Displaying publications 141 - 160 of 2158 in total

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  1. Md Ralib A, Mat Nor MB
    J Crit Care, 2015 Jun;30(3):636-42.
    PMID: 25701354 DOI: 10.1016/j.jcrc.2015.01.018
    Acute kidney injury (AKI) is common and carries a high mortality rate. Most epidemiological studies were retrospective and were done in Western populations. We aim to assess its incidence using both urine output and creatinine criteria and its association with risk factors and outcome.
    Matched MeSH terms: Prospective Studies
  2. Chow YW, Lim BB, Hooi LS
    Med J Malaysia, 2007 Mar;62(1):27-32.
    PMID: 17682566 MyJurnal
    A three month prospective study was carried out in 1994 (8/3/94 - 7/6/94) and late 2004/early 2005 (24/11/2004 - 15/2/2005) among patients with acute renal failure (ARF) (serum creatinine > 0.200 mmol/1). Incidence of ARF had increased from 0.48% (78/16,418) to 1.1% (211/18,697) of admissions between 1994 and 2004. Two thirds of patients were male. Mean age was 57.7 +/- 20.1 years in 1994 and 55.6 +/- 17.8 years in 2004. No difference was noted in causative factors, rate of oliguric ARF (about 10%) and mean peak urea and creatinine. The cause was pre-renal failure in 43.6% in 1994 and 53.5% in 2004. The second commonest cause was sepsis with 41% in 1994 and 37.9% in 2004. One in six patients needed dialysis and peritoneal dialysis was the main dialysis modality (69.2% and 74.3%). Mortality was 56.4% in 1994 and 44.5% in 2004. A quarter of deaths occurred within two days of admission due to severe underlying illness. Mortality among non-oliguric patients decreased from 52.9% in 1994 to 37.0% in 2004 (p = 0.04); for patients from intensive care units it was 78.3% in 1994 and 68.5% in 2004.
    Matched MeSH terms: Prospective Studies
  3. Norrashidah AW, Azizi BH, Zulfiqar MA
    Med J Malaysia, 1999 Jun;54(2):225-9.
    PMID: 10972033
    Acute respiratory distress syndrome (ARDS) is the final outcome of a common pathway of a variety of unrelated but massive insults to the lung. It is commonly seen in adults but also occurs in the paediatric age group. A prospective study was carried out to determine the incidence, predisposing conditions, clinical course and outcome of children with ARDS admitted to a paediatric intensive care unit (PICU). Six patients (aged 0.8 to 11 years) who fulfilled the strict criteria for ARDS were identified prospectively during a one year study period. The incidence was 1.7% of all PICU admission. The most common underlying conditions were septicemia and pneumonia. The mortality rate was 83%. Death most often occurred during the early phase of the disease. Treatment of ARDS included elimination of the cause of ARDS, early institution of mechanical ventilation with PEEP, prompt recognition and treatment of superimposed infection and careful management of additional organ failure.
    Matched MeSH terms: Prospective Studies
  4. Choo WS, Foo S, Tan E, Thayaparan FS, Chung YY, Raman S, et al.
    Med J Malaysia, 2009 Mar;64(1):34-6.
    PMID: 19852318 MyJurnal
    This is a prospective study to determine the severity of disability and prognosis of acute stroke patients related to their Body Mass index (BMI). A total of 79 consecutive CT-scan-proven acute stroke patients who were admitted to Hospital Tuanku Ja'afar, Seremban between November 2006 and April 2007 were recruited (male:female 49:30; mean age 62.7 years; ischemic stroke 70, intracerebral bleed 9). The patients were divided according to BMI less than 25 (Group A) and equal or greater than 25 (Group B). Severity of disability was measured between 24-48 hours by modified Rankin's score. Patients were followed up after one month. Thirty-seven patients had severe disability (Rankin Score 5). Twenty-nine patients had adverse outcomes including 11 deaths and 18 rehospitalizations or prolonged hospital/nursing home stay. 34.3% of Group B had severe disability compared to 56.8% of Group A (chi2 P = 0.046). Conversely 42.9% of Group B had adverse events at one month compared to 31.8% of Group A (chi2 P = 0.312). There were no statistical differences between high- and low-BMI groups for gender ratio, smoking, hypertension, diabetes, prior cardiovascular disease, mean age, mean lipid profile and blood pressure. When comparing patients with Rankin Score 1-4 versus 5, age and BMI were statistically significant between the two groups. By multivariate analysis only age is independent predictor for severe disability (P < 0.05). The results of this pilot study should be confirmed in larger prospective multicentre trial.
    Matched MeSH terms: Prospective Studies
  5. Sarin SK, Kedarisetty CK, Abbas Z, Amarapurkar D, Bihari C, Chan AC, et al.
    Hepatol Int, 2014 Oct;8(4):453-71.
    PMID: 26202751 DOI: 10.1007/s12072-014-9580-2
    The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. Due to the rapid advancements in the knowledge and available information, a consortium of members from countries across Asia Pacific, "APASL ACLF Research Consortium (AARC)," was formed in 2012. A large cohort of retrospective and prospective data of ACLF patients was collated and followed up in this data base. The current ACLF definition was reassessed based on the new AARC data base. These initiatives were concluded on a 2-day meeting in February 2014 at New Delhi and led to the development of the final AARC consensus. Only those statements which were based on the evidence and were unanimously recommended were accepted. These statements were circulated again to all the experts and subsequently presented at the annual conference of the APASL at Brisbane, on March 14, 2014. The suggestions from the delegates were analyzed by the expert panel, and the modifications in the consensus were made. The final consensus and guidelines document was prepared. After detailed deliberations and data analysis, the original proposed definition was found to withstand the test of time and identify a homogenous group of patients presenting with liver failure. Based on the AARC data, liver failure grading, and its impact on the "Golden therapeutic Window," extra-hepatic organ failure and development of sepsis were analyzed. New management options including the algorithms for the management of coagulation disorders, renal replacement therapy, sepsis, variceal bleed, antivirals, and criteria for liver transplantation for ACLF patients were proposed. The final consensus statements along with the relevant background information are presented here.
    Matched MeSH terms: Prospective Studies
  6. Haseeb A, Ajit Singh V, Teh CSJ, Loke MF
    J Orthop Surg (Hong Kong), 2019 5 30;27(2):2309499019850324.
    PMID: 31138005 DOI: 10.1177/2309499019850324
    BACKGROUND: Ceftaroline is a cephalosporin that is effective against methicillin-resistant Staphylococcus aureus (MRSA) infections. The objective of this study was to determine the feasibility of using ceftaroline-loaded Polymethyl methacrylate (PMMA) as antibiotic cement against MRSA versus vancomycin-loaded PMMA in an in vitro setting.

