Displaying publications 1 - 20 of 192 in total

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  1. Fulltext A curriculum in medical ethics and medical humanities
    Puthucheary SD
    Med J Malaysia, 1980 Sep;35(1):86-95.
    PMID: 7254006
    The code of ethics derived from the Hippocratic Oath needs to be supplemented by a formal curriculum in Medical Ethics and Medical Humanities in our Medical schools. The need and justification for it, a review of the medical ethics curricula in American. European. British and Australian Universities, together with an outline of the proposed curriculum is described.
    Matched MeSH terms: Review
  2. A retrospective study to assess the epidemiological and economic burden of pneumococcal diseases in adults aged 50 years and older in Taiwan
    Wu DB, Roberts CS, Huang YC, Chien L, Fang CH, Chang CJ
    J Med Econ, 2014 May;17(5):312-9.
    PMID: 24575941 DOI: 10.3111/13696998.2014.898644
    Invasive pneumococcal disease (IPD) and pneumococcal pneumonia cause substantial morbidity and mortality worldwide. This retrospective study was conducted to estimate the disease burden from pneumococcal disease in older adults in Taiwan from a health insurer's perspective.
    Matched MeSH terms: Insurance Claim Review/statistics & numerical data
  3. A review of ECT practices: Neurobehavioural
    Chandrasekaran PK
    Malaysian Journal of Psychiatry, 2008;17:79-85.
    The use of Electro-Convulsive Therapy (ECT) has again risen, and so have the restrictions laid in the path for its use. This communication serves to discuss the thoughts and practices of ECT in our setting and that in the West, which we all know vary from center to center and individual to individual. A reminder guide, incorporating those ideas along with a simple risk-benefit assessment checklist, is suggested to induce an approved perspective that will enable the drawing-up of a standard, sanctioned guideline on the applications of ECT in our region. This proposal will then be hoped to be of substantial medico-legal benefit in the future. Keywords: Re-stimulation, dosing, unilateral ECT, bilateral ECT, frequency, multiple monitored ECT
    Matched MeSH terms: Review
  4. Fulltext A review of maternal mortality in Malaysia
    Yadav H
    International e-Journal of Science, Medicine & Education, 2012;6(10):0-0.
    MyJurnal
    There has been a significant decline in maternal mortality from 540 per 100,000 live births
    in I957 to 28 per 100,000 in 2010. This decline is due to several factors. Firstly the introduction of the rural health infrastructure which is mainly constructing health centres and midwife clinics for the rural population. This provided the accessibility and availability of primary health care and specially, antenatal care for the women. This also helped to increase the antenatal coverage for the women to 98% in 2010 and it increased the average number of antenatal visits per women from6 in 1980 to 12 visits in 2010 for pregnant women. Along with the introduction of health centres, another main feature was the introduction of specific programmes to address the needs of the women and children. In the 1950s the introduction of Maternal and Child Health (MCH) programme was an important
    step. Later in the late 1970s there was the introduction of the High Risk Approach in MCH care and Safe Motherhood in the 1980s. In 1990, an important step was the introduction of the Confidential Enquiry into Maternal Deaths (CEMD). Another significant factor in the reduction is the identification of high risk mothers and this is being done by the introduction of the colour coding system in the health centres. Other factors include the increase in the number of safe deliveries by skilled personnel and the reduction in the number of deliveries by the Traditional Birth Attendants (TBAs). The reduction in fertility rate from 6.3 in 1960 to 3.3 in 2010 has been another important factor. To achieve the 2015 Millennium Development Goals (MDG) to further reduce maternal deaths by 50%, more needs to be done especially to identify maternal deaths that are missed by omission or misclassification and also to capture the late maternal deaths.
    Matched MeSH terms: Review
  5. Fulltext A review of stroke research in Malaysia from 2000 - 2014
    Cheah WK, Hor CP, Abdul Aziz Z, Looi I
    Med J Malaysia, 2016 Jun;71(Suppl 1):58-69.
