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Fulltext Maternal COVID-19 vaccine acceptance among Malaysian pregnant women: A multicenter cross-sectional study

Kalok A, Razak Dali W, Sharip S, Abdullah B, Kamarudin M, Dasrilsyah RA, et al.

Front Public Health, 2023;11:1092724.
PMID: 36908400 DOI: 10.3389/fpubh.2023.1092724

INTRODUCTION: The coronavirus disease 2019 (COVID-19) caused a global pandemic that resulted in devastating health, economic and social disruption. Pregnant mothers are susceptible to COVID-19 complications due to physiological and immunity changes in pregnancy. We aimed to assess the maternal vaccine acceptance of the COVID-19 vaccine.
METHODS: A multi-center study across four teaching hospitals in the Klang Valley, Malaysia was conducted between September 2021 and May 2022. A survey was conducted using a self-administered electronic questionnaire. The survey instruments included; (1) maternal perception and attitude toward COVID-19 vaccination, (2) COVID-19 pregnancy-related anxiety, and 3) generalized anxiety disorder.
RESULTS: The response rate was 96.6%, with a final number for analysis of 1,272. The majority of our women were Malays (89.5%), with a mean age (standard deviation, SD) of 32.2 (4.6). The maternal vaccine acceptance in our study was 77.1%. Household income (p < 0.001), employment status (p = 0.011), and health sector worker (p = 0.001) were independent predictors of maternal willingness to be vaccinated. COVID-19 infection to self or among social contact and greater COVID-19 pregnancy-related anxiety were associated with increased odds of accepting the SARS-CoV-2 vaccine. Women who rely on the internet and social media as a source of vaccine information were more likely to be receptive to vaccination (adjusted odd ratio, AOR 1.63; 95% CI 1.14-2.33). Strong correlations were observed between maternal vaccine acceptance and the positive perception of (1) vaccine information (p < 0.001), (2) protective effects of vaccine (p < 0.001), and (3) getting vaccinated as a societal responsibility (p < 0.001).
DISCUSSION: The high maternal vaccine acceptance rate among urban pregnant women in Malaysia is most likely related to their high socio-economic status. Responsible use of the internet and social media, alongside appropriate counseling by health professionals, is essential in reducing vaccine hesitancy among pregnant women.
Scale-up synthesis of lipase-catalyzed palm esters in stirred-tank reactor

Keng PS, Basri M, Ariff AB, Abdul Rahman MB, Abdul Rahman RN, Salleh AB

Bioresour Technol, 2008 Sep;99(14):6097-104.
PMID: 18243690 DOI: 10.1016/j.biortech.2007.12.049

Lipase-catalyzed production of palm esters by alcoholysis of palm oil with oleyl alcohol in n-hexane was performed in 2L stirred-tank reactor (STR). Investigation on the performance of reactor operation was carried out in batch mode STR with single impeller mounted on the centrally located shaft. Rushton turbine (RT) impellers provide the highest reaction yield (95.8%) at lower agitation speed as compared to AL-hydrofoil (AL-H) and 2-bladed elephant ear (EE) impellers. Homogenous enzyme particles suspension was obtained at 250 rpm by using RT impeller. At higher impeller speed, the shear effect on the enzyme particles caused by agitation has decreased the reaction performance. Palm esters reaction mixture in STR follows Newtons' law due to the linear relation between the shear stress (tau) and shear rate (dupsilon/dy). High stability of Lipozyme RM IM was observed as shown by its ability to be repeatedly used to give high percentage yield (79%) of palm esters even after 15 cycles of reaction. The process was successfully scale-up to 75 L STR (50 L working volume) based on a constant impeller tip speed approach, which gave the yield of 97.2% after 5h reaction time.
Fulltext Protein-Energy Wasting Assessment and Clinical Outcomes in Patients with Acute Kidney Injury: A Systematic Review with Meta-Analysis

