MyMedR

Chronic pain and pattern of health care utilization among Malaysian elderly population: National Health and Morbidity Survey III (NHMS III, 2006)

Mohamed Zaki LR, Hairi NN

Maturitas, 2014 Dec;79(4):435-41.

PMID: 25255974 DOI: 10.1016/j.maturitas.2014.08.014

OBJECTIVE: The aims of this study were to report prevalence of chronic pain and to examine whether chronic pain influence healthcare usage among elderly Malaysian population.
METHODS: This was a sub-population analysis of the elderly sample in the Malaysia's Third National Health and Morbidity Survey (NHMS III) 2006, a nation-wide population based survey. A subset of 4954 elderly aged 60 years and above was used in the analysis. Chronic pain, pain's interference and outcome variables of healthcare utilization (hospital admission and ambulatory care service) were all measured and determined by self-report.
RESULTS: Prevalence of chronic pain among elderly Malaysian was 15.2% (95% CI: 14.5, 16.8). Prevalence of chronic pain increased with advancing age, and the highest prevalence was seen among the old-old group category (21.5%). Across young-old and old-old groups, chronic pain was more prevalent among females, Indian ethnicity, widows/widowers, rural residency and those with no educational background. Our study showed that chronic pain alone increased hospitalization but not visits to ambulatory facilities. Presence of chronic pain was significantly associated with the frequency of hospitalization (aIRR 1.11; 95% CI 1.02, 1.38) but not ambulatory care service.
CONCLUSIONS: Chronic pain is a prevalent health problem among the elderly in Malaysia and is associated with higher hospitalization rate among the elderly population. This study provides insight into the distribution of chronic pain among the elderly and its relationship with the patterns of healthcare utilization.
KEYWORDS: Chronic pain; Elderly; Health care utilization; Malaysia
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Aged; Aged, 80 and over; Health Services for the Aged*; Middle Aged

Fulltext Prevalence of undetected cognitive impairment and depression in residents of an elderly care home

Al-Jawad M, Rashid AK, Narayan KA

Med J Malaysia, 2007 Dec;62(5):375-9.

PMID: 18705469 MyJurnal

The elderly population in Malaysia is growing rapidly. Some of the most vulnerable are in residential care. Research is needed into the characteristics of this population to aid clinicians and policy makers in addressing the needs of this group. This observational, cross-sectional study aims to determine prevalence of undetected cognitive impairment and depression in elderly care home residents in Malaysia. One hundred and sixty-seven people over 60 years of age living in a state run residential home were interviewed. Validated assessment tools were used to measure dependency, cognitive impairment and depression. The prevalence of probable dementia is 36.5%, with increasing prevalence with age and level of dependence. Prevalence of depression is 67.0% (major depression 13.2%), with more depression in males and in the Indian population. None of the identified cases had been previously investigated or treated for dementia or depression.

Matched MeSH terms: Aged; Aged, 80 and over; Homes for the Aged*; Middle Aged

Geriatric Telemedicine: Ensuring continuity of healthcare services to the older patients in Kedah, Malaysia during the COVID-19 pandemic

Teh HL, Mohd Suan MA, Mohammed NS

Med J Malaysia, 2021 07;76(4):562-564.

PMID: 34305118

Geriatric medicine practice requires a multidimensional and multidisciplinary assessment to provide a holistic overview of the older patients. During the current COVID-19 pandemic time, it becomes more critical to ensure that the elderly patients continue to receive regular geriatric care for their pre-existing chronic illness and at the same time avoid unnecessary exposure to COVID-19 virus. Geriatric telemedicine clinic provides a convenient solution to ensure continuity of care for the older patients. Careful patient selection, technical requirement, geriatric assessment via audio-visual communication, and caretaker involvement were among the important issues discussed in this article.

Matched MeSH terms: Aged; Aged, 80 and over; Health Services for the Aged*; Middle Aged

Fulltext Age and pathology of prostate cancer in South-Southern Nigeria; is there a pattern?

