Displaying publications 21 - 40 of 70 in total

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  1. Fulltext Pattern of antibiotic usage in hospitals in Malaysia
    Lim VK, Cheong YM, Suleiman AB
    Singapore Med J, 1993 Dec;34(6):525-8.
    PMID: 8153716
    A prospective survey of antibiotic prescribing patterns in six Ministry of Health general hospitals in Malaysia was undertaken. Information on antibiotic prescriptions including the types of antibiotics used and the purposes for prescription was obtained through the use of questionnaires. A total of 1,918 antibiotic prescriptions were available for analysis. About two-thirds of prescriptions were for therapeutic purposes. The most common infections treated were lower respiratory infection (31%), followed by skin and soft tissue infection (17%), and urinary tract infection (8%). Only 20% of the therapeutic prescriptions were based on microbiological test results. Prophylactic prescriptions were issued for a variety of indications, the most common being toilet and suture of wounds. Only 5% of prophylactic prescriptions were of less than 3 days duration. There was great diversity in antibiotics and antibiotic regimens employed. It was evident that there was a lack of compliance with guidelines on antibiotic use issued by the Ministry of Health.
    Matched MeSH terms: Obstetrics and Gynecology Department, Hospital/organization & administration
  2. Maternal mortality rate in the Obstetric Unit of University Kebangsaan Malaysia: 1981-1990
    Abdullah A, Mahmood JH, Adeeb N
    J Obstet Gynaecol (Tokyo 1995), 1995 Jun;21(3):299-303.
    PMID: 8590370
    This paper analyses maternal mortality as seen in the Obstetric Unit of the University Kebangsaan Malaysia. During the 10 year study period, the maternal mortality rate was 74/100,000 total births. Women who were non-booked, aged above 40 years, gradmultiparous and of India ethnicity were at the highest risk of maternal death. The commonest causes of death were hemorrhage, hypertension, embolism and sepsis. Post-mortem examinations were performed in only 8.2% of women who died.
    Matched MeSH terms: Obstetrics and Gynecology Department, Hospital
  3. Fulltext Is there a role for the obstetric flying squad in Peninsula Malaysia?
    Monga D, Achanna S
    Singapore Med J, 1999 Feb;40(2):78-80.
    PMID: 10414162
    The Obstetric Flying Squad (OFS) has been operating in Peninsular Malaysia for over three decades. In the light of current controversies regarding its role in modern day obstetric practice, its status in Malaysia over the last 12 years is reviewed.
    Matched MeSH terms: Obstetrics/organization & administration*
  4. Observations on obstetric practice in a multicultural setting
    TambyRaja RL
    Matern Child Health J, 1999 Jun;3(2):111-3.
    PMID: 10892419
    Singapore provides a rich environment for investigations into ethnic differences in pregnancy outcome, as it is populated by Malays, Indians, and Chinese. Years of clinical practice and obstetric research in this environment have affirmed the observation that many factors interact in determining length of gestation and birth weight, and that these factors have differential affects among these three different ethnic groups. Although technological advances have furthered our understanding of obstetrical outcomes and provided essential tools to promote the survival of premature infants, the persistent use of uniform growth standards hampers our ability to assure positive outcomes for women of different ethnicity. Recognition of ethnic differences has resulted in declines in certain negative pregnancy outcomes for women in Singapore. The development of race-specific uterine growth curves will enhance the provision of perinatal care for all women.
    Matched MeSH terms: Obstetrics/trends
  5. Fulltext Antenatal HIV screening--knowledge, attitudes and practices of obstetricians in KKH
    Tan TY, Teo KP, Tan KH
    Singapore Med J, 1999 Dec;40(12):733-7.
    PMID: 10709422
    To determine the knowledge, attitudes and practices of obstetricians with regards to HIV screening in pregnant women.
    Matched MeSH terms: Obstetrics/standards*
  6. Fulltext Clinical experience of medical students at University Sains Malaysia
    Quah BS, Malik AS, Simpson H
    Malays J Med Sci, 2000 Jan;7(1):27-32.
