Displaying publications 61 - 80 of 178 in total

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  1. Ravindran J, Shamsuddin K, Selvaraju S
    Med J Malaysia, 2003 Mar;58(1):37-53.
    PMID: 14556325
    Identification of pregnancies that are at greater than average risk is a fundamental component of antenatal care. The objective of this study was to assess the level of appropriate management and outcomes among mothers with hypertensive disorders of pregnancy, postdates and anemia in pregnancy, and to determine whether the colour coding system had any effect on the maternal mortality ratios. A retrospective follow-through study confined to users of government health services in Peninsular Malaysia was carried out in 1997. The study areas were stratified according to their high or low maternal mortality ratios. The study randomly sampled 1112 mothers out of 8388 mothers with the three common obstetric problems in the selected study districts. The study showed that the prevalence of anemia, hypertensive disorders in pregnancy and postmaturity among mothers with these conditions were according to known international standards. There was no significant difference in the colour coding practices between the high and low maternal mortality areas. Inappropriate referrals were surprisingly lower in the areas with high maternal mortality. Inappropriate care by diagnosis and by assigned colour code were significantly higher in the areas with high maternal mortality. The assigned colour code was accurate in only 56.1% of cases in the low maternal mortality areas and in 55.8% of the cases in the high maternal mortality areas and these two areas did not differ significantly in their accurate assignment of the colour codes. The colour coding system, as it exists now should be reviewed. Instead, a substantially revised system that takes cognisance of evidence in the scientific literature should be used to devise a more effective system that can be used by health care personnel involved in antenatal care to ensure appropriate level of care and referrals.
    Matched MeSH terms: Medical Records/classification*
  2. Nor-Farahain Yahya, Noraida Omar, Ummi-Nadira Daut, Siti-Nur’Asyura Adznam, Barakatun-Nisak Mohd Yusof
    MyJurnal
    Introduction: Chronic obstructive pulmonary disease (COPD) patients usually have dietary problems leading to malnutrition issues. Therefore, this study aimed to determine macro and micronutrient intakes and meal-related sit- uations among outpatients COPD elderly and its adequacy according to their requirements. Methods: 140 patients were included in this cross-sectional study at Respiratory Clinics of Hospital Serdang and Institut Perubatan Respira- tori. Socio-demographic and health status data were collected by interviewing patients and reviewing their medical records. A three-day diet history (two-day on weekdays, one day on weekend) was analysed using Nutritionist Pro and compared against their requirements. Meal-related situation was assessed using three open-ended questions that related to food shopping, cooking and eating and analysed using content analysis. Results: Patients were 70±7 years old, 97% male, 59% Malay, 48% had primary education, 75% married, 72% ex-smokers and 54% presented with comorbidities. Majority of them had no episode of exacerbation for the past one year and in moderate stage of the COPD severity. Mean energy intake was 916±221 kcal/day with 98% of them have under-reported their intake. Almost all patients had inadequate macro and micronutrient intake; energy (97%), protein (97%), carbohydrate (86%), fat (99%), vitamin A (95%), C (86%), D (99%) and E (99%). The meal-related situation reported patients had difficulties with food shopping and preparation and problems during mealtime. Conclusion: COPD elderly reported inadequate intake of macro and micronutrients and had problems during mealtime. This indicates the need for Ma- laysian nutrition guidelines specific to COPD patients and nutrition intervention in the primary setting.
    Matched MeSH terms: Medical Records
  3. Lam, C.S., Mushawiahti, M., Bastion, M.L.C.
    MyJurnal