Sapira MK, Obiorah CC

Med J Malaysia, 2012 Aug;67(4):417-9.

PMID: 23082453

Prostate cancer is a common health problem world wide. Age is its strong risk factor.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext Acral melanoma of the extremities: a study of 33 cases Sarawakian patients

Zainal AI, Zulkarnaen M, Norlida DK, Syed Alwi SA

Med J Malaysia, 2012 Feb;67(1):60-5.

PMID: 22582550

Acral melanoma involve the non-pigmented palmoplantar and subungual areas and are commonly seen among Asians. Patients commonly display advanced stage of disease at presentation. It may appear unnoticed and mimic benign lesions.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext Risk-adjusted analysis of patients undergoing laparotomy using POSSUM and P-POSSUM score in Queen Elizabeth Hospital, Sabah

Chieng TH, Roslan AC, Chuah JA

Med J Malaysia, 2010 Dec;65(4):286-90.

PMID: 21901947

Scoring systems such as POSSUM and P-POSSUM have been developed to help predict mortality and morbidity in patients. The ratio of observed-to-predicted (O/P ratio) mortality and morbidity has been used as a performance indicator to compare different procedures, clinicians or hospitals. The aim of this study was to assess the predictive value of POSSUM compared with P-POSSUM in patients undergoing laparotomy in Queen Elizabeth Hospital, Sabah.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext Corneal endothelial cell density and morphology in normal Malay eyes

Mohammad-Salih PA

Med J Malaysia, 2011 Oct;66(4):300-3.

PMID: 22299546 MyJurnal

This study was conducted to describe corneal endothelial cell density and morphology in Malay eyes. Non-contact specular microscopy was performed in 125 eyes of 125 Malay volunteers, aged 20-87 years. Studied parameters included endothelial cell density (CD), mean cell area (MCA), coefficient of variation (CV) in cell area, as well as hexagonal appearance of the cells. Mean endothelial cell density in the study population was 2648 +/- 310 cell/mm(2). Mean CA, CV and percentage of hexagonal cells were 382.8 +/- 47.7microm(2), 58.1 +/- 22.6, 44.3% +/- 11.5% respectively. There was a statistically significant decrease in endothelial cell density (correlation - 0.300, P = 0.001) and CV in cell size (correlation - 0.208, P = 0.02) with age. There was a statistically significant increase in mean cell area (correlation 0.300, P = 0.001) with increasing age. The correlation between age and percentage of hexagonal cells was insignificant (correlation 0.074, P = 0.41). In conclusion, a consistent decrease was noted in the endothelial cell density with increasing age. The differences in endothelial cell density between genders were statistically insignificant.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

The ideal measurement of the quality of life in post stroke patients: an urban study

Samsiah M, Das S, Chee SY, Rashidah R, Siti H, Ruth P, et al.

Clin Ter, 2011;162(3):209-15.

PMID: 21717044

There is paucity of literature on the measurement of the quality of life in post stroke patients in the developing countries. The main objective of this study was to determine the quality of life (QOL) of post stroke patients.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext Histomorphology of aberrant crypt foci in colorectal carcinoma

Norlida AO, Phang KS

Malays J Pathol, 2010 Dec;32(2):111-6.

PMID: 21329182 MyJurnal

Colorectal carcinogenesis is a complex multistep process that includes changes in histomorphological appearance of the colonic mucosa and changes at molecular level. Aberrant crypt foci (ACF) was first described by Bird in 1987 on examination of methylene-blue-stained colonic mucosa of azoxymethane-treated mice under light microscopy. Since then ACF was considered as the earliest preneoplastic change that can be seen in the colonic mucosa. The aim of this study was to look at the histomorphology and distribution of ACF in colorectal carcinoma. 50 formalin-fixed archival colectomy specimens for colorectal carcinoma were examined under light microscopy after staining with 0.2% methylene blue. ACF was identified by larger and darker crypts with thickened epithelium, and often elevated from adjacent normal mucosa. ACF was found in 41 of 50 colectomy specimens examined. There were 328 ACF consisting of 36 (11.0%) ACF without hyperplasia or dysplasia, 263 (80.2%) ACF with hyperplasia and 29 (8.8%) ACF with dysplasia. Of these 29 ACF with dysplasia, 25 showed low grade dysplasia and four high grade dysplasia. The density of ACF was higher in the left colon, those older than 65 years of age and among males but these findings were statistically not significant. The crypt multiplicity of hyperplastic ACF (30.149, SD 28.395) was larger than dysplastic ACF (20.613, SD 40.128). The spectrum of histological changes observed probably represent the evolution of ACF in colorectal carcinogenesis.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext A comparative study on the accuracy of noninvasive thermometers

