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Fulltext Anti-carbamylated protein antibodies in rheumatoid arthritis patients and their association with rheumatoid factor

Othman MA, Ghazali WSW, Hamid WZWA, Wong KK, Yahya NK

Saudi Med J, 2017 Sep;38(9):934-941.
PMID: 28889152 DOI: 10.15537/smj.2017.9.20841

OBJECTIVES: To evaluate levels of anti-carbamylated protein (anti-CarP) antibodies in rheumatoid arthritis (RA) patients and to determine their association with serological parameters and disease activity. Methods: A cross-sectional study involving 105 multiethnic RA patients (48 rheumatoid factor [RF]-positive and 57 RF-negative patients) was conducted at Hospital Universiti Sains Malaysia, Kelantan, Malaysia, from January 2015 to February 2016. Fifty healthy controls (HCs) were included. C-reactive protein (CRP), RF, anti-cyclic citrullinated peptide (anti-CCP) and anti-CarP antibodies were measured. A health assessment questionnaire (HAQ) was administered to the study participants and 28-joint Disease Activity Score (DAS28) were obtained. Results: The level of anti-CarP antibodies was significantly increased in the RA patients compared with HCs (p=0.042). The presence of anti-CarP antibodies was significantly associated with RF (p=0.019) and the HAQ (p=0.010). A significant association between the presence of anti-CarP antibodies and the DAS28 was not found (p=0.632). Conclusion: Our study provides further evidence that the level of anti-CarP antibodies is significantly elevated in RA patients.

Study site: Rheumatology clinic, Hospital Universiti Sains Malaysia

Matched MeSH terms: Hospitals, University
Predicting acute myocardial infarction (AMI) 30-days mortality: Using standardised mortality ratio (SMR) as the hospital performance measure

Kamarulariffin Kamarudin M, Tan Jen Ai C, Lisa Zaharan N, Yahya A

Int J Med Inform, 2022 Dec;168:104865.
PMID: 36334465 DOI: 10.1016/j.ijmedinf.2022.104865

BACKGROUND: A standardised mortality ratio (SMR) is the hospital observed mortality divided by its predicted mortality and has been used as an indicator to monitor hospital performance.
OBJECTIVES: This study developed a model that predicted 30-day mortality for acute myocardial infarction (AMI) and compared the SMR among 41 Malaysian public hospitals using statistical process control charts.
METHODS & RESULTS: Data from referral centres and specialist hospitals with cardiology services were analysed. Both referral centres and specialist hospitals had comparable mortality, except for Hospitals A and B, which the study considered outliers. Two-thirds of the remaining hospitals had an SMR of above one (SMR 1.05-1.51), but the indices were still within the expected variations.
CONCLUSION: The SMR coupled with a funnel plot and variable life adjusted display (VLAD) can identify hospitals with potentially higher than expected mortality rates.

Matched MeSH terms: Hospitals, Public
Fulltext Adherence to Clinical Practice Guidelines (CPG) management of dengue infection in adults (revised 2nd edition)

Abd Rahman M, Ahmad Zaki R, Sarimin R, Ariff MI, Suli Z, Mahmud M, et al.

