Perception of telemedicine among medical practitioners in Malaysia during COVID-19.

The novel Coronavirus Disease 2019 (COVID-19) has brought unprecedented changes in the way conventional health care is delivered. This study examined if clinicians' perceptions regarding telemedicine and its barriers to implementation in Malaysia have changed during this pandemic. A cross-sectional survey was conducted among Malaysian medical doctors of various specialties in four urban healthcare facilities between June 2020 and July 2020. A total of 146 (41.7%) out of 350 responses were obtained. 62% of doctors reported a reduction greater than 50% in outpatient visits during the COVID-19 pandemic. The majority of doctors either found telemedicine useful in situations similar to COVID-19 (34.2%) or that it is essential to their daily practice (42.5%). However, only 22% reported using telemedicine for consultation during the COVID-19 pandemic. 74% of doctors felt that telemedicine would only benefit up to 30% of their patient population. Significantly more female doctors (80%) felt that telemedicine would benefit their patients compared to male doctors (45.8%) (P=0.03). Physicians (51.3%) were more inclined to adopt telemedicine in comparison to surgeons (32.4%) (P=0.03). The majority cited medico-legal issues and consent (80.6%), billing and charges (66.7%) and insurance reimbursement (62.5%), technical difficulties (62.5%) as their barrier to the adoption of telemedicine. Female doctors and physicians were more willing to adopt telemedicine when compared to male doctors and surgeons. Although the COVID-19 pandemic appeared to improve the perception, significant barriers should be resolved before many can incorporate it into their practice.

Stomal recurrence after total laryngectomy: a 10-year review in Universiti Kebangsaan Malaysia Medical Center.

OBJECTIVE: To determine the frequency of stomal recurrence in patients following total laryngectomy in our center and to compare the frequency of previously reported risk factors such as preoperative tracheostomy, subglottic invasion and the level of lymph node metastases, with the rest of the world. METHODS: Clinical records of patients with carcinoma of the larynx who presented to Universiti Kebangsaan Malaysia (UKMMC) Otorhinolaryngology and Oncology clinics between January 1998 and December 2007 were reviewed. RESULTS: A total of all 18 male patients who underwent total laryngectomy for carcinoma of the larynx within this 10 year period. The youngest patient was 49 years old and the eldest was 79 years old with mean age of 63 +/- 8 years. Twelve of them had a tracheostomy prior to surgery. Median duration from tracheostomy to definitive surgery was 28.5 days. Only 1 patient developed stomal recurrence. CONCLUSION: The duration from tracheostomy and total laryngectomy was longer than what is accomplished in the developed countries but the frequency of stomal recurrence was still comparable to the rest of the world. The frequency of other previously reported risk factors namely subglottic invasion and lymph nodes metastases were comparably low.