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  1. Ahmad NA, Mohd MH, Musa KI, Abdullah JM, Othman NA
    Malays J Med Sci, 2021 Oct;28(5):1-9.
    PMID: 35115883 DOI: 10.21315/mjms2021.28.5.1
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 disease, which has become pandemic since December 2019. In the recent months, among five countries in the Southeast Asia, Malaysia has the highest per-capita daily new cases and daily new deaths. A mathematical modelling approach using a Singular Spectrum Analysis (SSA) technique was used to generate data-driven 30-days ahead forecasts for the number of daily cases in the states and federal territories in Malaysia at four consecutive time points between 27 July 2021 and 26 August 2021. Each forecast was produced using SSA prediction model of the current major trend at each time point. The objective is to understand the transition dynamics of COVID-19 in each state by analysing the direction of change of the major trends during the period of study. The states and federal territories in Malaysia were grouped in four categories based on the nature of the transition. Overall, it was found that the COVID-19 spread has progressed unevenly across states and federal territories. Major regions like Selangor, Kuala Lumpur, Putrajaya and Negeri Sembilan were in Group 3 (fast decrease in infectivity) and Labuan was in Group 4 (possible eradication of infectivity). Other states e.g. Pulau Pinang, Sabah, Sarawak, Kelantan and Johor were categorised in Group 1 (very high infectivity levels) with Perak, Kedah, Pahang, Terengganu and Melaka were classified in Group 2 (high infectivity levels). It is also cautioned that SSA provides a promising avenue for forecasting the transition dynamics of COVID-19; however, the reliability of this technique depends on the availability of good quality data.
  2. Joo CL, Husain M, Fadzil NA, Kueh YC
    Malays J Med Sci, 2022 Oct;29(5):105-116.
    PMID: 36474540 DOI: 10.21315/mjms2022.29.5.11
    BACKGROUND: Medical officers (MOs) face multiple sources of work-related stress, including work system transition, job insecurity, dissatisfaction with income and intense working environments. This study aimed to examine the quality of life (QOL), effort-reward imbalance (ERI) and their association among MOs working in government hospitals in Kuching, Sarawak, Malaysia.

    METHODS: This cross-sectional study was conducted among MOs from Sarawak General Hospital and Hospital Sentosa from May 2018 to March 2020. A total of 614 participants were selected through convenient sampling. An email with a link to three sets of questionnaires via Google forms including a questionnaire on sociodemographic data and job characteristics, the World Health Organization Quality of Life-Brief version (WHOQOL-BREF) (Malay version) and the effort-reward imbalance (ERI-Q) (long version) was sent to potential participants. A total of 276 MOs completed and returned the questionnaires. Data were analysed using descriptive, simple and multiple logistic regression analysis. A P-value of less than 0.05 was taken as a statistically significant result.

    RESULTS: Most MOs reported no adversity in the workplace (i.e. 29% low effort/high reward, 5.1% high effort/high reward, 6.2% low effort/low reward and 23.6% high effort/low reward). More than half of MOs (54%) reported poor general QOL and were associated with a combination of active and passive on-calls (adjusted odds ratio [AOR] = 5.36, 95% confidence interval [CI]: 1.21, 23.79). Poor QOL in the physical domain was associated with the presence of chronic illness (AOR = 23.35; 95% CI: 4.25, 128.45), active on-calls (AOR = 14.75; 95% CI: 1.16, 188.35) and a combination of active and passive on-calls (AOR = 18.25; 95% CI: 1.39, 238.98). Men had a higher risk of poor QOL in the environmental domain (AOR = 2.03; 95% CI: 1.04, 3.98). Only 23.6% of MOs reported psychosocial adversity at work (high effort/low reward). High effort/low reward was associated with poor QOL in general (AOR = 4.71; 95% CI: 1.71, 13.01), physical (AOR = 4.53; 95% CI: 2.02, 10.17), psychological (AOR = 5.95; 95% CI: 2.82, 12.58) and environmental domains (AOR = 4.21; 95% CI: 1.95, 9.08). Low effort/high reward was found to have a lower likelihood of poor QOL in the social domain (AOR = 0.13; 95% CI: 0.04, 0.44).

    CONCLUSION: Higher ERI was found to be associated with poor QOL among MOs in government hospitals. Future research should focus on interventions to improve working conditions.

