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Biomedical subjects

A B Suleiman

Publications and source records attributed to A B Suleiman.

At least 19 recordsLinked to original sources
PubMed2001

The untapped potential of Telehealth.

The people of Malaysia generally enjoy a high standard of health. This is largely attributed to the comprehensive range of health services provided by the Government and the private sector at affordable costs. However, there are changing trends that now seriously challenge this status quo. The changing population structure, lifestyle, disease patterns and globalization are causing healthcare costs to rise. New and innovative ways will have to be devised to further improve the health status and at the same time contain costs. Information and Communication Technology (ICT) presents unprecedented opportunities to help the health sector in Malaysia reinvent itself and transform the way health and healthcare is managed and delivered in the future. Malaysia's Telehealth initiative under the Multimedia Super Corridor (MSC) project is designed to realize Malaysia's health vision and goals and meet future health challenges. Multimedia and Internet technology will be fully harnessed to deploy services that will shift the emphasis from episodic management of illness to proactive promotion of lifelong wellness and disease prevention. Health information content and interactive applications will engage the people to work as partners of health with healthcare professionals in maintaining their own health or managing their illnesses.

Delivery of Health Care, Integrated↗
PubMed2000

Deaths of children during an outbreak of hand, foot, and mouth disease in sarawak, malaysia: clinical and pathological characteristics of the disease. For the Outbreak Study Group.

From April through June 1997, 29 previously healthy children aged <6 years (median, 1.5 years) in Sarawak, Malaysia, died of rapidly progressive cardiorespiratory failure during an outbreak of hand, foot, and mouth disease caused primarily by enterovirus 71 (EV71). The case children were hospitalized after a short illness (median duration, 2 days) that usually included fever (in 100% of case children), oral ulcers (66%), and extremity rashes (62%). The illness rapidly progressed to include seizures (28%), flaccid limb weakness (17%), or cardiopulmonary symptoms (of 24 children, 17 had chest radiographs showing pulmonary edema, and 24 had echocardiograms showing left ventricular dysfunction), resulting in cardiopulmonary arrest soon after hospitalization (median time, 9 h). Cardiac tissue from 10 patients showed normal myocardium, but central nervous system tissue from 5 patients showed inflammatory changes. Brain-stem specimens from 2 patients were available, and both specimens showed extensive neuronal degeneration, inflammation, and necrosis, suggesting that a central nervous system infection was responsible for the disease, with the cardiopulmonary dysfunction being neurogenic in origin. EV71 and possibly an adenovirus, other enteroviruses, or unknown cofactors are likely responsible for this rapidly fatal disease.

Antigens, Viral↗
PubMed2000

Distribution of blood glucose in a national sample of Malaysian adults.

We describe the distribution of capillary blood glucose (BG) by age, sex and ethnicity in Malaysian adults. A national sample of 20,041 individuals aged 30 or older had usable data. They were selected by stratified 2-stage cluster sampling. BG was measured using reflectance photometer. Percentile tables and curves by age, sex and ethnicity are presented. The BG distribution was right skewed and showed the expected increase with age. Except in Indian, women had higher BG than men. There were also marked ethnic differences. Indian had the highest BG concentration, followed by Chinese, Malay and other indigenous ethnic group.

Adult↗
PubMed2000

Distribution of blood total cholesterol in a national sample of Malaysian adults.

We describe the distribution of capillary blood total cholesterol (BC) by age, sex and ethnicity in Malaysian adults. A national sample of 20,041 individuals aged 30 or older had usable data. They were selected by stratified 2-stage cluster sampling. BC was measured using reflectance photometer. Percentile tables and curves by age, sex and ethnicity are presented. The BC distribution was right skewed and showed the expected increase with age. There were ethnic differences. Malay had the highest BC concentration, followed by Indian, Chinese and other indigenous ethnic group. However, for all ethnic groups, BC concentrations were low in comparison those prevailing in Western populations.

Adult↗
PubMed2000

Distribution of blood pressure in a national sample of Malaysian adults.

We describe the distribution of blood pressure (BP) by age, sex and ethnicity in Malaysian adults. A national sample of 21,391 individuals aged 30 or older had usable data. They were selected by stratified 2-stage cluster sampling. BP was measured using an automated oscillometric device, Visomat. Percentile tables and curves by age, sex and ethnicity are presented. The systolic and diastolic BP distribution was right skewed and showed the expected increase with age. This was markedly so in Malay and other indigenous women; as a result they had most severe hypertension.

Adult↗
PubMed2000

Distribution of body weight, height and body mass index in a national sample of Malaysian adults.

We describe the distribution of body weight, height and body mass index (BMI) by age, sex and ethnicity in Malaysian adults. A national sample of 28,737 individuals aged 20 or older had usable data. They were selected by stratified 2-stage cluster sampling. Percentile tables and curves by age, sex and ethnicity are presented. The body weight and BMI distributions were right skewed, while that of height was symmetrical. BMI distribution showed the expected increase with age, while that of height decrease with age. Differences in BMI between the 2 sexes and among the 4 ethnic groups were observed. Indian had the highest BMI, followed by Malay, Chinese and other indigenous ethnic group.

Adult↗
PubMed1999

Missions of a medical school: an Asian perspective.

