Displaying publications 141 - 160 of 272 in total

Abstract:
Sort:
  1. Coccolini F, Improta M, Sartelli M, Rasa K, Sawyer R, Coimbra R, et al.
    World J Emerg Surg, 2021 08 09;16(1):40.
    PMID: 34372902 DOI: 10.1186/s13017-021-00380-1
    Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality. Delayed diagnosis and treatment of surgical disease occur; these patients may seek medical assistance late because their symptoms are often ambiguous. Also, they develop unique surgical problems that do not affect the general population. Management of this population must be multidisciplinary.This paper presents the World Society of Emergency Surgery (WSES), Surgical Infection Society Europe (SIS-E), World Surgical Infection Society (WSIS), American Association for the Surgery of Trauma (AAST), and Global Alliance for Infection in Surgery (GAIS) joined guidelines about the management of acute abdomen in immunocompromised patients.
    Matched MeSH terms: Emergency Service, Hospital
  2. Nik Muhamad, N.A., anesan Murthi, J., Nik Ismail, N.A.
    Medicine & Health, 2015;10(2):103-111.
    MyJurnal
    The popularity of ultrasound for acute diagnosis of fractures in the Emergency Department (ED) has increased over the recent years. This present study aimed to determine the sensitivity and specificity of ultrasound use for detection of fractures in a different environment, which is at the triage area of the ED. We compared the results of bedside ultrasound in detecting non-critical fractures to the current gold standard of X-rays in the triage area. The design was a single centered crosssectional study. From August 2014 till November 2014, a total of 46 patients were recruited, creating 75 image pairs. Following consent, a bedside ultrasound was performed and subsequently compared with X-ray reporting regarding the presence or absence of fractures. SPSS analysis was used to determine the sensitivity and specificity of ultrasound in diagnosing fracture as compared to X-rays. Ultrasound had a sensitivity of 72% (95% CI, 50.6% - 87.9%) and a specificity of 80% (95%CI: 66.3 - 90%) when compared to X-rays in fracture diagnosis. The kappa analyses showed moderate inter observer agreement (0.5) between ultrasound and X-rays in diagnosing fractures. This study suggests that the use of ultrasound as a triage tool yet has unacceptable sensitivity and needs further evaluation and consideration.
    Matched MeSH terms: Emergency Service, Hospital
  3. Amer Siddiq Amer Nordin, Azreen Hashim, Mohamad Hussain Habil, Noor Zurani Md Haris Robson
    ASEAN Journal of Psychiatry, 2010;11(1):108-112.
    MyJurnal
    Objective: This case report highlights the abuse and dependence potential of Zolpidem and the risk of life-threatening withdrawal symptoms upon abrupt discontinuation. Method: We report a case of Zolpidem dependence which presented with withdrawal symptoms upon abrupt discontinuation. Results: A 32 year old male, who had abused non-benzodiazepine Zolpidem for 6 years presented to the accident and emergency unit with generalized seizures upon stopping Zolpidem ‘cold turkey’. He required admission to the neurology high dependency unit for stabilization of the seizures and was later managed by the addiction team where a tapering dose of benzodiazepine was prescribed. Conclusion: This case demonstrates that non-benzodiazepine agents can cause tolerance and dependence, and thus produce withdrawal symptoms upon discontinuation.
    Matched MeSH terms: Emergency Service, Hospital
  4. Roslinah, A., Azman, A.B., Roslan Johari, M.G., Noriah, B., Rohani, I., Faisal, S.
    MyJurnal
    Contact time was defined as the time spent by health personnel with a patient. The study was conducted for four months in 2007 to assess the contact time and to determine the appropriate contact time as perceived by patients attending clinics of various clinical disciplines as well as Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals. This study was a cross-sectional study carried out on out-patients who came to the hospitals’ clinics for treatment. Information was gathered through self-administered questionnaires, distributed at twenty-one hospitals. The respondents were selected using stratified random sampling method. Out of 21,750 questionnaires distributed, 13,463 patients responded, a response rate of 61.9%. This study shows that the average contact time increases from small hospitals (8 minutes) to bigger hospitals (15 minutes). The contact time also varies between the clinics of various disciplines. Obstetrics and Gynecology (O&G) clinics and Pediatric clinics had the longest average contact time of 20 minutes and 15 minutes respectively. The percentage of patients who were satisfied with the contact time corresponded with the type of clinics and hospitals which had the longest contact time. Thus, it is suggested that clinics and hospitals, whenever possible try their best to follow the duration of contact time as perceived appropriate by the patients.

