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  1. Fulltext Factors associated with ever used of modern contraception among married men attending a primary healthcare clinic
    Syahnaz MH, Rasina Nilofer JK, Azmawati MW, Harlina Halizah S
    Med J Malaysia, 2018 10;73(5):301-306.
    PMID: 30350809 MyJurnal
    BACKGROUND: The practice of modern contraceptives still remains a sceptical issue in the society and dormant due to increasing objection of husbands who play a significant role in the family planning practice.
    OBJECTIVES: This study was done to determine the factors affecting the ever use of modern contraceptive methods among married men visiting a healthcare clinic in Malaysia.
    MATERIAL AND METHOD: A cross sectional study of 443 men aged over 18 years was conducted using convenient sampling from January 2016 till March 2016 at a primary care clinic. A self-administered questionnaire assessing sociodemographic characteristic, attitude towards family planning, spousal communication and ever used of modern contraceptive methods was used.
    RESULTS: The proportion of ever used modern contraception was 48% (n=192). Multiple logistic regression revealed that spousal communication on family planning (Adjusted OR 15.8; 95% CI 7.0 - 35.6) and attitude towards marital relationship (Adjusted OR 1.1; CI 1.0 - 1.1) were significant predictors for ever used of modern contraception among married men.
    CONCLUSION: The proportion of ever used modern contraception is still not high. Men who communicated with their spouse on modern contraception and perceived family planning as means to preserve their marital relationship were more likely to practice modern contraceptive method.
    Study site: Klinik Kesihatan, Selangor, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  2. Stewardship opportunities in the treatment of urinary tract infection using oral fosfomycin
    Alias AM, Shahruniza AS, Sulaiman H
    Med J Malaysia, 2019 Oct;74(5):456-458.
    PMID: 31649232
    Fosfomycin (FMT) was first isolated in 1969 and has gained popularity in the past few decades, specifically in the treatment of uncomplicated urinary tract infection (UTI). A retrospective study was undertaken to study the pattern of FMT use in our outpatient clinics. Subjects were divided into guideline compliant (GC) and non-guideline compliant (NGC) groups, based on available guidelines. More than half of the subjects (51, 51%) fall in the NGC group. Diabetes was an independent risk factor for inappropriate FMT prescription. This represented an opportunity for antimicrobial stewardship in treating diabetic patients with uncomplicated UTI when this agent is chosen.
    Matched MeSH terms: Ambulatory Care Facilities
  3. Fulltext The effectiveness of diabetes medication therapy adherence clinic to improve glycaemic control among patients with type 2 diabetes mellitus: a randomised controlled trial
    Alison C, Anselm S
    Med J Malaysia, 2020 05;75(3):246-253.
    PMID: 32467540
    INTRODUCTION: In Malaysia, Diabetes Medication Therapy Adherence Clinic (DMTAC) in hospital settings significantly improved patients' glycaemic control and cardiovascular risk. Until now no randomised controlled trial of DMTAC has been done in a primary care setting where the access to subspecialist services (endocrinologists, expensive medication, etc.) is limited. The objective of this research is to compare the glycaemic control among diabetes mellitus (DM) patients between those received additional DMTAC service and those received normal clinic service in primary care settings.
    MATERIALS AND METHOD: This was a parallel, randomised controlled study. The selected participants were patients aged 18 to 70 years with type 2 DM on diabetic medication who were being treated in Kota Samarahan Health Clinic with HbA1c above 8% and who never attended any education of DM prior to the study. The control group received normal clinic visits with consultations by a medical officer. The intervention group received four or more DMTAC visits in addition to normal clinic visits. The primary outcomes were HbA1c while the secondary outcomes were the occurrence of severe hypoglycaemia, weight gain and medication compliance of patients. The subjects were randomised by numbered envelope opened chronologically by the investigator during the initial assessment. All health care professionals (nurse, lab staff and medical officer) except DMTAC pharmacist managing the subjects were blinded as there were no markings on the patients notes indicating that they were in this study. The demographic data was collected during screening while health data including glycated haemoglobin (HbA1c) levels were collected at baseline, sixth month and one year.
    RESULTS: In all, 100 patients were randomised into control and intervention groups (n=50 per arm). The change of HbA1c in the intervention group (mean=-1.58) was significantly more than the control group (mean=-0.48) at 12 months with a mean difference of -1.10% (p=0.005, Cohen's d=0.627). Both study groups had similar significant changes of subjects from non-compliance to compliance (control group, n=11 vs. intervention group, n=10). The changes of BMI after 12 months between control group (0.24 kg/m2) and intervention group (0.24 kg/m2) was not significant (p=0.910). There were no episodes of severe hypoglycaemia detected in both groups.
    CONCLUSION: The addition of DMTAC service in primary care can improve glycaemic control among patients. The study was registered in the National Medical Research Register (Malaysia): NMRR-13-1449-18955.
    Study site: Klinik Kesihatan Kota Samarahan, Sarawak, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  4. Fulltext Alteration of foot temperature in diabetic neuropathy: is it another piece of puzzle?
    Naicker AS, Roohi SA, Lee CS, Chan WH, Tay LS, Din XJ, et al.
    Med J Malaysia, 2006 Feb;61 Suppl A:10-3.
    PMID: 17042221
    Poor glycaemic control and the duration of diabetes mellitus are known to accelerate development and progression of neuropathy. Diabetic co-morbidities: hypertension and hyperlipidaemia, have been postulated to associate with development of neuropathy. A diabetic foot with low temperature and frequent exposure to low temperature environment has recently been hypothesized to be at higher risk to develop early neuropathy. This cross-sectional study is undertaken to identify risk factors for diabetic neuropathy and the association between foot temperature and development of diabetic neuropathy by using simple clinical examination in the outpatient setting. From April 18, to April 30, 2005, universal sampling method was used to select 134 diabetic patients (type 1 or type 2 for >1 year) with peripheral neuropathy. Excluded are those with chronic alcoholism, drug-induced neuropathy, dietary history of vitamin B deficiency and family history of porphyria and hereditary sensorimotor neuropathy. The patient's duration of diabetes, glycaemic control status and the presence of co-morbids: hypertension and hyperlipidemia, were recorded. The temperature of the foot was measured by using thermo buddy. Of 134 patients representing Malaysian ethnic distribution with an equal number of males and females, 20.1% were in the age group of 61 to 65 years and, 85.1% and 67.9% belonged to lower socioeconomic and educational groups respectively. Associations between diabetic neuropathy and glycaemic control (p = 0.018) and duration of diabetes (p < 0.05) were significant. However, hypertension, hyperlipidaemia and low foot temperature were not significantly associated with development of diabetic neuropathy. Poor glycaemic control is significantly associated with diabetic neuropathy. Foot temperature alteration is merely an effect of autonomic neuropathy with a cold foot is attributed to co-existing peripheral arterial disease.

