Common morbidity and utilization rate of the University Health Centre, International Islamic University Malaysia (Kuantan Campus) in 2010

Introduction: University Health Centre, International Islamic University, Malaysia, Kuantan campus, (UHC-IIUM), is a primary care clinic for its community, students, staff and their dependents. Common morbidity and utilization rate of the clinic need to be analyzed to know current practices environment for further planning to provide quality primary health care services in line with vision of the clinic. Aim : To scrutinize the common morbidity and utilization rate of University Health Centre , International Islamic University ( Kuantan Campus) Methods: A retrospective desktop study was done by using 2010 annual electronic medical record (EMR) data of UHC-IIUM (Kuantan-Campus) after getting approval from University authority. Background socio-demographic data and reason for encounter were extracted from the EMR and converted into the International Classification of Primary Care code for diseases under Reasons for Encounter (RFE) format. Utilization rate of UHC-IIUM (Kuantan Campus) was computed based on staff and students population of the University in 2010 which was analyzed in accordance with category of patients and faculty. Results: Total (9220) encounters of the University Health Centre were included in the study. Common morbidity of the health centre were respiratory diseases (24.4%), skin diseases (9.7%), gastrointestinal tract disorders (7.2%), general and unspecified (5.4%), locomotors-disorders (4.9%), eye and ear problems (3.6%), women health (3.2%), neurological disorders(2.2%), minor surgical cases( 1.8%) and endocrine disorders particularly Diabetes-Mellitus (1.9%). Minimum and maximum frequency of visit to the UHC were 1 and 30 respectively; 96% of patients visited 1 to 5 times per year. Utilization rate (visit per person per year) of UHC-IIUM (Kuantan) campus by staff was 2.31 and that of student was 1.72. Utilization rate in accordance with faculty were Office of Campus Director (12.96), followed by Security Department (5.65), Faculty of Dentistry (2.98), Faculty of Science (2.54), Faculty of Medicine (2.29%), Faculty of Pharmacy (1.85), Faculty of Nursing (1.33), Faculty of Allied Health Science (0.71) and others (0.95). Conclusion: This study illustrated common morbidity and current utilization rate of the UHC-IIUM (Kuantan-campus) by staff, students and faculty which is invaluable input to administrators and clinic health providers to plan further primary care activities in tailored to the need of community. Keywords : Utilization rate, common morbidity, University Health Centre, Electronic Medical Record

A comparative study of teaching anatomy using cadavers, prosected wet specimens and simulated plastic models among Malaysian undergraduates

It is a challenge that the dissecting room still has a place in teaching gross anatomy. Understanding the students’ perceptions and experiences of learning anatomy is important to get sound knowledge of the human body. This study was conducted to assess which teaching aid would facilitate students’ understanding of the human body in order to get a more evidence – based approach to clinical anatomy. A cross – sectional comparative study was carried out among 741 medical and dental students of International Islamic University Malaysia (IIUM), Universiti Teknologi MARA (UiTM), University Sabah Malaysia (USM) and University Malaysia Sarawak (UNIMAS). A pre-tested, semi-structured, self administrated questionnaire which includes open–ended questions was distributed to collect the data on handability, understanding, information, application and preference. The data was analysed using chi-square test at “α“ 0.05 (SPSS version 17). The students from IIUM, UiTM, USM and UNIMAS scored the highest preference for plastic models on handability and application in examination (OSPE). It was statistically significant (p0.05) in USM (information and application in OSPE) and UNIMAS (understanding and information). The overall preference for students of IIUM and UiTM was the plastic models (85.8% and 44.1% respectively) while for UNIMAS the prosected wet specimens (90.7%) followed by plastic models (87.8%). USM students mostly preferred the cadavers (51.9%) followed by plastic models (50%). These inter-universities differences were statistically significant (p<0.05). This study suggests that the plastic model can fit very well into the structure of modern medical training and therefore improve the teaching of anatomy in surgical specialities

A preliminary assessment on magnitude of oral health problems among five selected primary care clinics of Malaysia and Myanmar in 2012

