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Fulltext Primum Non Nocere

Van Rostenberghe H

Malays J Med Sci, 2021 Feb;28(1):122-124.
PMID: 33679230 DOI: 10.21315/mjms2021.28.1.17

The coronavirus disease 2019 (COVID-19) pandemic is severe and has not shown any signs of warning up to today. Biotech companies around the world have raced to come up with an acceptable vaccine and recently two mRNA vaccines have received emergency usage authorisation from regulatory bodies in several countries. mRNA vaccines, which consist of a new and revolutionary technology have not been previously tested widely on humans. Medium- and long-term safety data are not available. While many experts seem to support the start of a mass vaccination campaign, others feel there are too many unknowns to embark on a mass vaccination campaign. Concerns include uncertainties about the long-term effects of foreign mRNA on human cellular physiology and the possibility of vaccine-enhanced disease severity, which may not be unlikely with the current disease presentation of COVID-19.

Matched MeSH terms: Severity of Illness Index
Psychometric properties of Malay neuropsychiatry unit cognitive assessment tool among Alzheimer's disease patients in comparison to Malay Montreal Cognitive Assessment

Thong KS, Chee KY, Ng CG, Walterfang M, Velakoulis D

Asia Pac Psychiatry, 2016 Sep;8(3):238-40.
PMID: 26615809 DOI: 10.1111/appy.12227

This study aims to establish psychometric properties of the Malay Neuropsychiatry Unit Cognitive Assessment Tool (Malay NuCOG) in Alzheimer's disease. NuCOG was translated to Malay language and compared with Montreal Cognitive Assessment Tool on 80 individuals. The Malay NuCOG showed good internal consistency and reliability (Cronbach's alpha = 0.895). It demonstrated 100% sensitivity and 87.5% specificity at the cutoff score of 78.50/100. The Malay NuCOG is a valid and reliable cognitive instrument that is sensitive and specific for the detection of dementia and has clinical advantages in its ability to examine individual cognitive domains.

Matched MeSH terms: Severity of Illness Index*
Fulltext Acne analysis, grading and computational assessment methods: an overview

Ramli R, Malik AS, Hani AF, Jamil A

Skin Res Technol, 2012 Feb;18(1):1-14.
PMID: 21605170 DOI: 10.1111/j.1600-0846.2011.00542.x

INTRODUCTION: This paper presents a comprehensive review of acne grading and measurement. Acne is a chronic disorder of the pilosebaceous units, with excess sebum production, follicular epidermal hyperproliferation, inflammation and Propionibacterium acnes activity. Most patients are affected with acne vulgaris, which is the prevalent type of acne. Acne vulgaris consists of comedones (whitehead and blackhead), papules, pustules, nodules and cysts.
OBJECTIVES: To review and identify the issues for acne vulgaris grading and computational assessment methods. To determine the future direction for addressing the identified issues.
METHODS: There are two main methods of assessment for acne severity grading, namely, lesion counting and comparison of patient with a photographic standard. For the computational assessment method, the emphasis is on computational imaging techniques.
RESULTS: Current acne grading methods are very time consuming and tedious. Generally, they rely on approximation for counting lesions and hence the assessment is quite subjective, with both inter and intra-observer variability. It is important to accurately assess acne grade to evaluate its severity as this influences treatment selection and assessment of response to therapy. This will further help in better disease management and more efficacious treatment.
CONCLUSION: Semi-automated or automated methods based on computational imaging techniques should be devised for acne grade assessment.

Matched MeSH terms: Severity of Illness Index*
Self reported pain severity among multiethnic older Singaporeans: does adjusting for reporting heterogeneity matter?

