Displaying publications 1 - 20 of 178 in total

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  1. Ahmad M, Zin CS, Ab Rahman AF
    J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S737-S742.
    PMID: 33828370 DOI: 10.4103/jpbs.JPBS_298_19
    Introduction: Patients receiving continuous ambulatory peritoneal dialysis (CAPD) are commonly associated with peritonitis. However, little is known about the utilization of antibiotics for the treatment of peritonitis in these patients.

    Objectives: This study aimed to evaluate the patterns of intraperitoneal (IP) antibiotic utilization for the treatment of peritonitis in CAPD patients.

    Materials and Methods: This is a retrospective study conducted at a tertiary hospital setting in Malaysia. Medical records of CAPD patients who were diagnosed with peritonitis and registered with National Kidney Registry from 2013 to 2018 were reviewed. Types of antibiotics used and its dose and duration were recorded and reported using the anatomical therapeutic chemical/defined daily dose (ATC/DDD) system.

    Results: A total of 105 peritonitis episodes were recorded from 72 patients. The most common first-line empirical antibiotic combinations used were ceftazidime/cefazolin (40%, n = 42), followed by cefepime/cefazolin (30.5%, n = 32) and ceftazidime/cloxacillin (25.7%, n = 27). The definitive therapy for culture-proven CAPD-related peritonitis (CAPD-P) showed that vancomycin was the most frequently prescribed antibiotic (31.7%, n = 26/82), followed by amikacin (14.6%, n = 12/82), meropenem (11%, n = 9/82) and ampicillin (11%, n = 9/82). Ciprofloxacin was among the least prescribed definitive antibiotics for CAPD-P (2.4%, n = 2/82) but the DDD/100 patient-days estimates showed that it had the highest therapeutic intensity.

    Conclusion: There are various IP antibiotics used for CAPD-P and the most common empirical therapy was the combination of ceftazidime and cefazolin while vancomycin is predominantly used for definitive therapy. Future studies to evaluate the clinical outcomes of the antibiotic use should be conducted to have a better insight on the efficacy of the peritonitis treatment.

    Matched MeSH terms: Medical Records
  2. Ahmad-Shushami AH, Abdul-Karim S
    Malays Orthop J, 2020 Mar;14(1):28-33.
    PMID: 32296479 DOI: 10.5704/MOJ.2003.005
    Introduction: Football and futsal were the main sports in the Malaysian Games. However, they were associated with a risk of injury. The purpose of the study was to analyse the incidence, circumstances, and characteristics of football and futsal injuries during the Malaysian Games of 2018.

    Materials and method: During the tournament, 14 teams participated in men's football, 12 teams in men's futsal and 11 teams in women's futsal. The biannual event involved athletes aged under 21 years. A medical report form used by FIFA Medical Assessment and Research Centre (F-Marc), was provided to the physiotherapists and team doctors of all the teams to report all injuries after each match.

    Results: The response rate was 84.62% in football and 59.76% in futsal. A total of 48 injuries were reported from 26 football matches, equivalent to 64.64 injuries per 1000 match hours (95%CI 46.35 to 82.93). In futsal, a total of 48 injuries from 41 matches were reported, equivalent to 292.42 injuries per 1000 match hours (95% CI 209.7 to 375.14). The rate of injury in women futsal players was higher compared to men: 358.21 versus 247.04 injuries per 1000 match hours (p=0.224). Futsal recorded higher injuries per 1000 match hours than football (p<0.001).

    Conclusion: The rate of severe injury in futsal and football recorded in the study as compared to previous studies gave rise to serious concerns. Hence, there was an urgent need to pay more attention to injury prevention strategies.

    Matched MeSH terms: Medical Records
  3. Razak AA, Saddki N, Naing NN, Abdullah N
    Asian Pac J Cancer Prev, 2010;11(1):187-91.
    PMID: 20593955
    AIMS: This study was performed to determine oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia (HUSM), Kelantan.

