Displaying publications 1 - 20 of 266 in total

  1. Zyoud SH, Awang R, Sulaiman SA
    Pharmacoepidemiol Drug Saf, 2012 Feb;21(2):207-13.
    PMID: 21812068 DOI: 10.1002/pds.2218
    The present study examines the relationship between the dose of acetaminophen reported to have been ingested by patients and the occurrence of serum acetaminophen levels above the 'possible toxicity' line in patients presenting at the hospital after acetaminophen overdose. The prognostic value of patient-reported dosage cut-offs of 8, 10 and 12 g was determined.
    Matched MeSH terms: Emergency Service, Hospital/statistics & numerical data*
  2. Zuraida Ahmad Sabki, Zainal NZ
    Objective: The study aimed to explore the prevalence of burnout among the junior doctors and to examine the psychometric properties of abbreviated Maslach Burnout Inventory (aMBI). Methods: A cross-sectional study was conducted using aMBI self-reported questionnaire and Hospital Anxiety Depression Scale which was carried out on a sample of 117 junior doctors working in a teaching hospital in Malaysia. Results: Exploratory factor analysis of aMBI revealed a three-factor structure labelled as emotional exhaustion, depersonalization and personal accomplishment with Crohnbach’s alpha of 0.85, 0.59 and 0.64 respectively. The total variance was 67%. Prevalence of burnout was found at 26.5%. Emotional exhaustion and depersonalization were positively correlated with depression and anxiety. Shorter duration of residence (less than six months) and being posted to Trauma & Emergency unit were associated with higher mean score of burnout. Conclusion: This study provides the knowledge of level of burnout among the junior doctors and the abbreviated Maslach Burnout Inventory has a satisfied psychometirc properties for screening burnout among junior doctors in Malaysia.
    Matched MeSH terms: Emergency Service, Hospital
  3. Zhang ZY, Yang WY, Dominiczak AF, Wang JG, Wu Y, Almustafa B, et al.
    Hypertension, 2019 11;74(5):1064-1067.
    PMID: 31422692 DOI: 10.1161/HYPERTENSIONAHA.119.13206
    Matched MeSH terms: Emergency Service, Hospital
  4. Zainudin BM, Ismail O, Yusoff K
    Thorax, 1994 Mar;49(3):267-9.
    PMID: 8202885
    BACKGROUND: The benefit of adding theophylline to beta 2 agonists in acute asthmatic attacks has been debated frequently.
    METHODS: In an open randomised study 25 patients with severe acute asthma who presented to the emergency department were treated with either a combined nebulised salbutamol (5 mg/dose) and aminophylline infusion (0.6-0.9 mg/kg/hour), or nebulised salbutamol alone.
    RESULTS: The responses to treatment as measured by peak expiratory flow (PEF) and the time taken to achieve maximum PEF were similar in both groups. Side effects were observed more commonly in patients receiving the combined treatment.
    CONCLUSIONS: Nebulised salbutamol is equally efficacious in acute asthma when given alone or in combination with aminophylline.
    Study site: Emergency department, Hospital Kuala Lumpur, Malaysia
    Matched MeSH terms: Emergency Service, Hospital
  5. Zainal Abidin H, Omar SC, Mazlan MZ, Hassan MH, Isa R, Ali S, et al.
    Glob Pediatr Health, 2021;8:2333794X211007975.
    PMID: 33889680 DOI: 10.1177/2333794X211007975
    Over the years, the number of pediatric patients undergoing surgeries are increasing steadily. The types of surgery vary between elective to emergency with involvement of multidisciplinary teams. The development of day care surgery unit is expanding where the patients will only come to the hospital on the day of surgery and discharge home after such as satisfactory parameters achieved, minimal to no pain, minimal to no bleeding from surgical site and able to tolerate fluids. Hospitalization and surgery could contribute to significant psychological disturbance to the children. These issues are not being addressed as children have difficulty in conveying their problems and fear. They do however express it through negative behavioral changes.
