BACKGROUND: The outcomes of the physician-patient discussion intervene in the satisfaction of cardiovascular disease risk patients. Adherence to treatment, provision of continuous care, clinical management of the illness and patients' adjustment are influenced by satisfaction with physician-patient interaction. This study aims to determine the patient satisfaction with doctor-patient interaction and over six months after following prevention counselling, its associations with modifiable cardiovascular risk factors amongst moderately-high risk patients in a primary healthcare clinic in Kelantan, Malaysia.
METHODS: A prospective survey was conducted amongst patients with moderately-high cardiovascular risk. A total of 104 moderately-high risk patients were recruited and underwent structured prevention counselling based on the World Health Organization guideline, and their satisfaction with the doctor-patient interaction was assessed using 'Skala Kepuasan Interaksi Perubatan-11,' the Malay version of the Medical Interview Satisfaction Scale-21. Systolic blood pressure, total cholesterol and high-density lipoprotein cholesterol were measured at baseline and at a follow-up visit at six months. Descriptive analysis, paired t test and linear regression analyses were performed.
RESULTS: A total of 102 patients responded, giving a response rate of 98.1%. At baseline, 76.5% of the respondents were satisfied with the relation with their doctor, with the favourable domain of distress relief (85.3%) and rapport/confidence (91.2%). The unfavourable domain was interaction outcome, with satisfaction in only 67.6% of the respondents. Between the two visits, changes had occurred in total cholesterol (P = 0.022) and in systolic blood pressure (P risks.
DISCUSSION: The 'Skala Kepuasan Interaksi Perubatan-11' which represents a component of the interpersonal doctor-patient relationship can be used to assess improvements of the medical skills and in medical training to enhance the quality of therapeutic communication.
Despite the rapid advancement of left ventricular assist devices (LVADs), adverse events leading to deaths have been frequently reported in patients implanted with LVADs, including bleeding, infection, thromboembolism, neurological dysfunction and hemolysis. Cannulation forms an important component with regards to thrombus formation in assisted patients by varying the intraventricular flow distribution in the left ventricle (LV). To investigate the correlation between LVAD cannula placement and potential for thrombus formation, detailed analysis of the intraventricular flow field was carried out in the present study using a two way fluid structure interaction (FSI), axisymmetric model of a passive LV incorporating an inflow cannula. Three different cannula placements were simulated, with device insertion near the LV apex, penetrating one-fourth and mid-way into the LV long axis. The risk of thrombus formation is assessed by analyzing the intraventricular vorticity distribution and its associated vortex intensity, amount of stagnation flow in the ventricle as well as the level of wall shear stress. Our results show that the one-fourth placement of the cannula into the LV achieves the best performance in reducing the risk of thrombus formation. Compared to cannula placement near the apex, higher vortex intensity is achieved at the one-fourth placement, thus increasing wash out of platelets at the ventricular wall. One-fourth LV penetration produced negligible stagnation flow region near the apical wall region, helping to reduce platelet deposition on the surface of the cannula and the ventricular wall.
The rising epidemic of established modifiable cardiovascular risk factors (CVRF), such as hypertension, dyslipidaemia, diabetes and cigarette smoking, to a large part, are responsible for the clinical events such as acute coronary syndrome (ACS) and cerebrovascular events (strokes, CVE). In our National ACS and percutaneous coronary intervention (PCI) Registries, it has been documented that over 90% of patients have at least one identifiable CVRF.
We report a case of eosinophilic granulomatosis with polyangiitis (EGPA), a rare multisystem disorder characterized by difficult-to-control asthma, hypereosinophilia and polyneuropathy. We also discuss the Five Factor Score (FFS) risk stratification strategy, which is used to quantitate the extent of the disease and guide treatment strategy.
Hepatitis C virus (HCV) genotyping is very important for the clinical management of HCV-infected patients. The aim of this study was to determine the genotypes of HCV-infected patients and to identify their risk factors and comorbidities.
Lung cancer is a major cause of mortality and morbidity in Malaysia and worldwide. This paper reviews all research and publications on lung cancer in Malaysia published between 2000-2015. 89 papers were identified, of which 64 papers were selected and reviewed on the basis of their relevance to the review. The epidemiology, risk factors, cell types, clinical presentation, diagnosis, treatment, outcomes, prevention, and the social impact of lung cancer in the country are reviewed and summarized. The clinical relevance of the studies done in the country are discussed along with recommendations for future research.
This study develops a Road Safety Index (RSI) for commercial bus with the aim of determining whether the
proposed index can be beneficial to the stakeholders for the purpose of mitigating road accident and promoting road
safety. Five risk factors which include drivers, Vehicle, Task, Hazard/Risk and Road, where three critical factors out of
these factors, were identified as high contributing factors (Drivers, Vehicle and Road) were selected for the construction
of RSI. Drivers risk perceptions data were collected using survey instrument with sample size (n= 465) to test the
model and the data fits the model perfectly. The main benefits of this approach and the subsequent development of
RSI are: (1) Enable organisations to justify the investment on road safety by providing a measurement and evaluation
mechanism. (2) The index provides a balanced view of the impact of the three critical (DVR) risk factors that the
management can improve upon.