    METHODS: The medical records of 118 Malay patients with oral cancer admitted in HUSM from 1st January 1986 to 31st December 2005 were reviewed. Data collected include socio-demographic background, high-risk habits practiced, clinical and histological characteristics, and treatment profile of the patients. Survival status and duration were determined by active validation until 31st December 2006. Data entry and analysis were accomplished using SPSS version 12.0. The Kaplan-Meier method was used to perform survival estimates while the log-rank test and the Cox proportional hazards regression model were employed to perform univariate analysis and multivariable analysis of the variables, respectively.

    RESULTS: The overall five-year survival rate of Malay patients with oral cancer was 18.0%, with a median survival time of 9 months. Significant factors that influenced survival of the patients were age, sex, tumour site, TNM stage, histological type, and treatment received.

    CONCLUSION: Survival of oral cancer patients in HUSM was very low. Being elderly, male, presenting with an advanced stage at diagnosis, and not having treatment all contributed to poor survival.

    Matched MeSH terms: Medical Records
  4. Dayangku, N.P.S., Marina, M.B., Mawaddah, A., Sharifa Ezat, W.P., Abdullah, S.
    MyJurnal
    Background: The resultant dysphonia and aspiration in unilateral vocal cord palsy can be overcome with
    medialisation thyroplasty. With this background, we aim to determine the aetiology of the unilateral vocal
    cord palsy and effectiveness of the phonosurgical procedure with Gore-Tex as a sole treatment. Methods:
    Within a seven year period, 37 Gore-Tex medialisation thyroplasty were performed for unilateral vocal cord
    palsy at our institution and medical records were retrospectively reviewed. Results: There were 18
    males and 19 females with mean age of 48.7 years (range 19–81 years). The predominant aetiology was
    thyroidectomy (43.2%) with benign thyroid disease predominates (n=13) over thyroid malignancy (n=3). Voice
    outcome was evaluated subjectively using visual analogue scoring system, results indicating that Gore-Tex
    medialisation thyroplasty was effective in addressing dysphonia in 62.5% (n=15) patients. However it alone
    cannot address aspiration seen in those with high vagal nerve lesion. Airway compromise occurred in two
    cases postoperatively (5.4%) presenting as acute stridor. Conclusion: In unilateral vocal cord palsy, Gore-Tex
    medialisation thyroplasty can effectively improve the resultant dysphonia and often accompanying aspiration
    which would otherwise be disabling for the patients.
    Matched MeSH terms: Medical Records
  5. Zaidan AA, Zaidan BB, Al-Haiqi A, Kiah ML, Hussain M, Abdulnabi M
    J Biomed Inform, 2015 Feb;53:390-404.
    PMID: 25483886 DOI: 10.1016/j.jbi.2014.11.012
    Evaluating and selecting software packages that meet the requirements of an organization are difficult aspects of software engineering process. Selecting the wrong open-source EMR software package can be costly and may adversely affect business processes and functioning of the organization. This study aims to evaluate and select open-source EMR software packages based on multi-criteria decision-making. A hands-on study was performed and a set of open-source EMR software packages were implemented locally on separate virtual machines to examine the systems more closely. Several measures as evaluation basis were specified, and the systems were selected based a set of metric outcomes using Integrated Analytic Hierarchy Process (AHP) and TOPSIS. The experimental results showed that GNUmed and OpenEMR software can provide better basis on ranking score records than other open-source EMR software packages.
    Matched MeSH terms: Medical Records
  6. Abidi SS, Han CY, Abidi SR
    Stud Health Technol Inform, 2001;84(Pt 2):1425-9.
    PMID: 11604961
    We present an Internet-based Personalised Healthcare Information (PHI) dissemination system. Information personalisation is guided by the individual's current health profile as recorded in his/her EMR. A PHI package is composed by intelligently selecting and synthesizing various topic-specific documents, each corresponding to some health parameter noted in the EMR. To ensure medical consistency, constraint satisfaction techniques are employed during the information selection phase. The resultant PHI package--covering both long-term and immediate health-maintenance requirements--can be pro-actively pushed to the individual via email, thereby ensuring the timely availability of situation-specific health maintenance information. The featured work is in line with the Malaysian Multimedia Super Corridor Telemedicine initiative and can serve as a test-bed to evaluate the effectiveness of PHI, system design and operational considerations for larger-scale deployment.
    Matched MeSH terms: Medical Records Systems, Computerized
  7. Manickam S, Abidi SS
    Stud Health Technol Inform, 2001;84(Pt 1):643-7.
    PMID: 11604816