    Matched MeSH terms: Emergency Service, Hospital
  6. Yussof SJM, Zakaria MI, Mohamed FL, Bujang MA, Lakshmanan S, Asaari AH
    Med J Malaysia, 2012 Aug;67(4):406-11.
    PMID: 23082451
    INTRODUCTION: The importance of early recognition and treatment of sepsis and its effects on short-term survival outcome have long been recognized. Having reliable indicators and markers that would help prognosticate the survival of these patients is invaluable and would subsequently assist in the course of effective dynamic triaging and goal directed management.
    STUDY OBJECTIVES: To determine the prognosticative value of Shock Index (SI), taken upon arrival to the emergency department and after 2 hours of resuscitation on the shortterm outcome of severe sepsis and septic shock patients.
    METHODOLOGY: This is a retrospective observational study involving 50 patients admitted to the University of Malaya Medical Centre between June 2009 and June 2010 who have been diagnosed with either severe sepsis or septic shock. Patients were identified retrospectively from the details recorded in the registration book of the resuscitation room. 50 patients were selected for this pilot study. The population comprised 19 males (38%) and 31 females (62%). The median (min, max) age was 54.5 (17.0, 84.0) years. The number of severe sepsis and septic shock cases were 31 (62%), and 19 (38%) respectively. There were 17 (34%) cases of pneumonias, 13 (26%) cases of urological sepsis, 8 (16%) cases of gastro intestinal tract related infections and 12 (24%) cases of other infections. There were a total of 23 (46%) survivors and 27 (54%) deaths. The value of the shock index is defined as systolic blood pressure divided by heart rate was calculated. Shock Index on presentation to ED (SI 1) and after 2 hours of resuscitation in the ED (SI 2). The median, minimum and maximum variables were tested using Mann-Whitney U and Chi square analysis. The significant parameters were re-evaluated for sensitivity, specificity and cut-off points. ROC curves and AUC values were generated among these variables to assess prognostic utility for outcome.
    RESULTS: Amongst all 7 variables tested, 2 were tested to be significant (p: < 0.05). From the sensitivity, specificity and ROC analysis, the best predictor for death was (SI 2) with a sensitivity of 80.8%, specificity of 79.2%, AUC value of 0.8894 [CI 95 0.8052, 0.9736] at a cut-off point of > or = 1.0.
    CONCLUSION: (SI 2) may potentially be utilized as a reliable predictor for death in patients presenting with septic shock and severe sepsis in an emergency department. This parameters should be further analyzed in a larger scale prospective study to determine its validity.
    Matched MeSH terms: Emergency Service, Hospital
  7. Yunus SS, Ngeow WC, Ramli R
    Am J Emerg Med, 2015 Sep;33(9):1253-7.
    PMID: 26026365 DOI: 10.1016/j.ajem.2015.05.009
    A cross-sectional study to determine the pattern of craniomaxillofacial (CMF) injuries among children involved in road traffic crashes was performed. The association of protective equipment use with the CMF injuries was evaluated.
    Matched MeSH terms: Emergency Service, Hospital
  8. Yunos NM, Bellomo R, Taylor DM, Judkins S, Kerr F, Sutcliffe H, et al.
    Emerg Med Australas, 2017 Dec;29(6):643-649.
    PMID: 28597505 DOI: 10.1111/1742-6723.12821
    OBJECTIVE: Patients commonly receive i.v. fluids in the ED. It is still unclear whether the choice of i.v. fluids in this setting influences renal or patient outcomes. We aimed to assess the effects of restricting i.v. chloride administration in the ED on the incidence of acute kidney injury (AKI).

