysia; the current consensus on carbohydrates and fats and oils and the importance of considering the glycemic index of foods; and the importance of micronutrients in health and disease. The third and fourth sessions dealt with the rationale of FBDG and the process of their development, drawing from the 1990 FAO/WHO Consultation on Development of FBDG and the experience in the Philippines and in Europe. The importance of effective dissemination of nutrition messages to the public was thoroughhly discussed. The workshop sessions arrived at recommendations on important issues in the development of FBDG in the region, including main research and information needs, the steps in the development of FBDG, and strategies for their dissemination.
    Matched MeSH terms: Referral and Consultation
  3. Simpson D
    Aust N Z J Surg, 1994 Aug;64(8):525-6.
    PMID: 8048887
    Matched MeSH terms: Referral and Consultation
  4. Razali MS
    World Health Forum, 1995;16(1):56-8.
    PMID: 7873026
    Contrasting beliefs often make cooperation between folk healers and modern doctors seem impossible. In the field of mental health, where communication is of such central importance, better mutual understanding is especially desirable. After reviewing the complexities involved, the author makes some suggestions on how the two kinds of practitioner could help each other.
    Matched MeSH terms: Referral and Consultation
  5. Mai CW, Tan JSH, Koay GWL, Lim LYX
    Pharmacy (Basel), 2020 Sep 13;8(3).
    PMID: 32933158 DOI: 10.3390/pharmacy8030170
    Dietary supplementation is increasingly sought after by consumers looking to meet the demands of a modern lifestyle. Effective supplementation requires knowledge of the purpose and proper use of nutritional supplements. Unverified or inadequate guidance on supplementation can propagate misconceptions and increase undue fears of side effects. Community pharmacists are best placed to guide consumers on nutritional supplement use. In this review, a panel comprised of community pharmacists, pharmacy academia, and dietitians (n = 6) convened to provide an experience- and evidence-based guidance on rational drug use, patient education, and integrated and personalized nutrition care in both community and hospital pharmacy settings. A novel framework to guide community pharmacist-led consultations on supplementation is proposed. The four-step CARE (Categorize, Assess, Recommend, Empower) guide was developed to facilitate and optimize outcomes of pharmacist-led nutritional supplement consultation. Telehealth advancements in the form of digital health applications and personalized nutrigenomic DNA testing support Integrative Nutrition Care, and will further promote appropriate supplementation use to improve overall well-being in the community. Practical implementation of the CARE guide is necessary to ascertain its applicability for optimizing outcomes of pharmacist-led consultation and the recommendation of nutritional supplements.
    Matched MeSH terms: Referral and Consultation
  6. Suraya Hanim Abdullah Hashim, Liew K. Y., Sahadevan M., Shoib M. S., Zainal Abidin H., Abidin N. N., et al.
    MyJurnal
    Introduction:Increasing number and the complexity of dengue cases pose a great challenge. The dengue outbreak preparedness and contingency plan is a series of collective intervention or polices put into place via collective agreement between administrative, Medical, Emergency Department and Intensive Care Unit (ICU). The aim of this paper is to evaluate the impact implementation of a dengue contingency plan on the clinical outcome of dengue cases. Methods: Implementation of the dengue outbreak preparedness and contingency plan was commenced in 2017. A pre-intervention (2017) and post-intervention (2018) retrospective review of mortality cases and referral to ICU were undertaken. The interventions included mandatory fast review by Emergency Physician, Medical Physi-cian and Anaesthesist in Emergency Department for ill patients (Dengue Care Pathway), cohorting dengue patient to one ward with mandatory monitoring and review system, clinical management adhering to the Clinical Practice Guideline of Management of Dengue Infection in Adults (2015), referring ill patients to ICU, deployment of nurses and experienced doctors to the dengue ward based on ratio of staff to patients, increasing number of doctors on-call at the dengue ward and a dengue bed manager system led by the Matron and Sisters. The plan was activated by mutual agreement between the Head of Medical Department and the Hospital Director. Results: There was a marked increment of admission of dengue cases into intensive care unit by 59% either directly from emergency department or the dengue wards in 2018 compared to 2017. The mortality rates reduced significantly from 5.4 deaths for every 1000 admission in 2017 to 3.3 in 2018. This is a reduction 2.1 death for every 1000 dengue admission. Conclusion:The implementation of the dengue outbreak preparedness and contingency plan aided the team to provide best care and practice in dengue management especially in the severely ill.