    Subluxation or dislocation of PCIOL is one of the complications of cataract operation in RP patients. This paper reports the presentation of PCIOL dislocation and subluxation and the management and outcome in 3 eyes of 2 RP patients. Two medical records of patients with RP who developed dislocated or subluxated PCIOL and subsequently underwent explantation of the dropped IOL were evaluated. Two patients had bilateral eye cataract operation done and had PCIOL implanted. Patient 1 developed left eye subluxated PCIOL inferiorly after 2 years of the cataract operation and right eye dislocated PCIOL anteriorly 4 years after cataract operation. Patient 2 develop right eye subluxated PCIOL inferiorly after 12 years of the cataract operation. Patient 1 with right eye dislocated PCIOL underwent intraocular lens (IOL) explantation and was left aphakic as her visual prognosis was poor due to advanced RP. The left IOL remained within the visual axis despite subluxation and no intervention has been done. Patient 2 with right eye subluxated PCIOL underwent IOL explantation and anterior chamber intraocular lens (ACIOL) implantation. ACIOL remained stable and visual acuity improved post-operation. Both the operations were uneventful. Post-operatively, there was no elevated intraocular pressure and no prolonged ocular inflammation, which required prolonged anti-inflammatory and no retinal detachment was seen. Both patient and surgeon should be aware of potential PCIOL subluxation or dislocation in RP. The presentation may be as late as more than a decade after the cataract operation.
    Matched MeSH terms: Medical Records
  4. Atif M, Sulaiman SA, Shafie AA, Babar ZU
    Public Health, 2015 Jun;129(6):777-82.
    PMID: 25999175 DOI: 10.1016/j.puhe.2015.04.010
    BACKGROUND: Despite evidence of an association between tuberculosis (TB) treatment outcomes and the performance of national tuberculosis programmes (NTP), no study to date has rigorously documented the duration of treatment among TB patients. As such, this study was conducted to report the durations of the intensive and continuation phases of TB treatment and their predictors among new smear-positive pulmonary tuberculosis (PTB) patients in Malaysia.
    STUDY DESIGN: Descriptive, non-experimental, follow-up cohort study.
    METHODS: This study was conducted at the Chest Clinic of Penang General Hospital between March 2010 and February 2011. The medical records and TB notification forms of all new smear-positive PTB patients, diagnosed during the study period, were reviewed to obtain sociodemographic and clinical data. Based on standard guidelines, the normal benchmarks for the durations of the intensive and continuation phases of PTB treatment were taken as two and four months, respectively. A patient in whom the clinicians decided to extend the intensive phase of treatment by ≥2 weeks was categorized as a case with a prolonged intensive phase. The same criterion applied for the continuation phase. Multiple logistic regression analysis was performed to find independent factors associated with the duration of TB treatment. Data were analyzed using Predictive Analysis Software Version 19.0.
    RESULTS: Of the 336 patients included in this study, 261 completed the intensive phase of treatment, and 226 completed the continuation phase of treatment. The mean duration of TB treatment (n = 226) was 8.19 (standard deviation 1.65) months. Half (49.4%, 129/261) of the patients completed the intensive phase of treatment in two months, whereas only 37.6% (85/226) of the patients completed the continuation phase of treatment in four months. On multiple logistic regression analysis, being a smoker, being underweight and having a history of cough for ≥4 weeks at TB diagnosis were found to be predictive of a prolonged intensive phase of treatment. Diabetes mellitus and the presence of lung cavities at the start of treatment were the only predictors found for a prolonged continuation phase of treatment.
    CONCLUSIONS: The average durations of the intensive and continuation phases of treatment among PTB patients were longer than the targets recommended by the World Health Organization. As there are no internationally agreed criteria, it was not possible to judge how well the Malaysian NTP performed in terms of managing treatment duration among PTB patients.
    KEYWORDS: Duration of continuation phase; Duration of intensive phase; Duration of tuberculosis treatment; Malaysia; Penang; Smear-positive pulmonary tuberculosis
    Matched MeSH terms: Medical Records
  5. Lee, Wen Jih, Ong, Lieh Yan, Koay, Siew Ni, Kwan, Zuan Er
    MyJurnal
    Objective: The main aim of this study is to assess the prevalence of early
    readmissions to inpatient care in Hospital Bahagia Ulu Kinta and the associated
    socio-demographic and clinical factors.