    METHODS: We conducted a before-and-after trial with 5008 consecutive ED-treated hospital admissions in the control period and 5146 consecutive admissions in the intervention period. During the control period (18 February 2008 to 17 August 2008), patients received standard i.v. fluids. During the intervention period (18 February 2009 to 17 August 2009), we restricted all chloride-rich fluids. We used the Kidney Disease: Improving Global Outcomes (KDIGO) staging to define AKI.

    RESULTS: Stage 3 of KDIGO-defined AKI decreased from 54 (1.1%; 95% confidence interval [CI] 0.8-1.4) to 30 (0.6%; 95% CI 0.4-0.8) (P = 0.006). The rate of renal replacement therapy did not change, from 13 (0.3%; 95% CI 0.2-0.4) to 8 (0.2%; 95% CI 0.1-0.3) (P = 0.25). After adjustment for relevant covariates, liberal chloride therapy remained associated with a greater risk of KDIGO stage 3 (hazard ratio 1.82; 95% CI 1.13-2.95; P = 0.01). On sensitivity assessment after removing repeat admissions, KDIGO stage 3 remained significantly lower in the intervention period compared with the control period (P = 0.01).

    CONCLUSION: In a before-and-after trial, a chloride-restrictive strategy in an ED was associated with a significant decrease in the incidence of stage 3 of KDIGO-defined AKI.

    Matched MeSH terms: Emergency Service, Hospital/organization & administration
  9. Yuce A, Dedeoglu SS, Imren Y, Yerli M, Gurbuz H
    Malays Orthop J, 2020 Nov;14(3):90-97.
    PMID: 33403067 DOI: 10.5704/MOJ.2011.014
    Introduction: The selection of the stage where fibular plate was performed in two-stage surgery of the intra-articular distal tibiofibular fractures with soft tissue injury is still controversial. The aim of the study was to compare the complications, radiological and functional outcomes between the patients who had fibular plate at initial or second phase during surgical management of such fractures.

    Materials and Methods: In this study, medical records of 47 patients who underwent a two-stage surgical procedure for intra-articular distal tibia fractures accompanying soft tissue injury were retrospectively examined. Delta frame was applied in all cases within 24 hours following admission to the emergency department in accordance with AO principles. Those cases where fibular plate was applied during the initial stage and the second stage were classified as Group 1 and Group 2 in order to compare recorded data between the two groups.

    Results: According to the results of the study, there were 25 cases in Group 1 and 22 cases in Group 2 in which fibular plate was applied at the first stage and the second stage, respectively. The mean follow-up was found as 27.7±7.0 months in Group 1 and 28.2±6.2 months in Group 2 (p=0.778). No difference was found between the two groups in terms of the age, sex, hospital stay, the time between two surgical procedures, tibiofibular angle and AOFAS scoring (p>0.05).These two groups were also similar in mechanism of injury, Denise-Weber or AO classification, rates of tibiofibular malalignment on post-operative CT, fibular rotation, intra-articular tibial step-off, tibial varus-valgus duration of union, rate of infection, fibular angulation and the presence of the flap/graft/debridement (p>0.05).

    Conclusion: In conclusion, two-stage surgical procedure in intra-articular distal tibiofibular fractures may be an effective method decreasing soft tissue complications. The timing of the open reduction and internal fixation of the fibula at different stages may not necessarily have an impact on the success of the post-operative tibial reduction, the total duration of surgery, syndesmosis malalignment or soft tissue complications.

    Matched MeSH terms: Emergency Service, Hospital
  10. Yousuf R, Abdul Aziz S, Yusof N, Leong CF
    Indian J Hematol Blood Transfus, 2014 Sep;30(3):208-10.
    PMID: 25114411 DOI: 10.1007/s12288-012-0211-6
    We report a 47-year-old Malay lady, para 4 + 1, with known medical history of hypertension whom presented at Emergency Department with severe anaemia, most likely secondary to menorrhagia caused by uterine fibroids. Her haemoglobin was 5.5 g/dl and she was transfused with three units of packed cell without any adverse reaction, her haemoglobin level increased to 9.8 g/dl. She was then planned for total abdominal hysterectomy and bilateral salpingo-oophorectomy later. Four months later when she came for the elective surgery, her pre transfusion investigations showed blood group as B Rh D positive, with a probable R1R1 phenotype. Her antibody screening was positive in all the three panel cells. Further testings showed a negative Direct Coomb's test and negative autocontrol, antibody identification showed pan-agglutination reaction on all 11 panel cells with enzyme enhancement. Patient's red cell phenotype was Jk(a-b-). Anti-Jk3 was suspected and further confirmed in the reference laboratory by phenotyping as well as negative urea lysis test. This case report highlights an extremely rare but clinically significant anti-JK3 antibody detected during pretransfusion testing. This phenotype is rare in the white population, more commonly seen in various polynesians. Increased awareness among the blood bank personnel regarding the variability of the blood group phenotype and the capricious nature of the Kidd antibodies may contribute to the better management of these patients.
    Matched MeSH terms: Emergency Service, Hospital
  11. Yong YV, Shafie AA
    Value Health Reg Issues, 2018 May;15:6-11.
    PMID: 29474180 DOI: 10.1016/j.vhri.2017.05.001
    BACKGROUND: Patients with asthma need long-term management to maintain optimal control. In addition to routine maintenance, urgent visits and hospitalizations may be required, as these patients are prone to acute exacerbations. The aim of this study was to estimate the costs of maintenance and acute exacerbation managements in patients with asthma in a suburban public hospital in Malaysia.

