Appropriateness in utilization of emergency department services in Hospital Kota Bharu and Hospital Universiti Sains Malaysia

The prime concern in the inappropriate utilization of emergency departments antara J00-200 perkataan di (ED) is compromised management of patients requiring emergency treatment. dalam Bahasa Malaysia dan Significant attendance of non-emergency cases in ED was found in several Bahasa lnggeris. lni countries. kemudiannya akan dimuatkan ke dalam Laporan Talmnan Sahagian Penyelidikan & Pembangunan sebagai safll cara 11ntuk menyampaikan dapatan projek tuanl puan kepada pihak Universiti). The objectives of this study are to determine the proportion of inappropriate cases, as well as the distribution of utilization by time (over 24 hours and within a week) and by diagnoses (Phase I) and to determine the associated factors and the reported reasons in the inappropriate utilization of ED services (Phase II). A cross sectional study (Phase I) was conducted in ED, Hospital Kota Bharu (HKB) and ED, Hospital Universiti Sains Malaysia (HUSM). A sample of 350 cases from each ED was randomly selected from ED register of the year 2000. A decision flowchart, which was adopted from 4 guidelines, was applied to identify inappropriate cases. The proportions of inappropriate cases were 57.4 % for ED HKB and 55 % for ED HUSM. The inappropriate cases increased considerably in early morning, late evening, during the weekend and early part of the week. Most common diagnoses of inappropriate cases were upper respiratory tract infections, mild acute gastroenteritis and urinary tract infections. The subsequent case-control study (Phase II) with 170 cases in each group revealed the independently significant factors associated with inappropriate utilization of ED services such as perceived il lness (Odds Ratio (OR)=9.13; 95% Confidence Interval (CI): 4.99, 16.67), knowledge on roles and functions ofED (OR=0.65; 95% Cl : 0.50, 0.85}, knowledge on roles and functions of OPD (OR=0.24; 95% Cl: 0.13, 0.44), marital status (OR=4.58; 95% Cl : 1.16, 18.06), gender (OR= 3.00; 95% Cl: 1.73, 5.18), number of family members (OR=0.88; 95% Cl: 0.79, 0.97), and shift-work (OR= 2.34; 95% Cl: 1.15, 4.71). The first 3 factors seem to be modifiable by giving education, whereas the later 4 factors give some understanding on customer needs, which may help to customize ED and OPD services. Studies to explore further on customer needs and customizing the hospital services accordingly, which will lead to a more efficient primary care, are recommended

Effects of very low blood lead levels on neurobehavioral performances of male policemen in kota Bharu, Kelantan

Many published studies that examined the effect of lead exposur~ on neurobehavioral performances were conducted in confined manufacturing environment with low to moderate blood lead levels as a marker of exposure. This study was conducted in a general environmental setting with very low exposure intensity and blood lead levels. The objective of the study was to determine the effect of very low blood lead levels (below 10 J.Lg/dl) on the neurobehavioral performances of policemen in Kota Bharu, Kelantan. The study was cross-sectional in design and comprised of 89 policemen working in Kota Bharu district. The lead concentration of venous blood was determined . using graphite furnace absorption spectrometer. "-We assessed neurobehavioral performances using fh:e WHO Neurobehavioral Core Test Battery (NCTB). The mean blood lead concentr~tion was 2.5 ± 1.0 J.Lg/dl. Among the seven tests performed, the positive effect o~ blood lead on Benton visual retention was not significant after controlling for th~ confounding effect of smoke-dose. This study suggested that very low blood lead levels have no significant effects on the neurobehavioral performances. Therefore, more studies with blood lead levels below the recommended environmental limit of 10 J.Lg/dl, as recommended by the Centers for Disease Control (CDC), be conducted in order to justify that limit

Appropriateness in the Utilization of Emergency Department Services In Hospital Kota Sharu and Hospital Universiti Sains Malaysia

The prime concern in the inappropriate utilization of emergency departments (FD) is compromised management of patients requiring emergency treatment. Kesan utama penyalahgunaan jabatan kecemasan adalah gangguan terhadap perjalanan perkhidmatan ini kepada pesakit yang benar-benar didalam kecemasan atau tenat. Kajian menunjukkan penggunaan jabatan kecemasan bagi kes-kes bukan kecemasan adalah signifikan dibeberapa negara

