There is a growing interest in research on satisfaction with healthcare provider (HCP) and HCP- patient communication as a measure of healthcare quality of HCP’s communication competency. However, many communication assessments were not comprehensive measures and are not entirely accurate in measuring what is supposed to be measured. This study aimed at assessing the validity and reliability of a newly developed HCP-PC instrument in a Malaysian primary care setting. The HCP-PC instrument was developed using items adapted from existing instruments as well as self-developed items. A pilot study involving 277 clients of an outpatient clinic was conducted in HKL using the proposed instrument which was distributed immediately after face to face consultation. The content validity and Cronbach alpha reliability were assessed. Factor analysis constructed 3 components, exchanging information (EI), socioemotional behaviour (SB) and communication style (CS). All items loaded on the corresponding component with factor loading ≥0.6, suggesting that all items in the respective component are measuring the same direction. PCA of the final 30 items explain 61.98% of the total variance with 6.66%, 47.18% and 8.13% explained by EI, SB and CS respectively. Component-based reliability show strong internal consistency with Cronbach alpha, αEI= 0.92, αSB= 0.96 and αCS= 0.70. The pilot study supported the instrument validity and reliability after initial tests. However, further study needs to be done to confirm its construct validity to help establish a valid and reliable HCP-PC instrument for measuring patient satisfaction with HCP-PC that can be used in primary care setting.
Reproducibility of Results ; Health Personnel

Ageing anxiety is commoner among women compared to men. However, little is known on the possible contributing factors towards the development of ageing related anxiety among Malaysian women. This study aimed to explore ageing anxiety among the middle-aged women in Malaysia in facing the ageing process. Series of 6 focus group discussions (FGD) were conducted involving a total of 36 women aged between 35 and 59 years old. Each FGD consisted of 5 to 7 respondents and was conducted for an average of 1 to 2 hours. The respondents were selected using the maximum variation sampling method focussing on five age categories, between 35 to 39, 40 to 44, 45 to 49, 50 to 54 and 55 to 59 years old. Representative from several residential areas in the area of Putrajaya Federal Territory and Seri Kembangan, Selangor were involved in the selection of respondents. The interviews revealed that, majority of the respondents were seriously thinking of the possible negative experiences associated with ageing and being old, but very few experiencing ageing anxiety. Three main themes that were identified to contribute to the ageing anxiety were issues related to caregiving at old age and fear of loneliness, the welfare and care of their children when they are old and eventually die and also physical changes that occurred with ageing process. These themes were not specifically associated with any particular age groups, marital or income status. However, the development of the ageing anxiety was found to be related to their personal experiences and observations from the surrounding community. The findings show that women in Malaysia are still emphasizing on the importance of traditional caregiving system, where elderly parents are looked after by the children or extended family members rather than living in formal institutions. Despite the important role of formal institutions in the care of elderly people in the future, it is still negatively perceived. With the shrinking of the size of nuclear family and massive involvement of women in employment sector, more elderly will be expected to reside in formal institutions in the near future. Relevant authorities should be made aware on the importance to maintain the quality of care in the formal institution for elderly, in order to tackle the negative perceptions.

Nutrition screening is recommended as a first step of nutrition care to allow early identification and intervention of malnourished patients. The present study determined the validities and reliabilities of two malnutrition screening tools namely, the Malnutrition Universal Screening Tool (MUST) and Malnutrition Screening Tool (MST) among adult patients at the Hospital Kuala Lumpur. Methods: The sensitivity, specificity and predictive value of MUST and MST were conducted against the Subjective Global Assessment (SGA), anthropometric parameters including body mass index (BMI), calf circumference (CC),mid-upper arm circumference (MUAC) and energy intake. Inter-rater reliability was evaluated using kappa value (κ) to determine the level of agreement between raters. Results: A total of 151 subjects with mean age of 45.2 ± 13.7 years participated in this study. Prevalence of malnutrition according to MUST, MST and SGA was 34.4%, 33.8% and 19.9%, respectively. As compared to SGA, MUST and MST had a sensitivity of 96.6% and 93.3% respectively, whereas the specificity was 80.9% for both tools. The sensitivity and specificity of MUST against the anthropometric parameters (BMI, CC and MUAC) were between 53.8% to 88.8% and 67.4% to 69.9%, respectively. The sensitivity values for MST were between 46.1% to 63.6% and specificity values were between 64.4% to 67.6%. The inter-rater reliability of MUST was higher (substantial, mean (κ) = 0.78) than for MST (moderate, mean (κ) = 0.52). Conclusions: In conclusion, MUST was found to have similar validity levels but higher reliability result than MST. Based on our result, MUST is recommended for use in identifying adult patients who are at high risk of malnutrition. It can be used as a malnutrition screening tool but there is a need to evaluate the cost effectiveness of its implementation.