Khor BH, Tiong HC, Tan SC, Abdul Rahman R, Abdul Gafor AH

Nutrients, 2020 Sep 13;12(9).
PMID: 32933198 DOI: 10.3390/nu12092809

Nutritional assessment is essential to identify patients with acute kidney injury (AKI) who are protein-energy wasting (PEW) and at risk of poor clinical outcomes. This systematic review aimed to investigate the relationship of nutritional assessments for PEW with clinical outcomes in patients with AKI. A systematic search was performed in PubMed, Scopus, and Cochrane Library databases using search terms related to PEW, nutrition assessment, and AKI to identify prospective cohort studies that involved AKI adult patients with at least one nutritional assessment performed and reported relevant clinical outcomes, such as mortality, length of stay, and renal outcomes associated with the nutritional parameters. Seventeen studies reporting eight nutritional parameters for PEW assessment were identified and mortality was the main clinical outcome reported. A meta-analysis showed that PEW assessed using subjective global assessment (SGA) was associated with greater mortality risk (RR: 1.99, 95% CI: 1.36-2.91). Individual nutrition parameters, such as serum chemistry, body mass, muscle mass, and dietary intakes, were not consistently associated with mortality. In conclusion, SGA is a valid tool for PEW assessment in patients with AKI, while other nutrition parameters in isolation had limited validity for PEW assessment.
Fulltext Dermatomyositis Anteceding Lung Adenocarcinoma

Lim JL, Yusof NS, Md Tarekh NA, Abdul Rahman R

Cureus, 2020 Nov 19;12(11):e11580.
PMID: 33364104 DOI: 10.7759/cureus.11580

Dermatomyositis is often presented as paraneoplastic syndrome. The diagnosis of dermatomyositis can prompt clinicians to further investigate the underlying cause, in particular malignancy. This case report illustrates the association of lung adenocarcinoma and dermatomyositis with antecedent presentation of cutaneous and musculoskeletal manifestations, one year prior to the diagnosis of carcinoma.
Fulltext The Mentakab Hypertension Study project. Part I--Complicated hypertensives in hospital: who are they?

Lim TO, Ngah BA, Suppiah A, Ismail F, Abdul Rahman R

Singapore Med J, 1991 Aug;32(4):245-8.
PMID: 1776003

Consecutive hypertensives admitted with cardiovascular complications were studied. One hundred and eight complicated hypertensives (10%) out of 1,066 medical admissions were seen in the three month study. Thirty three per cent had cerebrovascular disease, 30% ischaemic heart disease, 2% had malignant hypertension and 85% had hypertensive heart disease. All patients had uncontrolled hypertension at admission (mean blood pressure 184/115 mmHg). Twenty-four patients (22%) were newly diagnosed; of the rest of previously diagnosed hypertensives (78%), 3% had never been on treatment and 56% had dropped out of treatment, which explained their ineffective blood pressure control. However, 18% of patients had apparently been on regular follow up and treatment, and yet their blood pressure control was poor. Many patients had evidence of renal disease. The prevalence of cardiovascular risk factors was also high; 56% had hypercholesterolaemia; 46% had hypertriglyceridaemia; 44% smoked, 38% were overweight or obese, and 18% were diabetic. This indicates that hypertension is best regarded as an ingredient of a cardiovascular risk profile and its management requires multifactorial correction of all risk factors identified.
Fulltext Supercritical fluid extraction of bioactive flavonoid from Strobilanthes crispus (pecah kaca) and its comparison with solvent extraction

Liza, M.S., Abdul Rahman, R., Mandana, B., Jinap, S., Rahmat, A., Zaidul, I.S.M., et al.

International Food Research Journal, 2012;19(2):503-508.
MyJurnal

Supercritical carbon dioxide extraction (SC-CO2) of bioactive flavonoid from Strobilanthes crispus (Pecah Kaca) was performed to study the effects of various parameters such as pressure, temperature and dynamic extraction time on the yield and composition of bioactive flavonoid. The results were also compared with those obtained by conventional Soxhlet extraction in lab conditions. The results from SFE showed that the effect of extraction variables on extraction yields decreased in the following order: pressure, temperature and dynamic extraction time. The extraction pressure played a dominant role in the yield of the sample while the effect of time could be ignored. This study also revealed that both Soxhlet extraction and SC-CO2 extraction can be used to obtain flavonoid compound. Under the optimum conditions, the highest bioactive flavonoid compound content was obtained at 3.98% and eight flavonoid compounds were identified by HPLC.
Pasting and leaching properties of irradiated starches from various botanical sources

Mohd Adzahan, N., Mat Hashim, D., Muhammad, K., Abdul Rahman, R., Ghazali, Z., Hashim, K.

