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Fulltext Factor Structure of The Malay-Version Generalized Anxiety Disorder-7 (GAD-7) questionnaire among patients with diabetes mellitus

Woon, L.S., Hatta, S., Norlaila, M.

Medicine & Health, 2020;15(1):208-217.
MyJurnal

Soal-selidik Kecelaruan Keresahan Menyeluruh-7 (GAD-7) versi Bahasa Melayu telah menunjukkan kesahan bersamaan, iaitu kepekaan dan kekhususan yang tinggi sebagai alat saringan untuk keresahan. Namun, ciri-ciri psikometriknya dari segi kesahan faktor belum lagi dikaji dengan lebih lanjut. Kajian ini memeriksa struktur faktor GAD-7 versi Bahasa Melayu di antara 300 orang pesakit luar kencing manis (purata umur: 60.4 tahun, sisihan piawai: 13.4 tahun; 52.7% lelaki) di sebuah hospital universiti di Kuala Lumpur, Malaysia. Peserta kajian mengisi soal-soal selidik tentang maklumat sosiodemografik, GAD-7, Inventori Kemurungan Beck (BDI), dan WHOQOL-BREF. GAD-7 versi Bahasa Melayu menunjukkan konsistensi dalaman yang baik (Alfa Cronbach=0.91) dan kesahan konvergen yang tinggi dengan kemurungan (R Pearson=0.642, p

Matched MeSH terms: Hospitals
Fulltext Written asthma action plan in emergency department improves knowledge and asthma control among adult acute asthma patients

Shamsuriani, M.J., Norhidayah, M.S.

Medicine & Health, 2020;15(1):218-224.
MyJurnal

Pengurusan kendiri asma menggunakan pelan tindakan asma secara bertulis (WAAP) penting dalam memastikan pengurusan asma yang berkesan kerana ia mengurangkan kadar kehadiran ke hospital. Kajian ini menilai peningkatan pengetahuan dan kawalan asma menggunakan WAAP di kalangan pesakit asma di Jabatan Kecemasan. Kajian cubaan kawalan rawak ini dijalankan selama 19 bulan di Jabatan Perubatan Kecemasan sebuah hospital universiti. Kajian ini melibatkan pesakit dewasa serangan asma ringan dan sederhana. Pesakit dibahagikan secara rawak kepada dua kumpulan iaitu kumpulan intervensi dan kawalan. Soal selidik pengetahuan penyakit asma diberikan pada pesakit. Pesakit dari kedua kumpulan menerima kaunseling tentang penyakit asma berdasarkan risalah asma yang telah disediakan. Kumpulan intervensi, kemudiannya menerima kaunseling WAAP mengikut keperluan individu tersebut. Kumpulan kawalan menerima kaunseling lisan berdasarkan perawatan. Susulan kajian dijalankan pada 1 dan 3 bulan. Pengetahuan penyakit asma dan kawalan penyakit asma dinilai melalui tinjauan telefon. Lima puluh pesakit telah dibahagikan secara rawak kepada kumpulan intervensi dan kawalan. Setiap kumpulan menerima 25 pesakit. Skor pengetahuan kumpulan intervensi jauh lebih tinggi daripada kawalan (16.88+0.44 vs 13.36+3.72; p19) pada 1 bulan berbanding kumpulan kawalan (20.64+3.26 vs 17.72+4.17). Kedua-dua kumpulan mencapai kawalan yang baik pada 3 bulan. Pengurusan kendiri asma dengan menggunakan WAAP di Jabatan Kecemasan meningkatkan pengetahuan dan kawalan asma di kalangan pesakit yang mendapat serangan asma ringan dan sederhana.

