ORTHOPAEDIC AND TRAUMATOLOGY Adjustment for non-response.

28 Table 1: Available Therapeutic and Diagnostic Facilities in Obstetrics Gynaecology Population Labour Suite Gynaecology Oncology Unit Assisted Reproductive Centre Fertility Center No in million No pmp No pmp No pmp Malaysia 26.64 198 100 5 10 100 16 100 1 Sector Public - NC - 5 50 NC - Private - NC - 5 50 NC - State Johor 3.17 32 16 10 1 10 3 19 1 Kedah Perlis 2.11 23 12 11 Kelantan 1.53 12 6 8 Melaka 0.73 8 4 11 3 30 4 1 6 1 Negeri Sembilan 0.96 15 8 15 1 10 1 Pahang 1.45 8 4 6 Perak 2.28 12 6 5 1 6 Terengganu 1.04 6 3 6 Pulau Pinang 1.49 15 8 10 1 10 1 3 19 2 Sabah 3 20 10 7 1 10 2 12 Sarawak 2.36 20 10 8 1 6 Selangor W.P Kuala Lumpur 6.43 27 14 4 3 30 5 31 1 Table 2: Available Medical Devices in Obstetrics Gynaecology Population Total Cardiotocograph assume each CTG has internal and external CTG functions External Cardiotocograph Internal Cardiotocograph Combined Internal and External CTG No in million No pmp No pmp No pmp No pmp Malaysia 26.64 789 100 30 581 100 22 196 100 7 76 - - Sector Public - NC - 419 72 166 85 NC - Private - NC - 163 28 30 15 NC - State Johor 3.17 100 13 31 38 7 12 7 4 2 ND - - Kedah Perlis 2.11 44 5 21 43 7 20 16 8 8 6 - 3 Kelantan 1.53 38 5 25 29 5 19 21 11 14 5 - 3 Melaka 0.73 40 5 55 13 2 18 3 2 4 15 - 21 N. Sembilan 0.96 40 5 42 31 5 32 6 3 6 5 - 5 Pahang 1.45 25 3 17 20 3 14 8 4 6 7 - 5 Perak 2.28 54 7 24 45 8 20 19 10 8 32 - 14 Terengganu 1.04 23 3 22 23 4 22 4 2 4 2 - 2 P. Pinang 1.49 55 7 37 48 8 32 14 7 9 4 - 3 Sabah 3 69 9 23 58 10 19 25 13 8 ND - - Sarawak 2.36 107 14 45 47 8 20 14 7 6 ND - - Selangor W.P Kuala Lumpur 6.43 194 25 30 187 33 29 59 29 9 ND - - 29 Population Colposcope system Hysteroscope system Transabdominal Transducer Ultrasound Transvaginal Transducer Ultrasound No in million No pmp No pmp No pmp No pmp Malaysia 26.64 91 100 3 87 100 3 279 100 10 195 100 8 Sector Public - NC - NC - NC - NC - Private - NC - NC - NC - NC - State Johor 3.17 18 20 5 17 20 5 60 21 19 55 27 17 Kedah Perlis 2.11 7 8 3 2 2 1 21 8 10 14 7 7 Kelantan 1.53 4 4 3 4 5 3 10 4 7 8 4 5 Melaka 0.73 4 4 5 3 3 4 20 7 27 15 7 21 N. Sembilan 0.96 6 7 6 5 6 5 25 9 26 15 7 16 Pahang 1.45 2 2 1 3 3 2 6 2 4 3 1 2 Perak 2.28 4 4 2 12 14 5 15 5 7 12 6 5 Terengganu 1.04 1 1 1 3 3 3 3 1 3 3 1 3 P. Pinang 1.49 8 9 5 5 6 3 14 5 9 13 6 9 Sabah 3 8 9 3 3 3 1 22 8 7 12 6 4 Sarawak 2.36 7 8 3 6 7 3 14 5 6 6 3 3 Selangor W.P Kuala Lumpur 6.43 22 24 3 24 28 4 69 25 11 47 23 7 Population Suction and Curettage System Amnioscope system blood gas machine for fetal sampling Laparoscope system No in million No pmp No pmp No pmp No pmp Malaysia 26.64 314 100 12 160 100 6 107 100 4 78 100 3 Sector Public - NC - NC - NC - NC - Private - NC - NC - NC - NC - State Johor 3.17 37 12 12 20 13 6 15 14 5 18 23 6 Kedah Perlis 2.11 17 5 8 2 3 1 Kelantan 1.53 12 4 8 1 1 1 2 3 1 Melaka 0.73 8 3 11 4 3 5 3 3 4 4 5 5 N. Sembilan 0.96 30 10 31 7 4 7 5 5 5 5 6 5 Pahang 1.45 7 2 5 6 3 4 3 3 2 2 3 1 Perak 2.28 32 10 14 15 9 7 12 11 5 4 5 2 Terengganu 1.04 2 1 2 3 2 3 3 3 3 1 1 1 P. Pinang 1.49 20 6 13 3 4 2 Sabah 3 28 9 9 22 14 7 12 11 4 8 10 3 Sarawak 2.36 22 7 9 14 9 6 6 6 3 7 9 3 Selangor W.P Kuala Lumpur 6.43 99 32 15 69 43 11 47 43 7 22 28 3 31 Edited by : Dr.Suganthi Chinnasami 1 , Dr. Mooi Chin Leong 1 , Dr. Santhi Datuk Puvanarajah 1 , Dato’ Dr. Hj. Md. Hanip Raia 1 . With contributions from : Neurophysiology Unit HKL 1 Hospital Kuala Lumpur. NEUROPHYSIOLOGY SERVICES IN PUbLIC SECTOR IN MALAYSIA The irst Neurophysiology