Displaying publications 101 - 120 of 1247 in total

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  1. Ghani SA
    Med J Malaysia, 1991 Mar;46(1):21-7.
    PMID: 1836034
    A personal series of 163 patients who underwent coronary artery bypass surgery (CABG) in the University Hospital, Kuala Lumpur between March 1988 and December 1990 were reviewed retrospectively to determine factors affecting hospital morbidity and mortality. One hundred and thirty eight were elective cases while 25 patients underwent emergency CABG surgery. Of these, 15 patients had recent myocardial infarction, with unstable haemodynamics or post infarct angina; six had failed angioplasty procedures and four patients immediately following coronary angiogram. The elective hospital mortality rate was 2.2% (three cases) and there were two deaths in the emergency group. Pre-operatively 20 patients (13%) had very poor left ventricular function of less than 30% ejection fraction. Significant improvement in ejection fraction was observed following surgery. The follow-up periods were between three months to three years. Ninety eight percent of patients showed improvement in their functional status (NYHA classification) in relation to angina and exercise performance.
    Matched MeSH terms: Coronary Artery Bypass/mortality*; Coronary Disease/mortality; Hospital Mortality
  2. Gardiner MR, Craig J
    Aust. Vet. J., 1970 Feb;46(2):65-9.
    PMID: 5463722
    Matched MeSH terms: Heat Exhaustion/mortality; Salmonella Infections, Animal/mortality; Sheep Diseases/mortality*
  3. Sartini C, Lomivorotov V, Pieri M, Lopez-Delgado JC, Baiardo Redaelli M, Hajjar L, et al.
    J Cardiothorac Vasc Anesth, 2019 05;33(5):1430-1439.
    PMID: 30600204 DOI: 10.1053/j.jvca.2018.11.026
    The authors aimed to identify interventions documented by randomized controlled trials (RCTs) that reduce mortality in adult critically ill and perioperative patients, followed by a survey of clinicians' opinions and routine practices to understand the clinicians' response to such evidence. The authors performed a comprehensive literature review to identify all topics reported to reduce mortality in perioperative and critical care settings according to at least 2 RCTs or to a multicenter RCT or to a single-center RCT plus guidelines. The authors generated position statements that were voted on online by physicians worldwide for agreement, use, and willingness to include in international guidelines. From 262 RCT manuscripts reporting mortality differences in the perioperative and critically ill settings, the authors selected 27 drugs, techniques, and strategies (66 RCTs, most frequently published by the New England Journal of Medicine [13 papers], Lancet [7], and Journal of the American Medical Association [5]) with an agreement ≥67% from over 250 physicians (46 countries). Noninvasive ventilation was the intervention supported by the largest number of RCTs (n = 13). The concordance between agreement and use (a positive answer both to "do you agree" and "do you use") showed differences between Western and other countries and between anesthesiologists and intensive care unit physicians. The authors identified 27 clinical interventions with randomized evidence of survival benefit and strong clinician support in support of their potential life-saving properties in perioperative and critically ill patients with noninvasive ventilation having the highest level of support. However, clinician views appear affected by specialty and geographical location.
    Matched MeSH terms: Mortality/trends; Critical Illness/mortality*
  4. Khoo EJ, Chua SH, Kutzsche S
    Arch Argent Pediatr, 2019 04 01;117(2):e181-e187.
    PMID: 30869503 DOI: 10.5546/aap.2019.eng.e181
    The Neonatal Resuscitation Programme is a good example of an effective educational intervention that has improved perinatal mortality rates in many countries. This paper shares our experience of planning an undergraduate Neonatal Resuscitation Programme using basic principles of education theory of spiral curriculum, Bloom's taxonomy in planning learning outcomes, Kolb's learning model and Miller's model of clinical assessment. Engaging clinicians in pedagogical theories may not be well aligned with how clinicians traditionally thought they learnt best, yet it is key to improving learning concept and educational intervention outcomes in the healthcare professions. This article aims to illustrate the application of such educational theories into one example of practice. We structured this paper in the scope of content, delivery and assessment when planning a psychomotor learning activity.
    Matched MeSH terms: Perinatal Mortality
  5. Smith TO, Sillito JA, Goh CH, Abdel-Fattah AR, Einarsson A, Soiza RL, et al.
    Age Ageing, 2020 02 27;49(2):184-192.
    PMID: 31985773 DOI: 10.1093/ageing/afz178
    BACKGROUND: Blood pressure variability (BPV) is a possible risk factor for adverse cardiovascular outcomes and mortality. There is uncertainty as to whether BPV is related to differences in populations studied, measurement methods or both. We systematically reviewed the evidence for different methods to assess blood pressure variability (BPV) and their association with future cardiovascular events, cardiovascular mortality and all-cause mortality.

