This study is a descriptive epidemiology on the frequency of injuries, characteristics, and type of injuries incurred during the 16th National SilatChampionships 2012 competitions. This was a retrospective study by using a Pre Hospital Care Emergency Medicine PPUKM Form. All injuries sustained during the competition days were documented. The total number of participants involved in this tournament was 158 (114 males and 44 females). 51.6% participants sustained various injuries during the competition. The common sites of injuries involved the upper and lower extremities. The injuries sustained consist of swelling, fracture, dislocation, muscle sprain, strain and others. Most of the injuries were minor and did not require hospitalization. This study identified that soft tissue injuries due to blunt trauma were common among the silatparticipants. Strict observation of the tournament regulations, vigorous training and protective measures or equipments may contribute to the absence of severe or serious injury.
The popularity of ultrasound for acute diagnosis of fractures in the Emergency Department (ED) has increased over the recent years. This present study aimed to determine the sensitivity and specificity of ultrasound use for detection of fractures in a different environment, which is at the triage area of the ED. We compared the results of bedside ultrasound in detecting non-critical fractures to the current gold standard of X-rays in the triage area. The design was a single centered crosssectional study. From August 2014 till November 2014, a total of 46 patients were recruited, creating 75 image pairs. Following consent, a bedside ultrasound was performed and subsequently compared with X-ray reporting regarding the presence or absence of fractures. SPSS analysis was used to determine the sensitivity and specificity of ultrasound in diagnosing fracture as compared to X-rays. Ultrasound had a sensitivity of 72% (95% CI, 50.6% - 87.9%) and a specificity of 80% (95%CI: 66.3 - 90%) when compared to X-rays in fracture diagnosis. The kappa analyses showed moderate inter observer agreement (0.5) between ultrasound and X-rays in diagnosing fractures. This study suggests that the use of ultrasound as a triage tool yet has unacceptable sensitivity and needs further evaluation and consideration.
Midazolam is one of the most commonly used drugs for sedation in Emergency Department (ED). This was a retrospective study conducted on 380 patients from December 2012 to May 2014 in ED of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The objective was to elicit the frequency of side effects and correlation to various factors i.e. socio-demography, co-morbidities, age groups and underlying illnesses. Out of 380 patients, 35 patients experienced side effects (20 patients with midazolam alone, 15 patients with combination of drugs). The average age was 42 years and the average dose of midazolam was 3.5mg. The most common other drug combined was fentanyl. The overall complication rate for midazolam was 5.3%. The most common side effect recorded was excessive somnolence (1.6%). Other side effects included local skin reactions (1.1%), vomiting (0.8%), headache (0.8%) and hypotension (0.5%). There was no significant association between the socio-demographic factors and drugs combination with the side effects of midazolam on patients. It was concluded that midazolam was a safe drug due to absence of any life-threatening side effects. There are possibilities that most side effects recorded could be caused by other comfounding factors e.g. underlying injuries or disease and combination with other drugs.