Pentingkah saringan penyakit jantung koronari untuk orang dewasa?

‘Atherosclerosis’ adalah penyebab patologi utama kepada penyakit jantung koronari. Ianya merupakan penyebab kepada morbiditi dan mortaliti yang utama di seluruh dunia. Di negara Malaysia, penyakit jantung koronari adalah 1 per 4 penyebab kematian utama di hospital- hospital kerajaan iaitu sebanyak 24.4%

Tekanan darah tinggi “silent killer!”

APAKAH ITU DARAH TINGGI? Tekanan darah adalah diukur terhadap kekuatan tekanan dinding salur darah bernama arteri. Hipertensi (Tinggi tekanan darah) adalah apabila tekanan darah tinggi dari normal. Tekanan darah disukat dengan 2 bahagian iaitu bahagian atas yang dipanggil sistolik iaitu mewakili jantung apabila ianya kontrak (berdegup) dan bahagian bawah yang dipanggil diastolik iaitu apabila jantung dalam keadaan rehat (relaksasi). Tekanan darah tinggi ditakrifkan sebagai tekanan sistolik adalah melebihi atau sama dengan 140 mmHg dan/atau diastolik melebihi atau sama dengan 90 mmHg pada 2 bacaan berasingan. Tekanan darah tinggi sistolik ≥140 mmHg dan atau tekanan darah tinggi diastolik ≥90 mmHg untuk 2 bacaan secara berasingan. Ianya adalah ‘silent killer’

Apakah risiko pesakit kencing manis berpuasa di bulan Ramadan?

Puasa bulan Ramadhan adalah salah satu rukun Islam yang wajib dijalankan oleh setiap ummat yang beragama islam yang sihat tubuh badan. Akan tetapi, bagi mereka yang sakit, Islam mengharuskan pesakit meninggalkan puasa jika tidak mampu dilakukannya

An open labelled randomized clinical trial of fluoxetine versus dapoxetine treatment among men with premature ejaculation and its effect on marital satisfaction

INTRODUCTION: Premature ejaculation (PE) causes reduces sexual satisfaction and quality of life. Both Selective Serotonin Re-uptake Inhibitor Fluoxetine and Dapoxetine have been used in treatment of PE. Fluoxetine is used as off-label treatment meanwhile Dapoxetine is the first SSRI specifically designed for PE that has a short half-life and few side effects. OBJECTIVES: To compare the PE symptoms score and marital satisfaction score between Fluoxetine and Dapoxetine groups. METHODS: In this open labelled randomized clinical trial, 44 participants aged between 18 and 64 with PEDT score of ≥ 9 from the Primary Care clinic of Hospital USM, Kelantan Malaysia were recruited and randomized into two groups; Fluoxetine Group (FG) and Dapoxetine Group (DG). They were prescribed with either daily oral Fluoxetine 20mg or Dapoxetine 30mg on demand twice weekly for 8 weeks. PE symptoms were measured using the Premature Ejaculation Diagnostics Tool (PEDT) score and marital satisfaction score were measured using the Dyadic Satisfaction-Dyadic Adjustment Scale (DS-DAS) score. Measurements were made at baseline and at the 8th week (post intervention). RESULTS: In FG and DG, 22 and 21 participants completed the study, respectively. PEDT scores reduced significantly within both groups [from 11.41 to 5.45 (P<0.001) within FG and from 13.43 to 3.10 (P<0.001) within the DG]. At the 8th week follow-up, PEDT scores was observed to be were lower in DG (6.03 vs. 2.49, P<0.001) after adjustment of the baseline PEDT score. Significantly increased DS-DAS scores were observed in both groups [from34.50 to 40.68 (P<0.001) within FG and from 36.57 to 44.33, (P<0.001) within DG] with no significant difference in DS-DAS scores at the end of study (41.13 vs. 43.86, P=0.055) after adjustment of the baseline DS-DAS score. CONCLUSIONS: Reduction in PE symptoms was observed for both groups. At 8 weeks, PE symptoms among participants on Dapoxetine were significantly lower compared to the participants on Fluoxetine group at 8 weeks. Treatment of PE with either Fluoxetine or Dapoxetine reduces symptoms of PE and improves marital satisfaction

Apakah itu penyakit Leptospirosis (kencing tikus)?

