Displaying publications 41 - 60 of 416 in total

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  1. Teh J, Mazlan M, Danaee M, Waran RJ, Waran V
    PLoS One, 2023;18(9):e0284484.
    PMID: 37703233 DOI: 10.1371/journal.pone.0284484
    OBJECTIVE: Road traffic accident (RTA) is the major cause of traumatic brain injury (TBI) in developing countries and affects mostly young adult population. This research aimed to describe the factors predicting functional outcome after TBI caused by RTA in a Malaysian setting.

    METHODS: This was a retrospective cross-sectional study conducted on specialist medical reports written from 2009 to 2019, involving patients who survived after TBI from RTA. The functional outcome was assessed using the Glasgow Outcome Scale-Extended (GOSE). Factors associated with good outcome were analysed via logistic regression analysis. Multivariate logistic regression analysis was used to derive the best fitting Prediction Model and split-sample cross-validation was performed to develop a prediction model.

    RESULTS: A total of 1939 reports were evaluated. The mean age of the study participants was 32.4 ± 13.7 years. Most patients were male, less than 40, and with average post RTA of two years. Good outcome (GOSE score 7 & 8) was reported in 30.3% of the patients. Factors significantly affecting functional outcome include age, gender, ethnicity, marital status, education level, severity of brain injury, neurosurgical intervention, ICU admission, presence of inpatient complications, cognitive impairment, post-traumatic headache, post traumatic seizures, presence of significant behavioural issue; and residence post discharge (p<0.05). After adjusting for confounding factors, prediction model identified age less than 40, mild TBI, absence of post traumatic seizure, absence of behaviour issue, absence of cognitive impairment and independent living post TBI as significant predictors of good functional outcome post trauma. Discrimination of the model was acceptable (C-statistic, 0.67; p<0.001, 95% CI: 0.62-0.73).

    CONCLUSION: Good functional outcome following TBI due to RTA in this study population is comparable to other low to middle income countries but lower than high income countries. Factors influencing outcome such as seizure, cognitive and behavioural issues, and independent living post injury should be addressed early to achieve favourable long-term outcomes.

    Matched MeSH terms: Accidents, Traffic
  2. Teah MK, Yap KY, Ismail AJ, Yeap TB
    BMJ Case Rep, 2021 Feb 17;14(2).
    PMID: 33597165 DOI: 10.1136/bcr-2020-241148
    Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.
    Matched MeSH terms: Accidents, Traffic
  3. Tay EL, Lee SWH, Jamaluddin SF, Tam CL, Wong CP
    BMC Pediatr, 2016 04 27;16:56.
    PMID: 27122016 DOI: 10.1186/s12887-016-0590-1
    BACKGROUND: There are limited studies describing the epidemiology of childhood brain injury, especially in developing countries. This study analyses data from the Malaysian National Trauma Database (NTrD) registry to estimate the incidence of childhood brain injury among various demographic groups within the state of Selangor and Federal Territory of Kuala Lumpur.

    METHODS: This study analysed all traumatic brain injury cases for children ages 0-19 included in the 2010 NTrD report.

    RESULTS: A total of 5,836 paediatric patients were admitted to emergency departments (ED) of reporting hospitals for trauma. Of these, 742 patients (12.7 %) suffered from brain injuries. Among those with brain injuries, the mortality rate was 11.9 and 71.2 % were aged between 15 and 19. Traffic accidents were the most common mode of injury (95.4 %). Out of the total for traffic accidents, 80.2 % of brain injuries were incurred in motorcycle accidents. Severity of injury was higher among males and patients who were transferred or referred to the reporting centres from other clinics. Glasgow Coma Scale (GCS) total score and type of admission were found to be statistically significant, χ (2) (5, N = 178) = 66.53, p 

    Matched MeSH terms: Accidents, Traffic/statistics & numerical data
  4. Tan PJ, Khoo EM, Chinna K, Saedon NI, Zakaria MI, Ahmad Zahedi AZ, et al.
    PLoS One, 2018;13(8):e0199219.
    PMID: 30074996 DOI: 10.1371/journal.pone.0199219
    OBJECTIVE: To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia.

