MyMedR

Displaying publications 161 - 180 of 838 in total

Abstract:

Sort:

Fulltext Refractive error, visual acuity, and corneal-curvature changes in high and low myopes with orthokeratology treatment: A Malaysian study

Liong SL, Mohidin N, Tan BW, Ali BM

Taiwan J Ophthalmol, 2015;5(4):164-168.
PMID: 29018692 DOI: 10.1016/j.tjo.2015.07.006

BACKGROUND/PURPOSE: The effect of orthokeratology (OK) on low myopia is well known, but there are a few reports on its effect on high myopia. In this study, the parametric changes in high and low myopia as results of wearing OK lenses for a period of 6 months have been analyzed.
METHODS: Records of schoolchildren (age 7-17 years) undergoing OK treatment from an optometry clinic were retrospectively reviewed. Data involving refractive errors, uncorrected visual acuity, and corneal curvatures at baseline and after 1 day, 1 week, 1 month, 3 months, and 6 months of OK treatment from 25 patients who fulfilled the inclusion criteria were examined. For the analysis, the participants were arbitrarily divided into two groups comprising high myopia (< -6.00 D) and low to moderate myopia (from -1.00 D to -6.00 D).
RESULTS: Significant reductions of refractive error, improvement in visual acuity, and corneal-curvature flattening were found in all participants after 6 months of OK lens wear compared to the baseline. No significant changes were found in corneal toricity in both high and low to moderate myopic groups. Almost all of these occurred after one night of lens wear in both the high- and low-myopia groups.
CONCLUSION: The OK lens wear significantly reduced the refractive error and corneal curvature that results in the improvement in visual acuity in both high- and low-myopia groups, and the reduction seemed to occur nearly at the same time despite the difference in initial myopic power. High myopes with refractive power up to -8.25 D would benefit significantly from OK lenses.
Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Diabetes-related distress and depressive symptoms are not merely negative over a 3-year period in Malaysian adults with type 2 diabetes mellitus receiving regular primary diabetes care

Chew BH, Vos RC, Stellato RK, Rutten GEHM

Front Psychol, 2017;8:1834.
PMID: 29089913 DOI: 10.3389/fpsyg.2017.01834

For people with type 2 diabetes mellitus (T2DM) the daily maintenance of physical and psychological health is challenging. However, the interrelatedness of these two health domains, and of diabetes-related distress (DRD) and depressive symptoms, in the Asian population is still poorly understood. DRD and depressive symptoms have important but distinct influences on diabetes self-care and disease control. Furthermore, the question of whether changes in DRD or depressive symptoms follow a more or less natural course or depend on disease and therapy-related factors is yet to be answered. The aim of this study was to identify the factors influencing changes in DRD or depressive symptoms, at a 3-year follow-up point, in Malaysian adults with T2DM who received regular primary diabetes care. Baseline data included age, sex, ethnicity, marital status, educational level, employment status, health-related quality of life (WHOQOL-BREF), insulin use, diabetes-related complications and HbA1c. DRD was assessed both at baseline and after 3 years using a 17-item Diabetes Distress Scale (DDS-17), while depressive symptoms were assessed using the Patient Health Questionnaire (PHQ-9). Linear mixed models were used to examine the relationship between baseline variables and change scores in DDS-17 and PHQ-9. Almost half (336) of 700 participants completed both measurements. At follow-up, their mean (SD) age and diabetes duration were 60.6 (10.1) years and 9.8 (5.9) years, respectively, and 54.8% were women. More symptoms of depression at baseline was the only significant and independent predictor of improved DRD at 3 years (adjusted β = -0.06, p = 0.002). Similarly, worse DRD at baseline was the only significant and independent predictor of fewer depressive symptoms 3 years later (adjusted β = -0.98, p = 0.005). Thus, more "negative feelings" at baseline could be a manifestation of initial coping behaviors or a facilitator of a better psychological coaching by physicians or nurses that might be beneficial in the long term. We therefore conclude that initial negative feelings should not be seen as a necessarily adverse factor in diabetes care.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Association of diet practice and glycaemic control among type 2 diabetes mellitus patients attending primary care clinic in Kuala Lumpur