    METHODS: PMMA pellets were prepared with three separate concentrations of each of the two antibiotics tested. They were tested to determine the effect of increasing concentration of antibiotics on the biomechanical properties of PMMA and antibiotic activity by measuring the zone of inhibition and broth elution assay.

    RESULTS: Ceftaroline PMMA at 3 wt%, three-point bending was 37.17 ± 0.51 N ( p < 0.001) and axial loading was 41.95 N ± 0.51 ( p < 0.001). At 5-wt% vancomycin-PMMA, three-point bending was 41.65 ± 0.79 N ( p = 0.02) and axial loading was 49.49 ± 2.21 N ( p = 0.01). Stiffness of ceftroline-loaded PMMA in low and medium concentration was significantly higher than the vancomycin. The zone of inhibition for ceftaroline was higher than vancomycin. Ceftaroline at 3 wt% eluted up to 6 weeks (0.3 ± 0.1 μg/ml) above the minimum inhibitory concentration (MIC) and vancomycin at 2.5 wt% eluted up to 3 weeks, same as MIC, that is, 0.5 ± 0.0 μg/ml.

    CONCLUSIONS: Ceftaroline, loaded at similar concentrations as vancomycin into PMMA, is a more potent alternative based on its more favourable bioactivity and elution properties, while having a lesser effect on the mechanical properties of the cement. The use of 3-wt% ceftaroline as antibiotic laden PMMA against MRSA is recommended. It should be noted that this was an in vitro study and to determine the clinical efficacy would need prospective, controlled and randomized studies.