    Development and usage of Case Based Reasoning (CBR) driven medical diagnostic system requires a large volume of clinical cases that depict the problem-solving methodology of medical experts. Successful usage of CBR based systems in healthcare is constrained by the need for a continuous supply of current and correct clinical cases (in an electronic medium) from medical experts. To address this constraint we present a strategy to pro-actively transform generic Electronic Patient Records (EPR) to Operable CBR-oriented Cases (OCC) that are compliant to specialised CBR-based medical systems. EPR-OCC transformation methodology is based on XML parse-trees, Unified Medical Language Source (UMLS) meta-thesauri and medical knowledge ontologies. The featured work involves the implementation of a Java-based computer system for the automatic transformation of XML-based EPR-originating from heterogeneous EPR repositories accessible over the Internet/WWW-to specialised OCC that can then be seamlessly incorporated within Intelligent CBR-based Medical Diagnostic Systems.
    Matched MeSH terms: Medical Records Systems, Computerized/organization & administration*
  8. Yusof MN, Ahmad-Alwi AA
    Malays Orthop J, 2019 Mar;13(1):25-29.
    PMID: 31001380 DOI: 10.5704/MOJ.1903.004
    Introduction: Large wounds in the leg require combination of local flaps or free flap for wound coverage. Gastrocnemius musculocutaneous flap (GMCF) allows a large wound to be covered by a single local flap. However, the conventional GMCF is often associated with donor site morbidity where the exposed soleus raphe causes poor uptake of the skin graft. Islanding the skin on the muscles allows the donor site to be closed primarily, thus avoiding the donor site morbidity. Materials and Methods: Medical records of twelve patients who underwent islanded GMCF surgery from 2004 till 2018 were reviewed retrospectively. Results: The mean age was 31 years old. Eight cases were with open fracture of the tibia, two degloving injury exposing the patella, one open fracture of patella and necrotising soft tissue infection. The wound size ranged from 12cm2 to 120cm2. All flaps survived. Three patients required skin grafting at the donor site while in the rest the donor sites were able to be closed primarily. Four patients developed deep infection, one healed after vacuum dressing, one after bone transport and one after split thickness skin graft. One patient ended up with below knee amputation after developing chronic osteomyelitis of the tibia. Conclusion: Islanded gastrocnemius musculocutaneous flap is an effective simple alternative for coverage of large soft tissue defects from the knee to half of the leg distally with minimal donor site morbidity. Aggressive debridement of unhealthy tissue is necessary to prevent infection following wound coverage with this flap.
    Matched MeSH terms: Medical Records
  9. Biswas R, Maniam J, Lee EW, Gopal P, Umakanth S, Dahiya S, et al.
    J Eval Clin Pract, 2008 Oct;14(5):750-60.
    PMID: 19018906 DOI: 10.1111/j.1365-2753.2008.00997.x
    The hypothesis in the conceptual model was that a user-driven innovation in presently available information and communication technology infrastructure would be able to meet patient and health professional users information needs and help them attain better health outcomes. An operational model was created to plan a trial on a sample diabetic population utilizing a randomized control trial design, assigning one randomly selected group of diabetics to receive electronic information intervention and analyse if it would improve their health outcomes in comparison with a matched diabetic population who would only receive regular medical intervention. Diabetes was chosen for this particular trial, as it is a major chronic illness in Malaysia as elsewhere in the world. It is in essence a position paper for how the study concept should be organized to stimulate wider discussion prior to beginning the study.
    Matched MeSH terms: Medical Records Systems, Computerized/organization & administration
  10. Arshad AR, Ganesananthan S, Ajik S
    Med J Malaysia, 2000 Sep;55(3):331-40.
    PMID: 11200713
    A study was carried out in Kuala Lumpur Hospital to review the adequacy of documentation of bio-data and clinical data including clinical examination, progress review, discharge process and doctor's identification in ten of our clinical departments. Twenty criteria were assessed in a retrospective manner to scrutinize the contents of medical notes and subsequently two prospective evaluations were conducted to see improvement in case notes documentation. Deficiencies were revealed in all the criteria selected. However there was a statistically significant improvement in the eleven clinical data criteria in the subsequent two evaluations. Illegibility of case note entries and an excessive usage of abbreviations were noted during this audit. All clinical departments and hospitals should carry out detailed studies into the contents of their medical notes.
    Matched MeSH terms: Medical Records/standards*
  11. Mohd Isa NA, Cheng CL, Nasir NH, Naidu V, Gopal VR, Alexander AK
    Med J Malaysia, 2020 07;75(4):331-337.
    PMID: 32723990
    INTRODUCTION: As the first point of contact for those presenting with asthma symptoms, primary healthcare plays a crucial role in asthma management. This is a nationwide study of assessment of asthma symptom control and adherence to asthma medication among outpatients in public health clinics in Malaysia.

