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  1. Fulltext Causes and predictors of mortality in biopsy-proven lupus nephritis: the Sarawak experience
    Teh CL, Phui VE, Ling GR, Ngu LS, Wan SA, Tan CH
    Clin Kidney J, 2018 Feb;11(1):56-61.
    PMID: 29423203 DOI: 10.1093/ckj/sfx063
    Background: Lupus nephritis (LN) is a serious manifestation of systemic lupus erythematosus that can be fatal if left untreated. The causes and prognostic predictors of mortality in LN have been well studied in developed countries but evidence is lacking for developing countries. The objective of this study was to investigate the causes and predictors of mortality in a cohort of Malaysian patients with biopsy-proven LN.

    Methods: We retrospectively studied all patients with biopsy-proven LN treated in Sarawak General Hospital during the period of 2000-15. Demographic data, clinical features and outcomes were collected. Cox regression analysis was carried out to determine the independent predictors of mortality.

    Results: There was a total of 250 patients with 259 renal biopsies available for our analysis. Our patients were of multi-ethnic origins with a female predominance (90%). Their mean ± standard deviation age was 37.7 ± 12.8 years. The patients had a mean disease duration of 135.6 ± 81.9 months. Nephrotic syndrome was the most common presentation (29.6%) and acute renal failure was evident at initial presentation in 16% of patients. Class IV LN was the predominant biopsy class within the cohort (66.8%). The majority of patients achieved remission (81.2%) and had normal renal function (83.9%) at the last follow-up. The 5-, 10-, 15- and 20-year survival rates for our cohort were 93%, 88%, 82% and 77%, respectively. There were 37 deaths (14.8%), of which the main causes were: infection and flare (52.7%), infection alone (25.0%) and other causes (22.3%). Independent predictors of mortality in our cohort of LN patients were: the presence of acute kidney injury at presentation [hazard ratio (HR) 3.41; confidence interval (CI) 1.50-7.76], failure to achieve remission at 1-year post-induction therapy (HR 2.99; CI 1.35-6.65) and non-compliance with treatment (HR 1.89; CI 1.22-2.96). Age, ethnicity, class of LN and type of immunosuppressant used were not predictive of mortality.

    Conclusions: Survival and renal outcomes in our LN cohort were comparable to most LN studies reported worldwide. Both flare and infection remained the main causes of death. The presence of acute renal failure at presentation, failure to achieve remission at 1 year post-treatment and non-compliance with treatment were independent prognostic predictors of mortality in LN.
    Matched MeSH terms: Hospitals, General
  2. Fulltext Cost of in-patient management of COVID-19 patients in a general hospital in Kuwait
    Nur AM, Aljunid SM, Almari M
    BMC Health Serv Res, 2023 Nov 28;23(1):1314.
    PMID: 38017444 DOI: 10.1186/s12913-023-10287-z
    BACKGROUND: Among the GCC countries affected by COVID-19 infections, Kuwait has been significantly impacted, with 658,520 cases and 2,563 deaths reported by the WHO on September 30, 2022. However, the impact of the COVID-19 epidemic on Kuwait's economy, especially in the healthcare sector, remains unknown.

    OBJECTIVE: This study aims to determine the total cost of managing COVID-19 in-patients in Kuwait.

    METHOD: A cross-sectional design was employed for this study. A total of 485 COVID-19 patients admitted to a general hospital responsible for COVID-19 cases management were randomly selected for this study from May 1st to September 31st, 2021. Data on sociodemographic information, length of stay (LOS), discharge status, and comorbidities were obtained from the patients' medical records. The data on costs in this study cover administration, utility, pharmacy, radiology, laboratory, nursing, and ICU costs. The unit cost per admission was calculated using a step-down costing method with three levels of cost centers. The unit cost was then multiplied by the individual patient's length of stay to determine the cost of care per patient per admission.

    FINDINGS: The mean cost of COVID-19 in-patient care per admission was KD 2,216 (SD = 2,018), which is equivalent to USD 7,344 (SD = 6,688), with an average length of stay of 9.4 (SD = 8.5) days per admission. The total treatment costs for COVID-19 in-patients (n = 485) were estimated to be KD 1,074,644 (USD 3,561,585), with physician and nursing care costs constituting the largest share at 42.1%, amounting to KD 452,154 (USD 1,498,529). The second and third-largest costs were intensive care (20.6%) at KD 221,439 (USD 733,893) and laboratory costs (10.2%) at KD 109,264 (USD 362,123). The average cost for severe COVID-19 patients was KD 4,626 (USD 15,332), which is almost three times higher than non-severe patients of KD 1,544 (USD 5,117).