Chan A, Malhotra C, Do YK, Malhotra R, Ostbye T

Eur J Pain, 2011 Nov;15(10):1094-9.
PMID: 21646030 DOI: 10.1016/j.ejpain.2011.05.006

The objective of this paper is to test and correct for systematic differences in reporting of pain severity among older adults by age, gender, ethnic group and socio-economic status using anchoring vignettes. Data from a national survey of community-dwelling older Singaporeans (aged 60 years and over) conducted in 2009 was used. Respondents were asked to rate the severity of their own pain as well as that of others described in the vignettes on a five-point scale ranging from none to extreme. An ordered probit model was used to estimate the coefficients of the independent variables (age, gender, ethnic group, education, housing type) on self-reported pain. Reporting heterogeneity in pain severity was then corrected using a Hierarchical Ordered Probit model. The results showed that before correcting for reporting heterogeneity, women, those older, and those of Malay ethnicity reported greater severity of pain, while there was no association of reported pain severity with housing type and education. However, after correcting for reporting heterogeneity, while women and those older were found to have an even greater severity of pain than what they had reported, Malays were found to have a lower severity of pain than what they had reported. We conclude that there are systematic differences in reporting pain severity by age, gender and ethnic group. We propose that pain management may be improved if medical professionals take into account reporting heterogeneity for pain severity among various population sub-groups in Singapore.

Matched MeSH terms: Severity of Illness Index*
Analysis of retinal fundus images for grading of diabetic retinopathy severity

Ahmad Fadzil MH, Izhar LI, Nugroho H, Nugroho HA

Med Biol Eng Comput, 2011 Jun;49(6):693-700.
PMID: 21271293 DOI: 10.1007/s11517-011-0734-2

Diabetic retinopathy (DR) is a sight threatening complication due to diabetes mellitus that affects the retina. In this article, a computerised DR grading system, which digitally analyses retinal fundus image, is used to measure foveal avascular zone. A v-fold cross-validation method is applied to the FINDeRS database to evaluate the performance of the DR system. It is shown that the system achieved sensitivity of >84%, specificity of >97% and accuracy of >95% for all DR stages. At high values of sensitivity (>95%), specificity (>97%) and accuracy (>98%) obtained for No DR and severe NPDR/PDR stages, the computerised DR grading system is suitable for early detection of DR and for effective treatment of severe cases.

Matched MeSH terms: Severity of Illness Index*
Analysis of foveal avascular zone in colour fundus images for grading of diabetic retinopathy severity

Ahmad Fadzil M, Ngah NF, George TM, Izhar LI, Nugroho H, Adi Nugroho H

Annu Int Conf IEEE Eng Med Biol Soc, 2010;2010:5632-5.
PMID: 21097305 DOI: 10.1109/IEMBS.2010.5628041

Diabetic retinopathy (DR) is a sight threatening complication due to diabetes mellitus that affects the retina. At present, the classification of DR is based on the International Clinical Diabetic Retinopathy Disease Severity. In this paper, FAZ enlargement with DR progression is investigated to enable a new and an effective grading protocol DR severity in an observational clinical study. The performance of a computerised DR monitoring and grading system that digitally analyses colour fundus image to measure the enlargement of FAZ and grade DR is evaluated. The range of FAZ area is optimised to accurately determine DR severity stage and progression stages using a Gaussian Bayes classifier. The system achieves high accuracies of above 96%, sensitivities higher than 88% and specificities higher than 96%, in grading of DR severity. In particular, high sensitivity (100%), specificity (>98%) and accuracy (99%) values are obtained for No DR (normal) and Severe NPDR/PDR stages. The system performance indicates that the DR system is suitable for early detection of DR and for effective treatment of severe cases.

Matched MeSH terms: Severity of Illness Index*
Lupus organ damage: what is damaged in Asian patients?

