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The use of an In House Scoring System Scale versus Glasgow Coma Scale in non-traumatic altered states of consciousness patients: can it be used for triaging patients in Southeast Asian developing countries?

Maheswaran M, Adnan WA, Ahmad R, Ab Rahman NH, Naing NN, Abdullah J

Southeast Asian J. Trop. Med. Public Health, 2007 Nov;38(6):1126-40.
PMID: 18613557

Non-traumatic Altered States of Consciousness (ASC) are a non-specific consequence of various etiologies, and are normally monitored by Glasgow Coma Scale (GCS). The GCS gives varriable results among untrained emergency medicine personel in developing countries where English is not the first language. An In House Scoring System (IHSS) scale was made by the first author for the purpose of triaging so as to quickly asses patients when seen by medical personel. This IHSS scale was compared to the GCS to determine it's specificity and sensitivity in the accident and emergency department (ED) of Hospital University Sains Malaysia (HUSM). All patients with non-traumatic ASC were selected by purposive sampling according to pre-determined criteria. Patients were evaluated by the two systems, IHSS and GCS, by emergency physicians who were on call. Patient demographics, clinical features, investigations, treatment given and outcomes were collected and followed for a period of 14 days. A total of 221 patients with non-traumatic ASC were studied, 54.3% were males. The mean age of the patients was 56 years old. The mean overall GCS score on presentation to the ED was 10.3. The mean duration of ASC was 11.6 hours. One hundred thirty patients (58.8%) experienced ASC secondary to general or focal cerebral disorders. The mortality rate was 40.3% 2 weeks after the ED visit. Fifty-four point three percent of the patients were awake and considered to have good outcomes while 45.7% of the patients had poor outcomes (comatose or dead) 2 weeks after the ED visit. The mean overall GCS score, verbal and motor subscores as well as the IHSS had significantly decreased (worsened) after treatment in the ED. A poor IHSS scale, hypertension, current smoking, abnormal pupillary reflexes and acidosis were associated with a worse 2-week outcome. The mean age and WBC count was lower and the mean overall GCS score and eye, verbal and motor subscores were higher as well as those having a lower IHSS scale for the good outcome category. Multivariate analysis revealed that smokers and hypertensives were at higher risk for a poor outcome. Higher eye scores on the GCS were associated fewer poor outcomes. There was significant agreement between the IHSS scale and GCS scores in the assessment of non-traumatic ASC. The sensitivity and specificity of the IHSS score versus GCS were 71.9% and 100.0%, respectively.

Matched MeSH terms: Developing Countries*
A preliminary study of using active vision guided robotic arm for bone drilling in a developing country

Abdullah MZ, Awang MS, Tan YC, Abdullah JM

J Neurol Surg A Cent Eur Neurosurg, 2014 Mar;75(2):155-7.
PMID: 23636911 DOI: 10.1055/s-0032-1330954

The study assesses the capability and accuracy of a robotic arm to perform burr holes.

Matched MeSH terms: Developing Countries
Diagnostic cerebral angiography in spontaneous intracranial haemorrhage: a guide for developing countries

Abu Bakar I, Shuaib IL, Mohd Ariff AR, Naing NN, Abdullah JM

Asian J Surg, 2005 Jan;28(1):1-6.
PMID: 15691788

OBJECTIVE: Spontaneous intracranial haemorrhage constitutes 18-40% of all stroke cases. Indications for cerebral angiography to find underlying potentially treatable vascular abnormalities are not clear. This study determined which intracranial haemorrhage patients need cerebral angiography by correlating computed tomography (CT) findings, age and hypertension history with cerebral angiography findings.
METHODS: A total of 54 patients (8-79 years) with intracranial haemorrhage who underwent both CT examination and six-vessel cerebral angiography were studied over a 2-year period. Cerebral angiography was repeated within 6 weeks if the first angiogram was negative.
RESULTS: Angiography detected vascular lesions in 50% of cases (aneurysm 38.9% and arteriovenous malformation, AVM, 11.1%). In the aneurysm group, angiographic yield was 34.3% whereas in the AVM group, it was 37.9%. Subarachnoid haemorrhage (SAH) combined with other types of haemorrhage (such as intracerebral haemorrhage, ICH) was not significantly correlated with the likelihood of finding a vascular lesion, both aneurysm and AVM (p = 0.157). Age less than 50 years had significant correlation (p = 0.021) in the AVM group as well as in the aneurysm group (p < 0.001). A history of hypertension was associated with both aneurysm (p = 0.039) and AVM (p = 0.008). No patients with deep intracerebral haematoma had vascular lesions. The presence of an intravascular haemorrhage (IVH) had significant correlation with aneurysm (p = 0.008) but not AVM. There was no significant difference in mean age between patients with and without a vascular lesion (p = 0.134).
CONCLUSION: Cerebral angiography is justified in patients with ICH accompanied by pure SAH (p = 0.001). Other factors associated with finding a vascular lesion were a history of hypertension and the presence of IVH. Diagnostic cerebral angiography is indicated for patients with ICH and SAH and IVH with a history of hypertension, regardless of age.