    METHODS: This is a prospective, observational multicentre study (ASCOPE; NCT03804632). Data on asthma control, assessment of control symptoms, and adherence to treatment were collected from medical records and interviews of patients. The level of asthma control was assessed using the Global Initiative for Asthma (GINA) Assessment of Symptom Control. Adherence of patient to medication for asthma was assessed through interview of patients using four questions adapted from the Malaysian Medication Adherence Scale.

    RESULTS: Among the 1011 patients recruited, 416 (41%) had well controlled asthma, 388 (38%) were partly controlled, and 207 (21%) had uncontrolled asthma. Majority (81%) had mild asthma and all patients were on asthma medication. Most patients did not have spirometry data (97%) but underwent peak flow rate measurements (98%). Poor adherence occurred at all levels of asthma control but was worst among those with uncontrolled asthma. This was statistically significant across all four questions on adherence (p<0.05). For example, more patients with uncontrolled asthma forgot doses (56%) or stopped treatment (39%) than those with well-controlled asthma (44% and 27%respectively).

    CONCLUSIONS: Among Malaysian primary care patients with asthma, less than 50% had well-controlled asthma, and low adherence to treatment was common. More effort is needed to improve asthma control among patients in Malaysia, including those with mild asthma.
    Matched MeSH terms: Medical Records
  12. Fei CM, Zainal H, Ali IAH
    Malays J Med Sci, 2018 Sep;25(5):103-114.
    PMID: 30914867 MyJurnal DOI: 10.21315/mjms2018.25.5.10
    Background: The use of multi-drug regimens in tuberculosis (TB) treatment has been associated with undesirable adverse drug reactions (ADRs). This study aims to assess the incidence and impact of ADRs on TB treatment in Hospital Pulau Pinang.

    Methods: This cross-sectional study was conducted via retrospective review of outpatients' medical records. Details regarding ADRs were identified by a pharmacist and verified by a consultant respiratory physician.

    Results: A total of 91 cases, out of 210 patients enrolled in this study, were detected with 75 patients (35.7%) experienced at least one ADR. The three most common ADRs detected were cutaneous adverse drug reactions (CADRs) (21.0%), drug-induced hepatitis (DIH) (7.1%) and gastrointestinal disturbance (4.8%). Pyrazinamide was the most common causative agent and 15.7% of all TB patients required treatment modification due to ADRs. Females were shown to have a higher tendency to develop ADRs than the males in this study (P = 0.009). The development of ADRs was shown not to affect the TB treatment outcomes (P = 0.955).