    Methods: This is an observational study
    for all patients with readmissions within 3 months from the last discharge, dated
    from 1 January 2013 to 31 December 2013. Related socio-demographic and
    clinical details are obtained from the medical records and compared between the
    patients who were readmitted within the first month after discharge to those who
    were readmitted later in the second and third month.

    Results: Total of 149
    records of patients who were readmitted within 3 months of last discharge were
    analyzed. Majority of them were from the same state of Perak (83.9%), male
    (74.5%), single (71.1%), unemployed (85.9%), taken care by family (75.2%),
    achieved secondary education level (59.7%) with mean age of 37.89 years (SD
    11.53). They were discharged for a mean of 32.52 days (SD 26.48) before
    readmission with a mean duration of 72.98 days in the previous admission, and
    mean previous admissions of 10.17 times. 69.8% of the patients were treated for
    psychotic disorders and the main reason for readmission was relapse (84.6%).
    Up to 34.2% of the patients reported to have substance abuse while 25.5% had
    medical co-morbidities. Most of the patients (63.8%) were not compliant to the
    treatment from the last discharge. Socioeconomic and clinical factors did not
    show statistical significance when the readmissions within the first month after
    discharge were compared to those who were admitted later at the second and
    third month.

    Conclusions: Due to limitations, further studies need to be done to
    identify risk factors associated with readmissions and adequate measures need to
    be taken to prevent these readmissions.
    Matched MeSH terms: Medical Records
  6. Danaraj TJ, LaBrooy EB
    Singapore Med J, 1960 Mar;1(1):16-32.
    PMID: 13719549
    Six cases of Ebstein's malformation are reported. The notable clinical features seen in four patients were gross enlargement of the
    heart, venous congestion and marked hepatosplenomegaly. There was complete heart block in one patient and auricular fibrillation in the remaining three. The unusual pathologic features in the four cases that came to necropsy were the large pericardial effusions associated with the cardiomegaly, the absence of an atrial septal defect or patent foramen ovale, the gross enlargement of liver with cirrhotic changes and the large spleen. Histologic examination of heart muscle revealed certain unusual features which are described.
    Matched MeSH terms: Medical Records*
  7. Aljunid S, Maimaiti N, Ahmed Z, Muhammad Nur A, Md Isa Z, Azmi S, et al.
    Value Health Reg Issues, 2014 May;3:146-155.
    PMID: 29702920 DOI: 10.1016/j.vhri.2014.04.008
    OBJECTIVE: To assess the cost-effectiveness of introducing pneumococcal polysaccharide and nontypeable Haemophilus influenzae protein D conjugate vaccine (PHiD-CV) in the National Immunization Programme of Malaysia. This study compared introducing PHiD-CV (10 valent vaccine) with current no vaccination, as well as against the alternative 13-valent pneumococcal conjugate vaccine (PCV13).

    METHODS: A lifetime Markov cohort model was adapted using national estimates of disease burden, outcomes of pneumococcal disease, and treatment costs of disease manifestations including pneumonia, acute otitis media, septicemia, and meningitis for a hypothetical birth cohort of 550,000 infants. Clinical information was obtained by review of medical records from four public hospitals in Malaysia from the year 2008 to 2009. Inpatient cost from the four study hospitals was obtained from a diagnostic-related group-based costing system. Outpatient cost was estimated using clinical pathways developed by an expert panel. The perspective assessed was that of the Ministry of Health, Malaysia.

    RESULTS: The estimated disease incidence was 1.2, 3.7, 70, and 6.9 per 100,000 population for meningitis, bacteremia, pneumonia, and acute otitis media, respectively. The Markov model predicted medical costs of Malaysian ringgit (RM) 4.86 billion (US $1.51 billion) in the absence of vaccination. Vaccination with PHiD-CV would be highly cost-effective against no vaccination at RM30,290 (US $7,407) per quality-adjusted life-year gained. On comparing PHiD-CV with PCV13, it was found that PHiD-CV dominates PCV13, with 179 quality-adjusted life-years gained while saving RM35 million (US $10.87 million).

    CONCLUSIONS: It is cost-effective to incorporate pneumococcal vaccination in the National Immunization Programme of Malaysia. Our model suggests that PHiD-CV would be more cost saving than PCV13 from the perspective of the Ministry of Health of Malaysia.