Leptospirosis adalah penyakit yang melibatkan manusia dan juga haiwan disebabkan oleh bakteria bahaya, leptospira sp. Untuk manusia, jangkitan bakteria ini menyebabkan pelbagai jenis gejala yang boleh tersalah dengan diagnosis penyakit-penyakit yang lain. Ada juga yang dijangkiti tidak mempunyai sebarang gejala penyakit. Penyakit jangkitan ini boleh menyebabkan kegagalan kepada buah pinggang, jangkitan kuman selaput otak, kerosakan hati, masalah pernafasan malahan yang lebih teruk adalah kematian

Factors associated with discharge against medical advice from Emergency Department, Universiti Kebangsaan Malaysia Medical Centre

Patients who self-discharge against medical advice (DAMA) are susceptible to life-threatening consequences. By understanding the factors associated with DAMA, healthcare centres can build strategies to assist patients to receive optimal medical care and prevent unfavourable outcome. The objective of this study was to determine the factors associated with DAMA from the Emergency Department (ED) of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This was a prospective unmatched case control study conducted over a 4-month period. For every DAMA episode, two patients who were admitted on the same day were randomly selected as control. Following patient consent, data was collected using a standardized questionnaire. Patients were contacted by the investigator for information regarding hospitalization within two weeks of DAMA. Ninety three patients were recruited; 31 DAMA patients and 62 admitted patients. Payment method was significantly associated with DAMA (OR 3.17 95% CI 1.29-7.98; p=0.01). The likelihood of self-paying patients to take DAMA was three times higher than those who had a guarantor letter from their employer or insurance provider. Other factors which influence DAMA were family obligations (OR 4.08 95% CI 1.09-15.26; p = 0.03) and work problems (OR 3.83 95% CI 1.13-12.94; p=0.03). A total of 19.4% of DAMA patients left following symptomatic pain relief. A total of 80.6% DAMA patients were admitted to hospital within two weeks of the DAMA episode. Payment method significantly influences DAMA. Payment planning, social welfare services, non-governmental organization funds and the introduction of a national health policy scheme may aid hospital payment, alleviate financial limitation of patients and reduce DAMA episodes

Patient management in primary care

Primary care is one of the medical disciplines which provides community- based, continuous, comprehensive and preventive healthcare. It is very common for a medical doctor in primary care to manage medical illness that covers a wide spectrum of clinical conditions from the most common and simple diseases to the rare ones. Features that make primary care practice to be different from a tertiary centre or any specialist-based medical practice include its role as the first point of contact care, the strategy used in arriving at the right diagnosis, personalised care, holistic approach, health promotion and providing domiciliary care as well as family care

A study on position of the state secretary in Selangor: the law and practice / Mazni Ibrahim, Nur Huda Mohamad and Siti Asmath Che Man

The topic on "A Study on Position of the State Secretary in Selangor: The Law and Practice'' was proposed following the incident in Selangor in December 2010 where there was a conflict between the appointment of the State Secretary by the Federal and the State. A State Secretary is the Head of the State Civil Servant which represents the civil servants of a state as a whole. Generally, the Public Services Commission has jurisdiction over the Federation, Malacca and Penang. The jurisdiction is extended to any state which has no State Services Commission. However, there seems to be an overlapping in terms of jurisdiction as highlighted in the incident that has happened in the state of Selangor on the appointment of a senior public officer, the State Secretary. This study contains a brief introduction on the principle of federalism as well as the key to the study as to the words "appropriate service Commission". The objective of the study is to analyse related procedures and provisions and, where possible related recommendations. The scope and limitation as well as the significance of the study are spelled out with the purpose of doing the study in relation to the appointment of a State Secretary. The literature review is the opinion of academicians and legal practitioners. Besides that, the proposal is also coded with a qualitative research and interview as the methodology for the study. We hope this study will be a guide for those who would like to understand the legal position of a public servant in theory and practical as well as the legal aspects and its implications on the above issue

Maqasid syariah dalam pelancongan menurut Islam / Nor Azlina Abd Wahab … [et al.]

