Journal articles on the topic 'Patient compliance Malaysia'
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Tuan Anuar, Tuan Nor Atiqah, Norazliah Samsudin, Nur Syahmina Rasudin, and Norhasmah Mohd Zain. "Knowledge and Compliance Regarding Standard Precautions among Nursing Students at Universiti Sains Malaysia." INTERNATIONAL JOURNAL OF CARE SCHOLARS 4, no. 1 (January 31, 2021): 10–17. http://dx.doi.org/10.31436/ijcs.v4i1.158.
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Background: Standard precautions (SP) are important in protecting both patients and healthcare professionals from occupational exposure as well as ensure patient safety. This study aimed to compare the knowledge and compliance regarding SP among diploma and degree nursing students at Universiti Sains Malaysia (USM). Methods: A cross-sectional study has been conducted among 134 nursing students using self-administered questionnaires. Respondents were recruited using a simple random sampling method. The data were analyzed by SPSS version 24 using descriptive and Spearman’s Rank-Order test. Results: The study showed that diploma and degree nursing students had good knowledge regarding SP (mean of 14.7±2.5 and 15.4 ± 2.4) and a high compliance level of SP (mean of 3.6 ± 0.3 and 3.7 ± 0.2 respectively). Washes hand immediately after contacting any blood, body fluid, secretion, excretion, and dirty substances has the highest degree of compliance among diploma nursing students, while washes hands when comes in different contact with different patients has the highest degree of compliance among bachelor degree nursing. Wear protective eye patch or google when performing operations/procedures that might induce spraying of blood, body fluids, secretions, and excretions was the lowest degree of compliance among both bachelor degree and diploma nursing students. There was no significant correlation between the level of knowledge and compliance with SP (p= 0.23) but there is a significant correlation between the duration of practical training and compliance with SP (p=0.02). Conclusion: Nursing students in USM had good knowledge and high compliance regarding SP. Knowledge did not influence compliance with SP but duration of practical training session did influence compliance with SP.
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Chuah, S. Y. "Factors associated with poor patient compliance with antituberculosis therapy in Northwest Perak, Malaysia." Tubercle 72, no. 4 (December 1991): 261–64. http://dx.doi.org/10.1016/0041-3879(91)90051-s.
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Awang, Mohamad Azlan, Rhendra Hardy Mohamad Zaini, and Wan Mohd Nazaruddin Wan Hassan. "Effectiveness of video tutorial on compliance of medical officers to sequence of intubation protocol in simulated Covid-19 patients." Malaysian Journal of Anaesthesiology 1, no. 2 (December 14, 2022): 78–87. http://dx.doi.org/10.35119/myja.v1i2.21.
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Introduction: The use of full PPE, aerosol box, and video laryngoscope are recommended when performing intubation on a Covid-19 patient. However, this technique may be difficult for medical officers unfamiliar with the intubation protocol sequence, especially for those with less experience in anaesthesia. Video tutorials may play a vital role in improving the technique. This study evaluated the compliance of medical officers in our anaesthesia department to the intubation protocol and the effect on compliance before and after viewing the video tutorial on the protocol. Methods: A total of 70 medical officers (n = 70) in the Department of Anaesthesia, Hospital Universiti Sains Malaysia, Kelantan participated in this study. The participants performed the intubation protocol sequence on a simulated Covid-19 mannequin. Participants then viewed a video tutorial after their initial attempt and repeated the intubation sequence afterward. The outcomes measured include the proportion of participants compliant with the intubation protocol, the association between years of experience and compliance, and the compliance score before and after the video tutorial. Results: There was no significant association between years of anaesthesia and compliance score (p = 0.058). A large proportion of the subjects were compliant (n = 57, 81.4%). There was a significant difference between initial and repeatedcompliance score post-video tutorial (p < 0.05). Conclusion: Years of experience in anaesthesia was not a determining factor for compliance with the intubation protocol sequence on simulated Covid-19 patients. However, the video tutorial played a significant role in improving compliance withthe intubation sequence.
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Katherason, Supaletchimi Gopal, Lin Naing, Kamarudin Jaalam, Nik Abdullah Nik Mohamad, Kavita Bhojwani, Najah Dato' Seri Hj Harussani, and Asma Ismail. "Hand decontamination practices and the appropriate use of gloves in two adult intensive care units in Malaysia." Journal of Infection in Developing Countries 4, no. 02 (December 28, 2009): 118–23. http://dx.doi.org/10.3855/jidc.593.
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Background: Hand decontamination is a critical infection control practice in the prevention of nosocomial infection. This study was conducted to observe the hand hygiene practices of nurses and doctors in two intensive care units (ICUs) in Malaysia. Methodology: Staff members were observed during patient contacts, and their hand washing techniques and hand hygiene practices were monitored. Five contact periods were observed for staff members while they cared for their assigned patients. Hand hygiene practices before and after patient contacts were categorized as clean uncontaminated, clean recontaminated, new gloves, and unchanged contaminated gloves. Compliance to hand-washing steps and time taken for hand washing were analyzed. Appropriate use of gloves based on CDC criteria also was assessed. Results: Compliance to hand hygiene practices was 70% before each patient contact. Staff members did not completely adhere to the hand-washing steps. The average time taken to wash hands was 20 seconds, and the necessary steps (rubbing palm over dorsum; rubbing fingers interlaced, and rotational rubbing of thumbs) were practiced minimally by all staff. Hand washing protocol was generally followed by all staff (100%). Alcohol hand rubs were available but were used moderately (60%); when used, staff members did not wait for the alcohol to dry. Only 4% of staff changed contaminated gloves between patients. Conclusions: Hand hygiene compliance by ICU staff members needs to be improved. Improving adherence to correct hand hygiene techniques will require effective education programs and behavioral modification techniques. Moreover, hand hygiene guidelines must be incorporated into new staff orientation programs and the continuing education curriculum in the two hospitals studied.
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Hong, L. L., J. C. Yong, K. Y. Lee, N. H. Binti Nasir, P. Gravitt, Y. K. Lee, and Y. L. Woo. "Understanding Barriers to Cervical Screening Follow-Up and Treatment Compliance in Malaysia: A Qualitative Study of Provider Perspectives." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 214s. http://dx.doi.org/10.1200/jgo.18.86200.
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Background: Cervical cancer is a leading cause of women mortality in Malaysia. In Malaysia, system of care remain fragmented despite the increased uptake of cervical screening. Thus, it is important to better understand factors that affect loss to follow-up and treatment along the care continuum. The ability of a patient to attend a cervical screening clinic, to return for possible treatment, and to return to clinic for follow-up evaluation (“the patient factor”) is a major component to the success of a screening program. Women diagnosed with early or local (stage 1) cervical cancer have a 92% chance of survival 5 years after diagnosis whereas survival rates decrease to 17% for women with late cancer diagnoses. Due to this, a better understanding of barriers to cervical cancer treatment can inform initiatives to address therapeutic delays, which is vitally important to providing optimal care. Aim: To explore, from the perspectives of healthcare professionals, the perceived barriers of cervical screening follow-up and treatment compliance in Malaysia. Methods: In-depth semistructured interviews with 45 government health clinic staffs comprise of clinicians, nurses, front desk staffs, medical laboratory technicians and IT support engineers were conducted from 5 government health clinics in Petaling District. Qualitative content analysis through an inductive approach was used to identify barriers of cervical cancer care continuum and treatment compliance in public health clinics settings. Results: Participants identified various potential barriers to seeking follow-up care and treatment after receiving a positive Pap test results or invalid test results at 2 levels: the structural level, and the patient level. Long waiting time, lack of transport to healthcare providers, fear of treatment, poor documentation, absence of cervical screening registry, as well as unsystematic referral or treatment procedures are some of the major reasons affecting follow-up and treatment compliance. Conclusion: The results highlight the need of structural and personal interventions that eliminate barriers to follow-up and treatment compliance along the care continuum.
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Jamaluddin, Nurul Adilla Hayat, Petrick Periyasamy, Chee Lan Lau, Sasheela Ponnampalavanar, Pauline Siew Mei Lai, Ramliza Ramli, Toh Leong Tan, et al. "Point Prevalence Survey of Antimicrobial Use in a Malaysian Tertiary Care University Hospital." Antibiotics 10, no. 5 (May 4, 2021): 531. http://dx.doi.org/10.3390/antibiotics10050531.
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Antimicrobial resistance remains a significant public health issue, and to a greater extent, caused by the misuse of antimicrobials. Monitoring and benchmarking antimicrobial use is critical for the antimicrobial stewardship team to enhance prudent use of antimicrobial and curb antimicrobial resistance in healthcare settings. Employing a comprehensive and established tool, this study investigated the trends and compliance of antimicrobial prescribing in a tertiary care teaching hospital in Malaysia to identify potential target areas for quality improvement. A point prevalence survey method following the National Antimicrobial Prescribing Survey (NAPS) was used to collect detailed data on antimicrobial prescribing and assessed a set of quality indicators associated with antimicrobial use. The paper-based survey was conducted across 37 adult wards, which included all adult in-patients on the day of the survey to form the study population. Of 478 patients surveyed, 234 (49%) patients received at least one antimicrobial agent, with 357 antimicrobial prescriptions. The highest prevalence of antimicrobial use was within the ICU (80%). Agents used were mainly amoxicillin/β-lactamase inhibitor (14.8%), piperacillin/β-lactamase inhibitor (10.6%) and third-generation cephalosporin (ceftriaxone, 9.5%). Intravenous administration was ordered in 62.7% of prescriptions. Many antimicrobials were prescribed empirically (65.5%) and commonly prescribed for pneumonia (19.6%). The indications for antimicrobials were documented in the patients’ notes for 80% of the prescriptions; however, the rate of review/stop date recorded must be improved (33.3%). One-half of surgical antimicrobial prophylaxis was administered for more than 24 h. From 280 assessable prescriptions, 141 (50.4%) were compliant with guidelines. Treating specialties, administration route, class of antimicrobial, and the number of prescriptions per patient were contributing factors associated with compliance. On multivariate analysis, administering non-oral routes of antimicrobial administration, and single antimicrobial prescription prescribed per patient was independently associated with non-compliance. NAPS can produce robust baseline information and identifying targets for improvement in antimicrobial prescribing in reference to current AMS initiatives within the tertiary care teaching hospital. The findings underscore the necessity to expand the AMS efforts towards reinforcing compliance, documentation, improving surgical prophylaxis prescribing practices, and updating local antibiotic guidelines.
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Embong, Julaida, L. K. Lim, F. S. Lee, M. Nawawi Adha, S. Rajadurai, N. A. A. Fadzil, N. S. Manap, E. G. M. Chong, and W. K. Yau. "133 Factor’s Contrubuting for Non-Compliance Physiotherapy Sesions among Geriatric Patient at Physiotherapy Fall Intervention Program." Age and Ageing 48, Supplement_4 (December 2019): iv28—iv33. http://dx.doi.org/10.1093/ageing/afz164.133.