    PMID: 27801388
    Over 100 articles related to stroke were found in a search through a database dedicated to indexing all literature with original data involving the Malaysian population between years 2000 and 2014. Stroke is emerging as a major public health problem. The development of the National Stroke Registry in the year 2009 aims to coordinate and improve stroke care, as well as to generate more data on various aspects of stroke in the country. Studies on predictors of survival after strokes have shown potential to improve the overall management of stroke, both during acute event and long term care. Stroke units were shown to be effective locally in stroke outcomes and prevention of stroke-related complications. The limited data looking at direct cost of stroke management suggests that the health economic burden in stroke management may be even higher. Innovative rehabilitation programmes including braincomputer interface technology were studied with encouraging results. Studies in traditional complementary medicine for strokes such as acupuncture, Urut Melayu and herbal medicine were still limited.
    Matched MeSH terms: Review
  6. A review of the nutritional status of the Indian community in Peninsular Malaysia
    Mirnalini K
    Family Practitioner, 1982;5:39-43.
    A review of recent data available on the nutritional health of Indian children seems to suggest that malnutrition is a major problem among poor Indian preschool and school children. Examination of indirect indicators of malnutrition reveals that for Indians, the annual percentage decrease in TMR is the lowest and incidence of low birth weight and perinatal mortality rate the highest. While there is very little documentation in the extent and severity of protein-malnutrition among Indian children, hospital admission returns for severe PEM show a predominance of Indian preschool children. This suggest that moderate forms of malnutrition may even be more widely prevalent amongst this group of the population thus posing a great problem from the public health point of view. The prevalence of moderate PEM as represented by acute ("wasting") and chronic forms ("stunting") was found to be the highest among Indian urban and rural children. Biochemical studies indicate widespread prevalence of anemia, vitamin A and B deficiencies especially among Indian preschool children. The presence of high parasitic infections may exacerbate such deficiencies. The causes of malnutrition are multiple and complex. Low family income as a consequence of high unemployment rate (8%) and low wages, lack of basic sanitation and adequate housing, large family size, alcoholism and apathy among parents, ignorance of good nutrition and disturbed conditions in the home environment have been identified as some of the factors that may contribute towards malnutrition in this community. Thus the viscous cycle of malnutrition appears to have gained a foothold in the poor Indian community. As has been well documented, the social implications of malnutrition are many, the most important being its effect on education. It is now well known that malnutrition hinders intellectual development; it interferes with a child's motivation, ability to concentrate, and ability to learn and cope with the school situation. Malnutrition thus could be one of the contributory factors to the generally poor performance in studies, to the low aspiration for higher education and to the alarming drop-out rate (60%) found among Indian school children. While this review attempts to highlight some of the nutritional problems confronting the Indian poor, it is clearly essential from a national view-point that community level surveys should be further undertaken to assess the nutritional health of this group. The problem of malnutrition among poor Indian children is real and needs urgent recognition and remedial measures from both public and political sectors alike.
    Matched MeSH terms: Review
  7. A simple pharmacopoeia for out-station skin clinics
    Pettit JHS
    Trop Doct, 1977 Jul;7(3):107-10.
    PMID: 142324
    Matched MeSH terms: Review
  8. A six-year review of 35 cases of eclampsia at General Hospital Seremban
    Tharmaseelan NKS
    Family Physician, 1990;2:34-37.
    Matched MeSH terms: Review
  9. A six-year review of tubal sterilization at a district hospital (1981-1986)
    Sivalingam N, Bhagat S, Pereira R
    Family Physician, 1989;1:23-27.
    Matched MeSH terms: Review
  10. Fulltext A strategy for reducing maternal mortality
    Suleiman AB, Mathews A, Jegasothy R, Ali R, Kandiah N
    Bull World Health Organ, 1999;77(2):190-3.
    PMID: 10083722
    A confidential system of enquiry into maternal mortality was introduced in Malaysia in 1991. The methods used and the findings obtained up to 1994 are reported below and an outline is given of the resulting recommendations and actions.