    Conclusion: The incidence of ADRs in this study was high so it is important to identify the risk factors for ADRs and the individuals who have those risk factors when initiating anti-TB drugs. These individuals require special attention when anti-TB drugs are initiated.

    Matched MeSH terms: Medical Records
  13. Zafirah SA, Nur AM, Puteh SEW, Aljunid SM
    BMC Health Serv Res, 2018 01 25;18(1):38.
    PMID: 29370785 DOI: 10.1186/s12913-018-2843-1
    BACKGROUND: The accuracy of clinical coding is crucial in the assignment of Diagnosis Related Groups (DRGs) codes, especially if the hospital is using Casemix System as a tool for resource allocations and efficiency monitoring. The aim of this study was to estimate the potential loss of income due to an error in clinical coding during the implementation of the Malaysia Diagnosis Related Group (MY-DRG®) Casemix System in a teaching hospital in Malaysia.

    METHODS: Four hundred and sixty-four (464) coded medical records were selected, re-examined and re-coded by an independent senior coder (ISC). This ISC re-examined and re-coded the error code that was originally entered by the hospital coders. The pre- and post-coding results were compared, and if there was any disagreement, the codes by the ISC were considered the accurate codes. The cases were then re-grouped using a MY-DRG® grouper to assess and compare the changes in the DRG assignment and the hospital tariff assignment. The outcomes were then verified by a casemix expert.

    RESULTS: Coding errors were found in 89.4% (415/424) of the selected patient medical records. Coding errors in secondary diagnoses were the highest, at 81.3% (377/464), followed by secondary procedures at 58.2% (270/464), principal procedures of 50.9% (236/464) and primary diagnoses at 49.8% (231/464), respectively. The coding errors resulted in the assignment of different MY-DRG® codes in 74.0% (307/415) of the cases. From this result, 52.1% (160/307) of the cases had a lower assigned hospital tariff. In total, the potential loss of income due to changes in the assignment of the MY-DRG® code was RM654,303.91.

    CONCLUSIONS: The quality of coding is a crucial aspect in implementing casemix systems. Intensive re-training and the close monitoring of coder performance in the hospital should be performed to prevent the potential loss of hospital income.
    Matched MeSH terms: Medical Records
  14. Sharif Nia H, Gorgulu O, Pahlevan Sharif S, Froelicher ES, Haghdoost AA, Golshani S, et al.
    Iran J Public Health, 2020 May;49(5):923-930.
    PMID: 32953680
    Background: The prevalence of Acute Myocardial Infarction (AMI) varies from region to region caused by seasonal climate changes and temperature variation. This study aimed to assess the relationship between changing meteorological conditions and incidence of AMI in Iran.

    Methods: This retrospective prevalence study was based on medical records of the heart center of Mazandaran Province on all patients diagnosed with AMI in Mazandaran, northern Iran between 2013 and 2015. Patients' sex and the day, month, year and time of hospital admission were extracted from patients' records. Moreover, the meteorological reports were gathered.

    Results: A statistically significant difference was found between the distributions of AMI cases across 12 months of the year (P < 0.01). Fuzzy clustering analysis using 16 different climatic variables showed that March, April, and May were in the same cluster together. The other 9 months were in different clusters.

    Conclusion: Significant increase in AMI was seen in March, April and May (cold to hot weather).

    Matched MeSH terms: Medical Records
  15. Liza-Sharmini AT, Ng GF, Nor-Sharina Y, Khairil Anuar MI, Nik Azlan Z, Azhany Y
    Med J Malaysia, 2014 Dec;69(6):245-51.
    PMID: 25934953 MyJurnal
    OBJECTIVE: To compare the clinical presentation, severity and progression of primary angle closure between Chinese and Malays residing in Malaysia.