Ismail H, Aris T, Ambak R, Lim KK

Int J Public Health Res, 2014;4(2):465-471.
MyJurnal

Introduction Healthy dietary practice is important in preventing diabetes, managing existing diabetes, and preventing, or at least slowing the rate of diabetes complication development. It is, therefore, important at all levels of diabetes prevention. The objective of this study was to determine the association of dietary practice with glycaemic control among Type 2 diabetes mellitus (T2DM) patients, who received treatment from an urban Health Clinic in Kuala Lumpur.
Methods A total of 307 patients with T2DM aged 18 years and above participated in this study. A pre-tested structured questionnaire with guided interview was used to collect information on socio-demographic, clinical and dietary practice. Anthropometric and biological measurements were also taken. Descriptive statistics and Chi-square were used in the data analysis. Good glycaemic control was defined as HbA1c level less than 6.5%.
Results The prevalence of good glycaemic control was only 27% (n=83). The highest percentage of good glycaemic control were among male patients (29.1%), aged 60 and above (33.3%), educational level of primary school (35.4%) and those with monthly income group between RM1001 to RM1500 (32.0%). About three quarter of T2DM patient (n=224) had poor control of HbA1c (≥6.5%). Age (p=0.045) and working status (p=0.039) had significant relationship with the level of HbA1c. Dietary practice showed no significant relationship with the HbA1c level.
Conclusions Effective interventional health education strategies are needed, focussing on modification of dietary behaviour in order to achieve glycaemic control among diabetic patients.
Study site: Klinik Kesihatan, Kuala Lumpur, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Weight perception among non-pregnant urban Malaysian women: is it reliable?

Fadzil F, Shamsuddin K, Wan Puteh SE, Ahmad S, Abdul Hayi NS, Abdul Samad A, et al.

Int J Public Health Res, 2015;5(2):637-642.
MyJurnal

Introduction: In maternal healthcare, pre-pregnancy weight is used to predict pregnancy outcomes. Since no recorded data on pre-pregnancy weight, perceived weight is used alternatively. This study examines the relationship between perceived and actual weight among non-pregnant urban Malaysian women of childbearing age and identifies differences in perceived and actual weight by selected socio-demographic characteristics.
Methods: A cross-sectional study was conducted between April and June 2013 among urban Malaysian women attending public health clinics in the Klang Valley. Information on height, perceived current weight and time when their weight was last taken were obtained and actual weight was the average of two measurements (TANITA-HD-323-digital-scale). Socio-demographic data collected were age, ethnicity, education level, marital and employment status and total household income.
Results: Mean age of 371 women in this study was 28.81±5.65, 82.2% were Malays, 62.8% had tertiary education, over 75% were married and employed, with more than half from middle-income households. Overall, the mean perceived and actual weight was 59.29±11.59 and 59.20±11.90 respectively. Pearson‟s Correlation test showed a very strong positive correlation between perceived and actual weight (r=0.957;p<0.0001), ranging between 0.852 to 0.994 among subgroups; 258 (69.5%) perceived their weight accurately (±2.0 kg of actual weight), 49 (13.2%) under and 64 (17.3%) overestimated their weight.Main outliers were among younger women, Malays, tertiary educated, employed, middle-income and had weight last measured a month or more ago.
Conclusion: Strong correlation between perceived and actual weight among women in this study reassured weight perception can be used more confidently in patients‟ history taking and future research among urban Malaysian women using public health services.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Outcome and predictors for smoking Cessation in a Quit Smoking Clinic

Muhammad Adil Zainal Abidin, Hayati Kadi @ Shahar, Rosliza Abdul Manaf

Int J Public Health Res, 2017;7(1):774-782.
MyJurnal

Smoking is the leading preventable cause of non-communicable disease mortality worldwide. Therefore, effort for the effective measure in smoking cessation is important. However, the central problem in the nicotine addiction treatment is relapse. A retrospective cohort study was done at Tanglin Quit Smoking Clinic to determine the outcome of smoking cessation and its predictors. A cohort of 770 smokers between 2008 and 2015 were identified through simple random sampling. Smokers were defined as current smoker, while smoking abstinence is defined as cessation more than 6 months and relapse as any smoking episode even a puff since the quit date. Majority were Malays, Muslims and had secondary or higher education. The mean initiating age for smoking was 17.6 years old, with majority smoke between 11 to 20 sticks, and had high nicotine dependence score (43%). At the end of the study 52.5% of them abstinence from smoking. The predictors for smoking cessation were number of quit attempt (1 to 10 times) (AOR = 1.582, 95% CI = 1.012-2.472) and pharmacotherapy (AOR = 0.711, 95% CI=0.511-0.989). More frequent follow up was required during the first crucial 6 months to prevent relapse. Number of follow up can enhance not only the medication compliance but also motivational aspect to smokers to reduce relapse rates. Healthcare provider should give extra attention to the potential relapser especially to those who attempt for the first time.
Keywords: Malaysia, Quit Smoking Clinic, Smoking Cessation, Cohort, Survival analysis