International Food Research Journal, 2009;16(3):415-429.
MyJurnal

Changes to the physicochemical properties of wheat, sago and tapioca starches subjected to gamma ray, electron beam and microwave irradiations and the conditions that lead to wheat starch having leaching behaviour similar to sago or tapioca starch were studied. The properties were characterised through swelling and leaching behaviours of the starch granules and retrogradation following pasting. The leaching of wheat starch increased tremendously and resulted in amylose to amylopectin ratios in the leachate similar to that of native sago and tapioca starches. This observation is significant as wheat starch is known to have a leachate composition of mostly amylose. This opens up the possibility of utilising wheat starch in snacks where tapioca and sago starch are commonly used. It was observed that the required conditions for such changes were exposure to microwave for 8 and 10 minutes, electron beam at 5 and 10 kGy and gamma ray at 5 kGy.
Fulltext Fatty acid, triacylglycerol composition and antioxidant properties of date seed oil

Mohd Jaih, A.A., Abdul Rahman, R., Abdull Razis, A.F., Ariffin, A.A., Al-Awaadh, A., Suleiman, N.

International Food Research Journal, 2019;26(2):517-527.
MyJurnal

Oil is one of the major components of date seed alongside dietary fibre, carbohydrate, protein, moisture and ash. Therefore, the present work focused on the extraction of oil from five varieties of date seed using Soxhlet extraction method and subsequently characterised their physicochemical and antioxidant properties accordingly. Oil extracted from the seeds ranged between 8 to 9.8%, whereas the iodine values were between 48.7 to 55.5 g I2/100g. Furthermore, oleic and lauric acids were revealed as the main fatty acids present in the date seed oil, with LaOO (La: lauric acid; O: oleic acid) as the main triacylglycerol. The total phenolic content in the oil ranged from 7.96 to 17.72 mg GAE/g oil, while the antioxidant activity, expressed as EC50, ranged from 5.17 to 17.18 mg/mL. Additionally, the highest reducing activity was observed at 4mg/mL. Hence, oil characteristics are dependent on the type of date, thus indicating that different potential applications may be suggested.
Fulltext A rare case of Pseudomonas putida ventriculitis in intensive care unit: A case report

Mokhtar MN, Azaharuddin I, Abdullah FH, Izaham A, Abdul Rahman R

Front Med (Lausanne), 2022;9:1058121.
PMID: 36569164 DOI: 10.3389/fmed.2022.1058121

Pseudomonas putida is a rare pathogen leading to nosocomial and central nervous system infections. Despite having a low virulence and being a rare organism to cause bacteremia, it can evolve into a multidrug-resistant organism and lead to mortality and morbidity in the intensive care setting. A 64-year-old male gardener was presented with extensive acute subarachnoid hemorrhage with intraventricular extension causing hydrocephalus requiring embolization and coiling following a cerebral angiogram, which showed bilateral posterior circulation aneurysm and left anterior circulation aneurysm. External ventricular drain (EVD) was inserted given the worsening hydrocephalus. During his stay in the intensive care unit (ICU), he was becoming more septic and a full septic workup including a cerebral spinal fluid culture taken from the indwelling catheter of the EVD and was found to be positive for a ceftazidime-sensitive strain of P. putida. Following the treatment with intravenous ceftazidime for 1 week and a revision of the EVD on day 32 of admission, he continued to recover well and showed an improvement in his Glasgow Coma Scale (GCS) and septic parameters. Eventually, he was able to wean off mechanical ventilation. He was discharged from ICU care to the neurosurgical ward with supplemental oxygen on day 42 of admission. It is necessary to be aware of the possibility of nosocomial P. putida infection, especially in patients with indwelling catheters, and to consider the early initiation of appropriate antibiotic regimens once detected as well as strict precautions in hygiene during the management of these patients to avoid further development of multi-drug resistant (MDR) strains.
Perioperative Management of Parturient Women With Severe Pulmonary Arterial Hypertension Secondary to Atrial Septal Defect