    Matched MeSH terms: Prospective Studies
  7. Loh LC, Quah SY, Khoo SK, Vijayasingham P, Thayaparan T
    Respirology, 2005 Jun;10(3):371-7.
    PMID: 15955152
    Current clinical practice guidelines, including those in south Asia, recommend the addition of a macrolide to a broad-spectrum antibiotic for the treatment of severe hospitalized community-acquired pneumonia (CAP). The aim of this study was to observe the influence of macrolide addition on clinical outcomes of hospitalized adult patients with CAP.
    Matched MeSH terms: Prospective Studies
  8. Abdullah B, Hassan S, Sidek D, Jaafar H
    J Laryngol Otol, 2006 Jul;120(7):556-60.
    PMID: 16834804 DOI: 10.1017/S002221510
    INTRODUCTION: Otitis media with effusion (OME) is an inflammation of the middle ear in which a collection of liquid is present in the middle-ear space while the tympanic membrane is intact. The association between adenoid inflammation and OME has long been noted but the exact mechanism is still much debated. We studied the role of adenoid mast cells in the causation of OME.
    OBJECTIVE: To study the distribution and role of adenoid mast cells in the causation of OME.
    METHODOLOGY: A cross-sectional, prospective study was carried out in the otorhinolaryngologic clinic, department of otorhinolaryngology (ORL), Science University of Malaysia, from June 1999 to September 2001. A total number of 50 cases were studied. Twenty-five of these patients underwent adenoidectomy, while another 25 patients underwent adenoidectomy and myringotomy with ventilation tube insertion. The adenoid specimens from all patients were examined for the number of adenoid mast cells present, using light microscopy and toluidine blue as the staining agent. The results were analysed using SPSS version 10.0 computer software.
    RESULT: The population of adenoid mast cells in children with OME was significantly greater than that in children without OME (p=0.000).
    CONCLUSION: The increased number of adenoid mast cells in patients with OME suggests that inflammation may play a role in this condition.
    Matched MeSH terms: Prospective Studies
  9. Wan Hazmy CH, Maizuliana SH, Mastura MT, Norazlina M
    Med J Malaysia, 2006 Feb;61 Suppl A:45-9.
    PMID: 17042229
    Adequate pain relief is a requisite for a successful closed manipulative reduction (CMR) of fractures and dislocations. This prospective study was undertaken to assess the mode and adequacy of pain relief given to patients undergoing such procedures at Seremban Hospital from the 1st April to the 31st May 2001. All patients with fractures and dislocations scheduled to undergo CMR were included in this study. The type of sedative agents and analgesia administered were recorded. Demographic data and the type of fracture or dislocation of the selected patients were documented. A visual analogue scale (VAS) for pain perception was given to both to the patients and the medical personnel who performed the procedure. All data were collected manually before entered into computerized database for analysis. Of 72 patients included in this study, 47% were Malay, 26% Indian, 21% Chinese and 6% others. There was male predominance and the patients' age ranged between 9 to 79 years (average 27.4 years). Upper limb injuries (79%) were mainly fractures of the radius and ulna (29%) and isolated fracture radius (21%). For the lower limb injuries (21%), combined tibia and fibula fractures constituted 10% of the total cases followed by isolated tibia fractures (10%) and hip dislocation (1%). The most common pain relieving agents given during the CMR were intravenous pethidine alone (43%) followed by combination of intravenous pethidine and valium (36%), intramuscular pethidine (17%) and intramuscular tramal (4%). The Visual Analogue Score (VAS) for pain perception revealed that 61% of the patients had moderate pain while 21% had severe pain during the course of the procedures. Suboptimal pain relief administered during CMR should prompt positive actions to ensure that the patient is not subjected to undue pain just for the sake of an acceptable fracture reduction.
    Matched MeSH terms: Prospective Studies
  10. Mousavi SM, Milajerdi A, Pouraram H, Saadatnia M, Shakeri F, Keshteli AH, et al.
    Int J Vitam Nutr Res, 2021 Jan;91(1-2):48-55.
    PMID: 31259666 DOI: 10.1024/0300-9831/a000603
    Background: Stroke is a major global health problem that contributes to a significant burden of morbidity and mortality. The association of several foods and nutrients with stroke has been well-established. However, the effect of the whole diet on stroke is poorly understood. In this work, we aimed to examine the association between the quality of whole diet, as measured using Alternate Healthy Eating Index-2010 (AHEI-2010), and risk of stroke in Iranian adults. Methods: In this hospital-based case-control study, 193 stroke patients (diagnosed based on clinical and brain CT findings) and 193 controls with no history of cerebrovascular diseases or neurologic disorders were included. The participants' dietary intakes were examined using a validated 168-item semi-quantitative food frequency questionnaire. AHEI-2010 was constructed based on earlier studies. Participants were classified according to tertiles of AHEI-2010 scores and multivariate logistic regression was used to evaluate the association between whole diet quality and risk of stroke. Results: Individuals with greater adherence to AHEI-2010 had a higher intake of fruits, vegetables, nuts and legumes, whole grains and carbohydrate, and a lower intake of trans-fatty acids, sugar-sweetened beverages, total energy and fat (P 
    Matched MeSH terms: Prospective Studies
  11. Oh CK, Aniwan S, Piyachaturawat P, Wong Z, Soe T, Luvsandagva B, et al.
    Gut Liver, 2021 11 15;15(6):878-886.
    PMID: 33790055 DOI: 10.5009/gnl20166
    Background/Aims: As the number of colonoscopies and polypectomies performed continues to increase in many Asian countries, there is a great demand for surveillance colonoscopy. The aim of this study was to investigate the adherence to postpolypectomy surveillance guidelines among physicians in Asia.