    Matched MeSH terms: Referral and Consultation
  7. Erni Noor, Nur Azielyana Noor Kamaruzaman, Nur Syahira Mohd Jeffri, Nik Nazurah Nik Eezammudden, Nur Zety Mohd Noh
    Compendium of Oral Science, 2018;5(1):37-45.
    MyJurnal
    Objectives: Periodontitis is a chronic disease which remain undiagnosed and untreated without proper examination and referral to specialist clinic for further management Therefore, this study was conducted to evaluate the pattern of referrals to Universiti Teknologi MARA (UiTM) Periodontal Specialist Clinic. Materials and methods: A total of 176 periodontal cases referred to UiTM Periodontal Specialist Clinic in year 2011 and 2016 were identified and patient’s referral forms were collected. The data obtained were the referred cases from undergraduate student clinics, other specialist clinics, UiTM primary dental care clinic and private dental clinics. Descriptive data analysis was conducted using frequency distribution by SPSS. Chi square analysis was used to evaluate the association of source of referral, diagnosis and reason for referrals to Periodontal Specialist Clinic. Results: There was increased referral cases to Periodontal Specialist Clinic in 2016 (86.9%) compared to 2011 (13.1%). Most referral to Periodontal Specialist Clinic were received from faculty’s undergraduate student clinic in both 2011 and 2016 (46%), followed by other specialists (27.3%), primary care clinic (25.6%) and private practice (1.1%). 96% of cases were referred for intervention by periodontist as more than half of the cases were referred for the non-surgical periodontal treatment. Chi square analysis showed the association between source of referral and reason for referral was statistically significant (p value=0.000). Conclusion: Proper periodontal screening in all patients and necessary referral to specialist clinic is crucial to prevent undiagnosed periodontal disease.
    Matched MeSH terms: Referral and Consultation
  8. Ramasamy V, Nadarajah S
    J Family Med Prim Care, 2019 1 2;7(5):1083-1085.
    PMID: 30598962 DOI: 10.4103/jfmpc.jfmpc_47_18
    A foreign body in the nose is a common referral dealt by the otolaryngologist on daily basis. Here we report a case of a 5-year-old girl who was referred from a primary care center with complaints of left nasal blockage and epistaxis along with foul smelling brownish discharge for 1-day duration. Nasal endoscopic examination of the left side of the nose revealed an impacted button battery at the cartilaginous portion of the nasal septum.
    Matched MeSH terms: Referral and Consultation
  9. Lee M, Son HJ, Kim NY, Kim SJ, Yu IK
    Malays J Pathol, 2019 Aug;41(2):201-206.
    PMID: 31427557
    We present a case of an undifferentiated subtype of non-keratinizing squamous cell carcinoma (NK-SCC) with sarcomatoid features in the nasopharynx in a 69-year-old man who was difficult to diagnose due to spindle-shaped malignant cells. He was admitted because of a right nasal obstruction and right headache, and imaging revealed a heterogeneously enhanced irregularly shaped mass at the nasopharynx. Histopathologically, the tumour was partially organised, and the tumour cells were epithelioid or spindle-shaped. Initially, we erroneously diagnosed the tumour as an angiosarcoma owing to its false-negative immunoreaction for cytokeratins and a mistaken interpretation for CD31. After in situ hybridization for Epstein-Barr virus was positive, a consultation and additional immunostaining (including re-staining for cytokeratin with varying dilutions) were performed, and the diagnosis was revised to NK-SCC with sarcomatoid features. We believe that sarcomatoid features may be observed in nasopharyngeal carcinoma and in this case, immunostaining using various epithelial markers is necessary and careful attention should be paid to the interpretation of immunostaining.