    PIP: This is a report on the methods, findings, resulting recommendations and actions of a study on maternal mortality in Malaysia during the period 1991-94. Maternal death was defined as the death of a woman while pregnant or within 42 days following termination of pregnancy from any cause related to the pregnancy or its management but not from accidental causes. Between 1991 and 1994 there were 1066 reported maternal deaths, and the maternal mortality ratios for the successive years were respectively 44, 48, 46 and 39 per 100,000 live births. The primary causes of maternal death were postpartum hemorrhage (24%), hypertensive disorders of pregnancy (16%), obstetric pulmonary embolism (13%), and associated medical conditions (7%). Analysis of the 375 deaths from 1992 - 1993 showed that the maternal mortality ratio was 53/100,000 live births for deliveries performed at home, 36/100,000 in government hospitals, and 21/100,000 in private institutions. Shortcomings among health personnel were detected in several cases; these involved failure to diagnose, failure to appreciate the severity of a patient's condition, inadequate therapy, and inappropriate, delayed or failed adherence to protocols. The high proportion of maternal mortality associated with substandard care demonstrates that it is important to make the standard of care more widely available. Reports have been circulated to institutions and organizations providing maternal care and to medical schools. Articles and case histories have been published, and many new protocols and procedures have been developed. Furthermore, seminars have been organized and training modules have been distributed to all involved in the provision of maternity care.
    Matched MeSH terms: Review
  11. Fulltext A systematic review and meta-analysis of pharmacist-led fee-for-services medication review
    Hatah E, Braund R, Tordoff J, Duffull SB
    Br J Clin Pharmacol, 2014 Jan;77(1):102-15.
    PMID: 23594037 DOI: 10.1111/bcp.12140
    The aim was to examine the impact of fee-for-service pharmacist-led medication review on patient outcomes and quantify this according to the type of review undertaken, e.g. adherence support and clinical medication review.
    Matched MeSH terms: Drug Utilization Review/statistics & numerical data*
  12. Addiction to sugar and its link to health morbidity: a primer for newer primary care and public health initiatives in Malaysia
    Swarna Nantha Y
    J Prim Care Community Health, 2014 Oct;5(4):263-70.
    PMID: 24879656 DOI: 10.1177/2150131914536988
    Objectives: The average consumption of sugar in the Malaysian population has reached an alarming rate, exceeding the benchmark recommended by experts. This article argues the need of a paradigm shift in the management of sugar consumption in the country through evidence derived from addiction research.
    Methods: “Food addiction” could lead to high levels of sugar consumption. This probable link could accelerate the development of diabetes and obesity in the community. A total of 94 reports and studies that describe the importance of addiction theory–based interventions were found through a search on PubMed, Google Scholar, and Academic Search Complete.
    Results: Research in the field of addiction medicine has revealed the addictive potential of high levels of sugar intake. Preexisting health promotion strategies could benefit from the integration of the concept of sugar addiction. A targeted intervention could yield more positive results in health outcomes within the country.
    Conclusion: Current literature seems to support food environment changes, targeted health policies, and special consultation skills as cost-effective remedies to curb the rise of sugar-related health morbidities.
    Keywords. sugar addiction, food environment, health promotion, non communicable diseases, dietary habits, health policies
    Matched MeSH terms: Review
  13. Addressing procedural challenges of ethical review system: Towards a better ethical quality of clinical trials review in Malaysia
    See HY, Mohamed MS, Mohd Noor SN, Low WY
    Account Res, 2019 01;26(1):49-64.
    PMID: 30526066 DOI: 10.1080/08989621.2018.1556646
    The review of clinical trials with human participants in Malaysia is governed by a decentralized control system. The clinical trial protocols are reviewed by 13 registered research ethics committees (RECs) in Malaysia. A governmental body, the National Pharmaceutical Control Bureau, is responsible for the inspection and oversight of these registered RECs to ensure that they comply with the regulatory requirements. However, this study highlights that each REC in Malaysia has a different standard operating procedure and ethical review process. Other procedural challenges identified include inadequate membership, poor mechanism for research monitoring after ethical approval, and insufficient resources. Establishments of a national standard of REC and a central ethics committee are suggested to ensure procedural compliance in the oversight of clinical trials in Malaysia. While there is a growing concern that procedural compliance may not have a direct impact on the protection of human subjects, our key point is that an ethical review system compliant with the national standards could serve as a strong framework to support and enhance the ethical quality of decision-making and judgement. We believe that being aware of how influential procedural compliance can be would help committees improve the ethical quality of their research review.