  3. Abdul Halim NA, Wee LH, Mohd Saat NZ, Jit Singh SJ, Siau CS, Chan CMH
    Malays J Med Sci, 2022 Oct;29(5):133-145.
    PMID: 36474542 DOI: 10.21315/mjms2022.29.5.14
    BACKGROUND: School-based smoking cessation intervention programmes are challenging to implement and evaluate. This study aimed to explain the process of developing the Fit and Smart Adolescent Smoking Cessation Programme (FSSCP). Logic model is a visual tool that helps programme planners to create an activity action plan that suits the target group to achieve programme objectives and goals.

    METHODS: This two-arm cluster-randomised controlled trial was implemented between January 2018 and November 2018. Six schools were selected using stratified random sampling, whereby students were purposively selected and invited. The criteria of inclusion to the programme were secondary school students (aged 13 years old-17 years old) who smoked conventional cigarettes (CC) and electronic cigarettes (EC).

    RESULTS: A total of 422 students from six schools participated in this study. Three schools were designated as intervention (n = 250) and the other three as control schools (n = 172). Formative evaluation of participants in the FSSCP using the logic model showed that participants were satisfied with the overall programme (91.5%), were motivated to stop smoking (90.4%) and were prevented from relapse (89.2%). The quit rate at a 3-month follow-up was 41.8%.

    CONCLUSION: The logic model supported the development of the programme, with details on the processes, dissemination activities, identification of barriers, evaluation criteria and outcomes provided.

  4. Lau ZC, Mohd Yusof BN, Abas F, Abd Wahab N, Wan Zukiman WZH, Ismail A
    Malays J Med Sci, 2022 Oct;29(5):5-16.
    PMID: 36474545 DOI: 10.21315/mjms2022.29.5.2
    The Identifying the dynamic metabolome of the individual in response to a particular stimulus using a metabolomic approach is an emerging research area. Measuring the postprandial metabolite response utilising a meal-challenge test (MCT) provides information beyond the fasting state, which is especially important since human beings spend most of their time in the postprandial state. This is pertinent as an excessive rise in postprandial glycaemia is common in individuals with type 2 diabetes mellitus (T2DM), which puts them at a high risk of developing cardiovascular disease (CVD). While a low glycaemic index (GI) meal improves postprandial glycaemia and insulin levels in MCT studies among individuals with T2DM, its effect on metabolite changes in the postprandial state is unclear. This review summarises the perturbation in postprandial metabolites following a low GI meal in comparison to that following a usual or high GI meal and maps the metabolites in their metabolic pathways. We undertook a literature review using electronic databases, with the Medical Subject Headings (MeSH) terms, to retrieve relevant studies based on specific criteria. A total of seven related studies were documented. For the majority of metabolites studied, it was identified that metabolic regulation following an MCT extends beyond the glucose pathway. Altered metabolic pathways after the consumption of a low GI meal include: i) essential amino acid metabolism by altering the levels of plasma phenylalanine, tyrosine, lysine, leucine, isoleucine and valine; ii) glycolysis and tricarboxylic acid (TCA) metabolism by altering citrate and alanine, and iii) gut microbiota metabolism by altering betaine and acetate. The altered metabolites regulated the pancreatic insulin secretion and related to other dietary factors beyond GI modifications. These metabolomics data need to be interpreted cautiously because the metabolic changes analysed might not be due to the beneficial effects of a low GI meal. Validation of the putative metabolomic biomarkers following a dietary intervention MCT is suggested because researchers need to fully understand the kinetics and metabolism of individuals metabolite before reaching a solid conclusion. Further research characterising the metabotype based on habitual dietary patterns is warranted.
  5. Abdul Karim AK, Azrai Abu M, Ahmad MF, Mat Jin N, Suharjono HN
    Malays J Med Sci, 2021 Oct;28(5):34-41.
    PMID: 35115885 DOI: 10.21315/mjms2021.28.5.3
    The novel coronavirus (COVID-19) pandemic has affected the community at large. It has affected almost everyone and every aspect of social, economic and educational activities. Training in reproductive medicine has not been spared, as training in this field requires a combination of clinical interaction with patients, procedural experience, constant discussions and the element of research. The changes to numbers of new infections or active cases dictate the restrictions placed on the community and health care services alike. At the beginning of the pandemic, both the patients' fear of going to a health care facility and movement restrictions had caused a significant reduction in the number of COVID-19 cases. Furthermore, the Ministry of Health (MOH) Malaysia's recommendation to withhold all non-essential medical services, including those related to reproductive medicine, falls under this category. Therefore, it could negatively impact the quality of training and lead to an extension of training duration in reproductive medicine. Thus, the procedural experience could be supplemented with simulator training, teleconsultation could replace standard clinic sessions and online meeting platforms could replace routine academic meetings. Any modifications must be adaptable or flexible, as similar infectious pandemics and restrictions could recur from time to time.
  6. Long GC, Umat C, Din NC
    Malays J Med Sci, 2021 Oct;28(5):10-33.
    PMID: 35115884 DOI: 10.21315/mjms2021.28.5.2
    Background: Attaining socio-emotional competence is challenging for children with hearing impairment. There is wide recognition of children with cochlear implant (CI) indicating significant improvement in their speech and language abilities, however many factors may restrict their chance of having reciprocal social interactions. A significant improvement in speech and language does not automatically affirm the quality of social interactions. This present observation on social-emotional development addressed a more current representative population of children with hearing loss who have benefitted from cochlear implantation.