Aktiviti pelancongan merupakan sebahagian daripada rutin kehidupan manusia yang sentiasa ingin merasai ketenangan, keseronokan dan kebahagiaan. Dalam al-Quran terdapat surah yang secara jelas menggalakkan aktiviti melancong, antaranya, dalam surah al-Naml, ayat 69 yang bermaksud “Katakanlah (wahai Muhammad), mengembaralah kamu di muka bumi, kemudian perhatikanlah bagaimana buruknya kesudahan orang-orang yang berdosa itu”. Berdasarkan saranan tersebut, maka Islam sentiasa menggalakkan umatnya melancong untuk memerhati dan menikmati keindahan alam dan juga memikirkan tentang kekuasaan Allah SWT serta melakukan pencerapan bagi memenuhi keperluan hidup serta melaksanakan tanggungjawab sebagai khalifah di muka bumi ini. Sehubungan itu Islam telah menggariskan panduan bagi memastikan aktiviti pelancongan selari dengan kehendak syarak dan dengan itu menepati makna ibadah dalam aktiviti tersebut. Dalam konteks ini aktiviti tersebut sewajarnya mengambil kira lima perkara asas yang disebut sebagai daruriyyat al-khams iaitu pemeliharaan terhadap agama, nyawa, akal, maruah dan harta. Kertas kerja ini akan membincangkan tentang lima perkara teras yang menjadi intipati penting maqasid syariah dalam aktiviti pelancongan menurut perspektif Islam. Metod penulisan ini adalah berdasarkan kepada rujukan dan penelitian terhadap dokumen-dokumen dari pelbagai sumber seperti artikel, jurnal, buku, brosur dan kajian-kajian imperikal. Penelitian terhadap sumber primer dan sekunder ini akan dilakukan bagi mendapat maklumat berkaitan konsep maqasid syariah, pelancongan menurut perspektif Islam serta penerapan maqasid syariah dalam konsep pelancongan. Kajian mendapati agama Islam sangat menggalakkan aktiviti pelancongan dalam memenuhi keperluan fitrah semulajadi manusia dan pada masa yang sama aktiviti tersebut perlulah berlandaskan tuntutan syarak serta memenuhi maqasid syariah seperti mana yang digariskan dalam ajaran Islam

Randomized clinical trial between Fluoxetine and Dapoxetine for premature ejaculation and its effect on marital relationship

INTRODUCTION: Premature ejaculation(PE) decreases sexual pleasure and quality of life, and both Fluoxetine and Dapoxetine were used in PE therapy. Dapoxetine is the first SSRI with a short half-life and fewer side effects, primarily designed for PE therapy. The aim is to evaluate and compare the effects of Fluoxetine and Dapoxetine on PE symptoms and marital satisfaction. MATERIALS AND METHODS:44 participants aged between 18 and 64 with a PEDT score of ≥9 from Hospital USM's Primary-Care-Clinic, Kelantan Malaysia were selected and randomized into two groups: Fluoxetine(FG) and Dapoxetine Group(DG), and administered for 8 weeks with either regular Fluoxetine(20mg) or Dapoxetine (30mg) on-demand at least once a week. Premature Ejaculation Diagnostics Tool(PEDT) score was used to assess PE symptoms and Dyadic Satisfaction-Dyadic Adjustment Scale(DS-DAS) used to evaluate marital satisfaction at baseline and the 8thweek. RESULT: 22 and 21 participants in FG and DG completed the study. For both groups, PEDT scores decreased substantially [from 11.41 to 5.45(P<0.001) among FG, from 13.43 to 3.10(P<0.001) among DG]. After adjustment of the baseline PEDT score, PEDT scores in DG(6.03 vs 2.49, P<0.001) were lower at the 8th week. All groups showed significantly improved DS-DAS scores [from 34.50 to 40.68(P<0.001) in FG, from 36.57 to 44.33(P<0.001) in DG]. No marked difference in DS-DAS was scored after adjustment of the baseline DS-DAS score(41.13 vs 43.86, P=0.055) at the end of the assessment. CONCLUSION:Treatment of PE with either Fluoxetine or Dapoxetine decreases PE symptoms and increases marital satisfaction