A retrospective analysis of 15 cases intracanalicular acoustic neuroma that undergone tumour excision by translabyrinthine approach spanning from August 1996 until December 2002 is presented. The main presenting complaints are unilateral hearing loss (100%) and tinnitus (86.7%). The mean age of presentation was 48.5 years old. Magnetic resonance imaging is the most important investigation tool to diagnose acoustic neuroma. At six months post operatively, the facial nerve was normal or near normal (grade I and II) in 46.6%, grade III to IV in 46.6% and grade V to VI in 6.7% of the cases respectively. There were also four cases of post operative cerebrospinal fluid leak, which was successfully managed with conservative measures. The translabyrinthine approach is the most familiar surgical technique employed by otologist. It is the most direct route to the cerebellopontine angle and internal auditory canal. It requires minimum cerebellar retraction. However, it sacrifices any residual hearing in the operated ear.
Neuroma, Acoustic ; Grade ; seconds ; Complications Specific to Antepartum or Postpartum ; sacrifice

Pericardial cysts occur rarely, with an incidence rate of 1 per 100,000. They are usually detected by chance and clinically silent in most cases. Pericardial cysts are the most common benign tumours of the pericardium and presents by the third or fourth decade of life, and equally common in males and females. In principle, they only require follow-up, however, an enlarging or symptomatic cyst requires surgical removal. We report a case of a 32 year-old Malay lady, who presented with history of recurrent pericardial effusion followed by right pleural effusion. Computed tomography (CT) thorax identified a large mediastinal cyst as the cause of her problem, requiring exploratory thoracotomy.

The importance of Campylobacter and Salmonella as foodborne pathogens is well recognised globally. A recent work in Penang found ducks in commercial farms were infected with these organisms. The aim of the study was to detect the presence of Campylobacter and Salmonella in ducks and Salmonella in duck eggs in farms in a small part of Selangor. Cloacal swabs were obtained from 75 ducks and 30 duck eggs from three farms. The isolation and identification of Campylobacter and Salmonella were done using conventional methods. Twelve percent of Campylobacter and 16.0% of Salmonella were isolated from the ducks sampled. Salmonella was absent on and in eggs. Campylobacter isolates consisted of 22% Campylobacter jejuni and the remaining was Campylobacter coli. Three Salmonella serovars identified were Salmonella Agona, S. Braenderup and S. Corvallis. The presence of Campylobacter and Salmonella in ducks may cause contamination of the meat during processing and handling which can constitute public health hazard. Moreover, the farm workers may be exposed to the organisms through contact with the infected animals.

Pericardial cysts occur rarely, with an incidence rate of 1 per 100,000. They are usually detected by chance and clinically silent in most cases. Pericardial cysts are the most common benign tumours of the pericardium and presents by the third or fourth decade of life, and equally common in males and females. In principle, they only require follow-up, however, an enlarging or symptomatic cyst requires surgical removal. We report a case of a 32 year-old Malay lady, who presented with history of recurrent pericardial effusion followed by right pleural effusion. Computed tomography (CT) thorax identified a large mediastinal cyst as the cause of her problem, requiring exploratory thoracotomy.

No abstract available.

The furnishings provided by the Institute of Higher Learning (IHL) are not suitable with the diverse student’s body shapes. This could leads to lack of comfort in usage of the furnishings as well as affecting the effectiveness of the delivery of the lectures. Therefore, the objectives of this study are to evaluate the student’s comfort level in the current seat of the Lecture Theatre (LT) and to gather student’s anthropometry data. Two hundred and twenty one students were involved in this study from one of the IHL in Selangor. A few similar design of LT were chosen for this study. The Standard Nordic Questionnaire was used to identify the comfort level of students. Eleven body parts measurements of all participated students were collected by using measurement apparatus such as callipers and ruler. Based on the findings, it showed that the current seat in LT is uncomfortable to be used, in line with the results from surveys and mismatch of the seat and student measurement data.

Breast cancer is the most common cancer among Malaysian women. This study aimed to determine the reproductive for premenopausal breast cancer risk in Kuala Lumpur, Malaysia. A case-control study was conducted in 216 histopathologically confirmed cases of premenopausal breast cancer and 216 community-based controls that were matched by age within a 5-year period and ethnicity. The results of this study showed that premenopausal breast cancer risks were strongly related to parity, number of live births and family history of breast cancer. Premenopausal women with these known reproductive and family history risk factors should take extra measures to undergo appropriate screening method for early detection of breast cancer