    Matched MeSH terms: Ethical Review/standards*
  14. An audit of fresh frozen plasma usage in a tertiary referral centre in a developing country
    Prathiba R, Jayaranee S, Ramesh JC, Lopez CG, Vasanthi N
    Malays J Pathol, 2001 Jun;23(1):41-6.
    PMID: 16329547
    This paper evaluates the practice of fresh frozen plasma (FFP) transfusion at the University Hospital, Kuala Lumpur, and analyses its usage by the various clinical departments. The aim of this study is to identify where it is inappropriately used and the clinical indications in which such misuse is common. A retrospective analysis of the blood bank request forms and work sheets during a 6-month period between January 1998 and June 1998 formed the basis of this study. Overall, 40% of 2665 units transfused were considered appropriate. However, out of the 931 episodes of FFP transfusions only 31% were for appropriate indications. The average FFP requirement when used for appropriate indication was about 4 units per episode, whereas for inappropriate indication it was 2.5 units per episode. Inappropriate use in terms of the number of units was highest by the surgical services (68%) and Orthopaedics (64%), while the Department of Paediatrics had the lowest incidence of inappropriate use (40%). When Paediatrics was used as the benchmark, the incidence of inappropriate use by other departments was significantly higher (p < 0.01). As for FFP usage in common clinical indications, there was a high incidence of inappropriate use in burns (82%), perioperative period (73%), cardiac surgery (68%), massive bleeding (62%) and trauma (60%). The findings in this study, specifically the use of FFP for volume support in trauma, massive bleeding and burns, routine requests without identified indication in cardiac bypass surgery, and prophylactic use in the perioperative period can be the basis for recommendations to minimize the inappropriate use of FFP in the future.
    Matched MeSH terms: Utilization Review*
  15. An overview of the national telehealth initiative in Malaysia
    Maon SN, Edirippulige S
    Stud Health Technol Inform, 2010;161:95-103.
    PMID: 21191162
    Malaysia's national health statistics for the last half century show a remarkable improvement in the nation's health status. One important factor for this improvement is the Malaysian government's proactive intervention in the health sector. Among others, e-health has played a vital role in delivering and managing healthcare services in Malaysia. While the Government has integrated telehealth in its national digital infrastructure re-design, it has heavily invested in telehealth. The enactment of new laws to facilitate telehealth practices can also be noted as an important measure.
    Matched MeSH terms: Review Literature as Topic
  16. An unusual cause of obstructive jaundice
    Shahrudin MD
    JUMMEC, 1996;1:41-43.
    Compression of the common bile duct by a stone impacted in the cystic duct is an uncommon cause of obstructive jaundice. We present a case study and review of the literature pertaining to the presentation, diagnosis, and surgical treatment of Mirizzi syndrome.
    Matched MeSH terms: Review
  17. Fulltext Anaesthetic related maternal deaths in Malaysia--a review
    Dalina AM, Inbasegaran K
    Med J Malaysia, 1996 Mar;51(1):52-63.
    PMID: 10967980
    The anaesthetic hazards for the obstetric patient are well known. Based on results of the first two reports on the confidential enquiry into maternal deaths in Malaysia for 1991 and 1992, ten cases of anaesthetic related deaths were analysed. There were 3 in 1991 and 7 in 1992 accounting for 1.34% and 2.8% of maternal deaths respectively. It was estimated that the crude mortality rate for the obstetric patient was 11.4 per 100,000 operative deliveries or a four-fold risk compared to the general surgical patient. One case resulted from administration of intravenous sedation while the rest involved general anaesthesia, seven of which were done under emergency conditions. Inadequate airway management and ventilation in the perioperative period, including during interhospital transfer was the single most important factor causing the majority of these deaths. The use of regional anaesthesia for Caesarean sections is strongly advocated. Substandard care was also present in all cases. Other issues pertinent to improvement of obstetric anaesthetic services are also discussed which include the quality of anaesthetic manpower, upgrading of infrastructure, facilities and staffing of operating and recovery areas, the use of regional anaesthesia, expanding the role of the anaesthetist and the quality of the anaesthetic services in general.