    CONCLUSION: Managing COVID-19 cases comes with substantial costs. This cost information can assist hospital managers and policymakers in designing more efficient interventions, especially for managing high-risk groups.

    Matched MeSH terms: Hospitals, General
  3. Fulltext Outcome of trabeculectomy in hospital Melaka, Malaysia
    Heng Hah M, Norliza Raja Omar R, Jalaluddin J, Fadzillah Abd Jalil N, Selvathurai A
    Int J Ophthalmol, 2012;5(3):384-8.
    PMID: 22773993 DOI: 10.3980/j.issn.2222-3959.2012.03.26
    AIM: To study the success and outcome of trabeculectomy in Hospital Melaka.
    METHODS: Medical records of all patients who underwent trabeculectomy between January 1, 2007 and October 31, 2010 whom were followed up for at least 6 months postoperatively in Hospital Melaka were retrospectively reviewed.
    RESULTS: A total number of 117 eyes of 91 patients with the age range between 12 to 84 years underwent primary trabeculectomy (n=20, 17.1%), combine trabeculectomy with cataract surgery (n=90, 76.9%), repeat trabeculectomy (n=5, 4.3%), and combine repeat trabeculectomy with cataract surgery (n=2, 1.7%). The disease spectrum includes primary open-angle glaucoma (POAG) (54 patients, 59.3%), priamry angle-closure glaucoma (PACG) (14 patients, 15.4%), secondary glaucomas (19 patients, 20.9%) and juvenile glaucomas (4 patients, 4.4%). Preoperative mean intraocular pressure (IOP) was (24.69±8.67)mmHg as compared to postoperative mean IOP of (15.81±6.66)mmHg, (15.07±4.72)mmHg and (15.68 ±3.65)mmHg at 6-month, 12-month and 24-month respectively. Eighty-two point one percent of eyes (n=96) achieved complete success (CS), 12.8% (n=15) with qualified success (QS) and only 5.1% (n=6) failed at 6 month with two of them warrant other filtering surgery. At twelve months, trabeculectomy with CS was 71.6% (n=63), QS in 22.7% (n=20) and failure in 5.7% (n=5). Sixty-seven point five percent (n=27) attained CS, 20.0% (n=8) with QS while 12.5% (n=5) failed at 24 month postoperative.
    CONCLUSION: As the understanding of the lower the IOP, the better the patients retaining the visual function, trabeculectomy is significantly a choice of treatment in uncontrolled glaucoma. This study concluded that trabeculectomy performed in Hospital Melaka has produced significant success as compared to other studies.
    KEYWORDS: glaucoma; success rate; trabeculectomy
    Matched MeSH terms: Hospitals, General
  4. Fulltext Assessing patient pain scores in the emergency department
    Baharuddin KA, Mohamad N, Nik Abdul Rahman NH, Ahmad R, Nik Him NA
    Malays J Med Sci, 2010 Jan;17(1):17-22.
    PMID: 22135521 MyJurnal
    BACKGROUND: Pain management in the Emergency Department is challenging. Do we need to ask patients specifically about their pain scores, or does our observational scoring suffice? The objective of this study was to determine the inter-rater differences in pain scores between patients and emergency healthcare (EHC) providers. Pain scores upon discharge or prior to ward admission were also determined.
    METHODS: A prospective study was conducted in which patients independently rated their pain scores at primary triage; EHC providers (triagers and doctors) separately rated the patients' pain scores, based on their observations.
    RESULTS: The mean patient pain score on arrival was 6.8 ± 1.6, whereas those estimated by doctors and triagers were 5.6±1.8 and 4.3±1.9, respectively. There were significant differences among patients, triagers and doctors (P< 0.001). There were five conditions (soft tissue injury, headache, abdominal pain, fracture and abscess/cellulites) that were significantly different in pain scores between patients and EHC providers (P<0.005). The mean pain score of patients upon discharge or admission to the ward was 3.3 ± 1.9.