Matched MeSH terms: Hospitals
Analysis of pre hospital emergency management in case of head injury

Sumardino, Widodo, Poddar S

Enferm Clin, 2020 06;30 Suppl 5:228-233.
PMID: 32713577 DOI: 10.1016/j.enfcli.2019.11.061

INTRODUCTION: Cases of trauma still becomes a health problem in almost all countries causing death in few cases. In some developing countries, the insidences of head injury tend to increase. One of the reasons for the many death and disability may be due to the inavailability and inadequacy of pre-hospital first aid.
AIM: The general objective of this study is to find out the description of community first responder in providing pre-hospital first aid to head injuries.
METHODS: This study uses qualitative descriptive method.
RESULTS: Most of the respondents have variety of educational backgrounds and do not have sufficient knowledge and skills to provide first aid. The average respondents provided help by performing initial assessment, managing effective airway and controlling bleeding. Limited pre-hospital facilities become one of the reasons for respondent not getting help so the efforts provided are not maximal. Respondents prefer to send patients directly to health facilities.
CONCLUSION: Regular education and training programs for the community first responders should be initiated so that the number of death and disability can be minimized.

Matched MeSH terms: Hospitals
Fulltext Kajian prevalens kandidiasis melalui lumuran pap lazim di hospital umum Sarawak, Malaysia

Harold Criso Ajin, Mohamed Kamel Abd Ghani, Abdul Hamid Abd Aziz, Ahmad Zorin Sahalan, Norazah Ahmad

Jurnal Sains Kesihatan Malaysia, 2013;11(1):15-18.
MyJurnal

Kajian ini dilakukan bertujuan untuk menentukan prevalens kandidiasis dalam kalangan wanita yang berumur 20 hingga 59 tahun di Hospital Umum Sarawak melalui pemeriksaan ke atas lumuran Pap lazim. Prevalens jangkitan ini dikaji dalam kalangan lima kumpulan etnik yang utama iaitu kaum Iban, Cina, Melayu, Bidayuh dan Orang Ulu. Penyaringan mikroskopik dijalankan ke atas lumuran Pap lazim sejumlah 300 sampel slaid yang telah diproses dan dicelup menggunakan pencelupan Papanicolaou. Berdasarkan maklumat pada borang permohonan penyaringan lumuran Pap, tanda dan gejala jangkitan diambil kira sebagai petunjuk penting semasa penyaringan kerana melalui tanda dan gejala jangkitan, lumuran Pap mempunyai hubungan yang rapat dengan ciri-ciri gambaran sitomorfologi jangkitan yang berlaku ke atas sel-sel epitelium sekiranya ia mengalami jangkitan. Kategori umur untuk setiap golongan etnik juga dijadikan sebagai salah satu faktor pengukur bagi menilai tahap kekerapan jangkitan. Hasil kajian menunjukkan Candida sp. telah dapat dikesan sebanyak 12.7% daripada jumlah spesimen. Jangkitan berlaku pada kesemua kumpulan etnik dan juga pada kesemua golongan umur 20 hingga 59 tahun. Kesemua kes turut menunjukkan tanda dan gejala jangkitan. Hasil kajian ini menunjukkan pentingnya menjalankan ujian penyaringan lumuran Pap bagi mengesan jangkitan kandida di samping sebagai saringan awal pengesanan kanser serviks.

Matched MeSH terms: Hospitals
Fulltext The impact of a patient education package on outcomes of pain management following orthopaedic surgery in a tertiary hospital in Malaysia

Ho, S.E., Wan Ahmad, L., Tan, Z.Y., Ho, Christopher Ck, Nursharifah, M.S., Choy, Y.C., et al.