This case study of medical schools in Malaysia addresses their role in meeting the demands of a young nation. Throughout the growth and development of these medical schools, there have been efforts to coordinate and cooperate with providers of health care. The treatment of illness must mesh with the changing paradigm of health and wellness as an achievable and indeed desirable goal, not only for the individual but also for society. The scientific basis of medicine is being emphasized with the advent of evidence-based medicine and outcome measures. Innovations have been made to bring the schools in closer contact with the service providers. Malaysia has prepared farsighted plans to become a developed nation by the year 2020. Accordingly, its health services will use advances in information technology and will introduce telemedicine in various strategic applications to extend the reach of the health care team. It is incumbent on the medical schools to move in concert with the Ministry of Health to realize goals of the nation and the society.

Delivery of Health Care↗
PubMed1999

A strategy for reducing maternal mortality.

A confidential system of enquiry into maternal mortality was introduced in Malaysia in 1991. The methods used and the findings obtained up to 1994 are reported below and an outline is given of the resulting recommendations and actions.

Adolescent↗
PubMed1999

Cost effectiveness evaluation of the Ministry of Health Malaysia dialysis programme.

We determine the cost effectiveness of centre and home haemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD) and intermittent peritoneal dialysis (IPD) treatment in the Ministry of Health (MOH) programme. The viewpoint taken for this evaluation is that of MOH. Cost categories identified were capital cost, dialysis operational cost, medical cost and general hospital cost. Cost estimates were mostly based on actual resource utilisation. Life years saved were estimated based on Dialysis Registry data on 2480 HD and 732 CAPD patients. Overall, the cost-effectiveness ratio (CER) of centre HD was RM21620/life year saved. Those of home HD, CAPD and IPD were RM23375, RM30469 and RM36016 respectively. Sensitivity analyses did not change the ranking of the CER. We conclude the MOH dialysis programme was cost-effective, and among the various dialysis modalities centre HD was the most cost-effective.

Adult↗
PubMed1999

Outcome assessment of the Ministry of Health Malaysia dialysis programme.

We describe the outcomes on haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) provided by the Ministry of Health (MOH). The assessment was based on data from the Malaysian Dialysis Registry on 2480 HD and 732 CAPD patients who commenced dialysis between 1980 and 1996. Young patients (age < 40) have remarkable long term survival (life expectancies of 16 years on HD, 18 years on CAPD). Adjusting for background mortality, relative survival of older patients was as good as younger ones. Diabetics did poorly. 52% of HD and 26% of CAPD patients were employed in 1996. 71% of HD patients scored 10(normal) on QL index (a measure of quality of life) while 60% of CAPD patients have similar score. Differences in rehabilitation and QL index scores by age, gender and diabetes were also observed. Outcomes of dialysis in the MOH programme are reassuring.

Adult↗
PubMed1998

Impact of the east Asian economic crisis on health and health care: Malaysia's response.

In the wake of the east Asian economic crisis, the health budget for the public sector in Malaysia was cut by 12%. The Ministry of Health responded swiftly with a series of broad-based and specific strategies. There was a careful examination of the operating expenditure and where possible measures were taken to minimise the effects of the budget constraints at the service interface. The MOH reprioritised the development of health projects. Important projects such as rural health projects and training facilities, and committed projects, were continued. In public health, population-based preventive and promotive activities were expected to experience some form of curtailment. There is a need to refocus priorities, maximise the utilisation of resources, and increase productivity at all levels and in all sectors, both public and private, in order to minimise the impact of the economic downturn on health.

Budgets↗
PubMed1998

Utilisation of specialist medical manpower in Malaysia.

One hundred and twenty specialists from the Ministry of Health, the Universities and the private sector provided information on 4,802 patients seen over a total of two hundred and forty working days. This information was used to classify the patients into four categories based on a disease complexity classification. Each specialist's perception on the appropriateness of utilisation of his expertise was obtained. Complex cases requiring specialist expertise in management made up 69.8%, 73.5% and 19.1% of the cases of the Ministry of Health, University and private sector specialists respectively. Underutilisation was most marked with paediatricians and obstetricians in the private sector. The Specialist Register, the Programme for Accreditation of Hospitals and a National Health Financing Plan can be used to influence positively the case-mix of specialists.

Health Services↗
PubMed1995

Preventive and promotive medicine in ambulatory clinical practice: a prospective simulated patient study.

OBJECTIVE: This study examines the extent to which preventive and promotive advice is integrated into the clinical practice of doctors. STUDY DESIGN: Using a cross-sectional descriptive survey design, the study compares the performance of doctors in giving healthy lifestyle advice for five clinical conditions, their perceived practice and their rating on the importance of disseminating selected key lifestyle messages. DATA EXTRACTION METHODS: A total of 28 volunteers were trained to simulate the five clinical conditions which required related health advice and to rate the doctors' performance with the use of a prepared checklist. Simulated patient ratings of 343 doctor-patient encounters provided the data on doctors' health promotion efforts for the selected clinical conditions. A post-visit self-administered questionnaire survey of a sub-sample of 100 doctors gave an insight into their opinions and perceived practice. PRINCIPAL FINDINGS: Only in 49% of the instances was a health promotion message given. The doctors' encouraging interest in health education and health promotion and their positive perceptions of their volume of healthy lifestyle counselling were not borne out in actual clinical practice. CONCLUSIONS: The results indicate that the extent of preventive and promotive health education in both the public and private health sectors is unacceptably low. The matter needs to be addressed through training programmes as well as the formulation of clear health promotion priorities and strategies in Malaysia.

Ambulatory Care↗