Knowledge and attitude of nurses towards diabetic foot care in a secondary health care centre in Malaysia.

INTRODUCTION: Nurses play a vital role in the care and prevention of ulcers in patients with diabetic foot. Patient education, prevention of ulcers and rehabilitation are some of the vital aspects that nurses provide on a daily basis. Thus, good knowledge and attitude of nurses towards diabetic foot ulcers and its care will ensure better patient care. OBJECTIVES: The aim is to study the level of knowledge and attitude of nurses towards diabetic foot ulcers and its care in Hospital Segamat, Malaysia. METHODS: A validated questionnaire was used between February 2019 to May 2019 covering area such as demography, predisposing factors of ulcer formation, characteristics of ulcers, complications of ulcers, and attitude towards diabetic foot care. RESULTS: A total of 101 nurses took part and 57% of the participants scored poorly in the knowledge section of the questionnaire. In all 72% had scored poorly when asked regarding complications of diabetic foot ulcers; 49.5% of the nurses had positive attitude towards diabetic foot care; and 79.3% thought that care for diabetic foot ulcer is timeconsuming. Majority of them think that their colleagues are the main source of information. All demographic variables were deemed to be confounders with the knowledge and attitude of nurses towards diabetic foot ulcers and its care. CONCLUSIONS: Nurses in this centre had poor knowledge towards diabetic foot ulcers and its care. None of the variable studied were correlated with the level know knowledge. Good or poor knowledge of nurses does not correspond equally to good or poor attitude towards diabetic foot ulcers care. More frequent formal training of diabetic foot care would be needed to ensure better knowledge.

Domiciliary non-invasive ventilatory devices--a general hospital experience.

Treatment for chronic respiratory failure has advanced since the introduction of domiciliary non-invasive ventilatory devices. This has given a new light of hope for patients with chronic respiratory failure secondary to various causes. We report a series of patients with respiratory failure of different origins and types of management that they received. Four patients received bilevel positive airway pressure (BiPAP) and one patient received continuous positive airway pressure (CPAP).

Correlation between hypertension and income distribution among United Arab Emirates population.

To determine the correlation between hypertension and income distribution among United Arab Emirates (UAE) population. Case-control study matched for age, sex, nationality and education. The survey included 500 hypertensive adults aged 20-65 years ascertained from Primay Health Care (PHC) Clinics along with a randomly selected sample of 500 control subjects from the community. Face-to-face interviews were done where data were gathered on socio-demographic-economic status (SES) and lifestyle habits. Hypertension was defined according to WHO criteria as having Systolic Blood Pressure (SBP) > or = 140 mm Hg and/or Diastolic Blood Pressure (DBP) > or = 90 mm Hg and/or being on antihypertensive treatment. The survey was carried out in urban and semi-urban PHC Clinics. A total of 818 subjects were included in this study from a sample of 1000; 409 cases and 409 controls. There were 422 males and 396 females in this study, with 255 UAE nationals and 438 expatriates. Hypertension was found to be significantly higher among the low income group (35.2% vs. 24.9% controls, p = 0.002; while mean SBP in the low income group was 130.2 +/- 17.6 vs. 128.0 +/- 17.4 controls, p = 0.022). Among males, smoking and alcohol consumption were higher among the group with low income level but only smoking showed significant difference (p value = 0.016). Activity level was higher among the low income groups. This study supports the importance of socio-economic factors as an income distribution effect on life-style habits and hypertension.

Mechanisms of cervical spine injuries for non-fatal motorcycle road crash.

Cervical spine injuries such as subluxation and fracture dislocation have long been known to result in severe consequences, as well as the trauma management itself. The injury to the region has been identified as one of the major causes of death in Malaysian motorcyclists involved in road crashes, besides head and chest injuries (Pang, 1999). Despite this, cervical spine injury in motorcyclists is not a well-studied injury, unlike the whiplash injury in motorcar accidents. The present study is a retrospective study on the mechanisms of injury in cervical spine sustained by Malaysian motorcyclists, who were involved in road crash using an established mechanistic classification system. This will serve as an initial step to look at the cervical injuries pattern. The information obtained gives engineer ideas to facilitate design and safety features to reduce injuries. All cervical spine injured motorcyclists admitted to Hospital Kuala Lumpur between January 1, 2000 and December 31, 2001 were included in the present study. Based on the medical notes and radiological investigations (X-rays, CT and MRI scans), the mechanisms of injuries were formulated using the injury mechanics classification. The result shows that flexion of the cervical vertebrae is the most common vertebral kinematics in causing injury to motorcyclists. This indicates that the cervical vertebrae sustained a high-energy loading at flexion movement in road crash, and exceeded its tolerance level. The high frequency of injury at the C5 vertebra, C6 vertebra and C5-C6 intervertebral space are recorded. Classification based on the Abbreviated Injury Scale (AIS) is made to give a view on injury severity, 9.1% of the study samples have been classified as AIS code 1, 51.5% with AIS 2 and 21.2% with AIS 3.

Accident characteristics of injured motorcyclists in Malaysia.

This study examines the accident characteristics of injured motorcyclists in Malaysia. The aim of this study is to identify the characteristics of motorcyclists who are at higher fatality risk and subsequently be the targeted group for the fatality-reduction countermeasures. A total of 412 motorcycle crash victims with serious or fatal injuries were analysed. The results showed that the injured motorcyclists were predominant young, novice riders of less than 3 years licensure and male. A fatal outcome was more likely to be associated with a larger engine capacity motorcycle, collision with a heavy vehicle, head on collision, and collision at a non-junction road. In contrast, a non-fatal outcome was more likely to be associated with a small engine capacity motorcycle, collision with another motorcycle or passenger car, junction accidents, and side or rear collisions.

Patient attendance at a major accident and emergency department: are public emergency services being abused?

A total of 37,152 patients attended the Accident & Emergency (A&E) Department of Hospital Universiti Kebangsaan Malaysia (HUKM) from 1st January to 31st December 1998. Attendance during early hours (midnight to 0659 hrs.) constituted only 10.4% (3853 cases) whereas that for three other time periods of 0700-1159 hrs., 1200-1759 hrs., and 1800-2359 hrs. was 29.4% (10,927 cases), 30.8% (11,448 cases), and 29.4% (10,924 cases) respectively. Two hundred and fifty-one patients were direct admissions from other hospitals into our hospital wards and they attended the A&E department for registration purposes only. Of the remaining 36,901 that were triaged, 196 (0.5%) were resuscitation cases [Triage 1], 3648 (9.9%) were emergency cases [Triage 21, 18,935 (51.3%) were urgent cases [Triage 3], and 14,122 (38.3%) were non-urgent cases [Triage 4]. Despite fluctuations in monthly patient attendance, the proportions of patients according to time of attendance, age group, gender and triage categories remained similar throughout. As majority of patients attended during convenient hours (89.6% from 0700-2359 hrs.) and a high proportion of patients (38.3%) belonged to the non-urgent Triage category, we feel that public emergency services are possibly being abused.

Mass cardio-pulmonary resuscitation: a new method of public cardio-pulmonary resuscitation teaching.

A mass CPR (cardio-pulmonary resuscitation) teaching programme, believed to be the first in Malaysia, was held at the Dewan Tunku Canselor, University of Malaya (UM) on Saturday, 13th July 1996. Organised by the Resuscitation Committee of University Hospital, Kuala Lumpur, this programme was conducted for 200 first year UM students. We describe the organisation of this non-traditional and non-threatening, new CPR teaching programme and propose that this be further developed for the dissemination of CPR skills to our Malaysian public.