A study on the use of clincal practice guidlines (CPG) on management of type 2 diabetes mellitus in Kelantan

INTRODUCTION The prevalence of diabetes is increasing in Malaysia. Majority of the patients were reported to have poor glycaemic control. CPG were developed to improve the practice of health care providers for better health outcomes in patients. OBJECTIVE The objective of this study was to determine the use of diabetic CPG among diabetes care team (DCT), to evaluate the effectiveness of intensive training on the CPG given to DCT in Kelantan on their knowledge, attitude and practice (KAP) and patients' KAP and diabetic control, and to determine the factors associated with HbAtc levels in type 2 diabetic patients with poor control in Kelantan. METHODS This study was conducted in all health centres (HC) in Kelantan from August 2005 till March 2006. Cross-sectional study design was used to determine the characteristics of DCT and their use of diabetic CPG, and the characteristics of type 2 diabetic patients with poor control and the factors associated with their HbAtc levels. To determine the effect of intensive course on diabetic CPG given to DCT on their KAP and their patients' KAP and diabetic control, randomised controlled trial was used where the participants were randomized into intervention and control group by cluster according to the districts in Kelantan. The participants were all DCT members and diabetic patients with poor control. Post-intervention data were collected four months after the intervention was completed. RESULTS A total of 176 DCT members participated in this study. Most of the participants knew about the existence of diabetic CPG (79. 5%) or have ever read it (71. 6% ). In term of the use of CPG, only 40.4% to 83.1% of them claimed always practice according to the diabetes care measured. The mean total knowledge scores were 23.6 marks (SD = 3.41) from the total score of 30 or 78. 7%, and the median total attitude and practice scores were 29 (IQR = 8) from the total score of 35 and 27 marks (IQR = 4) from the total score of30 or 82.9% and 90%, respectively. A total of 208 diabetic patients with poor control participated in this study. Their mean total practice scores were 21.9 (SD = 2.49) from the total score of 32 or 68.4%, and the median of total knowledge and attitude scores were 42 (IQR = 8) from the total score of 48 and 14 (IQR = 2) from the total score of IS or 87.5% and 93.3%, respectively. Patients who were married, had no formal education and receiving their diabetic care in HC without Family Medicine Specialist (FMS) were significantly associated with poorer HbAtc levels. Fasting blood glucose (FBG) levels were significantly increased with increasing levels ofHbAtc· A total of 88 DCT participants in intervention and 55 in control group completed this study. In the intervention group, significant improvement was observed in knowledge scores as compared to control group. A total of 86 patient participants in each group completed this study. Their practice scores were significantly reduced more in intervention compared to control group. However the changes observed here were minimal. No significant changes were observed in all the other outcome variables measured in DCT or patient participants. CONCLUSION Majority of the DCT members in Kelantan knew about the existence of diabetic CPG. However, their use of the CPG was not very satisfactory. The KAP ofDCT and patients were quite good but that did not translate into good diabetic control of the patients. Factors associated with HbAtc levels in the diabetic patients with poor control FBG, educational level, marital status and receiving care in HC with FMS. After intervention, significant improvement was only seen in the knowledge score ofDCT, albeit minimal. One day intensive course may not be enough to change DCT' s KAP and regularly structured continuing medical education (CME) might be needed to reinforce their KAP. Four months duration may not be enough for the DCT to properly manage their diabetic patients for observable changes in the patients' KAP and diabetic control measures

Knowledge, attitude and practice regarding dengue: a case study in Taman Temerloh Jaya, Malaysia

Dengue is an endemic tropical and subtropical disease caused by dengue virus. It is being transmitted by Aedes mosquito, mostly in urban and semi-urban areas. A cross-sectional study was carried out to assess the knowledge, attitude and practice (KAP) regarding dengue and its prevention among residents in Taman Temerloh Jaya, Malaysia using a structured interviewer-administered questionnaire. The KAP of the participants were described accordingly. The KAP were also analysed in order to find out their associated factors and to see whether there was any relationship between knowledge, attitude and practice regarding dengue and its prevention

