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Fulltext The Role of Speckle-Tracking Echocardiography in Predicting Mortality and Morbidity in Patients With Congenital Heart Disease: A Systematic Review and Meta-analysis

Dorobantu DM, Amir NH, Wadey CA, Sharma C, Stuart AG, Williams CA, et al.

J Am Soc Echocardiogr, 2024 Feb;37(2):216-225.
PMID: 37972793 DOI: 10.1016/j.echo.2023.11.003

BACKGROUND: Speckle-tracking echocardiography (STE) is now routinely included in cardiac evaluations, but its role in predicting mortality and morbidity in congenital heart disease (CHD) is not well described. We conducted a systematic review to evaluate the prognostic value of STE in patients with CHD.
METHODS: The EMBASE, Medline, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to January 2023 for terms related to all CHD, STE, and prognosis. Meta-analysis of association of right ventricle and left ventricle strain (RV Sl and LV Sl, respectively) with major adverse cardiovascular events (MACEs) was performed in atrial switch transposition of the great arteries (asTGA)/congenitally corrected TGA (ccTGA), tetralogy of Fallot (ToF), and congenital aortic stenosis (cAS)/bicuspid aortic valve (BAV). P-value combination analysis was additionally performed for all CHD groups.
RESULTS: A total of 33 studies (30 cohorts, n = 8,619 patients, children, and adults) were included. Meta-analysis showed the following parameters as being associated with MACE: RV Sl in asTGA/ccTGA (hazard ratio [HR] = 1.1/%; CI, [1.03; 1.18]), RV Sl and LV Sl in ToF (HR = 1.14/%; CI, [1.03; 1.26] and HR = 1.14/%; CI, [1.08; 1.2], respectively), and LV Sl in cAS/BAV (HR = 1.19/%; CI, [1.15; 1.23]). The RV Sl and strain rate were associated with outcomes also in single ventricle/hypoplastic left heart syndrome (at all palliation stages except before Norwood stage 1) and LV Sl in Ebstein's anomaly.
CONCLUSIONS: This systematic review and meta-analysis showed that biventricular strain and strain rate were associated with outcomes in a variety of CHD, highlighting the need for updated recommendations on the use of STE in the current guidelines, specific to disease types.

Matched MeSH terms: Morbidity
Fulltext Anastomotic Leak after Bariatric Surgery from a Critical Care Perspective: A Lesson Shared

Shukeri WFWM, Hassan MH, Hassan WMNW, Zaini RHM

Malays J Med Sci, 2018 Sep;25(5):158-159.
PMID: 30914872 DOI: 10.21315/mjms2018.25.5.15

Anastomotic leak after bariatric surgery is a rare complication with a recent prevalence ranging from 0.8% to 1.5%. The complication nevertheless can result in morbidity and even mortality. The purpose of this paper is to present a patient who suffered from an anastomotic leak presenting 2 days after laparoscopic sleeve gastrectomy in our intensive care unit. Review of the current literature regarding this complication from critical care perspective is also attempted.

Matched MeSH terms: Morbidity
Fulltext Provision of Prosthetic Services Following Lower Limb Amputation in Malaysia

Arifin N, Hasbollah HR, Hanafi MH, Ibrahim AH, Rahman WAWA, Aziz RC

Malays J Med Sci, 2017 Oct;24(5):106-111.
PMID: 29386978 MyJurnal DOI: 10.21315/mjms2017.24.5.12

The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved.

Matched MeSH terms: Morbidity
Neonatal tumours in Malaysia: a call for heightened awareness

Yeap BH, Zahari Z

Pediatr Surg Int, 2010 Feb;26(2):207-12.
PMID: 19943053 DOI: 10.1007/s00383-009-2523-7

Neonatal neoplasms are rare tumours notorious for their atypical presentation and unpredictable behaviour. Their optimal treatment remains uncertain, a dilemma compounded by the deleterious effects of adjuvant chemo- or radiotherapy during this vulnerable period of growth. This paper examined the relatively high incidence of these tumours and its impact on paediatric surgery in Malaysia.

