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  1. A prospective study on the pattern of medication use for schizophrenia in the outpatient pharmacy department, Hospital Tengku Ampuan Rahimah, Selangor, Malaysia
    Ponto T, Ismail NI, Abdul Majeed AB, Marmaya NH, Zakaria ZA
    Methods Find Exp Clin Pharmacol, 2010 Jul-Aug;32(6):427-32.
    PMID: 20852752 DOI: 10.1358/mf.2010.32.6.1477907
    Schizophrenia is a chronic psychiatric disorder and pharmacotherapy plays a major role in its management. The 1950s and early 1960s saw milestones in the introduction of psychotropic drugs in clinical practice. A review of drug prescriptions in different settings provides an insight into the pattern of drug use, identifies drug-related problems and may be used to compare recommended guidelines with actual practice. This effort led to the evaluation of the drug prescribing pattern of antipsychotics in patients attending the psychiatric clinic at a government hospital. The data from 371 antipsychotic medication prescriptions that included 200 prescriptions for schizophrenia were collected during one month (1rst-31rst August 2008) at the outpatient pharmacy department. The mean age of patients was 35.0 years (SD = 1.131), with a male to female ratio of 2:1. The most widely used oral antipsychotic was haloperidol (16.3%) while the most common depot preparation prescribed was zuclopenthixol decanoate (8.8%). The daily dose of the average antipsychotic prescribed in this clinic was 342.06 mg equivalent of chlorpromazine. There was no relation between the doses received and ethnicity of the patient (Malay, Chinese or Indian). However, there was a significant relationship between the prescribed dose and patient age (P < 0.042). Nearly 32% of the schizophrenia patients were prescribed with atypical antipsychotics such as olanzapine (10.8%), risperidone (10.0%), quetiapine (7.6%) and clozapine (3.2%). Monotherapy was given to 73.0% of the schizophrenia patients. The majority of patients also received antidepressants. To conclude, this study gave evidence that physicians had a strong preference for monotherapy with conventional antipsychotic drugs while the use of atypical drugs was less prevalent.
    Matched MeSH terms: Hospitals
  2. Multi-residue analytical methodology-based liquid chromatography-time-of-flight-mass spectrometry for the analysis of pharmaceutical residues in surface water and effluents from sewage treatment plants and hospitals
    Al-Qaim FF, Abdullah MP, Othman MR, Latip J, Zakaria Z
    J Chromatogr A, 2014 Jun 6;1345:139-53.
    PMID: 24768127 DOI: 10.1016/j.chroma.2014.04.025
    An analytical method that facilitated the analysis of 11 pharmaceuticals residue (caffeine, prazosin, enalapril, carbamazepine, nifedipine, levonorgestrel, simvastatin, hydrochlorothiazide, gliclazide, diclofenac-Na, and mefenamic acid) with a single pre-treatment protocol was developed. The proposed method included an isolation and concentration procedure using solid phase extraction (Oasis HLB), a separation step using high-performance liquid chromatography, and a detection procedure that applies time-of-flight mass spectrometry. The method was validated for drinking water (DW), surface water (SW), sewage treatment plant (STP) influent and effluent, and hospital (HSP) influent and effluent. The limits of quantification were as low as 0.4, 1.6, 5, 3, 2.2 and 11 ng/L in DW, SW, HSP influent and effluent, STP effluent, and STP influent, respectively. On average, good recoveries higher than 75% were obtained for most of the target analytes in all matrices. Matrix effect was evaluated for all samples matrices. The proposed method successfully determined and quantified the target compounds in raw and treated wastewater of four STPs and three hospitals in Malaysia, as well as in two SW sites. The results showed that a number of the studied compounds pose moderate to high persistency in sewage treatment effluents as well as in the recipient rivers, namely; caffeine, simvastatin, and hydrochlorothiazide. Ten out of 11 compounds were detected and quantified in 13 sampling points. Caffeine was detected with the highest level, with concentrations reaching up to 9099 ng/L in STP influent.