    Study site: Out-Patient Departments and Emergency Departments at Ministry of Health Hospitals (21)
    Matched MeSH terms: Emergency Service, Hospital
  5. Irfan Mohamad, Arumugam, Puvan Arul, Nik Fariza Husna Nik Hassan
    MyJurnal
    An 11-year-old Malay boy was allegedly involved in motor vehicle accident. He sustained left lung contusion and pneumothorax which necessitate chest tube insertion at a district hospital. On arrival at Accident & Emergency Unit, general physical examination was performed. Neck examination revealed multiple jagged lacerations wound on the left side of the neck (Panel 1). (Copied from article).
    Matched MeSH terms: Emergency Service, Hospital
  6. Noor Asmidar, A., Tan, T.L., Ong, W.J., Ahmad Fuad Fahmi, M.N., Chieng, Z.L., Noor Akmal, S.I.
    Medicine & Health, 2014;9(2):124-133.
    MyJurnal
    Sepsis causes high mortality and morbidity. Static lactate concentration and early lactate clearance are cited to be a predictor for sepsis survival. This study examined the clinical utility of static lactate concentration and early lactate clearance within the first six hours of admission in Emergency Department (ED) to predict 28-day mortality rate in sepsis patients. Patients who presented with sepsis, severe sepsis or septic shock and admitted to ED of Universiti Kebangsaan Malaysia Medical Centre were recruited. Blood lactate concentrations were measured upon admission (H0), at 1st hour (H1) and 6th hour (H6), respectively. Either standard treatment of sepsis or early goal directed therapy was initiated according to sepsis severity. A follow-up report was conducted at 28 days via telephone call, e-mail or case notes. Patients were later classified into survivor and non-survivor as final outcome. Static lactate concentration appeared to be significantly higher for non-survivor as compared to the survival group at H0, H1 and H6 (p
    Matched MeSH terms: Emergency Service, Hospital
  7. Rafidah Bahari, Muhammad N Mohamad Alwi, Muhammad R Ahmad, Ismail Mohd Saiboon
    ASEAN Journal of Psychiatry, 2015;16(2):203-211.
    MyJurnal
    There are a number of validated questionnaires available for the screening of Post-Traumatic Stress Disorder (PTSD), and the PTSD Checklist for Civilians is one of them. However, none was translated into the Malay Language and validated for use in the Malaysian population. The aim of this study is to translate and validate the Malay PTSD Checklist for Civilians (MPCL-C). Methods: The PCL-C was translated into the Malay Language and back-translated. The reliability and validity of the MPCL-C were then determined by administering them to those who presented at the emergency department for motor vehicle accident at least one month before. Results: The MPCL-C has good face and content validity. In terms of reliability, it is also good, with Chronbach’s alpha values of 0.90, 0.77, 0.75 and 0.74 for the full scale, re-experiencing, avoidance and arousal domains respectively. Conclusions: The MPCL-C is a valid and reliable instrument to screen for PTSD in motor vehicle accident victims for the studied population.