    PMID: 22844212 MyJurnal
    Experience of acute medical, surgical conditions, and clinical procedures of undergraduate students were assessed via a questionnaire survey during the final week of the 1993/1998 programme at the School of Medical Sciences, Univestiti Sains Malaysia. Individual performances were assessed by a scoring system. One hundred and twenty four students responded, (response rate 97%). More than 90% had seen myocardial infarction, cerebrovascular accident, pneumonia, respiratory distress, gastroenteritis, coma, and snake bite. Less than 33% had witnessed acute psychosis, diabetic ketoacidosis, acute hepatic failure, status epilepticus, near drowning, hypertensive encephalopathy, acute haemolysis or child abuse.Acute surgical/obstetrics cases, seen by >90% students, included fracture of long bones, head injury, acute abdominal pain, malpresentation and foetal distress. Less than 33% had observed epistaxis, sudden loss of vision, peritonitis or burns. Among operations only herniorrhaphy, Caesarian section, internal fixation of fracture and cataract extraction were seen by >80% students. The main deficits in clinical procedures are in rectal and vaginal examinations, urine collection and microscopic examinations. The performance of individual students, assessed by a scoring system, showed 15 students had unacceptably low scores (<149/230, 50%), 37 had good scores (>181.4/230, 70%) and 5 had superior scores (197.6/230, 80%).
    Matched MeSH terms: Obstetrics
  7. The Community Follow-up Project (CFUP)
    Mohd Sidik S, Azhar MZ, Mohd Yunus A, Azlan Hamzah SA
    Med J Malaysia, 2005 Aug;60 Suppl D:54-7.
    PMID: 16315625
    The Community Follow-up Project (CFUP) is a project where medical students choose a hospital in-ward patient during their clinical ward-based attachments and follow-up this patient's progress after discharge from the hospital. The students do a series of home visits and also accompany their patients for some of their follow-ups at the hospital, government clinics, general practitioners' clinics and even to the palliative care or social welfare centres. The students assess the physical, psychological and social impact of the illness on the patient, family and community. By following their patients from the time their patients were in the hospital and back to their homes and community, the students are able to understand in depth the problems faced by patients, the importance of communication skills in educating patients on their illness and the importance of good communication between primary, secondary and tertiary care.
    Matched MeSH terms: Obstetrics/education
  8. Evidence-based practical management of vulvovaginal candidiasis in primary care
    Loh KY, Sivalingam N
    Family Physician, 2005;13:20-21.
    Matched MeSH terms: Obstetrics
  9. Term breech trial and its consequences on practice: a retrospective study of the University of Malaya Medical Centre's experience
    Noor Azmi MA, Aniza A
    JUMMEC, 2005;8:39-44.
    To see the trend in managing singleton breech pregnancy after the term breech trial. Secondly to compare the safety of different modes of delivery for term, singleton breeches by looking at the immediate neonatal outcome, based on our own experience. Breech infants were identified by examining computer-stored maternal discharge records of hospitalization for the years 1990 and 2000 respectively. Parameters studied included planned mode of delivery, actual mode of delivery, parity, previous vaginal delivery, Apgar score at five minute, birth weight, referral to special care nursery and neonatal morbidity. Of 6,496 deliveries in 1990 and 5,081 in 2000, there were 220 (3.4%) and 148 (2.9%) term breech infants respectively, of which 115 (for 1990) and 102 (for 2000) case records were available. In 1990, 62.6% of the women had trial of vaginal breech delivery but only 24.5% of the women in 2000 were allowed to do so (p < 0.05). Caesarean section rate for singleton breeches increased from 51.3% in 1990 to 84.3% in 2000 (p < 0.05). Mean Apgar score at five minutes was significantly lower after vaginal breech delivery (9.40 ± 1.36) compared to after Caesarean section (9.72 ± 0.712) but there was no clinical significance. There was a noticeable trend towards Caesarean section and less trial of vaginal delivery. Neonatal outcomes of babies born abdominally were statistically better than those born vaginally but there was little clinical impact. Perhaps in properly selected cases, a planned vaginal breech delivery still has a role to play. KEYWORDS: Breech deliveries, Caesarean section, Apgar score
    Matched MeSH terms: Obstetrics
  10. Fulltext "Postpartum morbidity--what we can do"
    Zainur RZ, Loh KY
    Med J Malaysia, 2006 Dec;61(5):651-6.