    Study site: UKM Medical Centre, Hospital Kuala Lumpur, Hospital
    Alor Setar, and Hospital Queen Elizabeth, Kota Kinabalu
    Matched MeSH terms: Medical Records
  8. Wong SS, Ng CJ, Liew SM, Hussein N
    Diabetes Res Clin Pract, 2012 Feb;95(2):e41-4.
    PMID: 22119614 DOI: 10.1016/j.diabres.2011.11.001
    We conducted a six-month randomized-controlled-trial to evaluate the effectiveness of a colour-coded HbA1c-graphical record in improving HbA1c level among type 2 diabetes patients. There was an improvement in the mean HbA1c knowledge score but the usage of the colour-coded HbA1c-graphical record did not produce reduction in the HbA1c level.
    Study site: Primary care clinic, University Malaya Medical Centre, Kuala Lumpur, Malaysia
    Matched MeSH terms: Medical Records*
  9. Nasir NH, Mohamad M, Lum LCS, Ng CJ
    PLoS One, 2017;12(10):e0183544.
    PMID: 28977019 DOI: 10.1371/journal.pone.0183544
    INTRODUCTION: Dengue infection is the fastest spreading mosquito-borne viral disease in the world. One of the complications of dengue is dehydration which, if not carefully monitored and treated, may lead to shock, particularly in those with dengue haemorrhagic fever. WHO has recommended oral fluid intake of five glasses or more for adults who are suspected to have dengue fever. However, there have been no published studies looking at self-care intervention measures to improve oral fluid intake among patients suspected of dengue fever.
    OBJECTIVE: To assess the feasibility and effectiveness of using a fluid chart to improve oral fluid intake in patients with suspected dengue fever in a primary care setting.
    METHODS: This feasibility study used a randomized controlled study design. The data was collected over two months at a primary care clinic in a teaching hospital. The inclusion criteria were: age > 12 years, patients who were suspected to have dengue fever based on the assessment by the primary healthcare clinician, fever for > three days, and thrombocytopenia (platelets < 150 x 109/L). Both groups received a dengue home care card. The intervention group received the fluid chart and a cup (200ml). Baseline clinical and laboratory data, 24-hour fluid recall (control group), and fluid chart were collected. The main outcomes were: hospitalization rates, intravenous fluid requirement and total oral fluid intake.
    FINDINGS: Among the 138 participants who were included in the final analysis, there were fewer hospital admissions in the intervention group (n = 7, 10.0%) than the control group (n = 12, 17.6%) (p = 0.192). Similarly, fewer patients (n = 9, 12.9%) in the intervention group required intravenous fluid compared to the control group (n = 15, 22.1%), (p = 0.154). There was an increase in the amount of daily oral fluid intake in the intervention group (about 3,000 ml) compared to the control group (about 2,500 ml, p = 0.521). However, these differences did not reach statistical significance.
    CONCLUSION: This is a feasible and acceptable study to perform in a primary care setting. The fluid chart is a simple, inexpensive tool that may reduce hospitalization and intravenous fluid requirement in suspected dengue patients. A randomized controlled trial with larger sample size is needed to determine this conclusively.
    TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN) Registry ISRCTN25394628 http://www.isrctn.com/ISRCTN25394628.
    Study site: Primary care clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Medical Records*
  10. Roh YH, Yoo SJ, Choi YH, Yang HC, Nam KW
    Malays Orthop J, 2020 Nov;14(3):32-41.
    PMID: 33403060 DOI: 10.5704/MOJ.2011.007
    Introduction: The symptoms of Ischiogluteal Bursitis (IGB) are often nonspecific and atypical, and its diagnosis is more challenging. Moreover, it is difficult to predict cases of chronic progression or poor treatment response. Therefore, the aim of this study was to investigate the clinical course of IGB patients and identify factors that are predictive of failure of conservative treatment.

    Materials and Methods: Our study consisted of IGB patients diagnosed between 2010 March and 2016 December who had been followed-up for at least one year. Structured questionnaires and medical records were reviewed to analyse demographic characteristics, lifestyle patterns, blood tests, and imaging studies. We categorized the cases into two groups based on the response to conservative treatment and the need for surgical intervention.

    Results: The most common initial chief symptoms were buttock pains in 24 patients (37.5%). Physical examinations showed the tenderness of ischial tuberosity area in 59 (92.2%) patients, but no specific findings were confirmed in 5 patients (7.8%). 51 patients (79.7%) responded well to the conservative management, 11 patients (17.2%) needed injection, and 2 patients (3.1%) had surgical treatment performed due to continuous recurrence. There was no difference in demographic and blood lab data between the two groups. However, the incidence of inflammatory diseases (response group: 10.3% vs non-response group: 66.7%, p=0.004) was significantly different between the two groups.

    Conclusion: The diagnosis of IGB can be missed due to variations in clinical symptoms, and cautions should be exercised in patients with inflammatory diseases as conservative treatment is less effective in them, leading to chronic progression of IGB.