Fadzil FM, Choon D, Arumugam K

Aust Fam Physician, 2010 Apr;39(4):237-9.

PMID: 20372685

This study assessed the concordance of the temperatures of the digital, liquid crystal forehead and digital infrared tympanic thermometers with the mercury in glass thermometer.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

An insight into industrial accidents involving the hand

Abdullah S, Jaafar JM, Das S, Sapuan J

Clin Ter, 2009;160(6):427-33.

PMID: 20198282

BACKGROUND: Industrial hand injuries are a common occurrence and contributes to a large segment of workers' morbidity. The main aim of this study was to look into the day pattern, types and location of upper limbs injures, identify the types of machines involved and highlight the treatment received.
MATERIALS AND METHODS: The present study was performed on 57 industrial workers admitted and treated by the Orthopaedic team of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) for acute injuries sustained whilst working.
RESULTS: The majority of the workers were male (93%). The commonest age group involved was between 25-35 years (48%). The right hand was injured more then the left with majority of injuries involving the fingers. Interestingly, we also observed that injuries occurred more on Saturdays. Laceration was the most common injury followed by fractures and crush injuries. Treatment depends on the type and severity of injuries. For most lacerated wounds, treatment was debridement, primary suturing and antibiotic therapy. Injuries on Saturdays indicated that workers needed a longer time break especially during weekends after a long hectic week.
CONCLUSIONS: Injuries sustained by workers may be prevented by proper working techniques and conditions together with wearing of protective gadgets.

Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

The validity and reliability of the Malaysian Osteoporosis Knowledge Tool in postmenopausal women

Lai PS, Chua SS, Chan SP, Low WY

Maturitas, 2008 Jun 20;60(2):122-30.

PMID: 18508210 DOI: 10.1016/j.maturitas.2008.04.006

OBJECTIVES: To design a valid and reliable questionnaire, the Malaysian Osteoporosis Knowledge Tool (MOKT), to assess the knowledge of postmenopausal osteoporotic women in Malaysia, on osteoporosis and its treatment.
METHODS: A 40-item instrument was designed and tested in this study. The scores ranged from 1 to 40, which were then converted into percentage. This was administered to 88 postmenopausal osteoporotic women who were taking alendronate (patient group) and 43 pharmacists (professional group). The MOKT was administered again to the patient group after 1 month.
RESULTS: Flesch reading ease was 57, which is satisfactory, while the mean difficulty factor+/-S.D. was 0.73+/-0.25, indicating that the MOKT is moderately easy. Internal consistency of the instrument was good with Cronbach's alpha=0.82. The test and retest scores showed no significant difference for 38 out of the 40 items, indicating that the questionnaire has achieved a stable reliability. Level of knowledge on osteoporosis and its treatment was good with a mean score+/-S.D. of 69.0+/-13.9 and 81.6+/-9.5 in the patient and professional group, respectively. The difference in knowledge scores between the two groups was statistically significant (p<0.001).
CONCLUSIONS: In conclusion, the 40-item questionnaire (MOKT) is a reliable and valid instrument for measuring knowledge on osteoporosis in the Malaysian setting. Therefore, it can be used to identify individuals in need of educational interventions and to assess the effectiveness of education efforts as part of osteoporosis management.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Health issues in dialysis-dependent female patients

Shanmugavadivoo K, Shaariah W

Perit Dial Int, 2003 Dec;23 Suppl 2:S192-5.