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Abstract Introduction Current world is going through an increase in ageing population with one in eight people in the world are aged 60 or over. By 2025, 15 % of Malaysia population will be aged above 60 years old. Physiotherapy playing a major role in facilitates healthy ageing process. However, compliance to physiotherapy session is still low among geriatric population. A defaulter was defined as a patient who presented for less than 6 visits during the whole period. Method A Retrospective study will calling patient after patient did not turn up the physiotherapy appointment and interview was done on appointment with the doctor together. This study was conducted at Geriatric Clinic, Hospital Kuala Lumpur. Physiotherapy session records were tracked to get there number of defaulters in Physiotherapy Geriatric clinic during 2017 & 2018. Result Reasons for defaulting the therapy session was gained via phone call interview and during Geriatrician appointment. Total of 223 samples were tracked and interviewed in this study. The result reveals 73% of the patients defaulted in 2017 and 51% in 2018 respectively. Lack of facilities comprises 22% of factors for non-compliance. Meanwhile other factors such as human resource and functional capabilities contribute 14% and 19% respectively for patient’s non-compliance. Conclusion As conclusion, clinic need to take steps such as call to remind their appointment and provide proper home education to increase patient’s compliance. Together with in poor compliance which was successfully brought down by taking into consideration patient factors. This may be the best compromise until which time where special parking lots, improved transportation services or adequate skilled facilities in the periphery are made available to the patients.
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Gillani, Syed Wasif, Syed Azhar Syed Sulaiman, and Nur Hafzan. "A pilot study on patients’ knowledge, attitude and beliefs on medication compliance among medical out-patient pharmacy, Malaysia." International Journal of Food, Nutrition and Public Health 3, no. 2 (January 13, 2010): 101–17. http://dx.doi.org/10.47556/j.ijfnph.3.2.2010.1.
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Ang, Wei Chern, Noorsyahiruh Abdul Khadir, Nurfatin Amira Sofia Lahazir, and Alia Hayati Baharudin. "Perception of Halal Pharmaceuticals among State Hospital Outpatients in Perlis, Malaysia." International Journal of Human and Health Sciences (IJHHS) 7, no. 70 (January 22, 2023): 16. http://dx.doi.org/10.31344/ijhhs.v7i70.518.
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Objectives: Halal pharmaceuticals have expanded globally, which is one of the elements in Shariah compliance hospitals. With the emergence of COVID-19 vaccines, the ‘Halal’ status has become a debate causing some to reject it. The aim of this study was to explore the perception of halal pharmaceuticals among hospital outpatients. Methods: A qualitative study by in-depth interviews were conducted among adult Muslim outpatients collecting their medications. A Malay language semi-structured interview guide was prepared and underwent content trustworthiness by the State Mufti, a Malaysian pharmacy professor, two pharmacists with a special interest in Halal pharmaceuticals and two Islamic affairs officers in the Ministry of Health Malaysia. Subjects were recruited in the waiting area of the outpatient pharmacy, Hospital Tuanku Fauziah (HTF). Interview sessions were audio-recorded and transcribed verbatim. The transcripts were back-translated in English and analysed using thematic content analysis. Results: Ten outpatients were interviewed in which data saturation was reached. Overall, the patients were proactive in observing the label to ensure they received the correct medications. However, all patients were unfamiliar and not curious about the concepts of ‘halal pharmaceuticals’ and ‘Shariah-compliant hospital’. The patients also trusted that the government would provide only the safest and halal medicines. Most patients did not prioritise halal status while choosing their medicines. However, if options were available, most would choose halal medication regardless of its price and effectiveness. They still would consent to receive non-halal treatments for life-saving conditions. Conclusion: There was a good perception of halal pharmaceuticals among outpatients in HTF. There are many opportunities for patient education on this topic as the public is currently not familiar with the terms and halal concepts in medical settings. International Journal of Human and Health Sciences Supplementary Issue: 2023 Page: S16
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Lim, Mun Kit, Pauline Siew Mei Lai, Sasheela Sri La Sri Ponnampalavanar, Sharifah Faridah Syed Omar, Nur Aishah Taib, Mohamad Yasim Yusof, Claire Marie Italiano, David Chee Ming Kong, and Adeeba Kamarulzaman. "Antibiotics in surgical wards: use or misuse? A newly industrialized country’s perspective." Journal of Infection in Developing Countries 9, no. 11 (November 30, 2015): 1264–71. http://dx.doi.org/10.3855/jidc.6731.
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Introduction: Studies exploring the appropriateness of therapeutic antibiotic use among surgical patients are limited, particularly in developing countries. Therefore, the aim of our study was to determine the appropriateness of antibiotics prescribed in a surgical setting in Malaysia. Methodology: A prospective observational study was conducted in two surgical wards at a tertiary hospital in Malaysia from November 2012-July 2013. Data was collected using a case report form. The appropriateness of antibiotic therapy was based on compliance with either the Malaysian National Antibiotic Guidelines 2008 or International Clinical Practice Guidelines and determined by an expert panel (consisting of two infectious disease consultants and a pharmacist). Results: Over the study period, a total of 593 antibiotic courses were prescribed for 129 patients (4.6±3.4 antibiotics/patient). Only 34 (26.4%) patients received appropriate antibiotic therapy, whilst 95 (73.6%) patients received at least one course of inappropriate antibiotic therapy. The prevalence of inappropriate antibiotic use was 214 (66.3%) and 55 (42.0%) for prophylactic and therapeutic purposes, respectively. The most common causes of inappropriate prophylactic antibiotics were inappropriate timing 20 (36.4%) and inappropriate duration of prophylaxis 19 (34.5%). In cases of inappropriate timing, 9 (45%) were administered too late while 6 (30%) were too early. . In contrast, inappropriate choice of antibiotics (42.1%) and inappropriate indication (40.7%) were the most common reasons encountered for inappropriate therapeutic antibiotics. Conclusion: Our study suggests considerable inappropriate use of both prophylactic and therapeutic antibiotics in the surgical wards; highlighting an urgent need for antibiotic stewardship initiatives in this setting.
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Albert, Wanda Kiyah George, Adi Fahrudin, Steward Lindong, and Husmiati Yusuf. "The Suffering Experiences: Family Caregiver of Home Based Palliative Care in Malaysia." Open Access Macedonian Journal of Medical Sciences 10, E (June 15, 2022): 1623–29. http://dx.doi.org/10.3889/oamjms.2022.8573.
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BACKGROUND: Caring for a family member who has advanced cancer and is nearing the end of their life comes with a slew of concerns and obstacles for the caregiver. A thorough understanding of the hardships and tribulations of caregiving may be a step toward resolving the issues that these patients’ family caregivers confront. AIM: The present study aimed to explore the suffering experienced faced by Malaysian family member who has advanced cancer and is nearing the end of their life. MATERIALS: The present qualitative study was conducted through in-depth semi-structured interviews held with seven family caregivers of cancer patients selected through purposive sampling. Interviews continued until the saturation of data. All interviews were recorded, transcribed, and analyzed through conventional content analysis. RESULTS: The codes extracted from interviews produced five main themes, including empathic suffering, powerless and hopeless suffering, predictive suffering, compliance suffering, and barriers’ wrath, which collectively caused suffering for family caregivers. CONCLUSION: Care provided in an atmosphere of suffering and discontent diminishes the caregiver’s quality of life and quality of patient care. Health planners should therefore consider the challenges and sufferings faced by family caregivers and should seek to obviate them through plans.
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Teong, Lee-Fang, Ban-Hock Khor, Kristo Radion Purba, Abdul Halim Abdul Gafor, Bak-Leong Goh, Boon-Cheak Bee, Rosnawati Yahya, et al. "A Mobile App for Triangulating Strategies in Phosphate Education Targeting Patients with Chronic Kidney Disease in Malaysia: Development, Validation, and Patient Acceptance." Healthcare 10, no. 3 (March 14, 2022): 535. http://dx.doi.org/10.3390/healthcare10030535.
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Hyperphosphatemia afflicts end-stage chronic kidney disease (CKD) patients, contributing to comorbidities and mortality. Management strategies are dialysis, phosphate binder, and limiting dietary phosphate intake, but treatment barriers are poor patient compliance and low health literacy arising from low self-efficacy and lack of educational resources. This study describes developing and validating a phosphate mobile application (PMA). The PMA development based on the seven-stage Precaution Adoption Process Model prioritized titrating dietary phosphate intake with phosphate binder dose supported by educational videography. Experts (n = 13) first evaluated the PMA for knowledge-based accuracy, mobile heuristics, and clinical value. Adult HD patients validated the improved PMA using the seven-point mHealth App Usability Questionnaire (MAUQ). Patient feedback (n = 139) indicated agreement for ease of use (69.2%), interface and satisfaction (69.0%), and usefulness (70.1%), while 72.7% said they would recommend this PMA. The expectation confirmation for 25 PMA features ranged from 92.1% (lifestyle) up to 100.0% (language option); and the utilization rate of each feature varied from 21.6% (goal setting and feature-based log) to 91.4% (information on dietary phosphate and phosphate binder). The Conclusions: MyKidneyDiet-Phosphate Tracker PMA was acceptable to adult Malaysian HD patients as part of clinical phosphate management in low-resource settings.
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Chua, M., V. Silvathorai, M. Muniasamy, H. S. Mohd Hashim, C. Lim, N. I. Binti Junazli, S. L. Choo, and K. Y. Low. "Experience and Impact of a Locally-Based Peer, Volunteer Cancer Support Programme in Hospital Melaka, Melaka Malaysia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 113s. http://dx.doi.org/10.1200/jgo.18.47300.
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Background: Melaka is a small southern state in Peninsular Malaysia. On average, the state has an annual incidence of 200 odd breast cancer patients, largely treated out of its public, subsidized, single tertiary treatment center of Hospital Melaka. Hospital Melaka is an 800-bedded hospital with multiple specialties including surgery and radiology. Though the hospital does not have a dedicated oncology department, cancer treatment is carried out via phone consultations and visiting oncologists as well as a team of on-site nursing staff who are trained to initiate and monitor treatment. Feedback from Hospital Melaka staff highlighted that there was a drop-out rate of about 30% of patients from the treatment journey. Qualitative interviews with different stakeholders including patient revealed that the drop-out may be driven by factors such as: i) fear of surgery, ii) fear of chemotherapy, iii) fear of disfigurement, iv) loss of spouse v) emotional distress and shock; and vi) delay in waiting times for different levels of diagnostics and treatment. Aim: The aim of the initiative was to reduce the rate of patients who defaulted out from the cancer treatment journey via a three-pronged approach: a) improving understanding about cancer and treatment by patients and family members; b) integrating peer-support into the clinical treatment pathway at the hospital and reduction of waiting times; and c) maintaining a continuous interaction with the patient throughout the treatment journey. Methods: The inception and deployment of a locally-based peer, volunteer support program for breast cancer patients and families as part of the formal cancer treatment process in Hospital Melaka. Volunteers were consisted of a trained mix of cancer survivors, current and retired healthcare practitioners and provided information pertaining to treatment and care aspects of breast cancer as well as emotional support and follow-up of patients via phone or in person to ensure compliance to treatment. In this study, we engaged with various stakeholders including hospital management and clinicians. Then, support group's services were formalized into the care pathway for all patients with breast cancer; with both volunteers able to send and receive patient referrals. Results: Statistically significant reductions in patient delays in decision-making to seek treatment as well as a significant decrease of 12.5% in the number of defaulters. Conclusion: A support program built with support from all stakeholders and run by volunteers and embedded within the formal care process acts as a catalyst to enhance both service delivery as well as keeping patients engaged on the cancer care journey.
