EXPERIMENTS: Zeta potentials of small air bubbles and bunker oil drops dispersed in aqueous solutions of n-methylimidazolium chloride ionic liquids (n=0, 2, 3, 6, 8, 10, 12) of concentrations ranging from 1000PPM to 8000PPM, as were interfacial tensions of these solutions with bunker oil (180cst) and contact angles made by air bubbles at interfaces between these solutions and thin layers of bunker oil on flat solid surfaces were investigated. Finally, interparticle forces analysis using the Derjaguin-Landau, Verwey-Overbeek (DLVO) theory is also included.
FINDINGS: Analysis using the DLVO theory showed attractive forces between the oil particles and micro-bubbles are significantly more prevalent in short CCLs solutions of imidazolium-based ILs in low concentrations, namely [C0mim][Cl] and [C2mim][Cl] at a maximum zeta potential difference of 75.3mV. The results from CA measurements follows similarly whereby low concentrations of ILs with short CCLs were in favor for the bubble-particle attachment process with angles ranging between 93.95° for [C0mim][Cl] and 97.28° for [C2mim][Cl]. IFT which is important in reducing coalescence for the preferential BPA process to occur in flotation decreases with an increase of CCL and concentration of IL.
METHODS: This cross-sectional study was conducted from the healthcare providers' perspective from January 1st to June 30th 2014. TH is a university teaching hospital in the capital city, while GH is a state-level general hospital. Both are government-funded cardiac referral centers. Clinical data was extracted from a national cardiac registry. Cost data was collected using mixed method of top-down and bottom-up approaches. Total hospitalization cost per PCI patient was summed up from the costs of ward admission and cardiac catheterization laboratory utilization. Clinical characteristics were compared with chi-square and independent t-test, while hospitalization length and cost were analyzed using Mann-Whitney test.
RESULTS: The mean hospitalization cost was RM 12,117 (USD 3,366) at GH and RM 16,289 (USD 4,525) at TH. The higher cost at TH can be attributed to worse patients' comorbidities and cardiac status. In contrast, GH recorded a lower mean length of stay as more patients had same-day discharge, resulting in 29% reduction in mean cost of admission compared to TH. For both hospitals, PCI consumables accounted for the biggest proportion of total cost.
CONCLUSIONS: The high PCI consumables cost highlighted the importance of cost-effective purchasing mechanism. Findings on the heterogeneity of the patients, treatment practice and hospitalization cost between TH and GH are vital for formulation of cost-saving strategies to ensure sustainable and equitable cardiac service in Malaysia.
METHODS: This validation study involves retrospective review of available hospital discharge records and hand-search medical records for years 2010 and 2013. We randomly selected 3219 hospital discharge records coded with dengue and non-dengue infections as their discharge diagnoses from the national hospital discharge database. We then randomly sampled 216 and 144 records for patients with and without codes for dengue respectively, in keeping with their relative frequency in the MOH database, for chart review. The ICD codes for dengue were validated against lab-based diagnostic standard (NS1 or IgM).
RESULTS: The ICD-10-CM codes for dengue had a sensitivity of 94%, modest specificity of 83%, positive predictive value of 87% and negative predictive value 92%. These results were stable between 2010 and 2013. However, its specificity decreased substantially when patients manifested with bleeding or low platelet count.
CONCLUSION: The diagnostic performance of the ICD codes for dengue in the MOH's hospital discharge database is adequate for use in health services research on dengue.
METHODS: This study is based entirely on the available secondary data sources on dengue in Malaysia. The age-specific incidence of dengue between 2001 and 2013 was estimated using the prevalence and mortality estimates in an incidence-prevalence-mortality (IPM) model. Data on dengue prevalence were extracted from six sero-surveys conducted in Malaysia between 2001 and 2013; while statistics on dengue notification and Case Fatality Rate were derived from National Dengue Surveillance System. Dengue hospitalization data for the years 2009 to 2013 were extracted from the Health Informatics Centre and the volumes of dengue hospitalization for hospitals with missing data were estimated with Poisson models.
RESULTS: The dengue incidence in Malaysia varied from 69.9 to 93.4 per 1000 population (pkp) between 2001 and 2013.The temporal trend in incidence rate was decreasing since 2001. It has been reducing at an average rate of 2.57 pkp per year from 2001 to 2013 (p = 0.011). The age-specific incidence of dengue decreased steadily with dengue incidence reaching zero by age > 70 years. Dengue notification rate has remained stable since 2001 and the number of notified cases each year was only a small fraction of the incident cases (0.7 to 2.3%). Similarly, the dengue hospitalization was larger but still a small fraction of the incident cases (3.0 to 5.6%).
CONCLUSION: Dengue incidence can be estimated with the use of sero-prevalence surveys and mortality data. This study highlights a reducing trend of dengue incidence in Malaysia and demonstrates the discrepancy between true dengue disease burden and cases reported by national surveillance system. Sero-prevalence studies with representative samples should be conducted regularly to allow better estimation of dengue burden in Malaysia.
Method: The guidelines were developed by an appointed workgroup comprising experts in the Asia Pacific region, following reviews of previously published guidelines and recommendations relevant to each section.
Results: It recommends that healthcare facilities review specific risk factors and develop effective prevention strategies, which would be cost effective at local levels. Gaps identified are best closed using a quality improvement process. Surveillance of SSIs is recommended using accepted international methodology. The timely feedback of the data analysed would help in the monitoring of effective implementation of interventions.
Conclusions: Healthcare facilities should aim for excellence in safe surgery practices. The implementation of evidence-based practices using a quality improvement process helps towards achieving effective and sustainable results.
METHOD: A total of 431 medical interns at 26 Malaysian Ministry of Health hospitals participated in this cross-sectional study in 2017. Self-administered questionnaires consisting of sociodemographic characteristics, items from DASS and BRIEF COPE were used. Descriptive analysis was done followed by further analysis with chi-square and Spearman correlation tests.
RESULTS: The prevalence of stress, anxiety, and depression was 29.7%, 39.9%, and 26.2%, with a significantly higher prevalence among female and younger interns. Three-quarters of them (73.1%) applied problem-focused strategies as the main coping mechanism. Emotion-focused coping strategies showed a significant but weak correlation with anxiety and stress whereas avoidance-based coping strategies were significantly correlated with depression, anxiety, and stress.
DISCUSSION: Medical internship is a highly grueling period. Besides emphasizing clinical competency, internship training should also impart the practice of healthy coping mechanisms. The vulnerable groups of females and younger interns should be taught positive coping skills so that they are empowered to handle any stressors on their personal and professional lives. Optimum psychological wellbeing of the medical interns can improve the overall work performance and quality of care for patients.