    Matched MeSH terms: Hospitals
  3. Fulltext Social support and self-care activities among the elderly patients with diabetes in Kelantan
    Siti Khuzaimah AS, Shdaifat EA, Mohd Abd Majid HA, Shohor NA, Ahmad F, Zakaria Z
    Malays Fam Physician, 2015;10(1):34-43.
    PMID: 26425293 MyJurnal
    INTRODUCTION: Diabetes is common among the elderly and can significantly affect their lives including the issues related with social support and diabetic self-care activities.
    OBJECTIVES: The objective of this study was to examine the social support and self-care activities among the elderly patients with diabetes.
    METHODS: A survey involving 200 patients was conducted from March 2013 to May 2013 in three hospitals in Kelantan. Data were obtained through self-administered questionnaires and clinical characteristics were acquired from the patients' records.
    RESULTS: The scores for social support (mean = 19.26; SD = 2.63) and self-care activities (mean = 14.83; SD = 4.92) were moderate. Higher social support was associated with high levels of glycated haemoglobin (HbA1c), fasting blood sugar (FBS) level, the duration of diabetes and a decrease in body mass index (BMI) (p<0.05). It was observed that the patients with low educational, Hb1Ac and FBS level, with other chronic diseases and who have had diabetes for some time had low self-care activities (p<0.05). There was a significant negative relationship between an increase in social support and decrease in self-care activity (p<0.05).
    CONCLUSION: Healthcare providers, family and friends have to strengthen their relationship with the elderly patients with diabetes to provide more social support and promote the compliance with diabetic self-care activities to improve clinical outcomes.
    KEYWORDS: Social support; diabetes; elderly; self-care activities
    Study site: medical and diabetic clinics, three government hospitals in Kelantan, Malaysia (Gua Musang Hospital, Kuala Krai Hospital and Machang Hospital).
    Matched MeSH terms: Hospitals
  4. Fulltext Molecular characterization of multi-drug resistant Escherichia coli isolates from tropical environments in Southeast Asia
    Hara H, Yusaimi YA, Zulkeflle SNM, Sugiura N, Iwamoto K, Goto M, et al.
    J Gen Appl Microbiol, 2019 Jan 24;64(6):284-292.
    PMID: 29877296 DOI: 10.2323/jgam.2018.02.003
    The emergence of antibiotic resistance among multidrug-resistant (MDR) microbes is of growing concern, and threatens public health globally. A total of 129 Escherichia coli isolates were recovered from lowland aqueous environments near hospitals and medical service centers in the vicinity of Kuala Lumpur, Malaysia. Among the eleven antibacterial agents tested, the isolates were highly resistant to trimethoprim-sulfamethoxazole (83.7%) and nalidixic acid (71.3%) and moderately resistant to ampicillin and chloramphenicol (66.7%), tetracycline (65.1%), fosfomycin (57.4%), cefotaxime (57.4%), and ciprofloxacin (57.4%), while low resistance levels were found with aminoglycosides (kanamycin, 22.5%; gentamicin, 21.7%). The presence of relevant resistance determinants was evaluated, and the genotypic resistance determinants were as follows: sulfonamides (sulI, sulII, and sulIII), trimethoprim (dfrA1 and dfrA5), quinolones (qnrS), β-lactams (ampC and blaCTX-M), chloramphenicol (cmlA1 and cat2), tetracycline (tetA and tetM), fosfomycin (fosA and fosA3), and aminoglycosides (aphA1 and aacC2). Our data suggest that multidrug-resistant E. coli strains are ubiquitous in the aquatic systems of tropical countries and indicate that hospital wastewater may contribute to this phenomenon.
    Matched MeSH terms: Hospitals
  5. Screening for hemoglobinopathies among patients in a government hospital and health clinics in Perlis, Malaysia
    Chin YM, Esa E, Mohd Yacob A, Ramachandran S, Zakaria Z
    Journal of Medical Science & Technology, 2014;3(2):82-86.
