Confidentiality is the act of keeping patients’ health or personal information private. The Malaysia Medical Council (MMC) has created a Confidentiality Guideline for medical practitioners to secrete any shared particulars.
Take a look at why confidentiality is a sine qua non in your medical practice.
Why Does Confidentiality Matter?
Practising confidentiality is the key to tighten the trust between patients and their doctors. Any clinic and hospital staff should be responsible for preventing patients’ information leakage.
Some patients are not comfortable with sharing their medical records with a third party. For instance, sexual assault victims are less likely to disclose their medical reports due to social stigma around survivors.
The MMC will take legal actions against those who fail to commit this act according to Section 30 of the 1971 Medical Act. Therefore, it is in everyone’s best interest to conduct good medical ethics.
How to Know a Confidentiality Breach?
It is vital to recognise various types of confidentiality breaches. Here are the most common types of privacy violations:
Unauthorised access to clinical records and histories, regardless of paper or computer documentation.
Providing clinical information to medical personnel who is not in charge of patients’ medical care.
Improper disclosure due to insufficient clinical facilities and management.
Sharing patients’ medical conditions or personal information with family and friends.
Discussing confidential information in a public area.
How to Protect Patients’ Confidentiality?
You can consider these strategies to ensure protection upon your patients’ information:
Patient Confidential Agreement Form
The purpose of this agreement form is to ensure clinic staff do not divulge any patient-related information and record. This agreement also acts as proof in case there is a breach of confidentiality.
Strengthen Password Security
Clinical staff must encrypt computer-saved medical data with passwords. Do note that it is safer to create different passcodes for each file to avoid third-party easy access.
Soundproofing Healthcare Environment
Although soundproofing your examination office can cost much expenditure, investing in a proper room acoustics system can have a positive impact on healing and working attitude. It is also essential to prevent noise emissions from your office as others might overhear any private conversations taking place inside.
When to Disclose Patients’ Information?
It is wise only to reveal medical and personal details upon patients’ approval.
The patient’s documentation is needed for court or statute purposes
The health condition must be disclosed to a close relative for their best interest
The patient’s consent cannot be obtained during an emergency
The patient’s health condition bears a potential threat to the public (e.g. COVID-19 cases)
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Health screening is essential when detecting any hidden diseases or conditions at an early stage. It is helpful for medical practitioners to perform early diagnosis before the disease progresses to the advanced stages.
However, some patients may not be cooperative during the screening process. A study showed that factors such as negative experiences, complicated procedures, and time constraints could refrain patients from attending their health screening appointments.
Learn more about how to improve health screening procedures for patients to overcome their complications below.
1. Video Education on Health Screening
One of the main factors for low patient attendance in health screening is the lack of medical knowledge. Patients are less likely to undergo health screening procedures as they tend to get confused by the complicated process or various misinformation.
Consequently, practitioners must educate the public on the overall procedure and different types of chronic diseases. A practical method is recording a short clip that provides a comprehensible explanation that can be attainable on social media platforms like Facebook or YouTube.
Each video recording should preferably be less than 5 minutes long, with audio subtitles available. Furthermore, please refrain from using complex medical jargon as the target audience are less likely to understand them.
2. Digitalised Health Questionnaire
Although the majority prefers a face-to-face consultation, bear in mind that some patients are unable or uncomfortable with verbally describing their health conditions. Practitioners should prepare a questionnaire for those who prefer online communication.
Practitioners can achieve this by using a simple Google Form that includes a range of short-answer questions, scale ratings, yes/no questions, and checkboxes. This way, patients have the chance to answer a variety of questions without feeling lethargic. They will be more confident in providing information when there is no pressure to give out detailed answers.
Medical practitioners can benefit from this survey mode as well. Based on the patients’ answers, it is easy to compare and get quantitative and qualitative data.
Again, try not to use complicated medical jargon when designing your questionnaire.
3. Health Screening Tracking App
Have you ever encountered patients who keep losing their medical record cards? It is time to discard the small paper card and transition to a digital record via mobile app. This application will appeal to patients who lead a busy lifestyle and the elderly population.
When creating a simple yet efficient mobile app, you should consider usability, readability, and functionality. If the app interface design is excessively vibrant and the font size is below 12pt, patients are less likely to utilise it.