An examination of medical imaging literature in Malaysian Citation Index (Mycite)

Introduction: The Medical imaging service in Malaysia is expanding. The presence of imaging technologies needs to be supported by homegrown research to optimize their use. This study investigated the contribution of researches by Malaysian practitioners to the field of Medical imaging in the Malaysian Citation index (MyCite) database. Materials and method: Bibliometric and thematic analyses were performed on publications featured in the database from 2006 to 2016 using 13 keywords; radiology, radiography, medical imaging, radiation, x-ray, neuroimaging, nuclear imaging, magnetic resonance imaging, computed tomography scan, mammogram, ultrasound, fluoroscopy, and intravenous urogram. Results: A total of 268 articles were identified. The study reported the publications from Malaysians (54.1%) followed by non-Malaysians (41.8%) and collaboration between authors (4.1%). The researchers were mostly from university-based (67.4%) and hospital university-based (21.3%) compared to clinical-based (5.6%) researchers. For thematic analysis, the majority of the authors focused on certain topics such as clinical (42.9%) and modality (20.1%) with only a few on safety (12.3%), technical (9.7%), education (7.46%), professionalism (4.5%), quality (2.6%) and economy (0.4%) researches. Conclusion: The low number of publications related to Medical imaging do not reflect the real involvement of practitioners in research. Their research findings could have been indexed in other databases besides MyCite. However, the open access facility offered by MyCite should be optimized. The involvement of clinical-based practitioners can be enhanced in areas involving safety, technical, education, professionalism, quality and economy. Collaborative efforts by the practitioners could increase the number of publications and enhance homegrown research that will address local needs

Effect of diet counseling on knowledge, attitude and practice and quality of life of diabetic patients in Kuantan, Malaysia

This research was intended to assess the impact of dietary counseling for diabetic patients. By giving the advice to control the blood sugar, does it improve the wellness of the diabetic patients? This research was conducted from January until December 2011 with the aim to study the factors associated with knowledge, attitude and practice (KAP) and quality of life (QOL) of type 2 diabetic patients, and the effect of dietary counseling on their KAP and QOL. A total of 63 respondents were involved in this intervention study, including 31 respondents from the intervention group and 32 respondents from the control group. The intervention group was selected by purposive sampling based on doctor’s referral for diet counseling of the respondents, while a convenience sampling method was used for the control group. Based on the baseline results of both groups, a significant correlation was found between knowledge with duration of having DM (p=0.019) and race (p=0.002). Race and educational level were found to have significant correlation with attitude where the p=0.001 and p=0.037, respectively. Significant difference was only found in race for practice scores (p=0.019). There was a significant correlation found between QOL and age (p=0.031). Further analysis comparing the pre and post intervention result shows that the total scores for KAP and QOL in the intervention group was improved after the diet counseling given, as compared to the control group, but the difference was not significant statistically. In conclusion, better methods might need to be developed for more effective health education and counseling to better improve diabetic patients’ KAP and QOL, thus reducing the complications of the disease

Knowledge, attitude, and practice regarding dengue among students in a public university in Malaysia

Background: Dengue has become an important public health problem in the world. It is an infectious disease caused by dengue virus and transmitted by Aedes mosquito. The understanding the knowledge, attitude and practice (KAP) of the general community on dengue prevention are helpful to give information for good strategic planning and engaged the community with dengue control. The knowledge on preventive measures in dengue is important to decrease the mortality rate, but the implementation of knowledge among individuals to reduce dengue is still an issue. Study Objectives: This study aims to examine the KAP regarding dengue among IIUM Kuantan students. Besides that, this study also aims to find the factors associated with KAP of dengue and to assess the relationship between KAPs regarding dengue among IIUM Kuantan students. Methods: This study used cross-sectional study, and 135 respondents were selected by using convenience sampling method. The questionnaire consists of 67 questions which were divided into four parts (socio-demographic characteristic, knowledge regarding dengue, the attitude of dengue and practice on prevention of dengue). In this study, to evaluate the KAP of dengue among students in IIUM Kuantan. Independent t-test, Kruskal-Wallis test, Mann-Whitney test, and Pearson test were used to find all related factors influencing KAP of dengue. Results: This study shows that the level of KAP of dengue among students in IIUM Kuantan was relatively high. All the respondents have very good level of KAP towards dengue prevention, symptoms and transmission. There was a significant difference in attitude among marital statuses (p=0.004). The students from FOM had better knowledge (p=<0.001) as compared to FOD and better attitude scores than KOP (p=0.001). This study also depicted that dengue knowledge-attitude towards dengue prevention was significantly correlated (p=0.005). Conclusion: the KAP regarding dengue among IIUM Kuantan students was good. © 2020, Ibn Sina Trust. All rights reserved