    Matched MeSH terms: Referral and Consultation
  10. Wharton-Smith A, Green J, Loh EC, Gorrie A, Omar SFS, Bacchus L, et al.
    BMC Infect Dis, 2019 Jan 11;19(1):45.
    PMID: 30634929 DOI: 10.1186/s12879-019-3680-5
    BACKGROUND: Malaysia has rising dengue incidence. World Health Organization clinical practice guidelines for managing dengue have been adapted by the Ministry of Health in Malaysia, with evidence of good awareness by clinicians. However, dengue mortality has not reduced. This study aimed to explore the challenges of dengue management for Medical Officers, with a particular focus on use of clinical practice guidelines.

    METHODS: Qualitative study using six focus groups and 14 semi-structured interviews with doctors responsible for dengue management at a large tertiary hospital in Malaysia.

    RESULTS: Dengue was recognised as difficult to diagnose and manage. Wide awareness and use of both WHO and Ministry of Health guidelines was reported, but several limitations noted in their coverage of particular patient groups. However, the phrase 'guidelines' also referred to local algorithms for fluid management, which were less clinically evidence-based. Where Medical Officers were well trained in the appropriate use of evidence-based guidelines, barriers to use included: the potential for 'following the algorithm' to undermine junior clinicians' claims to clinical expertise; inability to recognise the pattern of clinical progress; and lack of clinical experience. Other reported barriers to improved case management were resource constraints, poor referral practices, and insufficient awareness of the need for timely help seeking.

    CONCLUSIONS: Awareness of clinical practice guidelines is a necessary, but not sufficient, condition for optimal dengue management. In high prevalence settings, all clinical staff would benefit from regular dengue management training which should include diagnosis, practice in monitoring disease progression and the use of clinical practice guidelines in a range of clinical contexts.

    Matched MeSH terms: Referral and Consultation
  11. Xinyi, Deborah Yong, Affizal Ahmad
    MyJurnal
    Awareness, involvement and training in dysphagia management are essential to ensure that patients are appropriately
    assessed for dysphagia and provided with intervention. The study aimed to identify levels of awareness, involvement and
    training of medical officers in dysphagia management. A total of 51 medical officers from the family medicine, medical,
    otorhinolaryngology, surgery, and neurosurgery departments in Hospital Universiti Sains Malaysia participated in the
    study. Levels of awareness, involvement and training of medical officers in dysphagia management were reported using
    descriptive analysis. Results indicate that medical officers lacked awareness and training in dysphagia management.
    Referral rates to speech-language pathologists for dysphagia management were low with 58.4% of medical officers having
    had seldom or never referred patients. The results provide valuable information for addressing dysphagia management
    in the hospital.
    Matched MeSH terms: Referral and Consultation
  12. Mohd Shaiful Ehsan Shalihin, Iskandar Firzada Osman, Muhammad Hapizie Bin Din
    MyJurnal
    Introduction: Long waiting time is a common issue complained by diabetic patients that came for an
    early morning appointment in a health clinic. Therefore, an audit was conducted among diabetic patients in
    a primary care clinic with the aim to assess the patients’ waiting time and to formulate strategies for
    improvement. Methods: This audit was conducted for four weeks using a universal sampling method in
    November 2017. All diabetic patients who attended the clinic during this period were included except those
    who required longer period such as critically ill patients or those who came for repeat medication or
    procedures. The arrival and departure time for each station was captured using the modified waiting time
    slip, which is manually filled at every station. The waiting and consultation time for registration, screening,
    laboratory investigation, diabetic educator, doctor and pharmacy were recorded. The data were entered into
    the statistical software SPSS version 17 for analysis. Results: Results showed that all patients were registered
    within 11.0 minutes (SD=2.52min). Average total waiting time to see a diabetic educator and a doctor was
    20.9 minutes (SD=15.53min) and 33.23 minutes (SD=27.85min), respectively. Average waiting time for other
    stations was less than 10 minutes. Average total time spend in the clinic for a diabetic patient was 107.58
    minutes, which is comparable to a non-diabetic patient. The identified problems were due to the poor
    tracing and filing system. Conclusion: Improvement strategies recommended include enforcing early file
    tracing prior to appointment and providing a checklist for consultation by doctors and diabetic educators.