    Matched MeSH terms: Emergency Service, Hospital
  8. Nik Rosmawati, N.H., Manaf, A.H., Ahmad Zaki, I., Naing, L.
    MyJurnal
    All road users are at risk of being involved in motor vehicle crashes (MVCs). Approximately 52.2% of all fatalities and 70.9% of all casualties related to MVCs in Kelantan were motorcycle riders and pilliori riders. A number of risk factors have been established in the relationship between traffic accidents and road-user, the vehicle as well as road and traffic conditions. The study was a cross-sectional study to identify factors associated with the severity of injury sustained by motorcyclist accident patients admitted to the Emergency Department, Hospital Universiti Sains Malaysia (HUSM), assessed through face to face interview based questionnaire and, at the same time the severity of injury was determined through Revised Trauma Score. Data analysis was done using simple and multiple logistic regressions. The study revealed that age more than 5O years, no motorcycle license, no stressful condition and crashes on two·way road showed higher risk of sustaining a more severe injury. However, sleep time of six to less than nine hours per day, crash on a straight roadway and wet road surface were associated with less severe injury. We recommend that public education, licensing and enforcement on accident prevention and safety riding should be given a priority.
    Matched MeSH terms: Emergency Service, Hospital
  9. Isamil Saiboon, Ho, Siew Eng, Krishnan, Bala, Siti Norraini Ali, Noorafindi Murad, Pathnathan, Audrey, et al.
    Medicine & Health, 2008;3(1):7-13.
    MyJurnal
    Patients’ satisfaction is of critical interest to all healthcare providers. Satisfied patients are more likely to seek health care and to comply with prescribed treatment regimes. The objective of the study was to identify factors that influence patient satisfaction with Emergency Department HUKM (ED HUKM). This study was conducted at ED HUKM from January 2007 till March 2007. A convenience sample of 100 participants was recruited from triage 4. The Davis Consumer Emergency Care Satisfaction Scale (CECSS) was adopted and modified. It consists of 19 questions; used a 5 point, Likert type scale of 1 to 5 (1= completely disagree and 5= completely agree) to measure patient satisfaction with triage, health care providers caring behaviours and health teaching. Results showed that 75 participants (75%) were satisfied. There were no significant difference found between male and female patients with total CESCC scores (t=0.308, p values >0.05). Pearson product moment correlation coefficients showed a positive relationship between total and subscale patient satisfaction scores, caring scores (r=0.905, p value
    Matched MeSH terms: Emergency Service, Hospital
  10. Premalatha, S., Nik Azlan, N.M., Maryam, M.F.
    Medicine & Health, 2014;9(2):150-154.
    MyJurnal
    Orogastric lavage has been performed since 200 years ago for intoxicated patients. Due to the risk that outweighs benefits it has fallen out of favour for the last decade. A teenage girl presented to Emergency Department with history of ingestion of a bottle of pesticide within the time frame before gastric emptying. The girl was resuscitated, intubated and orogastric lavage was performed. Fifty cc of the toxic substance was siphoned and antidote of the toxin was administered. She was admitted to the Intensive Care Unit, subsequently recovered and discharge five days later. Definitive airway management, proper technique, correct selection of patients and adequate monitoring are paramount to the success of orogastric lavage.
    Matched MeSH terms: Emergency Service, Hospital
  11. Ahmad, K.I., Shamsul, A.S., Ismail, M.S.
    MyJurnal
    Acute appendicitis is one of the most common differential diagnoses for acute abdominal pain made by emergency doctors. Suspected cases require surgical referral for observation or definitive intervention to prevent complications. A high index of suspicion and good clinical skills with the aid of scoring systems allows early decision making, which includes optimal pain control. The objective of this study was to identify the pain score and is relationship to the cut-off points of the Alvarado scoring system so that justifies early surgical referral or discharge for suspected acute appendicitis from the Emergency Department of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This was a cross sectional study of acute abdominal pain from June 2007 to September 2008. All patients who fulfilled the criteria and consented to the study were assessed for Alvarado score, verbal numerical pain score (VNRS) and their subsequent management. Patients with an Alvarado score of ≥7 were likely to have acute appendicitis (80.1% sensitivity and 52.63% specificity) and those with the score of ≤3 were unlikely to have acute appendicitis. The median pain score was 7.00 (IQR: 5.00-8.50) but 72.5% did not receive any analgesia. There was no direct relationship between the pain score with Alvarado score. Oligoanalgesia in patients with acute appendicitis still exist in Emergency Department of UKMMC.