Matched MeSH terms: Ambulatory Care Facilities
Fulltext A study on the health economics of General Practitioners in Malaysia: Trends, challenges and moving forward

Kenny K, Omar Z, Kanavathi ES, Madhavan P

Int J Public Health Res, 2017;7(1):765-773.
MyJurnal

Health care systems play a vital role in providing health services and in optimising the population’s health of each nation. The Malaysian health care system primarily consists of the public and private health services. One of the prominent private health care services offered in the General Practitioner’s (GP) Clinic. Despite the prominent role GPs play in the health care system in this country, little is known about their practices, the issues and challenges faced by GPs in this country. The objective of this study was to describe the current GP practice operations in Malaysia in terms of its general operations, financial expenditure and revenue, market competitiveness and laboratory services offered by the clinics.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Second-hand smoke exposure and psychological distress amongst non-smoking pregnant women in Malaysia

Siti Munira Yasin, Khairul Mizan Taib, Mohd Rodi Isa, Mohd Ariff Fadzil, Mohd Razilan Abdul Kadir

Pertanika Journal of Science & Technology, 2017;25(104):181-190.
MyJurnal

This study aimed to examine the association between second-hand smoke (SHS) exposure and psychological distress amongst non-smoking pregnant women. A cross-sectional study was used to obtain a representative sample of non-smoking pregnant women attending health clinics (n = 661) across six states in Malaysia. The duration of SHS exposure inside and outside the house was recorded from the participants. Psychological distress was assessed via General Health Questionnaire (GHQ12). The analyses were conducted using a logistic regression adjusted for demographic variables and other variables. Amongst non-smoking pregnant women, the prevalence of global SHS exposure and psychological distress was 80.4% and 64.2%, respectively. In the multivariate adjusted odds ratio (OR) models for psychological distress and the duration of SHS exposures, there was an OR of 1.04 (95% CI: 0.61-1.77) for individuals with SHS exposure of 1-4 hours/week, 0.44 (95% CI: 0.23-0.81) for SHS exposure of 5-14 hours/week and 0.84 (95% CI: 0.32-2.22) for exposures of >15 hours/week compared to those with no SHS exposure outside the home. Meanwhile, SHS exposure outside the house with the duration of 5-14 hours might have temporary calming effects against psychological distress. Nonetheless, more research is needed to ascertain this.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Gestational diabetes mellitus: The prevalence, associated factors and foeto-maternal outcome of women attending antenatal care

Logakodie S, Azahadi O, Fuziah P, Norizzati B, Tan SF, Zienna Z, et al.

Malays Fam Physician, 2017;12(2):9-17.
PMID: 29423124

Objective: The aim of the study is to determine the prevalence of gestational diabetes mellitus (GDM), its associated risk factors, foeto-maternal outcomes and prevalence of postnatal diabetes mellitus (DM).
Methods: This is a cross-sectional study using retrospective data from existing antenatal records of new antenatal women who registered at 72 public health clinics in Selangor in January 2014.
Results: A total of 745 antenatal records were reviewed. The prevalence of GDM women was 27.9% (n = 184). GDM risks were higher in women aged 35 years old and above and in those with maternal obesity. GDM women had a higher risk of having a non-spontaneous vaginal delivery compared to non-GDM women. The prevalence of postnatal DM among GDM mother was 12.1%. Working GDM mothers were at higher risk of developing postnatal DM.
Conclusion: The prevalence of GDM among newly registered women attending antenatal public health care in Selangor was higher than previous studies. Health care personnel need to be vigilant in screening women with risk factors.

