Displaying publications 61 - 80 of 1020 in total

Abstract:
Sort:
  1. Fulltext The use of end-tidal carbon dioxide monitoring in patients with hypotension in the emergency department
    Kheng CP, Rahman NH
    Int J Emerg Med, 2012;5(1):31.
    PMID: 22828152 DOI: 10.1186/1865-1380-5-31
    BACKGROUND: The aim of this study was to determine the usefulness of end tidal carbon dioxide (ETCO2) monitoring in hypotensive shock patients presenting to the ED.
    METHODS: This was a prospective observational study in a tertiary ED. One hundred three adults in shock with hypotension presenting to the ED were recruited into the study. They were grouped according to different types of shock, hypovolemic, cardiogenic, septic and others. Vital signs and ETCO2 were measured on presentation and at 30-min intervals up to 120 min. Blood gases and serum lactate levels were obtained on arrival. All patients were managed according to standard protocols and treatment regimes. Patient survival up to hospital admission and at 30 days was recorded.
    RESULTS: Mean ETCO2 for all patients on arrival was 29.07 ± 9.96 mmHg. Average ETCO2 for patients in hypovolemic, cardiogenic and septic shock was 29.64 ± 11.49, 28.60 ± 9.87 and 27.81 ± 7.39 mmHg, respectively. ETCO2 on arrival was positively correlated with systolic and diastolic BP, MAP, bicarbonate, base excess and lactate when analyzed in all shock patients. Early ETCO2 measurements were found to be significantly lower in patients who did not survive to hospital admission (p = 0.005). All patients who had ETCO2 ≤ 12mmHg died in the ED. However, normal ETCO2 does not ensure patient survival.
    CONCLUSION: The use of ETCO2 in the ED has great potential to be used as a method of non-invasive monitoring of patients in shock.
    Study site: Emergency department, Hospital Universiti Sains Malaysia
    Matched MeSH terms: Cohort Studies
  2. Fulltext Asymmetrical bone loss in a patient with poliomyelitis: an indication for anti-osteoporotic therapy
    Ratnasingam J, Ibrahim L, Paramasivam S, Lim LL, Boon AT, Vethakkan S
    Clin Cases Miner Bone Metab, 2016 05 11;13(1):61-3.
    PMID: 27252750 DOI: 10.11138/ccmbm/2016.13.1.061
    BACKGROUND: Poliomyelitis survivors suffer from post-myelitic complications including osteoporosis that are often overlooked.

    METHODS: We report a case of a 49-year-old lady with history of poliomyelitis with resultant flaccid paralysis of the involved limb.

    RESULTS: The bone mineral density revealed asymmetrical severe osteoporosis in the poliomyelitic limb. Given the risk of falls and fractures, she was commenced on oral bisphosphonate therapy.

    CONCLUSION: Poliomyelitis is an important acquired risk factor for regional osteoporosis. This condition should be detected and treated in this cohort of patients who are clearly at higher risk of fractures.