The function of the app is for patients to track screening history and review screening results easily. Besides that, patients could conveniently make and alter their follow-up screening appointment dates. Simultaneously, the app will push a reminder notification when their screening appointment date is approaching.
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Cases of counterfeit drugs sold online are a significant problem in the online trading world. From a 2020 report by the Organisation for Economic Co-operation and Development (OECD), antibiotics take the most counterfeited pharmaceutical product.
As health practitioners, it is best to have a keen eye on detecting fake medicine within the online pharmaceutical market. Hence, we provide a few pointers on how to differentiate authentic and forged drugs.
Counterfeit Drugs Pricing
If the price of a pharmaceutical good is significantly lower than the market price, it is more likely to be a counterfeit product. In other words, dishonest traders tend to perform this scam tactic to understand how products with lower costs can easily attract more customers.
Hence, the best way to prevent this is to research before purchasing. Moreover, it would be best to compare prices between different suppliers to know the product’s original market price.
Although it can be hard to distinguish between real and fake medical products at first glance, you can spot the contrast if you pay attention to the package design:
Colour: tone and shade
Typography: misspellings, font sizes, and font type
Vector: shape and size
Again, research is vital before making any purchase decisions.
In addition, some counterfeit products might not have a proper seal or packaging. If you find that your newly arrived batch of cough medicines are not within their boxes, there is a possibility the goods are not genuine.
Drug Registration Number
Authentic medical drugs have a series of registration numbers. In Malaysia, the valid serial number will start with MAL (short form for Malaysia), followed by an 8-digit number. Subsequently, the alphabet at the end of the serial indicates the registration category.
Here is a list of the categories:
A: Controlled medicines
X: Over the counter medicines (OTC)
T: Natural Products/ Traditional Medicines
N: Health Supplements
H: Veterinary Products
Therefore, having a registered serial number on the package shows that the drug is Ministry of Health (MOH) approved.
Anti-Counterfeit Hologram Meditag
Have you noticed the glowing sliver Meditag holographic sticker on the side of pharmaceutical packagings?
This sticker works as a security to ensure product authenticity and MOH approval. For instance, the latest version is the 2012’s third-generation Meditag with a picture of a tiger within a circle.
Here are the reasons why pirated medical packaging does not include this sticker:
Expensive to manufacture
The holographic sticker material is not publicly accessible as it is only available to licensed manufacturers
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Medication Error is a preventable adverse effect of medical care that leads to potential harm to patients. The common types of Medication Errors are wrong time error, unauthorised drug error, omission error, and dose error.
Hence, medical providers need to be aware of their working hours as much as they care about their patients. Besides, a forward rotation of shift work that will not disrupt the circadian rhythm may lead to less fatigue in the workplace.
Not only do reasonable working hours minimise exhaustion or stress in the workplace, but they also improve working satisfaction and motivation.
2. Proper Labelling and Branding to Avoid Medication Error
Similar medicine packaging and appearance may cause pharmacists to supply the wrong medicine to their patients accidentally. It is crucial to properly arrange the treatment according to their respective expiry date label and manufacture brand.
Moreover, different medicine brands contain different ingredients, even though they serve to treat the same illness. Therefore, proper labelling helps in handing out the right medicine to avoid fatal cases like drug allergies.
3. Proper Communication System
With unclear instructions, nurses and pharmacists can get confused when issuing medication to their patients. They might misinterpret the doctor’s hasty handwriting, which leads to providing the wrong dosage or timing.
One way to counter this problem is to adopt a proper communication strategy among staff members. For example, the STICC Protocol (situation, task, intent, concern, calibrate) encourages teams to provide feedback upon vague instructions.
Another way to improve communication efficiency is digitalised messages. Instead of giving prescriptions in rapid writing, doctors can send brief emails on the patients’ diagnosis results and further instructions.
In short, an excellent practitioner-nurse interaction can reduce chances of medical error.
4. Training Program on Medication Error
Many beginner-level medical practitioners may have learnt how to avoid medical errors, yet it is hard for them to recognise or manage this problem. Thus, a training program on detecting such errors is fundamental in clinics or hospitals.