    The hemoglobinopathies include all genetic diseases of hemoglobin (Hb) and fall into two main groups: the thalassemias and structural hemoglobin variants (abnormal hemoglobins). Thalassemia is a public health problem in Malaysia. About 4.5% of the Malays and Chinese are β-thalassemia carriers. We performed hemoglobin analysis on a total of 499 patients from a Government Hospital and Health Clinics in the state of Perlis, Malaysia. About 91.4% of the patients were Malays. All patients had microcytic hypochromic anemia except for a few who went for thalassemia screening. Female patients outnumbered male patients in the ratio of 3.5:1. About 75.7% of the female patients were of childbearing age (17 - 40 years) and a majority of them were there for their antenatal checkup. Using our screen tests (full blood count, high performance liquid chromatography (HPLC), and agarose gel electrophoresis), the common hemoglobinopathies detected were HbE trait (19.3%), β-thalassemia trait (14.6%), HbH disease (1.8%), Hb Constant Spring (1.6%), Homozygous HbE (1.4%), and HbE- β-thalassemia (1.4%). Thalassemia is preventable through screening and education programmes, and prenatal diagnosis. Thalassemia screening is provided free of charge at various government hospitals and health clinics throughout the country.
    Key words: Hemoglobinopathies screening, β-thalassemia trait, HbE trait, Thalassemic diseases
    Matched MeSH terms: Hospitals
  6. Fulltext Evaluating the effects of electronic health records system adoption on the performance of Malaysian health care providers
    Salleh MIM, Abdullah R, Zakaria N
    BMC Med Inform Decis Mak, 2021 02 25;21(1):75.
    PMID: 33632216 DOI: 10.1186/s12911-021-01447-4
    BACKGROUND: The Ministry of Health of Malaysia has invested significant resources to implement an electronic health record (EHR) system to ensure the full automation of hospitals for coordinated care delivery. Thus, evaluating whether the system has been effectively utilized is necessary, particularly regarding how it predicts the post-implementation primary care providers' performance impact.

    METHODS: Convenience sampling was employed for data collection in three government hospitals for 7 months. A standardized effectiveness survey for EHR systems was administered to primary health care providers (specialists, medical officers, and nurses) as they participated in medical education programs. Empirical data were assessed by employing partial least squares-structural equation modeling for hypothesis testing.

    RESULTS: The results demonstrated that knowledge quality had the highest score for predicting performance and had a large effect size, whereas system compatibility was the most substantial system quality component. The findings indicated that EHR systems supported the clinical tasks and workflows of care providers, which increased system quality, whereas the increased quality of knowledge improved user performance.

    CONCLUSION: Given these findings, knowledge quality and effective use should be incorporated into evaluating EHR system effectiveness in health institutions. Data mining features can be integrated into current systems for efficiently and systematically generating health populations and disease trend analysis, improving clinical knowledge of care providers, and increasing their productivity. The validated survey instrument can be further tested with empirical surveys in other public and private hospitals with different interoperable EHR systems.

    Matched MeSH terms: Hospitals, Public
  7. Workplace Bullying Among Junior Doctors in Malaysia: A Multicentre Cross-Sectional Study
    Samsudin EZ, Isahak M, Rampal S, Rosnah I, Zakaria MI
    Malays J Med Sci, 2021 Apr;28(2):142-156.
    PMID: 33958968 DOI: 10.21315/mjms2021.28.2.13
    Background: Research suggests that junior doctors often experience workplace bullying, which may have adverse impacts on medical training and delivery of quality healthcare. However, evidence among local population has not been established. The present study aims to examine the prevalence of workplace bullying among Malaysian junior doctors and explore its associated sociodemographic and employment factors.

    Methods: A multicentre cross-sectional study was conducted in 12 government hospitals accredited for housemanship training within the central zone of Malaysia. The study included a total of 1,074 house officers who had been working for at least 6 months in various housemanship rotations. The Negative Acts Questionnaire-Revised (NAQ-R) was used to examine workplace bullying.

