Satisfaction With Health Care Services at the Pediatric Specialist Clinic of the National Referral Center in Malaysia: Cross-sectional Study of Caregivers' Perspectives.

Background: The concept of customer satisfaction is gaining hold in all corporate sectors worldwide, and a satisfaction survey is used as a tool to discover service problems and as a chance for customers to rate their experience with health care services. A high degree of patient satisfaction with the services given has been found in numerous studies conducted in Malaysian public health care facilities. However, there is limited information available on caregiver satisfaction with pediatric clinics run by the Ministry of Health (MoH) of Malaysia.

Stiff Person-Like Syndrome: An Unusual Presentation of Pituitary Macroadenoma with Panhypopituitarism.

Pituitary adenoma can manifest as pituitary hypofunction, which can cause symptoms of panhypopituitarism. Commonly, symptoms of hormonal deficiencies such as lethargy, weight change, cold intolerance, and sexual dysfunction are reported. Optic chiasmal compression leads to visual field changes and the discovery of the pituitary lesion.

Case scenario: Management of major depressive disorder in primary care based on the updated Malaysian clinical practice guidelines.

Major depressive disorder (MDD) is a common but complex illness that is frequently presented in the primary care setting. Managing this disorder in primary care can be difficult, and many patients are underdiagnosed and/or undertreated. The Malaysian (2nd ed.

Translation and Validation of the Malay Version of the WHO-5 Well-Being Index: Reliability and Validity Evidence from a Sample of Type 2 Diabetes Mellitus Patients.

The translation and validation process of the WHO-5 Well-Being Index (WHO-5) into Malay is still not yet available. This study is the first psychometric evaluation of the Malay version of the WHO-5 in a sample of 127 primary care patients with type 2 diabetes mellitus. We evaluated the internal consistency and 5-week test-retest reliability of the WHO-5 Malay, and three aspects of its validity-first, the factorial validity in relation to the factor structure of the WHO-5 Malay; second, the concurrent validity in relation to depression and diabetes-related distress; and third, the convergent validity in relation to diabetes management self-efficacy and diabetes self-care behaviors.

TG: HDL-C Ratio as Insulin Resistance Marker for Metabolic Syndrome in Children With Obesity.

Insulin resistance (IR) is an important variable in the diagnosis of metabolic syndrome (MetS). Currently, IR is not part of the existing pediatric definition of MetS, instead elevated fasting blood glucose (FBG) is measured as an indicator of hyperglycemia. Arguably, many obese children with severe IR are still able to regulate their FBG well.

Peptide receptor radionuclide therapy induced carcinoid crisis: A case report.

Peptide receptor radionuclide therapy (PRRT) is a therapeutic option in inoperable or metastatic neuroendocrine tumours (NETs). PRRT proved to be promising in prolonging survival and delaying disease progression in patients with advanced bronchopulmonary carcinoid. However, it may lead to worsening of carcinoid symptoms or even precipitate carcinoid crises.

The effect of game-based in comparison to conventional circuit exercise on functions, motivation level, self-efficacy and quality of life among stroke survivors.

Introduction: Stroke survivors are commonly at risk of functional decline, which increase their dependency in activities of daily living and eventually affects their motivation level, self-efficacy, and quality of life. Circuit exercise has been shown to be useful in enhancing functional performance and quality of life of chronic stroke survivors. There is a need to review the existing "usual circuit exercise" and develop a better approach, such as game-based circuit exercise.

Diabetes and Ramadan: Practical guidelines 2021.

Fasting during Ramadan is one of the five pillars of Islam and is obligatory for all healthy Muslims from the age of puberty. Though individuals with some illness and serious medical conditions, including some people with diabetes, can be exempted from fasting, many will fast anyway. It is of paramount importance that people with diabetes that fast are given the appropriate guidance and receive proper care.

Acute Suppurative Thyroiditis Secondary to Tuberculosis with Superimposed Bacterial Infection: A Case Report.

Acute suppurative thyroiditis is a rare and potentially fatal condition. We present a case of an 18-year-old Malay female who presented with one-week history of painful right sided neck swelling, fever and odynophagia. Neck CT confirms ruptured multiloculated abscess with posterosuperior extension into prevertebral space.

Surgical subspecialty training outside Malaysia during COVID-19 Pandemic: Perspectives and experiences of Trainees.

Subspecialty surgical training is an integral part of continuous professional development. It represents a unique opportunity for surgeons to enhance and develop specific advanced skills in their sub-disciplines. Hence, hands-on training in an international training centre abroad allows one to bring home new technical and management skills in the expansion of Malaysian surgical services to raise to be on par with the international standards.

Elucidating factors influencing machine learning algorithm prediction in spasticity assessment: a prospective observational study.