    Matched MeSH terms: Cohort Studies
  3. Fulltext Reproducibility and Relative Validity of a Short Food Frequency Questionnaire in 9-10 Year-Old Children
    Saeedi P, Skeaff SA, Wong JE, Skidmore PM
    Nutrients, 2016;8(5).
    PMID: 27164137 DOI: 10.3390/nu8050271
    The aim of this study was to assess the reproducibility and validity of a non-quantitative 28-item food frequency questionnaire (FFQ). Children aged 9-10 years (n = 50) from three schools in Dunedin, New Zealand, completed the FFQ twice and a four-day estimated food diary (4DEFD) over a two-week period. Intraclass correlation coefficients (ICC) and Spearman's correlation coefficients (SCC) were used to determine reproducibility and validity of the FFQ, respectively. Weekly intakes were estimated for each food item and aggregated into 23 food items/groups. More than half of the food items/groups (52.2%) had an ICC ≥0.5. The median SCC between FFQ administrations was 0.66 (ranging from 0.40 for processed meat to 0.82 for sweets and non-dairy drinks). Cross-classification analysis between the first FFQ and 4DEFD for ranking participants into thirds showed that breakfast cereals had the highest agreement (54.0%) and pasta the lowest (34.0%). In validity analyses, 70% of food items/groups had a SCC ≥0.3. Results indicate that the FFQ is a useful tool for ranking children according to food items/groups intake. The low respondent burden and relative simplicity of the FFQ makes it suitable for use in large cohort studies of 9-10 year-old children in New Zealand.
    Matched MeSH terms: Cohort Studies
  4. Fulltext A Modified Hopfield Neural Network Algorithm (MHNNA) Using ALOS Image for Water Quality Mapping
    Kzar AA, Mat Jafri MZ, Mutter KN, Syahreza S
    Int J Environ Res Public Health, 2016 Jan;13(1).
    PMID: 26729148 DOI: 10.3390/ijerph13010092
    Decreasing water pollution is a big problem in coastal waters. Coastal health of ecosystems can be affected by high concentrations of suspended sediment. In this work, a Modified Hopfield Neural Network Algorithm (MHNNA) was used with remote sensing imagery to classify the total suspended solids (TSS) concentrations in the waters of coastal Langkawi Island, Malaysia. The adopted remote sensing image is the Advanced Land Observation Satellite (ALOS) image acquired on 18 January 2010. Our modification allows the Hopfield neural network to convert and classify color satellite images. The samples were collected from the study area simultaneously with the acquiring of satellite imagery. The sample locations were determined using a handheld global positioning system (GPS). The TSS concentration measurements were conducted in a lab and used for validation (real data), classification, and accuracy assessments. Mapping was achieved by using the MHNNA to classify the concentrations according to their reflectance values in band 1, band 2, and band 3. The TSS map was color-coded for visual interpretation. The efficiency of the proposed algorithm was investigated by dividing the validation data into two groups. The first group was used as source samples for supervisor classification via the MHNNA. The second group was used to test the MHNNA efficiency. After mapping, the locations of the second group in the produced classes were detected. Next, the correlation coefficient (R) and root mean square error (RMSE) were calculated between the two groups, according to their corresponding locations in the classes. The MHNNA exhibited a higher R (0.977) and lower RMSE (2.887). In addition, we test the MHNNA with noise, where it proves its accuracy with noisy images over a range of noise levels. All results have been compared with a minimum distance classifier (Min-Dis). Therefore, TSS mapping of polluted water in the coastal Langkawi Island, Malaysia can be performed using the adopted MHNNA with remote sensing techniques (as based on ALOS images).
    Matched MeSH terms: Cohort Studies
  5. Fulltext Variants in 6q25.1 Are Associated with Mammographic Density in Malaysian Chinese Women
    Mariapun S, Ho WK, Kang PC, Li J, Lindström S, Yip CH, et al.
    Cancer Epidemiol Biomarkers Prev, 2016 Feb;25(2):327-33.
    PMID: 26677210 DOI: 10.1158/1055-9965.EPI-15-0746
    Mammographic density is an established risk factor for breast cancer and has a strong heritable component. Genome-wide association studies (GWAS) for mammographic density conducted in women of European descent have identified several genetic associations, but none of the studies have been tested in Asians. We sought to investigate whether these genetic loci, and loci associated with breast cancer risk and breast size, are associated with mammographic density in an Asian cohort.
    Matched MeSH terms: Cohort Studies
  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: Cohort Studies
  7. Ten-year mortality in older patients attending the emergency department after a fall
    Tan MP, Kamaruzzaman SB, Zakaria MI, Chin AV, Poi PJ
    Geriatr Gerontol Int, 2015 Jan 22.
    PMID: 25613422 DOI: 10.1111/ggi.12446
    METHODS: Information on sociodemographics, dependency using the Barthel index and fall characteristics were collected from consecutive patients attending the ED over a 6-month period. Barthel score was reassessed at 12 months. Ten-year mortality data were obtained through the National Registry Department.
    RESULTS: A total of 198 participants, with a mean age (standard deviation) of 76.2 years (6.3 years) and 74% women, were recruited. Of these, 70% sustained falls indoors, while 49% of falls occurred between 06.00 to 12.00 hours. Total Barthel scores were significantly lower at 1-year follow up compared with baseline (median [interquartile range], 20 [2] vs 18 [5], P 
    Matched MeSH terms: Cohort Studies