    METHODS: An activity-based microcosting approach was applied to estimate the unit cost of events from the hospital's perspective. First, activities and resources that were involved in each cost center were identified and valued against a suitable form of unit. Thereafter, the mean cost of each resource per event was calculated by dividing the product of the quantity of the resource used and the unit cost of the resource by the number of events. The mean cost per event was the sum of the cost of resources for all cost centers involved. The costs were expressed in 2014 US dollars ($) and Malaysian Ringgit (RM).

    RESULTS: Data were collected from 15 maintenance, 20 acute exacerbation, and 50 hospitalization events. The mean (±SD) cost of maintenance management was $48.04 (±10.10); RM154.68 (±32.52). The cost of acute exacerbation management in the Emergency Department was $13.50 (±2.21), RM43.46 (±7.10); and in the medical ward, the cost was $552.13 (±303.41), RM1777.86 (±976.98), per hospitalization event.

    CONCLUSION: The microcosting of management of asthma-related events provides more accurate estimates that could be used in local economic studies. However, its possible limited generalizability to other types of health care settings in Malaysia needs to be kept in mind.

    Matched MeSH terms: Emergency Service, Hospital
  12. Yew Y, Arcos González P, Castro Delgado R
    Prehosp Disaster Med, 2020 Feb;35(1):76-82.
    PMID: 31928556 DOI: 10.1017/S1049023X19005247
    INTRODUCTION: The Richter Scale measures the magnitude of the seismic activity for an earthquake; however, it does not quantify the humanitarian need at the point of impact. This poses a challenge for humanitarian stakeholders in decision and policy making, especially in risk reduction, response, recovery, and reconstruction. The new disaster metrics tool titled "The YEW Disaster Severity Index" (DSI) was developed and presented at the 2017 World Congress of Disaster and Emergency Medicine, May 2017, Toronto, Canada. It uses a median score of three for vulnerability and exposure indicators, a median score percentage of 100%, and medium YEW DSI scoring of four to five as baseline, indicating the ability to cope within local capacity. Therefore, scoring more than baseline coping capacity indicates that external assistance is needed. This special real-time report was presented at the 2nd National Pre-Hospital Care Conference and Championship, October 2018, Malaysia.

    REPORT: The aim of this analysis is to present the real-time humanitarian impact and response to the 2018 earthquake and tsunami at Donggala and Palu, Sulawesi in Indonesia using the new disaster metrics YEW DSI. Based on the earthquake (measuring 7.7 on the Richter Scale) and tsunami at Donggala, the humanitarian impact calculated on September 29, 2018 scored 7.4 High in the YEW DSI with 11 of the total 17 indicators scoring more than the baseline coping capacity. The same YEW DSI score of 7.4 was scored on the earthquake and tsunami at Palu, with 13 of the total 17 indicators scoring more than baseline ability to cope within local capacity. Impact analysis reports were sent to relevant authorities on September 30, 2018.

    DISCUSSION & CONCLUSION: A State of Emergency was declared for a national response, which indicated an inability to cope within the local capacity, shown by the YEW DSI. The strong correlation between the earthquake magnitude, intensities, and the humanitarian impact at Donggala and Palu reported could be added into the science of knowledge in prehospital care and disaster medicine research and practice. As a conclusion, the real-time disaster response was found to be almost an exact fit with the YEW DSI indicators, demonstrating the inability to cope within the local capacity.

    Matched MeSH terms: Emergency Service, Hospital/standards*
  13. Yeoh C, Teo A, Azhar AMN, Suann ST, Thum Y, Wong KD, et al.
    J Acute Med, 2019 Sep 01;9(3):128-144.
    PMID: 32995241 DOI: 10.6705/j.jacme.201909_9(3).0005
    Background: Balanced fluids are preferred in initial resuscitation of septic patients based on several recent studies. The Stewart's concept on acid-base balance predicts that high strong ion difference (SID) fluid thus will increase the pH level. To date, the impact of high SID fluid in septic patient with metabolic acidosis remains uncertain. We conducted single center, randomized, double-blind trial to compare the effect of high SID fluid vs. Hartmann's solution on acid-base status in selected sepsis patients in the Emergency Department.