    Matched MeSH terms: Medical Records
  11. Kyaw MT, Sakthiswary R, Ani Amelia Z, Rahana AR, Munirah MM
    Cureus, 2020 Apr 11;12(4):e7632.
    PMID: 32399364 DOI: 10.7759/cureus.7632
    BACKGROUND: Methotrexate (MTX), which is the anchor drug in rheumatoid arthritis (RA), targets actively proliferating cells including the oocytes and granulosa cells which may impair the ovarian reserve. The purpose of this study was to determine the effects of MTX therapy on gonadotropic hormones, i.e. follicular stimulating hormone (FSH) and luteinizing hormone (LH) in female RA patients of reproductive age.

    MATERIALS AND METHODS: This is a cross-sectional study conducted at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC), from January 2018 to July 2018. Women with RA aged between 15 and 49 years who were on MTX therapy for at least six months, were consecutively recruited. All subjects were interviewed to gather information on their menstrual history and menopausal symptoms. The medical records were reviewed to obtain further data on the disease characteristics and RA treatment. The RA disease activity was determined using the DAS 28 scoring system. All subjects were tested for their serum FSH and LH levels.

    RESULTS: A total of 40 patients were included in this study. The median dose of MTX used by the subjects was 12.5 mg weekly. The mean cumulative MTX dose was 1664.92 ± 738.61 mg. More than half (53.1%) of the subjects reported menopausal symptoms especially hot flushes. We found that FSH levels had a significant positive correlation with cumulative MTX dose [(r = 0.86), p < 0.001] and the duration of MTX therapy [(r = 0.84), p < 0.001]. Besides, there was a significant relationship between disease activity based on DAS 28 and FSH levels (p < 0.01). Age, body mass index, disease duration, and weekly MTX dose showed no associations with the FSH levels. On multivariate analysis, DAS 28 was found to be the only parameter that remained significant [β = 1.74 (95% CI 1.17-2.31), p < 0.001]. The LH levels, on the other hand, were not associated with MTX therapy or disease activity.

    CONCLUSION: Higher levels of FSH, which is an indicator of diminished ovarian reserve, have a significant positive relationship with disease activity, cumulative dose, and duration of MTX therapy in RA.

    Matched MeSH terms: Medical Records
  12. Abd Ghani MK, Bali RK, Naguib RN, Marshall IM, Nilmini S. Wickramasinghe
    Int J Electron Healthc, 2008;4(1):78-104.
    PMID: 18583297
    An integrated Lifetime Health Record (LHR) is fundamental for achieving seamless and continuous access to patient medical information and for the continuum of care. However, the aim has not yet been fully realised. The efforts are actively progressing around the globe. Every stage of the development of the LHR initiatives had presented peculiar challenges. The best lessons in life are those of someone else's experiences. This paper presents an overview of the development approaches undertaken by four East Asian countries in implementing a national Electronic Health Record (EHR) in the public health system. The major challenges elicited from the review including integration efforts, process reengineering, funding, people, and law and regulation will be presented, compared, discussed and used as lessons learned for the further development of the Malaysian integrated LHR.
    Matched MeSH terms: Medical Records Systems, Computerized/legislation & jurisprudence; Medical Records Systems, Computerized/organization & administration*
  13. Rosdina Zamrud Ahmad Akbar, Sharifah Faradila Wan Muhammad Hatta, Rosnida Mohd Noh, Fatimah Zaherah Mohd Shah, Thuhairah Abdul Rahman, Rohana Abdul Ghani, et al.
    MyJurnal
    Introduction: Hormonal abnormality is one of many clinical manifestations of HIV infections
    that is not well understood. However, the consequences could affect quality of life and are
    potentially treatable. Thus, this study aimed to determine the prevalence and associated
    factors of thyroid, adrenal and gonadal dysfunctions among HIV-infected patients. Methods:
    This is a single centre cross-sectional study involving 150 HIV-infected patients attending the
    HIV clinic. Each subject was required to answer specific symptoms questionnaire and their
    medical records were reviewed for relevant clinical and biochemical data. Blood for was
    collected and thyroid hormones, cortisol, ACTH, FSH, LH, testosterone and estradiol were
    analysed using electrochemiluminescent immunoassay. Thyroid, adrenal and gonadal axes
    abnormalities were identified. Results: Hypogonadism had the highest prevalence amongst
    the endocrine abnormalities, which was detected in 23 patients (15.3%), followed by thyroid
    dysfunction in 18 patients (12%) and hypocortisolism in 2 patients (1.3%). There was
    significant correlation between CD4 count, BMI and age with the hormone levels. Conclusion:
    Prevalence of endocrine abnormalities was low in these well-treated HIV-positive patients,
    with hypogonadism being the most common. However, significant correlations between CD4
    count, age and BMI with the hormonal levels were detected. Clinical symptoms in relation to
    endocrinopathy are not specific as a screening tool thus underscoring the need for
    biochemical tests to identify these treatable conditions.
    Matched MeSH terms: Medical Records
  14. Abosadegh MM, Saddki N, Al-Tayar B, Rahman SA
    Biomed Res Int, 2019;2019:9024763.
    PMID: 30895196 DOI: 10.1155/2019/9024763
    Background/Aim: Epidemiology of maxillofacial fractures (MFF) varies between populations. This study investigated the epidemiology of MFF treated at the Oral and Maxillofacial Surgery (OMFS) Unit, Hospital Universiti Sains Malaysia (USM).