Matched MeSH terms: Developing Countries*
Fulltext Management of Severe Traumatic Brain Injury in Pregnancy: A Body with Two Lives

Kho GS, Abdullah JM

Malays J Med Sci, 2018 Sep;25(5):151-157.
PMID: 30914871 MyJurnal DOI: 10.21315/mjms2018.25.5.14

Traumatic brain injury is the major contributing factor in non-obstetric mortality in developing countries. Approximately 20% of maternal mortality is directly correlated to injuries. Road traffic accidents and domestic violence are the most common nonlethal injuries that can threaten either the maternal or foetal life, and such events occur in one out of every 12 pregnancies. The treatment of severe traumatic brain injury in pregnancy requires a multidisciplinary team approach. The management of a pregnant trauma patient warrants consideration of several issues specific to pregnancy, such as the alterations in the maternal physiology and anatomy. In the case of maternal cardiac arrest with amniotic fluid embolism, intact neonatal survival is linked with the timing of caesarean section after maternal cardiac arrest. Moreover, the decision for perimortem caesarean section is clear after maternal cardiac arrest. The foetal survival rate is 67% if the operation is done before 15 min of cardiopulmonary compromise has occurred, and it drops to 40% at the duration range of 16-25 min. Whether minor or severe, traumatic brain injury during pregnancy is associated with unfavourable maternal outcomes. Injuries considered minor for the general population are not minor for pregnant women. Therefore, these patients should be intensively monitored, and multidisciplinary approaches should always be involved.

Matched MeSH terms: Developing Countries
Fulltext Deep Brain Stimulation (DBS) for Movement Disorders: An Experience in Hospital Universiti Sains Malaysia (HUSM) Involving 12 Patients

Hooi LL, Fitzrol DN, Rajapathy SK, Chin TY, Halim SA, Kandasamy R, et al.

Malays J Med Sci, 2017 Mar;24(2):87-93.
PMID: 28894408 MyJurnal DOI: 10.21315/mjms2017.24.2.11

Deep brain stimulation (DBS) was first introduced in 1987 to the developed world. As a developing country Malaysia begun its movement disorder program by doing ablation therapy using the Radionics system. Hospital Universiti Sains Malaysia a rural based teaching hospital had to take into consideration both health economics and outcomes in the area that it was providing neurosurgical care for when it initiated its Deep Brain Stimulation program. Most of the patients were from the low to medium social economic groups and could not afford payment for a DBS implant. We concentrated our DBS services to Parkinson's disease, Tourette's Syndrome and dystonia patients who had exhausted medical therapy. The case series of these patients and their follow-up are presented in this brief communication.

Matched MeSH terms: Developing Countries
The NADI program and the JOICFP integrated project: partners in delivering primary health care

