A random survey of 400 doctors was carried out over a period of 3 months to determine the factors that would facilitate or inhibit the participation of doctors in continuing medical education (CME) in Malaysia. Regular participation in CME was defined as participation in any activity (self-directed reading or attending organized activities) at least once a month during the past year. It was found that 78% of doctors regularly participated in CME. Working in a hospital environment and being members of the Malaysian Medical Association and at least one specialty organization appeared to be important facilitatory factors in CME participation. These doctors also read the local medical journals regularly and subscribed to other journals. In addition, they were more likely to possess postgraduate qualifications and would have teaching, research, diagnostic or clinical responsibilities as major components of their work. They were more likely to practise in the big cities and would tend to be active in at least one voluntary or social organization. If they were in the Government sector, they were more likely to work in the Universities or in the Hospital Division of the Ministry of Health. The 22% who were less likely to participate in CME were general practitioners in the private sector. They worked long hours with day, evening and/or night shifts every day. If the doctors were in the Government sector, they were more likely to be in the Health Division, working in administration and public health, or they were in the armed forces and other organizations such as local councils. They worked in the smaller towns or in the districts.(ABSTRACT TRUNCATED AT 250 WORDS)
Malnutrition including vitamin A and iron deficiency and parasitic diseases have a strikingly similar geographical distribution with the same people experiencing both insults together for much of their lives. Parasitic infections are thought to contribute to child malnutrition and micronutrient deficiency through subtle reduction in digestion and absorption, chronic inflammation and loss of nutrients. Parasites may affect the intake of food; it's subsequent digestion and absorption, metabolism and the maintenance of nutrient pools. The most important parasites related to nutritional status are intestinal parasites especially soil transmitted helminthes, Giardia duodenalis, Entamoeba histolytica, followed by other parasites such as the coccidia, Schistosoma sp. and malarial parasites.
This study deals with personality variables of medical students in relation to their academic success in the preclinical stage. One hundred and one students completed the 16PF Questionnaire at the beginning of their medical course and the scores were analysed in relation to their marks obtained at the end of the 2-year preclinical stage. This study shows that the 16PF Questionnaire can be a useful instrument for identifying personality variables in candidates who are likely to have academic problems and those who are likely to do well in the preclinical stage of a medical course. Students of urban origin and the eldest in the family performed better in their preclinical years. Performance was not related to sex, ethnic group, family size of entrance qualification into medicine. Personality variables of being enthusiastic, venturesome, self-opinionated, imaginative, experimenting, resourceful and driven correlate positively with performance, whereas being self-assured has negative correlation. Problem students were more reserved, emotionally less stable and more apprehensive than non-problem students.
The competence of general practitioners (GPs) in diagnosing anxiety neurosis was assessed using standardized patients (SPs) unknown to the doctors. Out of a computer-generated random sample of 100 general practitioners in Kuala Lumpur, 42 volunteered to participate in the study. The results showed that the GPs can be divided into three groups: group A made the correct diagnosis and informed the SPs about their condition (11.9%); group B prescribed tranquillizers and did not inform the SPs of the actual diagnosis but instead said that they were either normal or were suffering from some stress (28.6%); and group C made various diagnoses of physical disorder or did not detect any abnormality at all (59.5%). Thus about 40% of the doctors considered an emotion-related disorder and only 12% of the doctors were confident enough to make and inform the patient of the actual diagnosis. Group A significantly (P < 0.001) asked higher numbers of relevant questions in the signs and symptoms section of the history than the other two groups. No differences between the three groups were observed in the other two sections of history-taking (personality, family, social and precipitating factors), in the general and specific physical examination and interpersonal skills. Generally, with the exception of the interpersonal skills section, the doctors performed less than 40% of the expected tasks in every section. The study highlighted the lack of competence in making a definite diagnosis of anxiety disorder. Among those who apparently made the diagnosis (group B) or made the diagnosis with certainty (group A), there was no demonstration of appropriate treatment behaviour with respect to pharmacological intervention.(ABSTRACT TRUNCATED AT 250 WORDS)
Intestinal parasites of importance to man are Enterobius vermicularis, the soil-transmitted helminthes (STH)--Ascaris lumbricoides Tricburis trichiura, bookworms (Necator americans/Ancylostoma duodenale) and Strongyloides stercoralis and the protozoa Entamoeba histolytica and Giardia duodenalis. Other protozoa such as Cryptosporidium sp. and Isopora sp. are becoming important in causing prolonged diarrhea in immunocompromised patients. It is estimated that almost 1 billion, 500 million and 900 million people worldwide are infected by the major nematode species--A. lumbricoides, T. trichiura and hookworms respectively. Most of the infections are endemic and widely distributed throughout poor and socio-economically deprived communities in the tropics and subtropics. Environmental, socio-economic, demographic and health-related behavior is known to influence the transmission and distribution of these infections. In giardiasis, one study indicates that age < or = 12 years and the presence of family members infected with Giardia were risk factors for infection. Most of the infections occur in children and both genders are equally affected. Epidemiological studies of STH infections have shown that the prevalence and intensity of infection are highest among children 4-15 years of age. The frequency of distribution of STH infections is over-dispersed and highly aggregated. areas reinfection can occur as early as 2 months post-treatment, and by 4 months, almost half of the population treated become reinfected. By 6 months the intensity of infection was similar to pretreatment level.
A cross sectional descriptive study of 2048 subjects was conducted to determine the prevalence of depression and factors influencing depression among students in secondary school from urban and rural areas in the state of Selangor, Malaysia. The children's depression inventory (CDI) developed by Maria Kovacs was used in this study. Students who participated in this study come from two urban schools and three rural schools. It was found that in the yield for scores for five factors were 9.2% have negative mood, 5% have interpersonal problems, 8.3% have ineffectiveness, 9.8% have anhedonia and 10.6% have negative self esteem. Following the interpretive guidelines for the T-scores, it was found that 10.3% of the students were much above average in the depression scale. This study also found that: 1% of students were smoking, 1.6% of students were gum sniffling, 0.9% took drugs, 4.1% took alcohol and 9.9% took things from other people. Females were more depressed than males. The Chinese students were more depressed compared to Indian students. Students whose parents had no formal education or had only primary education were more depressed than students whose parents had secondary, college or university education. Depression increased with increasing number of siblings. Depression contributed to the habit of drug abuse, gum sniffing and stealing but not to smoking and alcohol abuse. Suicidal tendencies were more likely among the depressed students. It is imperative that not only caregivers but also teachers have to be equipped with the knowledge, attitude and skills to assist secondary school children cope with their emotions, handle conflicts and manage stress early so that a more productive society will develop in the future.