Mokhtar MN, Abdul Rahman R, Md Nor N, Izaham A, Sayed Masri SNN

Cureus, 2023 Nov;15(11):e48369.
PMID: 38060730 DOI: 10.7759/cureus.48369

At our institution, we occasionally see pregnant patients in the later stages of pregnancy who present with severe pulmonary arterial hypertension caused by congenital heart disease. The physiological changes in pregnancy may worsen the cardiovascular status leading to heart failure which is associated with a high incidence of morbidity and mortality. A scheduled caesarean section in such patients ensures delivery in a controlled environment, avoiding prolonged labour, which is detrimental. Perioperative complications that may worsen pulmonary arterial hypertension should be prevented. The perioperative management, in particular, the anaesthesia technique used and the clinical outcome of this population, is discussed through five interesting cases. Despite a multidisciplinary team and intensive care management, two patients with existing cor pulmonale, one of whom received general and the other central neural blockade anaesthesia, succumbed to their illness immediately after lower segment caesarean section. The management of severe pulmonary arterial hypertension in pregnant patients remains a multidisciplinary challenge among participating physicians. Thorough perioperative preparation encompassing monitoring, medical therapy, timing and mode of delivery, and risk consultation is vital in avoiding circumstances that could exacerbate pulmonary arterial hypertension, with physicians readily equipped to promptly detect and manage any untoward event.
Application of response surface methodology (RSM) for optimisation of COD, NH3-N and 2,4-DCP removal from recycled paper wastewater in a pilot-scale granular activated carbon sequencing batch biofilm reactor (GAC-SBBR)

Muhamad MH, Sheikh Abdullah SR, Mohamad AB, Abdul Rahman R, Hasan Kadhum AA

J Environ Manage, 2013 May 30;121:179-90.
PMID: 23542216 DOI: 10.1016/j.jenvman.2013.02.016

In this study, the potential of a pilot-scale granular activated carbon sequencing batch biofilm reactor (GAC-SBBR) for removing chemical oxygen demand (COD), ammoniacal nitrogen (NH3-N) and 2,4-dichlorophenol (2,4-DCP) from recycled paper wastewater was assessed. For this purpose, the response surface methodology (RSM) was employed, using a central composite face-centred design (CCFD), to optimise three of the most important operating variables, i.e., hydraulic retention time (HRT), aeration rate (AR) and influent feed concentration (IFC), in the pilot-scale GAC-SBBR process for recycled paper wastewater treatment. Quadratic models were developed for the response variables, i.e., COD, NH3-N and 2,4-DCP removal, based on the high value (>0.9) of the coefficient of determination (R(2)) obtained from the analysis of variance (ANOVA). The optimal conditions were established at 750 mg COD/L IFC, 3.2 m(3)/min AR and 1 day HRT, corresponding to predicted COD, NH3-N and 2,4-DCP removal percentages of 94.8, 100 and 80.9%, respectively.
Fulltext Survivability of Salmonella and shiga-toxigenic Escherichia coli (STEC) O157 in microwave heated ready-to-eat (RTE) foods

New, C.Y., Abdul Rahman, R., Son, R., Mohammed, A.S.

Food Research, 2018;2(4):378-390.
MyJurnal

The safety level of microwaved foods remains at vague as this subject was less addressed
scientifically. A study was initiated to address the matter by investigating on the
survivability of Salmonella and Shiga-toxigenic Escherichia coli (STEC) O157 in
microwave heated ready-to-eat (RTE) foods using the Most Probable Number coupled
Polymerase Chain Reaction (MPN-PCR) technique. A total of 329 samples of various
ready-to-eat (RTE) convenience meals were collected around Wilayah Persekutuan Kuala
Lumpur and Selangor regions. Salmonella was positively identified in 66 samples (20.1%,
Fulltext Pain assessment using self-reported, nurse-reported, and observational pain assessment tools among older individuals with cognitive impairment

Ngu SS, Tan MP, Subramanian P, Abdul Rahman R, Kamaruzzaman S, Chin AV, et al.

Pain Manag Nurs, 2015 Aug;16(4):595-601.
PMID: 26088939 DOI: 10.1016/j.pmn.2014.12.002

Pain assessment in older individuals with cognitive impairment is challenging. Evidence on the performance of pain assessment tools in this population remains limited. The aim of this study was to evaluate the performance of self-reported pain, nurse-reported pain, and observational pain tools among older patients with cognitive impairment using a prospective observational design. In all, 152 older individuals admitted to the acute geriatric ward were recruited through convenience sampling. Three methods of pain assessment were compared: self-reported pain (SRP), observational pain using the Pain Assessment in Advanced Dementia (PAINAD) tool, and nurse-reported pain (NRP). Cognition and mood were assessed with the Mini-Mental State Examination (MMSE) and the 15-item Geriatric Depression Scale (GDS-15). There was moderate agreement between SRP and PAINAD (k = 0.438) and fair agreement between SRP and NRP (k = 0.263). There was statistically significant correlation between SRP and GDS-15 (r = 0.382, p r = 0.018, p = .824). These results suggest that the use of an observational pain scale would be helpful in pain assessment among older individuals when the ability to report pain is not possible. However, self-reported assessments should be attempted first for cognitively impaired patients.
Multicentre evaluations of two new rapid IgG4 tests (WB rapid and panLF rapid) for detection of lymphatic filariasis

Noordin R, Itoh M, Kimura E, Abdul Rahman R, Ravindran B, Mahmud R, et al.