Matched MeSH terms: Morbidity/trends
Fulltext Utilization of health care services for childhood morbidity and associated factors in India: a national cross-sectional household survey

Sreeramareddy CT, Sathyanarayana TN, Kumar HN

PLoS One, 2012;7(12):e51904.
PMID: 23284810 DOI: 10.1371/journal.pone.0051904

BACKGROUND: Information about utilization of health services and associated factors are useful for improving service delivery to achieve universal health coverage.
METHODS: Data on a sample of ever-married women from India Demographic and Health survey 2005-06 was used. Mothers of children aged 0-59 months were asked about child's illnesses and type of health facilities where treatment was given during 15 days prior to the survey date. Type of health facilities were grouped as informal provider, public provider and private provider. Factors associated with utilization of health services for diarrhea and fever/cough was assessed according to Andersen's health behavior model. Multinomial logistic regression analyses were done considering sampling weights for complex sampling design.
RESULTS: A total of 48,679 of ever-married women reported that 9.1% 14.8% and 17.67% of their children had diarrhea, fever and cough respectively. Nearly one-third of the children with diarrhea and fever/cough did not receive any treatment. Two-thirds of children who received treatment were from private health care providers (HCPs). Among predisposing factors, children aged 1-2 years and those born at health facility (public/private) were more likely to be taken to any type of HCP during illness. Among enabling factors, as compared to poorer household, wealthier households were 2.5 times more likely to choose private HCPs for any illness. Children in rural areas were likely to be taken to any type of HCP for diarrhea but rural children were less likely to utilize private HCP for fever/cough. 'Need' factors i.e. children having severe symptoms were 2-3 times more likely to be taken to any type of HCP.
CONCLUSION: Private HCPs were preferred for treatment of childhood illnesses. Involvement of private HCPs may be considered while planning child health programs. Health insurance scheme for childhood illnesses may to protect economically weaker sections from out-of-pocket health expenditure during child illness.

Matched MeSH terms: Morbidity*
Fulltext Body mass index and illness in rural Sarawak

Strickland SS, Ulijaszek SJ

Eur J Clin Nutr, 1994 Nov;48 Suppl 3:S98-108; discussion S108-9.
PMID: 7843165

This paper reports findings of a cross-sectional anthropometric survey of 447 men and 564 women aged > 18 years of the Iban tribe in rural Sarawak. The percentage of each approximately 10 year cohort with body mass index (BMI: kg/m2) < 18.5 increased progressively with age > 40 years in both sexes. BMI and arm-muscle plus bone cross-sectional area (AMBA) were influenced significantly by reported single symptoms in men and two concurrent symptoms in women. Sensitivity of BMI < 18.5 for identifying those reporting symptoms of illness was 21% in men and 29% in women. Independently of illness effects, values of stature, BMI and AMBA in men, and stature alone in women, were significantly greater in those farming plots with the shortest time left fallow, suggesting their comparative success. The BMI of men may reflect primarily their economic activities, while that of women their experience of illness; the AMBA may also be a better overall index of health than BMI in this population.

Matched MeSH terms: Morbidity*
Body mass index, ageing and differential reported morbidity in rural Sarawak

Strickland SS, Ulijaszek SJ

Eur J Clin Nutr, 1993 Jan;47(1):9-19.
PMID: 8422876

Classifications of adult low energy nutritional status based on the Quetelet or body mass index (weight/height2) have often assumed independence of age and sex. This paper reports findings of a study of 447 men and 564 women aged over 18 years and belonging to the Iban tribe of central Sarawak, East Malaysia. BMI and fat-free mass fell markedly in both sexes, and fat mass in women but not men, after about 40 years of age. In men over age 40, and women aged 18-40, BMI was sensitive to reported morbidity. For subjects aged over 40 years, BMI was related to morbidity independently of age effects in men, and to age alone in women. These findings suggest that the functional significance of low BMI differs between the sexes and with age.