PLoS One, 2017;12(11):e0184559.
PMID: 29095822 DOI: 10.1371/journal.pone.0184559

The Malaysian Dengue Clinical Practice Guidelines (CPG) have been developed to provide evidence-based guidance in the management of dengue infections. The use of these guidelines is essential to ensure its recommendations are being practiced. However, the adherence to the guidelines for management of dengue (revised 2nd edition) by healthcare providers still remains unknown. Therefore, the aim of this study was to evaluate the proportion among healthcare providers that adhere to this Dengue CPG. A retrospective cohort study of dengue cases registered from 1 January 2014 to 1 June 2015 was conducted in public hospitals and health clinics in Selangor, Putrajaya and Kuala Lumpur. Adherence to the CPG recommendations were recorded by reviewing patients' case notes. Overall proportion of adherence in clinical components of the recommendation were (7.1 to 100.0% versus 7.7 to 73.8%) in history taking, (6.7 to 100.0% versus 12.3 to 60.0%) in physical examinations, (18.4 to 100.0% versus 23.1 to 83.2%) in assessment of warning signs, (0.6 to 100.0% versus 12.3 to 87.7%) in assessment of haemodynamic status, (60.0 to 100.0% versus 27.7 to 40.0%) in diagnosis, (46.6 to 80.0% versus 52.3%) in case notifications, (73.2 to 100.0% versus 89.2 to 96.9%) in performing specific laboratory investigations and (7.9 to 100.0% versus 21.5%) in monitoring, for outpatient versus inpatient, respectively. Adherence trends were demonstrated to be higher in hospital settings compared to outpatient settings. Adherence to this Dengue CPG varies widely with overall good clinical outcomes observed.

Study site: public hospitals and health clinics in Selangor, Putrajaya and Kuala Lumpur

Matched MeSH terms: Hospitals
Fulltext Breastfeeding practices in a rural community in Kedah

Yadav, H.

JUMMEC, 2010;13(1):38-44.
MyJurnal

Breast feeding has been actively encouraged in Malaysia in the last few years in all public hospitals. This study proposes to find out the prevalence of breast feeding in three villages in a rural community in Kedah, Malaysia. This was a cross sectional study on breastfeeding practices in Kubang Pasu, a district of Kedah. Majority of the mothers initiated breast feeding but exclusive breastfeeding was only 21% for four months and predominant breastfeeding was about 12.6%. The breastfeeding practice was more prevalent among women from the higher educational strata and higher income than those from the lower strata and lower income (p

Matched MeSH terms: Hospitals, Public
Fulltext Maternal and cord serum immunoglobulins in four Malaysian races

Shah FH, Yadav M

Singapore Med J, 1977 Dec;18(4):246-57.
PMID: 614701

Immunoglobulin G, A and M levels were determined in paired maternal and cord sera of premature, full term and postmature newborns of urban dwelling Chinese, Indian, Malay and full term newborn of the forest dwelling Orang Asli (Malaysian aborigines). The mean serum IgC level in the full term Orang Asli newborns (1254±441 mg per 100 mil is comparable to that of the Indians (1211±282 mg per 100 ml) and Malays (1169±286 mg per 100 ml) but these levels are higher than those of the Chinese
newborns (1092±270 mg per 100 ml). Statistical analysis indicates a significant dependence of cord serum IgG level on maternal serum IgG level in the . Chinese, Indians and Malays. In addition, in Indians the cord serum IgG was significantly dependent at 5% level on the gestation age. The fetomaternal serum IgG level ratios at term were equal to or just less than one. The cord serum IgM levels of the Chinese, Indian, Malay and Orang Asli newborns at term were 11.6.±. 6.5, 12.5.±. 7.3, 10.9.±. 5.8 and
16.7±6.9 mg per 100 ml respectively. Statistical analysis showed absence of correlation between cord serum IgM level and birthweight, gestation age or maternal serum IgM level in Chinese and Malays. In Indians the cord sera IgM level showed a dependence on the birthweight. Immunoglobulin A was present in 34.6%, 40.5%, 31.6% and 62.5% of full term Chinese, Indian, Malay and Orang Asli newborns respectively. These observations are discussed in relation to the immunoglobulin levels observed in populations residing in temperate and other tropical regions.