    DESIGN: Pragmatic, randomized-controlled trial.

    SETTING: Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia.

    PARTICIPANTS: Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months.

    INTERVENTION: Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment.

    PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall.

    RESULTS: Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613-1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846-1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782-1.522)] and mortality rate [RR = 0.896 (95% CI 0.335-2.400)] did not differ between groups.

    CONCLUSION: Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations.

    TRIAL REGISTRATION: ISRCTN Registry no. ISRCTN11674947.

    Study site: emergency department, medical outpatients and primary care clinic at a teaching hospital in Kuala Lumpur, Malaysia
    Matched MeSH terms: Accidents, Home/prevention & control; Accidents, Home/statistics & numerical data
  5. Tan JH, Mohamad Y, Tan CLH, Kassim M, Warkentin TE
    J Med Case Rep, 2018 May 19;12(1):131.
    PMID: 29776439 DOI: 10.1186/s13256-018-1684-1
    BACKGROUND: Symmetrical peripheral gangrene is characterized as acral (distal extremity) ischemic limb injury affecting two or more extremities, without large vessel obstruction, typically in a symmetrical fashion. Risk factors include hypotension, disseminated intravascular coagulation, and acute ischemic hepatitis ("shock liver"). In contrast, venous limb gangrene is characterized by acral ischemic injury occurring in a limb with deep vein thrombosis. Both symmetrical peripheral gangrene and venous limb gangrene present as acral limb ischemic necrosis despite presence of arterial pulses. The coexistence of symmetrical peripheral gangrene and venous limb gangrene is rare, with potential to provide pathophysiological insights.

    CASE PRESENTATION: A 42-year-old Chinese man presented with polytrauma (severe head injury, lung contusions, and right femur fracture). Emergency craniotomy and debridement of right thigh wound were performed on presentation. Intraoperative hypotension secondary to bleeding was complicated by transient need for vasopressors and acute liver enzyme elevation indicating shock liver. Beginning on postoperative day 5, he developed an acute platelet count fall (from 559 to 250 × 109/L over 3 days) associated with left iliofemoral deep vein thrombosis that evolved to bilateral lower limb ischemic necrosis; ultimately, the extent of limb ischemic injury was greater in the left (requiring below-knee amputation) versus the right (transmetatarsal amputation). As the presence of deep vein thrombosis is a key feature known to localize microthrombosis and hence ischemic injury in venous limb gangrene, the concurrence of unilateral lower limb deep vein thrombosis in a typical clinical setting of symmetrical peripheral gangrene (hypotension, proximate shock liver, platelet count fall consistent with disseminated intravascular coagulation) helps to explain asymmetric limb injury - manifesting as a greater degree of ischemic necrosis and extent of amputation in the limb affected by deep vein thrombosis - in a patient whose clinical picture otherwise resembled symmetrical peripheral gangrene.

    CONCLUSIONS: Concurrence of unilateral lower limb deep vein thrombosis in a typical clinical setting of symmetrical peripheral gangrene is a potential explanation for greater extent of acral ischemic injury in the limb affected by deep vein thrombosis.

    Matched MeSH terms: Accidents, Traffic
  6. Tan Chor Lip H, Tan JH, Mohamad Y, Ariffin AC, Imran R, Azmah Tuan Mat TN
    Chin J Traumatol, 2019 Apr;22(2):69-74.
    PMID: 30583984 DOI: 10.1016/j.cjtee.2018.11.001
    PURPOSE: Amongst the ASEAN countries, Malaysia has the highest road fatality risk (>15 fatalities per 100 000 population) with 50% of these fatalities involving motorcyclist. This contributes greatly to ward admissions and poses a significant burden to the general surgery services. From mild rib fractures to severe intra-abdominal exsanguinations, the spectrum of cases managed by surgeons resulting from motorcycle accidents is extensive. The objective of this study is to report the clinical characteristics and identify predictors of death in motorcycle traumatic injuries from a Malaysian trauma surgery centre.

