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Skeletal-related events among breast and prostate cancer patients: towards new treatment initiation in Malaysia's hospital setting.

Sharifa Ezat WP, Aljunid SM, Noraziani K, et al.
Asian Pac J Cancer Prev . 2013; 14(5): 3357-3362

The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Patients with SRE may require palliative radiotherapy or surgery to bone for pain, having hypercalcaemia, pathologic fractures, and spinal cord compression. These complications contribute to a decline in patient health- related quality of life. The multidimensional assessment of health-related quality of life for those patients is important other than considering a beneficial treatment impact on patient survival, since the side effects of treatment and disease symptoms can significantly impact health-related quality of life. Cancer treatment could contribute to significant financial implications for the healthcare system. Therefore, it is essential to assess the health-related quality of life and treatment cost, among prostate and breast cancer patients in countries like Malaysia to rationalized cost-effective way for budget allocation or utilization of health care resources, hence helping in providing more personalized treatment for cancer patients.


Traditional male circumcision in a rural community in Kedah, Malaysia

Abdul Rashid, Khan Teh, Swee Ping Narayan, K. A.
IMU e-Journal of Science, Medicine and Education. 2009; 3(2): 19-23

Background: Circumcision though not mentioned in the Quran is believed to be a compulsory practice among the Muslims. In Malaysia, although there are several methods of circumcision available and traditional circumcision is still popular. Methods: A cross-sectional survey was carried out in a small fishing village of Kedah to study the methods of circumcision available to the villagers. This was followed with an in-depth interview conducted with òTok Mudim", a practitioner of traditional method of circumcision. Results: Forty three of the eligible 71 subjects participated in the study giving the response rate as 60.5%. The most common age for circumcision was 9 years old. Despite private clinics being the most common place of circumcisions, there was an increasing number of boys going to the òTok Mudim" for circumcision. A Mass Circumcision Ceremony is traditionally practiced. The òTok Mudim" described the procedure in detail and was of the opinion that the reason traditional method is still popular was because of the fear of injections and impotency among the parents. Most common complication faced by the òTok Mudim" was bleeding and infection. Discussion and Conclusion: Till the community shifts entirely to using modern medicine, there is a need to integrate traditional practitioners into the system. Training the òTok Mudim" to use modern instruments and aseptic techniques should be considered. Keywords: Male circumcision, rural, Malaysia


Hypospadias repair: Byar's two stage operation revisited

Arshad, A. R.
British journal of plastic surgery. 2005; 58(4): 481-486

BACKGROUND: Hypospadias is a congenital deformity characterised by an abnormally located urethral opening, that could occur anywhere proximal to its normal location on the ventral surface of glans penis to the perineum. Many operations had been described for the management of this deformity. METHODS: One hundred and fifteen patients with hypospadias were treated at the Department of Plastic Surgery, Hospital Kuala Lumpur, Malaysia between September 1987 and December 2002, of which 100 had Byar's procedure performed on them. RESULTS: The age of the patients ranged from neonates to 26 years old. Sixty-seven patients had penoscrotal (58%), 20 had proximal penile (18%), 13 had distal penile (11%) and 15 had subcoronal hypospadias (13%). Operations performed were Byar's two-staged (100), Bracka's two-staged (11), flip-flap (2) and MAGPI operation (2). The most common complication encountered following hypospadias surgery was urethral fistula at a rate of 18%. CONCLUSIONS: There is a higher incidence of proximal hypospadias in the Malaysian community. Byar's procedure is a very versatile technique and can be used for all types of hypospadias. Fistula rate is 18% in this series.


Reliability and validity of the National Institutes of Health: Chronic Prostatitis Symptom Index in a Malaysian population

Cheah P. Y., Liong M. L., Yuen K. H., Lee S., Yang J. R., Teh C. L., Khor T., Yap H. W., Krieger J. N.
World journal of urology. 2006; 24(1): 79-87

The objective of the study is to determine the short- and long-term utility of the Chinese, Malay and English versions of the National Institutes of Health--Chronic Prostatitis Symptom Index (NIH-CPSI) in our ethnically diverse population. The NIH-CPSI was translated into Chinese and Malay, and then verified by back translation into English. Subjects included 100 new chronic prostatitis/chronic pelvic pain (CP/CPPS) patients, 71 new benign prostatic hyperplasia patients and 97 healthy individuals. Reliability was evaluated with test-retest reproducibility (TR) by calculating intraclass correlation coefficients (ICC). Internal consistency was evaluated by calculating Cronbach's alpha (alpha). Validity assessments included discriminant and construct validity. (Presented in the order of Chinese, Malay then English). ICC values for short-term (1 week) TR were 0.90, 0.80 and 0.89, while ICC values for long-term (14 weeks) TR were 0.54, 0.61 and 0.61. Cronbach's alpha values were 0.63, 0.62 and 0.57. The NIH-CPSI total score discriminated CP/CPPS patients (P<0.001) from the control groups with receiver operating curve values of 0.95, 0.98 and 0.94, respectively. Construct validity, reflected by the correlation coefficient values between the International Prostate Symptom Score and the NIH-CPSI of CP/CPPS patients were 0.72, 0.49 and 0.63 (all P<0.05). The Chinese, Malay and English versions of the NIH-CPSI each proved effective in our population. Short-term TR and discriminant validity were excellent for all three versions. However, long-term TR was only moderate, which might reflect variation in patients' perceptions of symptoms over time.


Chronic prostatitis: symptom survey with follow-up clinical evaluation

Cheah P. Y., Liong M. L., Yuen K. H., Teh C. L., Khor T., Yang J. R., Yap H. W., Krieger J. N
Urology. 2003; 61(1): 60-64

OBJECTIVES: To determine the prevalence of chronic prostatitis/chronic pelvic pain syndrome (National Institutes of Health Category III prostatitis) in Penang, Malaysia and estimate the proportion of cases ascertained by population survey that met consensus clinical criteria for "chronic prostatitis." METHODS: One percent of 20 to 50-year-old men in Penang, Malaysia were surveyed using the National Institutes of Health Chronic Prostatitis Symptom Index. A clinical evaluation that included lower urinary tract localization studies was recommended for symptomatic subjects who met the survey definition to identify bacterial prostatitis and other diagnoses that would exclude them from the consensus clinical definition for chronic prostatitis (Category III). RESULTS: Of 3147 subjects surveyed, 275 (8.7%) met the survey criteria for chronic prostatitis. The prevalence of chronic prostatitis was 8.0% among Malays, 8.9% among non-Malays, and 16% among noncitizens (P = 0.025). The prevalence increased with age: 6.3% in 20 to 30-year-old men, 8.9% in 31 to 40-year-old men, and 12.6% in 41 to 50-year-old men (P <0.001). Of 87 subjects evaluated clinically, 65 (75%) met the consensus clinical criteria for chronic prostatitis. CONCLUSIONS: Chronic prostatitis represents an important, international healthcare problem. A thorough clinical evaluation is necessary to verify that chronic prostatitis is indeed responsible for a patient's pelvic pain and lower urinary tract symptoms.


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