    Matched MeSH terms: Review
  18. Fulltext Antibiotic use in residential aged care facilities
    Lim CJ, Stuart RL, Kong DC
    Aust Fam Physician, 2015 Apr;44(4):192-6.
    PMID: 25901402
    BACKGROUND: High infection burden among the residential aged care facility (RACF) population has long been recognised; however, existing infection prevention effort is often limited to infection surveillance activity. There is a scarcity of evidence to guide antimicrobial stewardship in the Australian RACF setting.
    OBJECTIVE: This review summarises the current trends in antibiotic use and multi-drug resistant (MDR) organisms, challenges related to antibiotic prescribing and areas of suboptimal antibiotic prescribing for further improvement, particularly in the Australian RACF setting.
    DISCUSSION: There is widespread antibiotic prescribing in RACF, which may lead to the emergence of antibiotic resistance. Accordingly, there is an immediate need for judicious antibiotic use in this high-risk population to curb the rapid emergence of MDR organisms and other adverse consequences associated with inappropriate antibiotic use, as well as to reduce healthcare costs.
    Matched MeSH terms: Drug Utilization Review*
  19. Appropriate antibiotic administration in elective surgical procedures: still missing the message
    Gul YA, Hong LC, Prasannan S
    Asian J Surg, 2005 Apr;28(2):104-8.
    PMID: 15851363
    OBJECTIVE: The aim of this study was to determine the appropriateness of antibiotic prophylaxis in selected elective surgical procedures in a tertiary referral centre.

    METHODS: A cross-sectional study using retrospective data from January 2000 to May 2002 was performed pertaining to elective colorectal surgery, cholecystectomy and inguinal hernia repairs. Appropriateness of antibiotic administration was determined based on compliance with national and internationally accepted guidelines on prophylactic antibiotic prescribing policy. A single dose or omission of antibiotic administration was judged appropriate for cholecystectomy and inguinal hernia repair, while up to 24 hours' dosing was considered appropriate practice for colorectal surgery.

    RESULTS: Of 419 cases, there were 55 (13.1%) colorectal procedures, 97 (23.2%) cholecystectomies and 267 (63.7%) inguinal hernia repairs. Antibiotics were administered in a total of 306 (73%) cases, with single-dose prophylaxis in only 125 (41%) of these. Prophylaxis was inappropriately prolonged in 80%, 52% and 31% of colorectal, cholecystectomy and inguinal hernia cases, respectively. The corresponding mean duration of anti-biotic administration was 2.4+/-2.2, 1.6+/-1.8 and 1.1+/-1.3 days, respectively.

    CONCLUSION: Antibiotic prophylaxis in elective surgery continues to be administered haphazardly. This study supports close surveillance of antibiotic utilization by a dedicated team, perhaps consisting of microbiologists or pharmacists, to minimize inappropriate administration.

    Matched MeSH terms: Drug Utilization Review*
  20. Fulltext Appropriate utilisation of emergency upper gastrointestinal endoscopy in a tertiary referral centre
    Gul YA, Jabar MF, Mo'min N, Hon SK
    Med J Malaysia, 2004 Mar;59(1):65-71.
    PMID: 15535338
    A retrospective cross-sectional study was carried out in a tertiary referral centre to determine the appropriateness of usage of emergency upper gastrointestinal endoscopy (EUGIE) with reference to the guidelines set by the American Society of Gastrointestinal Endoscopy (ASGE). EUGIE was defined as early, non-elective endoscopy performed for in-patients within 48 hours of acute hospital admission. The median age of the 668 patients was 55 years (age range 12- 90), 31% of whom had a previous upper gastrointestinal endoscopy. Bleeding in the form of haematemesis, melaena or anaemia was the most common indication (40.7%) for EUGIE. Eighty one percent of the procedures were judged appropriate by the ASGE guidelines. There was a statistically significant relationship between appropriateness and significant diagnostic yield (P<0.05). Procedures performed for melaena, symptomatic anaemia and haemetemesis led to greater significant diagnostic yield (P<0.05) and there was no difference in the yield between working-hours and after-hours EUGIE.
    Matched MeSH terms: Utilization Review*
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