Matched MeSH terms: Morbidity*
Fulltext Morbidity and process of care in urban Malaysian general practice: the impact of payment system

Teng CL, Syed Aljunid SM, Cheah M, Leong KC, Kwa SK

Med J Malaysia, 2003 Aug;58(3):365-74.
PMID: 14750376

BACKGROUND: The majority of primary care consultations in Malaysia occur in the general practice clinics. To date, there is no comprehensive documentation of the morbidity and practice activities in this setting.
OBJECTIVES: We reported the reasons for encounter, diagnoses and process of care in urban general practice and the influence of payment system on the morbidity and practice activities.
METHODS: 115 clinics in Kuala Lumpur, Ipoh and Penang participated in this study. General practitioners in these clinics completed a 2-page questionnaire for each of the 30 consecutive patients. The questionnaire requested for the following information: demographic data, reasons for encounter, important physical findings, diagnoses, investigations ordered, outpatient procedures performed, medical certificate given, medication prescribed and referral made. The morbidity (reasons for encounter and diagnoses) was coded using ICPC-2 and the medication data was coded using MIMS Classification Index.
RESULTS: During 3481 encounters, 5300 RFEs (152 RFEs per 100 encounters) and 3342 diagnoses (96 diagnoses per 100 encounters) were recorded. The majority of the RFEs and diagnoses are in the following ICPC Chapters: Respiratory, General and unspecified, Digestive, Neurological, Musculoskeletal and Skin. The frequencies of selected aspects of the process of care (rate per 100 encounters) were: laboratory investigations 14.7, outpatient procedures 2.4, sick certification 26.9, referral 2.4, and medication prescription 244. Consultation for chronic diseases and acute infections were influenced more by demographic variables (age, employment) rather than payment system. Cash-paying patients were more likely to receive laboratory investigations and injections.
CONCLUSION: This study demonstrated the breadth of clinical care in the general practice. Relatively fewer patients consulted specifically for preventive care and treatment of chronic diseases. The frequencies of outpatient procedures and referrals appeared to be low. Payment system results in important differences in patient mix and influences some types of practice activities.

Matched MeSH terms: Morbidity*
Low Acceptance of Surgery Results in High Morbidity and Mortality Among Asian Patients With IBD

Rajaram RB, Hilmi IN, Roslani AC

Dis Colon Rectum, 2020 04;63(4):415-417.
PMID: 32132461 DOI: 10.1097/DCR.0000000000001606
Matched MeSH terms: Morbidity/trends
The effect of the type of feeding on weight gain and illnesses in infants

Dugdale AE

Br J Nutr, 1971 Nov;26(3):423-32.
PMID: 5171959
Matched MeSH terms: Morbidity*
Reference interval establishment of full blood count extended research parameters in the multi-ethnic population of Malaysia

Angeli A, Andrew OS, Qian YZ, Anselm ST, Chang KM, Jameela S, et al.

Med J Malaysia, 2019 12;74(6):534-536.
PMID: 31929481

Haematological cellular structures may be elucidated using automated full blood count (FBC) analysers such as Unicel DxH 800 via cell population data (CPD) analysis. The CPD values are generated by calculating volume, conductivity, and five types of scatter angles of individual cells which would form clusters or populations. This study considered 126 CPD parameter values of 1077 healthy Malaysian adults to develop reference intervals for each CPD parameter. The utility of the CPD reference interval established may range from understanding the normal haematological cellular structures to analysis of distinct cellular features related to the development of haematological disorders and malignancies.

Matched MeSH terms: Morbidity/trends
Update the WHO EML to improve global paediatric rheumatology

Foster HE, Scott C

Nat Rev Rheumatol, 2020 03;16(3):123.
PMID: 31932748 DOI: 10.1038/s41584-020-0368-6
Matched MeSH terms: Morbidity/trends
Fulltext Risk-adjusted analysis of patients undergoing laparotomy using POSSUM and P-POSSUM score in Queen Elizabeth Hospital, Sabah

Chieng TH, Roslan AC, Chuah JA

Med J Malaysia, 2010 Dec;65(4):286-90.
PMID: 21901947

Scoring systems such as POSSUM and P-POSSUM have been developed to help predict mortality and morbidity in patients. The ratio of observed-to-predicted (O/P ratio) mortality and morbidity has been used as a performance indicator to compare different procedures, clinicians or hospitals. The aim of this study was to assess the predictive value of POSSUM compared with P-POSSUM in patients undergoing laparotomy in Queen Elizabeth Hospital, Sabah.