    Study site: Pusat Perubatan Primer Bandar Tasik Selatan, Kuala Lumpur, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  5. Fulltext Differences in public and private health services in a rural district of Malaysia.
    Aljunid SM, Zwi AB
    Med J Malaysia, 1996 Dec;51(4):426-36.
    PMID: 10968029
    A cross-sectional study, comparing the nature of services in 15 private clinics and 6 public health facilities, was undertaken in a rural district of Malaysia. Semi-structured interviews and observations using check-lists were employed. Public health facilities were run by younger doctors (mean age = 31.1 years), supported mostly by trained staff. The private clinics were run by older doctors (mean age = 41.2 years) who had served the district for much longer (8.9 years vs 1.5 years) but were supported by less well trained staff. The curative services were the main strength of the private clinics but their provision of preventive care was less comprehensive and of inferior quality. Private clinics were inclined to provide more expensive diagnostic services than the public facilities. 'Short hours' private clinics had very restricted opening hours and offered limited range of services.
    Comment in: Hee HW. Differences in public and private health services in a rural district of Malaysia. Med J Malaysia. 1997 Sep;52(3):296-8
    Matched MeSH terms: Ambulatory Care Facilities
  6. Assessment of the level of knowledge of colorectal cancer among public at outpatient clinics in Serdang Hospital: a survey based study
    Pan Y, Chieng CY, Haris AAH, Ang SY
    Med J Malaysia, 2017 12;72(6):338-344.
    PMID: 29308770 MyJurnal
    OBJECTIVES: Colorectal cancer (CRC) is one of the most common gastrointestinal cancers in the world. In the Asia- Pacific region, it is the fastest emerging gastrointestinal cancer. Level of awareness on CRC warning signs and risk factors in the rural population of Malaysia is reported of very low. The aim of this study was to assess the level of knowledge of CRC among the public at medical outpatient clinics in Serdang Hospital. The association between sociodemographic factors with level of knowledge among the respondents was further studied.