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Ithnain, Norbaidurah, Albeny Joslyn Panting, Rosnani Kassim, Nadia Amirudin, and Manimaran Krishnan. "Perception of Conventional Medicine and Herbal Medicine Usage Amongst Diabetic Patients: A Qualitative Study in Negeri Sembilan, Malaysia." Global Journal of Health Science 12, no. 10 (August 19, 2020): 122. http://dx.doi.org/10.5539/gjhs.v12n10p122.
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INTRODUCTION: The concomitant intake of herbal medicine and conventional medicine amongst patients is steadily increasing worldwide. However, concerns have been raised regarding potential adverse effects and drug interactions when consuming both medications together. Therefore, this work aimed to comprehending the perception of Type 2 Diabetic Mellitus (T2DM) patients on conventional medicine and the manner of its use with herbal medicine in managing diabetes mellitus.
METHODS: A qualitative study was conducted among 28 diabetic patients in four government clinics under the jurisdiction of the state of Negeri Sembilan, Malaysia. Purposive sampling was employed to recruit informants who consumed herbal medicine alongside their prescribed conventional medicine. This study employed semi-structured interviews, which were all digitally recorded, transcribed, and analysed thematically.
RESULTS: This study found that most of the patients perceived the negative side effects of conventional medicine, which led them to consider incorporating herbal medicine in treating diabetes. Such perception was influenced by the personal experiences of their family members and friends. A majority of the informants utilised herbal medicine as a complementary consumption to conventional medicine as opposed to implementing it as an alternative. However, they would alter the dosage and intake time of conventional medicine for several reasons, such as to complement their herbal medicine intake, being fed-up with conventional medicine, and reduce the risk of its side effects. Lastly, this study revealed that some of the patients noted their intention to discontinue conventional medicine, while some even tried to quit.
CONCLUSIONS: A complete understanding of patient’s perceptions regarding conventional medicine and its usage with herbal medicine will aid healthcare providers to deliver education on the importance of conventional medicine usage compliance. Additionally, people should be aware that its combination with herbal medicine when consumed may present adverse effects and subsequently cause serious health problems.
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Cheng, Chiao-Wen, Cheng-Min Feng, and Chian Sem Chua. "Help-Seeking Experiences of Hepatitis B Patients in Transnational Medical Care: The Solution to Health Inequality Is Social Mobility." Healthcare 7, no. 4 (October 31, 2019): 125. http://dx.doi.org/10.3390/healthcare7040125.
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This paper tracked hepatitis B patients from Medan, Indonesia to Penang, Malaysia under transnational medical care and has an understanding of their medical history and socioeconomic status. The condition of these patients improved as a result of good compliance with medical treatment, including lifestyle adjustment and regular medication. Under the influence of the marketization of healthcare, transnational medical patients in the social structure, based on their economic ability and socioeconomic status, may be expected to experience health inequalities. People with unhealthy medical distribution and weak socioeconomic status are easily prone to diseases due to environmental and social conditions; it is easier for such patients to delay or give up their medical treatment. After continuous tracking and increasing patient exposure to medical knowledge and self-care management opportunities, increasing awareness, screening, care, and treatment, the transmission of hepatitis B can be reduced to enable them to gain upward mobility by their capacities and thus improve their health. Social mobility is deemed the main approach to reduce social inequality. There have been limited medical clinical observations and tracking confirming this theory. This paper, which uses medical observation, confirmed that social mobility is considered as the principal key to reducing inequalities in health.
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Sarker, Sujit Kumar, Nur Azzra Ikram Bt Kamal, Adieza Amierul Bin Rohazaki, Afzal Fiaaz Bin Zainol Rashid, Fauhan Bt Mansor, Nabihah Bt Abdul Halim, Mohamad Syahir Bin Mohamed, et al. "Prevalence of Patients Compliance among Hypertensive Patients and Its Associated Factors in Klinik Kesihatan Botanic Klang, Malaysia." International Journal of Integrative Medical Sciences 3, no. 7 (July 31, 2016): 345–49. http://dx.doi.org/10.16965/ijims.2016.136.
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Zainodin, Elly Liyana, and Nurul Syafiqa Abdul Hadi. "Non-compliance Behavior in Contact Lens Wear and Care among University Students." Environment-Behaviour Proceedings Journal 5, no. 14 (June 30, 2020): 11–18. http://dx.doi.org/10.21834/ebpj.v5i14.2192.
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Non-compliance in contact lens wear poses risks for microbial infection. Understanding the scope and extent of non-compliance behaviour is vital for eye care practitioners in deciding which aspect of lens care is critical when consulting patients. A survey was done to assess the level and scope of non-compliance behaviour among 66 young contact lens wearers. Overall, more than half of the participants (52%) did not comply with lens wear and care regimens. The most non-compliant behaviour was the lens cleaning procedure (59%). Eye care practitioners need to establish creative guidelines to improve compliance among the young lens wearers. Keywords: Contact lens; Compliance; Students; Lens care. eISSN: 2398-4287© 2020. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open-access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v5i14.2192
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Lioufas, Nicole, Nigel D. Toussaint, Eugenia Pedagogos, Grahame Elder, Sunil V. Badve, Elaine Pascoe, Andrea Valks, and Carmel Hawley. "Can we IMPROVE cardiovascular outcomes through phosphate lowering in CKD? Rationale and protocol for the IMpact of Phosphate Reduction On Vascular End-points in Chronic Kidney Disease (IMPROVE-CKD) study." BMJ Open 9, no. 2 (February 2019): e024382. http://dx.doi.org/10.1136/bmjopen-2018-024382.
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IntroductionPatients with chronic kidney disease (CKD) are at heightened cardiovascular risk, which has been associated with abnormalities of bone and mineral metabolism. A deeper understanding of these abnormalities should facilitate improved treatment strategies and patient-level outcomes, but at present there are few large, randomised controlled clinical trials to guide management. Positive associations between serum phosphate and fibroblast growth factor 23 (FGF-23) and cardiovascular morbidity and mortality in both the general and CKD populations have resulted in clinical guidelines suggesting that serum phosphate be targeted towards the normal range, although few randomised and placebo-controlled studies have addressed clinical outcomes using interventions to improve phosphate control. Early preventive measures to reduce the development and progression of vascular calcification, left ventricular hypertrophy and arterial stiffness are crucial in patients with CKD.Methods and analysisWe outline the rationale and protocol for an international, multicentre, randomised parallel-group trial assessing the impact of the non-calcium-based phosphate binder, lanthanum carbonate, compared with placebo on surrogate markers of cardiovascular disease in a predialysis CKD population—the IMpact of Phosphate Reduction On Vascular End-points (IMPROVE)-CKD study. The primary objective of the IMPROVE-CKD study is to determine if the use of lanthanum carbonate reduces the burden of cardiovascular disease in patients with CKD stages 3b and 4 when compared with placebo. The primary end-point of the study is change in arterial compliance measured by pulse wave velocity over a 96-week period. Secondary outcomes include change in aortic calcification and biochemical parameters of serum phosphate, parathyroid hormone and FGF-23 levels.Ethics and disseminationEthical approval for the IMPROVE-CKD trial was obtained by each local Institutional Ethics Committee for all 17 participating sites in Australia, New Zealand and Malaysia prior to study commencement. Results of this clinical trial will be published in peer-reviewed journals and presented at conferences.Trial registration numberACTRN12610000650099.
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Selvadurai, S., L. Mohamed Nor, N. I. Redzuan, L. Mohd Isa, and N. S. Shahril. "FRI0077 THE PREVALENCE OF DEPRESSION AND ANXIETY IN PATIENTS WITH RHEUMATOID AND PSORIATIC ARTHRITIS AND ITS CONTRIBUTORY FACTORS." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 615.2–616. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5127.
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Background:Rheumatoid Arthritis (RA) and Psoriatic arthritis (PsA) are both chronic, progressive inflammatory arthritis that can cause significant disability and morbidity. Depression in RA has been associated with higher levels of disease activity, pain, fatigue, work disability, lower treatment compliance and increased suicidal risk and mortality [1]. PsA patients suffer from psoriasis and joint involvement; hence have greater odds of depression by 2.1 times compared with RA [2].Objectives:To compare the prevalence rates of depression and anxiety and its associated factors between RA and PsA patients in Hospital Putrajaya.Methods:A cross sectional survey using the Hospital Anxiety and Depression Scale (HADS) questionnaire were distributed to 300 patients who attended rheumatology outpatient clinic from February – April 2019. The HADS was categorized into 3 groups based on their scores 0-7 (Normal); 8-10 (Borderline); and 11-21 (Abnormal). Data on patient demographics and components of disease assessment scores were recorded. Disease activity was assessed using DAS 28-CRP for all patients. Additional evaluation using Bath Ankylosing Spondylitis Disease Activity Score (BASDAI) and body surface area (BSA) were done for PsA patients. P value of < 0.05 was taken as significant.Results:In total, 205 RA and 73 PsA patients were eligible for analysis. Majority of the patients were female, Malay and married for both groups. The mean age group for RA and PsA were 56.2 ± 11.9 years and 51.0 ± 14.6 years. The mean duration of disease for RA were 8 ± 10 years; while for PsA were 6 ± 11 years. The prevalence rates of depression and anxiety for RA were 8.3% and 13.7%; and PsA were 9.6% and 17.8% respectively. Borderline scores for depression occurred in 16.1% of RA patients and 12.3% for PsA. Twenty percent of RA patients (n=41) and twenty-four percent of PsA patients (n=18) scored borderline for anxiety. The significant positive correlations with depression and anxiety in RA include high disease activity scores (r = 0.27; r = 0.31), number of tender joints (r = 0.26; r = 0.24) and pain (r = 0.29; r = 0.27). Higher number of swollen joints significantly correlated with depression (r = 0.16) but not with anxiety. RA patients with Ischaemic Heart Disease (IHD) ± heart failure have higher depression scores (p < 0.05). As for PsA group, high BASDAI score (anxiety: r = 0.34, depression: r = 0.26) and psoriasis involving head and neck region (p < 0.05) were significant associated factors. Age was inversely correlated with anxiety in the PsA group.Conclusion:There is higher prevalence of anxiety in both RA and PsA as compared to depression. Higher disease activity scores were associated with depression and anxiety in both RA and PsA with axial involvement.References:[1]Faith Matcham et al. “Are depression and anxiety associated with disease activity in rheumatoid arthritis? A prospective study” BMC Musculoskeletal Disorders (2016) 17:155.[2]Sinnathurai et al. “Comorbids in psoriatic arthritis and rheumatoid arthritis”. July 2018. Internal Medicine Journal.Available fromhttps://doi.org/10.1111/imj.14046[3]RA Rahim et al. “ Self-reported symptoms of depression, anxiety and stress among patients with Rheumatoid Arthritis in a Malaysian rheumatology centre – prevalence and correlates”. Med J Malaysia Vol 73 No 4 August 2018Disclosure of Interests:None declared
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Chan, Yoke Mun, Mohd Shariff Zalilah, and Sing Ziunn Hii. "Determinants of Compliance Behaviours among Patients Undergoing Hemodialysis in Malaysia." PLoS ONE 7, no. 8 (August 3, 2012): e41362. http://dx.doi.org/10.1371/journal.pone.0041362.
