Amir Sharifuddin Md Khir

Prevalence of diabetes in Malaysia and usefulness of HbA1c as a diagnostic criterion

The prevalence of diabetes mellitus among Malaysians aged ≥ 30 years of age has increased by more than twofold over a 20‐year period. This study aimed to determine the current status and to evaluate the diagnostic usefulness of the HbA1c cut‐off point of 48 mmol/mol (6.5%).

Prevalence of Abnormal Glucose Tolerance and Risk Factors in Urban and Rural Malaysia

OBJECTIVE To determine the prevalence of prediabetes and diabetes among rural and urban Malaysians. RESEARCH DESIGN AND METHODS This cross-sectional survey was conducted among 3,879 Malaysian adults (1,335 men and 2,544 women). All subjects underwent the 75-g oral glucose tolerance test (OGTT). RESULTS The overall prevalence of prediabetes was 22.1% (30.2% in men and 69.8% in women). Isolated impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were found in 3.4 and 16.1% of the study population, respectively, whereas 2.6% of the subjects had both IFG and IGT. Based on an OGTT, the prevalence of newly diagnosed type 2 diabetes was 12.6% (31.0% in men and 69.0% in women). The prediabetic subjects also had an increased prevalence of cardiovascular disease risk factors. CONCLUSIONS The large proportion of undiagnosed cases of prediabetes and diabetes reflects the lack of public awareness of the disease.

Successive objective long-case assessment as a driver of clerkship learning – evaluation through perception questionnaire

personnel. In first year we are introduced to the idea of reflective practice through professional awareness lectures and clinical placements. Likewise to the participants of the study, at times we found this difficult due to the nature of the experience. We receive written and verbal feedback in terms of mentoring, but from different tutors. Both methods of critique clearly emphasize which aspects of reflective practice to focus on; however, in parallel to the study, attitudes of tutors were found to be variable. It would be interesting to make a comparison between second years, final years and junior doctors; in particular, to find out how reflective skills may benefit future implementation of ‘Situational Judgment Tests’ taken as part of the application process for foundation posts. Equally, it would be interesting to investigate how reflective practice (or lack of it) impacts on junior doctors in regards to their NHS e-portfolios. One aspect of reflective practice that the study did not comment on was the teaching of reflective practice. In our third year we are assigned an ‘Oncology Project.’ Each student is attached to a patient diagnosed with cancer with the aim to write a report on our experiences – essentially assessing our reflective skills. Many students felt that they were not taught how to reflect until this project making reflective practice prior to this appear potentially futile. It is evident that this aspect of the course needs careful consideration and we feel that it is somewhat overshadowed by the university’s more academic responsibilities. On reviewing the GMC guidelines, we hope to see positive developments in the future regarding reflective practice within medical school and throughout the rest of our careers.

Predictors of ischaemic heart disease in a Malaysian population with the metabolic syndrome.

Aims  Cardiovascular disease is the foremost cause of mortality in Malaysia but little is known about the prevalence of the metabolic syndrome and its associations with other known cardiovascular risk markers. We undertook a population‐based study to examine these.