Displaying publications 61 - 80 of 525 in total

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  1. Risk factors associated with adverse drug reactions in hospitalised children: international multicentre study
    Rashed AN, Wong IC, Cranswick N, Tomlin S, Rascher W, Neubert A
    Eur J Clin Pharmacol, 2012 May;68(5):801-10.
    PMID: 22166934 DOI: 10.1007/s00228-011-1183-4
    BACKGROUND: Understanding the epidemiology and risk factors of adverse drug reactions (ADRs) is important in order to develop appropriate prevention strategies. This study aimed to identify risk factors associated with ADRs in hospitalised children and recommend strategies to minimise ADRs.

    METHODS: A prospective multicentre cohort study was conducted on paediatric general medical wards in five European and non-European hospitals. ADRs were identified by intensive chart review. Multivariable logistic regression was used to investigate risk factors associated with ADRs. For the risk factor analysis, prescribed drugs were divided into high-risk and low-risk drug groups. Analgesics, anti-epileptics, antibacterials and antimycotics for systemic use, corticosteroids for systemic use and immunosuppressant agents were considered as high-risk groups whereas the remaining drug classes were defined as low-risk drug groups.

    RESULTS: A total of 1,253 paediatric patients were identified [Australia (n = 145), Germany (n = 372), Hong Kong (n = 138), Malaysia (n = 291), UK (n = 307)]. A total of 328 ADRs were observed in 16.7% of patients (186/1,115). Use of five or more low-risk drugs per patient or three or more high-risk drugs was a strong predictor for ADRs (OR 4.7, 95% CI 2.4-9.3; OR 6.5, 95% CI 2.7-16.0 respectively; p < 0.001). Older children were more likely to experience ADRs; gender was not significantly associated.

    CONCLUSION: To reduce the risk of ADRs in children, clinicians and pharmacists should aim to minimise polypharmacy and be aware of higher ADR risks associated with some drug groups.

    Matched MeSH terms: Hospitals, General
  2. Responsiveness of the Golombok Rust Inventory of Sexual Satisfaction in couples with incontinent partners
    Lim R, Liong ML, Lau YK, Yuen KH
    Eur J Obstet Gynecol Reprod Biol, 2018 Mar;222:109-112.
    PMID: 29408740 DOI: 10.1016/j.ejogrb.2018.01.024
    OBJECTIVE: In order for a measure to reliably evaluate treatment efficacy, it is important that the measure used has adequate responsiveness. However, the responsiveness of the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire, a highly recommended questionnaire by the International Consultation of Incontinence to assess sexual function in patients with incontinence, has not been established. To enable the use of GRISS to measure change in sexual function following incontinence treatment, we evaluated the short- and long-term responsiveness of the GRISS in couples with female stress urinary incontinence partners.
    STUDY DESIGN: Forty-eight couples with female stress urinary incontinence partners were included in the study. The GRISS, a 28-item multidimensional measure, comprises two sets of questionnaires to assess sexual function in both male and female partners. Responsiveness was investigated using data from our recent randomized controlled trials evaluating efficacy of pulsed magnetic stimulation for treatment of female patients with stress urinary incontinence. Effect size index and standardized response mean were used to measure responsiveness of the English and Chinese versions of GRISS.
    RESULTS: For short-term responsiveness, the overall female and male GRISS scores had effect sizes and standardized response means ranging from 0.60 to 0.83 and 0.44 to 0.78 respectively. For long-term responsiveness, the overall female and male GRISS scores had effect sizes and standardized response means ranging from 0.59 to 0.77 and 0.48 to 0.79 respectively.
    CONCLUSION: In conclusion, the English and Chinese versions of GRISS had adequate responsiveness for use in couples with incontinent partners. The GRISS can be a useful measure to detect change in sexual function of couples following treatment of females with stress urinary incontinence.