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Mustapha, M. H., H. Baharuddin, N. Zainudin, S. S. Ch’ng, H. Mohd Yusoof, I. S. Lau, M. Mohd Zain, and A. Rosman. "AB0932 FACTORS IN ACHIEVING TARGET SERUM URIC ACID LEVELS IN OUTPATIENT GOUT MANAGEMENT IN A MALAYSIAN TERTIARY RHEUMATOLOGY CENTRE." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1766.2–1766. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5823.
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Background:Gout is one of the most common inflammatory arthropathies. A target serum uric acid of less than 300µmol/l is recommended when tophi are present, and less than 360µmol/l for non-tophaceous gout. Urate-lowering therapy (ULT) should be titrated until the target is achieved and long-term maintenance of the target concentration is recommended. Although ULT has been proven to reduce the uric acid level, less than half of treated patients achieved the target serum uric acid (sUA) in real-world clinical practice.Objectives:To assess the mean treat-to-target achievement in outpatient management of gout by the tertiary rheumatology centre and to identify factors influencing the success rate.Methods:Retrospective cross-sectional study of all patients with gout attending out-patient clinics in a rheumatology referral centre from 1stJanuary 2018 until 31stDecember 2018. Electronic medical records were reviewed. The successful target achievement is defined as mean of all available sUA in 2018 which is ≤360 and ≤300µmol/l for non-tophaceous and tophaceous gout respectively. Chronic kidney disease (CKD) is defined as glomerular filtration rate of less than 60ml/min.Results:There were 251 patients analysed with mean age of 56.3±13.8 years and disease duration of 10.5±9.2 years. Majority were males (215, 85.7%) and 133 (53%) patients had tophaceous gout. The rate of success achieving the target SUA level of ≤360 and ≤300µmol/l were 33.9% (40) and 15.8% (21) in non-tophaceous and tophaceous gout respectively. However, in patients who are compliant, the target sUA achieved is 52.4% (33) and 31.7% (19) in non-tophaceous and tophaceous gout respectively. Characteristics of patients who achieved the targeted sUA were patients of more than 50 years old (48, 78.7%), without family history of gout (29, 65.9%), were prescribed colchicine prophylaxis upon initiating ULT (46, 76.7%), with absence of joint erosions (34, 73.9%) and those with normal creatinine clearance (40, 65.5%). There were 120 (48.4%) patients who were compliant to ULT. In 42 compliant patients who achieved target sUA, the mean allopurinol dose is 289.66mg±101.2 and 369.23mg±175 in non-tophaceous and tophaceous gout respectively. Sub-analysis in 31 compliant CKD patients, revealed no difference in allopurinol dose between those who achieved versus non-achieved target sUA (mean 243mg versus 263mg respectively). However, we noted that 11 (61%) CKD patients with tophi did not achieved target sUA at dose less than 300mg allopurinol. Lower achievement of target sUA was significantly associated with presence of tophi (p=0.001), poor compliance (p= 0.000) and presence of more than one comorbidity (p=0.041).Conclusion:There are several challenges in achieving target uric acid level contributed by both patient and clinician factors such as compliance, presence of comorbidity and ULT dose. Our study suggests that higher dosage of allopurinol is required in patients with tophaceous gout, with or without renal impairment. However, the limitation of this study is, the small number of subjects which therefore needsfurtherinvestigation.References:[1]Roddy, E., Packham, J., Obrenovic, K., Rivett, A., & Ledingham, J. M. (2018). Management of gout by UK rheumatologists: a British Society for Rheumatology national audit. Rheumatology, 57(5), 826–830.[2]Katayama A, Yokokawa H, Fukuda H, et al. Achievement of Target Serum Uric Acid Levels and Factors Associated with Therapeutic Failure among Japanese Men Treated for Hyperuricemia/Gout. Intern Med. 2019;58(9):1225–1231.Disclosure of Interests:Mariam Hamid Mustapha: None declared, Hazlyna Baharuddin Speakers bureau: Sanofi, J&J, Norliza Zainudin: None declared, Shereen Suyin Ch’ng Speakers bureau: Novartis, Pfizer, GSK, Habibah Mohd Yusoof: None declared, Ing Soo Lau: None declared, Mollyza Mohd Zain: None declared, Azmillah Rosman: None declared
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Loong, Ly Sia, Pauline Siew Mei Lai, Nurul Adilla Hayat Jamaluddin, Isa Naina-Mohamed, Petrick Periyasamy, Chee Lan Lau, Karin Thursky, Rodney James, Sasheela Ponnampalavanar, and The Malaysian NAPS Working Group. "Comparing the appropriateness of antimicrobial prescribing among medical patients in two tertiary hospitals in Malaysia." Journal of Infection in Developing Countries 16, no. 12 (December 31, 2022): 1877–86. http://dx.doi.org/10.3855/jidc.15925.
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Introduction: Malaysia is an upper-middle-income country with national antimicrobial stewardship programs in place. However, hospitals in this country are faced with a high incidence of multidrug-resistant organisms and high usage of broad-spectrum antibiotics. Therefore, this study aimed to use a standardized audit tool to assess clinical appropriateness, guideline compliance, and prescribing patterns of antimicrobial use among medical patients in two tertiary hospitals in Malaysia to benchmark practice. Methodology: A prospective hospital-wide point prevalence survey was carried out by a multidisciplinary team in April 2019 at the University Malaya Medical Centre (UMMC) and the Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia. Data was collected from the patient’s electronic medical records and recorded using the Hospital National Antimicrobial Prescribing Survey toolkit developed by the National Centre for Antimicrobial Stewardship, Australia. Results: The appropriateness of prescriptions was 60.1% (UMMC) and 67% (HCTM), with no significant difference between the two hospitals. Compliance with guidelines was 60.0% (UMMC) and 61.5% (HCTM). Amoxicillin-clavulanic acid was the most commonly prescribed antimicrobial (UMMC = 16.9%; HCTM = 11.9%). Conclusions: The appropriateness of antimicrobial prescribing in medical wards, compliance with guidelines, and prescribing patterns were similar between the two hospitals in Malaysia. The survey identified several areas of prescribing that would need targeted AMS interventions.
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Nik Zuraina, Nik Mohd Noor, Mohd Zulkifli Salleh, Mohd Habil Kamaruzaman, Nur Suhaila Idris, Alwi Muhd Besari, Wan Mohd Zahiruddin Wan Mohammad, Nabilah Ismail, Ahmad Sukari Halim, and Zakuan Zainy Deris. "Low Seroprevalence of SARS-CoV-2 among Healthcare Workers in Malaysia during the Third COVID-19 Wave: Prospective Study with Literature Survey on Infection Prevention and Control Measures." Healthcare 10, no. 10 (September 20, 2022): 1810. http://dx.doi.org/10.3390/healthcare10101810.
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Healthcare workers (HCWs) are at greater risk for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This serology surveillance study aimed to investigate the prevalence of SARS-CoV-2 antibodies among the HCWs who were asymptomatic during the third wave of COVID-19 in Malaysia. HCWs from the Universiti Sains Malaysia (USM) Health Campus were prospectively recruited between August 2020 and March 2021 on a voluntary basis. Data on socio-demographics, possible risk factors and travel history were recorded. Serological diagnoses from serum samples were examined for total antibodies against SARS-CoV-2 using an immunoassay kit. A literature survey was performed on the compliance with infection and prevention control (IPC) practices for COVID-19 among HCWs. The majority of the total 617 HCWs participating in this study were nurses (64.3%, n = 397), followed by health attendants (20.9%, n = 129), medical doctors (9.6%, n = 59) and others (6.3%, n = 39). Of those, 28.2% (n = 174) claimed to have exposure to COVID-19 cases, including history of close contact and casual contact with infected patients. Most importantly, all serum samples were found to be non-reactive to SARS-CoV-2, although nearly half (40.0%, n = 246) of the HCWs had been involved directly in the management of acute respiratory illness cases. A proportion of 12.7% (n = 78) of the HCWs reported having underlying health problems, such as diabetes mellitus, hypertension and hyperlipidemia. Despite the presence of medical and sociological risks associated with SARS-CoV-2 infections, the current study found zero prevalence of antibodies against SARS-CoV-2 among the HCWs of USM. Based on the literature survey, the vast majority of Malaysian HCWs demonstrated good IPC practices during the pandemic (average percentage ranged between 92.2% and 99.8%). High compliance with IPC measures may have led to the low seroprevalence of SARS-CoV-2 among the HCWs.
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Wong, Yew Meng, Eve Lyn Chong, and Vanessa Yung Ling Yeo. "Non-compliance among diabetic macular oedema patients on antivascular endothelial growth factor therapy in Malaysia." Malaysian Journal of Ophthalmology 3, no. 2 (June 21, 2021): 91–100. http://dx.doi.org/10.35119/myjo.v3i2.174.
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Introduction: Diabetic macular oedema (DMO) is a major cause of visual loss in the diabetic population. There are several treatment options for DMO, including intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections, which have been shown to improve visual outcomes. Good compliance to treatment regimens is associated with greater visual benefit.
Purpose: To estimate dropout rates and the associated reasons among DMO patients on three different anti-VEGF treatments.
Study design: A retrospective review of patients with DMO who were on bevacizumab, ranibizumab and aflibercept therapy from January 2014 to December 2016.
Materials and methods: Patients with DMO on anti-VEGF treatment in a private ophthalmology center were identified via an electronic database. Data on Malaysian residents aged 18 years or older were included. Foreign residents, the deceased, and those whose care had been transferred to another center were excluded from further analysis. Telephone interviews were then conducted with these patients based on a standard questionnaire to identify reasons for non-compliance.
Results: This study included 134 patients. The overall lost to follow-up rate was 56.0% (75/134). After excluding the deceased, those who opted for treatment at an alternative center, and uncontactable patients, 47 (35.1%) were then identified as drop-outs. Financial constraint was the most common reason cited by 38.3% patients (18/47) and was highest in the bevacizumab group (88.9%, 16/18). The second most common reason was lack of perceivable change in vision (25.5%). In addition, 19.1% opted to stop treatment due to logistical difficulties and 12.8% of patients were satisfied with their stable visual acuity. Lastly, 4.3% were unable to continue with treatment due to poor general health.
Conclusion: The dropout rate of 35.1% is higher than in previous publications from other countries. This study clarifies the challenges face by some Malaysian patients in seeking treatment for what is often a chronic disease. These results have implications on designing ways to assist patients’ cooperation with the standard of care.
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Abdul Razak, Athirah, Asma Abu-Samah, Normy Norfiza Abdul Razak, Ummu Jamaludin, Fatanah Mohamad Suhaimi, Azrina Ralib, Mohd Basri Mat Nor, Christopher Pretty, Jennifer Laura Knopp, and James Geoffrey Chase. "Assessment of Glycemic Control Protocol (STAR) Through Compliance Analysis Amongst Malaysian ICU Patients." Medical Devices: Evidence and Research Volume 13 (June 2020): 139–49. http://dx.doi.org/10.2147/mder.s231856.