    Methods: The research conducted a systematic review of selected articles from Scopus and PubMed databases, retrieved through three search-process keywords, namely socio-emotional, children and CI. The inclusion criteria only included journal articles published in English with empirical data from the year 2010-2019. The initial search had identified 189 potential abstracts and after removal of duplicates, only 38 eligible studies met the inclusion criteria.

    Results: Among 38 studies reviewed, 19 studies showed comparable socio-emotional skills with peers in social interaction, empathy, emotion theory of mind and comprehension skills. Conversely, the other 19 studies presented underprivileged results in socio-emotional functioning mainly in identifying facial expression, regulating emotion and emotional cues in the auditory domain.

    Conclusion: This review concluded that the socio-emotional development among children with CI, both at preschool-age and school-age, was not justified due to the heterogeneity in studies across measurement and small sample size. Also, the conclusion recommended extensive cross-referencing, mixed-mode research design, detailed distinguishing of socio-emotional functioning and identification of diverse groups of the population with impaired hearing as an approach to provide empirical evidence on socio-emotional functioning among children with CI in the future.

  7. Chan KS, Junnarkar SP, Low JK, Huey CWT, Shelat VG
    Malays J Med Sci, 2022 Oct;29(5):59-73.
    PMID: 36474543 DOI: 10.21315/mjms2022.29.5.7
    BACKGROUND: Mortality of pyogenic liver abscess (PLA) is high ranging 10%-40%. Old age predicts outcomes in many diseases but there is paucity of data on PLA outcomes. We aim to compare the morbidity and mortality between elderly and non-elderly in PLA.

    METHODS: This is a retrospective study from 2007-2011 comparing elderly (≥ 65 years old) and non-elderly (< 65 years old) with PLA. A 1:1 propensity score matching (PSM) was performed. Baseline clinical profile and outcomes were compared.

    RESULTS: There were 213 patients (elderly patients = 90 [42.3%], non-elderly patients = 123 [57.7%]). Overall median age is 62 (interquartile range [IQR] = 53-74) years old. PSM resulted in 102 patients (51 per arm). Length of hospitalisation stay (LOS) was significantly longer in elderly patients in both unmatched (16 [IQR = 10-24.5] versus 11 [IQR = 8-19] days; P < 0.001) and matched cohorts (17 [IQR = 13-27] versus 11 [IQR = 7-19] days; P = 0.001). In-hospital mortality was significantly higher in elderly patients in the unmatched cohort (elderly patients = 21.1%, non-elderly patients = 7.3%; P = 0.003) but was insignificant following PSM (elderly patients = 15.7%, non-elderly patients = 9.8%; P = 0.219). Duration of antibiotic therapy and need for percutaneous drainage (PD) were comparable before and after PSM.

    CONCLUSION: Age ≥ 65 years old is associated with longer LOS. In-hospital mortality though higher in elderly patients, was not statistically significant.

  8. Khongwichit S, Saelim M, Na-Songkhla Y, Buncherd H, Nopparatana C, Srinoun K
    Malays J Med Sci, 2022 Oct;29(5):39-47.
    PMID: 36474544 DOI: 10.21315/mjms2022.29.5.5
    BACKGROUND: The erythrocyte sedimentation rate (ESR) analyser is widely used in haematological testing. In addition to the Westergren method, new automatic methods for ESR measurements have been developed. We aimed to study the reliability, precision, accuracy and stability of the Caretium XC-A30 automated ESR analyser.

    METHODS: Ethylenediamine tetraacetic acid (EDTA)-treated blood samples were analysed via the Caretium XC-A30 automated ESR analyser and the Westergren method to compare accuracy. Precision was assessed using control samples and patient samples were classified into three groups-low, medium and high-according to their rates of sedimentation. Moreover, a stability test was performed.