    Methods: Septic patient with hyperlactatemia and metabolic acidosis were randomized to receive either high SID fl uid or Hartmann's solution during initial fl uid resuscitation. The primary outcome measures the pH and bicarbonate levels difference pre- and post- resuscitation.

    Results: One hundred and sixty-two patients underwent randomization, 81 were assigned each to receive high SID fluid or Hartmann's solution. Both groups had similar baseline characteristics. High SID group received 23.5 mL/kg and the Hartmann's group received 22.7 mL/kg (p = 0.360). High SID fluid increased the mean (± SD) pH by 0.107 (± 0.09) vs. Hartmann's solution by 0.014 (± 0.12), p ≤ 0.001. Mean bicarbonate level increased signifi cantly in high SID group compared to Hartmann's (4.30 ± 3.76 vs. 1.25 ± 3.33, p ≤ 0.001). High SID group had higher post resuscitation lactate clearance than Hartmann's group (25.4 ± 28.3% vs. 12.0 ± 34.1%, p = 0.009). Shorter hospital stay was observed in highSID group 8.04 ± 5.96 days vs. Hartmann's group 12.18 ± 12.41 days (p = 0.048). Both groups showed no difference in incidence of pulmonary oedema, acute kidney injury and mortality.

    Conclusions: Initial resuscitation using high SID fluid in selected septic patient improves pH and bicarbonate levels. The high SID group had better post resuscitation lactate clearance and shorter hospital stay.

    Matched MeSH terms: Emergency Service, Hospital
  14. Yazid MB, Fauzi MH, Hasan H, Md Noh AY, Deris ZZ
    J Immigr Minor Health, 2017 Jun;19(3):774-777.
    PMID: 27160769 DOI: 10.1007/s10903-016-0429-8
    A neglected tropical disease, melioidosis is known to have variability in clinical presentations. Here, we described clinical features that should alert the physicians on the possibility of melioidosis. In this review of 86 cases from 2001 to 2011, the common presentations of melioidosis in the Emergency Department (ED), Hospital Universiti Sains Malaysia were; male gender (79.1 %), in working age group (47.8 ± 15.2 year-old), worked in contact with soil (73.3 %), presented with fever (91.9 %), in rainy season (55.8 %), have underlying diabetes mellitus (79.1 %), have leukocytosis (67.4 %) and high blood glucose (62.8 %) during presentation. In 34.9 % of cases, the antimicrobials were initiated at the ED and only 10.5 % include antimelioid drugs. Thirty-one patients (36.0 %) died due to melioidosis and 51.6 % of this were within 48 h of admission. Despite high mortality rate, the clinical awareness on the possibility of melioidosis among emergency physicians is still low and need to be strengthened.
    Matched MeSH terms: Emergency Service, Hospital/statistics & numerical data*
  15. Yap XH, Ng CJ, Hsu KH, Chien CY, Goh ZNL, Li CH, et al.
    Sci Rep, 2019 11 12;9(1):16618.
    PMID: 31719593 DOI: 10.1038/s41598-019-52989-7
    This study assesses the performance of National Early Warning Score (NEWS), Quick Sepsis-related Organ Failure Assessment (qSOFA), Modified Early Warning Score (MEWS), Rapid Emergency Medicine Score (REMS), and Rapid Acute Physiology Score (RAPS) in predicting emphysematous pyelonephritis (EPN) patients' need for intensive care unit (ICU) admission. A retrospective analysis was conducted at four training and research hospitals' emergency departments (EDs) on all EPN adult patients from January 2007 to August 2017. Data extracted were used to calculate raw scores for five physiologic scoring systems. Mann-Whitney U tests and χ2 tests were done for numerical and categorical variables respectively to examine differences between characteristics of ICU and non-ICU patient populations. Predictability of ICU admission was evaluated with AUROC analysis. ICU patients had lower GCS scores, SpO2, platelet counts, and estimated glomerular filtration rate; and higher bands, blood urea nitrogen, creatinine, and incidences of septic shock and nephrectomy. NEWS performed best, with 73.85% accuracy at optimal cut-off of 3. In this multicentre ED EPN series, we recommend using NEWS in early identification of critical EPN patients and advance planning for ICU admission. This would reduce delays in ICU transfer and ultimately improve patient outcomes.
    Matched MeSH terms: Emergency Service, Hospital*
  16. Yahaya SN, Wahab SFA, Yusoff MSB, Yasin MAM, Rahman MAA
    World J Emerg Med, 2018;9(3):178-186.
    PMID: 29796141 DOI: 10.5847/wjem.j.1920-8642.2018.03.003
    BACKGROUND: Demanding profession has been associated with poor psychological health due to multiple factors such as overworking hours and night shifts. This study is to determine prevalence and associated factors of depression, anxiety and stress among medical officers working at emergency department in Malaysian hospitals.