  8. Fulltext Multiplex amplification refractory mutation system (MARMS) for the detection of β-globin gene mutations among the transfusion-dependent β-thalassemia Malay patients in Kelantan, Northeast of Peninsular Malaysia
    Hanafi S, Hassan R, Bahar R, Abdullah WZ, Johan MF, Rashid ND, et al.
    Am J Blood Res, 2014;4(1):33-40.
    PMID: 25232503
    The aim of this study was to adapt MARMS with some modifications to detect beta mutation in our cohort of thalassemia patients. We focused only on transfusion-dependent thalassemia Malay patients, the predominant ethnic group (95%) in the Kelantanese population. Eight mutations were identified in 46 out of 48 (95.83%) beta thalassemia alleles. Most of the patients (54.2%) were compound heterozygous with co-inheritance Cd 26 (G>A). The frequencies of spectrum beta chain mutation among these patients are presented in Table 2. Among the transfusion dependent beta thalassemia Malay patients studied, 26 patients were found to be compound heterozygous and the main alleles were Cd 26 (G>A). Compound heterozygous mutation of Cd 26 (G>A) and IVS 1-5 (G>C) were 12 (46.2%), Cd 26 (G>A) and Cd 41/42 (TTCT) were 9 (34.6%), Cd 26 (G>A) and IVS 1-1 (G>C) were 2 (7.7%) respectively. Meanwhile the minority were made of a single compound heterozygous of Cd 26 (G>A) and Cd 71/72, Cd 26 (>A) and Cd 17 (A>T), Cd 26 (G>A) and -28 (G>A) respectively. Twenty out of forty six patients were shown to have homozygous of IVS 1-5 (G>C) were 2 (10.0%), Cd 26 (G>A) were 15 (75.0%), Cd 19 (A>G) were 1 (5.0%), and IVS 1-1 (G>T) were 2 (10.0%). The beta chain mutations among the Kelantanese Malays followed closely the distribution of beta chain mutations among the Thais and the Malays of the Southern Thailand. The G-C transition at position 5 of the IVS 1-5 mutation was predominant among the Malay patients. In conclusion, this method has successfully identified the mutation spectrum in our cohort of transfusion-dependent beta thalassemia patients, and this method is equally effective in screening for mutation among thalassemia patients.
    Matched MeSH terms: Cohort Studies
  9. 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: Cohort Studies
  10. Fulltext Asia Cohort Consortium: challenges for collaborative research
    Song M, Rolland B, Potter JD, Kang D
    J Epidemiol, 2012;22(4):287-90.
    PMID: 22672913 DOI: 10.2188/jea.je20120024
    In this era of chronic diseases, large studies are essential in investigating genes, environment, and gene-environment interactions as disease causes, particularly when associations are important but not strong. Moreover, to allow expansion and generalization of the results, studies should be conducted in populations outside Western countries. Here, we briefly describe the Asia Cohort Consortium (ACC), a collaborative cancer cohort research project that was first proposed in 2004 and now involves more than 1 million healthy individuals across Asia. There are approximately 50 active members from Bangladesh, China, India, Japan, Korea, Malaysia, Singapore, Taiwan, Thailand, the United States, and elsewhere. To date, the work of the ACC includes 3 articles published in 2011 on the roles of body mass index, tobacco smoking, and alcohol consumption in mortality, diabetes, and cancer of the small intestine. Many challenges remain, including data harmonization, resolution of ethical and legal issues, establishment of protocols for biologic samples and transfer agreements, and funding procurement.
    Matched MeSH terms: Cohort Studies
  11. The utility of a 'non-significant' coronary angiogram
    Wang TK, Oh TH, Samaranayake CB, Webster MW, Stewart JT, Watson T, et al.
    Int J Clin Pract, 2015 Dec;69(12):1465-72.
    PMID: 26304046 DOI: 10.1111/ijcp.12723
    Coronary angiography is the gold standard for assessing coronary artery disease (CAD). In many patients with chest pain, no or mild CAD (< 50% stenosis) is found. It is uncertain whether this 'non-significant' result influences management and outcomes. We reviewed characteristics and outcomes in a contemporary cohort of chest pain referrals who had mild or absent CAD on coronary angiography.
    Matched MeSH terms: Cohort Studies
  12. Fulltext Postpartum mental health in relation to sociocultural practices
    Abdollahi F, Etemadinezhad S, Lye MS
    Taiwan J Obstet Gynecol, 2016 Feb;55(1):76-80.
    PMID: 26927254 DOI: 10.1016/j.tjog.2015.12.008
    OBJECTIVES: Cultural practices have been found to positively impact the mothering experience. This study sought to identify the relationship between sociocultural practices and postpartum depression (PPD) in a cohort of Iranian women for the first time.
    MATERIALS AND METHODS: In a longitudinal cohort design, 2279 pregnant women attending primary health centers of Mazandaran province in Iran were recruited using stratified random sampling method. Data were collected using the Edinburgh Postnatal Depression Scale and researchers developed validated cultural practices questionnaire at 3 months after delivery. Data were analyzed using Chi-square test and multiple logistic regression models.
    RESULTS: The prevalence of PPD was 19% among 1910 women who were followed postdelivery in this study. Cultural practices were not associated with lower odds of PPD in multiple logistic regression model after adjustment for all sociodemographic factors. The results of this study do not also provide any evidence to support that sex of baby is associated with the greater risk of PPD.
    CONCLUSIONS: Cultural practices could not be perceived as protective mechanisms that protect women from PPD in this traditional society. However, health professionals should be familiar with postpartum beliefs and practices that could support mothers in the postpartum period.
    KEYWORDS: culture; depression; postpartum; practices
    Matched MeSH terms: Cohort Studies
  13. Fulltext A prospective study of tuberculosis drug susceptibility in Sabah, Malaysia, and an algorithm for management of isoniazid resistance
