Introduction Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. A physician must recognize responsibility to patients first and foremost, as well as to society, to other health professionals, and to self. This paper presents some information regarding medical ethics, including the values and principles of ethical conduct. Later the requirements of consent form is presented to guide the researchers before conducting a study.
Introduction: The transboundary smoke haze has become a major concern as it had a wide ranging impact in Southeast Asia from the aspect of public health to national economics. This review aims to synthesize available literature in epidemiology, economics and haze related studies to provide essential information for the valuation of health costs associated with haze in Malaysia. Methods: Evidence on health economic impact of haze was gathered by conducting a literature review and collecting information on the health effects of haze and the cost of it as well as the hospitalization cost from medical illnesses and hospital admissions due to haze. Articles were taken from those that were published from 1999 to 2016.Results: The 1997 Asian Haze episode has caused increasing trend of prematurity of mortality and respiratory problems and several series of haze later had caused increased number of hospitalization. The cost impact on hospital admission ranges from MYR1.8 million in 2005 to MYR118.9 million in 2013. During the 1997 haze, the incremental cost of illness (COI) was noted to be MYR 21million and it shot up to MYR 410 million during the 2013 haze. Conclusion: The haze gives a serious health effect to our country and our neighbours. These health effect has caused a significant health economy impact which include rise in hospital admission cost and medication, incremental cost of illness and extend to cost of medical-related leaves taken and lead to loss of income opportunities.
Subclinical hypothyroidism (SHT) is a biochemical diagnosis, defined as an elevated Thyroid Stimulating Hormone (TSH) with normal free thyroxine (FT4). It affects 4-10% of the adult population and is more prevalent in elderly women. Its commonest cause is autoimmune thyroiditis, detected by anti- thyroid peroxidase antibody (TPO-Ab). About 2-5% of SHT patients progress to overt hypothyroidism annually. The SHT prevalence among depressed patients ranges between 3% and 17%. This study aimed to determine the prevalence of SHT and TPO-Ab positivity among patients diagnosed with depressive disorders. It was a cross-sectional study carried out in the Universiti Kebangsaan Malaysia Medical Centre over a 12 months period. Serum TSH, FT4 and TPO-Ab were measured. Results showed that 82% of depressed patients were euthyroid, 4% had SHT, 11% had subclinical hyperthyroidism and 2% had discordant thyroid function. TPO-Ab positivity among the subjects was 7%, one of whom had SHT. In conclusion, the prevalence of SHT and TPO-Ab positivity in the study population, at 4% and 7%, respectively, were comparable to previous findings.
Introduction The availability of obesity specific quality of life measurement tool is limited. The Malay version of Impact of Weight on Quality of Life-Lite is an obesity specific quality of life questionnaire which has been translated for use in Malaysia. The aim of this study is to evaluate the validity and reliability of this questionnaire to measure quality of life among different body mass index (BMI) groups.
Methods One hundred and twenty subjects with different BMI categories who attended an outpatient government clinic were recruited for this study. The translated Malay version of IWQOL-Lite was used to assess the impact of weight on quality of life of respondents. Content validity, criterion validity and construct validity were used to assess the questionnaire validity while internal consistencies and test-retest reliability were used to assess the questionnaire reliability.
Results The Malay version of IWQOL-Lite showed good psychometric properties. The content validity was agreed upon by expert panels. The mean score of all IWQOL-Lite domains were able to discriminate between different BMI groups. Good internal consistency was demonstrated by Cronbach alpha of 0.936. Test-retest reliability ranged from 0.828 to 0.932. The physical function score (IWQOL-Lite) correlated positively with Physical Component Summary of Short Form-36 questionnaire. Exploratory factor analysis found that the questions loaded on their respective five domains.
Conclusions The results suggested that the Malay version of IWQOL-Lite is a valid and reliable tool to measure quality of life among obese and overweight subjects in Malaysia.
The aim of this study was to determine the occurrence of renal cortical scarring and chronic kidney disease (CKD) in children with neurogenic bladder secondary to spina bifida (SB) managed at the Universiti Kebangsaan Malaysia Medical Centre. The secondary objective was to identify the clinical factors associated with these adverse outcomes.