    Matched MeSH terms: Emergency Service, Hospital
  12. Medicine & Health, 2009;4(2):101-107.
    MyJurnal
    Although stress among nursing staff is common, adopting effective coping styles helps in minimizing the problem. The objectives of this study were to compare stress level among ursing staff working in the above disciplines, to identify common coping style used and to determine the relationship between stress and coping styles. This cross-sectional study involved 106 nursing staff who were universally sampled from psychiatric wards and emergency departments in two public hospitals in the Klang Valley. Self-rated questionnaires i.e. Stress Arousal Checklist (SACL) and Coping inventory for Stressful Situations (CISS) were used to assess stress levels and coping styles respectively. There was insignificant difference in terms of stress level between the two nursing staffs. Stress dimension of SACL between the psychiatry (6.53 + 3.18, p=0.372) and emergency (6.02  + 2.67, p=0.372) nursing staffs were insignificant. Arousal dimension of SACL was also  insignificant between psychiatry (8.60  + 1.70, p=0.372) and emergency (9.19  + 1.61, p=0.07) nursing staff. Task coping was the most commonly used coping styles among the psychiatry (55.36  + 9.85) and emergency (57.73  + 9.87) nursing staff in this study. Stress dimension of SACL showed weak significant relationship with task coping (r=-0.313, p=0.001) and emotion coping (r=0.292, p=0.001). Arousal dimension of SACL was also found to have weak significant relationship with task coping  (r=0.271, p=0.003) and emotion coping (r=-0.251, p=0.005). While nursing was found to be a stressful profession, a significant relationship between stress and coping styles allows intervention to enable better adaptation to the stressful working environment.
    Matched MeSH terms: Emergency Service, Hospital
  13. Yahaya SN, Wahab SFA, Yusoff MSB, Yasin MAM, Rahman MAA
    World J Emerg Med, 2018;9(3):178-186.
    PMID: 29796141 DOI: 10.5847/wjem.j.1920-8642.2018.03.003
    BACKGROUND: Demanding profession has been associated with poor psychological health due to multiple factors such as overworking hours and night shifts. This study is to determine prevalence and associated factors of depression, anxiety and stress among medical officers working at emergency department in Malaysian hospitals.

    METHODS: A cross-sectional study was conducted on 140 emergency department medical officers working at general hospitals from seven Malaysia regions. They were randomly selected and their depression, anxiety and stress level were measured by the 21-item Depression, Anxiety, Stress Scale.

    RESULTS: The highest prevalence was anxiety (28.6%) followed by depression (10.7%) and stress (7.9%). Depression, anxiety and stress between seven hospitals were not significantly different (P>0.05). Male medical officers significantly experienced more anxiety symptoms than female medical officers (P=0.0022), however depression and stress symptoms between male and female medical officers were not significantly different (P>0.05). Depression, anxiety and stress were not associated with age, working experience, ethnicity, marital status, number of shifts and type of system adopted in different hospitals (P>0.05).

    CONCLUSION: The prevalence of anxiety was high, whereas for depression and stress were considerably low. Gender was the only factor significantly associated with anxiety. Other factors were not associated with depression, anxiety and stress. Future research should aim to gain better understanding on unique factors that affect female and male medical officers' anxiety level in emergency setting, thus guide authorities to chart strategic plans to remedy this condition.

    Matched MeSH terms: Emergency Service, Hospital
  14. Kurnaz R, Ikizler M, Ozbayburtlu M, Gunes T
    Malays Orthop J, 2018 Mar;12(1):51-53.