    CONCLUSIONS: There were significant differences in mean patient pain scores on arrival, compared to those of doctors and triagers. Thus, asking for pain scores is a very important step towards comprehensive pain management in emergency medicine.
    KEYWORDS: emergency medicine; neurosciences; pain assessment; pain management; pain score
    Study site: Emergency department, Hospital Kuala Lumpur
    Matched MeSH terms: Hospitals, General
  5. Fulltext The prevalence of tobacco smoking in patients with diabetes in Hospital Pulau Pinang, Malaysia [Abstract]
    Albaroodi KA, Syed Sulaiman SA, Shafie AA, Awaisu A, Lajis R
    Value Health, 2014 Nov;17(7):A590.
    PMID: 27202012 DOI: 10.1016/j.jval.2014.08.2023
    Widespread evidence has demonstrated the negative effects of tobacco smoking in patients with diabetes. Although many studies have explored the prevalence of tobacco smoking in the general population, data are lacking regarding its prevalence in a specific population with a chronic disease such as diabetes.
    Objectives: This study aims to determine the prevalence of tobacco smoking among patients with diabetes in Hospital Pulau Pinang, Malaysia.
    Methods: A cross-sectional survey was conducted to study diabetic patients who attended the endocrine clinic at Hospital Pulau Pinang in Malaysia from March to August 2012. All the diabetic patients who attended the endocrine clinic during that period were asked about their smoking status, and their medical records were reviewed. A total of 1,118 patients with diabetes were reviewed to determine the prevalence of tobacco smoking in diabetic patients at the endocrine clinic of Hospital Pulau Pinang.
    Results: The majority of the study population was male, with Malay and Chinese patients in almost equal proportions and a smaller proportion of Indian patients. Most of these patients had started smoking before they were diagnosed with diabetes. Among the 1,118 diabetic patients, only 108 patients smoked; therefore, the prevalence of tobacco smoking in our patients with diabetes was 9.66%.
    Conclusions: A low prevalence of tobacco smoking was estimated in this study. This prevalence is close to the corresponding value in the general population in Malaysia.
    Study site: Endocrine clinic, Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Hospitals, General
  6. Fulltext Assessing the cost effectiveness of an anticoagulation clinic in comparison with the usual medical clinic In Kuala Lumpur Hospital [Abstract]
    Thanimalai S, Shafie AA, Ahmad HM, Sinnadurai J
    Value Health, 2014 Nov;17(7):A487.
    PMID: 27201439 DOI: 10.1016/j.jval.2014.08.1428
    Objectives: Systematic anticoagulation management clinic is now recommended to manage warfarinized atrial fibrillation (AF) patient. In Malaysia, the service is recently introduced as pharmacist managed Warfarin Medication Therapy Adherence Clinic (WMTAC). The objective of the present study was to assess the cost effectiveness of anticoagulation clinic in comparison with usual medical in Kuala Lumpur Hospital.
    Methods: A Markov model built using the provider perspective and 20 year time horizon was used to assess the cost effectiveness. The base case analysis assumed a cohort of patients with AF 57 years of age with comorbid illnesses. Data sources include a 6 month retrospective cohort analysis of the effectiveness of the clinics, the cost of drugs, cost of personnel and space of the clinics, cost of monitoring and cost of adverse events were obtained from the local source and publications. The transition probabilities of these clinics outcomes were obtained from a literature search. Future costs were discounted by 3% to convert to present values. All costs were in Ringgit Malaysia (RM) based on year 2012.
    Results: The results of a 20-year period model showed that UMC was dominated by the WMTAC in the same time period. The mean cost of the WMTAC was RM 5864 whereas the UMC cost was RM 6550. The sensitivity analysis showed that clinic treatment costs and effectiveness influenced the cost-effectiveness. If the cost of WMTAC was increased by 50% of the current cost, the WMTAC would not be a dominant intervention. WMTAC was also cost effective for a willingness to pay of RM32000.
    Conclusions: The anticoagulation management service appears to cost less and provide greater effectiveness than usual care. In conclusion, the Markov model suggests that from the provider perspective the anticoagulation clinic is a more cost effective option than the usual medical clinic in Kuala Lumpur Hospital.