    METHODS: A cross-sectional study was conducted on 140 emergency department medical officers working at general hospitals from seven Malaysia regions. They were randomly selected and their depression, anxiety and stress level were measured by the 21-item Depression, Anxiety, Stress Scale.

    RESULTS: The highest prevalence was anxiety (28.6%) followed by depression (10.7%) and stress (7.9%). Depression, anxiety and stress between seven hospitals were not significantly different (P>0.05). Male medical officers significantly experienced more anxiety symptoms than female medical officers (P=0.0022), however depression and stress symptoms between male and female medical officers were not significantly different (P>0.05). Depression, anxiety and stress were not associated with age, working experience, ethnicity, marital status, number of shifts and type of system adopted in different hospitals (P>0.05).

    CONCLUSION: The prevalence of anxiety was high, whereas for depression and stress were considerably low. Gender was the only factor significantly associated with anxiety. Other factors were not associated with depression, anxiety and stress. Future research should aim to gain better understanding on unique factors that affect female and male medical officers' anxiety level in emergency setting, thus guide authorities to chart strategic plans to remedy this condition.

    Matched MeSH terms: Emergency Service, Hospital
  17. Woon YL, Lim MF, Tg Abd Rashid TR, Thayan R, Chidambaram SK, Syed Abdul Rahim SS, et al.
    BMC Infect Dis, 2019 Feb 13;19(1):152.
    PMID: 30760239 DOI: 10.1186/s12879-019-3786-9
    BACKGROUND: A major outbreak of the Zika virus (ZIKV) has been reported in Brazil in 2015. Since then, it spread further to other countries in the Americas and resulted in declaration of the Public Health Emergency of International Concern (PHEIC) by World Health Organization. In 2016, Singapore reported its first minor ZIKV epidemic. Malaysia shares similar ecological environment as Brazil and Singapore which may also favor ZIKV transmission. However, no ZIKV outbreak has been reported in Malaysia to date. This study aimed to discuss all confirmed ZIKV cases captured under Malaysia ZIKV surveillance system after declaration of the PHEIC; and explore why Malaysia did not suffer a similar ZIKV outbreak as the other two countries.

    METHODS: This was an observational study reviewing all confirmed ZIKV cases detected in Malaysia through the ZIKV clinical surveillance and Flavivirus laboratory surveillance between June 2015 and December 2017. All basic demographic characteristics, co-morbidities, clinical, laboratory and outcome data of the confirmed ZIKV cases were collected from the source documents.

    RESULTS: Only eight out of 4043 cases tested positive for ZIKV infection during that period. The median age of infected patients was 48.6 years and majority was Chinese. Two of the subjects were pregnant. The median interval between the onset of disease and the first detection of ZIKV Ribonucleic Acid (RNA) in body fluid was 3 days. Six cases had ZIKV RNA detected in both serum and urine samples. Phylogenetic analysis suggests that isolates from the 7 cases of ZIKV infection came from two clusters, both of which were local circulating strains.

    CONCLUSION: Despite similar ecological background characteristics, Malaysia was not as affected by the recent ZIKV outbreak compared to Brazil and Singapore. This could be related to pre-existing immunity against ZIKV in this population, which developed after the first introduction of the ZIKV in Malaysia decades ago. A serosurvey to determine the seroprevalence of ZIKV in Malaysia was carried out in 2017. The differences in circulating ZIKV strains could be another reason as to why Malaysia seemed to be protected from an outbreak.

