Thyroidectomy for benign and malignant diseases has progressed dramatically over the last two decades. Moving from large collar incision to no scar is a very good news to the patient with neck swellings. The morbidity of the surgery remains low regardless of the technique and approaches used but scarless surgery is still limited to benign diseases and small cancers. Further study and future refinement of the technique might make these techniques also applicable to large tumours.
Although around 70% of HIV+ cases used to have ocular manifestations, the late reporting of cases often results in severe forms of ocular morbidity that would otherwise have been prevented. The objective of this study was to describe the ocular manifestations of HIV and AIDS-related patients who had been admitted to TM Jafferji Hospital, Dar-es-Salaam, Tanzania.
Self-injury is a significant predictor of future self-harm and suicide, and is associated with significant psychological morbidity. However, despite an
apparent increase in prevalence, very little research on this behaviour has been conducted within Malaysia. This paper reviews the definitional issues
pertinent to the study of self-injury including the need to adopt a consistent nomenclature for the behaviour, separate self-injury which occurs with and
without suicidal intent, and to address role of culture in defining self-injurious behaviour. A review and critique of research exploring the prevalence, function, aetiology, and correlates of self-injury across both clinical and community samples is provided. Finally, in light of the current international knowledge regarding self-injurious behaviour, recommendations to guide future research in Malaysia are proposed.
Community-acquired pneumonia (CAP) is one of the most common infectious diseases and the world’s leading cause of mortality and morbidity, especially in patients aged 65 years and above.1,2 It is the 6th cause of mortality and the most important cause of hospitalisation in Malaysia. According to the British Thoracic Society, the gold standard in diagnosing CAP is based on radiological findings and it is defined into 2 different settings – community and hospital.3
Gestational Diabetes Mellitus (GDM) is the most common medical complication and metabolic disorder of pregnancy. This review provides an overview into the morbidity associated with GDM as well as the current methods of screening, diagnosis and management with the aim of early recognition and prevention of complications to both the mother and foetus.
OBJECTIVES: To compare the morbidity patterns in public and private primary care clinics; determine patients' reasons for encounter (RFE) and diagnoses using the ICPC-2, and compare ten commonest diagnoses and RFEs.
METHODS: A cross-sectional study on randomly selected clinics was conducted nationwide. Doctors completed the Patient Encounter Record (PER) for systematically selected encounters for a week.
RESULTS: Response rate was 82.0% (public clinic) and 33% (private clinic) with 4262 encounters and 7280 RFE. Overall, the three commonest disease categories encountered were respiratory (37.2%), general and unspecified (29.5%), and cardiovascular diseases (22.2%). Public and private clinics handled 27% versus 50% acute cases and 20.0% versus 3.1% chronic cases i.e. 33.7 and 5.6 chronic diseases per 100 RFE respectively.
CONCLUSION: Doctors in public clinics saw more chronic and complex diseases as well as pregnancy related complaints and follow-up cases while in private clinics more acute and minor illnesses were seen. Health services should be integrated and support given to co-manage chronic diseases in both sectors.
KEYWORDS: Malaysia; Primary practice; delivery of health care; morbidity pattern; reasons for encounter
The reasons why 860 patients visited the general medical clinic at the University Hospital, Kuala Lumpur were studied. 75.3% of the patients came for evaluation of symptoms; 12.4% sought checkups for chronic diseases; 4.9% requested diagnostic checkups and screening tests; 4.8% came to renew prescription. Few visits were made for evaluation of injuries, receiving test results or for administrative examination. This profile reflected the function of the clinic as an acute diagnostic centre. Other applications of the results are discussed.
Study site: General Medical Clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Disease patterns among outpatients seen at static and travelling dispensaries, as well as among hospital admissions and hospital deaths are compared between 1959 and 1974. While disease patterns of patients seen by travelling dispensaries show no change, patients seen by static dispensaries and hospital admissions in 1974 show a marked relative decline in infective and parasitic diseases and an increase in accidents, poisonings and violence. Causes of death in hospitals in 1974 were different, there being relative increases in diseases of early infancy, diseases of circulatory system, neoplasms, and accidents, poisonings, violence while infective and parasitic diseases, and diseases of the digestive system declined.
Turkey is the last country in the temperate zone on the edge of the European continent in which malaria is prevalent at endemic and occasionally epidemic proportions. Malaria was the most significant vector borne disease constituting a serious healthy problem until it was suppressed in 1965. Following the establishment of malaria eradication program in 1957 which began operation in 1960 after many years of malaria control, the incidence of malaria decreased annually and the stricken areas became more and more restricted. Unfortunately, an agricultural development program initiated in mid 70's in the Cukurova Plain caused a substantial migration of workers from the eastern areas where malaria at that time was more prevalent. This population movement together with the industrial expansion that took place resulted in a serious epidemic of vivax malaria in 1977 in the provinces of Adana, Icel and Hatay, where 101,867 cases were reported. The following years, Turkey targeted to reduce the number of malaria cases to less than 800 by 1984. After 1985, the number of malaria cases in the country has continued to increase and in the past five and six years a serious malaria epidemics has been building up in the southeastern provinces. The gravitational center of the disease has now moved from the Cukurova to the GAP area in South East Anatolia and beyond. The indicator of this movement is that 89% of total cases in 1998 is concerning to the GAP region. By the year 1998 the number of reported cases were 36,842. The common parasite type is P. vivax in the country. The other types are generally imported from other countries. These are Syria, S. Arabia, Pakistan, Afghanistan, Yemen, Nigeria, India, Malaysia, Ghana, Indonesia, Sudan etc. Malaria cases are registered in bordering areas of the country constantly. The suggested solutions for Malaria control in bordering areas are: 1. To establish control laboratories in customs in order to take blood from persons who come from risky areas for malaria. When positive cases are found these laboratories will also provide free treatment. 2. East country should give information about the malaria situation in their country to the other countries.