    RESULTS: The correlation coefficient of the results of the Caretium XC-A30 and Westergren analyses was 0.97. The correlation coefficient of ESR values obtained from the two methods assessed in the low, medium and high groups were r = 0.80, r = 0.68 and r = 0.74, respectively. The coefficient of variation of within-run (%CVw) and between-run (%CVb), with replicates performed with commercial controls samples, were 7.54% and 8.04% for the normal control and 4.68% and 3.50% for abnormal control, respectively. The %CVw obtained with patient samples in the low, medium and high groups were 10.68%, 13.13% and 4.45%, respectively. The Caretium XC-A30 measurements were stable for up to 24 h when samples were stored at 4 °C.

    CONCLUSION: The Caretium XC-A30 ESR analyser proved to be a suitable instrument for routine analysis of ESR.

  9. Roslan M, Mohd Nisfu FR, Arzmi MH, Abdul Wahab R, Zainuddin N
    Malays J Med Sci, 2023 Aug;30(4):8-24.
    PMID: 37655145 DOI: 10.21315/mjms2023.30.4.2
    Individuals with a history of coronavirus disease 2019 (COVID-19) exhibit memory immunity acquired during natural infection. However, a decline in immunity after infection renders these individuals vulnerable to re-infection, in addition to a higher risk of infection with new variants. This systematic review examined related studies to elucidate the antibody response in these infected individuals after messenger ribonucleic acid (mRNA) vaccination. Hence, the focus of this review was to ascertain differences in the concentration of binding and neutralising antibodies of previously infected individuals in comparison to those of infection-naïve individuals after administration of two doses of mRNA vaccination through available case-control and cohort studies. Positive reverse transcriptase-polymerase chain reaction (RT-PCR) test or detectable anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies at the baseline in included studies showed categorisation of infected and uninfected individuals. This review utilised three online databases: PubMed, Scopus and Cochrane with the following keywords: (COVID-19 OR 'Coronavirus Disease 2019' OR SARS-CoV-2) AND Immun* AND (Pfizer OR BioNTech OR BNT162b2 OR Comirnaty OR Moderna OR mRNA-1273) from January 2019 to July 2021. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol (PRISMA-P) 2020 guidelines and assessment based on the Crowe Critical Appraisal Tool (CCAT), we included 13 related qualified papers of observational studies discerning the binding and neutralising antibody concentrations of infected and uninfected individuals after administration of mRNA vaccines, such as the BNT162b2 and mRNA-1273 vaccine. The mRNA vaccines induced robust binding and neutralising antibody responses in both groups. However, infected individuals showed induction of higher antibody responses in a shorter time compared to uninfected individuals. Hence, a single dose of mRNA vaccination for infected individuals may be sufficient to reach the same level of antibody concentration as that observed in uninfected individuals after receiving two doses of vaccination.
  10. Md Khairi LNH, Gnanasan S
    Malays J Med Sci, 2023 Aug;30(4):33-47.
    PMID: 37655143 DOI: 10.21315/mjms2023.30.4.4
    The arrival of COVID-19 pandemic in March 2020 adversely affected every aspect of human life, including the management of asthma. The pandemic has forced clinicians to revisit the application of high-risk aerosol-generating procedures in asthma management, including spirometry and nebuliser therapy. The use of commercial spacers with pressurised metered-dose inhalers to replace nebulisation is limited by the high cost and pandemic-induced stock unavailability of these inhalers. The need for social distancing, healthcare reserves reallocation, and scarce personal protective equipment has promote increased telemedicine uptake for patients' asthma control and monitoring. Malaysian pharmacists have been providing long-term care of asthma through the introduction of the respiratory Medication Therapy Adherence Clinic (MTAC) to empower patients' general health literacy, train and regularly evaluate their inhalation technique, and reinforce the importance of medication compliance. To minimise the use of unplanned healthcare resources and avoidable COVID-19 infection exposure, Malaysian pharmacists need to better support asthma self-management via increased uptake of written Asthma Action Plans (AAPs). Pharmacist-led asthma treatment step-down to attain the lowest effective dose of inhaled corticosteroids (ICS) has become increasingly relevant during the pandemic, as its prolonged use carries risk of numerous side effects and possible hospitalisation. Telepharmacy offers a promising model for exploration and an alternative to the traditional service delivery of asthma education. Despite not being authorised as vaccinators, Malaysian pharmacists hold strong positions in COVID-19 immunisation programmes for pharmacovigilance and advocacy. The pandemic demands an increased role for pharmacists within medication management to prevent patients from the stockpiling that can cause adverse effects on pharmaceutical supply chain. This review intends to summarise the impact of COVID-19 on asthma management, with a focus on the transitional roles of Malaysian pharmacists before and after the pandemic era.
  11. Mohd Yosli HN, Hong W, Kazura K, Abdul Salim NH, Md Pauzi AL, Mat Din H, et al.
    Malays J Med Sci, 2023 Aug;30(4):157-174.
    PMID: 37655142 DOI: 10.21315/mjms2023.30.4.14
    INTRODUCTION: Despite the high prevalence of post-stroke delirium in Malaysia, there are no studies on good practices related to its management. This study aimed to analyse the knowledge, attitude, perception, and factors associated with current practices related to delirium in acute stroke patients among health personnel at Hospital Sultan Abdul Aziz Shah (HSAAS) (formerly known as Hospital Pengajar Universiti Putra Malaysia).