    PMID: 17623974
    Postpartum is a crucial period for a mother. During this period a mother is going through the physiological process of uterine involution and at the same time adapting to her new role in the family. Many postpartum complications occur during this period. Among the important obstetric morbidities are postpartum hemorrhage, pregnancy related hypertension, pulmonary embolism and puerperal sepsis. Common surgical complications are wound breakdown, breast abscess and urinary fecal incontinence. Medical conditions such as anemia, headache, backache, constipation and sexual problems may also be present. Unrecognized postpartum disorders can lead to physical discomfort, psychological distress and a poor quality of life for the mothers. Providing quality postnatal care including earlier identification of the problems (correction) and proper intervention will help the mother to achieve full recovery and restore her functional status back to the pre-pregnancy state sooner.
    Matched MeSH terms: Obstetrics/methods
  11. Fulltext A Prospective Cohort Study of Obstetric Immigrants in the Maternity Hospital Kuala Lumpur. A Pilot
    Noraihan Mohd. Nordin, Sharda, Priya, Zainab Shamsuddin
    International Medical Journal Malaysia, 2006;5(1):1-12.
    MyJurnal
    Objectives: The objectives of this study were to ascertain the prevalence of Indonesians obstetrics immigrant and to assess the fetal maternal outcome. Methodology: A prospective cohort study design was used to analyse 54 consecutive Indonesians obstetrics immigrant compared to 56 Malay women. Chi square and student t test were used where appropriate, p < 0.05 was considered to be of statistical significance. Results: There was a reducing trend in the incidence admission of Indonesians from 10.5 in 1999 to 6.5 % in 2002. The maternal mortality ratio showed an increasing trend from 1999 (40.0/100000) to 2001 (162.9/100000) but decreased to 5.8/100000 in 2002. The majority was between 20-40 years old, multiparous and booked, which was similar to the Malay population. Most Malays were in occupational class 1 to 3 and the husband has secondary and tertiary education compared to the Indonesians who were in class 4 and 5 and the husband has primary and no formal education. Significantly more immigrants were housewives compared to Malays who were working women. There was no significant difference in the antenatal complications. There were no significant difference in terms of delivery and most delivered vaginally. The perinatal outcome in terms of gestation, birth weight, Apgar score and admission to neonatal ICU were similar in both populations and there was no perinatal mortality. In conclusion, the incidence admission of Indonesian immigrant was on the decreasing trend. The outcome of these patients managed in MHKL was similar to the Malay population. Further studies with enrollment of a larger number of patients should be carried out to ascertain the significance of these findings.
    Matched MeSH terms: Obstetrics
  12. Fulltext Optimising reproductive and child health outcomes by building evidence-based research and practice in South East Asia (SEA-ORCHID): study protocol
    Henderson-Smart DJ, Lumbiganon P, Festin MR, Ho JJ, Mohammad H, McDonald SJ, et al.
    BMC Med Res Methodol, 2007;7:43.
    PMID: 17892586
    Disorders related to pregnancy and childbirth are a major health issue in South East Asia. They represent one of the biggest health risk differentials between the developed and developing world. Our broad research question is: Can the health of mothers and babies in Thailand, Indonesia, the Philippines and Malaysia be improved by increasing the local capacity for the synthesis of research, implementation of effective interventions, and identification of gaps in knowledge needing further research?
    Matched MeSH terms: Obstetrics and Gynecology Department, Hospital/standards*
  13. Fulltext Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia
    Martis R, Ho JJ, Crowther CA, SEA-ORCHID Study Group
    BMC Pregnancy Childbirth, 2008;8:34.
    PMID: 18680603 DOI: 10.1186/1471-2393-8-34
    Evidence-based practice (EBP) can provide appropriate care for women and their babies; however implementation of EBP requires health professionals to have access to knowledge, the ability to interpret health care information and then strategies to apply care. The aim of this survey was to assess current knowledge of evidence-based practice, information seeking practices, perceptions and potential enablers and barriers to clinical practice change among maternal and infant health practitioners in South East Asia.
    Matched MeSH terms: Obstetrics
  14. The application of empirical mode decomposition for the enhancement of cardiotocograph signals
    Krupa BN, Mohd Ali MA, Zahedi E
    Physiol Meas, 2009 Aug;30(8):729-43.