    PMID: 29725515 DOI: 10.5704/MOJ.1803.012
    Proximal humerus fracture is a common arm trauma and rarely occurs with vascular injury which however is a serious complication. In this case report, we present a long segment dissection of the axillary and brachial arteries as a rare complication due to fragmented proximal humerus fracture and shoulder dislocation. An 80-year old female patient was seen at the emergency department. Radiograph examination has revealed a fragmented proximal humerus fracture besides dislocation of the head of humerus towards the axillary area. On vascular examination, acute arterial occlusion such as absence of radial and ulnar pulses were observed in her left hand. The patient was immediately taken to the operating room. The dissection included the entire segment approximately 20cm between the distal subclavian artery and the distal brachial artery. This injured segment was removed and a 6mm Polytetrafluroethylene (PTFE) graft with rings was interpositoned between subclavian and brachial arteries. This case is a rarity because of such a significant complication after a small injury. Axillary artery injuries caused by humeral neck fractures are rare but should not be missed by the physician.
    Matched MeSH terms: Emergency Service, Hospital
  15. Nik Muhamad, N.A., Ismail, A.K., Kaharuddin, H., Miao Ching, H., Qamarul Ariffin, S., Syazwani Azwa, S., et al.
    Medicine & Health, 2016;11(1):2-10.
    MyJurnal
    Midazolam is one of the most commonly used drugs for sedation in Emergency Department (ED). This was a retrospective study conducted on 380 patients from December 2012 to May 2014 in ED of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The objective was to elicit the frequency of side effects and correlation to various factors i.e. socio-demography, co-morbidities, age groups and underlying illnesses. Out of 380 patients, 35 patients experienced side effects (20 patients with midazolam alone, 15 patients with combination of drugs). The average age was 42 years and the average dose of midazolam was 3.5mg. The most common other drug combined was fentanyl. The overall complication rate for midazolam was 5.3%. The most common side effect recorded was excessive somnolence (1.6%). Other side effects included local skin reactions (1.1%), vomiting (0.8%), headache (0.8%) and hypotension (0.5%). There was no significant association between the socio-demographic factors and drugs combination with the side effects of midazolam on patients. It was concluded that midazolam was a safe drug due to absence of any life-threatening side effects. There are possibilities that most side effects recorded could be caused by other comfounding factors e.g. underlying injuries or disease and combination with other drugs.
    Matched MeSH terms: Emergency Service, Hospital
  16. Koh, B.Y.E., Norharlina, B.
    MyJurnal
    The authors report a case of co-morbid diagnosis Anorexia Nervosa (AN) with co-morbid diagnosis of Obsessive-compulsive Disorder (OCD) by proxy. The patient is a 16-year-old female who presented to the emergency department with features of AN and also OCD. To reduce the anxiety of her AN, she incorporated her mother as a proxy to follow specific instructions. The patient received both inpatient and outpatient support, and her condition gradually improved with antidepressants and antipsychotics. This case illustrates a co-morbid presentation of OCD with AN and also the result of family accommodation that led to the family member aiding with the compulsion. Treatment for the case was also briefly discussed.
    Study site: emergency department (unspecified)
    Matched MeSH terms: Emergency Service, Hospital
  17. Loganathan T, Mohamed PY
    Med J Malaysia, 2018 10;73(5):340-341.
    PMID: 30350821 MyJurnal
    In November 2016, a 28-year-old Malay man presented to the emergency department in respiratory distress, with a history of fever and sore throat. A clinical diagnosis of acute diphtheria was made and the patient was isolated and ventilated in the intensive care unit, and received diphtheria antitoxin and intravenous antibiotics. Initial laboratory findings failed to confirm diphtheria, leading to discontinuation of antibiotics and quarantine. Public health measures were reinstated after a reference laboratory cultured Corynebacterium diphtheriae. Although there was no contact with ill persons, investigation revealed incomplete immunisation history, and injection of high dose steroids prior to onset of symptoms.