Matched MeSH terms: Hospitals, University
Fulltext Effects of monochromatic infrared energy therapy on diabetic feet with peripheral sensory neuropathy: a randomised controlled trial

Nawfar SA, Yacob NB

Singapore Med J, 2011 Sep;52(9):669-72.
PMID: 21947144

INTRODUCTION: Peripheral diabetic neuropathy, which is a cause of increasing morbidity and mortality following foot ulcers and amputations, is a burden to health and the economy. Various adjunct treatments to improve neuropathy have been introduced into the market; one such treatment is monochromatic infrared energy (MIRE) therapy, which claimed to produce promising results. This study aimed to evaluate the effects of MIRE on diabetic feet with peripheral neuropathy.
METHODS: A randomised controlled, single-blinded study was conducted at Hospital Universiti Sains Malaysia from February 2008 to October 2008. A total of 30 feet from 24 patients were studied. Neuropathy was screened using the Michigan neuropathy scoring instrument, followed by an assessment of the current perception threshold using a neurometer at frequencies of 2,000 Hz, 250 Hz and 5 Hz. The feet were randomised to receive either daily MIRE or sham treatment for a total of 12 treatments. Each foot was then reassessed using the neurometer at six weeks and three months following treatment.
RESULTS: The data obtained was analysed using a non-parametric test to compare the pre- and post-treatment groups. No significant difference was found between the neuropathic foot of diabetic patients in both the MIRE and sham groups.
CONCLUSION: No improvement of neuropathy was observed following MIRE treatment in the neuropathic feet of diabetic patients.

Matched MeSH terms: Hospitals, University
Fulltext A patient with nodular skin swelling

Khajotia R, Raman S, Rajadurai P, Yaacob W

Aust Fam Physician, 2010 Apr;39(4):219-20.
PMID: 20372682
Matched MeSH terms: Hospitals, General
Fulltext Interactive Low Back Pain Intervention Module Based on the Back School Program: A Cluster-Randomized Experimental Study Evaluating Its Effectiveness among Nurses in Public Hospitals

Ibrahim MI, Zubair IU, Shafei MN, Ahmad MI, Yaacob NM

Int J Environ Res Public Health, 2020 08 14;17(16).
PMID: 32824040 DOI: 10.3390/ijerph17165916

The prevalence of low back pain (LBP) among nurses is high. The main aim of this study was to evaluate the effectiveness of an interactive LBP module based on the Back School Program in improving Oswestry Disability Scores (ODSs) among nurses in government hospitals in Penang, Malaysia. A cluster-randomized experimental study was conducted within four public hospitals. These hospitals were randomized to intervention and control groups. A total of 284 nurses from the selected hospitals were randomly selected (142 in each group). An interactive LBP intervention module based on the Back School Program was designed and prescribed. Both the intervention and control groups were assessed using the Oswestry Disability Questionnaire at baseline and at the end of the third and sixth weeks. Out of 284 participants, 281 completed this study. A between-group comparison revealed that ODSs were significantly lower in the intervention group than in the control group at the ends of the third (p = 0.006) and sixth weeks (p < 0.001). Within-group changes revealed a significant reduction in ODSs within the intervention group from baseline to the third (p < 0.001) and sixth weeks (p < 0.001) of the intervention. This simple interactive LBP module was effective in reducing symptoms of LBP among nurses as early as three weeks, and this effect was sustained until the sixth week of the intervention.

Matched MeSH terms: Hospitals, Public
Fulltext Assessing Patient-Perceived Hospital Service Quality and Sentiment in Malaysian Public Hospitals Using Machine Learning and Facebook Reviews

A Rahim AI, Ibrahim MI, Musa KI, Chua SL, Yaacob NM

Int J Environ Res Public Health, 2021 09 21;18(18).
PMID: 34574835 DOI: 10.3390/ijerph18189912

