Full blood count values in adolescents and its comparison by gender and ethnicity in Seremban district, Malaysia.

BACKGROUND: Adolescence is when an individual undergoes development and growth. Many studies suggest variations in the number and size of blood cells during this period in various individuals. The full blood count (FBC) is often the starting point of medical investigations, which help diagnose a wide range of illnesses, infections, and diseases. This study aimed to report the mean FBC values and compare them by gender and ethnicity, using blood results from the thalassemia screening programme in Seremban District, Malaysia. MATERIALS AND METHODS: This cross-sectional study used secondary data from the thalassemia screening programme on Form 4 students aged 15-16 years from January 2018 to October 2018 by the Seremban District Health Office, Malaysia. These students participated in the thalassemia screening programme in which their blood samples were taken for FBC analysis. The data were extracted for this study. RESULTS: There were statistically significant gender-based differences for total white blood cell (WBC) count, neutrophils, lymphocytes, mixed WBC, and platelets. It was also observed that ethnic-specific differences were statistically significant for RBC count, platelets, platelet distribution width and mean platelet volume. CONCLUSION: This study was able to report the mean FBC values among Malaysian adolescents with respect to their gender and ethnicity, of which there is a lack of published data.

Awareness of Colorectal Cancer among the Urban Population in the Klang Valley.

BACKGROUND: Colorectal cancer (CRC) is the second most common cancer in Malaysia. Awareness of risk factors, symptoms and warning signs of CRC will help in early detection. This paper presents the level of CRC awareness among the urban population in Malaysia. METHOD: A cross-sectional study was conducted from November 2015 till December 2016 at three government clinics in the Klang Valley. The validated Bowel Cancer Awareness Measure questionnaire in both English and Malay was used. The mean knowledge scores for the warning signs and risk factors of CRC in different socio-demographic groups were compared using ANOVA in SPSS version 23. Statistical significance was set at p<0.05 and a 95% confidence level. RESULTS: Of the 426 respondents, 29.1% were unable to recall the warning signs and symptoms of CRC. Average recall was less than two warning signs and symptoms (mean 1.62, SD 1.33). The mean total knowledge score for CRC was 9.91 (SD 4.78), with a mean knowledge scores for warning signs and risk factors at 5.27 (SD 2.74) and 4.64 (SD 2.78), respectively. Respondents with a higher level of education were found to have higher level of knowledge regarding the warning signs of CRC. There was a significant positive association between knowledge score for warning signs and level of confidence in detecting warning signs. Regarding the total knowledge score for CRC, 3.3% of respondents scored zero. For warning signs and risk factors, 8.2% and 8.5% of respondents had zero knowledge scores, respectively. CONCLUSIONS: Generally, awareness of CRC is poor among the urban population of Klang Valley. Greater education and more confidence in detecting warning signs are significantly associated with better knowledge of warning signs. CRC awareness programs should be increased to improve awareness.

Morbidity and process of care in urban Malaysian general practice: the impact of payment system.

BACKGROUND: The majority of primary care consultations in Malaysia occur in the general practice clinics. To date, there is no comprehensive documentation of the morbidity and practice activities in this setting. OBJECTIVES: We reported the reasons for encounter, diagnoses and process of care in urban general practice and the influence of payment system on the morbidity and practice activities. METHODS: 115 clinics in Kuala Lumpur, Ipoh and Penang participated in this study. General practitioners in these clinics completed a 2-page questionnaire for each of the 30 consecutive patients. The questionnaire requested for the following information: demographic data, reasons for encounter, important physical findings, diagnoses, investigations ordered, outpatient procedures performed, medical certificate given, medication prescribed and referral made. The morbidity (reasons for encounter and diagnoses) was coded using ICPC-2 and the medication data was coded using MIMS Classification Index. RESULTS: During 3481 encounters, 5300 RFEs (152 RFEs per 100 encounters) and 3342 diagnoses (96 diagnoses per 100 encounters) were recorded. The majority of the RFEs and diagnoses are in the following ICPC Chapters: Respiratory, General and unspecified, Digestive, Neurological, Musculoskeletal and Skin. The frequencies of selected aspects of the process of care (rate per 100 encounters) were: laboratory investigations 14.7, outpatient procedures 2.4, sick certification 26.9, referral 2.4, and medication prescription 244. Consultation for chronic diseases and acute infections were influenced more by demographic variables (age, employment) rather than payment system. Cash-paying patients were more likely to receive laboratory investigations and injections. CONCLUSION: This study demonstrated the breadth of clinical care in the general practice. Relatively fewer patients consulted specifically for preventive care and treatment of chronic diseases. The frequencies of outpatient procedures and referrals appeared to be low. Payment system results in important differences in patient mix and influences some types of practice activities.

Breastfeeding and the use of maternal health services in Sarawak.

PIP: In Malaysia, a demographer analyzed data on 1583 children born to 1047 15-49 year old mothers in the 5 years before the 1989 Population and Family Survey was conducted in all districts of Sarawak, except Belaga. She examined the relationship between use of maternal health services, including contraception, and the breast feeding pattern. Most women used prenatal care and postnatal care services (98.2% and 82.6%, respectively). The mean duration of breast feeding was only 6.13 months while the median duration was even shorter (3 months). Mothers who received prenatal care were more likely to initiate breast feeding than those who received no prenatal care (84.1% vs. 75%), but their duration of breast feeding was much shorter (median, 5 vs. 14.3 months). Women who delivered at a private hospital compared to those who delivered elsewhere were less likely to initiate breast feeding (70.6% vs. 84.6-88.9%) and breast feed for a shorter period of time (median, 2.36 vs. 4.41-13.56 months). Nurses in private hospitals care for newborns in a separate room and give prelacteal feeds, particularly commercial infant formula, which jeopardizes mothers' initiation of breast feeding. Women who were assisted by a physician had the lowest rate of initiation of breast feeding (70.5% vs. 86.2-92.4%) and the shortest duration of breast feeding (2.68 vs. 4.67-14.55 months). Women who had ever used contraception compared to those who had never used contraception were somewhat less likely to initiate breast feeding (83.2% vs. 87.5%) and breast feed for a shorter time (4.29 vs. 12.82 months). These results suggest that the government needs to change its policies on health services to promote breast feeding. It should target health personnel and clients in the private sector and family planning workers.^ieng