Simulation-based learning programs prove to be functional in instructing various potential errors in healthcare. Trainees can learn different ways to encounter possible errors and collaborate to solve them.
Fully-trained staff can carry out the performance during training in an actual working environment. Another positive benefit from this training is optimising teamwork ability among members to overcome medical errors.
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As a result, a Covid-19 vaccine developed by Pfizer and BioNTech appears to protect against a coronavirus variant that spreads rapidly to others.
How the Pfizer/BioNTech Vaccine works?
After vaccination, symptoms such as fever sometimes can occur during the immune-building process.
These symptoms are normal and are signs that the body is building immunity.
The most common side effects are pain, swelling as well as redness on the arm where you got the shot.
Moreover, you may also experience other common side effects such as chills, tiredness and headache.
Usually, the side effects last within a day or two of receiving the vaccine.
Due to the flu-like symptoms, it may affect your ability to do daily work.
But don’t worry, the side effect will go away in a few days.
COVID-19 Vaccines Require More Than One Doses
This specific vaccine requires two doses.
After the first dose, immunity starts to build after 12 days.
Then, a second dose is given after 21 days.
Finally, your body will reach full immunity by day 28.
Who Should Get Vaccinated
The Pfizer-BioNTech vaccine now includes for people 12 years of age and older.
Pregnant mothers between 14 to 33 weeks of pregnancy.
Who Should Not Get Vaccinated
If you have had a severe allergic reaction such as anaphylaxis or an immediate allergic reaction to any ingredient in the mRNA COVID-19 vaccine, you should not receive the vaccine.
Moreover, anyone developing a severe allergic reaction or an immediate allergic reaction, even if it was not severe, after receiving the first dose of the vaccine, should not be given another dose of the mRNA COVID-19 vaccine.
Anyone who develops an immediate allergic reaction within 4 hours after vaccination. Symptoms includes hives, swelling, or wheezing.
People who are allergic to PEG or polysorbate should not receive the mRNA COVID-19 vaccine.
Cholesterol is actually beneficial for our health. However, if the cholesterol level in our blood is higher than normal, we are exposed to a higher risk of hyperlipidemia, hypercholesterolemia, or high blood cholesterol.
Many complications may arise due to this, for example:
Conorany artery disease
Types of Cholesterol
There are three types of cholesterol, such as:
Low-density lipoproteins (LDL): Also known as “bad” cholesterol. High levels of LDL cholesterol may increase the risk of heart disease and stroke.
High-density lipoproteins (HDL): Also known as “good” cholesterol, it carries cholesterol back to the liver. Then, the liver flushes it out from the body. Optimum levels of HDL cholesterol can in fact lower the risk of heart disease and stroke.
Very-low-density lipoproteins (VLDL): Also known as “bad” cholesterol because it causes build-up of plaques in arteries. However, VLDL and LDL are different as VLDL carries triglycerides whereas LDL carries cholesterol.
Test to Measure Cholesterol
What’s even more frightening is that you may not know you have bad cholesterol levels until a sudden heart attack or stroke happens.
So, it is important to check your cholesterol levels at least every 5 years.
The cholesterol screening requires a blood sample.
Hence, before doing a cholesterol test, you will need to fast for about 8 to 12 hours.
The cholesterol test checks the levels of your total cholesterol.
It is the total amount of cholesterol in the blood based on your HDL, LDL, and triglycerides.
Levels and Ranges
Cholesterol is measured in milligrams per deciliter (mg/dL).
According to The Center for Disease Control and Prevention [CDC] 2020, the target range for cholesterol levels are as below:
LDL (“bad”) cholesterol
HDL (“good”) cholesterol
≥ 60 mg/dL
≥ 60 mg/dL
What Risk Factors Affect Cholesterol Levels?
Risk factors that may raise your cholesterol level include:
Age: When we get older, our cholesterol levels may rise. However, young people, such as children and teenagers can also have high cholesterol.
Heredity: Genetic factors can also cause high cholesterol.
Weight: Being overweight or obese also increase your cholesterol level.
Race: Some races may have an increased risk of high cholesterol. For instance, African Americans have higher HDL and LDL cholesterol levels than Caucasians.
Diet:Saturated fat and trans fat in food, will increase cholesterol levels. Saturated fat can increase your cholesterol count, so take it in moderation. For instance, red meat, butter, and cheese have a lot of saturated fat.
