Getting appropriate healthcare is a challenge to the citizens in Malaysia due to the limited facilities, healthcare providers, and cost of healthcare. Uberization of healthcare will help fill this gap. Uberization helps modify the market or economic model with the introduction of a cheaper and more effective alternative service by introducing a different way of buying or using it, with the use of mobile technology. With powerful artificial intelligence engines operating on cloud servers, mobile apps can provide a better healthcare experience for patients. With uberization application, the patient need not come to the hospital to see a doctor before a treatment can be planned. Once a request is made by the patient, the healthcare providers can come to see the patient at an agreed place. This article aims to explore the possible uberization of healthcare in Malaysia.
Anaphylactic reaction towards antibiotics is common during anaesthesia. It may present as bronchospasm, hypotension, desaturation, or urticarial. However it is uncommon for anaphylaxis reaction to present only as supraventricular tachycardia (SVT). This is a rare interesting case report on a 23-year-old healthy man whose anaesthetic categorization is American Society of Anaesthesiologist (ASA) 1, developed supraventricular tachycardia (SVT) towards intravenous cefuroxime, peri operatively. His condition resolved with carotid sinus massage. No pharmacological interventions were used. His skin prick intradermal tests showed allergies towards cefuroxime, cefazoline and cefoperazone. The patient subsequently underwent.
Swallowing involves 55 muscles, five cranial nerves and two cervical nerve roots. When the coordination of this reflex is disturbed, dysphagia occurs. Dysphagia refers either to the difficulty someone may have with the initial phases of a swallow or to the sensation that the foods or the liquids are being obstructed in their passage from the mouth to the stomach. The objective of the study was to identify the diagnosis of patients attending Speech Therapy clinic, in Queen Elizabeth Hospital, Kota Kinabalu, Sabah, and to identify the demography of dysphagic patients. From the 406 patients that came during the study period, 139 patients (34.2%) were diagnosed with dysphagia, followed by developmental language disorders (33.3%). Of the 139 patients diagnosed with dysphagia, most of them are within the 41 to 60 (43.2%) and above 60 (42.2%) age groups. The majority were males (66.2%). A total of 81 (58.3%) patients with dysphagia had a history of cerebrovascular accident. Dysphagia is a common disorder among patients attending Speech Therapy Clinics at Queen Elizabeth Hospital, Kota Kinabalu. Training of Speech Therapists and early dysphagia intervention leads to a better outcome.
A 38-year-old man with an underlying psychiatric illness presented with altered sensorium and abnormal behaviour. He was febrile at 38°C and weak looking; otherwise no other abnormalities were detected. A blood film conducted for malarial parasite (BFMP) revealed Plasmodium falciparum; hence a diagnosis of cerebral malaria was made. He was treated with antimalarial drugs for 2 days prior to being transferred out to the ward following clinical improvement. He subsequently developed episodes of stupor and refusal of feeding. Following an evaluation by the psychiatrist, a diagnosis of catatonic schizophrenia was made and he was started on oral sulpiride and benhexol. Unfortunately, he developed high-grade fever at 40°C with muscle rigidity and fasciculation. The diagnosis of neuroleptic malignant syndrome (NMS) was clinched and the antipsychotics were discontinued. However he succumbed to NMS several days later due to multiorgan failure.
Introduction: Nutrition is an issue of great academic and public importance. However, there is evidence that parents do not have family breakfast, lunch or dinner with their children. This study aims to assess the prevalence of having regular family breakfast, lunch, dinner among primary school children age 7 to 12 years in Kota Kinabalu and its association with children’s weight status. Methods: The study is based on 485 children (mean age: 11.5+/-0.7 years, 54% girls) randomly selected in five primary schools in Kota Kinabalu who participated in a cross-sectional school- based survey in 2019. Data on family meals were self-reported by the parents by answering a validated question- naire. Children’s height and weight were measured to determine BMI status. Binary regression analyses assessed the associations of having regular family meals with children’s obesity status and to assess potential differences in having family meals according to gender and parental education. Results: The mean BMI male gender 24.3 ± 4.05 versus mean BMI female gender 17.9 ± 3.62 from 7 to 12 years old. The father mean BMI was 33.2 ± 8.24 versus 26.17 ±
9.63 mean BMI in mother from 32 to 52 years old. The prevalence of obesity within five (5) selected schools in Kota Kinabalu was only 13.2%. Regarding potential socio-demographic determinants, children of higher educated parents (STPM, DIPLOMA)[OR = 1.85 (95% CI 1.20–2.85)] were more likely to have breakfast together, while children of lower educated parents (SRP, SPM) [OR = 1.08 (95% CI 0.91–1.44)] were more likely to have dinner together. No significant associations of having family meals with gender observed. The prevalence of regular family meals was 94.6%, 74.17% and 93.8% for breakfast, lunch and dinner respectively. Conclusion: This study showed that having regular family breakfast, lunch and dinner was associated with children normal BMI between 18.50-24.99.