Social media is emerging as a new avenue for hospitals and patients to solicit input on the quality of care. However, social media data is unstructured and enormous in volume. Moreover, no empirical research on the use of social media data and perceived hospital quality of care based on patient online reviews has been performed in Malaysia. The purpose of this study was to investigate the determinants of positive sentiment expressed in hospital Facebook reviews in Malaysia, as well as the association between hospital accreditation and sentiments expressed in Facebook reviews. From 2017 to 2019, we retrieved comments from 48 official public hospitals' Facebook pages. We used machine learning to build a sentiment analyzer and service quality (SERVQUAL) classifier that automatically classifies the sentiment and SERVQUAL dimensions. We utilized logistic regression analysis to determine our goals. We evaluated a total of 1852 reviews and our machine learning sentiment analyzer detected 72.1% of positive reviews and 27.9% of negative reviews. We classified 240 reviews as tangible, 1257 reviews as trustworthy, 125 reviews as responsive, 356 reviews as assurance, and 1174 reviews as empathy using our machine learning SERVQUAL classifier. After adjusting for hospital characteristics, all SERVQUAL dimensions except Tangible were associated with positive sentiment. However, no significant relationship between hospital accreditation and online sentiment was discovered. Facebook reviews powered by machine learning algorithms provide valuable, real-time data that may be missed by traditional hospital quality assessments. Additionally, online patient reviews offer a hitherto untapped indication of quality that may benefit all healthcare stakeholders. Our results confirm prior studies and support the use of Facebook reviews as an adjunct method for assessing the quality of hospital services in Malaysia.

Matched MeSH terms: Hospitals, Public
Fulltext Congenital posterior mediastinal teratoma--a case report

Harun MH, Yaacob I

Singapore Med J, 1993 Dec;34(6):567-8.
PMID: 8153729

Almost all mediastinal teratomas are found in the anterior mediastinum. We describe a case of a 41-day-old baby girl who had teratoma in the posterior mediastinum. She presented at the age of 6 days with the problem of progressive jaundice and was found to have septicaemia. During septic screening, chest X-ray revealed a mass in the right mediastinum. Ultrasound and CT-scan of the chest showed a multiloculated mass at the right posterior mediastinum. Fine needle aspiration biopsy of the mass confirmed a teratoma.
Study site: Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Hospitals, University
Fulltext Munchausen syndrome by proxy

Yaacob BM

Malays J Med Sci, 1999 Jul;6(2):30-1.
PMID: 22589687 MyJurnal

Munchausen syndrome by proxy is a rare disorder in child psychiatric practice. A case of Munchausen syndrome by proxy that was managed in the Child Psychiatric clinic, Universiti Sains Malaysia Hospital is reported. Factors that suggest the diagnosis are discussed. Multidisciplinary approach to the management of such cases is warranted.

Matched MeSH terms: Hospitals
A hospital-based surveillance for Japanese encephalitis in Bali, Indonesia

Kari K, Liu W, Gautama K, Mammen MP, Clemens JD, Nisalak A, et al.

BMC Med, 2006;4:8.
PMID: 16603053

Japanese encephalitis (JE) is presumed to be endemic throughout Asia, yet only a few cases have been reported in tropical Asian countries such as Indonesia, Malaysia and the Philippines. To estimate the true disease burden due to JE in this region, we conducted a prospective, hospital-based surveillance with a catchment population of 599,120 children less than 12 years of age in Bali, Indonesia, from July 2001 through December 2003.

Matched MeSH terms: Hospitals
Concurrent benzodiazepine use in older adults treated with antidepressants in Asia

Zhong XM, Wang F, Zhang Q, Ungvari GS, Ng CH, Chiu HFK, et al.

Int Psychogeriatr, 2019 05;31(5):685-691.
PMID: 29212560 DOI: 10.1017/S1041610217002563

ABSTRACTBackground:Little is known about the combined use of benzodiazepines and antidepressants in older psychiatric patients. This study examined the prescription pattern of concurrent benzodiazepines in older adults treated with antidepressants in Asia, and explored its demographic and clinical correlates.
METHODS: The data of 955 older adults with any type of psychiatric disorders were extracted from the database of the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) project. Demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Both univariate and multiple logistic regression analyses were performed.
RESULTS: The proportion of benzodiazepine and antidepressant combination in this cohort was 44.3%. Multiple logistic regression analysis revealed that higher doses of antidepressants, younger age (<65 years), inpatients, public hospital, major comorbid medical conditions, antidepressant types, and country/territory were significantly associated with more frequent co-prescription of benzodiazepines and antidepressants.
CONCLUSIONS: Nearly, half of the older adults treated with antidepressants in Asia are prescribed concurrent benzodiazepines. Given the potentially adverse effects of benzodiazepines, the rationale of benzodiazepines and antidepressants co-prescription needs to be revisited.