    STUDY DESIGN: A study was conducted among the non-CRC patients' relatives accompanying their relatives to the medical outpatient clinics in Serdang Hospital from 1st April to 31st August 2016. The study was carried out with cluster sampling method.

    METHODS: The respondents were assessed using validated and modified Cancer Awareness Measures (CAM) questionnaire consists of three parts which are knowledge on warning signs, knowledge on risk factors and sociodemographic factors. All data were analysed using IBM SPSS Statistics 21.0.

    RESULTS: Altogether 308 subjects completed the questionnaires. It was shown high percentage of good knowledge for warning signs and risk factors of CRC among the respondents. A significant association between age groups and level of income with level of knowledge on warning signs was observed.

    CONCLUSIONS: The level of knowledge of CRC among the general public in Serdang Hospital was sufficient. The respondents with higher income or younger age had higher level of knowledge regarding CRC.

    Matched MeSH terms: Ambulatory Care Facilities*
  7. Perceived changes in symptoms and quality-of-life amongst patients with dizziness: A single-centre experience in Malaysia
    Wong KYR, Abdul Rasheed SRSMA, Jamaluddin SA, Hussein Al-Hadeethi YF
    Med J Malaysia, 2022 Nov;77(6):730-735.
    PMID: 36448392
    INTRODUCTION: Dizziness is a common complaint by patients, yet it always presents as a diagnostic challenge to the attending clinician. An accurate diagnosis is essential to correctly administer the precise treatment regime, alleviate the symptoms, and improve the quality-of-life of patients who present with dizziness. A specialised vestibular clinic with a holistic approach of meticulous history-taking, complete physical examination, a collection of audiovestibular test battery, and facilities for vestibular rehabilitation was set up to assist in the management of these patients. This study aims to investigate the effect of vestibular clinic intervention on the symptoms and qualityof- life of patients who were managed in the vestibular clinic.

    MATERIALS AND METHODS: A total of 64 new patients who were managed in the vestibular clinic were selected and the validated Malay - Vestibular Rehabilitation Benefit Questionnaire (My-VRBQ) was completed during the first and follow-up visits to measure the changes in symptoms and quality-of-life before and after receiving care at the vestibular clinic.

    RESULTS: Our study showed that there was a positive effect of vestibular clinic intervention on the symptoms and quality-of-life of patients who were managed by the vestibular clinic. Statistically significant improvements were seen in the total My-VRBQ scores, symptoms scores, and quality-of-life scores. The subscale scores of dizziness, anxiety, and motion-provoked dizziness also showed statistically significant improvement among the patients who received care at the vestibular clinic.

    CONCLUSION: This indicates that the vestibular clinic was an essential part of the work-up, diagnosis, and treatment of patients with dizziness; and a specialised vestibular clinic was able to bring about positive outcomes in the symptoms and quality-of-life of patients with balance disorders.