PMID: 17986546

BACKGROUND: Reproductive health issues in women with end-stage renal disease (ESRD) are often neglected. Data on these issues are also limited.

PURPOSE: We set out to describe the reproductive health issues in women being treated with either hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD).

PATIENTS AND METHODS: All adult female patients on chronic dialysis in Hospital Seremban from January 1991 to December 2001 were included in our study. Patients (or their spouses or children) were interviewed regarding the menstrual status of the patient, gynecologic screening tests administered to the patient, and the patient's use of hormone replacement therapy (HRT).

RESULTS: We recruited 137 women into the study. Of those women, 52.6% were on HD; the rest were on CAPD. Mean age at diagnosis of ESRD was 46.5 +/- 14.1 years (range: 14 - 82 years), and mean duration on dialysis was 33.3 months (range: 2 months - 18 years). Responses about menstrual status were obtained for 118 patients. Of those 118 patients, 55 (46.6%) were postmenopausal at dialysis initiation. Average age at menopause had been 48.5 +/- 4.9 years. Another 19 patients (16.1%) had still been menstruating at dialysis initiation, but subsequently entered menopause. Their average age at menopause had been 45.1 +/- 10.3 years. The remaining 44 patients (37.3%) were still menstruating at an average age of 35.7 years (range: 15 - 49 years). Only 3 of 73 responders were on HRT; 63% had undergone a Pap smear; and 54% had had a breast examination.

CONCLUSIONS: Patients with ESRD tend to experience premature menopause. Not all dialysis patients are amenorrheic. Despite frequent contact between dialysis patients and hospital staff, gynecologic screening and use of HRT in those patients are still very low.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Lifestyle of the elderly in rural and urban Malaysia

Selvaratnam DP, Poo BT

Ann N Y Acad Sci, 2007 Oct;1114:317-25.

PMID: 17986592 DOI: 10.1196/annals.1396.025

Malaysia is steadily progressing toward an aging population demographic pattern. While aging is a natural process, its impact can be painful individually as well as for the nation. Individually there is a loss of a paying job after retirement, loss of physical and mental fitness, and also occasionally the loss of social integration due to lack of mobility. For a nation, an aging population means a growing dependency ratio, a greater need of care, and more medical facilities for this age group. This article looks at the various economic and social implications of the aging population in Malaysia in general, and in the rural and urban setting specifically. The paper focuses on a research sample of 132 (66 rural, 66 urban) elderly persons. The findings suggest that the demographic patterns of the elderly vary from the rural to the urban setting, with differing issues that need to be addressed to alleviate problems encountered related to loneliness, lack of financial stability, and emotional strain. Policy suggestion will be geared toward providing a solution to problems at hand as well as aiding the working group members to prepare and sustain a comfortable livelihood for the aged in their later years.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext Measurement of patellar thickness in relation to patellar resurfacing

Sulaiman AS, Nordin S

Med J Malaysia, 2005 Jul;60 Suppl C:41-4.

PMID: 16381282

Patellar thickness is an important consideration for resurfacing in total knee arthroplasty. A patella of 25 mm in thickness is not suitable for resurfacing using the currently available total knee systems. A cross sectional study on patellar thickness using plain radiographs was undertaken on 56 patients. It was observed that the average thickness of the bony part of the patella was 20.05 mm (range 17-23 mm). The actual thickness of cartilage varies from 2.0 to 5.5 mm (mean 3.2 mm). Thus the mean thickness of the patella was 23.2 mm (range 20.2-26.2 mm). The majority of our patients (73%) had patellar thickness of 24 mm or less. The patellar thickness had a significant correlation with the patient's height (R=0.5). Since the majority of our patients have thin patella, we are of the opinion that majority of our patients are not suitable for patellar resurfacing.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext Audit on radiographs in anterior shoulder dislocations

Lee DJK, Yeap JS, Fazir M, Muhd Borhan TA, Kareem BA

Med J Malaysia, 2005 Mar;60(1):15-20.