    Study site: urology or gynecology clinics, hospitals, Pulau Pinang; general population
    Matched MeSH terms: Hospitals, General
  3. Fulltext Carica papaya leaves juice significantly accelerates the rate of increase in platelet count among patients with dengue fever and dengue haemorrhagic fever
    Subenthiran S, Choon TC, Cheong KC, Thayan R, Teck MB, Muniandy PK, et al.
    Evid Based Complement Alternat Med, 2013;2013:616737.
    PMID: 23662145 DOI: 10.1155/2013/616737
    The study was conducted to investigate the platelet increasing property of Carica papaya leaves juice (CPLJ) in patients with dengue fever (DF). An open labeled randomized controlled trial was carried out on 228 patients with DF and dengue haemorrhagic fever (DHF). Approximately half the patients received the juice, for 3 consecutive days while the others remained as controls and received the standard management. Their full blood count was monitored 8 hours for 48 hours. Gene expression studies were conducted on the ALOX 12 and PTAFR genes. The mean increase in platelet counts were compared in both groups using repeated measure ANCOVA. There was a significant increase in mean platelet count observed in the intervention group (P < 0.001) but not in the control group 40 hours since the first dose of CPLJ. Comparison of mean platelet count between intervention and control group showed that mean platelet count in intervention group was significantly higher than control group after 40 and 48 hours of admission (P < 0.01). The ALOX 12 (FC  =  15.00) and PTAFR (FC  =  13.42) genes were highly expressed among those on the juice. It was concluded that CPLJ does significantly increase the platelet count in patients with DF and DHF.
    Matched MeSH terms: Hospitals, General
  4. Fulltext Impact of objective airflow measurement on assessment of asthma severity and treatment appropriateness.
    Loh LC, Koh CN
    Family Physician, 2005;13(3):10-14.
    MyJurnal
    Current asthma treatment is directed by severity of symptoms and lung function. In Malaysia, spirometry is not widely available and therefore not used in most medical consultations. In 163 asthmatic patients [mean (95% CI) age: 41 (38-44) yrs; 29% male; 32% Malays, 32% Chinese, 34% Indians] who were being followed up in a State Hospital medical outpatient clinic and a large urban-based health clinic, we studied the effect on Global Initiative for Asthma (GINA) disease severity classification and the appropriateness of currently prescribed treatment when forced expiratory volume in one second (FEV1) was considered together with symptom severity. We showed that 52% of the patients were upgraded to a higher severity classification and 71% of the patients were under-treated. If based on symptoms alone to assess severity, 39% of the patients were still under-treated. We concluded that the disease severity in many asthmatic patients might have been underestimated and therefore not adequately treated, because spirometry was not available or used to assess asthma severity. The use of spirometry should be advocated more widely among clinicians treating asthma in Malaysia.
    Study site: Hospital Tuanku Jaafar, Seremban, Negeri Sembilan; Klinik Kesihatan Seremban, Malaysia
    Matched MeSH terms: Hospitals, General
  5. The demographic and morbidity patterns seen in an outpatient department in a Malaysian General Hospital
    Chan SC
    Family Physician, 1995;7:3-10.
    This study aimed to established baseline data on patients' demographic and morbidity patterns over three months in the Outpatients Department (OPD) Ipoh Hospital. Entry of the first ten thousand patients into a computerised database for analysis showed that the majority were unemployed and from the low income group. There were more Malays and Indians, less Chinese. Respiratory infections accounted for 18.5 % while major chronic diseases (hypertension, diabetes mellitus, asthma) were common. Overall a wide spectrum of illnesses were seen. A career structure for OPD doctors and incorporation of Family Medicine concepts were proposed to improve primary care in OPD.
    Study site: Outpatients Department (OPD), Hospital Ipoh, Perak, Malaysia
    Matched MeSH terms: Hospitals, General
  6. Weekend outpatient services at an urban public primary health care facility
    Usha Devi B, Paul E, Munjeet K
    Family Physician, 2005;13:5-9.