    Results: The 6-month prevalence of workplace bullying among study participants was 13%. Work-related bullying such as 'being ordered to do work below your level of competence', person-related bullying such as 'being humiliated or ridiculed in connection with your work', and physically intimidating bullying such as 'being shouted at or being the target of spontaneous anger' were commonly reported by study participants. Medical officers were reported to be the commonest perpetrators of negative actions at the workplace. Study participants who graduated from Eastern European medical schools (adjusted odds ratio [AOR] 2.27; 95% confidence interval [CI]: 1.27, 4.07) and worked in surgical-based rotation (AOR 1.83; 95% CI: 1.13, 2.97) had higher odds of bullying compared to those who graduated from local medical schools and worked in medical-based rotation, whereas study participants with good English proficiency (AOR 0.14; 95% CI: 0.02, 0.94) had lower odds of bullying compared to those with poor English proficiency.

    Conclusion: The present study shows that workplace bullying is prevalent among Malaysian junior doctors. Considering the gravity of its consequences, impactful strategies should be developed and implemented promptly in order to tackle this serious occupational hazard.

    Matched MeSH terms: Hospitals
  8. Fulltext Rare and unusual case of polyarteritis nodosa involving the gastrointestinal tract leading to bowel gangrene
    Jagwani AV, Fathi NQ, Jailani RF, Zakaria AD
    BMJ Case Rep, 2017 Jan 06;2017.
    PMID: 28062430 DOI: 10.1136/bcr-2016-217865
    Polyarteritis nodosa (PAN) is a systemic necrotising vasculitis preferentially targeting medium-sized arteries and not related with glomerulonephritis or small vessel involvement. Clinical manifestations of PAN are multisystem. The gastrointestinal, renal, cardiac, musculoskeletal, skin and central nervous systems may be involved. The aetiology remains unknown, and the ensuing vasculitis may lead to aneurysm formation and thrombosis in any organs of the body with resultant ischaemia. PAN of the intestines is a relatively common manifestation of this disease but rarely causes bowel ischaemia resulting in necrosis. Here we report a case of a young Chinese patient who presented with an acute abdomen requiring surgery and made good recovery post operatively. He remains free of symptoms while on steroid therapy.
    Matched MeSH terms: Hospitals, University
  9. Fulltext Pattern of occupational allergic dermatitis in the Dermatology Clinic, Hospital Kuala Lumpur
    Rohna R, Ganesapillai T, Salbiah D, Zaiton I
    Med J Malaysia, 1999 Mar;54(1):128-31.
    PMID: 10972018
    A two years retrospective analysis of patients diagnosed as contact allergic dermatitis with positive patch test attending the Dermatology clinic was performed. Of the 346 patients with a positive patch test, 14% had occupational dermatitis. This condition affected mainly young and inexperienced workers. An inverse relationship was seen between age and prevalence of occupational allergic dermatitis. Allergic hand dermatitis was the commonest presentation in occupational allergic dermatitis. This was followed by dermatitis of the exposed skin (face, neck, hands and forearms). The common sensitising agents identified were rubber chemicals and nickel. The two main groups at risk were factory workers and medical personnel. The common allergens found in factory workers were epoxy resin, pewter, nickel and rubber chemicals. Exposure dermatitis occurred in patients working in the pewter industry. Two thirds of medical personnel with hand dermatitis were allergic to rubber gloves. One year follow up after patch testing showed that 19% of patients still suffered from chronic dermatitis. Dermatitis improved in 34% of patients. Forty-seven percent were cured and stopped attending the clinic after patch testing and adequate counselling.

    Study site: Dermatology Clinic, Hospital Kuala Lumpur
    Matched MeSH terms: Hospitals, General
  10. Addition of inhaled salmeterol to inhaled corticosteroids in patients with poorly controlled nocturnal asthma
    Norhaya MR, Yap TM, Zainudin BM
    Respirology, 1999 Mar;4(1):77-81.