    Methods: A survey study was performed in seven Asian countries. An email invitation with a link to the survey was sent to participants who were asked to complete the questionnaire consisting of eight clinical scenarios.

    Results: Of the 137 doctors invited, 123 (89.8%) provided valid responses. Approximately 50% of the participants adhered to the guidelines regardless of the risk of adenoma, except in the case of tubulovillous adenoma ≥10 mm combined with high-grade dysplasia, in which 35% of the participants adhered to the guidelines. The participants were stratified according to the number of colonoscopies performed: ≥20 colonoscopies per month (high volume group) and <20 colonoscopies per month (low volume group). Higher adherence to the postpolypectomy surveillance guidelines was evident in the high volume group (60%) than in the low volume group (25%). The reasons for nonadherence included concern of missed polyps (59%), the low cost of colonoscopy (26%), concern of incomplete resection (25%), and concern of medical liability (15%).

    Conclusions: A discrepancy between clinical practice and surveillance guidelines among physicians in Asia was found. Physicians in the low volume group frequently did not adhere to the guidelines, suggesting a need for continuing education and appropriate control. Concerns regarding the quality of colonoscopy and complete polypectomy were the main reasons for nonadherence.

    Matched MeSH terms: Prospective Studies
  12. Bijker R, Jiamsakul A, Kityo C, Kiertiburanakul S, Siwale M, Phanuphak P, et al.
    J Int AIDS Soc, 2017 03 03;20(1):21218.
    PMID: 28362063 DOI: 10.7448/IAS.20.1.21218
    INTRODUCTION: Our understanding of how to achieve optimal long-term adherence to antiretroviral therapy (ART) in settings where the burden of HIV disease is highest remains limited. We compared levels and determinants of adherence over time between HIV-positive persons receiving ART who were enrolled in a bi-regional cohort in sub-Saharan Africa and Asia.
    METHODS: This multicentre prospective study of adults starting first-line ART assessed patient-reported adherence at follow-up clinic visits using a 30-day visual analogue scale. Determinants of suboptimal adherence (<95%) were assessed for six-month intervals, using generalized estimating equations multivariable logistic regression with multiple imputations. Region of residence (Africa vs. Asia) was assessed as a potential effect modifier.
    RESULTS: Of 13,001 adherence assessments in 3934 participants during the first 24 months of ART, 6.4% (837) were suboptimal, with 7.3% (619/8484) in the African cohort versus 4.8% (218/4517) in the Asian cohort (p 
    Matched MeSH terms: Prospective Studies
  13. Prasitsuebsai W, Sethaputra C, Lumbiganon P, Hansudewechakul R, Chokephaibulkit K, Truong KH, et al.
    AIDS Care, 2018 06;30(6):727-733.
    PMID: 29336591 DOI: 10.1080/09540121.2018.1425363
    We studied behavioral risks among HIV-infected and uninfected adolescents using an audio computer-assisted self-interview. A prospective cohort study was initiated between 2013 and 2014 in Malaysia, Thailand, and Vietnam. HIV-infected adolescents were matched to uninfected adolescents (4:1) by sex and age group (12-14 and 15-18 years). We enrolled 250 HIV-infected (48% male; median age 14.5 years; 93% perinatally infected) and 59 uninfected (51% male; median age 14.1 years) adolescents. At enrollment, HIV-infected adolescents were on antiretroviral therapy (ART) for a median (IQR) of 7.5 (4.7-10.2) years, and 14% had HIV-RNA >1000 copies/mL; 19% reported adherence <80%. Eighty-four (34%) HIV-infected and 26 (44%) uninfected adolescents reported having ever smoked cigarettes or drunk alcohol (p = 0.13); 10% of HIV-infected and 17% of uninfected adolescents reported having initiated sexual activity; 6 of the HIV-infected adolescents had HIV-RNA >1000 copies/mL. Risk behaviors were common among adolescents, with few differences between those with and without HIV.