Background: There is growing evidence that oral health is related to local and systemic diseases by sharing common risk factors. Although, oral health has long been overlooked in the medical community, electronic medical records study in 2011 found that 1.2% of all encounters of the University Primary Care Clinic were oral diseases. The first point of contact for patients with Primary Care Physicians (PCPs) can facilitate preventive dental care through timely referrals to dental profession4. Objectives: To assess the oral health concern of general/family medicine practices which may be used to set primary and emergency oral health care training for primary care physicians Methods: A uniform structured format was used to collect total number of patients and the patients with oral health problems (OHPs) who attended at the selected 3 primary care clinics of Kuantan, Malaysia (a private, a public and a University clinic) and two private clinics of Myanmar (one from Yangon (City) and one from Hninthada District within 1st April, 2012 to 31st July 2012. A cross-analysis was done between demographic data, reason for encounter (RFE) and the countries under study. Findings: In Malaysia, range of proportion of oral health problem (OHP) per month among the 3 primary care clinics was from 4.2 to 25.7 per 1000 patients/month. That of two Myanmar private clinics was from 3.6 to 11.6 per 1000 patients/month. Although, age group differences- the younger age group more in Malaysia and the older age group more in Myanmar was seen, there was no gender differences. Although the common OHP in both countries were more or less same -dental caries, periodontal diseases, oral ulcer, hand-foot mouth disease (HFMD); and co-morbidity with medical diseases were more in Myanmar than in Malaysia. Discussion and conclusion: This study confirms that Oral Health Problem is an important health issue in reason for encounter of primary care practices. It is recommend that all primary care physicians be more aware of oral health problems and if necessary be made part of the training as a primary care physician

Preference in learning gross anatomy among IIUM students

Both medical (Year I, Year II) and dental (Year I) students in IIUM are exposed to three types of teaching aids in learning gross anatomy. They are cadavers, prosected wet specimens and plastic models. This study aimed at exploring the students’ preference on teaching aids in learning gross anatomy and reasons for their preference. A cross-sectional comparative study was carried out among 185 medical and dental students by using the pretested, semi structured, self administrated questionnaires including open-ended questions. Significance of preferences were analysed by X2 test. Year I (99%) and Year II (97%) medical students preferred the plastic models as the best approach to learn gross anatomy because of their handleability and portability. Year I dental students (96%) preferred the prosected wet specimens because they were real human structures and well preserved. The preferred and less preferred rates were 86% and 4% for plastic model, 84% and 10% for prosected wet specimen and 77% and 17% for cadaver. These differences were statistically significant (p <0.05). Students didn’t prefer the cadavers most but they agreed that the cadavers are more realistic, informative and easier to remember. This study indicates that students prefer all three types of teaching aids while the most preferred one is the plastic model. The quality of teaching aid is the reason for their preference. Students’ suggestion to use the advanced technologies such as three dimensional animations or simulated videos should be considered to get discernable learning outcomes

Cardiovascular disease risk factors assessment and glycemic control among type-2 diabetes mellitus patients : a comparative study between primary care and diabetic specialist clinic in Kuantan, Pahang

Type-II Diabetes Mellitus (T2DM) patients have high prevalence of cardiovascular disease (CVD) and high morbidity and mortality. They present with other co-morbidity and suffer from its complications. Thus, modifiable cardiovascular risks assessment and glycaemic control should be analyzed for prevention and early intervention

Periodontal health status of Malaysian diabetic children and adolescent: a hospital based case-control study in Kuala Lumpur and Kuantan

Background: factor for periodontal disease (PD). PD includes a spectrum of disorders ranging from gingivitis to periodontitis. If undetected and left untreated the disease can lead to early tooth loss. Assessing PD health is beneficial for keeping good oral health, which affects on glycemic control of the children and adolescent with DM. To evaluate the periodontal health status of Malaysian diabetic children and adolescents compared to healthy controls. Periodontal health related parameters were clinically assessed in 32 children and adolescents (10-19 years of age) with diabetes and 32 non-diabetic control subjects. Age, gender, Body Mass Index (BMI), CDC percentiles and smoking status matching were done and purposive sampling was applied. HbA1C (%) results within 3-6 months before oral health assessment was used to define glycemic control status of the subjects. A cross analysis and Independent sample-t test were applied to infer periodontal health status difference between cases and controls. Most of the cases were Type-1 DM (68.8%) and diagnosed less than five years (68.2%). The cases had manifested an increased gingival inflammation and calculus significantly compared to controls. Regarding PD health assessment; clinical attachment loss (CAL), gingival index (GI), Modified Turesky Quigley Hein plaque index (TQHI) and bleeding on probing (BOP) were not significantly different between cases and controls except for probing pocket depth (PPD); mean of (SE) (1.81±0.13) compared to controls (1.65 ±0.06). Higher mean of (SE) GI (0.9±0.82) were also noticed among cases than those of (0.8±0.11) controls. Periodontal screening & prevention programs at early age for DM children and adolescent should be considered for both oral health and glycemic controls. A further study with controlling; Insulin treatment, types of DM, DM duration, and oral hygiene practice and dietary habits should be conducted for more valid results

Chronic periodontitis patients: their knowledge and its correlation with oral health related quality of life