    PMID: 10339734 DOI: 10.1046/j.1440-1843.1999.00153.x
    The effect of adding inhaled salmeterol to inhaled corticosteroids was studied in patients with poorly controlled nocturnal asthma. In a double-blind, cross-over study, 20 patients were randomized to receive either salmeterol 50 micrograms twice daily or placebo via a Diskhaler after a 1-week run-in period. After 4 weeks of treatment, patients were subsequently crossed over to receive the other treatment for a further 4 weeks with a 2-week wash-out period in between. The response to treatment was assessed by peak expiratory flow rates (PEF) measured in the morning and evening, symptom scores of asthma, number of bronchodilators used, forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) at regular intervals. Patients' preference for the Diskhaler or metered-dose inhaler was assessed at the last visit. The results showed that morning PEF was significantly higher while on salmeterol than on placebo (296.9 +/- 70.2 vs 274.6 +/- 77.4 L/min). Evening PEF showed a trend towards a higher value while on salmeterol than on placebo (321.1 +/- 73.4 vs 288.7 +/- 79.4 L/min), but the difference was not significant. There was no statistically significant improvement in symptom scores, number of rescue bronchodilators used and FEV1 or FVC between the two treatment groups. The occurrence of side effects in terms of tremors and palpitations between treatment and placebo were similar. There were more patients who preferred Diskhaler to metered-dose inhaler (70% vs 30%). We conclude that salmeterol 50 micrograms twice daily produces significant improvement in morning PEF and is well tolerated in patients with nocturnal asthma. Diskhaler is a device which is easy to use and preferred to a metered-dose inhaler.
    Study site: Respiratory Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  11. Fulltext Combination chemotherapy for small cell lung cancer
    Sufarlan AW, Zainudin BM
    Med J Malaysia, 1993 Jun;48(2):166-70.
    PMID: 8394502
    Small cell lung cancer (SCLC) disseminates early and has poor prognosis. However, SCLC is highly chemosensitive, thus chemotherapy has been established as the primary mode of treatment. Seventeen patients (15 males and 2 females) with median age of 60 years (range 49 to 74 years) were treated with combination cyclophosphamide 750 mg/m2, adriamycin 40 mg/m2, vincristine 1.4 mg/m2 on day 1 and etoposide (VP 16) 75 mg/m2 on days 1 to 3 (CAVE). This combination was given in 6 courses at 3 weekly intervals. The response to the chemotherapy and the quality of life of patients was assessed at the third cycle and after the completion of therapy (sixth cycle). The overall response rate was 76.4%; 52.9% achieved complete response and 23.5% had partial response. The survival rate at 6 months was 70.8% and 4 patients (23.5%) were still alive after 1 year of chemotherapy. The median survival after therapy was 36 weeks. There was a 30% overall improvement in the Karnofsky performance score at the completion of chemotherapy. This study illustrated that the CAVE regimen is effective and beneficial in the majority of our patients with small cell lung cancer.
    Matched MeSH terms: Hospitals, University
  12. Fulltext Lightning performance analysis of a rooftop grid-connected solar photovoltaic without external lightning protection system
    Nasir MSM, Ab-Kadir MZA, Radzi MAM, Izadi M, Ahmad NI, Zaini NH
    PLoS One, 2019;14(7):e0219326.