    Matched MeSH terms: Prospective Studies
  14. Radwan H, Hashim M, Hasan H, Abbas N, Obaid RRS, Al Ghazal H, et al.
    Br J Nutr, 2022 Oct 14;128(7):1401-1412.
    PMID: 34294166 DOI: 10.1017/S0007114521002762
    During the first 1000 d of life, gestational weight gain (GWG) and postpartum weight retention (PPWR) are considered critical determinants of nutritional status. This study examined the effect of adherence to the Mediterranean diet (MD) during pregnancy on GWG and PPWR at 2 and 6 months among women in the United Arab Emirates (UAE), using data from the Mother-Infant Study Cohort. The latter is a prospective study, for which pregnant women were recruited (n 243) during their third trimester and were followed up for 18 months. Data on socio-demographic characteristics and anthropometric measurements were obtained. An eighty-six-item FFQ was used to examine dietary intake during pregnancy. Adherence to the MD was assessed using the alternate MD (aMED) and the Lebanese MD (LMD). Adherence to the MD, PPWR2 (2 months) and PPWR6 (6 months) were considered high if participants belonged to the third tertile of the respective measures. Results indicated that 57·5 % of participants had excessive GWG while 50·7 % and 45 % retained ≥ 5 kg at 2 and 6 months postpartum, respectively. After adjustment, adherence to both MD scores was associated with lower odds of excessive GWG (aMED, OR:0·41, 95 % CI:0·18, 0·93; LMD, OR:0·40, 95 % CI: 0·16, 0·98). Adherence to MD was also associated with PPWR2 (aMED: OR: 0·23, 95 % CI: 0·06, 0·88) and PPWR6 (aMED OR:0·26; 95 % CI:0·08-0·86; LMD, OR:0·32; 95 % CI: 0·1, 0·98). The findings of this study showed that adherence to the MD may reduce GWG and PPWR and, hence, underscored the importance of promoting the MD for better health of the mother and infant.
    Matched MeSH terms: Prospective Studies
  15. Dossus L, Franceschi S, Biessy C, Navionis AS, Travis RC, Weiderpass E, et al.
    Int J Cancer, 2018 Apr 01;142(7):1332-1342.
    PMID: 29168186 DOI: 10.1002/ijc.31172
    Other than the influence of ionizing radiation and benign thyroid disease, little is known about the risk factors for differentiated thyroid cancer (TC) which is an increasing common cancer worldwide. Consistent evidence shows that body mass is positively associated with TC risk. As excess weight is a state of chronic inflammation, we investigated the relationship between concentrations of leptin, adiponectin, C-reactive protein, interleukin (IL)-6, IL-10 and tumor necrosis factor (TNF)-α and the risk of TC. A case-control study was nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) study and included 475 first primary incident TC cases (399 women and 76 men) and 1,016 matched cancer-free cohort participants. Biomarkers were measured in serum samples using validated and highly sensitive commercially available immunoassays. Odds ratios (ORs) of TC by levels of each biomarker were estimated using conditional logistic regression models, adjusting for BMI and alcohol consumption. Adiponectin was inversely associated with TC risk among women (ORT3vs.T1  = 0.69, 95% CI: 0.49-0.98, Ptrend  = 0.04) but not among men (ORT3vs.T1  = 1.36, 95% CI: 0.67-2.76, Ptrend  = 0.37). Increasing levels of IL-10 were positively associated with TC risk in both genders and significantly so in women (ORT3vs.T1  = 1.59, 95% CI: 1.13-2.25, Ptrend  = 0.01) but not in men (ORT3vs.T1  = 1.78, 95% CI: 0.80-3.98, Ptrend  = 0.17). Leptin, CRP, IL-6 and TNF-α were not associated with TC risk in either gender. These results indicate a positive association of TC risk with IL-10 and a negative association with adiponectin that is probably restricted to women. Inflammation may play a role in TC in combination with or independently of excess weight.