    Methods: A retrospective review of 473 medical records of patients with MFF treated from June 2013 to December 2015 was conducted. Information on demographic characteristics of patients, aetiology of injury, types of MFF, and treatment was obtained. Descriptive analysis, Pearson's chi-squared test, and multiple logistic regression analysis were conducted. The level of significance was set at 0.05.

    Results: Most patients treated for MFF were males (82.2%), aged 30 and below (63.1%), and from Malay ethnic (97.4%). Road traffic accident was the most common cause of MFF (83.1%), with motorcycle accident accounting for most injuries (73.6%). Orbital wall fracture was the most frequent MFF type (51.2%). About half of MFF patients (51.4%) were treated conservatively. Patients aged more than 20 years old were at higher odds of sustaining orbital wall fracture (AOR= 1.76; 95% CI: 1.214-2.558; P= 0.003) but were at lower odds of sustaining mandibular fracture (AOR= 0.47; 95% CI: 0.315-0.695; P= 0.001) than patients who are 20 years old and younger. Helmet use among motorcyclists was significantly associated with the nasal, orbital wall, and maxillary sinus wall fractures (P= 0.006, 0.010, and 0.004, respectively).

    Conclusion: Motorcycle accident was the most common cause of MFF in Kelantan, Malaysia. Ages of patient and helmet use were associated with the type of MFF sustained. This study provides important information to facilitate the planning of MFF prevention strategies among motorcyclists and emphasizes the importance of using a helmet when riding a motorcycle.

    Matched MeSH terms: Medical Records
  15. Zaidan AA, Zaidan BB, Al-Haiqi A, Kiah ML, Hussain M, Abdulnabi M
    J Biomed Inform, 2015 Feb;53:390-404.
    PMID: 25483886 DOI: 10.1016/j.jbi.2014.11.012
    Evaluating and selecting software packages that meet the requirements of an organization are difficult aspects of software engineering process. Selecting the wrong open-source EMR software package can be costly and may adversely affect business processes and functioning of the organization. This study aims to evaluate and select open-source EMR software packages based on multi-criteria decision-making. A hands-on study was performed and a set of open-source EMR software packages were implemented locally on separate virtual machines to examine the systems more closely. Several measures as evaluation basis were specified, and the systems were selected based a set of metric outcomes using Integrated Analytic Hierarchy Process (AHP) and TOPSIS. The experimental results showed that GNUmed and OpenEMR software can provide better basis on ranking score records than other open-source EMR software packages.
    Matched MeSH terms: Medical Records
  16. Fei CM, Zainal H, Ali IAH
    Malays J Med Sci, 2018 Sep;25(5):103-114.
    PMID: 30914867 MyJurnal DOI: 10.21315/mjms2018.25.5.10
    Background: The use of multi-drug regimens in tuberculosis (TB) treatment has been associated with undesirable adverse drug reactions (ADRs). This study aims to assess the incidence and impact of ADRs on TB treatment in Hospital Pulau Pinang.

    Methods: This cross-sectional study was conducted via retrospective review of outpatients' medical records. Details regarding ADRs were identified by a pharmacist and verified by a consultant respiratory physician.

    Results: A total of 91 cases, out of 210 patients enrolled in this study, were detected with 75 patients (35.7%) experienced at least one ADR. The three most common ADRs detected were cutaneous adverse drug reactions (CADRs) (21.0%), drug-induced hepatitis (DIH) (7.1%) and gastrointestinal disturbance (4.8%). Pyrazinamide was the most common causative agent and 15.7% of all TB patients required treatment modification due to ADRs. Females were shown to have a higher tendency to develop ADRs than the males in this study (P = 0.009). The development of ADRs was shown not to affect the TB treatment outcomes (P = 0.955).