    METHODS: This cross-sectional study was conducted from 26 April 2021 to 9 May 2021 (17 weeks). All health personnel from various departments managing patients with acute stroke in our centre were invited to participate. An online questionnaire was disseminated to assess their knowledge, attitude, perception, and current practices concerning delirium. Multiple logistic regression was used to examine the association between the independent and dependent variables. The level of significance was set at P < 0.05.

    RESULTS: The response rate was 22.49% (47 of 209 participants). More than half (61.7%, n = 29) had good current practices towards delirium in acute stroke patients. A significant association was found between knowledge and current practices related to delirium (P = 0.024). However, there was no significant association between current practices and sociodemographic factors (age, ethnicity, gender and job position), attitude, perceptions, screening barriers, or health service organisation.

    CONCLUSION: Most respondents had good current practices and knowledge in managing post-stroke delirium. Therefore, upskilling health personnel for managing this illness is essential to ensure good post-stroke care and improve prognosis related to delirium.

  12. Jong HY, Rauf RA, Abdullah JM, Reza F, Tye J, Karageorghis CI, et al.
    Malays J Med Sci, 2023 Aug;30(4):132-146.
    PMID: 37655149 DOI: 10.21315/mjms2023.30.4.12
    BACKGROUND: Adolescents with syntactic specific language impairment (S-SLI) fail to comprehend which object questions. We hypothesised that rhythmic music training is more effective in treating this condition than conventional methods because music is often perceived as having a clear, isochronous beat or pulse. Thus, this study aims to investigate the effects of rhythmic music training on the syntactic structure processing of Malay which questions among native adolescents.

    METHODS: In this research study, the participants were three groups of Malay adolescents aged 13 years old-15 years old: i) adolescents with S-SLI with music training, ii) adolescents with S-SLI without music training and iii) typically developing adolescents. Before and after music training, the participants were given a sentence-picture matching task. Accuracy measures and reaction times were captured using E-Prime 2.0.

    RESULTS: The results indicated that with music training, the accuracy and reaction time associated with which object questions among the two SLI groups were significantly higher and lower, respectively.

    CONCLUSION: The implications of using rhythmic music training in enhancing syntactic structure processing are also discussed.

  13. Boulesnam SL, Hamaidi-Chergui F, Benamara M, Azrou S
    Malays J Med Sci, 2023 Aug;30(4):85-93.
    PMID: 37655144 DOI: 10.21315/mjms2023.30.4.8
    BACKGROUND: Acinetobacter baumannii (A. baumannii) causes a variety of nosocomial infections that mainly affect critically ill patients in intensive care units (ICUs). The objective of this study was to assess the prevalence of A. baumannii in the ICU environment and evaluate the antibiotic resistance and biofilm formation ability of the environmental isolates compared to those isolated from ICU patients simultaneously.

    METHODS: A total of 166 non-duplicate ICU samples (80 environmental and 86 clinical) were collected between January 2019 and January 2020. Antimicrobial susceptibility detection was determined using the disc diffusion method, and the strains were evaluated for the minimum inhibitory concentration (MIC) of imipenem (IMP) using broth microdilution or metallo-β-lactamase (MBL) detection according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The isolates' capacity to produce biofilms was evaluated using the tube method and the crystal violet microtitre plate-based method.