This study is carried out to establish the prevalence of Work-related Musculoskeletal Disorders (MSD) among
the Malaysian workforce population in order to propose some measures to benefit the people at large. Secondary data
from three studies among drivers, clerical workers using visual display terminals (VDT) and fabrication workers were
used to report the prevalence of MSDs and the associated risk factors. The study identified high prevalence of MSDs in
multiple body regions. The MSD occurrence was also significantly associated with psychosocial factors. There is need
for organisations to consider such factors in work design, which will reduce the high prevalence and high financial
implications associated with MSDs among workers.
Ergonomics can be viewed as an approach to reduce injury and illness rates to improve the overall working
conditions for employees by addressing risk factor exposure that may occur during manual tasks. The objective
of this research was to analyze ergonomics risk factors by associating the perception of employer and employees
towards their workplace condition in quarry and mining industry. A Questionnaire on Ergonomics Risk Assessment
was used to determine the comparison level awareness and perception analysis among quarry and mining industry in
Malaysia. The findings of this research prove that the exposure of ergonomics risk factors towards the workers is in
a moderate level with a mean of 3.59 for the overall respondent review about the ergonomics risk among workers at
their workplace. Besides, the most concern in ergonomics is about the awkward posture at work. Some 8.8% of them
agreed and 6.6% of them totally agreed that they were in awkward posture while doing their work. As a conclusion,
assessment of ergonomics in quarry and mining industry will be a platform to provide a safe and healthy working
A review of the epidemiology of tuberculosis, its contributing risk factors (excluding HIV) and the role of screening latent tuberculosis infection in Malaysia was done. Despite the global and domestic decrease in prevalence rates of tuberculosis in the past decade, there is an alarming increase in the trend of non communicable diseases in the country. High prevalence rates of major risk factors leading to reactivation of tuberculosis were seen within the population, with diabetes mellitus being in the forefront. The rising numbers in the ageing population of Malaysia poses a further threat of re-emergence of tuberculosis in the years to come. Economically, screening of diabetic patients with comorbidities for latent tuberculosis infection (LTBI) using two major techniques, namely tuberculin sensitivity (TST) and Interferon gamma release assay tests (IGRA) could be a viable option. The role of future research in the detection of LTBI in the Malaysian setting might be necessary to gauge the disease reservoir before implementing prophylactic measures for high risk groups involved.
All around the world, there is growing evidence of the association between psoriasis and comorbidities which increase the risk of cardiovascular disease. This study aims to determine the prevalence of various comorbidities among adult psoriasis patients in Malaysia. A cross-sectional study was conducted among patients in the Malaysian Psoriasis Registry from January 2007 to December 2008. A total of 2,267 adult patients with psoriasis from 13 dermatology centers were included. Prevalence of various comorbidities were: hypertension 25.9%, diabetes mellitus 17.7 %, dyslipidaemia 17.8%, overweight 33.2%, obesity 20.7%, ischaemic heart disease 5.8% and cerebrovascular disease 1.4%. These comorbidities were more prevalent in patients with psoriasis of late-onset and longer duration. Active screening of these comorbidities in all adult psoriasis patients is recommended.
The history and epidemiology of human leptospirosis in Malaysia from 1925 to 2012 are described. Previous studies have demonstrated that leptospirosis is an endemic disease in Malaysia occurring in both urban and rural locations. The number of cases has risen dramatically since the Ministry of Health Malaysia highlighted leptospirosis as a notifiable disease in 2010, with reported cases increasing from 248 cases in 2004 to 3604 in 2012. The incidence of infection among the population suggests that occupation, sex, age, ethnic background, water recreational activities, and sporting events are risk factors. A robust surveillance system is now in place to monitor temporal and spatial changes in the incidence and prevalence of infection and to identify risk areas and disease behavior. Despite extensive studies over the past decade, there is a still a need to describe local serovars in host carriers and the human population, with the view to develop an effective vaccine against leptospirosis.
Elder abuse is a pervasive phenomenon around the world with devastating effects on the victims. Although it is not a new phenomenon, interest in examining elder abuse is relatively new. This paper aims to provide an overview of the aetiological theories and measures of elder abuse. The paper briefly reviews theories to explain causes of elder abuse and then discusses the most commonly used measures of elder abuse. Based on the reviewed theories, it can be concluded that elder abuse is a multifactorial problem that may affect elderly people from different backgrounds and involve a wide variety of potential perpetrators, including caregivers, adult children, and partners. The review of existing measurement instruments notes that many different screening and assessment instruments have been developed to identify elders who are at risk for or are victims of abuse. However, there is a real need for more measurements of elder abuse, as the current instruments are limited in scope.