Arshat H, Othman R, Kuan Lin Chee, Abdullah M

JOICFP Rev, 1985 Oct;10:10-5.
PMID: 12313881

PIP:
The NADI program (pulse in Malay) was initially launched as a pilot project in 1980 in Kuala Lumpur, Malaysia. It utilized an integrated approach involving both the government and the private sectors. By sharing resources and expertise, and by working together, the government and the people can achieve national development faster and with better results. The agencies work through a multi-level supportive structure, at the head of which is the steering committee. The NADI teams at the field level are the focal points of services from the various agencies. Members of NADI teams also work with urban poor families as well as health groups, parents-teachers associations, and other similar groups. The policy and planning functions are carried out by the steering committee, the 5 area action committees and the community action committees, while the implementation function is carried out by the area program managers and NADI teams. The chairman of each area action committee is the head of the branch office of city hall. Using intestinal parasite control as the entry point, the NADI Integrated Family Development Program has greatly helped in expanding inter-agency cooperation and exchange of experiences by a coordinated, effective and efficient resource-mobilization. The program was later expanded to other parts of the country including the industrial and estate sectors. Services provided by NADI include: comprehensive health services to promote maternal and child health; adequate water supply, proper waste disposal, construction of latrines and providing electricity; and initiating community and family development such as community education, preschool education, vocational training, family counseling and building special facilities for recreational and educational purposes.

Matched MeSH terms: Developing Countries
Persistence of cognitive deficits following paediatric head injury without professional rehabilitation in rural East Coast Malaysia

Abdullah JM, Kumaraswamy N, Awang N, Ghazali MM, Abdullah MR

Asian J Surg, 2005 Jul;28(3):163-7.
PMID: 16024307

To use data from a prospective, longitudinal study to determine whether psychomotor functions improve spontaneously during the first year following paediatric traumatic brain injury without modern rehabilitation facilities in a rural area of Malaysia.

Matched MeSH terms: Developing Countries
Fulltext Suitability of Parkinson's patients for surgery in the north East coast of peninsular malaysia: a prospective analysis

Abdullah J, Abdullah MR

Malays J Med Sci, 2003 Jan;10(1):74-7.
PMID: 23365504 MyJurnal

There is no report in the English literature on the criteria for neuroablation or neuroaugmentation for the treatment of Parkinson's disease in a developing country like Malaysia. A prospective study of patients with Parkinson's disease from the north-eastern peninsular Malaysia was done to assess their suitability of surgery. Age, race, duration of illness and dementia were considered important factors towards the success of such surgical procedures. A mathematical model is suggested for future cases deemed to be suitable for neuroaugmentative or ablative surgery.

Matched MeSH terms: Developing Countries
Early phase oncology clinical trials in Malaysia: current status and future perspectives

Voon PJ, Lai WH, Bustaman RS, Siu LL, Razak ARA, Yusof A, et al.

Asia Pac J Clin Oncol, 2023 Jun;19(3):296-304.
PMID: 36305522 DOI: 10.1111/ajco.13886

Historically, the majority of oncology clinical trials are conducted in Western Europe and North America. Globalization of drug development has resulted in sponsors shifting their focus to the Asia-Pacific region. In Malaysia, implementation of various government policies to promote clinical trials has been initiated over a decade ago and includes the establishment of Clinical Research Malaysia, which functions as a facilitator and enabler of industry-sponsored clinical trials on a nationwide basis. Although oncology clinical trials in Malaysia have seen promising growth, there are still only a limited number of early phase oncology studies being conducted. Hence, the Phase 1 Realization Project was initiated to develop Malaysia's early phase clinical trial capabilities. In addition, the adaptation of good practices from other countries contribute to the effective implementation of existing initiatives to drive progress in the development of early phase drug development set up in Malaysia. Furthermore, holistic approaches with emphasis in training and education, infrastructure capacities, strategic alliances, reinforcement of upstream activities in the value chain of drug development, enhanced patient advocacy, coupled with continued commitment from policy makers are imperative in nurturing a resilient clinical research ecosystem in Malaysia.

Matched MeSH terms: Developing Countries
Contraceptive method switching in Peninsular Malaysia: ethnic differences, 1940s-1970s

Davanzo J, Starbird E, Reboussin D, Tan Boon Ann, Abdullah SH

Malays J Reprod Health, 1988 Jun;6(1):1-21.
PMID: 12281591
Matched MeSH terms: Developing Countries
EU28 region's water security and the effect of bioenergy industry sustainability

Alsaleh M, Abdul-Rahim AS, Abdulwakil MM

Environ Sci Pollut Res Int, 2020 Nov 03.
PMID: 33141381 DOI: 10.1007/s11356-020-11425-4