    METHODS: Literature databases were searched to June 2019. Observational studies were eligible if they measured short-term BPV, defined as variability in blood pressure measurements acquired either over a 24-hour period or several days. Data were extracted on method of BPV and reported association (or not) on future cardiovascular events, cardiovascular mortality and all-cause mortality. Methodological quality was assessed using the CASP observational study tool and data narratively synthesised.

    RESULTS: Sixty-one studies including 3,333,801 individuals were eligible. BPV has been assessed by various methods including ambulatory and home-based BP monitors assessing 24-hour, "day-by-day" and "week-to-week" variability. There was moderate quality evidence of an association between BPV and cardiovascular events (43 studies analysed) or all-cause mortality (26 studies analysed) irrespective of the measurement method in the short- to longer-term. There was moderate quality evidence reporting inconsistent findings on the potential association between cardiovascular mortality, irrespective of methods of BPV assessment (17 studies analysed).

    CONCLUSION: An association between BPV, cardiovascular mortality and cardiovascular events and/or all-cause mortality were reported by the majority of studies irrespective of method of measurement. Direct comparisons between studies and reporting of pooled effect sizes were not possible.

    Matched MeSH terms: Cardiovascular Diseases/mortality; Mortality*
  6. Chen PC
    Med J Malaysia, 1979 Jun;33(4):294-8.
    PMID: 522739
    Matched MeSH terms: Mortality
  7. Wallace RB
    Trans R Soc Trop Med Hyg, 1933;27:131-146.
    1. 1. Paris green was used as a larvicide on an inland hilly estate where A. maculatus was the carrier-and where most of the water treated was moving, more or less rapidly. 2. 2. Three different diluents were tried, viz., lime, talcum and soapstone powder. 3. 3. The strength of the mixture was one part of Paris green to ninety-nine parts of diluent by volume. 4. 4. Distribution was carried out by mechanical blowers and sprayers. 5. 5. The application was checked twenty-four hours afterwards. For one month it was checked forty-eight hours afterwards. 6. 6. There was an increase in breeding places-most of which were found in moving water. 7. 7. There was an increase in larvæ, many of them being over two days old. 8. 8. In spite of treatment of epidemics with plasmochin and quinine, the malaria rate was higher than during the previous year. The rise was more or less consistent, pointing to constant infections. 9. 9. The morbidity rate, death rate and infantile mortality were apparently not adversely affected, but in view of the treatments given with plasmochin, they are of no help in deciding the value of Paris green. 10. 10. There was a distinct fall in anti-larval costs, but the total anti-malarial costs were still high on account of the treatments necessary for epidemics of malaria. 11. 11. The advantages and disadvantages of Paris green are discussed.
    Matched MeSH terms: Mortality
  8. Tey Nai Peng, Tan Boon Ann, Arshat H
    Malays J Reprod Health, 1985 Jun;3(1):46-58.
    PMID: 12314427
    Matched MeSH terms: Infant Mortality*; Mortality*
  9. Abdul Kader H
    Malays J Reprod Health, 1983 Dec;1(2):139-52.
    PMID: 12313335
    Matched MeSH terms: Infant Mortality*; Mortality*
  10. Jaiswal V, Ang SP, Ishak A, Nasir YM, Chia JE, Naz S, et al.
    J Investig Med, 2023 Mar;71(3):223-234.
    PMID: 36705027 DOI: 10.1177/10815589221140589
    To date, there were limited studies available on myocardial infarction (MI), and consequently, the outcomes of patients with type 1 myocardial infarction (T1MI) compared to type 2 myocardial infarction (T2MI) remained inconclusive. We aimed to compare the outcomes of T1MI and T2MI patients in terms of mortality and adverse cardiovascular outcomes. We performed a systematic literature search on PubMed, Embase, and Scopus for relevant articles from inception until March 20, 2022. 341,049 patients had T1MI, while the remaining 67,537 patients had T2MI. Mean age was similar between both groups (T1MI: 67.3 years, T2MI: 71.03 years), while the proportion of females was lower in T1MI (37.81% vs 47.15%). Our analysis revealed that patients with T1MI had significantly lower odds of all-cause mortality (OR 0.45, 95% CI 0.36-0.56, p 
    Matched MeSH terms: Hospital Mortality
  11. Boo NY
    Singapore Med J, 1992 Feb;33(1):33-7.
    PMID: 1598605