    Study site: Medication Therapy Adherence Clinic, Hospital Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, General
  7. Fulltext Predictors of frequent oral analgesic use in rheumatoid arthritis
    Das Gupta E, Tee HS, Sakthiswary R
    Pak J Med Sci, 2014 Sep;30(5):976-81.
    PMID: 25225510 DOI: 10.12669/pjms.305.5112
    Objective: The main objective of this study was to determine the predictors of frequent oral analgesic use among Rheumatoid Arthritis (RA) patients who were prescribed with the above medication on an ‘as needed’ basis.
    Methods: Patients with RA were recruited consecutively from the Rheumatology outpatient clinics in this cross-sectional study. The sociodemographic data, frequency of oral analgesic intake, Patient Global Assessment (PGA) scores and HAQ (Health Assessment Questionnaire) scores were determined by interviewing the subjects. Subjects were divided into 2 groups; frequent users (3 days and above in a week) and less frequent users (less than 3 days in a week).
    Results: In a total of 112 subjects, 39 (34.8%) were frequent analgesic users. Both the HAQ and PGA scores were significantly higher among the frequent users (p < 0.05). Using multivariate analysis, the HAQ scores (p=0.015, odds ratio 3.161 [95% confidence interval of 1.246-8.015]) and PGA scores (p=0.039 odds ratio 1.291 [95% confidence interval of 1.012-1.646]) were found to be independent predictors of frequent analgesic use.
    Conclusions: Our study confirms that the frequency of analgesic intake in Rheumatoid Arthritis has a significant relationship with patient-reported functional capacity and well being.
    KEY WORDS: Analgesic, Rheumatoid arthritis.

    Study site: Rheumatology clinic, Hospital Tunku Jaafar, Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Hospitals, General
  8. Fulltext Tuberculosis deaths: are we measuring accurately?
    Atif M, Sulaiman SA, Shafie AA, Qamar Uz Zaman M, Asif M
    J Pharm Policy Pract, 2014;7(1):16.
    PMID: 25838918 DOI: 10.1186/2052-3211-7-16
    Death among tuberculosis patients is one of the major reasons for non-attainment of 85% treatment success target set by World Health Organization. In this short paper, we evaluated whether the overall mortality rate in pulmonary tuberculosis is being affected by other comorbid conditions. All new smear positive pulmonary tuberculosis patients (N =336), who started their treatment at the chest clinic of the Penang General Hospital, between March 2010 and February 2011, were followed-up until December 2011. Tuberculosis treatment outcomes were reported according to six treatment outcome categories recommended by World Health Organization. The outcome category 'died' was defined as 'a patient who died due to tuberculosis or other cause during tuberculosis treatment'. Our findings showed that out of 336 smear positive pulmonary tuberculosis patients, 59 (17.6%) died during treatment (mortality rate = 1.003 cases per 1000 person-days of follow-up). Among the deceased patients, the mean age was 55.8 years (SD =16.17) and 49 were male. According to the mortality review forms, 29 deaths were tuberculosis-related, while the remaining 30 patients died due to reasons other than tuberculosis. Cerebrovascular accident (n =7), septicaemia shock (n =4) and acute coronary syndrome (n =4) were the most common non-tuberculosis related reasons for mortality in the patients. If the 30 patients, for whom tuberculosis was incidental to death, are excluded from the final cohort, the proportion of patients in the 'died' outcome category could be reduced to 9.5%. The treatment outcome criterion (i.e., died) set by World Health Organization has limitations. Therefore, it requires improvement for more objective evaluation of the performance of the National Tuberculosis Program.
    Study site: Chest clinic, Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Hospitals, General
  9. Fulltext Pancytopenia in a patient with Grave's disease
    Loh HH, Tan F
    Med J Malaysia, 2013 Aug;68(4):372-3.
    PMID: 24145274 MyJurnal
    Pancytopenia can rarely complicate Grave's disease. It can be due to uncontrolled thyrotoxicosis or as a result of rare side effect of antithyroid medication. Pernicious anemia leading to Vitamin B12 deficiency is another rare associated cause. We report a case of a patient with Grave's disease and undiagnosed pernicious anemia whom was assumed to have antithyroid drug induced pancytopenia. Failure to recognize this rare association of pernicious anemia as a cause of pancytopenia had resulted in delay in treatment and neurological complication in our patient.
