A cross-sectional survey of commercial vehicle drivers who were renewing their own licences was conducted at the Selangor Road Transport Department office in Padang Jawa between 1 February 2002 and 28 February 2002, using questionnaire and medical examination. The objective was to determine the prevalence of myopia, colour vision deficiency and visual field defect among the commercial vehicle drivers. The respondents that reported visual defect at the time of interview was compared with those detected by the author through medical examination. Out of the 223 respondents, 21 (9.4%) reported to have myopia by the questionnaire survey. Through the visual examination there were 63 (28.3%) with myopia (visual acuity worse than 6/12),six (2.6%) had a visual field defect and 14 (6.3%) had red-green colour deficiency. The visual defect detected during the study among the commercial vehicle drivers, which were missed at the time of the routine medical examination were significant. The process of the statutory medical examination should be reviewed.
Cubital tunnel syndrome (CuTS) is the second most common nerve compression neuropathy in the upper extremity. Intraneural ganglion cyst (IGC) within the ulnar nerve around the elbow, might present as CuTS. A 51-year-old Chinese man presented with paresthesia at the ulnar two digits of the left hand for one year. He was clinically diagnosed as severe CuTS. Nerve conduction study revealed marked axonal damage of the left ulnar nerve and ultrasonography showed a mass along the ulnar nerve, three centimetres proximal to the medial epicondyle, which was highly suggestive of Schwannoma. The mass was explored by a longitudinal incision. Intraoperatively, multiple cystic lesions were found within the epineurium of the ulnar nerve. Communication was seen between the elbow joint and the cyst. Swellings were partially excised under microscope. Decompression or partial excision of the cyst along with ligation of the articular branch should be the treatment of choice to prevent recurrence in case of IGC.
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
Four calves from each group of purebred Kedah kelantan (KK), halfbred KK X Friesian, and quarterbred KK X Friesian were experimentally infested with Boophilus micropills larvae. Two calves from each genotype were injected, intramuscularly with antihistamine while the remaining two animals in each genotype received the same dose of antihistamine and dexamethasone. Dexamethasone combined anti-histamine treatment suppress tick resistance as manifested by the production of higher number of engorged female ticks, higher mean weight of replete ticks, mean weight of eggs and mean number of larvae hatched from 1 g of eggs. In anti-histamine treated animals there was no reduction of resistant in all animals as manifested by a few ticks were able to feed successfully. At 1, 2, and 3 hours post-larval attachment in anti-histamine and dexamethasone treated cattle there was complete ablation of the cellular infiltration in the dermis beneath the tick mouthparts, especially eosinophil and basophils. There was little destruction of tissue. However, in anti-histamine treated cattle there were more cellular infiltration and degranulation in the dermis. The cells infiltrating the dermis were mainly eosinophils followed by neutrophs, mast cells and basophils and some of these cells showed sign of degranulation. At 24 hours postlarval attachment, animals lTeated with anti-histamine and dexamethasone showed reduction of, cellular infiltration, degranulation, size of the epidermal lesion and tissue damage. The neutrophils were the predominant cells within the epidermal lesions. However, animals in anti-histamine treatment showed edema, more cellular infiltration and degranulation, and destruction of tissues as compared to antihistamine and dexamethasone treated animals. In anti-histamine treated cattle the epidermal lesions were obviously larger and the percentage of eosinophils and basophils were higher than those of antihistamine and dexamethasone treated animals. KEYWORDS: Kedah-Kelantan cattle, KK X Friesian callie, B. micropflls, dexamethasone, antihistamine, cellular response.
About 27% of the eligible respondents reported having experienced some form of dental problems in the preceding one year prior to the interview. Female respondents (57.1%) were more likely to have encountered a dental problem as compared to male respondents (22.6%). Of the various nationalities, the Thais (60.7%) and the Pakistanis were the most and least likely respectively to have encountered a dental problem in the preceding one year. This pattern among the Thais was consistent for both the male (48.4%) and female (70.6%) population. Toothache (85.0%) was reportedly the most prevalent dental problems encountered regardless of gender and nationality, followed by sensitivity to hot and cold drinks (34.4%). About 1 in 4 subjects who had dental problem reported having bleeding gums. About 1 in 4 subjects who had dental problems had consulted the doctor or dentists regarding their problem and one more than one-half had self-medicated. Overall the majority (84.4%) of the respondents have never visited the dentists in Malaysia. Lack of perceived need was cited as the main reason for this.
Introduction: Health literacy (HL) has been linked to various health outcomes among diabetics. However, there is no study exploring HL among diabetics within Malaysia.
Materials and methods: This cross-sectional study examined HL levels among Type 2 Diabetes Mellitus (T2DM) patients, and its association with glycaemic control.