    PMID: 31295278 DOI: 10.1371/journal.pone.0219326
    The Sustainable Energy Development Authority of Malaysia (SEDA) regularly receives complaints about damaged components and distribution boards of PV systems due to lightning strikes. Permanent and momentary interruptions of distribution circuits may also occur from the disturbance. In this paper, a solar PV Rooftop system (3.91 kWp) provided by SEDA was modelled in the PSCAD/EMTDC. The Heidler function was used as a lightning current waveform model to analyse the transient current and voltage at two different points susceptible to the influence of lightning events such as different lightning current wave shape, standard lightning current and non-standard lightning current. This study examines the effect on the system components when lightning directly strikes at two different points of the installation. The two points lie between the inverter and the solar PV array and between inverter and grid. Exceptionally high current and voltage due to the direct lightning strike on a certain point of a PV Rooftop system was also studied. The result of this case study is observed with and without the inclusion of surge protective devices (SPDs). The parameters used were 31 kA of peak current, 10 metres cable length and lightning impulse current wave shape of 8/20μs. The high current and voltage at P1 striking point were 31 kA and 2397 kV, respectively. As for the AC part, the current and voltage values were found to be 5.97 kA and 5392 kV, respectively.Therefore, SPDs with suitable rating provided by SEDA were deployed. Results showed that high transient current voltage is expected to clamp sharply at the values of 1.915 kV and 0 A at the P1 striking point. As for the AC part, the current and voltage values were found to be 0 kA and 0.751 V, respectively. Varying lightning impulse current wave shapes at striking point P2 showed that the highest voltage was obtained at waveshape 10/350 μs at 11277 kV followed by wave shapes of 2/70 μs, 8/20 μs and 0.7/6 μs. The high value of transient voltage was clamped at a lower level of 2.029 kV. Different lightning amplitudes were also applied, ranging from 2-200 kA selected based on the CIGRE distribution. It showed that the current and voltage at P1 and P2 were directly proportional. Therefore, the SPD will be designed at an acceptable rating and proper position of SPD installation at solar PV Rooftop will be proposed. The results obtained in this study can then be utilised to appropriately assign a SPD to protect the PV systems that are connected to the grid. Installing SPDs without considering the needs of lightning protection zones would expose the expensive equipment to potential damage even though the proper energy coordination of SPDs is in place. As such, the simulation results provide a basis for controlling the impacts of direct lightning strikes on electrical equipment and power grids and thus justify SPD coordination to ensure the reliability of the system.
    Matched MeSH terms: Hospitals/supply & distribution
  13. Fulltext Demographic and clinical characteristics of red tag patients and their one-week mortality rate from the emergency department of the Hospital Universiti Sains Malaysia
    Ahmad R, Rahmat R, Hisamudin N, Rahman NA, Noh AY, Mohammad N, et al.
    Southeast Asian J. Trop. Med. Public Health, 2009 Nov;40(6):1322-30.
    PMID: 20578468
    Early identification and rapid treatment of red tag patients may decrease morbidity and mortality. We examined the clinical characteristics, etiologies and one week mortality rate of red tag (life threatening and potentially life threatening illness) patients at the Hospital Universiti Sains Malaysai (HUSM). A cross-sectional study was conducted at the Emergency Department of the HUSM from 1 August 2006 to 31 January 2007; 440 eligible patients were analyzed. The group had a mean age of 47.2 +/- 22 years, with 67.3% of the patients being male. Twenty-three percent were trauma cases with motor vehicle accident being the major mechanism of injury. Fifty-four percent of the cases had cardiac related illnesses. The mean duration of stay in the Emergency Department (ED) was 3.9 +/- 1.5 hours. The survival rate at one week was 76.6%. The non-trauma group comprised 74.0% of death cases. Acute coronary syndrome and road traffic accidents comprised 22.0% of total death cases at one week. Red tag patients constitute a large proportion of ED cases and may remain in the ED for significant periods of time.

    Study site: Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Hospitals, University
  14. Fulltext Prevalence of diabetic retinopathy in the University Hospital diabetic population
    Teoh GH, Yow CS, Ngan A, Zaini A
    Med J Malaysia, 1983 Mar;38(1):77-9.
    PMID: 6633344
    One hundred and forty-five diabetic patients attending diabetic clinic over a four week period were fully examined in an adjacent eye clinic. The fundi were examined with a Halogen light direct ophthalmoscope and the Binocular Indirect Ophthalmoscope after mydriasis to assess the presence of retinopathy. 44.1 percent of patients examined had Opbthalmoscopicaliy detectable retinopathy while 11 percent were found to have 'serious diabetic eye disease'. The prevalence of diabetic retinopathy in Malaysia is comparable to those of Western countries and Japan.
    Study site: Diabetic clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  15. Fulltext Anxiety, depression and coping strategies in breast cancer patients on chemotherapy
    Saniah, A.R., Zainal, N.Z.
