Introduction: Cardiovascular diseases remain as the principal cause of death in Malaysia. The rural areas in Sabah still suffer from shortage of doctors and specialists. Health Indicators 2018 from Ministry of Health Malaysia shows the ratio of doctor to population in Sabah is 1:1029. The lack of specialist care for the rural population is a major concern. To overcome the barrier of healthcare services, deployment of telecardiology system is necessary. The objective of this project is to develop a real-time telecardiology system that can transmit and guarantee the quality of the ECG signal. Methods: The proposed real-time telecardiology system used an ECG sensor AD8232 to collect the ECG signal. Arduino ESP32 as a main controller of the system. It uploads the collected ECG data to the online database in real-time through Wi-Fi or cellular network with MQTT protocol. A website is developed for displaying the real-time ECG signal. Results: The proposed system has successfully displayed the ECG signal in real-time with 10000 ECG raw data were tested and stored in online database with no package loss and package error during the data transmission. The online system able to display real-time ECG signal and BPM on webpage. The real-time BPM is extracted from the real-time ECG raw data. Conclusion: The proposed real-time telecardiology system has success-fully transmitted ECG in real-time with high data integrity. Telecardiology is one of the best solutions to resolve the issue of shortage of healthcare professionals in rural areas and improve the healthcare quality in rural areas.
As general population of obese patients in Malaysia rapidly increases, more obese patients are requiring anaesthesia for various operative procedures. Obesity is associated with anatomical and physiological differences and co-morbidities that influence on the choices of anaesthesia care. A surgical case with general anaesthesia is used as a basis of discussion. A 37-year-old female, history of untreated hypertension and gastrooesophageal reflux disease (GORD), BMI of 41 admitted for laparoscopic cholecystectomy for symptomatic cholelithiasis under general anaesthesia. She presented with pain at the upper right abdomen and associated with bloated abdomen, nausea and vomiting after intake of meals. General anaesthesia and right ultrasound-guided transversus abdominis plane (TAP) block for abdominal wall blocks via subcostal approach was performed. Operation was removal gallstones in the common bile duct via laparoscopic approach. Post-operation patient was extubated successfully. She was prescribed paracetamol 1g 4 hourly and started on fentanyl patient-controlled analgesia (PCA) for next 2 days. In this case report, there is the description of the application of TAP block which when used in obese abdominal surgical procedure, can provide excellent postoperative pain relief, early mobilization and recovery.
Introduction: Hypertension prevalence is increasing globally and has become a major issue of disease as it is a major cause for cerebrovascular, kidney and cardiovascular diseases. Even among treated patients, there is a dispropor-tional of blood pressure control causing a major public health challenge. This study is aimed to decide on the prev-alence of uncontrolled hypertension and its associated factors among hypertensive patient attending hypertension clinic at primary health clinics in Tuaran district. This study is justified by the fact that uncontrolled hypertension leads to high mortality, morbidity and even premature death. Methods: This study is a cross-sectional study among 460 hypertensive patients attending three primary health clinics in Tuaran district, Sabah. Data were collected using structured modified questionnaires through interviews, physical examinations and patient’s medical records. Types of data collected include socio-demography, lifestyle behavior, physical examination, co-morbidity status and med-ical adherence. Data analysis done using SPSS version 24.0. Results: Prevalence of uncontrolled hypertension was 45.9%. The study found that factors significantly associated with uncontrolled hypertension with p
The low back is usually associated with the lumbar spine which supports the entire weight of the upper body and significantly, is vital to the body mobility. Injury to the surrounding soft tissues can cause mild to debilitating symptoms due to muscle strain and ligament sprain. The causes of injury to the lower back are probably due to sudden twisting movement, poor posture position at work and manual handling of heavy objects or with twisting or bending movements while lifting. An Ergonomic Risk Assessment was carried out on a dental laboratory worker who complained of unresolved low back ache after a year on treatment and follow up at the outpatient department of a health clinic. From the various investigative methods used, it was found that the worker in question was placed in a situation that will over time encourage her to develop musculoskeletal disease. Our recommendations for change include immediate awareness and training in ergonomic principles of work and to report all cases so that appropriate action can be taken, reassess the workstation and environment of work, job enrichment, and creating a conducive environment for work. Once the changes have been implemented, a review will be necessary in three months time.
Introduction: Cholera is an infection caused by the bacterium Vibriocholerae that causes severe watery diarrhoea, which can lead to dehydration. Beet-roothas been shown to induce favourable outcomes and holds promise as an economic, practical natural dietary intervention in cholera. Methods: Systematic search of peer-reviewed literature on beet-root ORS and carrot ORS use for acute diarrhoea in below 6-year-old. We identified 3 studies for abstraction. Results: A study had compared a commercial carrot/rice-based ORS A (Na 52 mmol/L) and two glucose-based ORS B (Na 55 mmol/L) and C (Na 90 mmol/L). Fluid intake, faecal and urine output and absorption of fluid was measured in 161 infants and children (3-48 months old) during the first 48 hours after admission. The number of stools (p < 0.01) and the mean faecal output (p < 0.05) per kg body weight were significantly lower in group A. Children in group A also had significantly (p < 0.01) greater fluid absorption (mean 464 ml/kg) than in groups C (312 ml/kg) and B (140 ml/kg). Conclusions: While there are some promising results, this analysis indicates that the need for further investi- gation into approaches to increasing beet-root ORS and carrot ORS use.