    Matched MeSH terms: Emergency Service, Hospital
  18. Jia Ying S, Ian C, Azlanudin A, Zamri Z, Hairol O
    MyJurnal
    Hypervirulent Klebsiella pneumoniae strain is a major cause of liver abscess and this bacteria has metastatic properties. This distinct liver abscess syndrome has been increasingly reported in Asia over the past two decades, but is emerging as a global disease. We described an 81-year-old lady, who presented to the emergency department with 1-week prior duration of fever and right eye swelling. She had been admitted for recurrent liver abscess prior to this. Hence, she was initially treated as sepsis secondary to recurrent liver abscess. Meanwhile, she was managed concurrently by ophthalmology team for endophtalmitis. Despite the initiation of treatment with antibiotics, she did not show any improvement and required right eye evisceration to treat the sepsis. Invasive liver abscess syndrome with metastatic endophthalmitis should be screened in patient with Klebsiella liver abscess. They should be monitored for ocular symptoms as early recognition can prohibit delays in treatment, which has debilitating consequences.
    Matched MeSH terms: Emergency Service, Hospital
  19. Kesu Belani L, Leong JF, Narin Singh PSG, Abdullah S
    Cureus, 2019 Dec 13;11(12):e6377.
    PMID: 31938655 DOI: 10.7759/cureus.6377
    Hair thread tourniquet syndrome (HTTS) is a rare condition where fibres constrict around appendages causing ischaemia and necrosis. It is a sporadically reported condition, where almost all reported cases showed involvement of fingers, toes or genitalia. A significant number of the cases are infants aged two weeks to six months where it is attributed to the mother's excessive hair fall due to hormonal changes after delivery. We present a two-month-old infant who was irritable for the past two days with her left ring finger exhibiting an ischaemic constriction with no apparent insulting agent. She successfully treated surgically after we suspected an incomplete removal of hair thread in the emergency department. We would like to highlight the importance of a high index of suspicion in cases as such as early intervention saves the appendage.
    Matched MeSH terms: Emergency Service, Hospital
  20. Bhattacharya S, Singh A, Semwal J, Marzo RR, Sharma N, Goyal M, et al.
    PMID: 32154300 DOI: 10.4103/jehp.jehp_423_19
    INTRODUCTION: Disaster can occur at any time any place. Disaster preparedness plays an important role to reduce the loss of a community/country. The aim of this interventional study was to ascertain the impact of a video-based educational intervention program on improvement in knowledge and attitude of paramedical students in a hospital.

    MATERIALS AND METHODS: A pre-post study (interventional study design) was conducted on paramedic students. Our study period was 6 months which was divided into Phases I, II, and III. For administrative purpose, we included all paramedical students, and our sample size was 119. The baseline assessment of knowledge and attitude of paramedic students was done by a pretested questionnaire (Observation 1) with having a baseline scoring. After that, intervention Phase 1 was implemented, and later, end line observation (Observation 2) was made. Changes in knowledge and attitude were observed by the score difference (Observation 2-Observation 1). Descriptive statistics were calculated, and the mean of cumulative score was compared using the Wilcoxon signed-rank test. We applied Mann-Whitney U-test for finding associations between dependent variables with an independent variable using SPSS version 22 (IBM, Chicago, USA) software.

    RESULTS: Our baseline results showed that most of our participants had average knowledge (54.6%), followed by poor knowledge (24.4%). Approximately one-fifth (21.0%) of the participants had good knowledge regarding disaster preparedness. A significant improvement was observed in cumulative score (P < 0.005). A significant difference was observed in knowledge and attitude with respect to age and courses (P < 0.05). Forty percent of the students responded that they would like to get trained by that mock drill, and 26.1% were interested in disaster preparedness workshops in the future.

    CONCLUSION: Our present study results indicate that the overall knowledge and attitude level of the students was average and required improvement. A similar result was reported in some studies conducted globally for the same purpose. All of our students perceived that training for disaster preparedness is necessary for all health facilities, and it is important to have an emergency plan and disaster management committee. Regarding training methods, most of our students liked our interactive audiovisual method. However, their preferred methods were mock drill and workshops. It can be arranged in the future for them.

    Matched MeSH terms: Emergency Service, Hospital
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links