Avoid tobacco: Smoking may reduce the number of good cholesterol in your body.
Diet: Reduce the intake of trans fats and saturated fat. Eat heart-healthy food, such as fruits, vegetables, fatty fish, and whole grains. On the other hand, limit the intake of red meat, sugary products, and dairy products made with whole milk.
fruits such as apples, grapes, strawberries, and citrus
soy and soy-based foods
fatty fish such as salmon, tuna, and sardines
foods rich in fiber
Exercise regularly: Try to exercise about 30 minutes per day, 5 times a week.
Lose weight: Losing about 10% of your body weight can make a difference in your cholesterol levels. Get advice from your healthcare provider about safe ways to lose weight.
Avoid negative emotions: Learn how to deal with anger, stress, and other negative emotions.
Control blood sugar and blood pressure: Make sure to follow your healthcare provider’s guidelines for blood sugar levels, especially if you have diabetes, to keep your blood pressure healthy.
There are several types of medications to treat high cholesterol.
The type of lipid-lowering drug chosen depends on their level of cholesterol and other risk factors.
Healthcare practitioners usually will advise starting with diet and exercise first, but people with a higher risk of a heart attack may need to take statins or other medications to treat their disease.
Statin medications are one of the most well-known categories of cholesterol drugs.
Statins work by reducing the amount of cholesterol produced by the liver.
Furthermore, they help to decrease blood cholesterol and thus reduce the risk of heart attacks and stroke.
Several types of statins are available by prescription in Malaysia, such as:
Other lipid-lowering therapy
1. Selective cholesterol absorption inhibitors
2. Niacin is a B vitamin that affects the production of fats in the liver.
3. Bile acid sequestrants are another class of drugs used to treat high cholesterol levels. Drugs, also called resins, are attached to bile acid, which cannot be used for digestion. Consequently, the liver makes more bile by using more cholesterol. Examples of these drugs are Cholestyramine and Colesevelam HCL.
4. Fibrates are also called fibric acid derivatives. They are more effective at reducing triglyceride levels than LDL cholesterol. It also helps to boost the levels of HDL cholesterol. These drugs include Fenofibrate and Gemfibrozil.
5. Omega-3 fatty acid medications derived from fish oils work to lower high triglyceride levels.
Apart from having a healthy lifestyle, some medication helps to reduce the cholesterol level in our bodies.
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The state of our country has changed drastically in the past year. As industries weather the pandemic’s effects, medical practices are also approaching caregiving differently. Being a doctor on call is a rapidly growing trend in Malaysia, which comes with its advantages and disadvantages.
What brought about this trend?
When the coronavirus necessitated new protocols in line with social distancing, it influenced how doctors offer their services to patients. Minimising contact is the best way to guard against the virus, and patients with health problems might opt out of visiting the clinic or hospital. Ultimately, the emergence of “doctor on call” or teleconsultation in Malaysia hinges on this patient behaviour.
Besides that, technological advancements have allowed us to reimagine clinic visits as a house call without the extra mile. Online doctor consultations cover both primary care and specialists, enabling a more extensive reach for treating patients.
While this method is gaining traction for its benefits, there are still several apprehensions to address.
Advantages of Doctor on Call Services in Malaysia
Teleconsultation can help medical practices stretch their networks and expand access to healthcare. It is especially advantageous for patients seeking immediate medical attention and those who are disabled. Doctors may even reach patients in rural areas or outside the standard care delivery system with the right technologies.
Improves Patient Engagement
Healthcare providers are increasingly aware of the need to interact with patients to engage them in self-care between visits. After all, proactive treatment is never discouraged. Doctors and medical staff alike can utilise remote monitoring to improve outcomes of chronic illnesses whilst cutting costs.
Aside from reducing overhead costs per visit, doctors on call can extend hours to rake in more billable time. If patients fail to attend virtual appointments, they may also bill for uncompensated calls. In addition, this service provides a competitive advantage to attract and retain more patients, generating more revenue.
Enhances Clinical Workflow
Teleconsultation can improve clinical workflow efficiency, serving as a channel for quicker prioritisation and triaging cases. Not to mention, the automated record keeping allows better communication, convenience, and elimination of any discrepancies.