    Matched MeSH terms: Ambulatory Care Facilities
  8. Fulltext A survey of smoking habits among students in the University of Malaya, Kuala Lumpur
    Patrick E
    Med J Malaya, 1967 Dec;22(2):99-103.
    PMID: 4231986
    A survey of smoking habits among the students attending the Student Health Clinic for various ailments showed:
    (1) Smoking in women is very uncommon (only 2 out of 79; 2.53%)
    (2) About 30% of men smoke (106 out of 322; 32.9%)
    3. The majority of these had commenced smoking before they entered the university.
    4. The majority smoked filter tipped brands.
    5. Where the mothers in the family smoked, the sons seem to take to smoking more readily.
    6. Knowledge of the effects of smoking on health was poor, but equal in all three groups viz in women and in both smoking and non-smoking men.
    Matched MeSH terms: Ambulatory Care Facilities
  9. Fulltext Outpatient management of dengue infection in the University Hospital, Kuala Lumpur
    Chin CK
    Malays J Pathol, 1993 Jun;15(1):21-3.
    PMID: 8277784
    Dengue fever is endemic in Malaysia with frequent epidemics especially in urban areas. This infection can present in a wide range of severity, from a nonspecific febrile illness to life threatening dengue haemorrhagic fever and dengue shock syndrome. It is worth noting that dengue haemorrhagic fever comprised 11.2% of all reported cases in Malaysia in 1991.Patients tend to consult their primary care physicians early. It is the duty of the primary care physicians to make an accurate diagnosis and to detect the complications. However, there has not been any known reliable predictor for the occurrence of complications during the early stage of the illness. Hence, primary care physicians often face the problem of having to deal with this uncertainty. Referring all these patients to the hospitals for admission is obviously not practical but managing them at home may involve high risks. In order to assist primary care physicians, the Primary Care Unit in the University Hospital uses a set of guidelines for the outpatient management of the infection. These guidelines and their assessment will be discussed.
    Study site: Primary Care clinic, University Malaya Medical Centre, Kuala Lumpur, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  10. Fulltext Association of the Cocaine- and Amphetamine-Regulated Transcript Prepropeptide Gene (CARTPT) rs2239670 Variant with Obesity among Kampar Health Clinic Patrons, Malaysia
    Yeo L, Fan SH, Say YH
    Malays J Med Sci, 2012 Jan;19(1):43-51.
    PMID: 22977374 MyJurnal
    BACKGROUND: Cocaine- and amphetamine-regulated transcript (CART) is a hypothalamic anorectic neuropeptide that controls feeding behaviour and body weight. The study objective was to investigate the association of the CART prepropeptide gene (CARTPT) rs2239670 variant with obesity and its related anthropometric indicators among patients of a Malaysian health clinic in Kampar, Perak, Malaysia.
    METHODS: A total of 300 Malay/Peninsular Bumiputera, Chinese, and Indian subjects (115 males, 185 females; 163 non-obese, 137 obese) were recruited by convenience sampling, and anthropometric measurements, blood pressures, and pulse rate were taken. Genotyping was performed using AvaII polymerase chain reaction-restriction fragment length polymorphism.
    RESULTS: Genotyping revealed 203 (67.7%), 90 (30.0%), and 7 (2.3%) subjects with the GG, GA, and AA genotypes, respectively, with a minor allele (A) frequency of 0.17. No significant difference in the CARTPT rs2239670 genotype and allele distribution was found between obese and non-obese subjects, and logistic regression showed no association between the mutated genotypes (GA, AA) and allele (A) with obesity, even after adjusting for age, gender, and ethnicity. Furthermore, the measurements did not differ significantly between the genotypes and alleles. No significant difference in the genotype and allele distribution was found among genders, but they were significantly different among ethnicities (P = 0.030 and P = 0.019, respectively).
