Displaying publications 1 - 20 of 107 in total

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  1. Balasegaram M
    Ann Surg, 1969 Apr;169(4):544-50.
    PMID: 5774743
    Thirty-five patients with blunt hepatic injuries treated in a 7-year period are reviewed. The difficulties of diagnosis are stressed in that only 48.6%c were diagnosed
    preoperatively. Associated intra-abdominal and concomitant head, chest, pelvic and skeletal injuries accounted for most of these difficulties. Seventeen of the 35 patients had extensive lacerations or intra-lobar ruptures of the liver. Simple linear or stellate lacerated wounds were treated by drainage, or suture, or debridement of the ragged liver edges and suture. Prior to 1964 extensively lacerated liver wounds were treated by gauze packing. Three (60%c) of five patients thus treated died, while the others had multiple complications. Since 1964, packing has been abandoned in favor of major resection and of 11 patients who underwent such procedures only one died. Hepatic resection for severe blunt injuries has the advantages of removal of all devitalized liver, control of hemorrhage, reduction of postoperative complications such as secondary hemorrhage, intraabdominal and hepatic abscesses and hemobilia. Hepatic resection is recommended for subeapsular hematomas with intra-lobar rupture of the liver to avoid hepatic necrosis. These injuries are diagnosed by injection of methylene blue into the common hepatic duct. Low mortality and morbidity in this series is due to improved care of injured pa-tients, early surgical intervention and adequate removal of devitalized lacerated and injured tissues by debridement or major hepatic resection.
    Matched MeSH terms: Resuscitation
  2. Delilkan AE
    Med J Malaysia, 1973 Sep;28(1):29-31.
    PMID: 4273779
    Matched MeSH terms: Resuscitation*
  3. Krishnan R
    Family Physician, 1991;3:57-58.
    A 7 year-old Malay child with lightning burns is reported. Lightning injuries are rare. Victims who are clinically 'dead' may recover normally if resuscitation is carried out for prolonged periods.
    Matched MeSH terms: Resuscitation
  4. Mohandas K
    Ann Acad Med Singap, 1992 Jan;21(1):47-50.
    PMID: 1590656
    Cardiopulmonary resuscitation training in Malaysia was started at the General Hospital Kuala Lumpur in 1986. Now the programme has been extended to all the General Hospitals in the country and is fully supported by the Ministry of Health. The American Heart Association curriculum for Basic Life Support is followed. From February 1986 till March 1991, the programme has trained 3982 in Basic Life Support and 548 in Advanced Cardiac Life Support. We are making efforts to translate some of the American manuals into the National language. A preliminary survey on early defibrillation indicates that majority of the physicians will allow defibrillation by non-physician.
    Matched MeSH terms: Cardiopulmonary Resuscitation/education*; Cardiopulmonary Resuscitation/standards; Cardiopulmonary Resuscitation/statistics & numerical data
  5. Hamzah-Sendut, I., Tee, Ah Chuan
    MyJurnal
    A medical audit is defined as a systematic and critical analysis carried out by doctors looking at the things that doctors do. The concept of auditing is relatively new to the medical profession. It is indeed an excellent instrument to institute change to medical practices which have been "institutionalized". A properly carried out audit can provide highly revealing data that can often sway an administrator to institute change. At the University Hospital Kuala Lumpur we chose to audit the paediatric attendances at high risk deliveries. High risk deliveries were defined as any delivery to which the obstetrician requested a paediatric attendance prior to delivery. A paediatrician must be on hand at all high risk deliveries to ensure proper resuscitation of the new born. The aim of the audit was to determine if paediatric attendance at high risk deliveries were optimal at the University Hospital. (Copied from article).
    Matched MeSH terms: Resuscitation
  6. Mohamad Yunus A, Mohd Dun S
    JUMMEC, 1996;1:29-32.