    Matched MeSH terms: Hospitals, General
  10. Fulltext Epidemiology of psoriasis in Malaysia: a hospital based study
    Sinniah B, Saraswathy Devi S, Prashant BS
    Med J Malaysia, 2010 Jun;65(2):112-4.
    PMID: 23756793 MyJurnal
    BACKGROUND: Psoriasis is a complex chronic inflammatory skin disease with a worldwide distribution.
    OBJECTIVE: To determine the prevalence of psoriasis according to age, gender and ethnicity among outpatients attending the dermatology clinic in Hospital Tengku Ampuan Rahimah, Klang Malaysia.
    STUDY POPULATION: All outpatients attending the specialist clinic of the dermatology department in Hospital Tengku Ampuan Rahimah, Klang, Malaysia from January 2003 to December 2005.
    METHODS: This is a retrospective descriptive study of all outpatients who attended the specialist clinic from January 2003 to December 2005 and diagnosed for psoriasis. The study population consisted of patients of all ages, both gender and different ethnic groups (Malay, Chinese, Indians and foreign workers) living in the Klang Valley and the surrounding areas.
    RESULTS: A total of 5607 patients were examined during a period of three years and 9.5% were found to be suffering with psoriasis. It was more common in males (11.6%) than in females (7.2%). Patients within the 40-60 year age group had the highest (17.2%) rate and were lower in the younger age group including those aged over 60 years (8.1%). With regards to ethnicity, it was more common in Indians followed by Malays, Chinese and migrant foreign workers respectively. The study indicates that psoriasis is common in Malaysia and its distribution varies with age, ethnicity and gender.

    Study site: dermatology department in Hospital Tengku Ampuan Rahimah,
    Matched MeSH terms: Hospitals, General
  11. Fulltext The trends of DMARDS prescribed in rheumatoid arthritis patients in Malaysia
    Sulaiman W, Toib A, Chandrashekhar G, Arshad A
    Oman Med J, 2009 Oct;24(4):260-06.
    PMID: 22216379 DOI: 10.5001/omj.2009.53
    OBJECTIVES: To evaluate the trends of disease-modifying anti-rheumatic drugs (DMARDs) used in the treatment of rheumatoid arthritis (RA).
    METHODS: Patients who fulfilled the ACR criteria for RA from 1995 to 2006 and who attended the Rheumatology clinic at Ipoh Hospital were selected and their records were evaluated to determine the changing trends in the use of DMARDs.
    RESULTS: 128 patients with RA were identified. The most commonly prescribed DMARD as monotherapy was sulphasalazine (47.7%), followed by methotrexate (35.9%) and hydroxychloroquine. Methotrexate and sulphasalazine were the most frequently prescribed DMARDs, of which the use of methotrexate has increased 6 folds from 1997 to 2007 and the use of sulphasalazine remains around 30% to 50%. The combination of methotrexate with leflunomide has significantly increased in usage by 4 folds during the study period whilst methotrexate with sulphasalazine combination usage had slightly declined.
    CONCLUSION: DMARDs are still the cornerstone in the treatment of RA. Changes in the trend and aggressive use of DMARDs has been markedly influenced by the patient's awareness of early treatment, the incapacitating damage, availability of recently introduced leflunomide and the advancement of current recommended treatment protocol.
    Study site: Rheumatology clinic, Hospital Raja, Parmaisuri Bainum (HRBP), Ipoh, Perak, Malaysia
    Matched MeSH terms: Hospitals, General
  12. Fulltext Pleurovideoscopy in a general hospital
    Norhaya MR, Dzawani M
    Med J Malaysia, 2009 Mar;64(1):75-6.
    PMID: 19852328 MyJurnal
    A 48 a year old Malay gentleman, was investigated for recurrent unexplained right pleural effusion. Initial investigations showed exudative pleural effusion with neutrophil predominance. Tuberculosis (TB) workout were negative. Pleuroscopy showed multiple adhesions with granulomatous deposits at the parietal pleural surface. Adhesions were released by forceps. A chest tube was inserted. Intrapleural streptokinase instilled for three consecutive days. TB treatment was initiated. There was clinical and radiological improvement and he was discharged well after one week of hospitalization. He remained well at follow-up two months later.