Results: The response rate was 93.7%; whereby 289 T2DM patients from three public health clinics participated in the study between July 2018 and August 2018. 83.1% of the participants had limited HL (high likelihood of limited HL: 64.4%, adequate HL: 16.9%) and there was no association between HL and glycaemic control (P-value = 0.839). Forward logistic regression showed that limited HL was associated with age (OR 3.231; 95% CI 1.611-6.482) and education level (OR 7.290; 95% CI 3.547-14.984).
Conclusion: As our findings show, many T2DM patients have a limited HL, especially among those who are older and those who have a lower education level, diabetics should be consistently advised by using layman’s terms to improve their understanding.
The use of transobturator tape (TOT) for the treatment of stress urinary incontinence (SUI) has gained popularity since it was introduced in 2001. Only few studies have reported that TOT is superior in safety and efficacy when compared to tension free vaginal tape (TVT). This case-series study was conducted to investigate the safety and efficacy of the TOT procedure in patients at Ipoh Hospital. A cross sectional study on patients who underwent TOT procedures from Jan 2006 to Jun 2008 was conducted. Patients were followed-up 1 month, 3 month, 12 month and annually thereafter. Data were retrieved from patients‟ records based on the standard pre-operative assessment sheet and follow up record. Interviews were then made via telecommunication to assess the patients‟ progression and satisfaction using a validated questionnaire. Fifty-two subjects (n=52) were recruited. The mean age was 54.2 ± 10.6 years with the median follow up time of 19 months. Majority of cases (n=46; 88.5%) had concomitant pelvic organ prolapse (POP), while only 2 (3.8%) had an isolated stress urinary incontinence (SUI). Pre-operatively, only 16 patients (30.8%) were diagnosed with mixed urinary incontinence (MUI) and 24 patients (46.2%) had over active bladder symptoms (OAB) which include increased frequency and urgency. The objective cure rate for SUI was 42 (80.7%), 3 (5.8%) failed while 7 (13.5%) improved. Complications were limited to minor conditions and was only observed in four patients: one case (1.9%) of acute urinary retention, three (5.7%) had prolonged indwelling catheter more than 3 days and one (1.9%) each for mesh erosion, hematoma, urinary tract infection (UTI) and wound infection. Cure rate for MUI, frequency and urgency were 37.4%, 70.8% and 54.2% respectively. De novo urgency was noted in three (n=3: 5.7%) cases while (n=3: 5.7%) required revision of the tape. Forty-nine women (n=49: 94.2%) were satisfied with the procedure. TOT procedures significantly improve OAB symptoms with high patient‟s acceptance rate and no serious operative complication.
INTRODUCTION AND OBJECTIVE:
Most of important variables measured in medicine are in numerical forms or continuous in nature. New instruments and tests are constantly being developed for the purpose of measuring various variables, with the aim of providing cheaper, non-invasive, more convenient and safe methods. When a new method of measurement or instrument is invented, the quality of the instrument has to be assessed. Agreement and reliability are both important parameters in determining the quality of an instrument. This article will discuss some issues related to methods comparison study in medicine for the benefit of medical professional and researcher.
METHOD:
This is a narrative review and this article review the most common statistical methods used to assess agreement and reliability of medical instruments that measure the same continuous outcome. The two methods discussed in detail were the Bland-Altman Limits of Agreement, and Intra-class Correlation Coefficient (ICC). This article also discussed some issues related to method comparison studies including the application of inappropriate statistical methods, multiple statistical methods, and the strengths and weaknesses of each method. The importance of appropriate statistical method in the analysis of agreement and reliability in medicine is also highlighted in this article.
CONCLUSION:
There is no single perfect method to assess agreement and reliability; however researchers should be aware of the inappropriate methods that they should avoid when analysing data in method comparison studies. Inappropriate analysis will lead to invalid conclusions and thus validated instrument might not be accurate or reliable. Consequently this will affect the quality of care given to a patient.
Leadership and management in health organisations are essential and frequent topics of discussion among professionals and other staff, who are directly or indirectly involved with the operation of the said organisations. In a hospital setting for example, managers are appointed at different functional or unit levels. Though more often than not, we refer to them as the heads or managers or by any other names, the leadership component might be assumed to be just part but not the most important aspect of their roles.(Copied from article).
A survey of career choices was conducted for two batches of physicians applying for a medical speciality course in Malaysian medical schools. There were a total of 952 applications, with 477 males and 475 females. Surgery ranked highest, followed by obstetrics and gynaecology, fanlily medicine and orthopaedic surgery. The minor specialities of otorhinolaryngology, psychiatry and pathology were the least popular choices. Questionnaires were sent to a random sample of 250 physicians in each batch to note factors affecting their choices of speciality. A total of 359 physicians responded, giving a response rate of 71.8%. Fixed hours of work and the ability to have direct contact with patients were relatively important factors for choice of speciality. Working as a clinical consultant was the nlost popular nature of employment while worliing in the health office, service consultant in a public hospital, a non-clinical lecturer in a university hospital and working in a private clinic were less popular choices for these physicians. KEYWORDS: Career choice; medical speciality; doctors; Malaysia.