    METHODS: A comparative retrospective record review study was conducted involving one hundred (200 eyes) Malay and fifty eight (116 eyes) Chinese patients. They were selected from medical records of Hospital Universiti Sains Malaysia, Kelantan and Hospital Pulau Pinang, Penang, Malaysia. The selected patients were re-diagnosed based on the International Society of Geographical and Epidemiological classification. The clinical data on presentation including the presence of systemic diseases were documented. Progression of the disease was based on available reliable visual fields and optic disc changes of patients who have been on follow-up for at least five years.

    RESULTS: Malay patients presented at older age (61.4 years SD 8.4) compared to Chinese (60.6 years SD 8.3). There was significant higher baseline Intraocular Pressure (IOP) among Malays (34.7 SD 18.5mmHg) compared to Chinese (30.3 SD 16.7mmHg) (p=0.032). The Chinese patients presented with significantly better visual acuity (p<0.001) and less advanced cup to disc changes (p=0.001) compared to Malays. Malay patients progressed faster than the Chinese. Majority progressed within 1 year of diagnosis. Malays without laser peripheral iridotomy (LPI) have a 4 fold (95% CI 1.4, 10.9) risk of progression. Higher baseline IOP, more advanced visual field defect and absence of LPI was identified as significant predictors associated with progression.