Matched MeSH terms: Ambulatory Care Facilities
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
Fulltext Utilization of traditional birth attendants in MCH care in rural Malaysia

Yadav H

Singapore Med J, 1987 Dec;28(6):520-5.
PMID: 3441793

The traditional birth attendant (bidan kampong) or the TBA is still responsible for a substantial number of deliveries in Peninsular Malaysia. In the study area, the TBA s were responsible for about 47.2% of the deliveries in 1976. They were also responsible tor a substantial number of maternal deaths in the district. Therefore it was decided to identity and train the TBAs to identity ‘at risk’ cases at mothers and children and refer them to the nearest health facility. The TBA s were trained to use simple hygenic and aseptic procedures. At the end oi their training all at them were presented with a UNICEF midwifery kit. The short training proved useful because they now deliver fewer ‘at risk' cases and there is an in- creasing trend among them to refer the ‘at risk’ cases to the hospitals. The utilizations of TBA s in the maternal and child health program is a useful tool for the attainment at primary health care objective for developing countries by the year 2000.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Relationship between serum methadone concentration and cold pressor pain sensitivity in patients undergoing methadone maintenance therapy

Zahari Z, Lee CS, Ibrahim MA, Musa N, Mohd Yasin MA, Lee YY, et al.

Iran J Pharm Res, 2018;17(Suppl):8-16.
PMID: 29796025

Hyperalgesia is a common clinical phenomenon among opioid dependent patients on methadone maintenance therapy (MMT) and it may be associated with undertreated pain and/or therapeutic failure. This study aimed to investigate association between serum methadone concentration (SMC) and cold pressor pain responses. Cold pressor pain responses in 147 opioid dependent patients on MMT were assessed using cold pressor test (CPT) at 0 h and at 2, 4, 8, 12, and 24 h after the dose intake. Blood samples were collected at 24 h after the dose. Serum methadone concentrations were measured using the Methadone ELISA kit and classified into two categories: < 400 ng/mL and ≥ 400 ng/mL. Eighty-eight patients (59.9%) had trough concentrations of < 400 ng/mL and 40.1% had trough concentrations of ≥ 400 ng/mL. There were significant effects of SMC on the cold pressor pain threshold (p = 0.019). Patients with concentrations < 400 ng/mL had significantly higher (almost 60% higher) cold pressor pain threshold (adjusted mean (95% CI) = 30.15 (24.29, 36.01) s) compared to those with concentrations of ≥ 400 ng/mL (18.93 (11.77, 26.08) seconds). There was also a 20% difference in pain tolerance, and 6% difference in cold pressor pain intensity score, neither of which were significant statistically (p > 0.05). Our results suggest an association of trough methadone concentration with the cold pressor pain threshold among opioid dependent patients on MMT. It would be useful to study the mechanisms underlying this association to help managing pain in such a population.
Study site: Psychiatric Clinic, Hospital Universiti Sains Malaysia (HUSM); Psychiatric Clinic, Hospital Raja Perempuan Zainab II; and eight other government MMT clinics in Kelantan, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Factors associated with good glycemic control among patients with type 2 diabetes mellitus

Ahmad NS, Islahudin F, Paraidathathu T

J Diabetes Investig, 2014 Sep;5(5):563-9.
PMID: 25411625 DOI: 10.1111/jdi.12175

AIMS/INTRODUCTION: The aim of the present study was to determine the status of glycemic control and identify factors associated with good glycemic control among diabetic patients treated at primary health clinics.

MATERIALS AND METHODS: A systematic random sample of 557 patients was selected from seven clinics in the Hulu Langat District. Data were collected from patients' medication records, glycemic control tests and structured questionnaires. Logistic regression analysis was carried out to predict factors associated with good glycemic control.

RESULTS: Variables associated with good glycemic control included age (odds ratio 1.033; 95% confidence interval 1.008-1.059) and duration of diabetes mellitus (odds ratio 0.948; 95% confidence interval 0.909-0.989). Compared with the patients who were receiving a combination of insulin and oral antidiabetics, those receiving monotherapy (odds ratio 4.797; 95% confidence interval 1.992-11.552) and a combination of oral antidiabetics (odds ratio 2.334; 95% confidence interval 1.018-5.353) were more likely to have good glycemic control. In the present study, the proportion of patients with good glycemic control was lower than that in other published studies. Older patients with a shorter duration of diabetes who were receiving monotherapy showed better glycemic control.

CONCLUSIONS: Although self-management behavior did not appear to influence glycemic control, diabetic patients should be consistently advised to restrict sugar intake, exercise, stop smoking and adhere to medication instructions. Greater effort by healthcare providers in the primary health clinics is warranted to help a greater number of patients achieve good glycemic control.