    METHODS: This is a prospective cross-sectional study of all injured motorcyclists and pillion riders that were admitted to Hospital Sultanah Aminah and treated by the trauma surgery team from May 2011 to February 2015. Only injured motorcyclists and pillion riders were included in this study. Patient demography and predictors leading to mortality were identified. Significant predictors on univariate analysis were further analysed with multivariate analysis.

    RESULTS: We included 1653 patients with a mean age of (35 ± 16.17) years that were treated for traumatic injuries due to motorcycle accidents. The mortality rate was 8.6% (142) with equal amount of motorcycle riders (788) and pillion riders (865) that were injured. Amongst the injured were male predominant (1 537) and majority of ethnic groups were the Malays (897) and Chinese (350). Severity of injury was reflected with a mean Revised Trauma Score (RTS) of 7.31 ± 1.29, New Injury Severity Score (NISS) of 19.84 ± 13.84 and Trauma and Injury Severity Score (TRISS) of 0.91 ± 0.15. Univariate and multivariate analysis revealed that age≥35, lower GCS, head injuries, chest injuries, liver injuries, and small bowel injuries were significant predictors of motorcycle trauma related deaths with p 

    Matched MeSH terms: Accidents, Traffic/mortality*; Accidents, Traffic/statistics & numerical data*
  7. Tan CK
    Family Practitioner, 1985;8:75-78.
    Matched MeSH terms: Accidents
  8. Tagod M, Adeleke AQ, Moshood TD
    J Safety Res, 2021 06;77:139-150.
    PMID: 34092304 DOI: 10.1016/j.jsr.2021.02.011
    INTRODUCTION: The construction industry in Malaysia has been bedevilled by myriads of risk issues that have hampered its smooth operations in recent times. This paper is an empirical assessment that aims to examine the effect of coercive pressure on the relationship between organizational structure and construction risk management among construction industry in Malaysia.

    METHOD: Based on the proposed model, a quantitative method was employed to obtain data from G7 construction industry operating within the peninsular Malaysia. Out of the 180 copies of questionnaire, 165 copies were properly filled, returned, and used for the analysis. PLS-SEM was used to analyze the obtained data.

    RESULTS: The findings of the study affirmed that specialization, centralization, and management of risk by the construction industry had positive correlation.

    CONCLUSIONS: As anticipated, coercive pressure had positive moderating correlation with both formalization and the management of risk by the construction industry. Similarly, it was also found that in the course of carrying out construction activities, coercive pressure made significant interactive influence on formalization, specialization, and centralization. Practical Applications: Coercive pressure reduced the frequency of accidents among workers in the process of carrying out construction works.