    CONCLUSION: CARTPT rs2239670 is not a predictor for obesity among the Malaysian subjects in this study.
    KEYWORDS: Malaysia; anthropometry; cocaine- and amphetamine-regulated transcript protein; genetic association study; obesity; single nucleotide polymorphism
    Matched MeSH terms: Ambulatory Care Facilities
  11. Fulltext Profile of clients attending a methadone clinic
    Jacob SA, Mohammed F, Hassali MA
    Malays J Med Sci, 2015 Jan-Feb;22(1):58-69.
    PMID: 25892951 MyJurnal
    BACKGROUND: Client characteristics provide useful information for designing programs that target individuals with risk factors for substance use and for determining client retention. Therefore, this study examined the profiles of clients attending a methadone clinic.
    METHODS: A cross-sectional analysis of clients of a methadone clinic was conducted through a survey to obtain a profile of methadone clients.
    RESULTS: Of the 51 patients who responded (response rate: 66.2%), the mean (SD) age at which they started substance use was 19.8 (5.1) years. Friends were cited as the most regular source of drugs (82.4%), and heroin was the most commonly used drug (98%). Daily substance use was reported by 72.5% of the respondents; 23.5% admitted to having stolen money to purchase drugs; 92.2% tried quitting substance use on their own and 98% stated that the main reason for registering at the clinic was that they wanted to stop their drug dependence. Approximately 60% of clients were receiving methadone doses of less than 60 mg/day.
    CONCLUSION: Heroin is still the most popular drug of abuse and most clients still receive methadone doses below the recommended level, despite evidence of poor patient retention rates associated with these low doses.
    KEYWORDS: Malaysia; methadone; patient appointments; profile; substance use
    Study site: Methadone clinic, hospital, Malaysia.
    Matched MeSH terms: Ambulatory Care Facilities
  12. Fulltext Healthcare provider-patient communication: a satisfaction study in the outpatient clinic at Hospital Kuala Lumpur
    Azizam NA, Shamsuddin K
    Malays J Med Sci, 2015 May-Jun;22(3):56-64.
    PMID: 26715897 MyJurnal
    BACKGROUND: There is growing interest in research on patient satisfaction with healthcare provider (HCP) communication as a measure of healthcare quality and HCPs' communication competency. This study aimed to determine the levels of patient satisfaction with healthcare provider-patient communication (HCP-PC) and its associated factors at the outpatient clinic at Hospital Kuala Lumpur.
    METHODS: A cross-sectional study was conducted on a convenience sample in July 2012 using self-administered questionnaires for the data collection. Both overall and domain-specific satisfaction were measured, with the three domains being exchanging information (EI), socio-emotional behaviour (SB), and communication style (CS).
    RESULTS: The findings show that 92.8% of the 283 respondents were satisfied with overall HCP-PC, 89.5% with EI, 91.3% with SB, and 72.2% with CS. Satisfaction was statistically higher among Malays for CS and higher among those with low education and poor health for EI, SB and CS. EI and overall communication satisfaction were also higher among patients who reported short wait times, and patients who were in gender concordance with their HCPs showed higher SB satisfaction.
    CONCLUSION: Basic and continuous communication skills training and patient activation programs should be established to increase patient satisfaction. Health information technology use should be actively promoted to allow for structured and standardised information exchange between HCPs and patients.
    KEYWORDS: communication; patient satisfaction; primary care