Kuan WP, Li EK, Tam LS

Lupus, 2010 Oct;19(12):1436-41.
PMID: 20947554 DOI: 10.1177/0961203310370050

Assessment of organ damage has become the standard outcome measure for morbidity and mortality in patients with lupus. Ethnicity is thought to be a marker for genetic, environmental, behavioral, and other variables that may affect disease outcomes. Previous studies suggest that Asians residing in western countries had significantly higher prevalence of damage compared with Whites. In contrast, studies performed in Chinese, Korean and Arab patients showed that the overall prevalence of damage and the most commonly involved organs (neuropsychiatric and musculoskeletal) were similar to Whites. Compared with their Asian counterparts, Pakistani and Jewish patients appeared to have a higher prevalence of damage, most likely secondary to longer disease duration. Chinese patients had an increased prevalence of premature gonadal failure, whereas patients residing in western and southern Asia had more skin damage. When compared with Whites, Asian patients had more renal damage but less ocular and cardiovascular damage. Risk factors associated with organ damage in Asian lupus patients included older age, higher disease activity, and the use of cyclophosphamide and steroids. Further investigations into other determinants such as genetic predisposition, socioeconomic factors, prevalence and severity of disease manifestations, and treatment, is needed in order to understand the variation in damage accrual in lupus patients from different ethnicities.

Matched MeSH terms: Severity of Illness Index*
Validity and reliability of the Malay version of WHOQOL-HIV BREF in patients with HIV infection

Saddki N, Noor MM, Norbanee TH, Rusli MA, Norzila Z, Zaharah S, et al.

AIDS Care, 2009 Oct;21(10):1271-8.
PMID: 20024703 DOI: 10.1080/09540120902803216

This study determines the validity and reliability of the Malay version of the World Health Organization Quality of Life (WHOQOL) assessment instrument in patients with human immunodeficiency virus (HIV) infection. A cross-sectional study on 157 patients with HIV seen at the Infectious Disease Unit, Hospital Raja Perempuan Zainab II, Kota Bharu, Kelantan was conducted. Factor analysis identified five major domains: physical needs, spirituality, social relationship, psychological, and environment. Significant correlation was found between each domain scores and the general health questions. The instrument was able to discriminate between asymptomatic and symptomatic HIV positive patients for all domain scores except for the spirituality domain. The internal consistency of the five domains ranged from 0.70 to 0.83. The intraclass correlation coefficient (ICC) ranged from 0.60 to 0.87 across all domains. In conclusion, the Malay version of WHOQOL-HIV BREF is a valid and reliable instrument in assessing quality of life in HIV positive patients.

Matched MeSH terms: Severity of Illness Index*
Prediction of severe hyperbilirubinaemia using the Bilicheck transcutaneous bilirubinometer

Boo NY, Ishak S

J Paediatr Child Health, 2007 Apr;43(4):297-302.
PMID: 17444833

To determine the sensitivity and specificity of different levels of bilirubin measured by the transcutaneous bilirubinometer Bilicheck on forehead and sternum for predicting severe hyperbilirubinaemia of total serum bilirubin (TSB)>or=300 micromol/L in Malay, Chinese and Indian infants.

Matched MeSH terms: Severity of Illness Index*
Multimodal physiotherapeutic management for stage-IV osteitis pubis in a 15-year old soccer athlete: a case report

Vijayakumar P, Nagarajan M, Ramli A

J Back Musculoskelet Rehabil, 2012;25(4):225-30.
PMID: 23220803 DOI: 10.3233/BMR-2012-0337

Osteitis pubis among soccer athletes is a disabling painful condition and it is difficult to manage without integrating a multimodal treatment approach. There is limited scientific evidence on the effectiveness of exercise in treating Osteitis pubis especially when it progress to a chronic painful condition. The purpose of this case report is to discuss the successful multimodal physiotherapeutic management for a 15-year old soccer athlete diagnosed with stage-IV Osteitis pubis. Land and water based active core muscle strengthening exercises, Proprioceptive neuromuscular facilitation techniques (PNF) and Manual Therapy are some of the essential components incorporated in multimodal intervention approach with emphasis to water based strength and endurance training exercises. The athlete was able to make progress to a successful recovery from his chronic painful condition and accomplished the clearly established clinical outcomes during each phase of rehabilitation.