    A retrospective cohort study of 206 consecutive patients with colorectal cancer presenting to three general surgeons in the University Hospital, Kuala Lumpur over a 3-year period is reported. In all, 184 patients had an operation and are grouped according to whether their operation was within 24 hours of admission (n=16), more than 24 hours after admission (n=38), or elective (n=130). Operative mortalities for these groups were 15.9%,15.2°/o and 6.5%, respectively, significantly higher in both the emergency groups. Delayed surgery to allow complete resuscitation did not improve the operative mortality when compared with those patients having urgent surgery. Both groups of emergency patients, delayed (27%) and urgent (19%), showed poorer 5-year survival than the electively treated patients (36%), many dying of non-cancer causes. Patients who undergo emergency surgery for colorectal carcinoma are more l i k e l y to be in poorer physical condition than the patients undergoing elective surgery for the same condition. It appears that the physical status is the principal determinant of outcome after emergency colorectal surgery rather than any other factor. KEYWORDS: colorectal cancer, emergency, outcome
    Matched MeSH terms: Resuscitation
  7. Arokiasamy JT
    JUMMEC, 1996;1:33-36.
    A group of 265 urban private sector workers in Kuala Lumpur and adjacent Petaling Jaya responded to a self-administered questionnaires. Their knowledge of cardio-pulmonary resuscitation, risk factors for and preventive measures against cardiovascular diasease a n d w h e n these should be started are relatively weak, though knowledge on symptoms of heart a attack are satisfactory. Relatively more males than females are current smokers and consumers of alcohol. Males tended to start smoking and drinking in their teen years while females tended to do so later in their non-teen years.
    Matched MeSH terms: Resuscitation; Cardiopulmonary Resuscitation
  8. Loke YK, Tan MH
    Med J Malaysia, 1997 Jun;52(2):172-4.
    PMID: 10968077
    A 69-year-old lady who was referred by her general practitioner with a diagnosis of food poisoning developed cardiorespiratory arrest shortly after arriving at the Casualty Department. Cardiac output was successfully restored with resuscitation but she had to be mechanically ventilated due to the absence of any spontaneous respiratory effort. Assessment 24 hours after admission, showed fixed and dilated pupils with brain stem areflexia. Her family was told that the prognosis was hopeless. Surprisingly, her condition rapidly improved a day later and she eventually had a good recovery. Her condition was actually due to severe tetrodotoxin poisoning after eating roe of the puffer fish and it was fortunate that appropriate aggressive resuscitation was instituted to revive the patient from her critical state.
    Matched MeSH terms: Resuscitation
  9. Chan SC
    Med J Malaysia, 1997 Sep;52(3):244-50.
    PMID: 10968093
    Adequacy of active resuscitation in collapsed inpatients aged 12 and above (excluding those with terminal illness) were studied in 6 Malaysian district hospitals for 3 months starting 1/1/93. Results showed 59.5% (25 out of 42 inpatients) were inadequately resuscitated measured by: failure of nurses to initiate resuscitation (24%), duration of resuscitation less than 30 minutes (42%) and incompletely equipped emergency trolleys (44%). Questionnaires revealed lack of knowledge and training in cardiopulmonary resuscitation in medical staff. Regular cardiopulmonary resuscitation courses, regular spot checks on emergency trolleys and management protocols on active resuscitation are recommended. Each hospital should design its own criteria for adequacy.
    Matched MeSH terms: Cardiopulmonary Resuscitation/standards*
  10. Osman A, Norsidah AM
    Med J Malaysia, 1997 Dec;52(4):399-401.
    PMID: 10968117
    There is now increased public awareness of the value and role of cardiopulmonary resuscitation (CPR). It is therefore not surprising that the public expects a reasonable level of expertise of medical doctors in the application of the CPR techniques during emergency situations. Newly qualified doctors often lack confidence and are usually at a loss when faced with such situations as they have never had practical training before graduation. Most doctors are gradually introduced to CPR as part and parcel of their clinical experience. Many begin to attend formal CPR workshops later in their careers. Medical schools are expected to produce well trained doctors who are competent in clinical practice which include the techniques of basic resuscitation. By virtue of their expertise in airway management and clinical resuscitation, anaesthesiologists can significantly contribute to the teaching of CPR in the undergraduate medical curriculum. This is a retrospective review of Basic Life Support programmes conducted at the Department of Anaesthesiology, Faculty of Medicine, Universiti Kebangsaan Malaysia.
    Matched MeSH terms: Cardiopulmonary Resuscitation/education*
  11. Azhar AA
    Med J Malaysia, 1999 Jun;54(2):257-60.