Level of periodontal diseases knowledge was evaluated among 80 chronic periodontitis (PD) patients and its correlation with patients’ self-perceive OHQoL was investigated. The Malay version of OHQoL-UK was used. Patients’ with high knowledge of PD were of severe chronic periodontitis group (p>0.05); Malay (p<0.05) and had higher economic status (p<0.05). However majority of the high knowledge group perceived no effect of the PD on their OHQoL (p<0.05). Despite that, significant correlation but at lower strength was found between patients’ knowledge and the social aspects of OHQoL [r=0.249, p<0.05]. There were significant different in level of PD knowledge between chronic periodontitis patients with different perception on OHQoL

Maternal knowledge, attitude and practice regarding breastfeeding in Temerloh, Pahang, Malaysia

Background: Although, breast feeding is the best way to feed infant by providing the psychological and health benefit to mother and child, prevalence of practicing exclusive breastfeeding (EBF) for 6months and continuing it up to 2-years varies between countries and within countries from 75% in DPR Korea, Seri Lanka, Cambodia and the Solomon Islands, around half in India and less than 20% were in Thailand and Viet Nam. In Malaysia, national EBF rate in 2011 was 23.7%. Objectives: Aim of this study was to assess maternal knowledge, attitude and practices on exclusive breastfeeding and continuing it up to 2 years including its influencing factors and reasons for discontinuation of breastfeeding before 2-years. Methods: A cross sectional study was carried among 500 mothers of children aged from neonate to 3 years who attended at Maternal and Child Care Clinic, Temeloh, Pahang between July and December 2012. A face-to-face interview was done by using a semi-structured, pre-tested questionnaire including opened type questions to collect data. A cross analysis was done to infer statistical significance of influencing factors which affect pattern of breast feeding in terms of age, occupation, educational level of mother and socio-economic status of family. Results: Out of 500 mothers, 96% of them have knowledge regarding benefits of breastfeeding in general and particularly in characteristics and value of breast milk (91%), mother-infant bonding (77%). Sources of their knowledge were health personal (45.1%), media (20%), family (16.3%), and friends (14%). Regarding attitude, all mothers agreed that breast feeding is ideal food for babies, followed by agreement to feed breast milk to next child (98.6%), being comfortable with breast feeding(96%), encouraging breast feeding by family (95.8%), causing diarrhoea diseases by bottle feeding in babies (79.6), affecting on marital status by breast feeding (37%), feeling embarrassed with breast feeding (30.5), allowing breast feeding at home by employers (27%) and taking leave for breast feeding (12.6%). Regarding practices, 81% of them had early commencement of breast feeding. Exclusive breast feeding rate and continuing breastfeeding up to 2 years of age were 37.2% and 34.5% respectively. The reasons for discontinuing breastfeeding up to 2 years of age were no breast-milk production (81.7%), working mother (63.4%), refusal to feed (46.2%), retracted nipple (14%), maternal sickness (13%) and others reasons (37.6%). Mixed and bottle feeding rate were 54.4% and 22% respectively. The reasons for bottle feeding were no breast-milk production (36.4%), working mother (24.5%), refusal to feed (20%), maternal sickness (5.4%) and others (14.5%). Influence of maternal employment status on EBF was significantly (p <0.05) found out. Monthly family income was related significantly with continuing breastfeeding up to 2 years. Conclusion: EBF rate of Temerloh, Pahang was higher than that of National figure. Nevertheless, need to find out the ways to supports mothers to get higher achievement. The other reasons which influenced on discontinuing breastfeeding should be clarified in further study to get more understanding on the mothers who are unable to provide exclusive breastfeeding and continuing it up to 2 years of their children

Co-morbidity and cardiovascular risk assessment among Type-2 diabetes mellitus patients: A preliminary study at a public primary care clinic in Kuantan, Malaysia

Diabetes mellitus (DM) patients with cardiovascular (CVD) co-morbidity have higher risk of mortality. Hypertensions, dyslipidaemia, ischemic heart disease (IHD) are common CVD co-morbidity for DM patients. This study was done to determine relationship among CVD comorbidity, risk assessment and glycemic control status of type-2 DM patients

Reasons and pattern of tooth extraction in International Islamic University Malaysia, Kulliyyah of Dentistry Polyclinic

Objective: To investigate the reasons and pattern of tooth extraction among patients attending International Islamic University Malaysia, Kulliyyah of Dentistry Polyclinic. Materials and Methods: This is a retrospective study. The patient’s age, gender, race and reason for tooth extraction were recorded. Result: A total 1,036 teeth were extracted. Caries was the main reasons for 53.3% of extractions. The highest number of extraction was observed at age of 21 to 40 years old (44.4%) Females had 56.6%. Malay showed highest extraction case, 85.2%. Conclusion: Dental caries is the main reason for tooth extraction among patients attending IIUM Kulliyyah of Dentistry Polyclinic