Medicine & Health, 2015;10(1):58-65.
MyJurnal

Patient’s belief towards pain management may affect pain management outcomes and quality of life. The main aim of the present study was to determine the impact of a pre-operative pain education package towards pain belief among patients undergoing orthopaedic surgery in a tertiary hospital. A one-group pre-test post-test design study was conducted on orthopaedic surgery patients. Thirty respondents were recruited and pre-operative pain education was administered individually before surgery. Pre-operative and post-operative pain belief, management scores and side effects were measured using the Barrier Questionnaire (BQ-13). The results reported significant differences between pre-test scores (Mean = 41.87, Standard Deviation = 11.467) and post-test scores (Mean=34.80, Standard Deviation=13.026) of pain belief (t = 2.84, p = 0.004). There were also significant differences between pre-test scores (Mean = 37.10, Standard Deviation = 10.610) and post-test scores (Mean=30.80, Standard Deviation = 11.424) of pain management (t = 3.856, p = 0.0005). Respondent’s gender (t = -2.403, p = 0.023) and ethnicity (F = 5.038, p=0.014) reported significant differences with p value < 0.05, respectively. However, there were no significant differences between educational level, ethnicity, prior surgical history with pain belief (p> 0.05). There was positive impact of the pain education package towards pain belief and painmanagement among respondents who underwent orthopaedics surgery in a tertiary hospital. Reinforcement of pain educational program is pivotal in order to achieve optimal post-operative pain management.
Keywords: pain, education, orthopaedics, patient, surgery

Matched MeSH terms: Hospitals
Fulltext Kajian prevalens Trichomonas vaginalis melalui lumuran pap lazim di Hospital Umum Sarawak, Malaysia

Harold Criso Ajin, Mohamed Kamel Abd Ghani, Nurul Farhana Jufri, Ahmad Zorin Sahalan, Wan Omar Abdullah

Jurnal Sains Kesihatan Malaysia, 2012;10(1):19-22.
MyJurnal

Kajian ini dilakukan untuk menentukan prevalens jangkitan Trichomonas vaginalis, di kalangan wanita yang berumur 20 hingga 59 tahun di Hospital Umum Sarawak melalui pemeriksaan ke atas lumuran Pap lazim. Prevalens jangkitan ini dikaji di kalangan lima kumpulan etnik utama iaitu kaum Iban, Cina, Melayu, Bidayuh dan Orang Ulu. Penyaringan dijalankan pada lumuran Pap lazim ke atas 300 sampel slaid yang telah diproses dan dicelup menggunakan pencelup Papanicolaou. Berdasarkan maklumat pada borang permohonan penyaringan lumuran Pap, tanda dan gejala jangkitan diambil kira sebagai petunjuk penting semasa penyaringan kerana melalui tanda dan gejala jangkitan, lumuran Pap mempunyai hubungan yang rapat kepada ciri-ciri gambaran sitomorfologi jangkitan yang berlaku ke atas sel epitelial sekiranya ianya mengalami jangkitan. Kategori umur untuk setiap golongan etnik juga dijadikan sebagai salah satu faktor pengukur bagi menilai tahap kekerapan jangkitan. Hasil kajian menunjukkan trikomoniasis mencatatkan jangkitan sebanyak 7.7% kes. Jangkitan berlaku pada kesemua kumpulan etnik dan lebih kerap ditemui pada golongan umur 20 hingga 29 tahun. Kesemua kes turut menunjukkan tanda dan gejala jangkitan. Hasil kajian ini menunjukkan kepentingan menjalani ujian lumuran Pap sebagai ujian mengesan jangkitan Trikomonas vaginalis selain saringan awal pengesanan kanser serviks.

Matched MeSH terms: Hospitals
Fulltext Does Psychoeducation Improve Insight of Patients with Schizophrenia?

Ruzanna, Z., Marhani, M., Parveen, K.

Malaysian Journal of Psychiatry, 2010;19(2):1-14.
MyJurnal

The main aim of the study was to determine the effect of psychoeducation program on insight of patients with schizophrenia and to determine other factors associated with the change of the insight. This was an interventional study of 70 patients with schizophrenia who underwent a psychoeducation program. Diagnosis was confirmed using Mini International Neuropsychiatric Interview (M.I.N.I). Insight was assessed using the Schedule for the Assessment of Insight (SAI) before and after the psychoeducation programme. Effect on insight was measured as the change in SAI scores. There was an improvement in insight after the psychoeducation programme which was significant (p< 0.001). Patient’s age, shorter duration of illness and no previous history of admission to mental institution were significantly related to the improvement of insight (p< 0.05). Conclusion: Psychoeducation is an important tool in improving insight into illness among patients with schizophrenia. It needs to be given as early as possible during the course of the illness.