    Matched MeSH terms: Hospitals, General
  13. Fulltext High-risk behaviours and concomitant medical illnesses among patients at methadone maintenance therapy clinic, Hospital Tengku Ampuan Afzan, Malaysia
    Ramli M, Nora M, Zafri A, Junid M, Umeed A, Hajee M
    Malays Fam Physician, 2009;4(2-3):77-82.
    PMID: 25606168 MyJurnal
    BACKGROUND: High prevalence of high-risk behaviours and concurrent medical illnesses among opioid drug users would influence the outcome of Methadone Maintenance Programme. It would also require a special medical attention to contain these issues.
    OBJECTIVES: This study explored patients' characteristics and their high-risk behaviours in order to understand more about opioid dependent users in Malaysia.
    METHODS: A total of 172 patient case notes at Methadone Clinic Hospital Tengku Ampuan Afzan (HTAA) were retrieved for relevant data.
    RESULTS: Many of the patients were engaged in high-risk behaviours such as needle sharing, unsafe sex and criminal activities. A large number of the subjects had contracted blood-borne diseases such as HIV and hepatitis infections.
    CONCLUSIONS: Education on the issue of medical and psychosocial complications related to high risk behaviours is essential. Medical professionals dealing with this group have to pay attention and update their knowledge on the medical issue.
    KEYWORDS: Methadone therapy; high-risk behaviours; opioid dependence
    Study site: Methadone clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
    Matched MeSH terms: Hospitals, General
  14. Fulltext Preventing tuberculosis in healthcare workers of the radiology department: a Malaysian perspective
    Tan L, Kamarulzaman A
    Biomed Imaging Interv J, 2006 Jan;2(1):e3.
    PMID: 21614220 MyJurnal DOI: 10.2349/biij.2.1.e3
    Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.
    Matched MeSH terms: Hospitals, General
  15. A prospective prescription cost analysis of asthma medication. [Abstract]
    Khan AH, Aftab RA, Sulaiman SA, Ali I
    Value Health, 2015 Nov;18(7):A840.
    PMID: 26534490 DOI: 10.1016/j.jval.2015.09.373
    Objectives: To review patient’s prescriptions and calculate direct cost for the treatment and management of asthma
    Methods: A prospective cross-sectional detailed review of 180 prescriptions written by 6 doctors was conducted at respiratory department of Hospital Pulau Pinang, Malaysia. Medication price was confirmed from the hospital formulary. Interview with the key personals were conducted to identify activities of each service provided to asthma patients. This was followed by determination of time taken to complete each activity using stopwatch. The duration was captured 15 times for each for three alternate days and summarized as the mean time (minutes) for each activity. The cost of each employee per single activity was obtained by multiplying the mean time (minute) spent by that employee doing a specific activity by his/her salary per minute
    Results: A total of 6 different classes of medications were prescribed to 180 asthma patients. β agonist was the most prescribed class of asthma medication that included Salbutamol 72 (39.8) and albuterol 20 (11) followed by Corticosteroids that included budisonide 59 (32.8%), prednisolone 16 (8.8%) and fluticasone 11 (6.1%). Fifty one (28.3%) units of budisonide/formoterol combination medication were prescribed followed by fluticasone/salmeterol 40 (22.2%). A total of RM 10610.79(USD) medication were prescribed to 180 asthma patients with average cost of RM 59.08 per patient. The combination medication of budisonide/formoterol RM.5253 (USD) made the majority of total cost of asthma medication. Spirometry was performed for all 180 patients at every hospital visit that costed RM 5400.00. The cost of services provided by doctors and nursing staff for 180 asthma patients for single visit was RM 1198.8 and RM 331.2 respectively
    Conclusions: Combination medication adds a substantial cost to over all asthma cost. Careful selection of asthma pharmacotherapy can greatly reduce medication cost without compromising on treatment outcomes
    Matched MeSH terms: Hospitals, General
  16. Fulltext Knowledge and practice of diabetic foot care in an inpatient setting at a tertiary medical center
    Muhammad-Lutfi AR, Zaraihah MR, Anuar-Ramdhan IM
    Malays Orthop J, 2014 Nov;8(3):22-6.