Filaria journal, 2007;6:9.
PMID: 17961262

In the global effort to eliminate lymphatic filariasis (LF), rapid field-applicable tests are useful tools that will allow on-site testing to be performed in remote places and the results to be obtained rapidly. Exclusive reliance on the few existing tests may jeopardize the progress of the LF elimination program, thus the introduction of other rapid tests would be useful to address this issue. Two new rapid immunochromatographic IgG4 cassette tests have been produced, namely WB rapid and panLF rapid, for detection of bancroftian filariasis and all three species of lymphatic filaria respectively. WB rapid was developed using BmSXP recombinant antigen, while PanLF rapid was developed using BmR1 and BmSXP recombinant antigens. A total of 165 WB rapid and 276 panLF rapid tests respectively were evaluated at USM and the rest were couriered to another university in Malaysia (98 WB rapid, 129 panLF rapid) and to universities in Indonesia (56 WB rapid, 62 panLF rapid), Japan (152 of each test) and India (18 of each test) where each of the tests underwent independent evaluations in a blinded manner. The average sensitivities of WB rapid and panLF rapid were found to be 97.6% (94%-100%) and 96.5% (94%-100%) respectively; while their average specificities were both 99.6% (99%-100%). Thus this study demonstrated that both the IgG4 rapid tests were highly sensitive and specific, and would be useful additional tests to facilitate the global drive to eliminate this disease.
Fulltext Spatial distribution of Plasmodium knowlesi cases and their vectors in Johor, Malaysia: in light of human malaria elimination

Pramasivan S, Ngui R, Jeyaprakasam NK, Liew JWK, Low VL, Mohamed Hassan N, et al.

Malar J, 2021 Oct 29;20(1):426.
PMID: 34715864 DOI: 10.1186/s12936-021-03963-0

BACKGROUND: Plasmodium knowlesi, a simian malaria parasite infection, increases as Plasmodium falciparum and Plasmodium vivax infections decrease in Johor, Malaysia. Therefore, this study aimed to identify the distribution of vectors involved in knowlesi malaria transmission in Johor. This finding is vital in estimating hotspot areas for targeted control strategies.
METHODS: Anopheles mosquitoes were collected from the location where P. knowlesi cases were reported. Cases of knowlesi malaria from 2011 to 2019 in Johor were analyzed. Internal transcribed spacers 2 (ITS2) and cytochrome c oxidase subunit I (COI) genes were used to identify the Leucosphyrus Group of Anopheles mosquitoes. In addition, spatial analysis was carried out on the knowlesi cases and vectors in Johor.
RESULTS: One hundred and eighty-nine cases of P. knowlesi were reported in Johor over 10 years. Young adults between the ages of 20-39 years comprised 65% of the cases. Most infected individuals were involved in agriculture and army-related occupations (22% and 32%, respectively). Four hundred and eighteen Leucosphyrus Group Anopheles mosquitoes were captured during the study. Anopheles introlatus was the predominant species, followed by Anopheles latens. Spatial analysis by Kriging interpolation found that hotspot regions of P. knowlesi overlapped or were close to the areas where An. introlatus and An. latens were found. A significantly high number of vectors and P. knowlesi cases were found near the road within 0-5 km.
CONCLUSIONS: This study describes the distribution of P. knowlesi cases and Anopheles species in malaria-endemic transmission areas in Johor. Geospatial analysis is a valuable tool for studying the relationship between vectors and P. knowlesi cases. This study further supports that the Leucosphyrus Group of mosquitoes might be involved in transmitting knowlesi malaria cases in Johor. These findings may provide initial evidence to prioritize diseases and vector surveillance.
Indigenous use and trade of dugong (Dugong dugon) in Sabah, Malaysia

Rajamani L, Cabanban AS, Abdul Rahman R

Ambio, 2006 Aug;35(5):266-8.
PMID: 16989512
Pattern of maxillofacial injuries in motorcyclists in Malaysia

Ramli R, Abdul Rahman R, Abdul Rahman N, Abdul Karim F, Krsna Rajandram R, Mohamad MS, et al.