Water is an essential component of agriculture-food production. As the biomass and biofuel are known excellent sources of renewable and sustainable energy, cultivating process consumes significant quantities of water. Without sufficient, good-quality and easily accessible water, the European agriculture-food production could thus be under threat. This research analyses the impact of the water supply on the bioenergy production in the 28 European Union countries, for the 1990-2018 period within the pathway of the European Union 2030 agenda for sustainable development. The findings using the generalised least squares (GLS) technique show that bioenergy production and population density appear to decrease water supply. Precisely, the magnitude of the effects is - 0.224 and - 0.136 for developing countries and developed countries in the EU, respectively. This indicates that a serious reduction of water security is more likely to happen in developed countries than in developing countries as a result of the increase in bioenergy consumption. In the meantime, fossil fuel, income generation activities and institutional quality have already positively affected water supply. Thus, these findings implied that water scarcity is becoming one of the main obstacles for bioenergy expansion and growth. The results were also further verified by the random effect and pooled oriented least squares method. This study recommends that the Member of the European Union States should continue to increase bioenergy production in the energy mix efforts without any strenuous water security issues. Notwithstanding, there are several situations where a developing bioenergy industry is unlikely to be constrained by water shortage, and with the drive of bioenergy demand, the efforts might unlock new opportunities to adapt to water-related challenges and to improve water usage efficiencies. The authorities should illustrate organised water security and sustainable bioenergy policy by way of developing alternative strategies in reducing fossil fuel power and related CO2 emissions, accordingly to the unique characteristics of both developed and developing countries in the EU.

Matched MeSH terms: Developing Countries
Food safety knowledge, attitudes and practices among consumers in developing countries: An international survey

Odeyemi OA, Sani NA, Obadina AO, Saba CKS, Bamidele FA, Abughoush M, et al.

Food Res Int, 2019 02;116:1386-1390.
PMID: 30716930 DOI: 10.1016/j.foodres.2018.10.030

An international survey among consumers in developing countries from Asia and Africa on food safety knowledge, attitudes and practices (KAP) was carried out using structured questionnaires. Data were collected from 453 consumers comprising 265 from Africa and 188 from Asia. Significant difference (p 

Matched MeSH terms: Developing Countries
A seasonal analysis of Chinese births

Abeysinghe T

J Appl Stat, 1991;18(2):275-86.
PMID: 12343764
Matched MeSH terms: Developing Countries
Fulltext Limb salvage in osteosarcoma using autoclaved tumor-bearing bone

Pan KL, Chan WH, Ong GB, Premsenthil S, Zulkarnaen M, Norlida D, et al.

World J Surg Oncol, 2012;10:105.
PMID: 22681750 DOI: 10.1186/1477-7819-10-105

Tumor prostheses currently give the best short- and medium-term results for limb-salvage reconstruction procedures in the treatment of bone tumors. However, in developing countries, the cost of a tumor prosthesis is beyond the reach of much of the population. We report the use of autoclaved tumor-bearing bone in 10 patients, as an affordable alternative to the use of prostheses.

Matched MeSH terms: Developing Countries
Occupational safety and health in developing countries

Abrams HK

P N G Med J, 1984 Mar;27(1):24-31.
PMID: 6595901
Matched MeSH terms: Developing Countries*
HIV in Southeast Asia

Abrams S

Harv AIDS Rev, 1998.
PMID: 12294443
Matched MeSH terms: Developing Countries
Social pharmacy as a field of study: the needs and challenges in global pharmacy education

Hassali MA, Shafie AA, Al-Haddad MS, Abduelkarem AR, Ibrahim MI, Palaian S, et al.

Res Social Adm Pharm, 2011 Dec;7(4):415-20.
PMID: 21272536 DOI: 10.1016/j.sapharm.2010.10.003

The practice of pharmacy and, consequently, pharmacy curricula have undergone significant changes over the past years in response to a rapidly changing economic, political, and social environment. Within this context, the pharmacist's role had expanded to include more direct interaction with the public in terms of the provision of health information and advice on the safe and rational use of medications. To carry out these roles effectively, pharmacists need to be well prepared on how to deal with patients' behavior and psychology. The understanding of patient sociobehavioral aspects in the medication use process is paramount to achieving optimal clinical and humanistic outcomes from therapy. The concept of behavioral sciences and health psychology are embedded as the fundamental concepts in the field of social pharmacy, and thus it is imperative that this should be taught and nurtured to future pharmacy practitioners. Based on the growing needs for future pharmacists to be exposed to issues in social pharmacy, many pharmacy schools around the world have adopted this subject to be part of their standard curriculum. In this commentary, a discussion of the needs of social pharmacy courses in pharmacy curriculum will be addressed in the context of both developed and developing countries.