    Rashid Ali MR, Parameswaran U, William T, Bird E, Wilkes CS, Lee WK, et al.
    J Trop Med, 2015;2015:261925.
    PMID: 25838829 DOI: 10.1155/2015/261925
    Introduction. The burden of tuberculosis is high in eastern Malaysia, and rates of Mycobacterium tuberculosis drug resistance are poorly defined. Our objectives were to determine M. tuberculosis susceptibility and document management after receipt of susceptibility results.
    Methods. Prospective study of adult outpatients with smear-positive pulmonary tuberculosis (PTB) in Sabah, Malaysia. Additionally, hospital clinicians accessed the reference laboratory for clinical purposes during the study.
    Results. 176 outpatients were enrolled; 173 provided sputum samples. Mycobacterial culture yielded M. tuberculosis in 159 (91.9%) and nontuberculous Mycobacterium (NTM) in three (1.7%). Among outpatients there were no instances of multidrug resistant M. tuberculosis (MDR-TB). Seven people (4.5%) had isoniazid resistance (INH-R); all were switched to an appropriate second-line regimen for varying durations (4.5-9 months). Median delay to commencement of the second-line regimen was 13 weeks. Among 15 inpatients with suspected TB, 2 had multidrug resistant TB (one extensively drug resistant), 2 had INH-R, and 4 had NTM.
    Conclusions. Current community rates of MDR-TB in Sabah are low. However, INH-resistance poses challenges, and NTM is an important differential diagnosis in this setting, where smear microscopy is the usual diagnostic modality. To address INH-R management issues in our setting, we propose an algorithm for the treatment of isoniazid-resistant PTB.
    Study site: Tuberculosis clinic, Klinik Kesihatan Luyang, Kota Kinabalu, Sabah, Malaysia
    Matched MeSH terms: Cohort Studies
  14. Prevalence and characteristics associated with default of treatment and follow-up in patients with cancer
    Chan CM, Wan Ahmad WA, Md Yusof M, Ho GF, Krupat E
    Eur J Cancer Care (Engl), 2015 Nov;24(6):938-44.
    PMID: 25810106 DOI: 10.1111/ecc.12312
    Defaulting is an important issue across all medical specialties, but much more so in cancer as delayed or incomplete treatment has been shown to result in worse clinical outcomes such as treatment resistance, disease progression as well as lower survival. Our objective was to identify psychosocial variables and characteristics associated with default among cancer patients. A total of 467 consecutive adult cancer patients attending the oncology clinic at a single academic medical centre completed the Hospital Anxiety and Depression Scale and reported their preference for psychological support at baseline, 4-6 weeks and 12-18 months follow-up. Default was defined as refusal, delay or discontinuation of treatment or visit, despite the ability to do so. A total of 159 of 467 (34.0%) cancer patients were defaulters. Of these 159 defaulters, 89 (56.0%) desired psychological support, compared to only 13 (4.2%) of 308 non-defaulters. Using a logistic regression, patients who were defaulters had 52 times higher odds (P = 0.001; 95% confidence interval 20.61-134.47) of desiring psychological support than non-defaulters after adjusting for covariates. These findings suggest that defaulters should be offered psychological support which may increase cancer treatment acceptance rates and improve survival.
    Study site: Oncology clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Cohort Studies
  15. Fulltext Impulsivity, online disinhibition, and risk taking among digital millennials: challenges of e-safety in industry 4.0
    Erfianti, Levina Gendis, Nor Diana Mohd Mahudin
    Journal of Occupational Safety and Health, 2019;16(1):45-53.
    MyJurnal
    Digital Millennials (i.e., people born from 1980 to 2004) have often been portrayed as quick to embrace emerging technologies. The envisioned future of Industry 4.0 entails the blending of hardware, software, and people to complete work; and given their affinity for digital resources, technology, and social networking applications, the Millennials could be regarded as a much-needed asset in this future workforce. However, systematic research on how this cohort understands and reacts to safety issues surrounding the use of technologies has been lacking. In particular, behaviours such as impulsivity, online disinhibition, and risk-taking among them remain unclear. The present study investigated this gap with a sample of 203 Millennials of various nationality groups. Using the short version of the Urgency, Premeditation, Perseverance, Sensation Seeking, and Positive Urgency (Short UPPS-P) scale, the Revised Online Disinhibition Scale, and the Online Risky Behaviour scale, the results indicated that the most significant predictors of online risk-taking behaviours are lack of premeditation, positive urgency, and toxic disinhibition. Interestingly, though not hypothesised, was gender as a significant predictor of the outcome. The findings implied that these variables might be the most relevant target areas for interventions that could modify risky behaviours in cyberspace. The study’s findings are discussed in relation to the key challenges associated with e-safety where the future trends would be heading towards the gig economy and crowd-working.
    Matched MeSH terms: Cohort Studies
  16. Fulltext Regional variations in definitions and rates of hypoglycaemia: findings from the global HAT observational study of 27 585 people with Type 1 and insulin-treated type 2 diabetes mellitus
    Khunti K, Cigrovski Berković M, Ludvik B, Moberg E, Barner Lekdorf J, Gydesen H, et al.
    Diabet Med, 2018 May 05.
    PMID: 29729048 DOI: 10.1111/dme.13662
    AIM: To determine participant knowledge and reporting of hypoglycaemia in the non-interventional Hypoglycaemia Assessment Tool (HAT) study.