Matched MeSH terms: Hospitals, Psychiatric
Fulltext Advanced Stage at Presentation Remains a Major Factor Contributing to Breast Cancer Survival Disparity between Public and Private Hospitals in a Middle-Income Country

Kong YC, Bhoo-Pathy N, Subramaniam S, Bhoo-Pathy N, Taib NA, Jamaris S, et al.

Int J Environ Res Public Health, 2017 04 16;14(4).
PMID: 28420149 DOI: 10.3390/ijerph14040427

Background: Survival disparities in cancer are known to occur between public and private hospitals. We compared breast cancer presentation, treatment and survival between a public academic hospital and a private hospital in a middle-income country. Methods: The demographics, clinical characteristics, treatment and overall survival (OS) of 2767 patients with invasive breast carcinoma diagnosed between 2001 and 2011 in the public hospital were compared with 1199 patients from the private hospital. Results: Compared to patients in the private hospital, patients from the public hospital were older at presentation, and had more advanced cancer stages. They were also more likely to receive mastectomy and chemotherapy but less radiotherapy. The five-year OS in public patients was significantly lower than in private patients (71.6% vs. 86.8%). This difference was largely attributed to discrepancies in stage at diagnosis and, although to a much smaller extent, to demographic differences and treatment disparities. Even following adjustment for these factors, patients in the public hospital remained at increased risk of mortality compared to their counterparts in the private hospital (Hazard Ratio: 1.59; 95% Confidence Interval: 1.36-1.85). Conclusion: Late stage at diagnosis appears to be a major contributing factor explaining the breast cancer survival disparity between public and private patients in this middle-income setting.

Matched MeSH terms: Hospitals, Public*; Hospitals, Private*
Fulltext Use of complementary and alternative medicines among Malaysian cancer patients: A descriptive study

Farooqui M, Hassali MA, Shatar AK, Farooqui MA, Saleem F, Haq NU, et al.

J Tradit Complement Med, 2016 Oct;6(4):321-326.
PMID: 27774413

The use of Complementary and Alternative Medicine (CAM; bǔ chōng yǔ tì dài yī xué) has been rapidly increasing among cancer patients. However, this pervasiveness is still largely unexplored among Malaysian cancer patients. The current study aimed to evaluate the patterns of CAM use among cancer patients from a local hospital in Malaysia. In addition, the study focused on the information-seeking behavior and CAM use disclosure to doctors. Of 393 patients, 184 (46.1%) had used CAM for their cancers. CAM usage was significantly associated with gender (p = 0.021), level of education (p = 0.001), employment status (p = 0.02), and monthly income (p

Matched MeSH terms: Hospitals
Fulltext Giant cell tumor of temporomandibular joint masquerading as temporomandibular joint pain dysfunction syndrome: a rare case report

Sam JE, Rachmat RPN, Melano CSJ, Wahab NA

J Korean Assoc Oral Maxillofac Surg, 2017 Apr;43(2):134-137.
PMID: 28462199 DOI: 10.5125/jkaoms.2017.43.2.134

Giant cell tumor (GCT) of the craniofacial bones has been reported but they are not common. This tumor occurs more often in women than in men and predominantly affects patients around the third to fifth decade of life. GCTs are generally benign but can be locally aggressive as well. We report a case of GCT involving the temporomandibular joint (TMJ), which was initially thought to be temporomandibular disorder (TMD). A 22-year-old female presented with swelling and pain over the right temporal region for 18 months associated with jaw locking and clicking sounds. On examination, her jaw deviated to the right during opening and there was a 2×2 cm swelling over the right temporal region. Despite routine treatment for TMD, the swelling increased in size. Computed tomography and magnetic resonance imaging of the brain and TMJ revealed an erosive tumor of the temporal bone involving the TMJ which was displacing the temporal lobe. Surgical excision was done and the tumor removed completely. Histopathological examination was consistent with a GCT. No clinical or radiological recurrence was detected 10 months post-surgery.