    Matched MeSH terms: Accidents, Occupational/statistics & numerical data*
  9. Syed J, Zamri AR, Jamaluddin S, Ruben JK, Gopindran M
    Malays Orthop J, 2017 Mar;11(1):82-84.
    PMID: 28435584 MyJurnal DOI: 10.5704/MOJ.1703.016
    Traumatic elbow dislocations in children are rare but most of them are complex dislocations, and in such dislocations, medial humerus epicondyle fractureis the most common associated injury. Fracture incarceration in the elbow joint occurs in 5-18% of medial humerus epicondyle fractures but ulnar neuropraxia is very rare. Open reduction internal fixation is indicated in medial humerus epicondyle fracture with fracture incarceration, ulnar neuropraxia, marked instability or open fracture. Operative treatment options include fragment excision and sutures, closed or open reduction and Kirschner wire fixation, open reduction and suture fixation, open reduction and smooth pin fixation, and open reduction and screw fixation. However, ulnar nerve transposition is debatable as good outcome had been reported with and without nerve transposition. We report a case of a 13-year old boy, who presented with right elbow dislocation and intra-articular entrapment of medial humerus epicondyle fracture fragment, complicated with sensory ulnar neuropraxia, following a fall onto his right outstretched hand in a motor vehicle accident. The elbow joint was reduced using close manipulative reduction but the fracture fragment remained entrapped post-reduction. The patient then underwent open reduction and screw fixation of the medial humerus epicondyle fracture without ulnar nerve transposition. He had good functional outcome six weeks after surgical intervention, with complete recovery of ulnar neuropraxia six months later. Currently, he is doing well at school and is active with his sporting activity.
    Matched MeSH terms: Accidents
  10. Syed Hassan ST, Jamaludin H, Abd Raman R, Mohd Riji H, Wan Fei K
    Trauma Mon, 2013 Sep;18(2):56-61.
    PMID: 24350153 DOI: 10.5812/traumamon.11522
    CONTEXT: As with care giving and rehabilitation in chronic illnesses, the concern with traumatic brain injury (TBI), particularly with diffuse axonal injury (DAI), is that the caregivers are so overwhelmingly involved in caring and rehabilitation of the victim that in the process they become traumatized themselves. This review intends to shed light on the hidden and silent trauma sustained by the caregivers of severe brain injury survivors. Motor vehicle accident (MVA) is the highest contributor of TBI or DAI. The essence of trauma is the infliction of pain and suffering and having to bear the pain (i.e. by the TBI survivor) and the burden of having to take care and manage and rehabilitate the TBI survivor (i.e. by the TBI caregiver). Moreover many caregivers are not trained for their care giving task, thus compounding the stress of care giving and rehabilitating patients. Most research on TBI including DAI, focus on the survivors and not on the caregivers. TBI injury and its effects and impacts remain the core question of most studies, which are largely based on the quantitative approach.

    EVIDENCE ACQUISITION: Qualitative research can better assess human sufferings such as in the case of DAI trauma. While quantitative research can measure many psychometric parameters to assess some aspects of trauma conditions, qualitative research is able to fully reveal the meaning, ramification and experience of TBI trauma. Both care giving and rehabilitation are overwhelmingly demanding; hence , they may complicate the caregivers' stress. However, some positive outcomes also exist.

    RESULTS: Caregivers involved in caring and rehabilitation of TBI victims may become mentally traumatized. Posttraumatic recovery of the TBI survivor can enhance the entire family's closeness and bonding as well as improve the mental status of the caregiver.

    CONCLUSIONS: A long-term longitudinal study encompassing integrated research is needed to fully understand the traumatic experiences of caregivers. Unless research on TBI or DAI trauma is given its proper attention, the burden of trauma and injury on societies will continue to exacerbate globally.