Trends of motorcyclist accidents in Kelantan and factors associated With severity of motorcyclists' Injury seen in Hospital Universiti Sains Malaysia (HUSM), Kelantan

Motor vehicle crashes (MVCs) contribute large proportion of death and disability globally. In Malaysia, more than 50°/o of the registered vehicles are motorcycle and it becomes one of the most important forms of personal transportation. Approximately 52.2°/o of all fatalities and 70.9°/o of all casualties related to MVCs in Kelantan were motorcycle riders and pillion riders. The objectives of the study were to determine the trend of motorcycle crashes in Kelantan between 1998 and 2003 and to identify factors associated with the severity of injury sustained by motorcyclist accidents. This study has two parts. Part 1 was a retrospective record review of MVCs in Kelantan between 1998 and 2003. Part 2 was a cross-sectional study on associated factors of motorcyclist accidents, assessed through face to face interviewed-based questionnaire and, at the same time the severity of injury was determined through Revised Trauma Score. The study revealed that majority of road traffic injuries involved motorcycle users (58.5°/o to 63.1 °/o). The proportion of fatality was between 8.6o/o and 10.7% and majority involved those aged 11-30 years (60.0°/o- 69.7°/o). About 90°/o of the fatal motorcycle injuries were male. The peak hour for fatality was between 4.00 and 8.00 in the afternoons. There was no seasonal pattern of motorcycle accidents but, there was significant linear increasing trend over time (p<0.001) with an average increase of 9 cases every year. Age more than 50 years (OR=12.87, 95°/o Cl: 1.85, 89.58), no motorcycle license (OR=14.32, 95°/o Cl: 3.85, 53.23), no stressful condition (OR=4. 73, 95°/o Cl: 1.64, 13.69) and crash on two-way road (OR=4. 78, 95°/o Cl: 1.26, 18.1 0) increased the odds of getting low score (RTS<11 ). Accidents on straight roadways (OR=0.24, 95%> Cl: 0.07, 0.75) or on wet roads (OR=0.09, 95o/o Cl: 0.02, 0.55) and drivers sleeping six to less than nine hours at night prior to accidents (OR=0.11, 95o/o Cl: 0.02, 0.64) reduced the odds for low score. Based on the results above, we conclude that the trend of motorcycle accidents was increasing in the years 1998 - 2003, but with no seasonal pattern. Most of the fatal motorcycle crashes involved young men riders and occurred in afternoons. Age more than 50 years, no motorcycle license, no stressful condition and crashes on two-way road showed higher risk to sustain more severe injury. However, drivers sleeping six to less than nine hours at night, crashes on straight roadways and wet road surfaces were associated with less severe injury. We recommend that public education, licensing and enforcement on accident prevention and safety riding should be given a priority

Dental anomalies And Facial Profile abnormality Of The Non-Syndromic Cleft Lip and Palate Children In Kelantan.

Cleft lip and palate (CLP) has become a major public health problem affecting one in every 500 1000 births worldwide (1)

A study of the determinants of smoking behaviour and the association of smoking with lung function of male secondary school students in Kota Bahru.

Tabiat merokok dikalangan pelajar sekolah terus menjadi masalatr disiplin di sekolah. Seramai 34.6% daripada 541 responden adalah perokok semasa manakala 2.3Yo adalah bekas perokok. Hasil kajian juga menunjukkan tabiat merokok mempunyai hubungkait dengan ; mempunyai kawan yang merokok, persepsi tentang bahaya merokok,perhubungan pelajar dengan ibu bapa dan pendap at agamatentang tabiat merokok. Smoking in Malaysia has mostly been a male activity and it is among men that there has been a high prevalence of smoking prevalence. This is true for adult as well as for adolescents, based on the National Health and Morbidity Surveys (NHMS) and several studies conducted in Malaysia (Country Report: Malaysia, 2001). The high overall smoking prevalence in Malaysia has been actually contributed by the prevalence among male population