Subsequently, capturing and storing patient data will lead to better medical decision-making as well.
Not Always Suitable
The online service has the potential to be highly favourable but might not always be practical. Doctors cannot perform a complete routine medical exam on patients over video call; our technology is unfortunately not there yet. Plus, any samples collected for tests will have to be delivered to the lab, particularly for patients with more severe conditions.
Like it or not, sometimes technology fails us. A simple glitch can withhold medical providers from offering the proper consult at the right time, perhaps even causing miscommunication. However, those living in modern metropolises and towns with seamless internet connectivity have a lower chance of facing this problem.
To sum up, being a doctor on call in Malaysia is evidently worth the deliberation. Prescribing medication is only two clicks away, and employing an online pharmacy to make deliveries benefits both patients and providers.
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Epilepsy, a common neurological disease, is a chronic disorder that causes repetitive seizures.
A seizure is a sudden rush of electrical activity in the brain.
There are two types of seizures; generalized seizures and focal seizures.
Generalized seizures affect the whole brain while focal seizures affect just one part of the brain.
Epilepsy is caused by abnormal activity in the brain. Sign and symptoms include:
A staring spell or gaze
Uncontrollable jerking movements of the arms and legs
Loss of consciousness
Psychic symptoms such as fear and anxiety.
The risk of having epilepsy may be increased by certain factors, namely:
Family history: A person can develop a seizure disorder when any family member has epilepsy.
Age: Evidently, the disease is more common in children and older adults.
Stroke and other vascular diseases: This can lead to brain damage and triggers epilepsy.
This disease, like many other diseases, comes with several complications.
Seizures at certain times may be dangerous to patients and to others.
For instance, the likelihood of falling during a seizure attack is high. Falling during a seizure may injure the head.
Epileptic patients are also more likely to drown while bathing or swimming.
Moreover,epilepsy during pregnancy may pose danger to both the mother and the fetus.
To add, a certain anti-epileptic drug may increase the risk of birth defects. Discuss with your doctor before planning to get pregnant.
On the other hand, people with epilepsy tend to get psychological problems, such as depression, and anxiety. This is because of the difficulties dealing with the condition itself and medication side effects.
Several types of treatments exist to treat this disease.
Most commonly patients are treated with oral medications, called anti-epileptic drugs.
However, if oral medications fail to give desirable effect, another type of treatment is also available, such as:
Vagus nerve stimulator: This device is placed under the skin on the chest during surgery. It electrically stimulates the nerve that runs through your neck and prevents seizures.
Ketogenic diet: This is a high fat with low carbohydrate diet.
Brain surgery: Remove the area of the brain that causes seizures.
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Making your skin younger is easier with antioxidant-rich foods
A research was conducted to see if eating foods that are high in antioxidants can protect against premature skin ageing.
The research was done on individuals who are exposed to sun damage and with moderate to high UV exposure.
777 Australian adults from both genders with a mean age of 39 years participated in this research.
Their estimated total dietary antioxidant was estimated.
Moreover, the participants’ photoaging severity was looked into using microtopography over 15-year follow up, in three-time points.
Initially, 42% of the population has had severe photoaging (grades ranging to 5 or 6).
Obviously, the number increases to 51% and 89% in 1996 and 2007, respectively.
Individuals with high photoaging grades had the following characteristics, which are:
More likely to be male,
Was born in Australia or New Zealand
Fair skin that always burned
Clinical photoaging around the neck
≥1 actinic keratosis
Participants whose diets consisted of fruits, lower intakes of red meat, oily fish, soft drinks, tea, unrefined cereals and vegetables, as well as a greater amount of wine consumed than beer had a greater antioxidant capacity and they tended to be female, not currently smoking, older, regular consumers of dietary supplements and users of sunscreen, among others.
The levels of photoaging were not associated with body mass index, leisure-time sun exposure, smoking status, sunscreen use prior to trial, and trial treatment allocation.
The researchers also stated that consumption of foods with high vs low antioxidant capacity reduced photoaging by 10 per cent over 15 years among adults aged >45 years on an ordinal logistic regression analysis. Antioxidants from foods may mitigate the effects of sun exposure on skin ageing among healthy men and women aged >45 years.