Matched MeSH terms: Severity of Illness Index*
Fulltext Biomarkers of severe dengue disease - a review

John DV, Lin YS, Perng GC

J Biomed Sci, 2015;22:83.
PMID: 26462910 DOI: 10.1186/s12929-015-0191-6

Dengue virus infection presents a wide spectrum of manifestations including asymptomatic condition, dengue fever (DF), or severe forms, such as dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) in affected individuals. The early prediction of severe dengue in patients without any warning signs who may later develop severe DHF is very important to choose appropriate intensive supportive therapy since available vaccines for immunization are yet to be approved. Severe dengue responses include T and B cell activation and apoptosis, cytokine storm, hematologic disorders and complement activation. Cytokines, complement and other unidentified factors may transiently act on the endothelium and alter normal fluid barrier function of the endothelial cells and cause plasma leakage. In this review, the host factors such as activated immune and endothelial cells and their products which can be utilized as biomarkers for severe dengue disease are discussed.

Matched MeSH terms: Severity of Illness Index*
Loss of Control as a Discriminating Factor Between Different Latent Classes of Disordered Gambling Severity

James RJ, O'Malley C, Tunney RJ

J Gambl Stud, 2016 Dec;32(4):1155-1173.
PMID: 26892198

Analyses of disordered gambling assessment data have indicated that commonly used screens appear to measure latent categories. This stands in contrast to the oft-held assumption that problem gambling is at the extreme of a continuum. To explore this further, we report a series of latent class analyses of a number of prevalent problem gambling assessments (PGSI, SOGS, DSM-IV Pathological Gambling based assessments) in nationally representative British surveys between 1999 and 2012, analysing data from nearly fifty thousand individuals. The analyses converged on a three class model in which the classes differed by problem gambling severity. This identified an initial class of gamblers showing minimal problems, a additional class predominantly endorsing indicators of preoccupation and loss chasing, and a third endorsing a range of disordered gambling criteria. However, there was considerable evidence to suggest that classes of intermediate and high severity disordered gamblers differed systematically in their responses to items related to loss of control, and not simply on the most 'difficult' items. It appeared that these differences were similar between assessments. An important exception to this was one set of DSM-IV criteria based analyses using a specific cutoff, which was also used in an analysis that identified an increase in UK problem gambling prevalence between 2007 and 2010. The results suggest that disordered gambling has a mixed latent structure, and that present assessments of problem gambling appear to converge on a broadly similar construct.

Matched MeSH terms: Severity of Illness Index*
Reliability and validity of the International Prostate Symptom Score in a Malaysian population

Quek KF, Low WY, Razack AH, Loh CS

BJU Int, 2001 Jul;88(1):21-5.
PMID: 11446839

OBJECTIVE: To validate the English version of the International Prostate Symptom Score (IPSS) in patients with and without urinary symptoms in a Malaysian population.
PATIENTS AND METHODS: Validity and reliability were assessed in patients with lower urinary tract symptoms (LUTS) and in patients with no LUTS. Reliability was evaluated using the test-retest method and internal consistency using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate (TURP).
RESULTS: Internal consistency was excellent; there was a high degree of internal consistency for each of the seven domains and for the total score (Cronbach's alpha > or = 0.60 and > or = 0.79, respectively) in the populations studied. The test-retest correlation coefficient for the seven domain scores was highly significant. The intra-class correlation coefficient was high (> or = 0.59). There was a high level of sensitivity and specificity for the effects of treatment, with a very significant change between the seven scores domains in the treated group but not in the control group.
CONCLUSIONS: The IPSS is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.

Matched MeSH terms: Severity of Illness Index*
Fulltext The performance properties of the International Index of Erectile Function (IIEF-15) in assessing erectile dysfunction in patients with lower urinary tract symptoms

Quek KF, Low WY, Razack AH, Chua CB, Loh CS, Dublin N

Med J Malaysia, 2002 Dec;57(4):445-53.
PMID: 12733169

To validate the International Index of Erectile Function (IIEF-15) in Malaysian population. Reliability and internal consistency were evaluated using the test-retest method and Cronbach's alpha. Sensitivity to change was expressed as the effect size index. Internal consistency was excellent (Cronbach's alpha value = 0.75 to 0.90) Test-retest correlation coefficient and intraclass correlation coefficient were highly significant (ICC = 0.75 and above) and a high degree of sensitivity and specificity was observed. The IIEF-15 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.