    Malaysian Journal of Psychiatry, 2010;19(2):1-6.
    MyJurnal
    The aim of the study was to determine coping strategies among breast cancer patients with depression and anxiety during chemotherapy. Methods: Breast cancer patients with confirmed diagnosis who were undergoing out-patient chemotherapy at the Oncology Unit, University Malaya Medical Centre were invited to participate in the study. They were assessed on their socio demographic profiles and clinical history. The Hospital Anxiety Depression Scale (HADS) was used by patients to report anxiety and depression. The Brief COPE Scale was used to assess coping strategies among the patients. Results: One hundred and forty one patients with mean age of fifty years participated in the study. Prevalence for depression was 19.1% and prevalence for anxiety was 24.1%. Patients who were having anxiety symptoms scored significantly higher on denial, behavioural disengagement and venting as their coping strategies compared to patients who were not anxious. Patients with depressive symptoms scored significantly higher in behavioural disengagement and self-blame as their coping strategies compared to those who were not depressed. Conclusion: Breast cancer patients undergoing chemotherapy experienced high level of depressive and anxiety symptoms. However different coping strategies were adopted to cope with their illness, chemotherapy treatment, practical and family problems, emotional and physical symptoms.
    Study site: Oncology clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  16. Fulltext General Hospital Without Consultation-Liaison Psychiatrist
    Zainal, N.Z.
    Malaysian Journal of Psychiatry, 2010;19(1):1-2.
    MyJurnal
    Most general hospitals in the country have a psychiatric department. According to the Malaysia Mental Health Regulations 2010, "a psychiatric facility shall ensure that each patient has a care plan for the management of the patient during the treatment and upon discharge of the patient". However not every psychiatric department has a trained consultation-liaison psychiatrist. In Malaysia there are only a few numbers of psychiatrists that have undergone a formal sub-specialty training in Consultation-Liaison Psychiatry.
    Matched MeSH terms: Hospitals, General
  17. Fulltext Factorial validation of the Malay version of multidimensional scale of perceived social support among a group of psychiatric patients
    Ng, C.G., Nurasikin, M.S., Loh, H.S., Yee, Anne H.A., Zainal, N.Z.
    Malaysian Journal of Psychiatry, 2012;21(2):0-0.
    MyJurnal
    Introduction: There is increasing awareness of the contribution of perceived social support (PSS) to emotional and physical well-being. Numerous scales measuring PSS have been developed, including the widely used Multidimensional Scale of Perceived Social Support (MSPSS). The psychometric properties of the MSPSS have been demonstrated in diverse samples, however mostly are conducted in English. Malay is the official languange in Malaysia, and this study was conducted to provide evidence of the validity and reliability of a Malay version MSPSS (MSPSS-M) suited for our population.
    Methods: This is a cross sectional study. The socio-demographic and clinical information of the selected patients from psychiatric outpatient clinic over a 3-month period, were obtained via pre-designed questionnaire, interviews and medical records. Assessment of psychiatric symptoms and social support were measured by various instruments including the Brief Psychiatric Rating Scale (BPRS-E), Depressive, Anxiety and Stress Scale (DASS) and MSPSS-M.
    Results: Data were reported for 228 psychiatric outpatients with the mean age of 40.3 years old. The 3-factor structure of the MSPSS-M (significant others, family, and friends) fitted the data well. The MSPSS-M showed good internal consistency (Cronbach α of 0.89) and validity. The scores of the total subscales for MSPSS-M were negatively correlated with the depression subscale in DASS (P < 0.05). BPRS was negatively correlated with significant others (P < 0.01) compared to the other two subscales in MSPSS-M.
    Conclusions: The Malay version MSPSS (MSPSS-M) is a psychometrically valid instrument with high internal consistency, which is useful in assessing perceived social support in Malaysian population.

    Study site: psychiatric clinic, University Malaya
    Medical Center (UMMC)
    Matched MeSH terms: Hospitals, University
  18. Fulltext Exploring burnout among Malaysian junior doctors using the abbreviated Maslach Burnout Inventory
    Zuraida Ahmad Sabki, Zainal NZ
    Malaysian Journal of Psychiatry, 2015;24(1):23-32.