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Disclosure of traditional and complementary medicine use and Its associated factors to medical doctor in primary care clinics in Kuching Division, Sarawak, Malaysia

Kelak J, Cheah WL, Razitasham S

Evid Based Complement Alternat Med, 2017;2017:5146478.
PMID: 28529529 DOI: 10.1155/2017/5146478

The decision by the patients to disclose traditional and complementary medicine (TCM) use to their doctor is an important area to be explored. This study aimed to determine the disclosure of TCM use and its associated factors to medical doctor among primary care clinic attendees in Kuching Division, Sarawak. It was a cross-sectional study using questionnaire, interviewer administered questionnaire. A total of 1130 patients were screened with 80.2% reporting using TCM. Logistic regression analysis revealed that being female (AOR = 3.219, 95% CI: 1.385, 7.481), perceived benefits that TCM can prevent complication of illness (AOR = 3.999, 95% CI: 1.850, 8.644) and that TCM is more gentle and safer (AOR = 4.537, 95% CI: 2.332, 8.828), perceived barriers of not having enough knowledge about TCM (AOR = 0.530, 95% CI: 0.309, 0.910), patient dissatisfaction towards healthcare providers being too business-like and impersonal (AOR = 0.365, 95% CI: 0.199, 0.669) and paying more for healthcare than one can afford (AOR = 0.413, 95% CI: 0.250, 0.680), and accessibility of doctors (AOR = 3.971, 95% CI: 2.245, 7.023) are the predictors of disclosure of TCM use. An open communication between patients and doctor is important to ensure safe implementation and integration of both TCM and medical treatment.
Study site: Klinik kesihatan, Kuching, Sarawak, Malaysia

Matched MeSH terms: Ambulatory Care Facilities
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
Fulltext Effects of soy on body composition: A 12-week randomized controlled trial among Iranian elderly women with metabolic syndrome

Bakhtiari A, Yassin Z, Hanachi P, Rahmat A, Ahmad Z, Sajadi P, et al.

Iran J Public Health, 2012;41(4):9-18.
PMID: 23113160

BACKGROUND: To examine the effects of soy [in the form of textured soy protein (TSP) and soy-nut] on body composition in elderly women with metabolic syndrome (MetS).
METHODS: A 12-week randomized clinical trial was conducted on 75 women between 60-70 years of age with MetS in rural health clinics around Babol, Iran in 2009. The participants were randomly assigned to one of the three groups of soy-nut (35g/d), TSP (35g/d) and control. Body fat, lean mass and anthropometric indicators were measured before and after intervention, too.
RESULTS: Participants were classified as overweight and showing android fat distribution. After 12 weeks of intervention, both soy-nut and TSP groups showed an increase of non-significant in lean mass (0.9 and 0.7 kg), hip circumference (0.45 and 0.28 cm), triceps skinfold (TSF) thickness (0.87 and 0.67mm) and reduction in BMI (-0.15 and -0.33), waist circumference (-0.83 and -1.2) and body fat (-1.5% and -1.7%). Significant increase in the mean change of TSF and lean mass was observed in the users of soy-nut compared to the control group (P<0.01, P<0.05).
CONCLUSION: 12-week intervention of soy had a mild favorable effect on body composition in elderly women with MetS.
KEYWORDS: Body composition; Metabolic syndrome; Older women; Soy

Matched MeSH terms: Ambulatory Care Facilities
Fulltext Synthetic-type control charts for time-between-events monitoring

Yen FY, Chong KM, Ha LM

PLoS One, 2013;8(6):e65440.
PMID: 23755231 DOI: 10.1371/journal.pone.0065440

This paper proposes three synthetic-type control charts to monitor the mean time-between-events of a homogenous Poisson process. The first proposed chart combines an Erlang (cumulative time between events, Tr ) chart and a conforming run length (CRL) chart, denoted as Synth-Tr chart. The second proposed chart combines an exponential (or T) chart and a group conforming run length (GCRL) chart, denoted as GR-T chart. The third proposed chart combines an Erlang chart and a GCRL chart, denoted as GR-Tr chart. By using a Markov chain approach, the zero- and steady-state average number of observations to signal (ANOS) of the proposed charts are obtained, in order to evaluate the performance of the three charts. The optimal design of the proposed charts is shown in this paper. The proposed charts are superior to the existing T chart, Tr chart, and Synth-T chart. As compared to the EWMA-T chart, the GR-T chart performs better in detecting large shifts, in terms of the zero- and steady-state performances. The zero-state Synth-T4 and GR-Tr (r = 3 or 4) charts outperform the EWMA-T chart for all shifts, whereas the Synth-Tr (r = 2 or 3) and GR-T 2 charts perform better for moderate to large shifts. For the steady-state process, the Synth-Tr and GR-Tr charts are more efficient than the EWMA-T chart in detecting small to moderate shifts.