    Study site: outpatient clinic at Hospital Kuala Lumpur
    Azizam NA, Shamsuddin K
    Matched MeSH terms: Ambulatory Care Facilities
  13. Fulltext Validity and Reliability of Questionnaire on Knowledge, Attitude and Dietary Practices Related to Colorectal Cancer
    Norsa'adah B, Aminu AR, Zaidi Z
    Malays J Med Sci, 2020 Feb;27(1):115-123.
    PMID: 32158351 MyJurnal DOI: 10.21315/mjms2020.27.1.12
    Introduction: Colorectal cancer (CRC) is one of the leading cancers in Malaysia where new cases are increasing every year. The aim of this study was to test the reliability and validity of a newly developed questionnaire on knowledge, attitude and dietary practices (KAP) related to CRC for the Malay population.

    Methods: The respondents were conveniently selected among visitors attending an outpatient clinic in a tertiary hospital. We excluded those with any cancers, chronic diseases and those that were illiterate. The exploratory factor and reliability analyses were conducted.

    Results: A total of 108 respondents were recruited of which 67.7% were males and the mean age was 54.59 years (standard deviation 8.93). The Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy values for KAP were 0.64, 0.66 and 0.67, respectively (P < 0.001). The 17 items of knowledge formed five domains with loading factors ranging from 0.54-0.89. The six items of attitude formed two domains with loading factors ranging from 0.64-0.80 and the 15 practices had four domains with loading factors ranging from 0.52-0.83. The total variances explained for each KAP were 61.02%, 56.41% and 53.12%, respectively. The internal consistency Cronbach alpha values on KAP were 0.61, 0.60 and 0.70, respectively.

    Conclusion: The final questionnaire is suitable for measuring KAP related to CRC among the Malay population.

    Matched MeSH terms: Ambulatory Care Facilities
  14. Knowledge of Pre-Pregnancy Care Among Men Attending the Outpatient Clinics of Hospital Universiti Sains Malaysia
    Ishak SH, Yaacob LH, Ishak A
    Malays J Med Sci, 2021 Apr;28(2):119-127.
    PMID: 33958966 DOI: 10.21315/mjms2021.28.2.11
    Background: Men's involvement in pre-pregnancy care is important to ensure a positive pregnancy outcome. The objective of this study is to determine the level of knowledge of pre-pregnancy care among men and the factors associated with poor knowledge.

    Methods: This work is a cross-sectional study conducted at the outpatient clinics of Hospital Universiti Sains Malaysia involving 235 married men. A self-administered questionnaire was used and it consisted of four sections: socio-demographic data, reproductive characteristics of couples, clinical characteristics and knowledge of pre-pregnancy care.

    Results: More than half of the men (51.9%) had poor knowledge of pre-pregnancy care, mostly on high-risk pregnancy, consequences of poor birth spacing and effect of maternal anaemia on a baby. The mean (SD) knowledge was 11.86 (3.85). Poor knowledge of pre-pregnancy care was significantly associated with age (adjusted odds ratio [AOR] = 0.96; 95% CI: 0.94, 0.99, P = 0.002) and education level (AOR = 2.61; 95% CI: 1.49, 4.57; P = 0.001).

    Conclusion: The men in our study had poor knowledge of pre-pregnancy care. Further health promotion and education are needed to be focused on men to increase their knowledge and share the responsibilities in maternal health.

    Matched MeSH terms: Ambulatory Care Facilities
  15. Fulltext Clinical and Sociodemographic Predictors of the Quality of Life among Patients with Type 2 Diabetes Mellitus on the East Coast of Peninsular Malaysia
    Jusoh Z, Tohid H, Omar K, Muhammad NA, Ahmad S
    Malays J Med Sci, 2018 Feb;25(1):84-95.
    PMID: 29599638 MyJurnal DOI: 10.21315/mjms2018.25.1.10
    Background: The quality of life (QoL) describes the multidimensional self-perceived well-being of a person, which is an important diabetes outcome. This study aimed to measure the QoL scores among patients with type 2 diabetes mellitus (T2DM), as well as their clinical and sociodemographic predictors.

    Methods: This cross-sectional study involved 180 randomly sampled patients at a primary care clinic on the East Coast of Peninsular Malaysia. A self-administered questionnaire containing the Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) was used.

    Results: Most of the respondents (96.7%) were Malay, with a median (interquartile range, IQR) age of 54.0 (14.0) years old. The majority of them were females (60.0%), married (81.1%) and from low-income families (63.3%), who attained a secondary education or lower (75.6%). Only 49.4% of them were employed. The mean (standard deviation, SD) ADDQoL-18 average weighted impact score was -4.58 (2.21) and all 18 domains were negatively affected, particularly the living condition, family life and working life. The multiple linear regression analysis showed that the age (adjusted B = 0.05,P= 0.004) and insulin use (adjusted B = -0.84,P= 0.011) were QoL predictors.