    PMID: 10972038
    A mass CPR (cardio-pulmonary resuscitation) teaching programme, believed to be the first in Malaysia, was held at the Dewan Tunku Canselor, University of Malaya (UM) on Saturday, 13th July 1996. Organised by the Resuscitation Committee of University Hospital, Kuala Lumpur, this programme was conducted for 200 first year UM students. We describe the organisation of this non-traditional and non-threatening, new CPR teaching programme and propose that this be further developed for the dissemination of CPR skills to our Malaysian public.
    Matched MeSH terms: Cardiopulmonary Resuscitation/education*
  12. Lee HT, Low BT
    Med J Malaysia, 1999 Jun;54(2):167-8.
    PMID: 10972024
    Matched MeSH terms: Cardiopulmonary Resuscitation/education*
  13. Ida, S.B.O., Teh, K.H., Quah, B.S.
    MyJurnal
    Meconium aspiration syndrome (MAS) frequently occurs in neonates born in thick meconium-stained liquor (TMSL). It continues to be a significant cause of neonatal morbidity and mortality despite aggressive approaches to intervention. This study aims to identify the perinatal characteristics of deliveries with TMSL associated with the development of MAS and to describe the outcome of those babies who developed MAS.
    All newborns with TMSL born in Hospital Alor Setar, Kedah from 1 October 1998 to 30 April 1999 were prospectively studied. In the hospital, all newborns with TMSL were routinely admitted to the Special Care Nursery for observation. Relevant data regarding pregnancy, delivery, resuscitation and outcome of newborns with and without MAS were collected and analysed. The incidence of TMSL among hospital deliveries was 2.2% (95% C.I. 1.8-2.5%). Thirty-six percent (95% C.I. 28.4-44.7%) of newborns with TMSL developed MAS. Significant risk factors associated with the development of MAS were non-Malay mothers (p=0.04, OR=3.32), resuscitation by paediatric medical officers (p=0.02, OR=2.84) and direct tracheal suction during resuscitation (p=0.02, OR=2.61). The presence of non-Malay mothers or resuscitation by paediatric medical officers or direct tracheal suction during resuscitation gave a sensitivity of 88.2%, specificity of 36.7%, a positive predictive value of 44.1% and a negative predictive value of 84.6% for the development of MAS. Asphyxia, pneumothorax and persistent pulmonary hyper-tension occurred in 25.5%, 7.8% and 5.9% of the babies with MAS respectively. Mechanical ventilation was required in 51% and the mortality rate was 3.9%. In conclusion, the incidence of TMSL and MAS and the mortality rate of neonates with MAS were comparable with that in developed countries. The presence of any one of the significant risk factors had high sensitivity but low specificity for the development of MAS. Newborns were unlikely to develop MAS if all these risk factors were absent.
    Matched MeSH terms: Resuscitation
  14. Boo NY, Pong KM
    J Paediatr Child Health, 2001 Apr;37(2):118-24.
    PMID: 11328464
    OBJECTIVES: To determine the number of providers and instructors trained by the initial 37 core instructors during the first 2 years following the launch of the Malaysian Neonatal Resuscitation Program (NRP). To identify remediable problems which interfered with the propagation of the NRP in Malaysia.

    METHODOLOGY: A prospective observational study carried out over a 2-year period between 2 September 1996 to 2 September 1998. For every training course conducted, the instructors completed a NRP course report form (Form A) that documented the instructors involved in the course. For every participant who attended the course and successfully completed it, the instructors submitted a record form (Form B) that contained the name, hospital address, department, profession, place of work, language used for training and the marks obtained by the individual participant. After each course, completed forms A and B were returned to the NRP secretariat for compilation.

    RESULTS: Of the 37 core instructors, 35 (94.6%) carried out training courses in their respective home states. A further 513 new instructors and 2256 providers were trained subsequently. A total of 2806 health personnel from all 13 states of Malaysia were NRP-certified during the first 2 years. However, 61.2% (n = 335) of the 550 instructors were inactive trainers, having trained less than four personnel per instructor a year. Most of the NRP-certified personnel were either doctors (32.0%) or nursing staff (64.4%). More than 60% of these worked either in the labour rooms, neonatal intensive care units or special care nurseries. At least one person from all three university hospitals and all general hospitals, 89.3% (92/103) of the district hospitals, 3.5% (73/2090) of the maternal and child health services, and 21% (46/219) of the private hospitals and maternity homes, were trained in the NRP.