    Matched MeSH terms: Prospective Studies
  16. Boo NY, Guat-Sim Cheah I, Malaysian National Neonatal Registry
    J Trop Pediatr, 2013 Dec;59(6):447-52.
    PMID: 23774951 DOI: 10.1093/tropej/fmt051
    This study aimed to determine the prevalence of admission hypothermia (AH) among very-low-birth-weight (≤1500 g) infants in 32 Malaysian neonatal intensive care units (NICUs). This was a retrospective analysis of prospectively collected data of all very-low-birth-weight infants admitted and a questionnaire survey of the practice of AH prevention. Of the 3768 (99.8%) infants with admission temperature recorded, 64.8% (n = 2440) were hypothermic: 40.3% (n = 983) mildly (36.0-36.4°C), 58.5% (n = 1428) moderately (32.0-35.9°C) and 1.2% (n = 29) severely (<32.0°C). Mean ambient temperature of these NICUs was 22.8°C (SD = 2.7, n = 28) in labour rooms and 20.1°C (SD = 1.6, n = 30) in operation theatres. None of the NICUs practised complete care bundle against AH at birth (i.e. use of pre-warmed radiant warmer and cling wrap, ambient temperature of at least 25°C and use of pre-warmed transport incubator). Care bundle against neonatal hypothermia should be actively promoted in Malaysian labour rooms and operation theatres.
    Matched MeSH terms: Prospective Studies
  17. Izzuddin Poo M, Lee WS
    Med J Malaysia, 2007 Aug;62(3):189-93.
    PMID: 18246904 MyJurnal
    Mortality from acute diarrhoea in developed countries is low, but the morbidity and financial cost remains significant. A one-year prospective, descriptive, non-interventional, hospital-based study of acute gastroenteritis (AGE) was conducted in the year 2002 in the paediatric unit of University of Malaya Medical Centre, Kuala Lumpur, an urban hospital in Malaysia, to determine its morbidity and management. During the study period, 393 children with AGE were admitted, utilizing 0.50% of total patient-bed-day of the hospital. The median duration of symptoms before admission was two days. Seventy-seven percent of patients had consulted family physicians before admission. Antidiarrhoeal drugs (57%) and anti-emetics (48%) were commonly prescribed, but oral rehydrating solution (36%) was rarely advised. Upon admission, severe vomiting (24%) and severe diarrhea (24%) were not common, while 17% had moderate or severe dehydration. Rotavirus (22%) was the commonest pathogen identified. Electrolyte derangement, secondary septicaemia and chronic diarrhoea were all rare. Eighty-nine percent of patients received intravenous fluid therapy whilst in the hospital. No death was noted. The morbidity and mortality of children with AGE requiring hospital care in this study was low. However, preadmission management and fluid therapy after admission was not ideal. Efforts to encourage better adherence to established management protocol of AGE among family physicians and hospital clinicians should be instituted.
    Matched MeSH terms: Prospective Studies
  18. Freestone B, Rajaratnam R, Hussain N, Lip GY
    Int J Cardiol, 2003 Oct;91(2-3):233-8.
    PMID: 14559136
    BACKGROUND: There are established differences in cardiovascular disease in different racial groups. Worldwide, the literature regarding the clinical epidemiology of atrial fibrillation in non-white populations is scarce.