    Conclusion: T2DM negatively impacts the patient's QoL in all aspects of their life. The QoL improvement with age suggests that the older patients had accepted and adapted to their illness. The need to improve the QoL among insulin users was also highlighted.
    Study site: Klinik Kesihatan, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  16. Fulltext Munchausen syndrome by proxy
    Yaacob BM
    Malays J Med Sci, 1999 Jul;6(2):30-1.
    PMID: 22589687 MyJurnal
    Munchausen syndrome by proxy is a rare disorder in child psychiatric practice. A case of Munchausen syndrome by proxy that was managed in the Child Psychiatric clinic, Universiti Sains Malaysia Hospital is reported. Factors that suggest the diagnosis are discussed. Multidisciplinary approach to the management of such cases is warranted.
    Matched MeSH terms: Ambulatory Care Facilities
  17. Fulltext Comparison of dry eye parameters between diabetics and non-diabetics in district of Kuantan, Pahang
    Aljarousha M, Badarudin NE, Che Azemin MZ
    Malays J Med Sci, 2016 May;23(3):72-7.
    PMID: 27418872 MyJurnal
    INTRODUCTION: Diabetes may affect the human body's systems and organs, including the eye. Diabetic retinopathy is the 5th leading cause of blindness globally. Diabetic subjects demonstrated dry eye symptoms that were also supported by the low values of the clinical tests.
    PURPOSE: This study aimed to compare the dry eye symptoms and signs between diabetics and non-diabetics and tear functions between diabetic subjects with and without dry eye.
    METHODS: This retrospective study was based on the observation of 643 medical files. Using a convenience sampling method, 88 subjects were found to report diabetes mellitus. The information extracted from the files included: date of first examination, age at first visit, gender, past ocular history, systemic disease, symptoms of dry eye disease and details of clinical diagnostic signs. Non-contact lens wearers were excluded. A group of 88, age and gender matched, control subjects were included for this comparison study.
    RESULTS: The percentage of dry eye symptoms was higher in diabetic subjects (15.9%) compared with non-diabetic subjects (13.6%; p<0.001). The percentage of dry eye symptoms was also higher in diabetics with dry eye (63%) than in diabetics without dry eye (36.9%; p<0.001). Tear break up time was significantly different between diabetics and non-diabetics (p<0.001) and between diabetics with and without dry eye (p=0.046). The corneal staining was significantly different between diabetic subjects with and without dry eye (p=0.028).
    CONCLUSION: Dry eye symptoms were significantly associated with diabetics. Tear break up time was significantly shorter in diabetics with dry eye compared to diabetics without dry eye.
    KEYWORDS: Diabetes mellitus; cornea; dry eye syndromes; signs and symptoms; tears
    Study site: Klinik Kesihatan Jalan Hospital, Kuantan, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  18. Fulltext Validation of the malay version of Diabetes Quality of Life (DQOL) questionnaire for adult population with type 2 diabetes mellitus
    Bujang MA, Ismail M, Hatta NKBM, Othman SH, Baharum N, Lazim SSM
    Malays J Med Sci, 2017 Aug;24(4):86-96.
    PMID: 28951693 MyJurnal DOI: 10.21315/mjms2017.24.4.10
    OBJECTIVE: We aimed to validate the Malay version of Diabetes Quality of Life (DQOL) questionnaire for Malaysian adult population with type 2 diabetes mellitus (DM).
    METHODS: This is a cross-sectional study to validate Malay version of DQOL among the adult diabetic patients. DQOL questionnaire has 46 items consist of three domains, namely Satisfaction Domain, Impact Domain and Worry Domain. Both forward and backward translations from the English version of DQOL into Malay version were performed. After the face validity of the Malay version was established, it was then pilot-tested. Finally, the validity and reliability of the final Malay version of DQOL questionnaire were evaluated.
    RESULTS: There were 290 patients participated in this study with a mean (SD) age of 53.1 (10.0) years. The Cronbach's alpha coefficients of the overall items and the main domains were between 0.846 and 0.941. The Pearson's correlation coefficients for the three domains were between 0.228 and 0.451. HbA1C was found to be positively correlated with Impact Domain (P = 0.006). The Worry Domain was associated with diabetic retinopathy (P = 0.014) and nephropathy (P = 0.033).
    CONCLUSION: The Malay version of diabetes quality of life (DQOL) questionnaire was found to be a valid and reliable survey instrument to be used for Malaysian adult patients with diabetes mellitus.
    Study site: Klinik Kesihatan Seremban 2, Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
  19. Fulltext Achievement of LDL Cholesterol Goal and Adherence to Statin by Diabetes Patients in Kelantan
    Yudin ZM, Yaacob LH, Hassan NB, Ismail SB, Draman N, Yusoff SSM
    Malays J Med Sci, 2017 May;24(3):44-50.
    PMID: 28814932 MyJurnal DOI: 10.21315/mjms2016.24.3.6
    BACKGROUND: Statins are a class of potent drugs that can be used to reduce cholesterol, especially low-density lipoprotein cholesterol (LDL-C). However, their effectiveness is limited if adherence to treatment is poor. The objectives of the study are to estimate the proportion of diabetic patient who has achieved LDL-C goal and to determine the association of LDL-C achievement with socio demographic factors and statin therapy adherence.