    Matched MeSH terms: Referral and Consultation
  13. Nurjasmine Aida Jaman, Nor Azam Kamaruzaman, Abdul Hadi Said
    Malaysian Family Physician, 2020;15(2):46-49.
    MyJurnal
    Undernutrition remains a major public health concern, especially in developing countries. Despite
    being rich in resources, Malaysia is still home to children sufering from severe undernutrition.
    Tis paper presents the case of a 5-month-old boy with kwashiorkor stemming from improper
    weaning which was overlooked. Tis case highlights the importance of recognizing the early signs of
    kwashiorkor to allow for early referrals for proper management and prevent its possible complications.
    Matched MeSH terms: Referral and Consultation
  14. Lai CK, Tay KT, Abdullah R
    Med J Malaysia, 2021 03;76(2):233-235.
    PMID: 33742634
    In recognising the palliative care (PC) needs globally and in Malaysia, services were developed to serve the rural area of Kuala Lipis, Pahang. This communication describes the initial a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, stages of development towards achieving a successful implementation. PC services were led by Kuala Lipis district hospital include inpatient referrals, outpatient and community care through home visits. These services involve multi-disciplinary team inclusive of representatives from health clinics and allied health. Referrals and opioid usage have demonstrated an increasing trend since its implementation in October 2018. Implementation of rural PC services is feasible; however, long-term sustainability needs to addressed.
    Matched MeSH terms: Referral and Consultation
  15. Putri Yubbu, Johan Aref Jamaluddin, Lydia Chang Mun Yin, Geetha Kandavello, Mazeni Alwi, Hasri Samion, et al.
    MyJurnal
    The present study aims to determine the limitations of traditional Jones criteria during the first episode of acute rheu- matic fever (ARF) at the initial referral hospital, in a cohort of patients below 18 years old who had undergone mitral valve repair in National Heart Institute (IJN) from 2011 to 2016. Carditis followed by fever and joint involvement were the most frequent manifestations at first diagnosis. Of the 50 patients, only seven (14%) fulfilled the traditional Jones criteria for the diagnosis of the first episode of ARF. When compulsory evidence of a previous group A Beta he- molytic streptococcus (GABHS) was disregarded, this figure rose to 54%. Therefore, strict adherence to Jones criteria with absolute documentation of GABHS will lead to underdiagnoses of ARF. The application of echocardiographic diagnostic criteria of rheumatic heart disease (RHD) needs to be emphasized to allow early diagnosis and adminis- tration of secondary prophylaxis to prevent progression to severe valvular disease.
    Matched MeSH terms: Referral and Consultation
  16. Siti BC, Zulkifli MM, Mohd Yusoff SS, Muhamad R, Ahmad TM
    Malays Fam Physician, 2020;15(3):90-94.
    PMID: 33329869
    Schizencephaly is a very rare congenital birth defect. It is characterized by a cortical brain malformation that manifests as a grey-matter-lined cleft extending from the ependyma to the pia mater. It is a rare condition, and few cases have been reported in the literature. The exact cause is unknown. Herein, we report a case of an infant presenting with left side hemiparesis. The CT scan of her brain revealed right fronto-temporal and left parieto-temporal open-lip schizencephaly; thus, urgent referral to a pediatric neurologist was made for early intervention.