PMID: 16250275

The radiographs of 115 anterior shoulder dislocations (100 patients; 74 males, 26 female were reviewed to assess the radiographic views used in the management of this dislocation. Eighty-eight patients (88%) had only the anteroposterior (AP) view, 10 patients had 2 radiographic views taken and only 2 patients had three radiographic views. Hill-Sachs lesions were found in 18%, and glenoid rim fractures in 3% of the patients. A greater tuberosity fracture was found in 18% of the patients. Therefore, the current practice in the management of an acute anterior shoulder dislocation appears to be to perform a single view (AP) pre-reduction radiograph to confirm the diagnosis and a single view (AP) post reduction radiograph to confirm reduction after a close manipulative reduction has been performed. This practice is likely to result in an underestimate of associated Hill Sachs lesion and glenoid rim fractures, but not greater tuberosity fractures.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext Nerve injuries in anterior shoulder dislocations

Yeap JS, Lee DJK, Fazir M, Kareem BA, Yeap JK

Med J Malaysia, 2004 Oct;59(4):450-4.

PMID: 15779576

A retrospective study was conducted to determine the incidence of nerve injuries in anterior dislocations of the shoulder and to determine if a neurological examination is routinely performed in such cases. One hundred and fifteen shoulder dislocations in 100 patients (74 males, 26 females; mean age 35+/-18 years) were reviewed. Eighty-seven patients were examined for neurological injuries prior to reduction and 8 of these patients (9.2%) were found to have sustained neurological injuries. Following reduction, neurological examination was performed in 85 patients. Three patients who were not examined initially prior to reduction were subsequently found to have nerve injuries after reduction. Seven patients (7%) were not examined for neurological injury both before and after reduction of the dislocation. Eleven patients were found to have sustained nerve injuries in the final analysis. Axillary nerve injuries were the most common, occurring in 8 patients. In conclusion, nerve injuries are common in shoulder dislocations. The importance of performing and documenting the findings of neurological examination anterior shoulder dislocations needs to be reiterated.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Tuberculous pleurisy as a manifestation of primary and reactivation disease in a region with a high prevalence of tuberculosis

Liam CK, Lim KH, Wong CM

Int J Tuberc Lung Dis, 1999 Sep;3(9):816-22.

PMID: 10488891

A teaching hospital in Malaysia.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext The dimensions of ocular morbidity amongst the nursing home geriatrics population

Normalina M, Zainal M

Med J Malaysia, 1998 Sep;53(3):239-44.

PMID: 10968160

A cross-sectional prevalence study amongst a nursing home elderly population was carried out at Rumah Sri Kenangan, Seremban, Negeri Sembilan between June 1995 until June 1996. A total of 204 cases of 60 years and older were examined in order to determine the ocular morbidity amongst them. It was found that 47.5% had low vision and 19.1% were legally blind. Cataract was found to be the leading cause of low vision and blindness occurring in 81.4% and 74.3% respectively. Glaucoma occurred in 1% of those who had low vision and none due to macular degeneration or diabetic retinopathy. The magnitude of visual impairment and blindness in this nursing home is high but is preventable and avoidable.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

Fulltext A hospital based study of cancer admissions

Hooi LN, Devaraj T

Med J Malaysia, 1998 Mar;53(1):22-9.

PMID: 10968133

A study was done on patients admitted to Penang Hospital with malignant disease in 1995. A total of 1333 patients (638 male, 695 female) with 1335 malignancies were studied. The majority (77.3%) were aged 41-80 years. The commonest cancers in males were cancers of lung, nasopharynx, colon and rectum, leukemia and larynx whereas the commonest malignancies in females were of the breast, cervix, colon and rectum, leukemia and ovarian/lung carcinoma. The average number of admissions was 2.2 and the average length of stay was 12.7 days. Cancer admissions account for a significant proportion of the inpatient workload of Penang Hospital.

Matched MeSH terms: Aged; Aged, 80 and over; Middle Aged

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