    A study was conducted at the Outpatient Department (OPD) of Ipoh Hospital, an urban public primary healthcare facility, over a weekend, to determine the profile of patients attending the clinic, the reasons for encounter and the reasons for choosing after hours medical care. The data from this study would be useful in determining the need for and formulating a policy for after hours medical care at urban primary health care facilities in the country. The study showed there was a low proportion of acute illness in the weekend clinic. A total of 17% of the patients had an acute illness and a further 8% had aggravation of an existing illness. This group of patients requires access to weekend medical services. The main reason for choosing after hours care was social, that is the convenience of an off-day from work or school. Several options can be explored to provide after hours care, including volunteer government doctors or private general practitioners running the service. Another option is to direct public patients during the weekends to private general practitioners in their locality who will be subsidized. The cost of providing after hours care is expected to be higher. Misuse of services may have to be considered as the study showed 5 % of the patients were not ill during the encounter.

    Study site: Outpatient Department (OPD) of Hospital Ipoh
    Matched MeSH terms: Hospitals, General
  7. A six-year review of 35 cases of eclampsia at General Hospital Seremban
    Tharmaseelan NKS
    Family Physician, 1990;2:34-37.
    Matched MeSH terms: Hospitals, General
  8. Ectopic pregnancy: a three-year review at General Hospital Seremban
    Tharmaseelan NKS
    Family Physician, 1991;3:22-24.
    Matched MeSH terms: Hospitals, General
  9. Fulltext A study to compare measured and predicted creatinine clearance and its clinical applications
    Liao CM, Cheong IKS, Kong NCT
    Family Physician, 1991;3(2):31-33.
    Creatinine clearance is calculated from 24 hour urine creatinine excretion. This method of measuring creatinine clearance is cumbersome. Many formulae have been proposed as an alternative method of obtaining predicted creatinine clearance and they have all shown satisfactory results. From our study using 4 formulae, the correlation coefficient using these formulae rangedfrom 0.71 - 0.75. The correlation clearance was even better at > 0.90. We therefore advocate the routine use of these formulae for predicting creatinine clearance by clinicians.
    Study site: Nephrology clinic, Universiti Kebangsaan Malaysia unit at Hospital Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, General
  10. Acute right upper quadrant pain: Evaluation by ultrasound at the General Hospital, Kota Bharu
    Sathyamoorthy P
    Family Physician, 1992;4:20-22.
    A retrospective study of 100 patients with acute right upper quadrant pain was performed in order to indicate the diagnostic role of ultrasound including the diagnostic role of ultrasound including guided percutaneous procedures in the evaluation of such cases at the General Hospital Kota Bharu (GH, KB). In the majority of these patients the leading clinical consideration was acute cholecystitis. In all the patients the initial sonographic diagnoses were compared with the final diagnoses. In 35 patients (35%) biliary pathology was diagnosed. In this group the conographic correlation was good. In 65 patients (65%) the symptoms were due to non-biliary pathology. In this group ultrasound detected the actual site of pathology in 28%. Ultrasonography which can image multiple organs rapidly is a useful initial screening procedure in patients presenting with acute right upper quadrant pain because it can detect the actual size of pathology in about two-thirds of the cases.
    Matched MeSH terms: Hospitals, General
  11. Hysterosalpingogram in the diagnosis of tuboperitoneal abnormalities in female infertility: Experience at the General Hospital, Kota Bharu
    Sathyamoorthy P, Abdul Rahman MA
    Family Physician, 1994;6:9-11.
    Matched MeSH terms: Hospitals, General
  12. Fulltext Allergies in asthma
    Zulkifli A, Ng WH, Chelvam P
    Family Practitioner, 1979;3(5):32-34.
    148 patients, 79 males and 60 females were seen in 1978 at Medical Unit Universiti Kebangsaan Kuala Lumpur. For majority of the patients the attacks of asthma begin at an early age. History of allergies were found in majority of the patients. Family history of asthma was noted in about 50%. Of the allergens that triggers of an attack of asthma, household dusts, rhinitis and pollen tops the list. Of the food the common allergens were shrimps, eggs and crabs. Most of the above allergens can be avoided or counteracted.