    CONCLUSION: The Malays presented with more advanced angle closure glaucoma as compared to the Chinese in Malaysia. Aggressive disease progression was observed in Malays with the onset of optic neuropathy. Effective public awareness and aggressive management is important to prevent blindness in the Malaysian population.
    Matched MeSH terms: Medical Records
  16. Zain JM, Fauzi AM, Aziz AA
    Conf Proc IEEE Eng Med Biol Soc, 2007 10 20;2006:5459-62.
    PMID: 17946306
    Digital watermarking medical images provides security to the images. The purpose of this study was to see whether digitally watermarked images changed clinical diagnoses when assessed by radiologists. We embedded 256 bits watermark to various medical images in the region of non-interest (RONI) and 480K bits in both region of interest (ROI) and RONI. Our results showed that watermarking medical images did not alter clinical diagnoses. In addition, there was no difference in image quality when visually assessed by the medical radiologists. We therefore concluded that digital watermarking medical images were safe in terms of preserving image quality for clinical purposes.
    Matched MeSH terms: Medical Records Systems, Computerized/instrumentation*
  17. Shamsul Azhar Shah, Lee, Jing, Muhammad Syahmi Khalid, Fatimah Najid, Intan Sabrina Haniff, Azmee Mohd Ghazi
    MyJurnal
    Limited studies on prevalence and risk factors of Premature Coronary Artery Disease (PCAD) were done in Malaysia, primarily on lipid profile. This cross sectional study aims to identify any changing patterns in prevalence and risk factors of Premature CAD between 2000 and 2012. From 2000 to 2012 we included 21862 patients who underwent the first Percutaneous Coronary Intervention (PCI). Analysis of risk factors was done to 1660 and 2098 patients from year 2007 and 2012 respectively. Age of less than 45 years was taken as PCAD. Data was collected from PCI database of National Heart Institute (NHI), NHI TrakCare System, and patients’ medical records. PCAD significantly decreased from 18.8% (2000) to 11.6% (2012). Malay ethnicity showed increasing trend over the years from 55.1% to 66.9%. Multiple logistic regression analysis in 2007 showed that smoking had the higher risk (AOR=2.52), followed by male gender (AOR=2.06), family history of PCAD (AOR=1.96), Indian ethnicity, (AOR=1.65), triglycerides level (AOR=1.20) and BMI (AOR=1.06). In 2012, family history of PCAD had the highest risk (AOR=2.00) followed by smoking (AOR=1.91) and BMI (AOR=1.11). There are changes in risk factors patterns of premature CAD between 2007 and 2012. Most of them are preventable at earlier stage.
    Matched MeSH terms: Medical Records
  18. Faridah K, Azmi MT
    MyJurnal
    Background : Foot ulcers and its complications are an important cause of morbidity and mortality in diabetes. The aim of this retrospective study is to determine the ulcer-free survival in diabetic foot and its relevant predictors in a cohort of diabetic patients in the primary health care setting.
    Methods : Data of newly diagnosed diabetics (n=1121) who received treatment in five health centers in the district of Kuala Langat, Selangor between 1st January 1999 until the 30th June 2008 were studied. Information was gathered by reviewing patient’s medical records. All patients were followed until 31st December 2008. The duration of ulcer-free survival was measured from the date of being diagnosed as diabetic until the development of the ulcer.
    Results : The total incidence of diabetic foot ulcer was 9.9% (n=111), with an average annual incidence of 1%. The total incidence of amputation was 1.2%. Mean age of being diagnosed having diabetic was 52+10.7 year old and mean age of being diagnosed having diabetic foot ulcer was 54.68+10.16 year old. The mean for overall ulcer-free survival was 99 months (95%CI:96-102). Male gender (LR=6.56; p=0.01), smokers (LR=3.94; p=0.04), low body mass index (LR=4.45; p=0.03), impaired renal function (LR=5.17; p=0.02) and long duration between follow-up (LR=25.10; p
    Matched MeSH terms: Medical Records
  19. BURTON-BRADLEY BG
    Med J Malaya, 1959 Jun;13:269-75.
    PMID: 13806345
    Matched MeSH terms: Medical Records*
  20. Atif M, Sulaiman SA, Shafie AA, Babar ZU
    Public Health, 2015 Jun;129(6):777-82.
    PMID: 25999175 DOI: 10.1016/j.puhe.2015.04.010
    BACKGROUND: Despite evidence of an association between tuberculosis (TB) treatment outcomes and the performance of national tuberculosis programmes (NTP), no study to date has rigorously documented the duration of treatment among TB patients. As such, this study was conducted to report the durations of the intensive and continuation phases of TB treatment and their predictors among new smear-positive pulmonary tuberculosis (PTB) patients in Malaysia.
    STUDY DESIGN: Descriptive, non-experimental, follow-up cohort study.
    METHODS: This study was conducted at the Chest Clinic of Penang General Hospital between March 2010 and February 2011. The medical records and TB notification forms of all new smear-positive PTB patients, diagnosed during the study period, were reviewed to obtain sociodemographic and clinical data. Based on standard guidelines, the normal benchmarks for the durations of the intensive and continuation phases of PTB treatment were taken as two and four months, respectively. A patient in whom the clinicians decided to extend the intensive phase of treatment by ≥2 weeks was categorized as a case with a prolonged intensive phase. The same criterion applied for the continuation phase. Multiple logistic regression analysis was performed to find independent factors associated with the duration of TB treatment. Data were analyzed using Predictive Analysis Software Version 19.0.
    RESULTS: Of the 336 patients included in this study, 261 completed the intensive phase of treatment, and 226 completed the continuation phase of treatment. The mean duration of TB treatment (n = 226) was 8.19 (standard deviation 1.65) months. Half (49.4%, 129/261) of the patients completed the intensive phase of treatment in two months, whereas only 37.6% (85/226) of the patients completed the continuation phase of treatment in four months. On multiple logistic regression analysis, being a smoker, being underweight and having a history of cough for ≥4 weeks at TB diagnosis were found to be predictive of a prolonged intensive phase of treatment. Diabetes mellitus and the presence of lung cavities at the start of treatment were the only predictors found for a prolonged continuation phase of treatment.
    CONCLUSIONS: The average durations of the intensive and continuation phases of treatment among PTB patients were longer than the targets recommended by the World Health Organization. As there are no internationally agreed criteria, it was not possible to judge how well the Malaysian NTP performed in terms of managing treatment duration among PTB patients.
    KEYWORDS: Duration of continuation phase; Duration of intensive phase; Duration of tuberculosis treatment; Malaysia; Penang; Smear-positive pulmonary tuberculosis
    Matched MeSH terms: Medical Records
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