Patient’s appointment compliance refers to the willingness and ability of a patient to attend to their scheduled clinical appointment. Failure to do so have various consequences, especially so for a teaching clinic such as the Optometry Clinic, Universiti Kebangsaan Malaysia (UKM). The percentage of appoinment compliance at the Optometry Clinic was analysed from September to December 2015. Compliance rate was categorised based on clinic type and session, and on patient’s gender and ethnicity. Attendance compliance was around 60% for the Primary Care Clinic. It increased to 70% for patients with vision problems who where referred to specialty clinics i.e. Low Vision and Paediatric Clinics. Clinic day and session did not influence compliance significanly (p > 0.05). Patient’s gender and ethnicity did not influence compliance significantly as well but those of Indian ethnicity consistently showed the lowest appointment compliance rates. A protocol should be developed to increase the rate of patients’ appoinment compliance. This would then maximise productivity of students and clinic staff and optimise the clinic’s resources. The cost of each clinical session could be informed to the patients, even when the cost is not borne by them.
Keywords: Appointment compliance; Optometry Clinic; appointments; clinical teaching and learning; public health
Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
1. Observations made on groups of light and dark skinned individuals indicate that the percentage of dark skinned people who can be recognized as immune by their reaction to vaccination is considerably lower than in the case of people with a lesser skin pigmentation.
2. It is suggested that the reading of "immune reaction" is influenced considerably by the intensity of skin pigment found in the individual.
3. It would appear that while the usefulness of immune reaction readings in light-skinned peope is very great, its value is limited when applied to those with dark skins.
Several lines of evidence suggest that, of the three main races of Singapore, peptic ulcers are more common among the Chinese and Indians when compared to the Malays. These include studies on hospital series of patients with or without appropriate control groups, studies on the incidence of surgery for perforated ulcer as well as mortality statistics. A reduction in the Chinese:Malay difference in the incidence of perforated ulcer over three decades suggests that environmental factors are involved in producing these racial differences. However, we have to date been unable to determine the factor(s) responsible. The incidence of perforated ulcer in Singapore is increasing while ulcer mortality is declining. This is similar to the situation in Hong Kong but different from that in the western countries.
Benign cystic teratoma of the ovary has a varied incidence, varying from 30 to 50 per cent of all benign ovarian tumours. This tumour tends to occur in the reproductive age group (20 to 40 years), and the majority of patients are married with children. About 40 per cent of patients are symptomless. Of those with symptoms, abdominal pain and mass are the commonest. Torsion is the most frequent complication encountered, and the presence of acute pain should make one suspect this complication. The tumour is bilateral in 10 to 20 per cent of patients. This high bilateral occurrence places a responsibility on the gynaecologist to inspect the opposite ovary in all cases of unilateral dermoid cyst of the ovary at the time of laparotomy. Germ·layer derivatives are predominantly ectodermal in origin, although both mesodermal and entodermal derivatives occur frequently.
The incidence of congenital hypertrophic pyloric stenosis among 141,215 Chinese, Malay and Indian live births in Singapore from 1972 to 1974 was determined. The incidence per 100,000 live births among these ethnic groups are: Chinese 21.2, Malay 9.7 and Indian 35.0. Pyloric stenosis is not absent although rare in oriental babies.
The clinical features and pathology of 17 patients with gastrointestinal lymphoma are reviewed. The small intestine was the site most commonly involved. Emergency presentation was usual: 11 of the 17 patients presented as acute abdomen or gastrointestinal haemorrhage. The frequency of gastrointestinal lymphoma to carcinoma in the Chinese and Indians was comparable to that in the West but a higher frequency was found in the Malays and Orang
Asli.
Surveys in a number of European and American populations have found the frequency of occurrence of the heterozygotes for the gene for the dibucaine-resistant variant of cholinesterase (E.C.3.1.1.8) to be relatively constant. Similar surveys in Oriental population have shown low incidence of the same gene. This study done on the multi-racial population consisting of 3 major groups shows an absence of the gene for the dibucaine resistant variant of cholinesterase. This is supported by the clinical experience in the use of suxamethonium as a single dose in more than 25,000 individuals.
The weights and heights of 3,312 Malaysian primary school boys and girls, aged 6 to 11 years, belonging to various ethnic groups in Malaysia were measured. On the whole, the Chinese children were taller and heavier than the Malay and the Indian children who were the least heavy among the three ethnic groups. Economically the Indians were the poorest among the three ethnic groups and they also had the largest family size. When the household incomes were taken into consideration it was found that the growth achievement of the higher income children was better than that of the poorer children, irrespective of their ethnic groups. It is interesting to note that, although the Indian children as a whole, were the least heavy of the three ethnic groups, yet the growth achievement of the higher income Indian children was similar to that of the higher income Chinese children. The differences in growth achievement of the various ethnic groups are probably due to environmental differences, rather than genetic differences. It seems likely that Malaysian children of different ethnic groups (Malay, Chinese and Indian) can attain similar statures if environmental conditions are similar.
Serum samples from Sinhalese subjects, from Punjab and from Singapore have been studied. The Gm phenotypes found are very numerous and we can observe some similarities concerning the Gm gene frequencies between the Singapore Indians with the Indians of North India, and with the Sinhalese. In contrast, Gm gene frequencies found among Chinese and Malays from Singapore are quite different from those found among Indians of Singapore. Our results here are very similar to those obtained in Malaya studies.
In a study of Malaysians of different racial groups, 1,510 sera (908 from Malays, 371 from Chinese and 231 from Indians) were identified for their protease inhibitor (Pi) types. The gene frequencies for the alleles PiM, PiS and PiX in Malays were, respectively, 0.979, 0.015, and 0.007. In Chinese, the frequencies were 0.981, 0.019 and 0.000, and in Indians they were 0.976, 0.24, and 0.000. It is interesting that the usually rare PiX type is found in appreciable frequency in the Malays. Two different types with unusual behavior and obscure origin were also found.