    Between January 1989 to April 1990 (16 months), a prospective observational study was carried out on 329 consecutive very low birthweight (VLBW) less than or equal to 1500 grams) Malaysian neonates born in the Maternity Hospital, Kuala Lumpur before their first discharge from the hospital. The objectives of the study were to determine the common causes of early morbidity and mortality of this group of Malaysian neonates. The study shows that the incidence of Malaysian VLBW neonates was 9.9 per 1000 livebirths (95% confidence intervals 9.0 to 10.8). The mean duration of stay in the hospital was 19.3 days (SD = 21.4). One hundred and ninety-six (59.6 percent) of the VLBW neonates died. They accounted for 60 percent (196/334) of all neonatal deaths in the hospital during the study period. Mortality was significantly higher in neonates of birthweight less than 1000 grams (p less than 0.01) and of gestation of less than 33 weeks (p less than 0.001). The three most common clinical problems were respiratory distress syndrome (RDS) (72.6 percent), septicemia (28.0 percent) and intraventricular haemorrhage (IVH) (21.9 percent). Death occurred in 71.1 percent of the septicemic patients. The most common causative organisms of septicemia were multiresistant klebsiella (52.3 percent) and multiresistant acinetobacter (14.7 percent). RDS (33.2 percent), septicemia (29.6%) and IVH (17.9 percent) were the three most common causes of death. Improvement in the nursing staff situation and basic neonatal care facilities in this hospital and prevention of premature delivery could help to decrease morbidity and mortality in this group of neonates.
    Matched MeSH terms: Infant Mortality*; Sepsis/mortality
  12. Khan A, Khan AH, Adnan AS, Syed Sulaiman SA, Gan SH, Khan I
    Biomed Res Int, 2016;2016:9710965.
    PMID: 27833921
    Background. Hemodialysis related hemodynamic instability is a major but an underestimated issue. Moreover, cardiovascular events are the leading cause of morbidity and mortality associated with blood pressure in hemodialysis patients. However, there have been many controversies regarding the role and management of hyper- and/or hypotension during hemodialysis that needs to be addressed. Objective. To critically review the available published data on the atypical role of hyper- and/or hypotension in cardiovascular associated morbidity and mortality in patients on hemodialysis and to understand the discrepancies in this context. Methods. A comprehensive search of literature employing electronic as well as manual sources and screening 2783 papers published between Jan 1980 and Oct 2015 was conducted to collect, identify, and analyze relevant information through peer-reviewed research articles, systematic reviews, and other published works. The cardiovascular events, including accelerated atherosclerotic cardiovascular disease (ASCVD), stroke, heart failure, myocardial infarction, myocardial ischemia, and stress induced myocardial dysfunction, leading to death were considered relevant. Results. A total of 23 published articles met the inclusion criteria and were included for in-depth review and analysis to finalize a comprehensive systematic review article. All the studies showed a significant association between the blood pressure and cardiovascular disease events in hemodialysis patients. Conclusions. Both intradialytic hypertension/hypotension episodes are major risk factors for cardiovascular mortality with a high percentage of probable causality; however, clinicians are faced with a dilemma on how to evaluate blood pressure and treat this condition.
    Matched MeSH terms: Cardiovascular Diseases/mortality; Hypertension/mortality; Hypotension/mortality
  13. O'Connor RC, Worthman CM, Abanga M, Athanassopoulou N, Boyce N, Chan LF, et al.
    Lancet Psychiatry, 2023 Jun;10(6):452-464.
    PMID: 37182526 DOI: 10.1016/S2215-0366(23)00058-5
    Globally, too many people die prematurely from suicide and the physical comorbidities associated with mental illness and mental distress. The purpose of this Review is to mobilise the translation of evidence into prioritised actions that reduce this inequity. The mental health research charity, MQ Mental Health Research, convened an international panel that used roadmapping methods and review evidence to identify key factors, mechanisms, and solutions for premature mortality across the social-ecological system. We identified 12 key overarching risk factors and mechanisms, with more commonalities than differences across the suicide and physical comorbidities domains. We also identified 18 actionable solutions across three organising principles: the integration of mental and physical health care; the prioritisation of prevention while strengthening treatment; and the optimisation of intervention synergies across social-ecological levels and the intervention cycle. These solutions included accessible, integrated high-quality primary care; early life, workplace, and community-based interventions co-designed by the people they should serve; decriminalisation of suicide and restriction of access to lethal means; stigma reduction; reduction of income, gender, and racial inequality; and increased investment. The time to act is now, to rebuild health-care systems, leverage changes in funding landscapes, and address the effects of stigma, discrimination, marginalisation, gender violence, and victimisation.
    Matched MeSH terms: Mortality, Premature
  14. King TL, Tiong LL, Abdul Aziz Z, Law WC
    J Stroke Cerebrovasc Dis, 2023 Sep;32(9):107230.
    PMID: 37478524 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107230
    OBJECTIVES: The study aimed to determine the prevalence of untreated pharmacologically modifiable cardiovascular risk factors (PMRF) among patients with ischaemic stroke and the association with in-hospital mortality and functional outcome.