    OBJECTIVES: To document the prevalence of atrial fibrillation (AF) in the multiracial population of Malaysia, and to describe the clinical features and management of these patients.

    SETTING: Busy city centre general hospital in Kuala Lumpur, Malaysia, over a 1-month period.

    SUBJECTS: One-thousand four hundred and thirty-five acute medical admissions, of whom 40 patients (2.8%) had AF.

    RESULTS: Of 1435 acute medical admissions to Kuala Lumpur General Hospital over the 4-week study period, 40 had AF (21 male, 19 female; mean age 65 years). Of these, 18 were Malay, 16 Chinese and six Indian. Nineteen patients had previously known AF (seven with paroxysmal AF) and 21 were newly diagnosed cases. The principal associated medical conditions were ischaemic heart disease (42.5%), hypertension (40%) and heart failure (40%). Dyspnoea was the commonest presentation, whilst stroke was the cause of presentation in only two patients. Investigations were under-utilised, with chest X-ray and echocardiography in only 62.5% of patients and thyroid function checked in 15%. Only 16% of those with previously diagnosed AF were on warfarin, with a further three on aspirin. Anticoagulant therapy was started in 13.5% of patients previously not on warfarin, and aspirin in 8%. Records of contraindications to warfarin were unreliable, being identified in only 25%. For those with known AF, 58% were on digoxin. For new onset AF, digoxin was again the most common rate-limiting treatment, initiated in 38%, whilst five patients with new onset AF were commenced on amiodarone. DC cardioversion was not used in any of the patients with new onset AF.

    CONCLUSION: Amongst acute medical admissions to a single centre in Malaysia the prevalence of AF was 2.8%. Consistent with previous similar surveys in mainly western (caucasian) populations, standard investigations in this Malaysian cohort were also inadequate and there was underuse of anticoagulation, medication for ventricular rate control and cardioversion to sinus rhythm.

    Matched MeSH terms: Prospective Studies
  19. Loh LC, Khoo SK, Quah SY, Visvalingam V, Radhakrishnan A, Vijayasingham P, et al.
    Respirology, 2004 Aug;9(3):379-86.
    PMID: 15363012
    Prediction of mortality in patients with community-acquired pneumonia (CAP) can be assessed using clinical severity scores on admission to hospital. The clinical benefit of such tools is untested in Asian countries. The aim of this study was to determine the early adverse prognostic factors in patients hospitalized with CAP in Malaysia and to assess the usefulness of the British Thoracic Society (BTS) severity criteria.
    Matched MeSH terms: Prospective Studies
  20. Yong HH, Hamann SL, Borland R, Fong GT, Omar M, ITC-SEA project team
    Soc Sci Med, 2009 Oct;69(7):1025-31.
    PMID: 19695758 DOI: 10.1016/j.socscimed.2009.07.042
    In recent years, attempts have been made to incorporate religion into tobacco control efforts, especially in countries like Malaysia and Thailand where religion is central to the lives of people. This paper is a prospective examination of the perceived relevance and role of religion and religious authorities in influencing smoking behaviour among Muslims in Malaysia and Buddhists in Thailand. Data were collected from 1482 Muslim Malaysian and 1971 Buddhist Thai adult smokers who completed wave 1 (early 2005) of the International Tobacco Control Southeast Asia Survey (ITC-SEA). Respondents were asked about the role of religion and religious leadership on smoking at Wave 1 and among those recontacted, quitting activity at Wave 2. Results revealed that over 90% of both religious groups reported that their religion guides their day-to-day behaviour at least sometimes, but Malaysian Muslims were more likely to report that this was always the case. The majority (79% Muslims and 88% Buddhists) of both groups believed that their religion discourages smoking. About 61% of the Muslims and 58% of the Buddhists reported that their religious leaders had encouraged them to quit before and a minority (30% and 26%, respectively) said they would be an influential source to motivate them to quit. Logistic regression models suggest that these religious factors had a clear independent association with making quitting attempts in both countries and this translated to success for Malaysian Muslims but not for the Thai Buddhists. Taken together, results from this study indicate that religion and religious authorities are both relevant and important drivers of quitting, but whether this is always enough to guarantee success is less clear. Religion can be a culturally relevant vehicle to complement other tobacco control efforts.
    Matched MeSH terms: Prospective Studies
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