Matched MeSH terms: Developing Countries
Fulltext Colorectal cancer in Malaysia: Its burden and implications for a multiethnic country

Veettil SK, Lim KG, Chaiyakunapruk N, Ching SM, Abu Hassan MR

Asian J Surg, 2017 Nov;40(6):481-489.
PMID: 27492344 DOI: 10.1016/j.asjsur.2016.07.005

BACKGROUND: This study aims to provide an analytical overview of the changing burden of colorectal cancer and highlight the implementable control measures that can help reduce the future burden of colorectal cancer in Malaysia.
METHODS: We performed a MEDLINE search via OVID with the Medical Subject Headings (MeSH) terms "Colorectal Neoplasms"[Mesh] and "Malaysia"[Mesh], and PubMed with the key words "colorectal cancer" and "Malaysia" from 1990 to 2015 for studies reporting any clinical, societal, and economical findings associated with colorectal cancer in Malaysia. Incidence and mortality data were retrieved from population-based cancer registries/databases.
RESULTS: In Malaysia, colorectal cancer is the second most common cancer in males and the third most common cancer in females. The economic burden of colorectal cancer is substantial and is likely to increase over time in Malaysia owing to the current trend in colorectal cancer incidence. In Malaysia, most patients with colorectal cancer have been diagnosed at a late stage, with the 5-year relative survival by stage being lower than that in developed Asian countries. Public awareness of the rising incidence of colorectal cancer and the participation rates for colorectal cancer screening are low.
CONCLUSION: The efficiency of different screening approaches must be assessed, and an organized national screening program should be developed in a phased manner. It is essential to maintain a balanced investment in awareness programs targeting general population and primary care providers, focused on increasing the knowledge on symptoms and risk factors of colorectal cancer, awareness on benefits of screening, and promotion of healthy life styles to prevent this important disease.

Matched MeSH terms: Developing Countries
Outcome of children with different accessibility to tertiary pediatric intensive care in a developing country--a prospective cohort study

Goh AY, Abdel-Latif Mel-A, Lum LC, Abu-Bakar MN

Intensive Care Med, 2003 Jan;29(1):97-102.
PMID: 12528029 DOI: 10.1007/s00134-002-1534-9

Objective: Lack of direct access to tertiary pediatric intensive care services in rural hospitals may be associated with poorer outcome among critically ill children. Inter-hospital transport by non-specialized teams may also lead to increased morbidity and even mortality. We therefore studied the outcome of children with different accessibility to tertiary pediatric care in Malaysia.

Methods: We prospectively compared the Pediatric Risk of Mortality (PRISM II) adjusted standardized mortality ratio (SMR), unanticipated deaths and length of stay of 131 patients transported from rural hospitals (limited access) with 215 transferred from the casualty wards or other in-hospital wards (direct access) to a tertiary pediatric ICU.

Results: The transported patients were younger than the in-hospital patients (median age 1.0 versus 6.0 months, p=0.000) and were more likely to have respiratory diseases. Other baseline characteristics did not differ significantly. Differences in access to tertiary intensive care from community hospitals was associated with an extended median length of stay (4.0 versus 2.0 days, p=0.000) but did not affect SMR (0.92 versus 0.84, rate ratio 1.09, 95% CI 0.57-2.01; p=0.348) or percentage of unexpected deaths (4.8% versus 2.8%, p=0.485). The adjusted odds ratio for mortality (1.7, 95% CI 0.7-4.3) associated with transfer was not statistically significant (p=0.248).

Conclusions: The outcome of critically ill children transferred from community hospitals did not differ from that of those who develop ICU needs in the wards of a tertiary center, despite being transported by non-specialized teams. Outcome was not affected by initial inaccessibility to intensive care if the children finally received care in a tertiary center.

Matched MeSH terms: Developing Countries
Malaysia [Population education in countries of the region]

Abu-bakar F

Bull Unesco Reg Off Educ Asia Pac, 1982 Jun.
PMID: 12265670
Matched MeSH terms: Developing Countries

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