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Fulltext The study of broken hearts: A pragmatic case report on takotsubo cardiomyopathy in Malaysia

Syeda Humayra, Abd. Rahim Mohamad, Ab. Kahar Ab. Ghapar, L Mohamed

JUMMEC, 2020;23(2):5-7.
MyJurnal

The Takotsubo syndrome is an acquired, non-ischemic stress-induced cardiomyopathy popularly known as the ‘broken heart syndrome’. It is an acute left ventricular dysfunction presenting mostly in older women after an intensely stressful event. The exact pathophysiology remains elusive. The term came into existence in the early 1990s in Japan, where the distinctive change in the shape of the left ventricle with apical ballooning during systole, resembled the Takotsubo, an octopus pot used bythe Japanese fisherman. From a rare underrecognized syndrome, it has been increasingly recognised as a form of acute cardiac failure. Clinical diagnosis of the syndrome may be unidentified due to its similarity with the acute coronary syndrome, but without the narrowing of coronary vessels in angiographic imaging. There is a substantial elevation of the cardiac biomarkers, troponin and the natriuretic peptides which helps in differentiating the Takotsubo syndrome from myocardial infarction. A case report of a 59-year old Malaysian lady with typical, recurrent episodes of the Takotsubo syndrome is presented.
Fulltext Hand hygiene knowledge, perception, and self-reported performance among nurses in Kelantan, Malaysia: a cross-sectional study

Abd Rahim MH, Ibrahim MI

BMC Nurs, 2022 Jan 31;21(1):38.
PMID: 35101001 DOI: 10.1186/s12912-022-00820-6

BACKGROUND: Nurses interact with patients 24 hours a day, and this connection has the potential to raise the risk of infection transmission to patients. Nursing plays a vital role in pre-venting healthcare-associated infections (HCAIs) by ensuring that hand hygiene (HH) practises are followed and maintained. The purpose of this study was to evaluate nurses' knowledge, perceptions, and self-reported HH performance scores, as well as their correlation, in tertiary care hospitals in Kelantan, Malaysia.
METHODS: A cross-sectional study was undertaken in all four Kelantan tertiary care hospitals from December 2019 to February 2020. A stratified random selection method was used to obtain a sample of 438 registered nurses. A validated WHO self-administered HH knowledge and perception questionnaire for healthcare personnel was used to measure HH knowledge, perception, and self-reported HH performance.
RESULTS: The mean (SD) score of knowledge was 15.08 (1.96) out of the total 25. The score of perception participants towards HH was 68.02 (10.14) out of the total 81 and the average self-reported HH performance was 87.58 (12.03) out of 100. Pearson's correlation analysis showed significant positive correlations between perception and knowledge scores; r (436) =0.17, p<0.001 and Perception and self-reported HH performance scores; r (436) =0.27, p<0.001.
CONCLUSIONS: There is a strong link between knowledge and perception scores. Lack of understanding of HH during patient care might lead to a negative perception, which can affect overall self-reported HH performance. The need of monitoring and maintaining HH knowledge among nurses was established in this study.
Fulltext Development and Validation of Creatinine-Based Estimates of the Glomerular Filtration Rate Equation from 99mTc-DTPA Imaging in the Malaysian Setting

Md Ralib A, Mohd Hanafiah FN, Abd Rashid I, Abd Rahim MS, Dzaharudin F, Mat Nor MB

Int J Nephrol, 2021;2021:3465472.
PMID: 34540290 DOI: 10.1155/2021/3465472

Introduction: Accurate assessment of glomerular filtration rate (GFR) is very important for diagnostic and therapeutic intervention. Clinically, GFR is estimated from plasma creatinine using equations such as Cockcroft-Gault, Modification of Diet in Renal Disease, and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equations. However, these were developed in the Western population. To the best of our knowledge, there was no equation that has been developed specifically in our population.
Objectives: We developed a new equation based on the gold standard of 99mTc-DTPA imaging measured GFR. We then performed an internal validation by comparing the bias, precision, and accuracy of the new equation and the other equations with the gold standard of 99mTc-DTPA imaging measured GFR.
Methods: This was a cross-sectional study using the existing record of patients who were referred for 99mTc-DTPA imaging at the Nuclear Medicine Centre, International Islamic University Malaysia. As this is a retrospective study utilising routinely collected data from the existing pool of data, the ethical committee has waived the need for informed consent.
Results: Data of 187 patients were analysed from January 2016 to March 2021. Of these, 94 were randomised to the development cohort and 93 to the validation cohort. A new equation of eGFR was determined as 16.637 ∗ 0.9935Age ∗ (SCr/23.473)-0.45159. In the validation cohort, both CKD-EPI and the new equation had the highest correlation to 99mTc-DTPA with a correlation coefficient of 0.81 (p < 0.0001). However, the new equation had the least bias and was the most precise (mean bias of -3.58 ± 12.01) and accurate (P30 of 64.5% and P50 of 84.9%) compared to the other equations.
Conclusion: The new equation which was developed specifically using our local data population was the most accurate and precise, with less bias compared to the other equations. Further study validating this equation in the perioperative and intensive care patients is needed.

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