    Matched MeSH terms: Emergency Service, Hospital
  18. Woon TH, Loke KH
    Singapore Med J, 1984 Jun;25(3):161-4.
    PMID: 6484584
    In February to March 1982 at the psychiatric emergency service of the University Hospital, Kuala Lumpur, some data on 491 patients (92% of 531 patients seen) were collected. Two-hundred and eighty-three patients had received psychiatric treatment and 65 had previously received medical treatment. Fifty-three per cent of the patients have schizophrenic disorders, 5.1% had situational reactions and 1.63% had chronic alcoholism. Of the 111 patients presented with either physical complaints or insomnia, eleven of them were admitted to the psychiatric wards. Three-hundred and eleven patients were followed-up in the psychiatric outpatient clinics. The availability of a psychiatric emergency service in a general hospital can contribute towards early psychiatric case findings and preventive Intervention. II provides an opportunity for liaison and consultation with other medical colleagues in the care of patients with physical complaints and attempted suicides.

    Study site: Universiti Malaya Medical Centre (UMMC)
    Matched MeSH terms: Emergency Service, Hospital
  19. Wong TH, Lim GH, Chow KY, Trauma Coordinators and Trauma Service Representatives, Zaw NN, Nguyen HV, et al.
    BMC Public Health, 2016 05 14;16:402.
    PMID: 27180046 DOI: 10.1186/s12889-016-3080-3
    BACKGROUND: Seatbelt non-compliance is a problem in middle income countries, and little is known about seatbelt compliance in populations with a high proportion of non-residents. This study analyses the profile of seatbelt non-compliance in Singapore based on trauma registry data from five of the six public hospitals.

    METHODS: This is a cross-sectional study of seatbelt compliance of patients aged over 18 years, attending the emergency departments of five public hospitals in Singapore after road collisions from 2011-2014. Seatbelt data was obtained from paramedic and patient history.

    RESULTS: There were 4,576 patients studied. Most were Singapore citizens (83.4 %) or permanent residents (2.4 %), with the largest non-resident groups from Malaysia, India, and China. Overall seatbelt compliance was 82.1 %. On univariate analysis, seatbelt compliance was higher in older patients (OR 1.02, 95 % CI 1.001-1.021, p 

    Matched MeSH terms: Emergency Service, Hospital/statistics & numerical data*
  20. Ur Rehman A, Hassali MAA, Muhammad SA, Shakeel S, Chin OS, Ali IABH, et al.
    Pharmacoecon Open, 2021 Mar;5(1):35-44.
    PMID: 32291727 DOI: 10.1007/s41669-020-00214-x
    BACKGROUND: Chronic obstructive pulmonary disease (COPD) requires long-term pharmacological and non-pharmacological management that encompasses continuous economic burden on patients and society, and also results in productivity losses due to compromised quality of life. Among working-age patients, COPD is the 11th leading cause of work productivity loss.

    OBJECTIVE: The aim of this study was to assess the economic burden of COPD in Malaysia, including direct costs for the management of COPD and indirect costs due to productivity losses for COPD patients.

    METHODOLOGY: Overall, 150 patients with an established diagnosis of COPD were followed-up for a period of 1 year from August 2018 to August 2019. An activity-based costing, 'bottom-up' approach was used to calculate direct costs, while indirect costs of patients were assessed using the Work Productivity and Activity Impairment Questionnaire.

    RESULTS: The mean annual per-patient direct cost for the management of COPD was calculated as US$506.92. The mean annual costs per patient in the management phase, emergency department visits, and hospital admissions were reported as US$395.65, US$86.4, and US$297.79, respectively; 31.66% of COPD patients visited the emergency department and 42.47% of COPD patients were admitted to the hospital due to exacerbation. The annual mean indirect cost per patient was calculated as US$1699.76. Productivity losses at the workplace were reported as 31.87% and activity limitations were reported as 17.42%.

    CONCLUSION: Drugs and consumables costs were the main cost-driving factors in the management of COPD. The higher ratio of indirect cost to direct medical costs shows that therapeutic interventions aimed to prevent work productivity losses may reduce the economic burden of COPD.

    Matched MeSH terms: Emergency Service, Hospital
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