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Ng, Eileen Suk Ying, Poh Yoong Wong, Ahmad Teguh Hakiki Kamaruddin, Christopher Thiam Seong Lim, and Yoke Mun Chan. "Poor Sleep Quality, Depression and Social Support Are Determinants of Serum Phosphate Level among Hemodialysis Patients in Malaysia." International Journal of Environmental Research and Public Health 17, no. 14 (July 16, 2020): 5144. http://dx.doi.org/10.3390/ijerph17145144.
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Despite optimal control of serum phosphate level being imperative to avoid undesirable health outcomes, hyperphosphataemia is a highly prevalent mineral abnormality among the dialysis population. This study aimed to determine factors associated with hyperphosphatemia among hemodialysis patients in Malaysia. Multiple linear regression analysis was used to ascertain the possible factors that influence serum phosphate levels. A total of 217 hemodialysis patients were recruited. Hyperphosphatemia was prevalent. Only approximately 25% of the patients were aware that optimal control of hyperphosphatemia requires the combined effort of phosphate binder medication therapy, dietary restriction, and dialysis prescription. The presence of diabetes mellitus may affect serum phosphate levels, complicating dietary phosphorus management. Patients who were less depressive portrayed higher serum phosphate levels, implying intentional non-compliance. Better compliance on phosphate binder, longer sleep duration, and higher social support was associated with a lower level of serum phosphate. Despite sleep disturbance being one of the most prevalent and intense symptom burdens identified by hemodialysis patients, relatively few studies have addressed this issue. It is time to formulate sleep therapeutic interventions besides the encouragement of strong social support, hoping which many clinical outcomes including hyperphosphatemia can be better controlled among hemodialysis patients.
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Zainodin, Elly Liyana, Nur Aresya Ahmad Najmee, Farah Najwa Hamzah, and Noor Haziq Saliman. "Ocular Complications in Contact Lens Wear and the Risk Factors: A retrospective analysis." Environment-Behaviour Proceedings Journal 6, no. 17 (August 15, 2021): 111–16. http://dx.doi.org/10.21834/ebpj.v6i17.2881.
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Contact lens-related complications might range from harmless irritation to sight-threatening reactions. The key to prevention other than adhering to good hygiene is preliminary eye examinations and timely aftercare assessments. A retrospective analysis of 33 patient clinical records at the university clinic was performed to determine the ocular complications among soft contact lens wearers and its risk factors. Overall, findings indicate that conjunctival hyperemia was the most prevalent complication. Poor lens fit was associated with limbal injection and CLPC. Sleeping with lenses was the most non-compliant behaviour. Eyecare practitioners need to be alarmed by these risk parameters among the young wearers. Keywords: Contact lens; complications; risk factors; hygiene eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ebpj.v6i17.2881
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Nurmunirah Ramli, Mohammad Naqib Hamdan, Mohd Anuar Ramli, Saiful Izwan Abd Razak, Hussein ‘Azeemi Abdullah Thaidi, Mohd Farhan Md Ariffin, and Norhidayu Muhamad Zain. "A Need of Shariah Compliant Model of 3D Bioprinting." Journal of Islamic Thought and Civilization 12, no. 2 (October 11, 2022): 103–15. http://dx.doi.org/10.32350/jitc.122.08.
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One of the credible inventions is 3D Bioprinting or organ printing which uses layer by layer fabrication manner and is an emerging and developing technology offered by the research industry and can help the humanity in certain areas of life e.g., health, food, etc. The technology has been found beneficial in wide spectrum within the medical industry in fighting the shortage of organ and tissues donations. It is also helpful for the pharmaceuticals for determining effectiveness of new drugs and the food industry players to develop new type of edible meat for humans’ consumption. However, behind all these benefits, there are unresolved issues that need be discussed critically and addressed properly within the ethics, law and orders of Islamic worldview. This study aims to indentify the Sharī‘ah related issues raised consequent upon the invention of 3D bioprinting. The study uses data collection from scholars’ writings, academic journals, and Islamic fatwa related to bioethics. The data are analysed thematically. The results show that there is a loophole in bioethics research on Sharī‘ah compliant guidelines for the Muslims users with regards to bioprinting usage. It is suggested for the experts to do thorough research on Sharī‘ah compliant guidelines of bioprinting to be the benchmark guideline for authorities such as JAKIM in Malaysia and other authorities such as the Ministry of Health in treating the Muslim patients.
Keywords:3D Bioprinting, Ethical and Legal Issues, Organ Printing, Sharī ‘ah Compliance.
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Gendeh, Hardip Singh, Asma binti Abdullah, Bee See Goh, and Noor Dina Hashim. "Intracranial Complications of Chronic Otitis Media: Why Does It Still Occur?" Ear, Nose & Throat Journal 98, no. 7 (April 24, 2019): 416–19. http://dx.doi.org/10.1177/0145561319840166.
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Intracranial complications secondary to chronic otitis media (COM) include otogenic brain abscess and sinus thrombosis. Intravenous antibiotics and imaging have significantly reduced the incidence of intracranial complications secondary to COM. However, the same does not apply to a developing country like Malaysia, which still experiences persisting otogenic complications. This case series describes 3 patients with COM and intracranial complications. All 3 patients had COM with mastoiditis, with 1 of the 3 having a cholesteatoma. Postulated reasons for the continued occurrence include poor access to health care, poor compliance with medication, and the lack of pneumococcal vaccination during childhood. In conclusion, public awareness and a timely specialty referral can reduce the incidence of intracranial complications of COM.
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Ibrahim, Muhammad Amin, Ahmad Izuanuddin Ismail, and Mohammed Fauzi Abdul Rani. "A Brief Review of Severe Asthma." Journal of Clinical and Health Sciences 6, no. 2 (September 1, 2021): 4–12. http://dx.doi.org/10.24191/jchs.v6i2.14942.
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Severe asthma describes an asthma condition that requires a substantial amount of inhaled corticosteroid and bronchodilators to keep it under control including the frequent additional need for oral steroid to avoid exacerbations. The incidence of severe asthma in Malaysia is unknown but data elsewhere shows that it is around 5 to 10 % of asthmatics. This category of asthmatic patients has considerable morbidity, is disproportionate cost-wise to the number of sufferers and requires specialised and focused care. The management of severe asthma should be undertaken at a severe asthma clinic led by a physician with a special interest in its management. The diagnosis needs confirmation, comorbidities identified and triggering factors addressed. Inhaler technique and compliance are major contributing issues and must be addressed at all consultation opportunities. Once the diagnosis of severe asthma is confirmed, the disease needs phenotyping to plan for the most appropriate treatment, termed as a personalised approach to severe asthma care. The advances in biologics have changed the landscape of treatment of this disease but in Malaysia especially, there are many limitations namely the cost. This article briefly explores the current understanding of severe asthma, the assessment including phenotyping and possible treatment options.
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Dongen, Daan-Max van. "Impact of Health Financing on Healthcare Quality and Affordability in Malaysia: A Conceptual Review." Malaysian Journal of Medical and Biological Research 9, no. 1 (June 21, 2022): 33–40. http://dx.doi.org/10.18034/mjmbr.v9i1.638.
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In comparison to the majority of essential health indices, the health care system in Malaysia has performed exceptionally well. Despite this, it is still behind the techniques used in many other Asian countries, despite its great potential. The primary reason for this is that patients in Malaysia are subjected to a significant amount of financial risk while seeking medical treatment. The implications of health care finance in Malaysia are investigated in this study, with a particular focus on access and equality issues. This exemplifies the urgent requirement for novel ways to the financing of medical care that are compliant with the norms that have been established. According to the findings of this study, it is recommended that efforts should be increased by employing policy changes to include money pooling and risk sharing, subsidization for the poor and the vulnerable, and mandatory enrollment. In addition, it is recommended that the efforts be increased by employing policy changes to include money pooling and risk sharing. Finally, the implication for public policy indicates that the government ought to commit to the tremendously feasible improvement of the nation's healthcare system through spending.
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Abd Hamid, Norhaliza, Nur Amirah Hamdan, Nizuwan Azman, and Mohammad Farris Iman Leong Bin Abdullah. "VALIDATION OF THE MALAY VERSION OF THE CANCER THERAPY SATISFACTION QUESTIONNAIRE AMONG MALAYSIAN CANCER PATIENTS." Malaysian Journal of Public Health Medicine 21, no. 1 (April 24, 2021): 274–85. http://dx.doi.org/10.37268/mjphm/vol.21/no.1/art.845.
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Satisfaction with treatment among cancer patients is vital for planning of healthcare strategies and to ensure compliance to cancer therapy. Hence, this study translated the original English version of the Cancer Therapy Satisfaction Questionnaire (CTSQ) into Malay and investigated the reliability and validity of the Malay version for use to assess satisfaction with treatment among Malaysian cancer patients. Initially, concurrent translation and back translation of the English version of the CTSQ was performed. Then, the Malay version of the CTSQ (CTSQ-M) was administered to 200 cancer patients with different sites and stages of cancer for assessment of its reliability and validity. The CTSQ-M and its domains exhibited acceptable internal consistency (Cronbach’s α ranged from 0.724 to 0.882). Convergent and discriminant validity were achieved by the CTSQ-M. Construct validity was achieved by the CTSQ-M as exploratory factor analysis extracted 3 factors, while confirmatory factor analysis confirmed that the CTSQ-M consisted of 16 items in 3 domains. We concluded that the CTSQ-M had acceptable psychometric properties.
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Arulappen, Ann L., Monica Danial, Ling Wei Ng, and Jui Chang Teoh. "The Impact of Antibiotics Administration on Mortality for Time in Sepsis and Septic Shock Patients including Possible Reasons for Delayed Administration in Malaysia." Antibiotics 11, no. 9 (September 5, 2022): 1202. http://dx.doi.org/10.3390/antibiotics11091202.
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The 2017 Surviving Sepsis Campaign guidelines endorse a focus on the rapidity of treatment once sepsis has been identified, with a strong recommendation for the administration of antimicrobial drugs within one hour; however, the quality of the supporting evidence is evaluated as moderate. This study was conducted for six months prospectively at a single center in an intensive care unit (ICU) from March 2020 to August 2020. All the patients, regardless of their age and gender, admitted into ICU who had their first episode of sepsis or septic shock concomitantly started on a broad-spectrum antibiotic given intravenously. For patients who had multiple episodes of sepsis throughout the study period, data from the very first episode of the sepsis were included in this study. Of all the 78 patients, only 38 (48.7%) received the antibiotics prescribed within an hour. The compliance rate as per the Surviving Sepsis Campaign was only 51.3%, which accounted for 40 patients. The overall survival rate was 60.3%. This study revealed that delayed antibiotics administration (more than an hour) significantly affects mortality.