    PMID: 19550027 DOI: 10.1088/0967-3334/30/8/001
    Cardiotocograph (CTG) is widely used in everyday clinical practice for fetal surveillance, where it is used to record fetal heart rate (FHR) and uterine activity (UA). These two biosignals can be used for antepartum and intrapartum fetal monitoring and are, in fact, nonlinear and non-stationary. CTG recordings are often corrupted by artifacts such as missing beats in FHR, high-frequency noise in FHR and UA signals. In this paper, an empirical mode decomposition (EMD) method is applied on CTG signals. A recursive algorithm is first utilized to eliminate missing beats. High-frequency noise is reduced using EMD followed by the partial reconstruction (PAR) method, where the noise order is identified by a statistical method. The obtained signal enhancement from the proposed method is validated by comparing the resulting traces with the output obtained by applying classical signal processing methods such as Butterworth low-pass filtering, linear interpolation and a moving average filter on 12 CTG signals. Three obstetricians evaluated all 12 sets of traces and rated the proposed method, on average, 3.8 out of 5 on a scale of 1(lowest) to 5 (highest).
    Matched MeSH terms: Obstetrics
  15. Fulltext Building capacity for evidence generation, synthesis and implementation to improve the care of mothers and babies in South East Asia: methods and design of the SEA-ORCHID Project using a logical framework approach
    McDonald S, Turner T, Chamberlain C, Lumbiganon P, Thinkhamrop J, Festin MR, et al.
    BMC Med Res Methodol, 2010;10:61.
    PMID: 20594325 DOI: 10.1186/1471-2288-10-61
    Rates of maternal and perinatal mortality remain high in developing countries despite the existence of effective interventions. Efforts to strengthen evidence-based approaches to improve health in these settings are partly hindered by restricted access to the best available evidence, limited training in evidence-based practice and concerns about the relevance of existing evidence. South East Asia--Optimising Reproductive and Child Health in Developing Countries (SEA-ORCHID) was a five-year project that aimed to determine whether a multifaceted intervention designed to strengthen the capacity for research synthesis, evidence-based care and knowledge implementation improved clinical practice and led to better health outcomes for mothers and babies. This paper describes the development and design of the SEA-ORCHID intervention plan using a logical framework approach.
    Matched MeSH terms: Obstetrics and Gynecology Department, Hospital/organization & administration; Obstetrics and Gynecology Department, Hospital/standards
  16. Perinatal Care Manual
    Section 1: Pre-pregnancy Section 2: Antenatal Care Section 3: Intrapartum Care Section 4: Postpartum Care Section 5: Neonatal Care
    Matched MeSH terms: Obstetrics
  17. Contemporary approaches to hyperemesis during pregnancy
    Tan PC, Omar SZ
    Curr Opin Obstet Gynecol, 2011 Apr;23(2):87-93.
    PMID: 21297474 DOI: 10.1097/GCO.0b013e328342d208
    PURPOSE OF REVIEW: Nausea and vomiting of pregnancy (NVP) affects 90% of pregnant women and its impact is often underappreciated. Hyperemesis gravidarum, the most severe end of the spectrum, affects 0.5-2% of pregnancies. The pathogenesis of this condition remains obscure and its management has largely been empirical. This review aims to provide an update on advances in pregnancy hyperemesis focusing on papers published within the past 2 years.

    RECENT FINDINGS: The cause of hyperemesis is continuing to be elaborated. Recent data attest to the effectiveness of the oral doxylamine-pyridoxine in NVP. Follow-up data of children exposed in early pregnancy to doxylamine-pyridoxine for NVP are reassuring. Evidence is increasing for ginger as an effective herbal remedy for NVP. Metoclopramide is effective in NVP and hyperemesis gravidarum, with a good balance of efficacy and tolerability. A recent large-scale study on first trimester exposure to metoclopramide is reassuring of its safety. Evidence is emerging for the treatment of acid reflux to ameliorate NVP. The role of corticosteroids for hyperemesis gravidarum remains controversial. Transpyloric feeding may be warranted for persistent weight loss, despite optimal antiemetic therapy.

    SUMMARY: Women with significant NVP should be identified so that they can be safely and effectively treated.