Matched MeSH terms: Severity of Illness Index*
Fulltext APACHE II: preliminary report on 100 intensive care unit cases in University Hospital, Kuala Lumpur

Teoh GS, Mah KK, Majid S, Streram, Yee MK

Med J Malaysia, 1991 Mar;46(1):72-81.
PMID: 1836042

A good overall assessment of the severity of illnesses of patients admitted to a general intensive care unit (ICU) is not without problems. The APACHE (acute physiology and chronic health evaluation) prognostic scoring system enables us to stratify acutely ill patients and compare efficiency of ICU therapy in different hospitals. This preliminary study carried out on 100 consecutive admissions to the ICU in University Hospital, Kuala Lumpur showed the spectrum of ICU admissions and the direct relationship between APACHE II score and mortality.

Matched MeSH terms: Severity of Illness Index*
Fulltext Factors associated with the severity of hypertension among Malaysian adults

Mahadir Naidu B, Mohd Yusoff MF, Abdullah S, Musa KI, Yaacob NM, Mohamad MS, et al.

PLoS One, 2019;14(1):e0207472.
PMID: 30605462 DOI: 10.1371/journal.pone.0207472

High blood pressure is a worldwide problem and major global health burden. Whether alone or combined with other metabolic diseases, high blood pressure increases the risk of cardiovascular disease. This study is a secondary data analysis from the National Health and Morbidity Survey 2015, a population-based study that was conducted nationwide in Malaysia using a multi-stage stratified cluster sampling design. A total of 15,738 adults ≥18-years-old were recruited into the study, which reports the prevalence of hypertension stages among adults in Malaysia using the JNC7 criteria and determinants of its severity. The overall prevalence of raised blood pressure was 66.8%, with 45.8% having prehypertension, 15.1% having Stage 1 hypertension, and 5.9% having Stage 2 hypertension. In the multivariate analysis, a higher likelihood of having prehypertension was observed among respondents with advancing age, males (OR = 2.74, 95% CI: 2.41-3.12), Malay ethnicity (OR = 1.21, 95% CI: 1.02-1.44), lower socioeconomic status, and excessive weight. The factors associated with clinical hypertension (Stages 1 and 2) were older age, rural residency (Stage 1 OR = 1.22, Stage 2 OR = 1.28), Malay ethnicity (Stage 2 OR = 1.64), diabetes (Stage 2 OR = 1.47), hypercholesterolemia (Stage 1 OR = 1.34, Stage 2 OR = 1.82), being overweight (Stage 1 OR = 2.86, Stage 2 OR = 3.44), obesity (Stage 1 OR = 9.01, Stage 2 OR = 13.72), and lower socioeconomic status. Almost 70% of Malaysian adults are at a risk of elevated blood pressure. The highest prevalence was in the prehypertension group, which clearly predicts a future incurable burden of the disease. Public health awareness, campaigns through mass and social media, and intervention in the work place should be a priority to control this epidemic.

Matched MeSH terms: Severity of Illness Index*
Fulltext Risk-adjusted surgical audit with the POSSUM scoring system in a developing country. Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity

Yii MK, Ng KJ

Br J Surg, 2002 Jan;89(1):110-3.
PMID: 11851674

BACKGROUND: The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is an objective and appropriate scoring system for risk-adjusted comparative general surgical audit. This score was devised in the UK and has been used widely, but application of POSSUM to centres outside the UK has been limited, especially in developing countries. This prospective study validated its application in a surgical practice with a different population and level of resources.
METHODS: All general surgical patients who were operated on under regional or general anaesthesia as inpatients over a 4-month period at Sarawak General Hospital in 1999 were entered into the study. All data (12 physiological and six operative factors) were analysed for mortality only with the POSSUM equation and the modified Portsmouth POSSUM (P-POSSUM) equation. Comparisons were made between predicted and observed mortality rates according to four groups of risk: 0-4, 5-14, 15-49 and 50 per cent or more using the 'linear' method of analysis.
RESULTS: There were 605 patients who satisfied the criteria for the study. Some 56.7 per cent of patients were in the lowest risk group. The POSSUM predictor equation significantly overestimated the mortality in this group, by a factor of 9.3. The overall observed mortality rate was 6.1 per cent and, again, the POSSUM predictor equation overestimated it at 10.5 per cent (P < 0.01). In contrast, the observed and predicted mortality rates for all risk groups, including the predicted overall mortality rate of 4.8 per cent, were comparable when the P-POSSUM predictor equation was used.
CONCLUSION: The POSSUM scoring system with the modified P-POSSUM predictor equation for mortality was applicable in Malaysia, a developing country, for risk-adjusted surgical audit. This scoring system may serve as a useful comparative audit tool for surgical practice in many geographical locations.

Matched MeSH terms: Severity of Illness Index*
Fulltext Reliability and validity of the Malay version of the International Index of Erectile Function (IIEF-15) in the Malaysian population

Quek KF, Low WY, Razack AH, Chua CB, Loh CS

Int J Impot Res, 2002 Aug;14(4):310-5.
PMID: 12152122

The objective of this study was to validate the Malay version of the International Index of Erectile Function (IIEF-15) in patients with lower urinary tract symptoms. Reliability and validity was assessed by using the test-retest while Cronbach's alpha was used to assess internal consistency. Effect size 5was evaluated to assess the sensitivity to change in the pre-transurethral resection of the prostate (TURP) vs post-TURP. Internal consistency was excellent. A high degree of internal consistency was observed for each of the 15 items and five domains (Cronbach's alpha value=0.56 and higher and 0.74 and higher, respectively). Test-retest correlation coefficient for the 15 items and domains scores showed no significant changes. Intraclass correlation coefficient for 15 items and domains were high (ICC=0.59 and above). It can be concluded that the Mal-IIEF-15 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.

Matched MeSH terms: Severity of Illness Index*
Fulltext The Site of Airway Collapse in Sleep Apnea, Its Associations with Disease Severity and Obesity, and Implications for Mechanical Interventions

Sung CM, Tan SN, Shin MH, Lee J, Kim HC, Lim SC, et al.

Am J Respir Crit Care Med, 2021 07 01;204(1):103-106.
PMID: 33826879 DOI: 10.1164/rccm.202011-4266LE
Matched MeSH terms: Severity of Illness Index*
Characterization and classification of asthmatic wheeze sounds according to severity level using spectral integrated features

Nabi FG, Sundaraj K, Lam CK, Palaniappan R

Comput Biol Med, 2019 01;104:52-61.
PMID: 30439599 DOI: 10.1016/j.compbiomed.2018.10.035

OBJECTIVE: This study aimed to investigate and classify wheeze sounds of asthmatic patients according to their severity level (mild, moderate and severe) using spectral integrated (SI) features.
METHOD: Segmented and validated wheeze sounds were obtained from auscultation recordings of the trachea and lower lung base of 55 asthmatic patients during tidal breathing manoeuvres. The segments were multi-labelled into 9 groups based on the auscultation location and/or breath phases. Bandwidths were selected based on the physiology, and a corresponding SI feature was computed for each segment. Univariate and multivariate statistical analyses were then performed to investigate the discriminatory behaviour of the features with respect to the severity levels in the various groups. The asthmatic severity levels in the groups were then classified using the ensemble (ENS), support vector machine (SVM) and k-nearest neighbour (KNN) methods.
RESULTS AND CONCLUSION: All statistical comparisons exhibited a significant difference (p 

Matched MeSH terms: Severity of Illness Index*

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