    CONCLUSION: Dissemination of the NRP in Malaysia during the first 2 years was very encouraging. Further efforts should be made to spread the program to private hospitals and the maternal and child health services. In view of the large number of inactive instructors, the criteria for future selection of instructors should be more stringent.

    Matched MeSH terms: Resuscitation/education*
  15. Tudehope DI, Osuch M
    J Paediatr Child Health, 2001 Apr;37(2):103-4.
    PMID: 11328460
    Matched MeSH terms: Resuscitation/education*
  16. Rahoma AH
    JUMMEC, 2002;7:127-131.
    During the period from January 1992 up to the end of July 2001, the Burns Unit in King Khalid C Hospital treated 1735 cases of burns. The burns cases were of varying causes, age groups, degree, depth and extent. The formula used in lTeating these burns patients was a modification of Parkland fonnula. The fluid used was Ringer lactate solution. This fluid was administered for the first 3 days post burn until the general condilion of the palient was sfabilized. Early oral intake was encouraged in aU patients and was started as early as the second or the third day. Colloids were given by the end of the third or even the fourth day and according to the individual patients' needs. The results of this treatment regime significantly avoided renal complications and ensured patient rehydration. KEYWORDS; Major burns, fluids resuscitation
    Matched MeSH terms: Resuscitation
  17. Sharifah H, Naidu A, Vimal K
    BJOG, 2003 Jul;110(7):701-3.
    PMID: 12842063
    Matched MeSH terms: Cardiopulmonary Resuscitation
  18. Goh AY, Mok Q
    Acta Paediatr, 2004 Jan;93(1):47-52.
    PMID: 14989439
    AIM: To study the aetiology and clinical course of children with brainstem death in a paediatric intensive care unit (ICU) and to determine whether current the practices that are used to declare brainstem death conform to accepted criteria.
    METHODS: A retrospective review chart of all patients with brainstem death (n = 31) admitted to the paediatric ICU between January 1995 and December 1998 was drawn up.
    RESULTS: Mean age of the patients was 51.9 +/- 54.5 mo with the main diagnoses being head trauma in 11 children, anoxic encephalopathy in 7, brain tumour in 5, drowning in 4, CNS haemorrhage in 3 and CNS infection in 1 child; 32.3% of the children were given pre-ICU admission cardiopulmonary resuscitation. The average time from insult to suspected brainstem death was 27 h and suspected brainstem death to confirmation was 25 h, with an average of 1.6 examinations performed. EEG was done in 14 patients, with electrocerebral silence in 8 after the first examination and in a further 5 after repeat testing. Cerebral blood-flow scans were done in 3 children and evoked potentials in 1 child.
    CONCLUSIONS: Trauma remains the most common primary diagnosis leading to brainstem death. Intensivists in this large hospital for children mainly conform to accepted guidelines for determination of brainstem death although there is a wider use of ancillary tests to aid diagnosis. The study also showed a low rate of < 10% of organ procurement for transplantation.

    Study site: Paediatric ICU, Great Ormond Street Hospital, London, United Kingdom
    Matched MeSH terms: Cardiopulmonary Resuscitation
  19. Azim N, Wang CY
    Anaesthesia, 2004 Jun;59(6):610-2.
    PMID: 15144304
    A 62-year-old male underwent off-pump coronary artery grafting surgery while cerebral function was monitored with bispectral index (BIS). The BIS monitoring was continued into the immediate postoperative period, during which time the patient experienced a cardiopulmonary arrest. The changes in the BIS values helped the resuscitating team in assessing the cerebral response to the cardiopulmonary resuscitation.
    Matched MeSH terms: Cardiopulmonary Resuscitation/methods*
  20. Martinez AM, Partridge JC, Yu V, Wee Tan K, Yeung CY, Lu JH, et al.
    J Paediatr Child Health, 2005 Apr;41(4):209-14.
    PMID: 15813876
    This study was undertaken to evaluate physician counselling practices and resuscitation decisions for extremely preterm infants in countries of the Pacific Rim. We sought to determine the degree to which physician beliefs, parents' opinion and medical resources influence decision-making for infants at the margin of viability.
    Matched MeSH terms: Resuscitation/psychology*
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