    PMID: 26401231 MyJurnal DOI: 10.5704/MOJ.1411.005
    Good knowledge and practice regarding diabetic foot care will reduce the risk of diabetic foot complications and ultimately amputation. This study is conducted to assess patients' knowledge and compliance of diabetic foot care. A cross sectional study performed on patients who were admitted to HSNZ from the 1st September 2013 to 30th April 2014 for diabetic foot infections. They were interviewed with a questionnaire of 15 'yes' or 'no' questions on foot care knowledge and practice. Score of 1 was given for each 'yes' answer. The level of knowledge and practice, whether good or poor, was determined based on the median score of each category. The result was tested using a chi-square test in SPSS version 17. A total of 157 patients were included in this study with a mean age of 56.33 years (31-77). There were 72 male (45.9%) and 85 female (54.1%) patients with the majority of them being Malays (154 patients, 98.1%). Majority of the patients (58%) had poor foot care knowledge while 97 patients (61.8%) had poor diabetic foot care practice as compared to the median score. Based on the chi square test of relatedness, there was no significant association between knowledge and practice with any of the variables. In conclusion, the majority of patients admitted for diabetic foot infections had poor knowledge and practice of diabetic foot care. Education regarding foot care strategies should be emphasized and empowered within the diabetic population.
    Study site: Hospital Sultanah Nur Zahirah, Kuala Terengganu,Terengganu, Malaysia
    Matched MeSH terms: Hospitals, General
  17. Fulltext An audit of inpatient case records and suggestions for improvements
    Arshad AR, Ganesananthan S, Ajik S
    Med J Malaysia, 2000 Sep;55(3):331-40.
    PMID: 11200713
    A study was carried out in Kuala Lumpur Hospital to review the adequacy of documentation of bio-data and clinical data including clinical examination, progress review, discharge process and doctor's identification in ten of our clinical departments. Twenty criteria were assessed in a retrospective manner to scrutinize the contents of medical notes and subsequently two prospective evaluations were conducted to see improvement in case notes documentation. Deficiencies were revealed in all the criteria selected. However there was a statistically significant improvement in the eleven clinical data criteria in the subsequent two evaluations. Illegibility of case note entries and an excessive usage of abbreviations were noted during this audit. All clinical departments and hospitals should carry out detailed studies into the contents of their medical notes.
    Matched MeSH terms: Hospitals, General
  18. Fulltext Mixed lymphocyte culture (MLC) test and living related donor kidney transplantation
    Suleiman AB, Mohd Zaher ZM, Chan SH, Awang H
    Med J Malaysia, 1984 Mar;39(1):56-8.
    PMID: 6239969
    The MtC tests performed prospectively was correlated with graft survival in 73 living, related grafts. The MLC was expressed as the relative response (RR), and graft survival assessed at six months, one year and two years. The l-haplotype matched grafts with high RR had poorer graft survival at one and two years than those with low RR, but this difference was not statistically significant.
    Matched MeSH terms: Hospitals, General
  19. Fulltext Acute renal failure in Kuala Lumpur
    Suleiman AB, Yahya S
    Med J Malaysia, 1981 Mar;36(1):11-3.
    PMID: 7321930
    One hundred and fifty two patients were treated for acute renal failure in 1976-1978. Overall mortality was 46 (30.3 percent) and was highest among the surgical patients 15 (51.7 percent) and lowest in patients with outflow tract obstruction 2 (8.7 percent) uncontrolled sepsis was the commonest cause of death.
    Matched MeSH terms: Hospitals, General
  20. Fulltext Acute appendicitis and the leucocyte count
    Singh KJ
    Med J Malaysia, 1980 Mar;34(3):314-6.
    PMID: 7412672
    The total and differential leucocyte counts were estimated in 100 consecutive cases operated for acute appendicitis. Leucocytosis was seen in 52% of cases. 480/0 of patients had a leucocyte count below 10000 per c. mm. A study of the differential count was also made to see if this parameter could be used as a specific diagnostic aid. Though the neutrophil count was high in 74% of the cases, the comparative count among the below 10000 per c.mm. group was not significant. It is concluded that the total and differential counts are of limited value in the assessment of these patients. It is suggested that such estimation be used as a supportive aid only. In those doubtful cases with normal or low counts, frequent clinical reviews should be done and reliance placed on clinical assessment rather than laboratory information.
    Matched MeSH terms: Hospitals, General
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