Study site: Hospital Pulau Pinang

Matched MeSH terms: Hospitals
Fulltext Effectiveness of hospital-based pulmonary rehabilitation programme as compared to home-based pulmonary programme in improving the condition of the chronic obstructive pulmonary disease (COPD) patients. [Perbandingan antara rehabilitasi pulmonari di rumah dengan di hospital bagi pesakit COPD dalam memperbaiki status fungsi paru-paru]

Ayiesah Ramli, Roslina Abdul Manap, Joseph, Leonard

Jurnal Sains Kesihatan Malaysia, 2008;6(1):95-108.
MyJurnal

This study was aimed at identifying the effectiveness of hospital-based pulmonary rehabilitation programme as compared to home-based pulmonary programme in improving the condition of the chronic obstructive pulmonary disease (COPD) patients of Universiti Kebangsaan Malaysia Hospital. A total of 35 patients aging between 17 to 78 years old were randomised either to hospital (48.6%, n = 20) or home (43%, n = 15) -based pulmonary rehabilitation by the Physiotherapists. For the hospital-based rehabilitation programme, the patients were scheduled to come to the hospital twice a week for eight weeks. For home-based rehabilitation programme, subjects were scheduled to come to the Physiotherapy Department twice to learn on the exercises that need to be carried out before they are allowed to do on their own at home. Each subject was given a diary to record the exercises that have been done. A telephone call is made once a week for monitoring purpose. Assessment of lung function, six-minute-walk test and Borg score were carried out before and after the eight-week rehabilitation is conducted. The Results showed that there was no significant change in lung function for both groups before and after rehabilitation. There is a significant different (p < 0.05) in 6MWT before and after rehabilitation for hospital-based pulmonary rehabilitation patients. However, the difference is not significant (p > 0.05) for home-base pulmonary rehabilitation patients. The results also show that there exist no significant correlation between lung function and 6MWT even though there is an increase in walking distance at baseline or the eighth week. In conclusion, hospitalbased pulmonary rehabilitation is more effective than the home-based pulmonary rehabilitation in improving the exercise endurance which would helps in reduce dyspnoea among COPD patients.
Keywords: Home-based pulmonary programme; Hospital-based pulmonary programme; COPD; Lung function

Matched MeSH terms: Hospitals
Fulltext Hospital efficiency: concept, measurement techniques and review of hospital efficiency studies

Hossein Moshiri, Syed Mohammed Aljunid, Rahmah Mohd Amin

Malaysian Journal of Public Health Medicine, 2010;10(2):35-43.
MyJurnal

In a time of rising demands on hospital reimbursement levels, focus on efficient operations is becoming more imperative. In health care systems, the measurement of efficiency is usually the first step in auditing individual performance of production units, e.g. hospitals, health centers, etc. It constitutes the rational framework for the distribution of human and other resources between and within health care facilities. The term efficiency is broadly used in economics and refers to the best utilization of resources in production. Typical example of efficiency is technical efficiency, referring to the effective use of resources in producing outputs. In the Farrell framework, a hospital is judged to be technically efficient if it is operating on the best practice production frontier in its hospital industry. In general, there are two main frontier methods in measuring efficiency. The first is Data Envelopment Analysis (DEA), a linear programming method which enables the measurement of efficiency consistent with the theoretically based concept of production efficiency. DEA typically examines the relationship between inputs to a production process and the outputs of that process. The second technique for assessing efficiency that is employed is Stochastic Frontier Analysis (SFA). This is an econometric technique to estimate a conventional function; with the difference being that efficiency is measured using the residuals from the estimated equation. The error term is therefore divided into a stochastic error term and a systematic inefficiency term.

