Study on characteristics of patients with repeated admissions for asthma in Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia

ABSTRACT (Perlu disediakan makluman di antara 100 - 200 perkataan di dalam Bahasa Malaysia dan Bahasa lnggeris. lni kemudiannya akan dimuatkan ke dalam Laporan Tahunan Sahagian Penyelidikan & Pembangunan sebagai satu cara untuk menyampaikan dapatan projek tuan/puan kepada pihak Universiti). Objective To determine the characteristics in patients with repeated admissions for asthma compared to patients with no repeated admission for asthma over the same period of one-year duration. Methods A cross-sectional comparative study among 30 patients with asthma who had repeated admissions and another 30 patients with asthma who had no repeated admission for exacerbation of asthma over the same period of one-year duration (2001 ). The socio-demographic, clinical characteristics and evaluation data were collected. The evaluation included measurement of peak expiratory flow (PEF), inhaler technique skills and questionnaires on knowledge of asthma. Results There was no significant difference in socio-demographic characteristics, measurement of PEF and inhaler technique skills in both groups. In clinical characteristics, there was significant difference noted in history of atopy, history of absenteeism, asthma symptoms and use of medications. There was significant difference in .the knowledge of asthma where the total mean scores was 14.8 in repeated admissions group and 17.7 in non - repeated admission group from the total sco~e of 31. Conclusions Patients with repeated admissions for asthma tend to have high past history of atopy, high history of absenteeism from work or school, more frequent nocturnal symptoms and more use of low dose inhaler corticosteroids. They also had poor inhaler techniques and less asthma knowledge. USM J

Doctor-shopping behaviour amongst adult patients attending family medicine clinic Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan

Introduction: Doctor-shopping refers to the changing of doctor without professional referral in a single episode of illness. It leads to some health risk and social problems. Objectives: To determine the prevalence and associated factors of doctorshopping behaviour amongst adult patients attending Family Medicine Clinic (FMC) Hospital Universiti Sains Malaysia (HUSM). Methodology: It was a cross-sectional study conducted on 442 adult patients aged 18 years and above. It was conducted as face to face interview using questionnaires. Data were analysed using SPSS version 11. Results: Fifty-six percents of these patients met our criteria for doctor-shopping patients. Most of the patients went to general practitioners for consultation prior to FMC visit. One-fifth of the respondents went for alternative treatment for the current illness episode. The main reason for changing doctors was due to no improvement of the illness. Doctor-shopping behaviour was found to be significantly associated with older age group and employed patients. Doctorshopping patients were found to be high among married people, females and patients with low education level, but the associations were not significant. The significant associated factors of doctor-shopping behaviour were chronic duration of illness, and advice to seek treatment from somebody. Conclusion: Prevalence of doctor-shopping behaviour amongst adult patients attending FMC was high. It is important to recognise and anticipate problems related to doctor-shopping behaviour. We need to emphasise on the importance of a good doctor-patient relationship, and give accurate explanation and health education to maintain a proper continuity of care

A study on risk factors of repeated admissions among schizophrenic patients in Hospital Kota Bharu

Introduction: The number of people with psychological problems in the world has reached 1.5 billion in 1996, but only one percent of them have received treatment (1Oth International Psychopathology Conference). Schizophrenia is a difficult disease that many choose to conceal. Relapse and frequent readmissions among schizophrenic patients are common and various risk factors have been associated with them. These further enhance the existing societal stigma which causes pain to the patients, their family and friends. Objective: To identify the risk factors of readmission in less than 6 months from the previous admission among schizophrenic patients in Hospital Kota Bharu. Methodology: A total of 120 outpatients and 120 inpatients who fulfilled DSM IV criteria for schizophrenia from Hospital Kota Bharu between 1st October 2002 until 31st March 2003 were interviewed using a validated questionnaire. The questionnaire ·includes questions on patients' sociodemographic data, compliance, insight, family support and life events.Results: Using multiple logistic regression, it was shown that young age ( OR: 0.94, p: 0. 004 ), number of previous admission (OR: 1.163, p: 0.001 ), good compliance ( OR: 0.046, p: 0.001 ), poor insight ( OR: 7 .32, p: 0.001 ), partial insight ( OR: 3.08, p: 0.023), importance of follow up (OR: 2.94, p: 0.043) and family remind follow up ( OR: 0.17, p: 0.001) were significant risk factors of repeated admissions. Other variables such as marital status, income, education, distance and life events showed no significant associations. Conclusions. Age, number of previous hospitalization, poor compliance, poor insight and poor family support were important factors in determining repeated admissions among schizophrenic patients. In the management of these patients, good family supports need to be emphasized