    METHODS: We analysed the data from ischaemic stroke cases admitted to Sarawak General Hospital between June 2013 and June 2021. We matched the underlying PMRFs with prior medications and categorised them as treated, untreated, or no PMRF. We calculated the prevalence and assessed the association between untreated PMRFs and in-hospital mortality or favourable functional outcome (FFO) at discharge, which was adjusted for age, sex, and other covariates in multivariable models.

    RESULTS: We included 1963 patients [65.4% male, 59.8 (SD 13.4) years]; 43.8% who had at least one untreated PMRF had triple the odds of in-hospital mortality [adjusted OR (aOR) 2.86, (95%CI 1.44, 5.70)], whereas 30.2% who had all PMRFs treated showed no significant association. Untreated hypertension [aOR 2.19 (95%CI 1.21, 3.98)], treated [aOR 3.02 (95%CI 1.32, 6.92)], and untreated atrial fibrillation [aOR 1.89 (95%CI 1.18, 3.03)] were significantly associated with more in-hospital death, whereas treated prior stroke was associated with fewer in-hospital death [aOR 0.31 (95%CI 0.11, 0.84)]. Treated diabetes [aOR 0.66 (95%CI 0.49, 0.88)] and untreated prior stroke [aOR 0.53 (95%CI 0.33, 0.83)] were associated with fewer FFO.

