MyMedR

Comparing catheter related bloodstream infection rate between cuffed tunnelled and non-cuffed tunnelled peripherally inserted central catheter

Sze Yong T, Vijayanathan AA, Chung E, Ng WL, Yaakup NA, Sulaiman N

J Vasc Access, 2021 Jan 13.

PMID: 33438482 DOI: 10.1177/1129729820987373

OBJECTIVE: To compare catheter related blood stream infection (CRBSI) rate between cuffed tunnelled and non-cuffed tunnelled PICC.

METHODS: We prospectively followed 100 patients (50:50 cuffed and non-cuffed PICC) and compared CRBSI rate between these groups. Daily review and similar catheter care were performed until a PICC-related complication, completion of therapy, death or defined end-of-study date necessitate removal. CRBSI was confirmed in each case by demonstrating concordance between isolates colonizing the PICC at the time of infection and from peripheral blood cultures.

RESULTS: A total of 50 cuffed PICC were placed for 1864 catheter-days. Of these, 12 patients (24%) developed infection, for which 5 patients (10%) had a CRBSI for a rate of 2.7 per 1000 catheter-days. Another 50 tunnelled non-cuffed PICCs were placed for 2057 catheter-days. Of these, 7 patients (14%) developed infection, for which 3 patients (6%) had a CRBSI. for a rate of 1.5 per 1000 catheter-days. The mean time to development of infection is 24 days in cuffed and 19 days in non-cuffed groups. The mean duration of utilization was significantly longer in non-cuffed than in cuffed group (43 days in non-cuffed vs 37 days in cuffed group, p = 0.008).

CONCLUSIONS: Cuffed PICC does not further reduce the rate of local or bloodstream infection. Tunnelled non-cuffed PICC is shown to be as effective if not better at reducing risk of CRBSI and providing longer catheter dwell time compared to cuffed PICC.

Matched MeSH terms: Humans

Reply to: CHAI and MACK-3 as noninvasive indices for nonalcoholic steatohepatitis

Chuah KH, Chan WK

Liver Int, 2019 08;39(8):1588.

PMID: 31161724 DOI: 10.1111/liv.14139

Matched MeSH terms: Humans

Fulltext Surgical Prophylaxis Guide 2018

ISBN: 978-967-16406-0-9

Citation: Surgical Prophylaxis Guide 2018. Kuala Lumpur: Antimicrobial stewardship committee, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia; 2018

Matched MeSH terms: Humans

Guideline for Management of Scabies in Adults and Children

Matched MeSH terms: Humans

Fulltext Android mobile applications in eye care

Karthikeyan SK, Thangarajan R, Theruvedhi N, Srinivasan K

Oman J Ophthalmol, 2019 6 15;12(2):73-77.

PMID: 31198290 DOI: 10.4103/ojo.OJO_226_2018

Google Play Store was used to search for eye care-related applications the android simulator using various general terms related to eye care to review and categorize various interactive eye care-related applications in android platform from the details available in the application website. Data collected from application description and application developer's webpage include target audience, category of apps, estimated number of downloads, average user rating, involvement of eye care professionals in developing the application, and cost of the app. All these data were collected only from the details provided in the application website considering on online user perspective and the developers were not contacted to collect any other details. In total, 475 applications were identified and grouped into 13 categories depending on the type of service the application provide. Out of which, only 107 (22.53%) applications had mentioned about the eye care professional involvement in their design or development of the application. The applications were also stratified according to the target audience, and many had no user rating with very few downloads. The lack of evidence-based principles and standardization of application development should be taken into consideration to avoid its negative impact on the community, especially in eye care.

Matched MeSH terms: Humans

Tuberculosis in Malaya

MORLAND A

Tubercle, 1950 Feb;31(2):38-40.

PMID: 15403821

Matched MeSH terms: Humans

Fulltext Breast Necrosis: a rare case of neglected Phyllodes tumour

Ho, Hui Lian, Ambikapathan, Theiyallen, Nornazirah Azizan, Lee, Li Ping Doreen, Siti Zubaidah Sharif, Firdaus Hayati

Malaysian Journal of Medicine and Health Sciences, 2019;15(1):79-81.

MyJurnal

Phyllodes tumour (PT) of the breast is firstly described in literature as early as 1838. This article reports the youngest recorded case of giant complicated PT and the role of toilet mastectomy as a salvage surgery. A 19-year-old lady presented with a gigantic lump of the left breast for 6 months which was rapidly growing (20 x 20 cm) and complicated with a foul-smelling blackish discoloration of the breast skin and tissues. Toilet mastectomy was performed as a result. The specimen weighed 4.0 kg with histopathological report of the tumor being borderline phyllodes. Herein, we describe a case of PT, who presented with breast necrosis and we discuss its medico-social aspect of it.