Efficacy of Tongkat Ali (Eurycoma longifolia) on erectile function improvement: Systematic review and meta-analysis of randomized controlled trials

Objective: To determine the efficacy of Tongkat Ali (Eurycoma longifolia) herbal extract on erectile function improvement. Methods: Comprehensive electronic databases were searched from inception through October 2014. Randomized controlled trials investigating Tongkat Ali compared to placebo were included. Outcome of interest was the improvement of erectile dysfunction. The difference of changes from baseline of the outcome between Tongkat Ali and placebo was pooled using weighted mean difference (WMD). Methodological quality of included studies was assessed using Jadad's quality scale and Cochrane's risk of bias. Results: Of the 342 articles identified, 2 studies involving a total of 139 participants were analyzed. No significance between group difference was found in the mean WMD of the change in the 5- item version of the international index of erectile function (IIEF-5) at week-12 (0.91; 95% CI: -1.50 to 3.33 with I2=89.5%, P-value=0.002) with statistical heterogeneity. Based on the subgroup analysis, significant improved IIEF-5 score of 2.15 (95% CI 1.03-3.27) was found in subjects with lower baseline IIEF-5 score, but this was not seen among those with higher baseline IIEF-5 score. Conclusion: Based on current evidence, the herbal extract of Tongkat Ali may have clinical effect on erectile function. However, more efficacy trials are warranted to further support current evidence

Study on characteristics of patients with repeated admission for asthma in Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia

Objective: To determine the characteristics among patients with repeated admissions for asthma compared with patients with no repeated admission for asthma over the same period of one-year duration. Methods: A cross-sectional comparative study among 30 patients with asthma who had repeated admissions with another 30 patients with asthma who had no repeated admission for exacerbation of asthma over a same period of one-year duration (2001). The socio-demographic, clinical characteristics and evaluation data were collected. An evaluation included measurement of peak expiratory flow (PEF), inhaler technique skills and questionnaires on knowledge of asthma. Results : There were no significant differences in socio-demographic characteristics, measurement of PEF and inhaler technique skill in between both groups. In clinical characteristics, there were significant differences in duration of asthma, history of atopy, history of absenteeism, asthma symptoms and use of medications. There was significant difference between groups in their knowledge of asthma where the total mean scores of both groups were 14.8 in repeated admissions group and 17.7 in non - repeated admission group from the total score of 31. Conclusions: Patients with repeated admissions for asthma tends to have less duration of asthma, high past history of atopy, high history of absenteeism from works or schools, more frequent nocturnal symptoms and more use of inhaler corticosteroids. They also had poor inhaler techniques and lesser asthma knowledge

Prevalence of psychosomatic and genitourinary syndrome among menopausal women: a systematic review and meta-analysis

Introduction: The menopausal transition represents the passage from reproductive to non-reproductive life and is characterized by a number of menstrual disturbances. We systematically reviewed the evidence on the prevalence of psychosomatic and genitourinary syndrome amongmenopausal women and compared the risk of symptoms between premenopausal, perimenopausal, and post-menopausal women. Methods: We performed a systematic search in MEDLINE, CINAHL, and ScienceDirect through March 2021. Case series/reports, conference papers and proceedings, articles available only in abstract form, editorial reviews, letters of communication, commentaries, systematic reviews, and qualitative studies were excluded. Two reviewers independently extracted and assessed the quality of data using the Joanna Briggs Institute Meta- Analysis. The outcomes were assessed with random-effects model using the Review Manager software. Results: In total, 29 studies had a low risk of bias and were included in the review. Our findings showed that the pooled prevalence of somatic symptoms in post-menopausal women (52.6%) was higher than in the premenopausal and perimenopausal stages (34.6 and 39.5%, respectively). There was a low prevalence of psychological symptoms in premenopausal women (28.4%). The genitourinary syndrome was highest among post- menopausal women (55.1%), followed by perimenopausal (31.9%) and premenopausal (19.2%) women. Conclusion: Post-menopausal women have a higher risk of experiencing menopausal symptoms particularly genitourinary syndrome than premenopausal and perimenopausal women. It is pertinent for healthcare professionals to evaluate the symptoms in order to provide them with a better quality of life