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Azmi, Nazmi Liana, Nurul Aida Md Rosly, Hock Chun Tang, Anis Fariha Che Darof, and Nor Dini Zuki. "Assessment of medication adherence and quality of life among patients with type 2 diabetes mellitus in a tertiary hospital in Kelantan, Malaysia." Journal of Pharmacy 1, no. 2 (July 31, 2021): 79–86. http://dx.doi.org/10.31436/jop.v1i2.66.
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Introduction: Previous studies have reported the relationship between medication adherence and quality of life are interrelated. However, many of the results were found to be conflicting. This study aimed to assess the level and association of medication adherence and quality of life among type 2 diabetes mellitus patients in Raja Perempuan Zainab II Hospital, Kelantan, Malaysia. Materials and methods: A cross-sectional survey was conducted among adult type 2 diabetes mellitus patients on treatment for over 1 year using convenience sampling at outpatient. Medication Compliance Questionnaire (MCQ) and revised Diabetes Quality of Life Questionnaire (DQOL) instrument were self-administered to eligible subjects. Data were analysed using GNU PSPP version 0.8.5 and reported for descriptive statistics as well as correlation of both parameters. Results: A total of 200 patients were recruited and they were mostly at the age of 40 to 60 years old. The mean (SD) score for MCQ was 26.0 (1.6) with the majority of them were non-adherent (55.0%, n=110). The mean (SD) score for overall revised DQOL instrument was 25.5 (8.9) while each domain of “satisfaction”, “impact” and “worry” had mean (SD) scores of 12.0 (5.0), 7.7 (3.4) and 5.9 (2.7), respectively. The scores obtained were only approximately half of the possible range of scores for QoL. There was no significant correlation between total score of medication adherence and quality of life when tested using Pearson’s correlation (r=-0.083, p=0.240). Independent t-test also demonstrated no significant relationship between medication adherence status and quality of life (p=0.883). Conclusion: Type 2 diabetes mellitus patients in our setting had unsatisfactory adherence but exhibited acceptable quality of life. We observed that both variables were not associated with one another. Further research is warranted to identify potential factors affecting non-adherence to medication.
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Hussien, Hiba M., Zena Hekmat Altaee, Mohammed Nahidh, and Sajid Chaffat Auliawi Al-Mayahi. "The Use and Preference of Functional Appliances among a Sample of Iraqi Orthodontists: A Web-Based Survey." International Journal of Dentistry 2022 (October 3, 2022): 1–9. http://dx.doi.org/10.1155/2022/8919830.
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Objectives. This study evaluated the use and preference of different types of functional appliances among a sample of Iraqi orthodontists. Materials and Methods. About 200 orthodontists were invited to fill out an online Google form questionnaire with multiple-choice questions. The questions were modified from previous England and Malaysian studies. The data were tabulated as frequency tables. Results. The response rate was 61%. About 91.80% of the participants used functional appliances, with the removable type being the most used. The twin block was thought to be the best compliance one but not the most used functional appliance. About 62% depended on the clinical observations in determining the growth spurt and asked patients to wear the appliance full-time except at meal time. The majority preferred a period of retention of about 4–6 months and frequent visits for adjustments. Conclusions. Removable functional appliances are the most frequently used among the studied sample.
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Panting, Albeny Joslyn, Tengku Puteri Nadiah Tengku Baharudin Shah, Nurul Nadhirah Nasir, Nur Izzati Mohammed Nadzri, Nadia Amirudin, Norbaidurah Ithnain, Saiful Adli Suhaimi, Rosnani Kassim, and Manimaran Krishnan. "Information, Motivation and Behavioural Factors in Influencing Diabetes Self-Care: A Conceptual Paper." Malaysian Journal of Social Sciences and Humanities (MJSSH) 5, no. 8 (August 2, 2020): 39–47. http://dx.doi.org/10.47405/mjssh.v5i8.460.
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Globally, diabetes is a major public health concern and has impacted an estimated 425 million adults. The increasing trend of diabetes incidence has impacted the Malaysian population and healthcare system. Evidence from studies suggested that diabetes can be treated and controlled through behavioural intervention. These include combining lifestyle with pharmacotherapy. Scholars in health behaviour highlighted the importance of assessing and monitoring the behavioural intervention among diabetic patients in terms of psychosocial aspects, such as information, motivation and behavioural factors, in relations with diabetes self-care. This article provides an overview of the empirical evidence regarding the importance of identifying information, motivation and behavioural factors, in relations with diabetes self-care. Information is among the prominent factors in establishing good diabetes management. Motivation can be conceptually defined as factors that predispose one to action and cues to behaviour change. Behavioural factors identified in this review includes compliance towards diabetes self-care. The outcome of this review could provide a better understanding of information, motivation and behavioural factors, and its relations with diabetes self-care.
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Siddique, Abu Bakkar, Mary Krebs, Sarai Alvarez, Iris Greenspan, Amit Patel, Julianna Kinsolving, and Naoru Koizumi. "Mobile Apps for the Care Management of Chronic Kidney and End-Stage Renal Diseases: Systematic Search in App Stores and Evaluation." JMIR mHealth and uHealth 7, no. 9 (September 4, 2019): e12604. http://dx.doi.org/10.2196/12604.
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Background Numerous free and low-cost mobile apps for the care management of kidney disease have become available in recent years. Although these appear to be promising tools, they have not been evaluated comparatively based on standard mobile app metrics, and thus, limited evidence is available regarding their efficacy. This study systematically cataloged and assessed mobile apps designed to assist medication compliance and nutrition tracking that are useful to the chronic kidney disease (CKD) and the end-stage renal disease (ESRD) patients who are on dialysis. Objective The objective of this study was to comprehensively evaluate mobile apps used for medication compliance and nutrition tracking for possible use by CKD and ESRD patients. Methods A systematic review framework was applied to the search, screening, and assessment of apps identified and downloaded from the iOS and Android app stores. We selected apps using 13 relevant search terms, narrowed down based on a set of inclusion and exclusion criteria, and then used the Mobile App Rating Scale (MARS), a widely adopted app evaluation tool to assess the effectiveness of apps. The internal consistency and interrater reliability were tested using Cronbach alpha and interclass correlation coefficients (ICCs), respectively. Results The MARS total score had excellent internal consistency (Cronbach alpha=.90) and a moderate level of interrater reliability (2-way mixed ICC 0.65). Overall, 11 out of the 12 reviewed apps met the minimum acceptable score of 3.0 in MARS rating. The 3 apps with the highest combined scores were My Kidneys, My Health Handbook (MARS=4.68); My Food Coach (MARS=4.48); and National Kidney Foundation Malaysia (MARS=4.20). The study identified 2 general weaknesses in the existing apps: the apps fell short of accommodating advanced interactive features such as providing motivational feedback and promoting family member and caregiver participations in the app utilization. Conclusions The MARS rating system performed well in the app evaluation. The 3 highest ranked apps scored consistently high across the 5 dimensions specified in MARS. These apps were developed in collaboration with reputable organizations and field experts, demonstrating the importance of expert guidance in developing medical apps.
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Ng, C. R., and X. Y. Ng. "AB1425 MENTAL DISTRESS AND ITS CONTRIBUTING FACTORS AMONG ADOLESCENTS IN A RHEUMATOLOGY CENTER IN MALAYSIA." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1818.1–1818. http://dx.doi.org/10.1136/annrheumdis-2022-eular.334.
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BackgroundAccording to World Health Organization 2021, approximately 1 in 7 from the age group of 10-19 years old encountered mental health conditions [1]. Multiple factors can affect their mental health including their underlying medical conditions and depression may influence both reporting symptoms and response to treatment. This study is to investigate the prevalence of depression among adolescents diagnosed with rheumatic diseases by using CES-D questionnaire and to determine its contributing factors.ObjectivesTo screen for depression by using center for epidemiologic studies depression (CES-D) among adolescents diagnosed with rheumatic diseases and to determine its contributing factors.MethodsThis was a survey interview. All rheumatology patients from the age group of 12-21 who followed up in rheumatology clinic Hospital Sultan Ismail from March 2020 to December 2021 were identified and interviewed. Demographic data, clinical data and disease duration were identified and the results were analysed by using IBM SPSS Statistics version 20.ResultsA total of 71 patients were identified. 93% of them were female (66/71) and majority of them were Malay (60.6%). This was followed by Chinese (23.9%), Indian (7%) and others (8.5%). The mean age group was 16 (range from 12 to 21).85.9% of them were diagnosed to have systemic lupus erythematosus. 5.6% of them were having juvenile idiopathic arthritis followed by 2.8 % for each juvenile dermatomyositis and psoriatic arthritis. The rest of them were having mixed connective tissues disease and rheumatoid arthritis with the percentage of 1.4% for both diseases.57 .7% of the respondents were having inactive disease during the interview session.From our survey, it showed that 53.5 % of the respondents were considered depressed with the score of 16 points and above according to the cut off point determined by CES-D questionnaire.The statistics showed association in between disease activity with the score of depression by using Chi Square (p<0.015). However, there was no association between the races and the score of depression (p = 0.1, using Chi Square).There was also no association between duration of disease with the score of depression. (p= 0.485, by using independent t-test).ConclusionOur study showed the prevalence of depression amongst adolescents diagnosed with rheumatic diseases are more than 50% and there was an association between depression score and disease activity. Hence, it is recommended to routinely screen for depression among adolescent as it helps to improve their response and compliant to treatment. Treat to target approach must always be implemented by treating physician to keep disease in remission and indirectly helps to reduce emotional distress among patients.References[1]Institute of health Metrics and Evaluation. Global Health Data Exchange (GHDx)Disclosure of InterestsNone declared
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Singh, Ranjit K. Pritam, Zainab Abdullah, and Salimah Saleh. "A Community-Based Clinical Breast Examination Program: Is it Feasible?" Journal of Global Oncology 4, Supplement 3 (October 2018): 36s. http://dx.doi.org/10.1200/jgo.18.10420.
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Purpose Breast cancer presents in advanced stages in low- and middle-income countries where screening mammography is not available. In Malaysia, almost 60% of women, particularly in those the low socioeconomic group, present with stage III and IV breast cancer. We evaluated the feasibility of a community-based early detection program using clinical breast examination (CBE) carried out by the Breast Cancer Welfare Association, a nongovernmental organization. Methods Using a mobile clinic that was equipped to carry out CBE, a team of six health professionals trained in CBE techniques reached out to urban poor communities on the outskirts of the city and the rural population at the invitation of community leaders. At these events, breast self-awareness was taught to the community, with particular regard to the signs and symptoms of breast cancer and to breast self-examination. CBE was carried out in those women who agreed to be examined. Women who were found to have breast lumps were referred to the nearest public hospital and were observed for compliance. Women with anxiety were counseled. Results In 2016 to 2017, CBE was performed for 7,503 women, and 295 (3.9%) were found to have a palpable breast lump. These women were referred to the nearest hospital for additional assessment. Of these women, 156 (52.9%) consulted the doctor and sought additional examination. A total of 153 patients had no malignant findings, whereas three were found to have breast cancer. The mean age for women found to have a palpable breast lump was younger than 40 years—35 years in 2016 and 33 years in 2017—whereas the median age among the 295 women was 33 years in 2016 and 31 years in 2017 (range, 17 to 67 years). Conclusion A community outreach program using CBE as a method of early detection is feasible in Malaysia. Additional study is required to determine why 47% of those who were found to have a breast lump did not seek additional assessment. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
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Robiatul Adawiah, Laila, and Yeni Rachmawati. "Parenting Program to Protect Children's Privacy: The Phenomenon of Sharenting Children on social media." JPUD - Jurnal Pendidikan Usia Dini 15, no. 1 (April 30, 2021): 162–80. http://dx.doi.org/10.21009/jpud.151.09.