Islamic perspectives of reproductive and maternal health: what role can Nigerian Muslim religious leaders play in the prevention of maternal mortality? –With Particular Reference to Zamfara State NorthWest Nigeria

Reproductive and Maternal health are an important components of public health and medicine which are concerned with the complete state of physical, mental and social wellbeing in all matters regarding reproductive system and health of mother especially during pregnancy.It implies ensuring that all women receive the care they need to be safe and healthy throughout pregnancy, childbirth and beyond. However, according to World Health Organization, millions of women all over the world do not have access to good quality health services during pregnancy and childbirth resulting in mortalities. Islam is a complete way of life. The Qur’an and Hadith consider pregnancy and child bearing as signs among other signs of the divine existence of Allah.The importance of maternal and reproductive is thus not unexplained in the Islamic perspectives. The study look at what role Muslim religious leaders can play in the prevention of maternal deaths and morbidities in developing countries. A qualitative study was conducted through in-depth interviews and focus groups discussion with a purposive sample of some Muslim religious leaders from Gusau local government area of Zamfara state northwest Nigeria in order to elicit information about the Islamic perspectives of reproductive and maternal health and the roles they can play in the prevention of maternal deaths among the Muslim communities. Muslim Religious leaders have a crucial role and contribution for the attainment and maintenance of good heath of women and children among Muslim communities through public enlightenment in the context of ‘ilm’, providing guidance through ‘Fatwah’ and community mobilization in the spirit brotherhood ‘ukhuwah’.Islam does not accept the “preventable death of a woman” due to childbirth or pregnancy. Thus, Islam encourages attendance of antenatal care visits and health care seeking

Internet use and addiction among medical students of Universiti Sultan Zainal Abidin,Malaysia

The use of Internet has now become indispensable, and the technology has revolutionized the medical education and practice worldwide. Currently, medical students and professionals have an enormous opportunity to keep them always updated with the exponential growth of knowledge because of potential progression of Internet throughout the world that enables them to become a lifelong learner. Internet addiction is a widespread phenomenon among students and academicians at universities in Malaysia. Students use the Internet for recreational purpose and personal and professional development. The Internet has become an integral part of day-to-day life of the university students, including medical students. The aim of the present study was to examine the Internet use and addiction among students of Universiti Sultan Zainal Abidin, Malaysia. Methods: This was a cross-sectional study in which a questionnaire, Internet Addiction Diagnostic Questionnaire, developed by the Center for Internet Addiction, USA, was used. One hundred forty-nine medical students of Universiti Sultan Zainal Abidin participated in this study. Data were analyzed using Statistical Package for the Social Sciences software. Results: The mean scores were 44.9±14.05 and 41.4±13.05 for male and female participants, espectively, which indicated that both the genders were suffering from mild Internet addiction. Conclusion: This study shows almost similar level of Internet usage among medical students irrespective of their socioeconomic background, with no statistically significant (p>0.05) differences, except among the years of study (p=0.007). Overall, from the research data and having worked with this cohort very closely, Universiti Sultan Zainal Abidin medical students can be labeled as wonted and recurring users of the Internet. Nevertheless, it is very difficult to define as Internet addicts or pathological users of the Internet because of small sample size and cross-sectional study

A systematic review on prevention of methicillin-resistant Staphylococcus aureus infection by pre-admission screening: the cost effectiveness and practicality