    RESULTS: A. baumannii was identified in 25 (31.25%) environmental and 30 (34.88%) clinical samples, and beds were the most infected (60%). Both types of isolate demonstrated a rate surpassing 80% resistance to the tested antibiotics. Phenotypically, the environmental and clinical strains were found to be MBL producers. Fourteen environmental (56%) and 15 clinical (50%) strains were found to be moderate biofilm producers, indicating that each isolate has a high biofilm-forming capacity.

    CONCLUSION: These results show that the spread of multidrug-resistant (MDR) A. baumannii in an ICU setting emphasises the necessity of disinfecting and cleaning medical devices and surfaces to prevent and restrict cross-transmission. Intensive surveillance and infection control methods are also of paramount importance.

  14. Lim CW, Othman A, Hashim HA
    Malays J Med Sci, 2023 Aug;30(4):102-115.
    PMID: 37655146 DOI: 10.21315/mjms2023.30.4.10
    BACKGROUND: In the context of the coronavirus (COVID-19) pandemic, effectively coping with daily stressors is crucial for children who experience restrictions on physical movement and social activities. We examined the effects of the online-delivered guided imagery relaxation (GIR) technique on the stress and well-being of primary school children.

    METHODS: Thirty-four (N = 34) 11-year-old students were randomly assigned to either intervention (n = 17) or waitlist-control (n = 17) groups. The participants from the intervention group were required to attend a 4-week online GIR session and practice the techniques daily for 5 min-10 min. The Stress in Children (SiC) questionnaire, the Strengths and Difficulties Questionnaire-Parent Reported (SDQ-PR) and tracking form were administered pre- and post-intervention.

    RESULTS: Eleven (64.7%) participants attended all sessions and eight (47.0%) completed daily practices. Mixed-model ANOVA indicated no significant difference between participants from intervention and waitlist-control groups across pre- and post-intervention time points, with P-values greater than 0.05 for stress and well-being.

    CONCLUSION: Issues regarding online intervention, including managing children's activities from a distance, Internet connectivity, and time limitations might have affected their adherence and the research outcome. Nonetheless, the online-delivered GIR technique is a promising intervention modality. However, its implementation should be improvised to be more impactful.

  15. Saidin NIS, Noor NHM, Yusoff SM, Sauli MS
    Malays J Med Sci, 2023 Aug;30(4):61-70.
    PMID: 37655148 DOI: 10.21315/mjms2023.30.4.6
    BACKGROUND: Haemolytic transfusion reactions (HTRs) due to anti-A and anti-B antibodies in Group O blood products are rare but potentially fatal. This study aimed to identify the prevalence of high ABO antibody titre and the immunoglobulin (Ig) classes (IgM only or with IgG) and the prevalence of haemolysin antibodies in Group O blood donors.

    METHODS: Plasma from Group O blood donors was tested by using antibody titration at room temperature. Titres ≥ 64 were considered high. The plasma was treated with 0.01 M dithiothreitol (DTT) to determine the presence of IgG antibodies and titre. IgG titres ≥ 64 were considered high. Tests for haemolysis were conducted by mixing the plasma with 3% fresh A1 and B cell suspensions and incubating at 37 °C. The haemolysis was observed macroscopically.

    RESULTS: Of 311 donors, 238 (76.5%) showed high anti-A and/or anti-B antibody titres. The highest antibody titre obtained was 256. Female and younger donors (< 40 years old) had higher anti-A and anti-B titres. The anti-B titre showed an association with gender (P < 0.001), and was high in female donors (77.8%). Males aged over 50 years old were found to have low mean titre antibodies. Most donors had both IgM and IgG ABO antibodies. The prevalence of haemolysins in our population was 3.5%.

    CONCLUSION: Most of our O blood donors had a high ABO antibody titre but a low prevalence of haemolysins. Males aged over 50 years old are the best O donors for preventing HTRs, particularly when mismatch transfusion is required. We recommend a transfusion unit screen for ABO antibody titre in younger female donors (< 40 years old), to prevent the transfusion of high titre O blood products into non-O recipients.

  16. Zakaria Z, Van Rostenberghe H, Ramli N, Suhaimi MS, Hazlan SNH, Abdullah JM
    Malays J Med Sci, 2023 Aug;30(4):193-206.
    PMID: 37655147 DOI: 10.21315/mjms2023.30.4.16
    The physical examination of the newborn is essential in diagnosing neurological or neurosurgical conditions in the newborn. This article focuses on three clinical assessments of newborns and infants that are especially important if neurological problems are suspected: The Ballard score, the examination of the head in a baby with (suspected) hydrocephalus, and the neurological and developmental evaluation of an infant in an ambulatory setting. A textual description and a link to a video describe each assessment.
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