Economic burden issues in SARS-CoV-2 patients with underlying co-morbidities are enormous resources for patient treatment and management. The uncertainty costs for clinical management render the healthcare system catatonic and incurs deficits in national annual budgets. This article focuses on systematic steps towards selecting and evaluating literature to uncover gaps and ways to help healthcare stakeholders optimize resources in treating and managing COVID-19 patients with multi-morbidity. A systematic review of all COVID-19 treatment procedures with co-morbidities or multi-morbidity for the period from 2019 to 2022 was conducted. The search includes studies describing treatment costs associated with multi- or co-morbidity cases for infected patients and, if concurrently reported, determining recurring expenses. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Galbraith plots and I2 statistics will be deployed to assess heterogeneity and to identify potential sources. A backward elimination process will be applied in the regression modelling procedure. Based on the number of studies retrieved and their sample size, the subgroup analysis will be stratified on participant disease category, associated total costs, and degree of freedom in cost estimation. These studies were registered in the PROSPERO registry (ID: CRD42022323071).
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.
Mental disorders are highly comorbid and occur together with physical diseases, which are often considered to arise from separate pathogenic pathways. We observed in alcohol-dependent patients increased serum activity of neutral sphingomyelinase. A genetic association analysis in 456,693 volunteers found associations of haplotypes of SMPD3 coding for NSM-2 (NSM) with alcohol consumption, but also with affective state, and bone mineralisation. Functional analysis in mice showed that NSM controls alcohol consumption, affective behaviour, and their interaction by regulating hippocampal volume, cortical connectivity, and monoaminergic responses. Furthermore, NSM controlled bone-brain communication by enhancing osteocalcin signalling, which can independently supress alcohol consumption and reduce depressive behaviour. Altogether, we identified a single gene source for multiple pathways originating in the brain and bone, which interlink disorders of a mental-physical co-morbidity trias of alcohol abuse-depression/anxiety-bone disorder. Targeting NSM and osteocalcin signalling may, thus, provide a new systems approach in the treatment of a mental-physical co-morbidity trias.
Given that validity is the baseline of psychological assessments, there is a need to provide evidence-based data for construct validity of such scales to advance the clinicians for evaluating psychiatric morbidity in psychiatric and psychosomatic setting.
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
1. 1. Paris green was used as a larvicide on an inland hilly estate where A. maculatus was the carrier-and where most of the water treated was moving, more or less rapidly. 2. 2. Three different diluents were tried, viz., lime, talcum and soapstone powder. 3. 3. The strength of the mixture was one part of Paris green to ninety-nine parts of diluent by volume. 4. 4. Distribution was carried out by mechanical blowers and sprayers. 5. 5. The application was checked twenty-four hours afterwards. For one month it was checked forty-eight hours afterwards. 6. 6. There was an increase in breeding places-most of which were found in moving water. 7. 7. There was an increase in larvæ, many of them being over two days old. 8. 8. In spite of treatment of epidemics with plasmochin and quinine, the malaria rate was higher than during the previous year. The rise was more or less consistent, pointing to constant infections. 9. 9. The morbidity rate, death rate and infantile mortality were apparently not adversely affected, but in view of the treatments given with plasmochin, they are of no help in deciding the value of Paris green. 10. 10. There was a distinct fall in anti-larval costs, but the total anti-malarial costs were still high on account of the treatments necessary for epidemics of malaria. 11. 11. The advantages and disadvantages of Paris green are discussed.
Although the majority of the snakebite cases in Malaysia are due to non-venomous snakes, venomous bites cause significant morbidity and mortality if treatment measures, especially ant-venom therapy, are delayed.
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.
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.
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
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.
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.