The Machine Learning Model (MLM) has garnered popularity in rehabilitation, ranging from developing algorithms in outcome prediction, prognostication, and training artificial intelligence. High-quality data plays a critical role in algorithm development. Limited studies have explored factors that may influence the MLM algorithm performance in predicting spasticity severity level.

Expression of Autophagy and Mitophagy Markers in Breast Cancer Tissues.

Mitochondria play important roles in regulating cell bioenergetics status and reactive oxygen species (ROS) generation. ROS-induced mitochondrial damage is among the main intracellular signal inducers of autophagy. Autophagy is a cellular catabolic process that regulates protein and organelle turnover, while a selective form of autophagy, mitophagy, specifically targets dysfunctional mitochondrial degradation.

Giant Parathyroid Adenoma versus Parathyroid Carcinoma: Differentiating Two Entities.

Giant parathyroid adenoma (GPA) is defined as adenoma larger than 3.5 g. Twenty-one cases of parathyroid mass >3.

Ectopic Cushing's Syndrome secondary to Recurrent Thymic Neuroendocrine Carcinoma with Bilateral Ovarian Metastases: A Case Report.

Cushing's syndrome due to ectopic adrenocorticotrophic hormone (ACTH) secretion is uncommon, accounting for 9 to 18% of cases; approximately 10% of ACTH producing tumours are caused by thymic carcinomas. We describe a young lady who presented with Cushing's syndrome secondary to a primary neuroendocrine tumour (NET) arising from the thymus. She had surgical resection of her primary tumour with remission of her Cushing's syndrome however subsequently went on to have locoregional recurrence followed by distant metastases to her bilateral ovaries.

Effects of Concurrent Tasks on Gait Performance in Children With Traumatic Brain Injury Versus Children With Typical Development.

Objective: To investigate how gait parameters in children with traumatic brain injury (TBI) versus typically developing (TD) children are influenced by secondary concurrent tasks and examine the correlations between gait parameters and attention and balance in children with TBI.

Methods: Sixteen children with TBI (mean age, 11.63±1.

Correlation between Hounsfield unit derived from head, thorax, abdomen, spine and pelvis CT and t-scores from DXA.

Objectives: CT examination can potentially be utilised for early detection of bone density changes with no additional procedure and radiation dose. We hypothesise that the Hounsfield unit (HU) measured from CT images is correlated to the t-scores derived from dual energy X-ray absorptiometry (DXA) in multiple anatomic regions.

Materials & Methods: Data were obtained retrospectively from all patients who underwent both CT examinations - brain (frontal bone), thorax (T7), abdomen (L3), spine (T7 & L3) or pelvis (left hip) - and DXA between 2014 and 2018 in our centre.

Malaysian clinical practice guidelines for management of diabetic foot: A synopsis for the primary care physician.

Diabetic foot requires careful attention and coordinated management by a dedicated team. Screening, prevention, adequate assessment, and appropriate referral are crucial to prevent complications. Multimodal treatment and rehabilitation are recommended to ensure a better quality of life and reduction of amputation rate in people with diabetic foot.

Presumed diffuse unilateral subacute neuroretinitis and cat-scratch disease: Dual infection in a single patient.

A healthy 35-year-old Malay woman presented with left eye pain for 1 week, and ocular examination showed evidence of panuveitis. She had granulomatous type of anterior uveitis with secondary high intraocular pressure (IOP). Fundus showed optic disc swelling, mild vitritis, and multiple subretinal lesions, which later formed a migratory track.

Use of Composite Outcomes in Neonatal Trials: An Analysis of the Cochrane Reviews.

Introduction: Composite outcomes are used to increase the power of a study by combining event rates. Many composite outcomes in adult clinical trials have components that differ substantially in patient importance, event rate, and effect size, making interpretation challenging. Little is known about the use of composite outcomes in neonatal randomized controlled trials (RCTs).

Development of the rural Palliative Care Services by the Kuala Lipis District Hospital.

In recognising the palliative care (PC) needs globally and in Malaysia, services were developed to serve the rural area of Kuala Lipis, Pahang. This communication describes the initial a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, stages of development towards achieving a successful implementation. PC services were led by Kuala Lipis district hospital include inpatient referrals, outpatient and community care through home visits.

Perception of nurses on the practice environment: experience from Malaysia.

Introduction: Positive professional practice environments are crucial to safeguard a healthy and safe working conditions for health workforce, including nurses; so as to ensure provision of quality healthcare and safety of patient.

Methods: This was a cross-sectional study to assess nurses' perceptions towards nursing practice environment and factors associated with their perceptions. A validated Practice Environment Scale of the Nursing Work Index (PESNWI) questionnaire was administered to nurses working in two Ministry of Health hospitals.