Matched MeSH terms: Hospitals, Public
Self-efficacy and self-care behavior of Malaysian patients with type 2 diabetes: a cross sectional survey

Sharoni SK, Wu SF

Nurs Health Sci, 2012 Mar;14(1):38-45.
PMID: 22288688 DOI: 10.1111/j.1442-2018.2011.00658.x

This study investigated the association between self-efficacy and self-care behavior to determine the degree of self-efficacy and to examine differences in self-efficacy according to patient variables, including state of health, of Malaysian patients with type 2 diabetes. The sample comprised 388 patients (respondents). We collected the data from December 2010 to February 2011. We found a significant positive relationship between self-efficacy and self-care behavior (r(s) = 0.481, P < 0.001). The degree of self-efficacy was moderately high (mean = 7.570). We found significant differences between self-efficacy and education level (Wilk's Lambda = 0.918, F[12, 1008] = 2.779, P < 0.05), duration of diabetes (Wilk's Lambda = 0.954, F[8, 736] = 2.264, P < 0.05), other chronic conditions (Wilk's Lambda = 0.967, F[4, 383] = 3.304, P < 0.05) and diabetic complications (Wilk's Lambda = 0.963, F[4, 383] = 3.653, P < 0.05). Self-efficacy can be used as a model to understand self-care behavior. Individualized nursing interventions based on self-efficacy theory should be utilized in high risk diabetic patients so as to assist and improve self-care behavior.
Study site: Diabetic clinic and the medical, nephrology, orthopedic, and surgery wards, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Hospitals, University
Fulltext Final height in growth-hormone-treated children with idiopathic growth hormone deficiency: the Malaysian experience

Ooi HL, Wu LL

Med J Malaysia, 2011 Dec;66(5):479-83.
PMID: 22390105
Matched MeSH terms: Hospitals, University
Knowledge, attitude and awareness among healthcare professionals about influenza vaccination in Peshawar, Pakistan

Khan TM, Khan AU, Ali I, Wu DB

Vaccine, 2016 Mar 8;34(11):1393-8.
PMID: 26845740 DOI: 10.1016/j.vaccine.2016.01.045

A cross-sectional study was carried out among HCPs in Northwest General Hospital & Research Centre, Hayatabad Peshawar, Pakistan. The purpose of this study was to investigate knowledge, awareness and attitude of HCPs towards influenza vaccination. A total of N=170 questionnaires were distributed among the staff. There was a 97% response rate to this survey (n=165). The median age of the respondents was 30 years and most of them, 98 (59.0%), were from age group of 24-30 years. The majority of the HCPs that participated in this study were male 106 (64.2%), and by profession, the majority were physicians 77 (46.7%), followed by pharmacists and nurses. A majority 114 (69.1%) believed that it was not compulsory for HCPs to get vaccinated for influenza. Top three identified barriers to vaccination were: not everyone is familiar with the availability of the influenza vaccination at their institution (Relative importance weight factors (RIWF)=0.71), due to needle fear I do not like to get vaccinated (RIWF=0.70) and it is not compulsory for healthcare professionals to get vaccinated for influenza (RIWF=0.64). The logistic regression analysis has revealed association for job experience and profession with the most of the eleven knowledge item. However, when overall sum of eleven items were tested to identify the factors affecting the knowledge score, along with profession (-0.215 [-0.389 to 0.040]; p=0.016) and job experience (0.823 [0.521-1.125]; p<0.001) HCPs age (-0.409 [-0.755 to -0.064]; p=0.020) was found to be another significant factor affecting the total knowledge score of HCPs. Overall, scoring of the correct responses revealed that nurses have better knowledge and understanding about influenza and the influenza vaccination (6.5±0.8, p<0.001*), followed by pharmacists (6.3±1.14) and physicians. In spite of the published guidelines and recommendations, a very low percentage of the healthcare professionals in our hospital were vaccinated against influenza, and the barriers to vaccination were prevalent. Various strategies, including arranging seminars regarding awareness about vaccinations, are required to improve the knowledge and overall outcomes.