Background: Methicillin Resistant Staphylococcus aureus (MRSA) is a common source of nosocomial infection, which is spreading through the community and hospitals across the countries. The performance of screening program really needs major effort related to laboratory capacity and ethical consideration, among other costly components. Significant literature research was conducted to review the cost, effectiveness and practicality of different methods of pre-admission MRSA screening in the hospital setting. A systematic literature review was conducted with search strategy using the PubMed Medline, Scopus and the Science Direct databases. The relevant data was abstracted from all studies based on various countries which in line with the finalized eligibility criteria. Results: PCR method was reported to have high sensitivity with low turnaround time as compared to culture method. A review of selected studies found the increasing annual costs of screening from standard culture, chromogenic agar to rapid PCR. In the meantime, other studies reported the total costs for labor and materials was lower for rapid PCR screening compared to culture methods. The culturing method offers a high level of variability due to time consumption and additional costs. Whereas PCR was reported as advantageous in term of saving time to identify MRSA positive patients, which involved isolation, thus increase the effectiveness of screening programs. It can pick up false negative results by conventional methods in the early condition of disease. Conclusion: Most studies verified that PCR is the most accurate method for detection of MRSA with Xpert MRSA having the best performance. Otherwise, oxacillin agar screen was revealed as a good alternative method to PCR. Targeted screening on high risk patients using rapid PCR may be the best choice to be implemented, in order to balance the economic and practicality of screening. We recommend that further clinical studies should be done to provide a sharp evidence of MRSA screening

Wabak demam kepialu (Tifoid) di daerah Bachok, Kelantan Mac - Mei 2005

Penyakit tifoid adalah penyakit berjangkit bawaan air dan makanan yang disebabkan oleh Salmonella typhii. Penyakit ini berlaku di seluruh dunia dan endemik di Kelantan. Pada April 2005, terdapat peningkatan kes tifoid yang dinotifikasi di daerah Bachok dan wabak telah diistiharkan. Pasukan siasatan telah dibentuk di mana setiap kes disiasat dengan segera dan tindakan kawalan telah diambil seperti pemeriksaan dan penutupan premis makanan, kerja-kerja sanitasi dan pendidikan kesihatan. Pengesanan kes secara aktif juga telah dilakukan. Mukim Gunong mencatatkan jumlah kes tertinggi iaitu 46.3%. Majoriti daripada kes terdiri daripada pelajar. Dua pembawa dari kalangan kontek juga turut dikesan. Lekuk epidemik menggambarkan berlakunya wabak punca lazim. Lima daripada 111 bilangan sampel air dan dua daripada 146 bilangan sampel makanan yang diperiksa adalah positif terhadap Salmonella spesies tetapi tiada yang positif terhadap Salmonella typhii. Meskipun Pasar Jelawat merupakan lokasi yang disyakki sebagai punca utama jangkitan, ianya tidak dapat disahkan melalui penyiasatan dan ujian makmal

The proposed future infrastructure model for basic occupational health services in Malaysia

The objectives of occupational health services (OHS) are to create a healthy and safe working environment, prevent work-related diseases, optimise employees’ functional capacity and promote health. According to the literature, global accessibility to OHS has not shown much improvement and even worsened in certain countries. The main challenges come from the small and medium enterprises (SMEs). To respond to these global challenges, the basic occupational health services (BOHS) guideline was published under the purview of the World Health Organization and the International Labour Organization. The guideline describes BOHS as part of the infrastructure called the occupational safety and health system, an essential element that ensures the high service coverage and sustainability of the programme. The BOHS guideline was introduced in Malaysia by the Department of Occupational Safety and Health with a focus on SMEs, but its accessibility is low. A gap analysis was conducted between the current BOHS in Malaysia and the published international guideline. The important challenges identified that contributes to the low BOHS accessibility in Malaysia is the weakness in the BOHS infrastructure and OHS system provision. The proposed BOHS infrastructure model is meant to increase accessibility and to provide fair and equitable health services for Malaysians