    METHODS: HAT was conducted in 24 countries over a 6-month retrospective/4-week prospective period in 27 585 adults with Type 1 or insulin-treated Type 2 diabetes mellitus. Participants recorded whether hypoglycaemia was based on blood glucose levels, symptoms or both.

    RESULTS: Hypoglycaemia rates were consistently higher in the prospective compared with the retrospective period. Most respondents (96.8% Type 1 diabetes; 85.6% Type 2 diabetes) knew the American Diabetes Association/European Association for the Study of Diabetes hypoglycaemia definition, but there were regional differences in the use of blood glucose measurements and/or symptoms to define events. Confirmed symptomatic hypoglycaemia rates were highest in Northern Europe/Canada for Type 1 diabetes (63.9 events/year) and in Eastern Europe for Type 2 diabetes (19.4 events/year), and lowest in South East Asia (Type 1 diabetes: 6.0 events/year; Type 2 diabetes: 3.2 events/year). Unconfirmed symptomatic hypoglycaemia rates were highest in Eastern Europe for Type 1 diabetes (5.6 events/year) and South East Asia for Type 2 diabetes (4.7 events/year), and lowest for both in Russia (Type 1 diabetes: 2.1 events/year; Type 2 diabetes: 0.4 events/year). Participants in Latin America reported the highest rates of severe hypoglycaemia (Type 1 diabetes: 10.8 events/year; Type 2 diabetes 3.7 events/year) and severe hypoglycaemia requiring hospitalization (Type 1 diabetes: 0.56 events/year; Type 2 diabetes: 0.44 events/year). The lowest rates of severe hypoglycaemia were reported in South East Asia (Type 1 diabetes: 2.0 events/year) and Northern Europe/Canada (Type 2 diabetes: 1.3 events/year), and the lowest rates of severe hypoglycaemia requiring hospitalization were in Russia (Type 1 diabetes: 0.15 events/year; Type 2 diabetes: 0.09 events/year). The blood glucose cut-off used to define hypoglycaemia varied between regions (Type 1 diabetes: 3.1-3.6 mmol/l; Type 2 diabetes: 3.5-3.8 mmol/l).