    MyJurnal
    Objective: The study aimed to explore the prevalence of burnout among the junior doctors and to examine the psychometric properties of abbreviated Maslach Burnout Inventory (aMBI). Methods: A cross-sectional study was conducted using aMBI self-reported questionnaire and Hospital Anxiety Depression Scale which was carried out on a sample of 117 junior doctors working in a teaching hospital in Malaysia. Results: Exploratory factor analysis of aMBI revealed a three-factor structure labelled as emotional exhaustion, depersonalization and personal accomplishment with Crohnbach’s alpha of 0.85, 0.59 and 0.64 respectively. The total variance was 67%. Prevalence of burnout was found at 26.5%. Emotional exhaustion and depersonalization were positively correlated with depression and anxiety. Shorter duration of residence (less than six months) and being posted to Trauma & Emergency unit were associated with higher mean score of burnout. Conclusion: This study provides the knowledge of level of burnout among the junior doctors and the abbreviated Maslach Burnout Inventory has a satisfied psychometirc properties for screening burnout among junior doctors in Malaysia.
    Matched MeSH terms: Hospitals, Teaching
  19. Fulltext Acute renal failure in a teaching hospital
    Loo CS, Zainal D
    Singapore Med J, 1995 Jun;36(3):278-81.
    PMID: 8553092
    This was a retrospective study of the clinical course of 164 adult inpatients with acute renal failure (ARF) at the Hospital of the University of Science Malaysia admitted from June 1986 to May 1990. The mean age was 49.8 +/- 17.2 years. 33.5%, 54.9% and 11.6% were surgical, medical and obstetrical patients respectively. Obstructive uropathy, poor cardiac output or decrease in intravascular volume and infection accounted for more than 67% of the cases. Acute renal failure was present at admission in 113 (69%) patients. The majority of the patients (80%) had nonoliguric acute renal failure with daily output of urine of more than 400 ml. Compared with nonoliguric patients, oliguric patients had higher mortality (56.3% vs 18.9%, p < 0.01), and needed dialysis more frequently (43.8% vs 12.9%, p < 0.01). Early recognition of acute renal failure, improvement in early treatment of renal stones and discerning use of nephrotoxic drugs could result in decrease in incidence and severity of renal failure.
    Matched MeSH terms: Hospitals, Teaching
  20. Fulltext Prevalence and risk factors for menstrual disorders among systemic lupus erythematosus patients
    Fatnoon NN, Azarisman SM, Zainal D
    Singapore Med J, 2008 May;49(5):413-8.
    PMID: 18465054
    INTRODUCTION: This study aims to determine the prevalence and the types of menstrual disorders among patients with systemic lupus erythematosus (SLE) and to identify factors that influence their development.
    METHODS: 61 patients with SLE were enrolled into a cross-sectional, observational study at the medical outpatient clinic, Hospital Universiti Sains Malaysia. A total of 120 healthy women were selected randomly to act as the control group. A questionnaire was administered, vital signs were recorded, and blood was evaluated for routine investigations. A review of past medical records was also undertaken.
    RESULTS: The mean age and standard deviation for the study group was 33.23 +/- 10.96 years, the majority being ethnic Malays. 75 percent had a severe SLE disease activity index score on initial presentation, and 59 percent were on cyclophosphamide. 49 percent of the study population had menstrual irregularities, of which 60 percent had sustained amenorrhoea. Nine patients with sustained amenorrhoea had hormonal assays, which confirmed the diagnosis of premature menopause.
    CONCLUSION: This study showed that SLE patients had a higher risk of developing menstrual irregularities compared to the normal/healthy population. The risk was higher in the older age group (greater than 30 years old) and those on cyclophosphamide therapy, especially those with a cumulative dose of more than 10 g. Sustained amenorrhoea was the commonest irregularity and a majority of them had confirmed premature menopause.
    Study site: medical outpatient clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Hospitals, University
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