The feasibility of a public-private mix program on pulmonary tuberculosis screening in Penang:A pilot study

@#Background: The low detection rate of tuberculosis (TB) cases in Malaysia remains a challenge in the effort to end TB by 2030. The collaboration between private and public health care facilities is essential in addressing this issue. As of now, no private-public health care collaborative program in pulmonary tuberculosis (PTB) screening exists in Malaysia. Aim: To determine the feasibility of a collaborative program between private general practitioners (GPs) and the public primary health clinics in PTB screening and to assess the yield of smearpositive PTB from this program. Methods: A prospective cohort study using convenient sampling was conducted involving GPs and public health clinics in the North-East District, Penang, from March 2018 to May 2019. In this study, GPs could direct all suspected PTB patients to perform a sputum acid fast bacilli (AFB) direct smear in any of the dedicated public primary health clinics. The satisfaction level of both the GPs and their patients were assessed using a self-administered client satisfaction questionnaire. IBM SPSS Statistical Software was used to analyze the data. Results: Out of a total of 31 patients who underwent the sputum investigation for PTB, one (3.2%) was diagnosed to have smear-positive PTB. Most of the patients (>90%) and GPs (66.7%) agreed to continue with this program in the future. Furthermore, most of the patients (>90%) were satisfied with the program structure. Conclusion: It is potentially feasible to involve GPs in combating TB. However, a more structured program addressing the identified issues is needed to make the collaborative program a success.

The impact of music guided deep breathing exercise on blood pressure control - A participant blinded randomized controlled study

Introduction: As pharmacological treatment of hypertensionhas become a burden worldwide, the study looked into nonpharmacological ways of reducing blood pressure. Theobjective was to determine if music guided, slow and deepbreathing will reduce the blood pressure among patientswith hypertension in eight weeks.Methods: A participant blinded, multi-centre, randomisedcontrolled trial was conducted in which the participants inthe intervention group (IG) practiced deep breathingexercise guided by sound cues and those in the controlgroup (CG) listened to the music. The primary end point wasreduction in blood pressure at eight weeks.Results: 87 patients, 46 males and 41 females with mean ageof 61.1 years were recruited and 93.1% of them successfullycompleted the study. There was significant reduction insystolic and diastolic Blood Pressure from baseline by 8weeks in both groups. The reduction in Mean systolic bloodpressure (SBP) in the control arm was 10.5mmHg comparedto 8.3mmHg (p<0.001) in intervention group. Diastolic bloodpressure (DBP) reduction in control and intervention groupswere 5.2 mmHg (p<0.001) and 5.6 mmHg (p<0.001)respectively. The absolute difference in SBP reduction frombaseline in IG & CG was -2.2 (95%CI: -7.8 to 3.5) and DBPwas -0.4 (95%CI: -2.9 to 3.6). However, blood pressurereduction between the two groups was not significant.Conclusions: Both listening to music and deep breathingexercise were associated with a clinically significantreduction in SBP and DBP. However, deep breathingexercise did not augment the benefit of music in reducingBP.