Matched MeSH terms: Ambulatory Care/statistics & numerical data
Fulltext Patient-reported side effects of lamotrigine during routine clinic visits

Daud NA, Ab-Rahman A

Neurosciences (Riyadh), 2012 Jul;17(3):269-70.
PMID: 22772938
Matched MeSH terms: Ambulatory Care/psychology
Fulltext Appropriateness of medical admissions from a Malaysian public primary care clinic

Chan SC

Med J Malaysia, 1999 Sep;54(3):329-37.
PMID: 11045059

Appropriateness of medical admissions from a Malaysian public primary care clinic (Outpatient Department, Hospital Ipoh) was assessed by two physicians using a modified appropriateness evaluation protocol. Of 122 admissions between 16/6/96 and 15/7/96, 107 records (88%) could be traced from the records office. Eighty percent (86/107) were found to be appropriate and 20% (21/107) inappropriate admissions. Inappropriate admissions included admissions to the wrong discipline and patients who could be investigated and stabilised as outpatients or could be referred to specialist clinics. Protocols, provisions for urgent referrals and medical updates for doctors are recommended.

Study site: Outpatient Department, Hospital Ipoh

Matched MeSH terms: Ambulatory Care Facilities*
Fulltext Practice of breast self-examination amongst women attending a Malaysian Well Person's Clinic

Chan SC

Med J Malaysia, 1999 Dec;54(4):433-7.
PMID: 11072459

The practice of breast self-examination (BSE) amongst 1,303 women registered with the Well Person's Clinic, Outpatient Department, Hospital Ipoh between April 1995 and March 1997 were assessed through a questionnaire. Majority (98.2%) were never taught and did not practise BSE, 17(1.3%) practised BSE while 6 (0.5%) were taught BSE but failed to put it into practice. Only 5.8% of 52 women with past/family history of breast cancer/lump and 2.9% of 207 women with past/family history of other cancers were practising BSE regularly. Three out of 64 women with breast lumps found on clinical breast examination discovered the lumps themselves. Five of the 64 women were subsequently confirmed to have breast carcinoma.
Study site: Outpatient clinic, Hospital Ipoh, Perak, Malaysia

Matched MeSH terms: Ambulatory Care Facilities*
Fulltext Outpatient procedures for cervical dysplasia: a 3 year review of laser vaporisation and LEEP

Lee KE, Koh CF, Watt WF

Med J Malaysia, 1999 Mar;54(1):47-51.
PMID: 10972004

A 3 year retrospective review (1995 to 1997) of 127 patients with cervical dysplasia who underwent Laser Vaporisation of the cervix and LEEP at the Gynaecological Cancer Centre, KK Women's & Children's Hospital, Singapore, was undertaken. Amongst the patients in the Laser Vaporisation group, the mean age was 37.7 years (SD 8.8), the mean operating time was 14.8 minutes (SD 8.5), 63.6% were given prophylactic antibiotics and the mean follow up period was 15.3 months (SD 12.0), whilst in the LEEP group, mean age was 40.3 years (SD 8.4), mean operating time, 11.8 minutes (SD 4.9), prophylactic antibiotic rate, 53.8% and mean follow up period was 19.1 months (SD 9.3). Mild and moderate haemorrhage post procedure were the only complications encountered, 10.2% (5/49) in the Laser group and 3.8% (3/78) in the LEEP group. 98% (48/49) and 97.4% (76/78) of the Laser and LEEP groups, respectively, were free of disease on follow up. None of the 3 patients with persistent or recurrent disease were diagnosed as having invasive cancer. Overall, there were no significant differences in the patient characteristics, histopathology, operating times, follow up period, the use of prophylactic antibiotics, and complications in the 2 groups. The low complication rate, high disease-free rate and the relatively short operating time of Laser Vaporisation and LEEP in our study suggests that, indeed, both the procedures can be done safely and efficiently in the outpatient setting. However the discrepancy between the histology of colposcopically directed biopsy and that of LEEP specimens suggests that colposcopically directed biopsy may not be as accurate as one might believe, and further studies analysing the concordance between colposcopically directed biopsy and LEEP biopsy histologies are needed.

Matched MeSH terms: Ambulatory Care*

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links