    CONCLUSION: The high prevalence of untreated underlying PMRFs was significantly associated with poorer outcomes among Malaysian patients with ischaemic stroke in Sarawak. Efforts are needed to promote early screening and treatment of cardiovascular risk factors to reduce the burdens and improve stroke outcomes in this region.

    Matched MeSH terms: Hospital Mortality
  15. Abdelhafez MM, Ahmed KA, Daud MN, Eldiasty AM, Amri MF, Jeffree MS, et al.
    Afr J Reprod Health, 2023 May;27(5):81-94.
    PMID: 37584933 DOI: 10.29063/ajrh2023/v27i5.8
    This review aims to provide the mother carers with the most recent evidence-based guidelines in the context of managing of pregnancy-associated VTE, where an extensive search through the medical journals addressing the topic including the medical database such as Pubmed, Medline, Sience direct,Embase and others using the title and key-words in order to gather the most concerned as well as the up-to-date publications concerned with the problem under research, the search resulted in recognising pregnancy as a significant risk factor for the development of VTE, both during the prenatal and postnatal periods, with an estimated increased likelihood risk of five and sixty times, respectively and concluded that venous thromboembolism (VTE) is one of the leading causes of maternal mortality hence, all pregnant women should be assessed for the risk of developing the condition as early as possible (when scheduling a booking antenatal appointment) or even in the pre-pregnancy clinic.
    Matched MeSH terms: Maternal Mortality
  16. Wang H, Liddell CA, Coates MM, Mooney MD, Levitz CE, Schumacher AE, et al.
    Lancet, 2014 Sep 13;384(9947):957-79.
    PMID: 24797572 DOI: 10.1016/S0140-6736(14)60497-9
    BACKGROUND: Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success.

    METHODS: We generated updated estimates of child mortality in early neonatal (age 0-6 days), late neonatal (7-28 days), postneonatal (29-364 days), childhood (1-4 years), and under-5 (0-4 years) age groups for 188 countries from 1970 to 2013, with more than 29,000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030.

    FINDINGS: We estimated that 6·3 million (95% UI 6·0-6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1-18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6-177·4) in Guinea-Bissau to 2·3 (1·8-2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from -6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000-13 than during 1990-2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only -1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone.

    INTERPRETATION: Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030.

    FUNDING: Bill & Melinda Gates Foundation, US Agency for International Development.

    Matched MeSH terms: Infant Mortality/trends*; Child Mortality/trends*
  17. Ayed M, Borahmah AA, Yazdani A, Sultan A, Mossad A, Rawdhan H
    Med Princ Pract, 2021;30(2):185-192.
    PMID: 33197912 DOI: 10.1159/000513047
    OBJECTIVE: The objective of this study was to assess the clinical characteristics and identify mortality risk factors in intensive care unit (ICU)-admitted COVID-19 patients.

    METHODS: We recruited and analyzed SARS-CoV-2-infected adult patients (age ≥18 years) who were admitted to the ICU at Jaber Al-Ahmad Al Sabah Hospital, Kuwait, between March 1, 2020, and April 30, 2020. The risk factors associated with in-hospital mortality were assessed using multiple regression analysis.

    RESULTS: We recruited a total of 103 ICU patients in this retrospective cohort. The median age of the patients was 53 years and the fatality rate was 45.6%; majority (85.5%) were males and 37% patients had more than 2 comorbidities. Preexisting hypertension, moderate/severe acute respiratory distress syndrome, lymphocyte count <0.5 × 109, serum albumin <22 g/L, procalcitonin >0.2 ng/mL, D-dimer >1,200 ng/mL, and the need for continuous renal replacement therapy were significantly associated with mortality.

    CONCLUSION: This study describes the clinical characteristics and risk factors for mortality among ICU patients with CO-VID-19. Early identification of risk factors for mortality might help improve outcomes.

    Matched MeSH terms: Pneumonia, Viral/mortality*; Hospital Mortality*
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