The paucity of published literature on periodontal treatment needs and services in developing countries has undermined the significance of periodontal disease burden on healthcare systems. This study analyses periodontal status and population treatment needs of Malaysians, and patterns of periodontal services provided at public sector dental clinics. A retrospective approach to secondary data analysis was employed. Data for population treatment needs were extracted from three decennial national oral health surveys for adults (1990, 2000 and 2010). Annual reports from the dental subsystem of the government Health Information Management System (HIMS) provided information on oral health care delivery for years 2006-2010. They were based on summaries of aggregated data; analyses were limited to reporting absolute numbers and frequency distributions. Periodontal disease prevalence declined between 1990 (92.8%) to 2000 (87.2%) but a sharp rise was observed in the 2010 survey (94.0%). The proportion of participants demonstrating periodontal pockets of 6 mm and more increased in 2010 survey after showing improvements in 2000. Individuals not requiring periodontal treatment (TN0) increased in proportion from 1990 to 2000, only to drop in 2010. An increase in utilisation was observed alongside a growing uptake of periodontal procedures (62.2% in 2006 to 73.6% in 2010). Only about 10% of treatment was surgeries. While the clinical burden of periodontal disease is observed to be substantial, the types of treatment provided did not reflect the increasing needs for complex periodontal treatment. Emphasis on downstream and multi-collaborative efforts of oral health care is deemed fit to contain the burden of periodontal disease.
Health system reform has been a major concern for different countries. The aim of this research was to develop a reliable and valid questionnaire suitable to assess the consequences of health reform process from people's perspective. An extensive literature review used to extract a set of statements as possible indicators for health system reform. Expert panel used to determine the content validity rate (CVR) and the content validity index (CVI). The first version produced in Turkish language and pre-piloted with 20 heads of household. Qualified committee used to translate the Turkish version to English version. Group of eighteen academics and graduate students recruited to tests both versions for parallel test validity. The construct validity of the questionnaire was determined using principal components analysis with Varimax rotation method (PCA). Internal consistency and questionnaire's reliability were calculated by Cronbach's alpha and the test–retest reliability test. A 17- items questionnaire was developed through the qualitative phase. The Bartlett's test was significant (p < 0.001), and the KMO value (0.842) showed that using principal component analysis (PCA) was suitable. Eigenvalues equal or higher than 1 were considered significant and chosen for interpretation. By PCA, 4 factors were extracted (accessibility, attitude and preference, quality of care and availability of resources) that jointly accounted for 85.2% of observed variance. The Cronbach's alpha coefficient showed excellent internal consistency (alpha=0.97), and test-retest of the scale with 2-weeks intervals indicated an appropriate stability for the scale (Intra-class coefficient = 0.96). The findings showed that the designed questionnaire was valid and reliable and can be used easily to assess the consequences of health reform process by comparing the situation before and after the reform from people's perspective.
There is high expectation from the population on part of the healthcare providers. These include; skilful and timely medication administration; and knowledge, honesty, listening skills, availability and professional attitude. The aim of this paper is to evaluate the expectation of population with regards to the healthcare providers in Turkey. A cross- sectional study was conducted in Turkey, including both rural and urban population, carried out from October 2011 till January 2012. A total of 540 household heads were selected using multistage random sampling technique. Data was collected using modified self-administered 16-items QUOTE (Quality of Care Through the Patients’ Eyes) questionnaire. The questionnaire measures communication/ accessibility, organizational skills and professional skills. The response rate was (77.1%) and data was analyzed by using SPSS version 16.0. All the aspects measured using QUOTE questionnaire were found to be important by the majority of respondents, but with varying degrees of priority. The quality aspects related to the professional skills of physicians was ranked first followed by communication/ accessibility and last but not the least is the organizational skills of health care providers. This study explored the Turkish people priorities and expectations regarding healthcare providers. The public priorities and expectation were different across population. This may reflect the need to understand people's expectations before providing the services to avoid complaints that may occur after the services have been rendered.