Matched MeSH terms: Hospitals, General
Fulltext Remedial education in specific reading retardation

Tan CK, Malhotra KK, Woon TH

Med J Malaysia, 1980 Mar;34(3):273-8.
PMID: 7412667

The concept of specific reading retardation was discussed, and compared with other terms used as synonymous with it viz. dyslexia and minimal brain dysfunction. It was suggested that specific reading retardation may be a more suitable term to use. The feature's of specific reading retardation, the evaluation of reading disability and management in terms of supportive psychotherapy, environmental manipulation and remedial education was described, using a case-report. of a 13-year old boy with such a disorder as an example.
Study site: Psychiatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Hospitals, University
Fulltext Short-term psychotherapy by medical students: its therapeutic effectiveness and its educational value

Teoh JI, Woon TH

Singapore Med J, 1975 Jun;16(2):128-37.
PMID: 1162391

This paper deals with the evaluation of the effectiveness of individual psychotherapy by students on patients' subjective symptomatic improvement and the therapeutic benefits to medical students. The results of the study indicated that student psychotherapy was of significant benefit to psychoneurotic patients, but was of dubious value in the clinical teaching of psychotherapy in the psychiatric curriculum of the medical course at the University of Malaya, Kuala Lumpur.

Matched MeSH terms: Hospitals, University
Risk factors for fragility fracture in Seremban district, Malaysia: a comparison of patients with fragility fracture in the orthopedic ward versus those in the outpatient department

Loh KY, Shong KH, Lan SN, Lo WY, Woon SY

Asia Pac J Public Health, 2008;20(3):251-7.
PMID: 19124319 DOI: 10.1177/1010539508317130

Osteoporosis is a silent disease and becomes clinically significant in the presence of fragility fracture. Identifying risk factors that are associated with osteoporosis in the community is important in reducing the incidence of fragility fracture. The aim of this study is to identify risk factors associated with fragility fracture in the Seremban District of Malaysia. This is a population comparison study between orthopedic ward patients and outpatients attending a community health clinic for 6 months. Epidemiological data and the possible risk factors for osteoporosis were collected by direct interview. This study demonstrates that advancing age, low body weight, smoking, lack of regular exercise, low consumption of calcium containing foods, and using bone depleting drugs (steroids, thyroid hormone, and frusemides) are major risk factors for fragility fracture. Most of these risk factors are modifiable through effective lifestyle intervention.
Study site: Klinik Kesihatan Seremban; Hospital Seremban, Negeri Sembilan, Malaysia

Matched MeSH terms: Hospitals, General
Fulltext Combined oral and parenteral iron chelation in beta thalassaemia major

Balveer K, Pyar K, Wonke B

Med J Malaysia, 2000 Dec;55(4):493-7.
PMID: 11221163

Thalassaemics in Malaysia are poorly chelated because desferrioxamine is too expensive and cumbersome for long term compliance. The efficacy and tolerability of the oral chelator deferiprone, and the effects of using a combination therapy in our patients were studied. Ten patients completed the study and the mean serum ferritin reduced from 7066.11 ug/L (2577-12,896 ug/L) to 3242.24 ug/L (955-6120 ug/L). The liver iron concentration did not show a significant drop (19.6 vs 18.2 mg/g dry weight) although 3 patients showed reductions ranging from 30-40%. Concomitant use of desferrioxamine increased the urinary excretion from a mean of 13.66 mg/day to 27.38 mg/day. Main side effects seen were nausea and rashes.

Matched MeSH terms: Hospitals, General

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