J Craniofac Surg, 2008 Mar;19(2):316-21.
PMID: 18362705 DOI: 10.1097/SCS.0b013e318163f94d

Motorcycle casualties represent significant number in road traffic accidents in Malaysia, and among all the injuries, facial injuries pose many significant problems physiologically, functionally, and aesthetically. The aim of this study was to analyze the pattern of maxillofacial as well as other injuries in motorcyclists who were seen at Hospital Universiti Kebangsaan Malaysia.Patients' records from January 2004 to December 2005 were reviewed. Data related to demographics, vehicle/object involved in collision, involvement as a rider or pillion, whether a helmet was worn or not, location of injuries on the face/facial bones, and other associated injuries were collected.A total of 113 cases of motorcycle accidents were recorded; 106 males and 7 females were involved. Mean age was 25.8 years. Among all the races, Malay had the highest involvement (72.3%), followed by Chinese (14.3%), Indians (8.9%), and others (5.4%). The types of collision were either a single-vehicle collision (i.e., skidded) or with another vehicle/s or object (e.g., tree, stone, or lamppost). The injuries were mainly seen on the lower face (46.9%) followed by midface (25.7%) and a combination of the midface and lower face (15%) and others (12.4%). The most frequent other associated injuries recorded were orthopedic and head injuries.
Minor oral surgery in anticoagulated patients: local measures alone are sufficient for haemostasis

Ramli R, Abdul Rahman R

Singapore Dent J, 2005 Dec;27(1):13-6.
PMID: 16438263

Minor oral surgery in warfarinized patients can be performed without stopping or altering the dose of the drug. Thirty patients underwent various types of oral surgical procedures without interruption of their anticoagulant therapy and their therapeutic international normalized ratio maintained. Local measures such as pressure, packing the sockets with oxidized regenerated cellulose, and suturing were applied. In some patients, tranexamic acid mouthwashes were prescribed to further enhance haemostasis. Four patients had minimal postoperative bleeding in the form of bloodstained saliva, which lasted for 24 hours. This study highlights the importance of local measures in controlling postoperative bleeding in warfarinized patients undergoing minor oral surgical procedures.
A survey of perceived stress among undergraduate dental students in Universiti Kebangsaan Malaysia

Rosli TI, Abdul Rahman R, Abdul Rahman SR, Ramli R

Singapore Dent J, 2005 Dec;27(1):17-22.
PMID: 16438264

The objectives of this study were to determine the sources of stress among undergraduate dental students, and to compare the sources of stress among the 5 years of undergraduate study, between gender, and with other studies done elsewhere. A total of 325 students across the 5 academic years (88.8% response rate) of the Faculty of Dentistry, Universiti Kebangsaan Malaysia, completed the modified Dental Environment Stress questionnaire. All respondents reported that they experienced some form of stress. The preclinical students reported that examinations and fear of failure caused the most stress. The main stressor for clinical students was clinical training, particularly factors relating to meeting clinical requirements. Female students perceived more stress generally than male students. However, male students were more stressed when faced with factors related to clinical training.
Fulltext Cost analysis of facial injury treatment in two university hospitals in Malaysia: a prospective study

Saperi BS, Ramli R, Ahmed Z, Muhd Nur A, Ibrahim MI, Rashdi MF, et al.

Clinicoecon Outcomes Res, 2017;9:107-113.
PMID: 28223831 DOI: 10.2147/CEOR.S119910

OBJECTIVE: Facial injury (FI) may occur in isolation or in association with injuries to other parts of the body (facial and other injury [FOI]). The objective of this study was to determine the direct treatment costs incurred during the management of facial trauma.
MATERIALS AND METHODS: A prospective cohort study on treatment cost for FIs and FOIs due to road-traffic crashes in two university hospitals in Malaysia was conducted from July 2010 to June 2011. The patients were recruited from emergency departments and reviewed after 6 months from the date of initial treatment. Direct cost analysis, comparison of cost and length of hospital stay, and Injury Severity Score (ISS) were performed.
RESULTS: A total of 190 patients were enrolled in the study, of whom 83 (43.7%) had FI only, and 107 (56.3%) had FOI. The mean ISS was 5.4. The mean length of stay and costs for patients with FI only were 5.8 days with a total cost of US$1,261.96, whereas patients with FOI were admitted for 7.8 days with a total cost of US$1,716.47. Costs doubled if the treatment was performed under general anesthesia compared to local anesthesia.
CONCLUSION: Treatment of FI and FOI imposes a financial burden on the health care system in Malaysia.

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