unit in Malaysia was set up in 1964 at Kuala Lumpur Hospital with only one staff in charge of the unit. Over the years there has been a gradual increase in the total number of neurophysiology units in various states in Malaysia. Currently, there are about 19 units with 67 trained Medical Assistants. The Clinical Neurophysiology Unit provides standard electroencephalography EEG and video-telemetry VT; nerve conduction studies NCS and electromyography EMG; evoked potentials EP which include visual, somatosensory and brainstem auditory evoked response; Transcranial Doppler TCD; and sleep studies. The unit in HKL also runs a 6 months training programme every year for technologists working in the various neurophysiology units in other major hospitals nationwide since. Epilepsy is one of the most common neurological conditions affecting at any given time between 0.5 and 1 of the general population in developed country. Most studies of the prevalence of active epilepsy have estimated the igure to be 4 and 10 per 1000. The diagnosis of epilepsy is clinical and rests on the description of the seizure provided by the patient and eyewitnesses. Electroencephalogram EEG is the study used to record the electrical activity of the brain and should only be carried out in those patients in whom the symptoms suspicious of epilepsy. In such patients the indings of epileptic abnormalities in the EEG lends weight to the diagnosis and the seizure type may also be clariied. EEGs are often insensitive as more than 50 of patients with epilepsy will have a normal tracing. Portable EEG recording is done in cases where better detection of the interictal and ictal events may be achieved with prolonged recording using portable equipment and this allows recording to take place in the patient’s usual environment. Behavioral correlation can be achieved in inpatients by video monitoring during EEG and this is called as Video-EEG telemetry. This investigation is mandatory in the evaluation for Epilepsy Surgery and may be the only way to distinguish epileptic seizures from the nonepileptic events. Electrodiagnostic EDX studies play a key role in the evaluation of patients with neuromuscular disorders. Nerve conduction study and needle electromyography form the core of the EDX study and are often used to diagnose disorders of the nerve and muscles. Performed and interpreted correctly, EDX studies yield critical information about the underlying neuromuscular disorder and allow use of other laboratory tests in an appropriate and eficient manner. The principal goals of every EDX study are to localize the disorder and assess its severity. If the disorder localizes the peripheral nerves i.e. neuropathic, EDX studies often yield further key information, including the iber types involving the underlying pathophysiology and the temporal course of the disorder. Polysomnography PSG is a diagnostic test during which a number of physiological variables are measured and recorded during sleep. Information is gathered from all leads and fed into a computer and results in a series of waveform tracings, which enable the technician to visualize the various waveforms, assign a score for the test, and assist in the diagnostic process. The PSG monitors many body functions including brainEEG, eye movements EOG, muscle activity or skeletal activation EMG heart rhythm ECG, and breathing function or respiratory effort during sleep. PSG is useful in identifying the abnormality in sleep disorders such as dyssomnias and parasomnias.