    Matched MeSH terms: Accidents, Traffic
  11. Syadatul Syaeda Mat Saleh, Najihan Awang @ Ali, Nik Ruslawati Nik Mustapa, Nurul Husna Jamian, Hussin bin Abdul Hamid
    Jurnal Inovasi Malaysia, 2020;3(2):75-86.
    MyJurnal
    Road accident is not stranger matter in Malaysia. Subsequently, often leads to a claim for personal injury by the persecuted party. In Malaysia, the method for calculating claims applies a multiplier-multiplicand approach. This approach is no longer relevant and unfair to the claimant as it excludes personal status in the quantum calculation of damages. Hence, this study uses the Ogden Table as introduced in the United Kingdom as benchmarking guidelines, by taking into account of all aspect of claimant's personal condition for the purpose of such calculation. This study is built upon a proposed framework of data modelling system known as Entity Relationship Diagram (ERD) and the created process modelling known as data flow diagram (DFD). Doing so, the claimants will insert their input data, run it through the first process, and store the information in the claim injury part database. They can also edit and store to claim injury part database on their own. This will generate a report with the information in claim injury part database and can be viewed by claimant, court and lawyer as target users. It is hoped that it will facilitate the calculation of injury claim which would serve justice and accuracy of personal injury in road accidents
    Matched MeSH terms: Accidents
  12. Suzilawati Mohamed Ariffin, Mimi Nor Aliza Setapani
    MyJurnal
    Malaysia has the highest road fatality risk (per 100,000 populations) compared to other ASEAN nations and more than 50% of the road accident fatalities involving motorcyclists. Hence, this becomes the leading cause of death among young people, aged 15–29 years. The most common cause of fatalities involving motorcyclist is the head injury., This present study aimed to evaluate the knowledge, attitude, and practice on helmet usage among secondary school students in Kuantan. A descriptive cross-sectional design (two months of data collection) was used in this study. Questionnaires were distributed to 200 participants from two schools in Kuantan. The main finding of this study suggests that common reason for the participants to wear a helmet is that ‘it can save a life’. Besides that, the poor practice regarding helmet usage was also found as only 4.5% of them wore the helmet all the time. However, the overall result showed that most of the participants have a good knowledge and positive attitude regarding utilization of helmet.
    Matched MeSH terms: Accidents
  13. Sureisen M, Achannan R, Chong KC, Wong CC
    BMJ Case Rep, 2015 Oct 27;2015.
    PMID: 26508120 DOI: 10.1136/bcr-2015-212748
    Congenital spinal fusion of an odontoid process to an atlantal hemiarch is very rare. The unfamiliarity of the medical fraternity with this congenital malformation can easily be mistaken for an acute fracture, chronic infection or inflammatory disease. We present our experience of managing an adult who presented with neck pain after a motor vehicle accident. Radiological investigation revealed congenital fusion of the odontoid process to the atlantal hemiarch. The prevalence, embryology and clinical significance of this anomaly are discussed. As the natural progression of this anomaly is not well documented, we suggest periodic follow-up to monitor the progression of degenerative changes and instability of the occipitoatlantal junction.
    Matched MeSH terms: Accidents, Traffic
  14. Sumaiyah Jamaludin @ Thandar Soe, Muhammad Allif Zakaria
    MyJurnal
    Accidental injuries are one of the leading causes of morbidity and mortality
    worldwide. Approximately 1.25 million lives are cut short because of road traffic
    accident every year. As the incidences of emergencies is steadily increasing in recent
    years, it is important to ensure that individuals are adequately trained to deal with such
    events including university students. First aid is given to preserve life and minimize the
    consequences of injury and illness until help is obtained from health care practitioners.
    This study aimed to assess the level of knowledge, awareness and attitude related to
    first aid among IIUM Kuantan campus students. (Copied from article).
    Matched MeSH terms: Accidents
  15. Subramanian N
    Med J Malaysia, 1989 Sep;44(3):178-82.
    PMID: 2626131
    Matched MeSH terms: Accidents, Traffic/prevention & control*; Accidents, Traffic/trends; Accidents, Traffic/statistics & numerical data
  16. Subramaniam T, Loo RCN, Poovaneswaran S
    MyJurnal
    Background: This cross sectional study was done to identify the areas of lack of knowledge, practice and awareness of students about the effective use of personal protective equipment (PPE).
    Methods: A total of 40 students were selected when they were posted to the accident and emergency unit (A&E) in Seremban Hospital; all of them answered a questionnaire and were observed unaware on the effective use of PPE in the A&E.
    Results: We found that 17.5% of students were unaware of the right technique of removing the gloves after a procedure and 25% of students were unaware of safety of hand washing. During invasive procedures, 12.5 % of students did not wash their hands before invasive procedures, 65% did not wear aprons and 57.5% did not wear masks. During non- invasive procedures more than 25% of students did not wash hands before or after the procedures.
    Conclusion: There is still significant lack of knowledge in students about the effective use of PPE that needs to be addressed.
    Keywords: PPE, Personal protective equipment, effective practice of PPE, A&E
    Matched MeSH terms: Accidents
  17. Subash Y
    Malays Orthop J, 2020 Nov;14(3):98-103.
    PMID: 33403068 DOI: 10.5704/MOJ.2011.015
    Introduction: Malunited intertrochanteric fractures are frequently seen in rural populations as they tend to go in for native treatment with traditional bone setters. The resulting Coxa vara is associated with shortening, abductor weakness, limp and decreased range of movement of the affected hip. The aim of this study was to evaluate the role of Valgus osteotomy with Dynamic hip screw (DHS) fixation in the management of these fractures and to evaluate the functional outcome using the Harris hip score.