Dengue infection is a major cause of morbidity and mortality in Malaysia. To date, much research on dengue infection conducted in Malaysia have been published. One hundred and sixty six articles related to dengue in Malaysia were found from a search through a database dedicated to indexing all original data relevant to medicine published between the years 2000-2013. Ninety articles with clinical relevance and future research implications were selected and reviewed. These papers showed evidence of an exponential increase in the disease epidemic and a varying pattern of prevalent dengue serotypes at different times. The early febrile phase of dengue infection consist of an undifferentiated fever. Clinical suspicion and ability to identify patients at risk of severe dengue infection is important. Treatment of dengue infection involves judicious use of volume expander and supportive care. Potential future research areas are discussed to narrow our current knowledge gaps on dengue infection.
Detection of cancer at the early stage is of utmost importance to decrease the morbidity and mortality of the disease. Apart from the conventional biopsy, minimally invasive methods like serum evaluation are used for screening large populations. Thus, this study aimed to estimate serum levels of sialic acid and fucose and their ratio in oral cancer patients and in healthy control group to evaluate their role in diagnosis.
The third National Health Morbidity Survey was conducted in 2006 on a nationally representative sample of population in Malaysia in order to obtain community-based data and information on the prevalence of chronic illness. Of 57,500 eligible respondents 56710 (98.6%) participated in the study. Estimated overall prevalence of chronic illness in the Malaysian population within a recall period of one year was 15.5% (95% CI 15.1% - 15.9%). Chronic illness was reported significantly higher among the females, 16.8% (16.3 - 17.3). The most common chronic illness was hypertension (7.9%, 7.6 - 8.2), followed by diabetes mellitus (4.0%, 3.8 - 4.2) and highest reported by the Indians (19.7%, 18.4 - 21.0). Among the respondents who had sought treatment for chronic illness from government health facilities, Malays (65.8%) and those with monthly household income of less than RM400 (76.6%) were the highest. Chinese (44.5%) and those with household income of RM5000 and above (54.3%) were the highest groups who sought treatment from the private health facilities. Most of the respondents reported mild illness was the main reason for not seeking treatment for their chronic illness. It is hoped that the results of this survey will help the Ministry of Health Malaysia to enhance health programmes and planning resource allocation in order to improve health status of the population.
Study name: National Health and Morbidity Survey (NHMS-2006)
The Reason for Encounter Classification (RFEC) was designed by a WHO Working Party to classify the reasons why patients seek care at the primary care level. It is designed along two axes: Chapters and Components. Each chapter carries an alpha-code which is the first character of the basic 3-character alphanumeric code. Each chapter is subdivided into seven "components" carrying 2-digit numeric codes. The field trial was undertaken by family physicians and nurses in: Australia, Barbados, Brazil, Hungary, Malaysia, the Netherlands, Norway and the US. 90497 RFE's were analysed. Their distribution over the chapters and components characterize the content of international primary care. Listings with the most common RFE's in the participating countries reflect the cultural differences. It is concluded that the RFEC is not only feasible to classify reasons why patients seek care but also to classify the diagnosis and the process of primary care. As a result of this, the International Classification of Primary Care (ICPC) succeeds the RFEC.
Dengue fever is an endemic disease in many tropical and subtropical regions. In
Malaysia, it is the leading public health challenge despite the extensive intervention
programs by the related authorities. Distribution of dengue cases in Malaysia varies
according to states and districts where cases are more distinct in urban and suburban
areas. Preparedness strategies of dengue cases could be more successful with some
comprehensive and technical analysis on disease incidences. Hence, the present study
analyses dengue cases using mathematical modelling in the state of Penang, one of the
more urbanised state. In particular, two time series models are fitted to the dengue
data from the region in order to identify the mathematical model that best describe
the data. Results show that both proposed models are able to represent the cases
rather well; however numerical inspection revealed that Double Exponential
Smoothing method is the better choice. Subsequently, the identified model is used to
make forecasting on the number of expected cases. Results show that dengue cases in
Penang are expected to increase gradually.
Symptomatic arterial pseudoaneurysm is not an uncommon emergent
vascular case presenting to a tertiary hospital. These are mainly associated with
infection, iatrogenic puncture or trauma. The resultant morbidity, limb loss and
mortality present a challenge to the surgeons managing these cases. (Copied from article).