Matched MeSH terms: Humans

Nurses should be empowered to be proactively involved in family decision meetings on intensive care unit patient care decisions

Khan M

Evid Based Nurs, 2020 10;23(4):114.

PMID: 31511244 DOI: 10.1136/ebnurs-2019-103089

Matched MeSH terms: Humans

Fulltext A review on the prevalence of depression in Malaysia

Mukhtar F, Oei TPS

Current Psychiatry Reviews, 2011;7:234-238.

DOI: 10.2174/157340011797183201

Transforming western technology to Eastern populations, including Malaysia, presents important implications in understanding the development, maintenance, and treatment of depression. The present paper aims to review the literature on the prevalence of depression studies in Malaysia. PsycINFO, Medline databases, local journals, and 13 published articles, were included in the current review. Findings were presented in three categories i.e., 'prevalence of depression in primary care', 'general community', and 'among clinical population'. Major limitations of previous studies were noted, and thus, problems associated with the implementation and future direction of clinical and research on depression in Malaysia, was provided. In short, the contribution of empirical research on the prevalence of depression has remained inconsistent and fragmented and it is therefore, a time to venture modification. © 2011 Bentham Science Publishers.

Matched MeSH terms: Humans

The relationship between post-natal depression, somatization and behaviour in Malaysian women

Grace J, Lee KK, Ballard C, Herbert M

Transcult Psychiatry, 2001;38:27-34.

DOI: 10.1177/136346150103800103

This study evaluated the rate of post-natal depression (PND) in a Malaysian population, investigated the relationship between belief systems and PND, and examined the relationship between PND and somatization. The sample included 154 consecutive attendees for a 6-week post-natal check at a general hospital well-baby clinic in Kuala Lumpur. Patients were assessed using the Edinburgh Post-Natal Depression Score (EPNDS), the Bradford Somatisation Inventory (BSI), and a questionnaire to assess beliefs about pregnancy and childbirth. The rate of PND was 3.9%. EPNDS and BSI were moderately correlated. Women who practised specific post-natal practices had a higher EPNDS and BSI than those who did not. The rate of PND is lower than in Western studies but similar to that seen in other Asian countries. The correlation between BSI and EPNDS suggest that the BSI will not detect cases missed by the EPNDS. © 2001, Sage Publications. All rights reserved.

Matched MeSH terms: Humans

Trachyonychia

Leung AKC, Leong KF, Barankin B

J Pediatr, 2020 01;216:239-239.e1.

PMID: 31542154 DOI: 10.1016/j.jpeds.2019.08.034

Matched MeSH terms: Humans

Fulltext Development and validation of the knowledge and clinical reasoning of acute asthma management in emergency department (K-CRAMED)

Mohd Muzammil Ozair, Kamarul Aryffin Baharuddin, Saiful Azlan Mohamed, Wafaak Esa, Muhamad Saiful Bahri Yusof

Education in Medicine Journal, 2017;9(2):1-17.

MyJurnal

Suboptimal management of asthma can lead to increase morbidity and mortality. Unfortunately, this has become global issue and approximately 40% of asthmatic patients received suboptimal management in emergency department. Therefore, this study aimed to develop a tool to assess knowledge and clinical reasoning of healthcare providers on acute asthmatic management in emergency setting.
Method: The tool was developed via three phases: (a) domain identification, (b) domain blueprinting based the Global Initiative of Asthma (GINA) and the British Thoracic Society (BTS) guidelines, and (c) item generation for each domain for assessing knowledge and clinical reasoning. Three forms of validity evidence related to content, response process and internal structure were appraised. Content validity index (CVI), face validity index (FVI), and intraclass correlation coefficient (ICC) estimate the content validity, response process and internal structure of the tool.
Results: A new tool was developed, named as Knowledge and Clinical Reasoning of Acute Asthma Management in Emergency Department (K-CRAMED), which assesses knowledge and clinical reasoning on three domains related to management of acute asthma – diagnosis, treatment and disposition. CVI values for the three domains were more than 0.83. FVI values for the three domains among doctors and paramedics were at least 0.83. The ICC between scores given by emergency specialists was 0.989 (CI 95% 0.982, 0.994, p-value < 0.001).
Conclusion: The newly developed tool, named as K-CRAMED, is a valid tool to assess knowledge and clinical reasoning of healthcare providers who manage patients with acute asthma. Further validation is required to verify its validity in other setting.