Matched MeSH terms: Morbidity
Trends and factors associated with mental health problems among children and adolescents in Malaysia

Ahmad N, MuhdYusoff F, Ratnasingam S, Mohamed F, Nasir NH, MohdSallehuddin S, et al.

International journal of culture and mental health, 2015 Apr 03;8(2):125-136.
PMID: 26000035

Studying trends in mental health morbidity will guide the planning of future interventions for mental and public health services. To assess the trends in mental health problems among children and adolescents aged 5 through 15 years in Malaysia from 1996 to 2011, data from the children's mental health component of three population-based surveys was analysed using a two-stage stratified sampling design. Mental health problems were assessed using the Reporting Questionnaire for Children. The prevalence of mental health problems among children and adolescents aged 5 through 15 years showed an increasing trend from 13.0% (95% Confidence Interval [CI]: 11.5-14.6) in 1996 to 19.4% (95% CI: 18.5-20.3) in 2006 and 20.0% (95% CI: 18.8-21.3) in 2011. In 2011, male children and adolescents and those who were in less affluent families were significantly associated with mental health problems. The findings indicate that even though mental health problems among children and adolescents in Malaysia are increasing, the rate of increase has decreased in the past five years. Socially and economically disadvantaged groups were most vulnerable to mental health problems.

Matched MeSH terms: Morbidity
Fulltext The burden of human influenza in Malaysia

Sam JIC

Med J Malaysia, 2015 Jun;70(3):127-30.
PMID: 26248773 MyJurnal

Seasonal and pandemic influenza causes considerable morbidity and mortality globally, but the burden of disease is understudied and underreported in developing countries such as Malaysia. Before considering the cost-effectiveness of introducing interventions such as vaccines to control influenza, it is imperative to determine clinical and socioeconomic impact of the disease. This review summarises the main available literature on human influenza in Malaysia, the possible reasons for the lack of study and awareness of influenza, and important knowledge gaps for future study.

Matched MeSH terms: Morbidity
Fulltext Shewanella dysentery in a patient with underlying malignancy

Jeffery S

Med J Malaysia, 2014 Dec;69(6):284-5.
PMID: 25934962 MyJurnal

Shewanella spp is a facultatively anaerobic, motile, gramnegative bacillus and can be found throughout the world mainly in marine environments and soil. It is a rare pathogen in human and infection by it is usually associated with underlying severe morbidities. We report a case of a 69- years old woman who presented with Shewanella putrefaciens dysentery and who was subsequently found to have underlying malignancy.

Matched MeSH terms: Morbidity
Problems and potential of researching epidemiological transition: examples from Southeast Asia

Phillips DR

Soc Sci Med, 1991;33(4):395-404.
PMID: 1948152

The concept of epidemiological transition is now quite widely recognized, if not so widely accepted. The transition appears to progress at varying speeds and to different extents spatially; it seems that there can be considerable international, regional and local variations in its progress. The paper examines this contention in the case of a number of countries in Southeast Asia, principally Hong Kong, Malaysia and Thailand. Drawing on evidence from this region, the paper highlights the importance when researching epidemiological transition of the time period under consideration; socio-cultural variations; the nature and quality of data, and spatial scale. It makes some suggestions as to the potential of the concept of epidemiological transition in health care planning and development studies.