    Study site: Medical Unit, Hospital Kuala Lumpur (UKM unit), Malaysia
    Matched MeSH terms: Hospitals, General
  13. Fulltext Rheumatic heart disease in referred cases: Experience at a cardiology centre
    Jamal F, Abdullah N, Zambahari R
    Family Practitioner, 1988;11(1):46-47.
    Matched MeSH terms: Hospitals, General
  14. Evaluation of reported adverse drug reactions in antibiotic usage: a retrospective study from a tertiary care hospital, Malaysia
    Arulappen AL, Danial M, Sulaiman SAS
    Front Pharmacol, 2018;9:809.
    PMID: 30177879 DOI: 10.3389/fphar.2018.00809
    Adverse drug reaction (ADR) primarily caused by many drugs including antibiotics. At present, the incidence and pattern of ADR caused by antibiotics have remained as neglected area in Malaysia. This study was conducted to determine the incidence and analyze the pattern of ADR caused by antibiotics among patients in a tertiary care hospital. It is a 2-year retrospective observational study conducted at Hospital Pulau Pinang, Malaysia. All eligible patients who had antibiotic prescribed belonging to any age group either from outpatient or inpatient that had experienced ADR was included in this study. The outcomes were measured with the aid of Naranjo's and Hartwig's scales. The incidence of the ADRs among patients prescribed with antibiotics in Hospital Pulau Pinang is about 1.1%. Vancomycin and Trimethoprim/Sulfamethoxazole both are considered to be the major contributors to ADR incidences. The skin was the most affected organ by ADRs followed by gastrointestinal system. Most of the severe ADRs were caused by Penicillin. The causality relationship of all the severe reactions was mostly probable. General Medicine unit had reported the highest number of ADRs caused by antibiotics. The common manifestations of ADRs are acute kidney injury and exanthem. In addition, majority of the ADRs caused by antibiotics were reversible. A large multicenter study is suggested to confirm the present findings.

    Study site: Hospital Pulau Pinang
    Matched MeSH terms: Hospitals, General
  15. Fulltext The Autonomic Progress Bar Motivates Treatment Completion for Patients of Stimulant Use Disorder and Cannabis Use Disorder
    Chen IC, Teng G, Chen CJ, Lan TH, Liu HJ
    Front Psychiatry, 2019;10:944.
    PMID: 31998160 DOI: 10.3389/fpsyt.2019.00944
    Background: The intrinsic motivation behind the "need to complete" is more influential than external incentives. We introduced a novel progress-bar tool to motivate the completion of programs designed to treat stimulant and cannabis use disorders. We further examined the effectiveness of the progress bar's scoring approach in forecasting consistently negative urine tests. Methods: This study's participants included 568 patients with stimulant, amphetamine-type, and cannabis use disorders who were undergoing 12-month mandatory treatment programs at Taichung Veterans General Hospital in Taiwan. Patients were given scores of 1, -1, or 0 depending on whether they received negative, positive, or missing urinalysis reports, respectively. The autonomic progress bar generated weekly score totals. At the group level, scorei donated scores from all patients for a given week (i denoted the week). Scorei was standardized to adjusted scorei. We then conducted Autoregressive Integrated Moving Average (ARIMA) Model of time-series analyses for the adjusted scorei. Results: A total of 312 patients maintained treatment progress over the 12-month program. The autonomic score calculator totaled the shared achievements of these patients. The coefficients of the lag variables for mean (p), lag variables for residual error term (q), and number of orders for ensuring stationary (d) were estimated at p = 3, d = 4, and q = 7 for the first half of the treatment program, and were estimated at p = 2, d = 2, and q = 3 for the second half. Both models were stationary and tested as fit for prediction (p < 0.05). Sharply raised adjusted scores were predicted during the high-demand treatment phase. Discussion: This study's novel progress-bar tool effectively motivated treatment completion. It was also effective in forecasting continually negative urine tests. The tool's free open-source code makes it easy to implement among many substance-treatment services.