Matched MeSH terms: Humans

Fulltext Flow Injection Analysis with Direct UV Detection Following Electric Field Driven Membrane Extraction

See HH, Mamat NA, Hauser PC

Molecules, 2018 Apr 24;23(5).

PMID: 29695126 DOI: 10.3390/molecules23051000

A method for on-line matrix elimination to enable selective quantification of ultraviolet absorbing analytes by a flow-injection analysis procedure is described. Selectivity is achieved by electric field driven extraction across a polymer inclusion membrane. The method was demonstrated on the example of the determination of naproxen from spiked human urine. Membranes of 10 μm thickness were employed which consisted of 7.5 mg cellulose triacetate as base polymer, 5 mg of o-nitrophenyl octyl ether as plasticizer and 7.5 mg of Aliquat 336 as cationic carrier. Ten μL of sample was introduced into a continuous stream of background solution consisting of 100 µM aqueous NaClO₄ with a flow rate of 2 μL/min while applying a voltage of 150 V to the extraction cell. The target ion was electrokinetically transported across the membrane and enriched in 1.5 μL of a stagnant acceptor solution. This was subsequently pumped past a flow-through UV detector for quantification. The method showed a linear range from 5 to 200 µM with a correlation coefficient of 0.9978 and a reproducibility of typically 7% (n = 8). The detection limit of the method for naproxen was 2 µM.

Matched MeSH terms: Humans

Fulltext The man with sweaty palms and soles

Jamani NA, Puteri Shanaz JK, Azwanis AH

Malays Fam Physician, 2018;13(1):52-54.

PMID: 29796213 MyJurnal

A 21-year-old male college student presented with excessive severe bilateral sweating of his palms and
soles for the past 3 years, which has progressively worsened. His symptoms occur throughout the day
but worsened during exams or whenever he felt anxious. The condition has caused him difficulty in
holding objects and writing assignments, and has resulted in public embarrassment on several occasions.
He has to wipe his hands with a handkerchief each time they sweat. He also needs to change his socks
frequently. No other area of his body is similarly affected. He denied any associated symptoms, such as
pungent body odour, changes in weight, fever, heat intolerance, or changes in bowel habits. He has no
known medical illness and is not on any medication. (Copied from article).

Matched MeSH terms: Humans

Capillary electrophoresis for the analysis of antidepressant drugs: A review

Abdul Keyon AS, Miskam M, Ishak NS, Mahat NA, Mohamed Huri MA, Abdul Wahab R, et al.

J Sep Sci, 2019 Feb;42(4):906-924.

PMID: 30605233 DOI: 10.1002/jssc.201800859

Depression is a common mental disorder that may lead to major mental health problems, and antidepressant drugs have been used as a treatment of choice to mitigate symptoms of major depressive disorders by ameliorating the chemical imbalances of neurotransmitters in brain. Since abusing antidepressant drugs such as selective serotonin reuptake inhibitors and tricyclic antidepressant drugs can cause severe adverse effects, continuous toxicological monitoring of the parent compounds as well as their metabolites using numerous analytical methods appears pertinent. Among them, capillary electrophoresis has been popularly utilized since the method has a lot of advantages viz. using small amounts of sample and solvents, ease of operation, and rapid analysis. This review paper brings a survey of more than 30 papers on capillary electrophoresis of antidepressant drugs published approximately from 1999 until 2018. It focuses on the reported capillary electrophoresis techniques and their applications and challenges for determining antidepressant drugs and their metabolites. It is organized according to the commonly used capillary zone electrophoresis method, followed by non-aqueous capillary electrophoresis and micellar electrokinetic chromatography, with details on breakthrough findings. Where available, information is given about the background electrolyte used, detector utilized, and sensitivity obtained.

Matched MeSH terms: Humans

A critical view on the analysis of fluorescence quenching data for determining ligand-protein binding affinity

Bakar KA, Feroz SR

Spectrochim Acta A Mol Biomol Spectrosc, 2019 Dec 05;223:117337.

PMID: 31302564 DOI: 10.1016/j.saa.2019.117337

The past decade has seen an increase in the number of research papers on ligand binding to proteins based on fluorescence spectroscopy. In most cases, determination of the binding affinity is made by analyzing the quenching of protein fluorescence induced by the ligand. However, many such articles, even those published in reputed journals, suffer from several mistakes with regard to analysis of fluorescence quenching data. Using the binding of phenylbutazone to human serum albumin as a model, we consider some of these mistakes and show how they affect the values of the association constant. In particular, the failure to correct for the inner filter effect and the use of unsuitable equations are discussed. Ligand binding data presented in these articles should be treated with caution, especially in the absence of data from complementary techniques.