Matched MeSH terms: Morbidity
Fulltext Content of general practice

Lim TO

Med J Malaysia, 1991 Jun;46(2):155-62.
PMID: 1839420

Eight general practitioners participated in a survey of content of general practice. This is useful as an indicator or morbidity in the community as well as of workload of general practice. A total of 3164 consultations were recorded, of which 2764 (87%) were because of an illness and the rest (13%) for other reasons like medical examinations, antenatal check, family planning advice, pregnancy tests, pap smear and vaccination. The old and the young have high consultation rates for an illness, men consulted as often as women. The most common illness seen was upper respiratory tract infections, accounting for 37% of all illnesses. Other common minor illnesses were skin infections (6%), genito-urinary infections (5%), minor musculoskeletal (6%) and gastrointestinal (6%) complaints as well as minor injuries and cuts (4%). Major disorders form an unusually low proportion (18%) of all illnesses seen, in comparison with figures from United Kingdom. The common major disorders seen were hypertension, asthma, chronic rheumatic disorders and diabetes. Circulatory disorders were remarkably rare, accounting for only 1% of illnesses. Psychological disorders, both major and minor, were also rarely seen, accounting for only 1% of illnesses which is in marked contrast with figures from the United Kingdom. Factors contributing to these notable findings are discussed.

Matched MeSH terms: Morbidity
Fulltext A Review of Guidelines to Resuming Elective Orthopaedic Surgeries Amid COVID-19 Pandemic: Deriving a Simple Traffic Light Model

Attia AK, Omar UF, Kaliya-Perumal AK

Malays Orthop J, 2020 Nov;14(3):10-15.
PMID: 33403057 DOI: 10.5704/MOJ.2011.003

The COVID-19 pandemic has affected most healthcare systems around the world. Routine care operations such as outpatient clinics and elective surgery remain badly hit. This situation cannot continue for long as it puts patients at a higher risk for complications due to delayed management. Hence, it is essential to resume routine, especially elective surgery. Regarding orthopaedic practice, various authors and organisations have come out with guidelines to resume elective surgeries. However, clear consensus and common strategies need be derived. With this motive, we conducted a review of the literature for guidelines to resume elective orthopaedic surgery amid COVID-19 pandemic and shortlisted scholarly publications and information from regional organisations. We have summarised the information and derived an organised algorithm considering the guidelines provided by various sources. In this extraordinary time, guidelines come in as a relief for every surgeon who is in a dilemma whether to resume electives or not. Putting safety first, these guidelines or suitable versions should be followed at all levels wherever possible to avoid the lack of trained manpower in the event of staff morbidity.

Matched MeSH terms: Morbidity
The effect of acute coronary syndrome care pathways on in-hospital patients: A systematic review

Daghash H, Lim Abdullah K, Ismail MD

J Eval Clin Pract, 2020 Aug;26(4):1280-1291.
PMID: 31489762 DOI: 10.1111/jep.13280

BACKGROUND: Health care institutions need to construct management strategies for patients diagnosed with acute coronary syndrome (ACS) that focus on evidence-based treatments, adherence to treatment guidelines, and organized care. These help to reduce variations as well as the mortality and morbidity rates, which indicates the critical need for standardized care and adherence to evidence-based practices for patients hospitalized with ACS. The care pathways translate research and guidelines into clinical practice to close the gap between the guidelines and the clinical practices.
OBJECTIVES: This review focuses on identifying the indicators used to evaluate ACS care pathways and their effect on the care process and clinical outcomes.
METHODS: This review follows the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The systematic research was conducted using five research databases. Two groups were created by dividing the studies according to their year of publication. The first group included those studies published from 1997 to 2007 ("Group 1"), while the second included those published from 2008 to 2018 ("Group 2"). Selected studies were screened using the Effective Public Health Practice Project (EPHPP) quality assessment tool.
RESULTS: Seventeen studies were included in this review. One study was a randomized controlled trial, 14 were predesigns and postdesigns, and two were longitudinal observational designs. The Group 1 studies demonstrated that ACS care pathways had a positive effect on reducing the length of the hospital stay and the door-to-balloon times. Similar effects were observed for the Group 2 studies.
CONCLUSION: Implementing ACS care pathway helps to organize care processes and decrease treatment delays as well as improve the patient outcomes without adverse consequences for patients or additional resources and costs. While the current level of evidence is inadequate to warrant a formal recommendation, there is a need for more studies with an emphasis on well-designed randomization to measure patient outcomes.

Matched MeSH terms: Morbidity

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