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Sharenting is a habit of using social media to share content that disseminates pictures, videos, information, and parenting styles for their children. The purpose of this article is to describe the sharenting phenomenon that occurs among young parents, and the importance of parenting programs, rather than protecting children's privacy. Writing articles use a qualitative approach as a literature review method that utilizes various scientific articles describing the sharenting phenomenon in various countries. The findings show that sharenting behaviour can create the spread of children's identity openly on social media and tends not to protect children's privacy and even seems to exploit children. Apart from that, sharenting can also create pressure on the children themselves and can even have an impact on online crime. This article is expected to provide benefits to parents regarding the importance of maintaining attitudes and behaviour when sharing and maintaining children's privacy and rights on social media.
Keywords: Sharenting on social media, Children's Privacy, Parenting Program
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Zulkipli, Zafirah Amalina binti, Muhammad Amir Hafiz bin Mohd Salleh, and Musaab Nassereldeen Ahmed. "Pulmonary Tuberculosis: Treatment Outcomes and Factors Associated with Poor Treatment Outcome in Pahang, Malaysia." IIUM Medical Journal Malaysia 17, no. 1 (December 14, 2018). http://dx.doi.org/10.31436/imjm.v17i1.899.
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Introduction: Tuberculosis (TB) remains a formidable public health concern in Malaysia. Malaysia’s national treatment success rate is still below the ideal 90% positive outcome recommended by the End TB Strategy (2015-2035). In this study, we evaluated the treatment outcomes and associated predictors of smear or culture positive pulmonary tuberculosis (PTB) patients. Materials and Methods: This is a retrospective cohort study conducted in chest clinic of Hospital Tengku Ampuan Afzan (HTAA), Pahang from January 2012 to December 2016. PTB cases in HTAA were crosschecked with TB registry and patients who fulfilled the inclusion criteria were selected. Data was collected using a standardized clinical report form and analyzed using multiple logistic regression. Results: There were a total of 342 patients recruited. Majority were Malaysian (94.2%), male (67.8%) and Malay (80.0%). The treatment success rate was 55.26%, with a cure rate of 42.98%. The high portion of defaulters (21.05%) in our study population was amongst the most striking findings. Multiple logistic regression analysis revealed that the factors associated with unfavourable treatment outcome were time in treatment, case after treatment interruption or failure and poor compliance. Univariate analysis revealed that male, hepatitis, smoking and intravenous drug user were found to be significant factors associated with poorer treatment outcomes. Conclusion: Achieving a higher patient retention rate is a significant factor in increasing effectiveness of treatment services. Thus, our study recommends stricter Directly Observed Treatment, Short Course (DOTS) and an enhanced understanding of the real barriers to patients’ treatment regimen adherence in order to overcome them.
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Zulkipli, Zafirah Amalina binti, Muhammad Amir Hafiz bin Mohd Salleh, and Musaab Nassereldeen Ahmed. "Pulmonary Tuberculosis: Treatment Outcomes and Factors Associated with Poor Treatment Outcome in Pahang, Malaysia." IIUM Medical Journal Malaysia 17, no. 1 (December 14, 2018). http://dx.doi.org/10.31436/imjm.v17i1.899.
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Introduction: Tuberculosis (TB) remains a formidable public health concern in Malaysia. Malaysia’s national treatment success rate is still below the ideal 90% positive outcome recommended by the End TB Strategy (2015-2035). In this study, we evaluated the treatment outcomes and associated predictors of smear or culture positive pulmonary tuberculosis (PTB) patients. Materials and Methods: This is a retrospective cohort study conducted in chest clinic of Hospital Tengku Ampuan Afzan (HTAA), Pahang from January 2012 to December 2016. PTB cases in HTAA were crosschecked with TB registry and patients who fulfilled the inclusion criteria were selected. Data was collected using a standardized clinical report form and analyzed using multiple logistic regression. Results: There were a total of 342 patients recruited. Majority were Malaysian (94.2%), male (67.8%) and Malay (80.0%). The treatment success rate was 55.26%, with a cure rate of 42.98%. The high portion of defaulters (21.05%) in our study population was amongst the most striking findings. Multiple logistic regression analysis revealed that the factors associated with unfavourable treatment outcome were time in treatment, case after treatment interruption or failure and poor compliance. Univariate analysis revealed that male, hepatitis, smoking and intravenous drug user were found to be significant factors associated with poorer treatment outcomes. Conclusion: Achieving a higher patient retention rate is a significant factor in increasing effectiveness of treatment services. Thus, our study recommends stricter Directly Observed Treatment, Short Course (DOTS) and an enhanced understanding of the real barriers to patients’ treatment regimen adherence in order to overcome them.
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Arumugam, Thilagavathy A/P, Aini Ahmad, Puziah Yusof, and Annamma Kunjukunju. "The Effect of Education Program on Registered Nurse Perceptions, Satisfaction and Compliance towards Bedside Handover in a Private Hospital, Malaysia." Nursing & Primary Care 5, no. 6 (December 30, 2021). http://dx.doi.org/10.33425/2639-9474.1197.
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A nursing handover involves one nurse handing over the responsibility of care for a patient to another nurse. Failure of ineffective nursing handover is associated with medication errors, delayed diagnostic testing, adverse reactions, and sentinel events. Critical information related to patient care must be efficiently communicated among registered nurses during bedside handover. This study examined registered nurses' perception, satisfaction, and compliance with bedside handovers in a private hospital in Malaysia. A quasi-experimental study using one group pre and post was conducted. A purposive sampling of 154 registered nurses who had experienced practising bedside report handover participated in the study. Compliance of registered nurses with clinical bedside handover practices was assessed using the bedside handover audit tool. The researchers used the handover evaluation scale to assess the perception of nurses regarding bedside handover. A researcher self-developed questionnaire with seven items on a 5-point Likert scale was used to assess satisfaction among registered nurses. Data was collected from 1st July 2020 to 30th December 2020. The researcher organised a bedside handover training program for the participants, and data was collected pre and post-training. The result shows the perception mean score of the pre-intervention phase as M= 5.68 (SD =.58) and post-intervention phase as M = 5.71 (SD =.38). Satisfaction level before the intervention was M = 4.13 (SD =.47) and after M = 4.31(SD =.41). This study confirmed that compliance with bedside handover (M = 66.69, SD = 5.95) was greater than in the post-intervention phase (M = 99.06, SD = 1.96). Data demonstrated an increase in perception, satisfaction, and compliance after the bedside handover education program. In conclusion, the handover practice of bedside reports and education training promotes positive working conditions, employee satisfaction, and a safe work environment, resulting in significantly increased efficiency, patient outcomes, and preservation of a safe workplace.
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Abdullah, Baharudin, Kornkiat Snidvongs, Marysia Recto, Niken Lestari Poerbonegoro, and De Yun Wang. "Primary care management of allergic rhinitis: A cross-sectional study in four ASEAN countries." Multidisciplinary Respiratory Medicine 15 (December 11, 2020). http://dx.doi.org/10.4081/mrm.2020.726.
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Background: In primary care, general practitioners (GPs) and pharmacists are tasked with the frontline responsibility of identifying and managing allergic rhinitis (AR) patients. There are currently no consolidated data on current treatment practices, patient compliance, and usage of guidelines within Southeast Asian Nations (ASEAN).Objective: To assess the attitudes and practices on AR of GPs and pharmacists in 4 ASEAN countries (Philippines, Indonesia, Thailand, and Malaysia).Methods: A cross-sectional survey of 329 GPs and 548 pharmacists was conducted from May to November 2019. Participants answered a questionnaire focused on their i) current practice in the management of AR, ii) views on patient compliance, iii) understanding and usage of guidelines.Results: Clinical history was the most preferred method to diagnose AR by 95.4% of GPs and 58.8% of pharmacists. Second-generation antihistamines were the most widely available treatment option in GP clinics and pharmacies (94.8% and 97.2%) and correspondingly the most preferred treatment for both mild (90.3%, 76.8%) to moderate-severe rhinitis (90.3%, 78.6%) by GPs and pharmacists, respectively. Loratadine was ranked as the most preferred 2nd generation antihistamines (GP vs pharmacists: 55.3% vs 58.9%). More than 90% of GPs and pharmacists ranked length and efficacy of treatment as important factors that increase patient compliance. Awareness of the ARIA guidelines was high among GPs (80%) and lower among pharmacists (48.4%). However, only 63.3% of GPs and 48.2% of pharmacists knew how to identify AR patients.Conclusion: The survey in the 4 ASEAN countries has identified a need to strengthen the awareness and use of ARIA guidelines among primary care practitioners. Adherence to ARIA guidelines, choosing the appropriate treatment option and prioritizing factors that increase patient compliance may contribute to better management outcomes of AR at the primary care practice.
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Koh, Wenjun, Murali Chakravarthy, Edgard Simon, Raveenthiran Rasiah, Somrat Charuluxananan, Tae-Yop Kim, Sophia T. H. Chew, Anselm Bräuer, and Lian Kah Ti. "Perioperative temperature management: a survey of 6 Asia–Pacific countries." BMC Anesthesiology 21, no. 1 (August 16, 2021). http://dx.doi.org/10.1186/s12871-021-01414-6.
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Abstract Background Anesthesia leads to impairments in central and peripheral thermoregulatory responses. Inadvertent perioperative hypothermia is hence a common perioperative complication, and is associated with coagulopathy, increased surgical site infection, delayed drug metabolism, prolonged recovery, and shivering. However, surveys across the world have shown poor compliance to perioperative temperature management guidelines. Therefore, we evaluated the prevalent practices and attitudes to perioperative temperature management in the Asia–Pacific region, and determined the individual and institutional factors that lead to noncompliance. Methods A 40-question anonymous online questionnaire was distributed to anesthesiologists and anesthesia trainees in six countries in the Asia–Pacific (Singapore, Malaysia, Philippines, Thailand, India and South Korea). Participants were polled about their current practices in patient warming and temperature measurement across the preoperative, intraoperative and postoperative periods. Questions were also asked regarding various individual and environmental barriers to compliance. Results In total, 1154 valid survey responses were obtained and analyzed. 279 (24.2%) of respondents prewarm, 508 (44.0%) perform intraoperative active warming, and 486 (42.1%) perform postoperative active warming in the majority of patients. Additionally, 531 (46.0%) measure temperature preoperatively, 767 (67.5%) measure temperature intraoperatively during general anesthesia, and 953 (82.6%) measure temperature postoperatively in the majority of patients. The availability of active warming devices in the operating room (p < 0.001, OR 10.040), absence of financial restriction (p < 0.001, OR 2.817), presence of hospital training courses (p = 0.011, OR 1.428), and presence of a hospital SOP (p < 0.001, OR 1.926) were significantly associated with compliance to intraoperative active warming. Conclusions Compliance to international perioperative temperature management guidelines in Asia–Pacific remains poor, especially in small hospitals. Barriers to compliance were limited temperature management equipment, lack of locally-relevant standard operating procedures and training. This may inform international guideline committees on the needs of developing countries, or spur local anesthesiology societies to publish their own national guidelines.
