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  1. Fulltext Successful implantation via in Vitro Fertilization (IVF) in Hospital Wanita Kanak-Kanak Sabah: single centre experience
    Dg Marshitah Pg Baharuddin, Hatta Tarmizi, Nathira Abdul Majed, Sardiana Sarmidi, Rahmatia Ibrahim, Sabilah Mohd Tahir, et al.
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):88-88.
    MyJurnal
    Introduction: Implantation is one of critical step in human reproductive processes. There are many factors that affect successful implantation. Good quality embryo or blastocyst is a prerequisite to successful implantation together with a receptive endometrium. The purpose of this study is to describe the patient clinical profile and to investigate the factors of interest association with implantation status. Methods: This is a cross sectional study involving patients planned for in vitro fertilization (IVF) treatment in the hospital infertility clinic. All demographic data and clinical profile data of the patient in each visit was recorded. Among the data taken were, physical examination data, patient history, causes of infertility, hormonal investigation and outcome at the end of treatment (presence of fetal heart). Successful implantation is indicated by presence of fetal heart. Results: A total of 246 patients record were collected. Mean age of the patient was 34.2 (SD = 4.12) years old. Mean BMI was 24.5 kg/m2 (SD=4.70). Mean of infertility years among the patients was 5.9 years (SD= 3.40). Most cause of infertility was tubal issues 87 cases (35.4%). The prevalence of successful implantation was 12.8% ((95% CI 7.8%, 17.8%). None of the factors of interest (age, BMI, infertility duration, progesterone at baseline, progesterone at trigger day) were found associated with successful implantation. Out of 224 patients, 53 (21.5%) were having elevated progesterone level at trigger day. However, in this study, there is no conclusive evidence that level of progesterone is associated with successful implantation. Conclusion: The successful implantation in our setting is approximately 1/10 of IVF treatment. Implantation involved a complex mechanism, thus there is wide variety of etiologies to predict for successful implantation. Thus, further study on wide comprehensive of risk factors is warranted.
  2. Fulltext Treatment outcomes of extended versus nonextended intensive phase in pulmonary tuberculosis smear positive patients with delayed sputum smear conversion: A retrospective cohort study at primary care clinics in Kota Kinabalu
    Atiqah A, Tong SF, Nadirah S
    Malays Fam Physician, 2023;18:2.
    PMID: 36969335 DOI: 10.51866/oa.191
    INTRODUCTION: Delayed sputum smear conversion in patients with smear-positive pulmonary tuberculosis is a crucial problem at primary care clinics in Sabah resulting in poor treatment outcomes. This study aimed to compare the treatment outcomes between extended and nonextended intensive phase treatments among patients with delayed sputum smear conversion and to identify the factors associated with unsuccessful treatment outcomes.

    METHOD: This retrospective cohort study was conducted using data from a Malaysian tuberculosis registry, medical records and clinic referral emails from five primary care clinics in Kota Kinabalu from January 2014 to December 2018. A total of 163 patients with delayed sputum smear conversion were selected and divided into cohort groups: 90 patients received 3 months of intensive phase treatment (extended intensive phase), and 73 patients received 2 months of intensive phase treatment (non-extended intensive phase).

    RESULTS: Of the 163 patients, 33.7% had unsuccessful treatment outcomes (25.2% had treatment failure; 0.6% died; 3.7% defaulted; and 4.3% transferred out), and 3.7% had relapse. There were no significant differences in the prevalence of unsuccessful treatment outcomes (37.6% vs 28.6%, OR=1.51, CI=0.77-2.94, P=0.226) and relapse (2.2% vs 5.7%, 0R=0.36, CI=0.65-2.04, P=0.404) between the extended and non-extended intensive phase groups. High sputum acid-fast bacilli grade (AFB) at 2 months, drug resistance and lack of directly observed treatment, short-course supervision (DOTS) were associated with unsuccessful treatment outcomes.

    CONCLUSION: Extended intensive phase treatment in patients with delayed sputum smear conversion does not prevent unsuccessful treatment outcomes and relapse.

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