Matched MeSH terms: Hospitals
Fulltext Empowering patient’s relatives: how to do it right using the media

Khalib, A.L., Natrah, M.S.

Malaysian Journal of Community Health, 2011;17(1):51-55.
MyJurnal

Introduction: Relatives play an important role in patient care - not only providing social support but also help to complement the existing care. They must be empowered with relevant knowledge and skills of patient care including motivating patient towards immediate healing and acceptance of his fate. Although these are various approaches, the media is regarded as the most effective method in educating the family or the relatives. This paper highlights the significant role of the media as an educational tool to mobilize patient’s relatives in total patient care.
Methodology: This is a review conducted on reports, observations and feedbacks gathered from various sources involved in patient education in hospital setting. It was endorsed by a series of in-depth expert forum under patient education module.
Results: Relative empowerment has been identified to be as an important role and yet it is not fully utilized. The manpower resources are so scarce and crucial in patient as well as relative education. The media is the only alternative educational tool that could compliment the educational needs. Of all potential media available in the market we have recognized at least four types of media that can be optimally resourced and used. Through manipulation of its content and making it interactive, the role of media seemed to be extremely effective in patient management that include relatives.
Conclusion: The role of media in relative’s education in support of patient care is undeniable. The media with the most potential should be identified and the management of its content to be enhanced. It must be incorporated with an interactive approach in order to have more self-involvement and undersatanding of its content.

Matched MeSH terms: Hospitals
Fulltext Factors deterring registered nurses from pursuing post graduate nursing degree in a private hospital in Penang, Malaysia

Ng, Mei Foong, Ooi, Bee Yean, Siew, Wei Fern

International e-Journal of Science, Medicine & Education, 2015;9(3):38-46.
MyJurnal

Background: In Malaysia the percentage of diploma registered nurses outnumber the percentage of degree registered nurses. Internationally, most registered nurses earn associate degrees or bachelor’s degrees in nursing. Malaysia is in the pipeline of ensuring that its registered nurses are professionally qualified with nursing degree by year 2020. Registered nurses with diploma qualification are feeling the pressure to upgrade their qualification to degree. There are concerns as to why these nurses are not pursuing their post registration nursing degree. Objective: To determine factors that are deterring the registered nurses of a private hospital in Penang from pursuing the post registered nursing degree. Methods: This descriptive study utilised a convenient sample of 150 registered nurses from Lam Wah Ee Hospital in Penang. The instrument of this study was developed based on literature search and the conceptual framework of Force Fields Analysis developed by Kurt Lewin in 1952. Results: The deterring factors for registered nurses not pursuing post registration nursing degree from this hospital were determined through negative mean score, which was valued at less than 2.5. The top 3 deterring factors identified were: high educational cost, with a score of 1.92; financial commitment, with a score of 2.22 and time constraints and high workload, with a score of 2.27. Conclusions: High educational cost, financial commitment, time constraint and high workload were the main factors deterring the registered nurses from this hospital from pursuing their post registration nursing degree. Thus it is timely for the organisational management to consider workable measures to assist and motivate their nurses to upgrade themselves with nursing degree in line with Malaysia’s vision to meet the increasing challenges and complex needs in the care of clients in health services.