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Chong, Diane Woei-Quan, Vivek Jason Jayaraj, Chiu-Wan Ng, I.-Ching Sam, Mas Ayu Said, Rafdzah Ahmad Zaki, Noran Naqiah Hairi, et al. "Propagation of a hospital-associated cluster of COVID-19 in Malaysia." BMC Infectious Diseases 21, no. 1 (December 2021). http://dx.doi.org/10.1186/s12879-021-06894-y.
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Abstract Background Hospitals are vulnerable to COVID-19 outbreaks. Intrahospital transmission of the disease is a threat to the healthcare systems as it increases morbidity and mortality among patients. It is imperative to deepen our understanding of transmission events in hospital-associated cases of COVID-19 for timely implementation of infection prevention and control measures in the hospital in avoiding future outbreaks. We examined the use of epidemiological case investigation combined with whole genome sequencing of cases to investigate and manage a hospital-associated cluster of COVID-19 cases. Methods An epidemiological investigation was conducted in a University Hospital in Malaysia from 23 March to 22 April 2020. Contact tracing, risk assessment, testing, symptom surveillance, and outbreak management were conducted following the diagnosis of a healthcare worker with SARS-CoV-2 by real-time PCR. These findings were complemented by whole genome sequencing analysis of a subset of positive cases. Results The index case was symptomatic but did not fulfill the initial epidemiological criteria for routine screening. Contact tracing suggested epidemiological linkages of 38 cases with COVID-19. Phylogenetic analysis excluded four of these cases. This cluster included 34 cases comprising ten healthcare worker-cases, nine patient-cases, and 15 community-cases. The epidemic curve demonstrated initial intrahospital transmission that propagated into the community. The estimated median incubation period was 4.7 days (95% CI: 3.5–6.4), and the serial interval was 5.3 days (95% CI: 4.3–6.5). Conclusion The study demonstrated the contribution of integrating epidemiological investigation and whole genome sequencing in understanding disease transmission in the hospital setting. Contact tracing, risk assessment, testing, and symptom surveillance remain imperative in resource-limited settings to identify and isolate cases, thereby controlling COVID-19 outbreaks. The use of whole genome sequencing complements field investigation findings in clarifying transmission networks. The safety of a hospital population during this COVID-19 pandemic may be secured with a multidisciplinary approach, good infection control measures, effective preparedness and response plan, and individual-level compliance among the hospital population.
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Vicknasingam, Balasingam, Nur Afiqah Mohd Salleh, Weng-Tink Chooi, Darshan Singh, Norzarina Mohd Zaharim, Adeeba Kamarulzaman, and Marek C. Chawarski. "COVID-19 Impact on Healthcare and Supportive Services for People Who Use Drugs (PWUDs) in Malaysia." Frontiers in Psychiatry 12 (March 29, 2021). http://dx.doi.org/10.3389/fpsyt.2021.630730.
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Background: Restrictive orders and temporary programmatic or ad hoc changes within healthcare and other supportive systems that were implemented in response to the COVID-19 epidemic in Malaysia may have created hindrances to accessing healthcare and/or receiving other supportive services for people who use drugs (PWUDs).Design: A primarily qualitative study has been conducted to evaluate how service providers and recipients were adapting and coping during the initial periods of the COVID-19 response.Settings: The study engaged several healthcare and non-governmental organizations (NGOs) in the peninsular states of Penang, Kelantan, Selangor, and Melaka.Participants: Medical personnel of methadone maintenance treatment (MMT) programs (n = 2) and HIV clinics (n = 3), staff of NGO services (n = 4), and MMT patients (n = 9) were interviewed using a semi-structured format.Results: Interviewed participants reported significant organizational, programmatic, and treatment protocols related changes implemented within the healthcare and support services in addition to nationally imposed Movement Control Orders (MCOs). Changes aimed to reduce patient flow and concentration at the on-site services locations, including less frequent in-person visits, increased use of telemedicine resources, and greater reliance on telecommunication methods to maintain contacts with patients and clients; changes in medication dispensing protocols, including increased take-home doses and relaxed rules for obtaining them, or delivery of medications to patients' homes or locations near their homes were reported by the majority of study participants. No significant rates of COVID-19 infections among PWUDs, including among those with HIV have been reported at the study sites.Conclusions: Although the reported changes presented new challenges for both services providers and recipients and resulted in some degree of initial disruption, generally, all participants reported successful implementation and high levels of compliance with the newly introduced restrictions, regulations, and protocols, resulting in relatively low rates of treatment disruption or discontinuation at the study sites.
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Mohamed Amin Mostafa, A., H. Mostafa, M. A. Sk Abdul Kader, and Y. Kah Hay. "P258 Pharmacometabolomics analysis of plasma and urine to identify clopidogrel exposure metabolic biomarkers." European Heart Journal 41, Supplement_1 (January 1, 2020). http://dx.doi.org/10.1093/ehjci/ehz872.084.
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Abstract Funding Acknowledgements This research was funded by Universiti Sains Malaysia Introduction Clopidogrel is a widely used P2Y12 antiplatelet drug. Patient"s compliance to clopidogrel is crucial to achieve therapeutic outcome and prevent thromboembolic events. While measuring serum level of clopidogrel and/or its active metabolite may indicate compliance, many confounding factors interfere, however, often compromising the reliability of the results. Identifying drug exposure metabolic biomarkers is reliable and fast tool to evaluate patient"s compliance, as well as getting in-depth information on the metabolic perturbation associated with drug exposure. We hypothesized that Nuclear magnetic resonance (1HNMR) pharmacometabolomics analysis of plasma and urine can phenotype clopidogrel loading dose (LD) in coronary artery disease (CAD) patients. Purpose We aimed to phenotype clopidogrel exposure in plasma and urine of CAD patients using 1HNMR pharmacometabolomics. Methods We analysed pre-dose and post-dose plasma and urine samples from 79 CAD patients who had clopidogrel 600 mg LD using 1HNMR pharmacometabolomics technique. Data analysis of 1HNMR spectra was performed by developing preliminary orthogonal partial least square discriminant analysis models (OPLS-DA). This was followed by univariate logistic regression (ULR), factor analysis (FA) and multivariate logistic regression (MVLR) for the 1HNMR spectral regions with variable influence on projection (VIP) > 1 in the OPLS-DA preliminary models to indicate the best discriminating models (metabotypes). Area under receiver operating characteristic (AUROC) was used to evaluate the OPLS-DA and MVLR models. Results OPLS-DA models discriminated between pre-dose and post-dose in plasma and urine with accuracy of 91.77% and 100%, respectively. MVLR indicated final plasma and urine metabotypes with accuracy of 84.2% and 82.2%, respectively. From the final exposure metabotypes, 27 and 20 metabolites were found perturbed in plasma and urine upon exposure to clopidogrel LD, respectively. Conclusion 1HNMR pharmacometabolomics analysis of plasma and urine was efficient in phenotyping clopidogrel exposure with good accuracy. The study is ongoing to indicate metabolic pathways associated with clopidogrel exposure. Models Accuracy Metabotype OPLS-DA Model MVLR Model Specificity Sensitivity Accuracy AUROC Specificity Sensitivity Accuracy AUROC Plasma 96.20% 87.34% 91.77% 0.99 97.5% 70.9% 84.2% 0.88 Urine 100% 100% 100% 1.0 93.2% 71.2% 82.2% 0.924 OPLS-DA: orthogonal partial least square discriminant analysis, MVLR: multivariate logistic regression, AUROC: Area under receiver operating characteristic
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NH, Azmi, Abdul Hadi A, Md Aris MA, Nasreen HE, and Che-Ahmad A. "Diabetic Foot Care Practice and its Associated Factors among Type 2 Diabetes Mellitus Patients Attending Primary Health Clinics in Kuantan, Malaysia: A Cross Sectional Study." IIUM Medical Journal Malaysia 19, no. 2 (October 28, 2020). http://dx.doi.org/10.31436/imjm.v19i2.1560.
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INTRODUCTION: One of the most important and debilitating complication of diabetes mellitus is foot problem such as ulcers, infections and amputations. However, these complications are preventable by simple intervention such as regular foot care practice. This study aims to assess the foot care practice and its associated factors among type 2 diabetes mellitus patients attending primary health clinics in Kuantan. MATERIALS AND METHODS: This was a cross-sectional study conducted at four primary health clinics in Kuantan involving 450 study participants who were selected by using universal sampling method. Level of awareness and practice toward diabetic foot care was assessed using validated self-administered questionnaire. Multiple logistic regressions were performed to identify factors associated with poor foot care practice among the respondents. RESULTS: About 59.6% of respondents had poor foot care practice and 50.9% had poor awareness level. Multivariate logistic regression analysis identified that, increasing age (OR 0.97, 95% CI: 0.955-0.993) and good awareness towards foot problem (OR 0.43, 95%CI: 0.289-0.643) were less likely to have poor foot care practice. However, Malay ethnicity (OR 1.81, 95% CI: 1.002-3.271) and obesity (OR 1.9, 95% CI: 1.225-2.976) were associated with poor foot care practice after controlling other variables. CONCLUSION: Majority of the respondents had poor foot care practice and poor awareness. Respondents who are older and have better awareness are less likely to have poor foot care practice. Diabetic patients who are Malays and/or obese are predicted to have poor diabetic foot practice and hence must be prioritized for a sustainable patient education and compliance towards foot care practice at primary care level.
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Halim Basari. "New Frontiers in Halal Pharmaceuticals." International Journal of Research in Pharmaceutical Sciences 10, SPL1 (November 7, 2019). http://dx.doi.org/10.26452/ijrps.v10ispl1.1687.
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It has been 20 years since the Department of Islamic Development Malaysia (JAKIM) issued the first Halal certification to health supplements manufactured by CCM. Many innovative halal medicines were produced locally, since. However, halal medicines do not get much attention from the market, except by the Ministry of Defence, despite Malaysia being the world champion on the Global Islamic Economy Indicator for 5 consecutive years. Malaysia leads through its robust, comprehensive halal standards and extensive halal ecosystem. Muslims, in general, are unaware of Malaysia's halal achievement and hardly create demand for halal medicines. Studies also show a significant occurrence of medicine errors, while 50% of patients deliberately did not take their medicines. Medicine prescribing practice should be revamped using alternative perspectives to improve compliance and prevent unnecessary medication errors, namely personalized or individualized medicine, ethnocentricity, halalopathy, Muslim friendly hospitality, and Syariah compliant pharmacy practice. Healthcare practitioners and patients must enhance their Knowledge, Attitude and Practice towards halal medicines. Religious beliefs, sentiments or ethnocentricity have formed the Social Norms and Values that play a vital role in the decision-making process of medicine-taking. Healthcare practitioners should empower patients to choose their ethnocentric medicines, thus improving their compliance, enhancing their therapeutic outcome, and also reducing unnecessary medicine errors.