    Materials and Methods: Fifteen patients with malunited intertrochanteric fractures who presented between January 2011 to January 2013 were managed by Valgus osteotomy with DHS fixation and were followed-up for a minimum period of three years.

    Results: There was a male preponderance seen in our study with the right hip being more commonly affected. The most common mode of injury was slip and fall followed by road traffic accidents. The duration of native treatment ranged from seven to 12 weeks and the time of presentation to the hospital ranged from four to nine months following injury. Pre-operative mean neck shaft angle was 94.73° while it was 134.6° post-operatively. The mean pre-operative Harris hip score was 72.33 and it was 91 at follow-up. All patients were happy with the procedure and the functional outcome.

    Conclusion: Valgus osteotomy with DHS fixation is an effective procedure in the management of malunited intertrochanteric fractures. It corrects the limb length discrepancy, restores the decreased neck shaft angle, improves range of movement, restores the integrity of the abductor mechanism of the hip and gives good functional results.

    Matched MeSH terms: Accidents, Traffic
  18. Su Na Chin, Phee Kheng Cheah, Muhamad Yaakub Arifin, Hui Shan Kang, Zaturrawiah A Omar, Fouziah Md Yassin, et al.
    MyJurnal
    Ambulance response time (ART) has an inseparable relationship with mortality rates and therefore is important to be reduced. However, an unprecedented increase in road traffic congestion has led to longer ART, especially during peak hours. To reduce ART despite congested traffic, a pre-dispatched ambulance is deployed at hotspot locations during peak hours. This study aims to determine if the hotspot strategy is able to reduce ART in an Urban Emergency Medical Services system.
    Matched MeSH terms: Accidents, Traffic
  19. Sridharan R, Low SF, Mohd MR, Kew TY
    Singapore Med J, 2014 Oct;55(10):e165-8.
    PMID: 25631906
    Epistaxis is commonly encountered in otorhinolaryngologic practice. However, severe and recurrent epistaxis is rarely seen, especially that originating from a pseudoaneurysm of the intracavernous internal carotid artery (ICA). We herein present the case of a 32-year-old man who was involved in a motor vehicle accident and subsequently developed recurrent episodes of profuse epistaxis for the next three months, which required blood transfusion and nasal packing to control the bleeding. Computed tomography angiography revealed a large intracavernous ICA pseudoaneurysm measuring 1.7 cm × 1.2 cm × 1.0 cm. The patient underwent emergent four-vessel angiography and coil embolisation and was discharged one week later without any episode of bleeding. He remained asymptomatic after three-month and one‑year intervals. This case report highlights a large intracavernous ICA pseudoaneurysm as a rare cause of epistaxis, which requires a high index of suspicion in the right clinical setting and emergent endovascular treatment to prevent mortality.
    Matched MeSH terms: Accidents, Traffic*
  20. Sreetharan SS, Prepageran N, Satwant S
    Singapore Med J, 2004 Oct;45(10):487-8.
    PMID: 15455170
    Reports of ingested foreign bodies penetrating the pharynx and migrating through the neck are rare, and mostly involved fish bones. We describe a 44-year-old man who was involved in a motor vehicle accident and accidentally swallowed his tooth. The swallowed tooth penetrated the pharynx and became lodged adjacent to his right thyroid gland. It was successfully removed via neck exploration and the patient recovered well.
    Matched MeSH terms: Accidents, Traffic
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