Matched MeSH terms: Hospitals, Private
Fulltext Attendances at an outpatient department of a district hospital

Arokiasamy JT

Med J Malaysia, 1979 Sep;34(1):13-7.
PMID: 542143

Study site: Outpatient clinic at District hospital in Terengganu

Matched MeSH terms: Hospitals, District/utilization*; Hospitals, Public/utilization*
Fulltext Barriers and motivation factors towards treatment compliance from the perspective of defaulted tuberculosis patients in Kuala Lumpur

Noorsuzana Mohd Shariff, Shamsul Azhar Shah, Fadzilah Kamaludin

Jurnal Sains Kesihatan Malaysia, 2017;15(1):75-87.
MyJurnal

There is a large volume of published studies describing the adverse relationship between treatment non-adherence with tuberculosis treatment outcome. Non-adherence could result in increased risks of prolonged infectiousness, drug resistance, relapse cases and poor survival among tuberculosis patients. Nevertheless, few studies are to be found providing detailed on the reason of defaulting treatment among tuberculosis patients in Malaysia. Hence the goal of this paper is to find out the barriers and motivations factors that affect patients’ treatment compliance among our local tuberculosis patients. This is a qualitative study which included 12 in-depth interviews with tuberculosis non-compliance patients who were treated at Institute of Respiratory Medicine, Kuala Lumpur. All the conversations were recorded, transcribed and analysed by using thematic analysis. It was found that low knowledge, self-negative attitudes, traditional believes, negative perceptions towards health caregiver, drug side effects, stigma, financial problems, less family support and work commitments are the barriers that prevent the patients from religiously taking their anti-tuberculosis treatment. Meanwhile, factors that encourage them to continue their treatment were the believes of bad effects of the disease onto their lives and health, good relationship between patient and health caregiver and social support from people around them. In conclusion, non-adherence involved a dynamic influence of individual, socio-economic and treatment-related factors on the patients. The results presented here may facilitate improvement in the activities in promoting compliance among tuberculosis patients in the future which tailored to the patients’ specific needs.

Matched MeSH terms: Hospitals
Fulltext The level of depression, anxiety, stress and coping strategies in parents with congenital talipes equinovarus children

Mohd Shukrimi Awang, Ardilla Hanim bt Abdul Razak, Nurazlina bt Azizi, Nur Amalina Syazwani Bukhori, Hanisah Mohamad Zainuddin, Nora Mat Zin

International Medical Journal Malaysia, 2017;16(11):38-38.
MyJurnal

Having children with congenital anomalies, particularly congenital talipes
equinovarus (CTEV) may impact the psychological wellbeing of the parents. This study
is to assess the psychological impact of CTEV, the related factors, and the coping
strategies used by the parents in Hospital Tengku Ampuan Afzan (HTAA), Kuantan,
Pahang. (Copied from article).

Matched MeSH terms: Hospitals
Fulltext Serum matrix metalloproteinase-3 predicts radiographic joint damage and functional disability in rheumatoid arthritis

Sakthiswary R, Omimah KJN, Endom I, Shaharir SS, Sridharan R

Medicine & Health, 2016;11(2):209-217.
MyJurnal

The search for novel biomarkers has taken centre stage in the past decades of research in Rheumatoid Arthritis (RA). The purpose of the present study was to determine the correlation of serum matrix metalloproteinase-3 (MMP-3) with disease activity, joint damage and functional disability in patients with RA. We consecutively recruited RA patients who were under follow-up at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Information on the RA disease characteristics were obtained from the medical records and all RA patients were
assessed for DAS28 (disease activity score based on 28 joints) and Stanford Health Assessment Questionnaire (HAQ) 8-item Disability Index (HAQ-DI). The hand radiographs of the RA patients were assessed for joint damage using the Modified Sharp Score (MSS). Serum MMP-3 levels from RA patients and healthy controls were measured using the ELISA method. We recruited a total of 77 RA patients and 18 healthy controls. The serum MMP-3 levels were significantly higher among the RA patients (p<0.05). There were significant correlations between the serum MMP3 levels and MSS (r =0.327) and HAQ-DI (r=0.256), both p<0.05. The mean serum MMP levels in RA patients with radiographic joint erosions was significantly higher than in patients without erosions (p<0.05). Likewise, the subjects with significant functional impairment i.e HAQ-DI ≥1; had significantly higher mean MMP-3 levels compared to RA patients without significant disability (p<0.05). Using multivariate analysis, HAQ-DI remained the independent predictor of serum MMP-3 in RA patients. Serum MMP-3 is a potential biomarker and predictor of radiographic joint damage and functional disability in RA.
Keywords: acquired joint deformity, matrix metalloproteinases, rheumatoid arthritis

