Methods: This cross-sectional study involved patients over age 3 years old who presented with URTI to the green zone of the ED of a tertiary hospital on the east coast of Malaysia in 2018-2019. Convenient sampling was done. The patients were categorised into two groups according to their McIsaac scores: positive (≥ 2) or negative (< 2). Antibiotics given to the negative McIsaac group were considered inappropriate.
Results: A total of 261 cases were included - 127 with positive and 134 with negative McIsaac scores. The most common symptoms were fever and cough. About 29% had inappropriate antibiotic prescribing with a high rate for amoxycillin. Duration of symptoms of one day or less (OR 18.5; 95% CI: 1.65, 207.10; P = 0.018), presence of chills (OR 4.36; 95% CI: 1.13, 16.88; P = 0.033) and diagnosis of acute tonsillitis (OR 5.26; 95% CI: 1.76, 15.72; P = 0.003) were significantly associated with inappropriate antibiotic prescription.
Conclusion: Factors influencing inappropriate antibiotic prescribing should be pointed out to emergency doctors to reduce its incidence.
Methods: NPC cases that were diagnosed between 2012 and 2017 in two referral hospitals in Pahang were traced. The crude incidence rate (CR) and age-standardised rate (ASR) were calculated to investigate the NPC incidence.
Results: There were 143 new cases of NPC reported from the two hospitals. The mean age at diagnosis was 52.0 ± 13.7 years old. The majority of cases involved males (74.1%) with a male to female ratio of 2.9:1. Chinese males were found to have the highest incidence with a mean ASR of 4.7 per 100,000 population. Overall, the mean ASR for Pahang was 2.4 per 100,000 population for males and 0.9 per 100,000 population for females.
Conclusion: The total number of NPC cases reveals an increasing trend from 2012 to 2014 and then a slightly decreasing trend from 2015 to 2017. The incidence of NPC in Pahang was intermediate in males and low in females.
Methods: Proliferation and apoptosis studies of U-87 MG cells following stingless bee honey treatment were carried out using MTS assay and acridine orange/propidium iodide dual staining, respectively.
Results: Results demonstrated time and dose-dependent cytotoxicity using 0.625%, 1.25% and 10% stingless bee honey (P < 0.05). IC50 values were calculated using cells treated with 10% stingless bee honey. It was also observed that 10% stingless bee honey induced nuclear shrinkage, chromatin condensation and nucleus fragmentation, indicating that cellular changes were consistent with the apoptotic characteristics of the cells.
Conclusion: These data provide a good basis for further evaluation of the medicinal properties of stingless bee honey from Heterotrigona itama sp. This source of honey may serve as a potential therapy for malignant glioma.
METHODS: This study uses outpatient data from the HKL's Patient Management System (SPP) throughout 2019. The final data set has 246,943 appointment records with 13 attributes used for both descriptive and predictive analyses. The predictive analysis was carried out using seven machine learning algorithms, namely, logistic regression (LR), decision tree (DT), k-near neighbours (k-NN), Naïve Bayes (NB), random forest (RF), gradient boosting (GB) and multilayer perceptron (MLP).
RESULTS: The descriptive analysis showed that the no-show rate was 28%, and attributes such as the month of the appointment and the gender of the patient seem to influence the possibility of a patient not showing up. Evaluation of the predictive model found that the GB model had the highest accuracy of 78%, F1 score of 0.76 and area under the curve (AUC) value of 0.65.
CONCLUSION: The predictive model could be used to formulate intervention steps to reduce no-shows, improving patient care quality.
Methods: Histopathological examination of appendicectomies conducted between 2016 and 2017 in Melaka Hospital, Malaysia were traced and categorised into three groups: i) G1 (normal appendix), ii) G2 (acute appendicitis) and iii) G3 (perforated appendicitis). The reports were randomised and a total of 338 samples were collected. NLR values were compared between the three different groups and analysed.
Results: The median values of NLR for G1, G2 and G3 were 2.37, 5.25 and 9.27, respectively. We found a statistically significant difference in NLR between G1 and G2 (P < 0.001), and G2 and G3 (P < 0.001). The diagnostic values of NLR for acute appendicitis and perforated appendicitis were 3.11 (sensitivity: 75.23%, specificity: 68.70%) and 6.17 (sensitivity: 76.32%, specificity: 58.72%), respectively. There was a substantial correlation between NLR and disease severity, and a moderate correlation between NLR and duration of admission.
Conclusion: NLR, with a sensitivity of 75.23% and specificity of 68.70%, is a useful and reliable adjunct in diagnosing acute appendicitis. Hence, it will help in reducing the rate of negative appendicectomies.
Methods: The NanoLuc™ Luciferase reporter protein was engineered to be expressed as a fusion protein for MNV-1 minor capsid protein, VP2. The foot-and-mouth disease virus 2A (FMDV2A) sequence was inserted between the 3'end of the reporter gene and the VP2 start sequence to allow co-translational 'cleavage' of fusion proteins during intracellular transcript expression. Amplification of the fusion gene was performed using a series of standard and overlapping polymerase chain reactions. The resulting amplicon was then cloned into three readily available backbones of MNV-1 cDNA clones.
Results: Restriction enzyme analysis indicated that the NanoLucTM Luciferase gene was successfully inserted into the parental MNV-1 cDNA clone. The insertion was further confirmed by using DNA sequencing.
Conclusion: NanoLuc™ Luciferase-tagged MNV-1 cDNA clones were successfully engineered. Such clones can be exploited to develop robust experimental assays for in vitro assessments of viral RNA replication.
Methods: The study consists of six phases which begins with eliciting a conceptual understanding of the subject matter which is then followed by questions development, designing the overall structure and format of the questionnaire, assessing both its content validity and face validity, conducting a pilot study and finally a field test. A sample of study respondents who were permanent hospital staff above 18 years of age had been recruited from three government hospitals in Kuching, Sarawak, Malaysia.
Results: The finalised JS-Q consists of a total of 34 questions that were based on 8 domains. For all these 8 domains, the minimum loading of each item on the factors was calculated to be at least 0.500, its coefficient of Cronbach's alpha was calculated to be at least 0.750 and its corrected item-total correlation was calculated to be at least 0.500. The goodness of fit of the model was determined to be satisfactory with a value of Chi-square/df < 3.0, and a value of root mean square error approximation (RMSEA) < 0.8 and finally with both Tucker Lewis index (TLI) and comparative fit index (CFI) > 0.9.
Conclusion: This newly developed and validated questionnaire (JS-Q) is found to be a valid and reliable study instrument for assessing job satisfaction among health workforce.
METHODS: Patients were selected randomly by convenience sampling. One hundred and twenty-four patients were included in the study. The mean age was 40.3 ± 18.5 years (95% CI: 37.2 to 43.8).
RESULTS: Among the common clinical problems were abdominal discomfort (23%), diarrhoea and vomiting (13%) and fever (13%). Reasons for OW admission included diagnostic uncertainty (63%) and short course of treatment (33%). The mean length of stay was 4.1 ± 1.8 hours (95% CI=3.8 to 4.4 hours). Most of the patients (85%) were discharged.
CONCLUSIONS: The OW of HUSM is effective in managing adult patients as determined by the hospitalisation rate and the length of stay.