A thirty two year old taxi driver presented with cotnplaints of headache, nausea, vomiting and blurring of vision of the left eye of two days duration. He was found to have an acute anterior uveities and secondary glaucoma. On further examination patient was also found to have a neuroretinitis and phlebitis in the same eye. A worm was found in the anterior chamber and it was removed via a limbal incision under local anaesthesia. The worm-like structure sent to the Department of Parasitology was identified as Gnathostoma spinigerum. he patient was treated with topical eye drops and oral steroids at the same time to reduce the inflammation. No neurological symptoms were seen. The patient was not available for further evaluation and followup. KEYWORDS: Blurring of vision, Gnathostomiasis
Educational environment of an institution is the environment experienced or perceived by students and teachers. Individual students and teachers will respond differently to these subtle elements in their learning experience. Curriculum's most significant manifestation and conceptualisation is the environment. There is a proven connection between the environment and the valuable outcomes of students' achievement, satisfaction and success. If one wants to describe, assess or get a handle on the curriculum in a medical school, then the educational and organisational environment or total milieu associated with the curriculum and the medical school needs to be studied. Educational environment is one of the most important determinants of an effective curriculum. Educational environment fosters scholarly or intellectual activities; it encourages friendliness, co-operation and supportiveness. It also fosters the learning, growth and development of students. Students' perceptions of their educational environment are a useful basis for modifying and improving the quality of educational environment. Several research groups over the years have attempted to identify and quantify the presence and impact of rather intangible aspects of a learning environment. Each study has used different survey questionnaires to solicit student reactions.
Background: TheJob Demand – Resource Model (JD-R) is a job-stress model that focuses on assessing the effect of the employees’ health-related outcomes, and their performances due to stress induced by their job demands, and job resources. Different occupations possess different combinations of specific job-related demands, and job resources. The Copenhagen Psychosocial Questionnaire (COPSOQ) is an established self-reported tool that has been widely used to measure general job demands through the JD-R model. In contrast, the BDJD-24 is a model that was developed to assess the specific job demands of the bus drivers’ job demands.
Objective: This study aims to measure the validity and reliability of the job demand questionnaire by applying it on the taxi drivers of Malaysia so as to assess their safety performance (safety motivation and safety compliance).
Method: A sample of 33 (N = 333) taxi drivers from the Klang Valley, Malaysia was recruited. Participants completed the questionnaire in the native language (Malay). To examine the psychometric properties of the COPSOQ and BDJD-24, we used the Exploratory Factor Analysis (EFA) derived from SPSS, and then confirmed it with the Confirmatory Factor Analysis (CFA) derived from AMOS.
Results: The internal consistency was found to be acceptable, between 0.71 to 0.84. The CFA revealed that the taxi drivers’ job demands, as proposed, had a 5-dimensional influence. The five demands (i.e. emotional, hiding emotion, sensory, time, and safety) were clearly distinguished in the factor analysis. The KMO was adequate, at 0.78, and the variance for the 5-factor structure was 51.97%. The CFA also confirmed the correlation among these demands.
Discussion: It is found that the COPSOQ and the BDJD-24 measurement were both reliable and valid for measuring the taxi drivers’ job demands. However, the general vs. specific job demands hypothesis, as proposed by the JD-R model, was not supported. The general job demands (emotional demands) were found to be more strongly associated with safety motivation, and safety compliance. The practical implications and limitations of the present study are further discussed in the paper.
This paper describes a case of invasive arnoebiasis in a 72 year old woman. About 1 week prior to admission she had right iliac fossa pain and physical examination suggested perforated appendix or carcinoma of caecum. Laparotomy revealed perforation of caecum. Histopathology of tissue removed showed abundant trophozoites of Entamoeba histolytica. After surgery treatment was instituted and patient had an uneventful recovery. KEYWORDS: Rupture of caecum, amoebiasis
MicroRNAs (miRNAs) are short, single-stranded non-coding RNAs that control gene expression by annealing to complementary sequences in mRNAs. They are estimated to regulate at least one third of human transcripts and hence, manipulation of these miRNAs can profoundly affect the proteome and ultimately cellular phenotypes. A substantial amount of work has shed light on the crucial roles of miRNAs in diseases. miRNA expression profiles between normal and diseased tissues have identified miRNA signature patterns that correlate to disease development and progression. This review discusses some of the important miRNAs that are involved in endothelial cell senescence and dysfunction that contribute to the development and progression of cardiovascular diseases.