    Matched MeSH terms: Hospitals, General
  16. INR Control of Patients with Mechanical Heart Valve on Long-Term Warfarin Therapy
    Tan CSY, Fong AYY, Jong YH, Ong TK
    Glob Heart, 2018 12;13(4):241-244.
    PMID: 30213574 DOI: 10.1016/j.gheart.2018.08.003
    BACKGROUND: Warfarin is an anticoagulant indicated for patients who had undergone mechanical heart valve(s) replacement (MHVR). In these patients, time in therapeutic range (TTR) is important in predicting the bleeding and thrombotic risks.
    OBJECTIVE: This study aimed to describe the anticoagulation control of warfarin using TTR in patients with MHVR in a tertiary health care referral Center.
    METHODS: Data were collected retrospectively by reviewing clinical notes of outpatients who attended international normalized ratio (INR) clinics in November 2015. Patients who had MHVR and who took warfarin were included. The data collected were demographics, relevant laboratory investigations, and patients' prior medical history. TTR was calculated using Rosendaal and traditional methods.
    RESULTS: A total of 103 patients with MHVR were recruited. The mean age was 51.72 ± 13.97 years and 46.6% were male. A total of 54.4% had mitral valve replacement (MVR), whereas 26.2% had aortic valve replacement (AVR). The mean TTR calculated using the Rosendaal method was 57.1%. There was no significant difference among patients with AVR, MVR, and both valves (AMVR) in terms of TTR (AVR vs. MVR vs. AMVR, 62.94 ± 23.08, 54.12 ± 21.62, 57.63 ± 17.47; p = 0.213). The average dose of warfarin for all groups was approximately 3 mg/day. Moreover, MVR, AVR, and AMVR patients who had TTR (Rosendaal method) ≤60% were 58.9%, 37.0%, and 45.0%, respectively. Only 4.8% had minor bleeding, whereas none had stroke in the period of TTR determination.
    CONCLUSIONS: Despite a majority of patients having <60% TTR, there were low incidences of bleeding and stroke events in this center. There were no factors found to be associated with INR control in this study.
    Study site: INR clinic, Sarawak Heart Centre, Sarawak General Hospital, Malaysia
    Matched MeSH terms: Hospitals, General
  17. Systemic lupus erythematosus in a tertiary, east Malaysian hospital: Admission, readmission and death
    Teh CL, Chan GYL, Lee J
    Int J Rheum Dis, 2008;11(1):24-29.
    DOI: 10.1111/j.1756-185X.2008.00325.x
    Objective: There are limited data on hospitalization of systemic lupus erythematosus (SLE) patients in Asian countries. Our aim of this study is to describe the characteristics and poor prognostic factors in our patients. Method: We performed a retrospective study of SLE hospitalization during a 1-year period (2006) in our centre. Results: There were 125 episodes of hospitalization of 79 patients with SLE. This is the first report of SLE patients from the native population of east Malaysia. The cause of admission was flare of SLE (80.8%), infection (23.2%), renal biopsy (22.4%) and others (4%). There was only one admission for thromboembolism. Patients with both flare of SLE and infection have the longest median length of stay of 11 days (IQR 5,24) requiring more intensive care therapy (P < 0.01). Readmission occurred in 31.4% and was associated with admission for other reasons during the first admission. Flare of SLE was protective against readmission (P < 0.05, OR = 0.36). There were six deaths (4.8% of admissions). The deaths were due to infection in three patients, active SLE in two and acute myocardial infarction in one. The deaths have a higher cumulative prednisolone dose than the survivals (P < 0.01). In multivariate modelling, the only predictor of death was high Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index score (P < 0.05, OR = 9.61 per increase of 1 score). Conclusion: Active disease and infection remains the main cause of admission, readmission and death in SLE patients. © 2008 Asia Pacific League of Associations for Rheumatology.