    Conclusion: The incidence of ADRs in this study was high so it is important to identify the risk factors for ADRs and the individuals who have those risk factors when initiating anti-TB drugs. These individuals require special attention when anti-TB drugs are initiated.

    Matched MeSH terms: Medical Records
  17. Ling TE, Othman K, Yan OP, Rashid RA, Tet CM, Yaakob A, et al.
    Open Ophthalmol J, 2017;11:31-39.
    PMID: 28400889 DOI: 10.2174/1874364101711010031
    OBJECTIVE: To evaluate the incidence of ocular surface disease (OSD) and to determine the effects of topical pressure-lowering drugs on ocular surface disease in primary angle closure patients.

    METHODS: This was a cross-sectional comparative study comparing primary angle closure glaucoma (PACG) patients (Group A) with primary angle closure and primary angle closure suspect (Group B). Group A was treated with topical pressure-lowering drugs; Group B was not. Data on ocular diagnosis and details of treatment were obtained from medical records. Ocular surface disease incidence was assessed using the Ocular Surface Disease Index (OSDI) questionnaire and from clinical signs using Schirmer's test, tear break-up time and corneal fluorescein stain. Predictive Analytic Software 20 and STATA analysis software were used for statistical analyses.

    RESULTS: Group A demonstrated a higher rate of OSD (OSDI 52.3%, Schirmer's test 70.5%, tear break-up time (TBUT) 75%, corneal staining 77.3%) compared to Group B (OSDI 39.0%, Schirmer's test 73.2%, TBUT 58.5% and cornea staining 14.6%) except for Schirmer's test. There was a significant difference in mean score of OSDI (p=0.004), TBUT (p=0.008) and cornea staining (p<0.001) between two groups. Primary angle closure glaucoma treated with more than two medications and for more than three years had worse ocular surface disease parameters but without statistical significant difference.

    CONCLUSION: Ocular surface disease is common in PACG patients treated with topical pressure-lowering drugs. Topical pressure-lowering drugs caused significant OSD symptoms and signs except for tear production in PACG patients. Thorough evaluation of ocular surface disease is important to ensure appropriate treatment and intervention in PACG patients.

    Matched MeSH terms: Medical Records
  18. Zain JM, Fauzi AR
    PMID: 18003297
    This paper will study and evaluate watermarking technique by Zain and Fauzi [1]. Recommendations will then be made to enhance the technique especially in the aspect of recovery or reconstruction rate for medical images. A proposal will also be made for a better distribution of watermark to minimize the distortion of the Region of Interest (ROI). The final proposal will enhance AW-TDR in three aspects; firstly the image quality in the ROI will be improved as the maximum change is only 2 bits in every 4 pixels, or embedding rate of 0.5 bits/pixel. Secondly the recovery rate will also be better since the recovery bits are located outside the region of interest. The disadvantage in this is that, only manipulation done in the ROI will be detected. Thirdly the quality of the reconstructed image will be enhanced since the average of 2 x 2 pixels would be used to reconstruct the tampered image.
    Matched MeSH terms: Medical Records Systems, Computerized*
  19. Manickam S, Abidi SS
    Stud Health Technol Inform, 2001;84(Pt 1):643-7.
    PMID: 11604816
    Development and usage of Case Based Reasoning (CBR) driven medical diagnostic system requires a large volume of clinical cases that depict the problem-solving methodology of medical experts. Successful usage of CBR based systems in healthcare is constrained by the need for a continuous supply of current and correct clinical cases (in an electronic medium) from medical experts. To address this constraint we present a strategy to pro-actively transform generic Electronic Patient Records (EPR) to Operable CBR-oriented Cases (OCC) that are compliant to specialised CBR-based medical systems. EPR-OCC transformation methodology is based on XML parse-trees, Unified Medical Language Source (UMLS) meta-thesauri and medical knowledge ontologies. The featured work involves the implementation of a Java-based computer system for the automatic transformation of XML-based EPR-originating from heterogeneous EPR repositories accessible over the Internet/WWW-to specialised OCC that can then be seamlessly incorporated within Intelligent CBR-based Medical Diagnostic Systems.
    Matched MeSH terms: Medical Records Systems, Computerized/organization & administration*
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