    CONCLUSIONS: Under-reporting of hypoglycaemia rates in retrospective recall and regional variations in participant definitions of hypoglycaemia may contribute to the global differences in reported rates. Discrepancies between participant definitions and guidelines may highlight a need to redefine hypoglycaemia criteria. (Clinical Trials Registry No: NCT01696266).
    Matched MeSH terms: Cohort Studies
  17. Fulltext Evaluating the effect of chlorpheniramine on patch test reactions amongst eczema patients sensitised to nickel
    Shafinaz, S., Chan, L.C., Adawiyah, J., Norazirah, M.N.
    Medicine & Health, 2018;13(1):71-76.
    MyJurnal
    Discontinuing antihistamines for patch testing (PT) in allergic contact dermatitis (ACD) is more conventional than evidence based. Data suggests that non-sedating antihistamines do not interfere with PT. Investigating the effects of sedating antihistamines are more relevant as these are recommended for eczema. We aimed to evaluate the effect of chlorpheniramine on PT, to determine the prevalence of nickel sensitization and common sensitizing allergens. An open labeled cohort study was conducted at two dermatology clinics. Patients indicated for PT underwent standard protocol where antihistamines were discontinued. Patients sensitised to nickel were subjected to a second nickel PT while taking chlorpheniramine. Results were evaluated using the North American Contact Dermatitis Research Group (NACDRG) score, a Mexameter measured erythema and pruritus was assessed using a visual analogue score. A total 82 patients were recruited, 28 (34.1%) were sensitised to nickel. The mean age was 40 ± 17.7 years with 22(26.8%) males and 60 (73.2%) females. Indications for PT included suspected ACD (57.3%), hand and feet eczema (34.1%) and severe eczema with suspected superimposed ACD (6.1%). The commonest sensitizing allergens were methyldibromoglutaronitrile (40.2%) nickel sulphate (34.1%), potassium dichromate (29.3%) and formaldehyde (24.4%). A second PT was performed on 23 patients. There was no difference in the NACDRG score with chlorpheniramine or without chlorpheniramine (p=0.968). Pruritus score was reduced by 1.39 ± 2.9, p=0.031 with chlorpheniramine. The degree of erythema was 611.46 ± 21.59 with chlorpheniramine versus 613.87 ± 27.5 without chlorpheniramine, p=0.671. Chlorpheniramine did not affect PT based on clinical and objective scorings. It has the additional benefit of reducing test-induced itch.
    Study site: Dermatology clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur and Hospital Pulau Pinang, Malaysia
    Matched MeSH terms: Cohort Studies
  18. Fulltext The outcomes that an interview-based medical school admission process has on academic performance, psychological health, personality traits, and emotional intelligence
    Yusoff MSB
    J Taibah Univ Med Sci, 2018 Dec;13(6):503-511.
    PMID: 31435370 DOI: 10.1016/j.jtumed.2018.09.003
    Objectives: This study investigated the outcomes that an interview-based medical school admission process has on academic performance, psychological health, personality traits, and emotional intelligence.