    Matched MeSH terms: Hospitals, General
  18. Fulltext Factors influencing the perception of mothers toward their children with cleft defect. [Faktor-faktor yang mempengaruhi persepsi ibu terhadap kanak-kanak dengan kecacatan klef]
    Mohd Rohaizat Hassan, Mohd Hafiz Yahya, Normala Basiron, Zairizam Zakaria, Mohd Rizam Abdul Rahman, Hazlina Mohd Miskam, et al.
    Int J Public Health Res, 2017;7(2):836-844.
    MyJurnal
    Introduction A study was conducted to determine the level of mothers' perception on children with cleft deformity and its associated factors
    Methods This was a cross sectional study involving 110 mothers with children attending the Plastic And Reconstructive Surgery Clinic. Data was gathered from a face to face interview based on a questionnaire that assesses the level of perception and its associated factors. The level of perception was evaluated from a scoring method and divided into four domains namely psychosocial, care management, treatment and education.
    Results The level of perception was high in all four domains ranged from 62% for treatment and 80% for education. Factors that were significantly associated with the level of perception were ethnicity, religion, type of cleft deformity and level of information.
    Conclusions Information regarding cleft deformity must be tailored toward mothers’ personal characteristics and type of cleft deformity to improve mothers' perception on this problem.
    Study site: Plastic And Reconstructive Surgery Clinic, Hospital Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, General
  19. Fulltext Intestinal obstruction: etiology, correlation between pre-operative and operative diagnosis
    Kadhim Jawad Obaid
    Int J Public Health Res, 2011;1(2):41-49.
    MyJurnal
    A prospective study done In al Zaafaranya General Hospital in Baghdad/Iraq In the period between April 2003 and February 2007. Ninety two patients admitted to the surgical wards diagnosed as Intestinal obstruction. The aim is to find out the possible common conditions resulting in causing this common surgical emergency. Also to compare the provisional clinical diagnosis about ischemic obstruction and the definitive post operative diagnosis. To encourage post graduate students to use their clinical abilities with the few laboratory and radiological facilities available needed to decide about the management of those patients.
    Matched MeSH terms: Hospitals, General
  20. Fulltext Socio demographic profiles of rheumatic heart disease (RHD) patients in Sabah
    Narwani Hussin, Wong, Mabelle, Liew, Houng Bang, Liau, Siow Yen
    Int J Public Health Res, 2016;6(2):736-740.
    MyJurnal
    Introduction: Rheumatic Heart Disease (RHD) has been thought as a disease of poor socioeconomic status. It is more prevalent in underdeveloped and developing countries than in developed countries. It is also common among the population with multiple social issues such as overcrowded dwellings, undernutrition, poor sanitation and suboptimal medical care. This study was done to review the socio demographic profiles of RHD patients in Hospital Queen Elizabeth (HQE) II, Kota Kinabalu, Sabah.
    Methods: A secondary data review of all patients registered under the RHD registry in HQE II for one- year starting from July 2013 to June 2014.
    Results: 204 RHD patients were included. Nearly three quarter (74.0%) were female. The mean age was 40.43 (14.75) years old. 61.1% has completed secondary
    education. 42.7% were housewives. The mean monthly income was RM 1363.83 (1297.05) which was categorized under the vulnerable income group. When they were categorized under the poverty level and the vulnerable income group, 42.6% and 76.5% of them fell under those categories respectively. The nearest health facilities to their houses were district hospitals (33.3%) with the mean distance of 9.17 km and health clinics (30.8%) with the mean distance of 4.27 km. Only 11.5% of them lived near the specialist hospitals with the mean distance of 21.32 km.
    Conclusions: Results from this review suggested that majority of RHD patients were in the low socioeconomic group with less access to health care facilities with specialist care. They are the most vulnerable groups and need to be prioritized in the specialized care program. .
    Matched MeSH terms: Hospitals, General
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