    METHODS: This is a cross-sectional study involving 234 patients with type 2 diabetes mellitus (T2DM) and dyslipidaemia attending an outpatient clinic in a hospital in Kelantan. Interviews and self-administered questionnaires were used to determine their sociodemographic and clinical characteristics. Adherence to therapy was assessed using the Medication Compliance Questionnaire (MCQ). The associations between the achievement of LDL targets and sociodemographic/clinical factors, including adherence, were analysed with simple logistic regression.

    RESULTS: About 37.6% of patients achieved their LDL-C target. The percentage of patients who adhered to statin use was 98.3%, and 20.5% of these patients reported full adherence. There was no significant association between achievement of LDL-C targets with adherence or any other sociodemographic factors, such as age, gender and educational or economic status (all P-value < 0.05).

    CONCLUSION: Despite a high level of adherence, the majority of patients failed to achieve LDL-C targets. More concerted efforts are needed to improve this.

    Study site: primary
    care clinic in Hospital Universiti Sains Malaysia,
    Matched MeSH terms: Ambulatory Care Facilities
  20. Fulltext Assessing airflow limitation among smokers in a primary care setting
    Chean KY, Rahim FF, Chin JS, Choi XL, Liew KW, Tan CC, et al.
    Malays J Med Sci, 2018 May;25(3):78-87.
    PMID: 30899189 MyJurnal DOI: 10.21315/mjms2018.25.3.8
    Background: Many smokers have undiagnosed chronic obstructive pulmonary disease (COPD), and yet screening for COPD is not recommended. Smokers who know that they have airflow limitation are more likely to quit smoking. This study aims to identify the prevalence and predictors of airflow limitation among smokers in primary care.
    Methods: Current smokers ≥ 40 years old who were asymptomatic clinic attendees in a primary care setting were recruited consecutively for two months. We used a two-step strategy. Step 1: participants filled in a questionnaire. Step 2: Assessment of airflow limitation using a pocket spirometer. Multiple logistic regression was utilised to determine the best risk predictors for airflow limitation.
    Results: Three hundred participants were recruited. Mean age was 58.35 (SD 10.30) years old and mean smoking history was 34.56 pack-years (SD 25.23). One in two smokers were found to have airflow limitation; the predictors were Indian ethnicity, prolonged smoking pack-year history and Lung Function Questionnaire score ≤ 18. Readiness to quit smoking and the awareness of COPD were low.
    Conclusions: The high prevalence of airflow limitation and low readiness to quit smoking imply urgency with helping smokers to quit smoking. Identifying airflow limitation as an additional motivator for smoking cessation intervention may be considered. A two-step case-finding method is potentially feasible.
    Study site: primary care clinic (outpatient clinic), Pulau Pinang, Malaysia
    Matched MeSH terms: Ambulatory Care Facilities
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