Matched MeSH terms: Humans

Fulltext An Enhanced Distributed Data Aggregation Method in the Internet of Things

Homaei MH, Salwana E, Shamshirband S

Sensors (Basel), 2019 Jul 18;19(14).

PMID: 31323905 DOI: 10.3390/s19143173

"Internet of Things (IoT)" has emerged as a novel concept in the world of technology and communication. In modern network technologies, the capability of transmitting data through data communication networks (such as Internet or intranet) is provided for each organism (e.g. human beings, animals, things, and so forth). Due to the limited hardware and operational communication capability as well as small dimensions, IoT undergoes several challenges. Such inherent challenges not only cause fundamental restrictions in the efficiency of aggregation, transmission, and communication between nodes; but they also degrade routing performance. To cope with the reduced availability time and unstable communications among nodes, data aggregation, and transmission approaches in such networks are designed more intelligently. In this paper, a distributed method is proposed to set child balance among nodes. In this method, the height of the network graph increased through restricting the degree; and network congestion reduced as a result. In addition, a dynamic data aggregation approach based on Learning Automata was proposed for Routing Protocol for Low-Power and Lossy Networks (LA-RPL). More specifically, each node was equipped with learning automata in order to perform data aggregation and transmissions. Simulation and experimental results indicate that the LA-RPL has better efficiency than the basic methods used in terms of energy consumption, network control overhead, end-to-end delay, loss packet and aggregation rates.

Matched MeSH terms: Humans

Letters about Published Papers

Chiu CK, Chan CYW, Chandren JR, Ong JY, Loo SF, Hasan MS, et al.

J Orthop Surg (Hong Kong), 2019 8 1;27(3):2309499019861233.

PMID: 31362584 DOI: 10.1177/2309499019861233

Matched MeSH terms: Humans

Fulltext Intramyocardial dissecting haematoma mimicking left ventricular clot, a rare complication of myocardial infarction: a case report

Lee TJ, Roslan A, Teh KC, Ghazi A

Eur Heart J Case Rep, 2019 Jun 01;3(2).

PMID: 31449618 DOI: 10.1093/ehjcr/ytz056

BACKGROUND: Intramyocardial dissecting haematoma is a rare complication of myocardial infarction (MI) associated with high mortality rates. Studies and research of this occurrence are limited largely to isolated case reports or case series.

CASE SUMMARY: We report a case of late presenting MI, where on initial echocardiogram had what was thought to be an intraventricular clot. However, upon further evaluation, the patient actually had an intramyocardial haematoma, with the supporting echocardiographic features to distinguish it from typical left ventricular (LV) clot. While this prevented the patient from receiving otherwise unnecessary anticoagulation, this diagnosis also put him at a much higher risk of mortality. Despite exhaustive medical and supportive management, death as consequence of pump failure occurred after 2 weeks.

DISCUSSION: This report highlights the features seen on echocardiography which support the diagnosis of an intramyocardial haematoma rather than an LV clot, notably the various acoustic densities, a well visualized myocardial dissecting tear leading into a neocavity filled with blood, and an independent endocardial layer seen above the haematoma. Based on this report, we wish to highlight the importance of differentiating intramyocardial haematomas from intraventricular clots in patients with recent MI.

Matched MeSH terms: Humans

Fulltext Benign Lymphoepithelial Cyst: An Unusual Cause of Parotid Swelling in Two Immunocompetent Patients

Thong HK, Athar PPSH, Mustaffa WMW

Open Access Maced J Med Sci, 2019 Jul 15;7(13):2142-2145.

PMID: 31456841 DOI: 10.3889/oamjms.2019.577

BACKGROUND: Lymphoepithelial cysts, which are benign and slow-growing tumours, usually involve the head and neck regions. Benign lymphoepithelial cysts (BLECs) are the most common cause of parotid swelling in human immunodeficiency virus (HIV)-positive patients and are less common in immunocompetent patients.

CASE PRESENTATION: Here, we present two cases of immunocompetent patients with long-standing, progressively enlarging parotid swelling. Postoperative histopathological examination of these patients revealed features of BLEC.

CONCLUSION: Wide surgical excision is the gold standard for treatment and recurrences is rare. These cases are of particular interest because of the rarity of BLEC in HIV-negative patients and highlight an important differential diagnosis of parotid swelling.

Matched MeSH terms: Humans

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