Matched MeSH terms: Hospitals, University
Fulltext Factors associated with discharge against medical advice from emergency department, Universiti Kebangsaan Malaysia Medical Centre

Ismail, A.K., Mohamad Ali, S., Che' Man, Z.

Medicine & Health, 2016;11(1):29-37.
MyJurnal

Patients who self-discharge against medical advice (DAMA) are susceptible to life-threatening consequences. By understanding the factors associated with DAMA, healthcare centres can build strategies to assist patients to receive optimal medical care and prevent unfavourable outcome. The objective of this study was to determine the factors associated with DAMA from the Emergency Department (ED) of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). This was a prospective unmatched case control study conducted over a 4-month period. For every DAMA episode, two patients who were admitted on the same day were randomly selected as control. Following patient consent, data was collected using a standardized questionnaire. Patients were contacted by the investigator for information regarding hospitalization within two weeks of DAMA. Ninety three patients were recruited; 31 DAMA patients and 62 admitted patients. Payment method was significantly associated with DAMA (OR 3.17 95% CI 1.29-7.98; p=0.01). The likelihood of self-paying patients to take DAMA was three times higher than those who had a guarantor letter from their employer or insurance provider. Other factors which influence DAMA were family obligations (OR 4.08 95% CI 1.09-15.26; p = 0.03) and work problems (OR 3.83 95% CI 1.13-12.94; p=0.03). A total of 19.4% of DAMA patients left following symptomatic pain relief. A total of 80.6% DAMA patients were admitted to hospital within two weeks of the DAMA episode. Payment method significantly influences DAMA. Payment planning, social welfare services, non-governmental organization funds and the introduction of a national health policy scheme may aid hospital payment, alleviate financial limitation of patients and reduce DAMA episodes.

Matched MeSH terms: Hospitals, University
Fulltext Medication wastage and its disposal amongst patients at Suri Seri Begawan Hospital in Brunei Darussalam

Nurolaini, K., Sultana, S.M., Wai See, W.

Medicine & Health, 2016;11(2):139-150.
MyJurnal

Medication wastage poses a financial burden on the nation’s economy, as well as, environmental implications associated with wastage disposal. This study was conducted in a public hospital in Brunei and aimed to measure the extent of medication wastage and its disposal. This cross-sectional study used a self-designed questionnaire for patients attending outpatient pharmacy at the Suri Seri Begawan (SSB) hospital in which 253 patients participated over a period of two weeks. Exclusion criteria were: i) patients below 18 yrs, ii) patients visiting the Accident and Emergency Department and iii) patients admitted to the hospital. Majority of the participants were reported to have unused medication at home (75.1%, n=189). Nearly half (54.2%) had unused medicines and this was due to improvements in their medical conditions. Most of the participants (70.8%) were not given necessary advice on how to dispose their medicines in a proper manner. Majority disposed their unused medicines in the household garbage (70%), despite 50.2% (n=189) knowing that disposing of medicines in the garbage can cause detrimental effects on the environment. It was found that 47.7% of the participants would return their unused medicines back to the pharmacy, but in practice, only 18.6% did such. There was no significant association between knowing detrimental effects of medicine on
the environment and returning their medicines to the pharmacy (p=0.065). Results showed that medication wastage exists in SSB hospital and patients’ knowledge and
practices on its proper disposal was relatively poor. Health policy makers should be informed to implement wastage reduction strategies.

Matched MeSH terms: Hospitals

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