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

The primary health care performance initiative (PHPCI): issues and challenges for Malaysia as a trailblazer country / Anis Safura Ramli … [et al.]

A strong and robust Primary Health Care system is essential to achieving universal health coverage and to save lives. The Global Conference on Primary Health Care 2018: from Alma-Ata towards achieving Universal Health Coverage and the Sustainable Development Goals at Astana, Kazakhstan provided a platform for low‐ and middle‐ income countries to join the Primary Health Care Performance Initiative (PHCPI). At this Global Conference, Malaysia has declared to become a Trailblazer Country in the PHCPI and pledged to monitor her Vital Signs Profiles (VSP). However, the VSP project requires an honest and transparent data collection and monitoring of the Primary Health Care system, so as to identify gaps and guide policy in support of Primary Health Care reform. This is a huge commitment and can only be materialised if there is a collaborative partnership between Primary Care and Public Health providers. Fundamental to all of these, is the controversy concerning whether or not ‘Primary Care’ and ‘Primary Health Care’ represent the same entity. Confusion also occurs with regards to the role of ‘Primary Care’ and ‘Public Health’ providers in the Malaysian Primary Health Care system. This review aims to differentiate between Primary Care, Primary Health Care and Public Health, describe the relationships between the three entities and redefine the role of Primary Care and Public Health in the PHCPI-VSP in order to transform the Malaysian Primary Health Care system

Angiotensin receptor blockers for erectile dysfunction in hypertensive men: a brief meta-analysis of randomized control trials

Erectile dysfunction is common in adult men, particularly those with hypertension and diabetes. The present study determines the effectiveness of angiotensin receptor blocker (ARB) drugs on erectile function in hypertensive male adults. For this purpose, CENTRAL and MEDLINE and reference lists of the articles were searched. The randomized controlled trials (RCTs) were selected that compared ARBs with conventional therapy or no treatment in men of any ethnicity who were presented with hypertension and/or diabetes. A total four trials that had 2,809 men were included. Three trials reported adequate random sequence allocation, two reported adequate blinding. Attrition bias is low in one of the included studies. All three studies are of low risk of selective reporting bias. There was an improvement in sexual activity with ARBs (valsartan) (mean difference (MD): 0.71, 95% Confidence Interval (CI) 0.66 to 0.76, I2 statistic = 0%). However, the erectile functions did not increase significantly in ARBs (losartan or telmisartan) treated men as compared to control or placebo (n = 203 vs n = 232; MD: 1.36; 95% CI: −0.97 to −3.69; I2 statistic = 80%). These results suggested that ARBs significantly improved sexual activity among hypertensive men. However, the erectile function was not significantly improved in ARBs treated men as compared to the control or placebo-treated. There were limited studies available. Hence, additional studies are needed to support findings from this review. ARBs should be considered when prescribing antihypertensive drugs to men

Comparison on the Effects and Safety of Tualang Honey and Tribestan in Sperm Parameters, Erectile Function, and Hormonal Profiles among Oligospermic Males

This study aims to evaluate the effectiveness of Tualang honey on sperm parameters, erectile function, and hormonal and safety profiles. Methodology. A randomized control trial was done using Tualang honey (20 grams) and Tribestan (750mg) over a period of 12 weeks. Sperm parameters including sperm concentration, motility, and morphology were analyzed and erectile function was assessed using IIEF-5 questionnaire. Hormonal profiles of testosterone, FSH, and LH were studied. The volunteers were randomized into two groups and the outcomes were analyzed using SPSS version 18. Results. A total of 66 participants were involved. A significant increment of mean sperm concentration