    Methods: A comparative cross-sectional study was conducted on the interviewed and non-interviewed cohorts. Their examination marks were obtained from the academic office, psychological health was measured by DASS-21, personality traits were measured by USMaP-15, and emotional intelligence was measured by USMEQ-17.

    Results: The interviewed cohort performed significantly better in the clinical examination than the non-interviewed cohort. Conversely, the non-interviewed cohort performed significantly better in the theoretical examination. Depression, anxiety, and stress level between the two cohorts showed no difference. The interviewed cohort demonstrated more desirable personality traits, higher emotional intelligence, and social competence than the non-interviewed cohort.

    Discussion: This study provides evidence to support the claim that the interview-based admission process has favourable outcomes on clinical performance, emotional intelligence, and personality traits. Several insights gained as a result of this study are discussed.

    Matched MeSH terms: Cohort Studies
  19. Number of blood pressure measurements needed to estimate long term visit-to-visit systolic blood pressure variability for predicting 10-year cardiovascular risk [Abstract OS 14-04]
    Lim HM, Chia YC, Ching SM
    J Hypertens, 2016 Sep;34 Suppl 1 - ISH 2016 Abstract Book:e212-e213.
    PMID: 27754047 DOI: 10.1097/01.hjh.0000500462.09000.21
    Conference abstract:
    OBJECTIVE: To determine the minimum number and duration of blood pressure(BP) measurement needed to estimate long term visit-to-visit blood pressure variability (BPV) for predicting 10-year cardiovascular (CV) risk.
    DESIGN AND METHOD: This is a 10-year retrospective cohort study of 1403 patients from a primary care clinic. Three monthly BP readings per year were retrieved from 10 years of clinic visits. Standard deviation (SD) of systolic blood pressure (SBP) was used as a measure of BPV. SD was calculated for each cumulative year of readings. CV events defined as fatal and nonfatal coronary heart disease and fatal and nonfatal stroke. We used Pearson's correlation to examine the concordance between the SD of each additional year of follow-up and SD at the end of 10 years. Multiple logistic regression was used to estimate the CV risk and compare the odd ratio (OR) between 10-year SD and SD of each additional year of follow-up.
    RESULTS: Mean SD increased with more SBP measurements for each increasing year. Pearson's correlation increased with the years of SBP measurements indicating increasing concordance with 10-year SD when more years of SBP readings was included from the baseline. With 10-year SD, the OR for CV risk was associated with an increase in SD (OR 1.121, 95% CI 1.057-1.188, p 
    Matched MeSH terms: Cohort Studies
  20. Alternate careers for medical graduates and house officers in Malaysia
    Naicker AS, Vinoshn DK, Yuliawiratman BS, Alaga A, Kevin Ng WS, Naicker MS, et al.
    Med J Malaysia, 2021 03;76(2):183-189.
    PMID: 33742626
    INTRODUCTION: In recent years, many unresolved issues pertaining to house officers in Malaysia have led to a longer waiting time and a 'glut' of medical graduates with a surprising 20% dropout amongst those who join the housemanship programme. This appears to reflect the changing times, mindsets and work expectations of millennials who comprise this cohort reflecting a need to consider possibilities of career shifts especially so in these uncertain times. This study explores the perceptions, awareness and interest in alternative career options amongst recent graduates and house officers.

    MATERIALS AND METHODS: This was a study done between 2018 and 2019 using a questionnaire which was shared on various social platforms. Data analysis was done using Excel spreadsheet.

    RESULTS: A total of 450 house officers and 657 medical graduates responded. Expectedly 66.8% claimed lifelong passion whilst another 12.1% claimed family influence as their reason to do medicine. Most were aware of their career challenges and 40% of them were keen to consider career change and reskilling indicating a possible shift from traditional expectations of a medical career.

    CONCLUSION: Whilst medicine is often considered a true calling, current challenges will require mental and emotional flexibility to explore other career opportunities. Thus, engagement programmes should be directed at medical graduates and house officers to identify and support those open to career transitions. This will help address current issues of internship bottleneck and rising dropout rates amongst internees. Early career change engagements will give them insight into their true career goals whilst opening up opportunities for those who wish to change.

    Matched MeSH terms: Cohort Studies
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links