    Matched MeSH terms: Referral and Consultation
  17. Siti Mariam Ja’afa, Azriani Ab Rahman, Wan Nor Ariffin Wan Mansor
    MyJurnal
    Introduction: Child abuse is an epidemic and in Malaysia, the numbers are rising. Statistic showed that 60% of the victims were below seven years old. Since most of them goes to preschool at this age, the role of childcare providers (CPs) in addressing this issue is crucial. However, previous data showed that referrals made by them to the author-ities was less than 1%. The objective of this study was to determine the knowledge and attitude of CPs in KEMAS preschools towards child abuse. Methods: This is a cross-sectional study involving CPs working in the KEMAS pre-schools in Kota Bharu and Tumpat, Kelantan, Malaysia, from April to June 2019. Results: From 218 respondents, 78% and 83% of them had good awareness on signs of neglect and physical abuse respectively compared to sexual abuse (64.6%). In terms of knowledge, 80% answered correctly about signs of abuse. However, only 18.8% an-swered correctly about sexual abuse. Moreover, 86.7% of CPs believed that they should be responsible to lodge a report, while only 6% of them objected. Although 76.1% were correct about the information to be prepared for reporting, only 4.6% of them realised that suspicions about a case would suffice to lodge a report. There were 94.5%, and 65.1% of CPs who correctly answered about the protection of the reporter under the law and its penalty respectively. But, only 26.6% of the CPs were correct about the category of mandated reporters according to the law. Conclusion: Although majority of CPs had good knowledge and awareness, there was still 26.6% who did not realise that they were mandated to report suspected cases. Therefore, educational programs need to be planned to increase awareness and knowledge on abuse and its legal aspects among CPs.
    Matched MeSH terms: Referral and Consultation
  18. Lam CS, Umi Kalthum MN, Norshamsiah MD, Bastion M
    Malays Fam Physician, 2018;13(3):32-37.
    PMID: 30800232
    Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids, particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent, and children are commonly being prescribed topical anti-inflammatories, including topical steroids, by general practitioners. Furthermore, topical steroids are also available over the counter, and this availability contributes to overuse without proper monitoring by an ophthalmologist. We present a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids among children for vernal keratoconjunctivitis. The medications were prescribed initially by general ophthalmologists and were continually bought over the counter by parents. At the presentation to our center, these patients were already compromised visually, exhibiting glaucomatous optic disc changes and high intraocular pressure. The series highlights the optic nerve damage resulting in irreversible visual compromises among children on long-term, topical steroids and the importance of regular monitoring with a low threshold for ophthalmologist referral.
    Matched MeSH terms: Referral and Consultation
  19. Gendeh HS, Abdullah AB, Goh BS, Hashim ND
    Ear Nose Throat J, 2019 Aug;98(7):416-419.
    PMID: 31018687 DOI: 10.1177/0145561319840166
    Intracranial complications secondary to chronic otitis media (COM) include otogenic brain abscess and sinus thrombosis. Intravenous antibiotics and imaging have significantly reduced the incidence of intracranial complications secondary to COM. However, the same does not apply to a developing country like Malaysia, which still experiences persisting otogenic complications. This case series describes 3 patients with COM and intracranial complications. All 3 patients had COM with mastoiditis, with 1 of the 3 having a cholesteatoma. Postulated reasons for the continued occurrence include poor access to health care, poor compliance with medication, and the lack of pneumococcal vaccination during childhood. In conclusion, public awareness and a timely specialty referral can reduce the incidence of intracranial complications of COM.
    Matched MeSH terms: Referral and Consultation
  20. Lam, C.S., Umi Kalthum, M.N., Norshamsiah, M.D., Bastion, M.L.C.
    Malaysian Family Physician, 2018;13(3):32-37.
    MyJurnal
    Steroid-induced glaucoma is the most serious complication of the injudicious use of steroids,
    particularly among children affected by allergic conjunctivitis. This condition is steroid-dependent,
    and children are commonly being prescribed topical anti-inflammatories, including topical steroids,
    by general practitioners. Furthermore, topical steroids are also available over the counter, and this
    availability contributes to overuse without proper monitoring by an ophthalmologist. We present
    a series of five cases illustrating the devastating effect of unmonitored, long-term use of steroids
    among children for vernal keratoconjunctivitis. The medications were prescribed initially by general
    ophthalmologists and were continually bought over the counter by parents. At the presentation to
    our center, these patients were already compromised visually, exhibiting glaucomatous optic disc
    changes and high intraocular pressure. The series highlights the optic nerve damage resulting in
    irreversible visual compromises among children on long-term, topical steroids and the importance
    of regular monitoring with a low threshold for ophthalmologist referral.
    Matched MeSH terms: Referral and Consultation
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