    Matched MeSH terms: Obstetrics/methods
  18. Fulltext Development, validity and reliability of a pregnancy symptoms questionnaire (PSQ)
    Marhazlina Mohamad, Loy, See-Ling, Nik Mohamed Zaki Nik Mahmood, Nor Azwany Yaacob, Hamid Jan Jan Mohamed
    Jurnal Sains Kesihatan Malaysia, 2011;9(2):15-21.
    MyJurnal
    This study aimed to develop and examine the validity and reliability of a pregnancy symptoms questionnaire. A total of 214 pregnant women aged 19 to 40 years old were purposive randomly recruited from December 2009 to January 2010 in Antenatal Clinic, Hospital Universiti Sains Malaysia. Pregnant mothers at second and third trimesters were interviewed to complete the Pregnancy Symptoms Questionnaire (PSQ). The PSQ was developed by experts in nutrition, obstetrics and statistics. The PSQ consists of 38 items on frequency and severity of pregnancy symptoms. Factor analysis was done using Promax rotation method to check for construct validity. A total of 16 items which had poor correlation (<0.3) and less important content were removed during the final revise. The 22 remaining items were found to be loaded on the three components (general, constitutional and somatic pain). The overall Cronbach’s alpha coefficient was 0.93 and for each three components ranges from 0.70–0.87. The results suggest that the final PSQ consisting of 22 items is valid and reliable for measuring the frequency and severity of the symptoms experienced during pregnancy. It can be used in nutritional studies related to pregnancy and its outcome.
    Keywords: Pregnant mothers; Pregnancy symptoms; Questionnaire; Validation
    Study site: Antenatal Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Obstetrics
  19. Fulltext Morbidly adherent placenta at extreme prematurity: can major haemorrhage and hysterectomy be prevented?
    Shafiee, M.N., Rahana, A.R., Lim, P.S., Nor Azlin, M.I., Wan Faraliza, Z.A., Isa, M.R., et al.
    Journal of Surgical Academia, 2011;1(1):56-60.
    MyJurnal
    Morbidly adherent placenta with spontaneous rupture of membrane at extreme prematurity poses poor pregnancy outcome. Various issues on different management modalities still remain perplexed and individual consideration is vital. Two cases of morbidly adherent placenta with symptomatic per vaginal bleeding and spontaneous rupture of membrane at severe prematurity were reviewed and discussed. We found that, active intervention by termination of pregnancy and methotrexate therapy at early gestation can prevent the need of hysterectomy following major obstetrics haemorrhage.
    Matched MeSH terms: Obstetrics
  20. Differences in physician attitudes towards patient-centredness: across four medical specialties
    Chan CM, Ahmad WA
    Int J Clin Pract, 2012 Jan;66(1):16-20.
    PMID: 22171901 DOI: 10.1111/j.1742-1241.2011.02831.x
    Aims: There is limited study on patient-centred attitudes with regards to the patient–physician relationship in physicians. The objective of this study was to examine and compare physician attitudes toward patient-centredness in four different medical settings.
    Methods: The present study utilised a cross-sectional survey design and purposive sampling to recruit physicians from a single academic medical centre via face-to-face interviews. Patient-centred attitudes of physicians specialising in surgery, oncology, obstetrics and gynaecology and primary care
    (N = 78) were compared on the Patient–Practitioner Orientation Scale (PPOS) using an independent one-way analysis of variance (ANOVA). The four medical
    specialties comprised the four levels, with role orientation (patient-centred orientation vs. doctor-centred orientation) as the dependent measure.
    Results: A significant level of difference (p < 0.001) was found between the four specialisations:
    oncologists were found to have the highest level of patient-centeredness, followed by obstetricians & gynaecologists and primary care physicians, with surgeons being the least patient-centred among specialisations sampled.
    Conclusion: These data are the first from the South-East Asian region to demonstrate differences in
    physician attitudes between medical specialties. Our findings prompt further investigation and confirmation as to whether physicians with particular attitudinal traits are attracted to any particular specialties of medicine, or if physician attitudes are acquired through professional experience and training. In addition, this study offers better insight into the attitudinal differences of physician between medical specialities.
    Questionnaire: Patient–Practitioner Orientation Scale; PPOS
    Matched MeSH terms: Obstetrics
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