Displaying publications 1 - 20 of 212 in total

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  1. Lee LK, Hassim IN
    Environ Health Prev Med, 2005 Jan;10(1):33-41.
    PMID: 21432161 DOI: 10.1265/ehpm.10.33
    OBJECTIVES: To determine the prevalence of cases and episodes of needlestick injury among three groups of health care workers in the past one-year, the level of knowledge on blood-borne diseases and universal precautions and the practice of universal precautions. Other factors associated with the occurrence of needlestick injuries and the reporting of needlestick injuries were also analysed.

    METHODS: A cross-sectional study was conducted in May 2003 to study the needlestick injuries among 285 health care workers (doctors, nurses, medical students) in a public teaching hospital in Negeri Sembilan, Malaysia.

    RESULTS: The prevalence of needlestick injuries among the respondents was 24.6% involving 71 cases i.e. 48.0% among doctors, 22.4% among medical students, and 18.7% among nurses and the difference was statistically significant (p<0.001). There were a total of 174 episodes of needlestick injury. Prevalence of episode of needlestick injuries was highest among doctors (146%), followed by nurses (50.7%) and medical students (29.4%). Cases of needlestick injuries attained lower scores on practice of universal precautions compared to non-cases (p<0.001). About 59% of cases of needlestick injury did not report their injuries.

    CONCLUSIONS: The study showed that needlestick injuries pose a high risk to health care workers and it is underreported most of the time. Many needlestick injuries can be prevented by strictly following the practice of universal precautions.

    Study site: Hospital Tunku Ja'afar, Seremban
    Matched MeSH terms: Hospitals, Teaching
  2. Rowley SD
    Aust Health Rev, 2006 May;30(2):232-40.
    PMID: 16646772
    This paper describes how an acute tertiary referral hospital moved away from a "culture of blame", using change management principles aligned with the concept of the learning organisation. I outline the process of change, and describe its outcomes. The result is summarised as an improvement in desired attributes of the organisation's culture, as evidenced by consistent improvement in the results of a proprietary staff survey. I conclude that the concept of the learning organisation is a useful one for hospitals that seek to improve the organisational culture.
    Matched MeSH terms: Hospitals, Teaching/organization & administration*
  3. Yong L
    J Hosp Supply Process Distrib, 1984 Nov-Dec;2(6):52-4.
    PMID: 10269457
    Matched MeSH terms: Hospitals, Teaching*
  4. Wagner NN, Adiseshan N
    Med J Aust, 1968 Mar 9;1(10):422.
    PMID: 5645273
    Matched MeSH terms: Hospitals, Teaching*
  5. Ruwanpura R, Rathnaweera A, Hettiarachchi M, Dhahanayake K, Amararatne S
    Med J Malaysia, 2012 Dec;67(6):595-600.
    PMID: 23770952
    INTRODUCTION: According to statistical unit of the Karapitiya Teaching Hospital, Galle, the main tertiary care institution of the Southern Province serving approximately three million population, in 2008, there were 459 patients with clinical diagnosis of leptospirosis, with 25 fatalities, 21 out of which were referred for autopsy examination.

    OBJECTIVES: The present study to study and correlate pathological changes in deaths associated with pulmonary form of leptospirosis with clinico-diagnostic aspects of the infection.

    METHOD: There had been 21 leptospirosis related autopsy examinations performed at forensic medicine unit of the Karapitiya Teaching Hospital from January to December 2008. The clinical, laboratory and autopsy findings of these cases were recorded in detail and analyzed.

    RESULTS: The characteristic autopsy feature of all these cases was a moderate to severe pulmonary haemorrhage in association with hepato-renal, myocardial and cerebral lesions. The histology of the lung tissues in most cases showed extensive alveolar haemorrhages, hyaline like deposits, neutrophilic infiltrations, swollen septa with congested blood vessels.

    CONCLUSION: Severe pulmonary complications are mostly responsible for all fatalities due to leptospirosis in our series. Though there are no reliable clinical indicators that suggest probability of developing pulmonary haemorrhages, we emphasize that respiratory functions and haematological parameters need to be closely monitored in all hospitalized patients with leptospirosis for early detection and prevention of haemorrhagic complications.
    Matched MeSH terms: Hospitals, Teaching
  6. Ooi CG, Haizee HN, Kando OV, Lua GW, Philip H, Chan SP, et al.
    Med J Malaysia, 2002 Jun;57(2):195-200.
    PMID: 24326650
    We examined the prevalence of diabetes among inpatients in our hospital, the relationship of the diagnoses on admission to diabetes, and the frequency of testing for HbA1c as a marker of long-term glycaemic control, proteinuria, and hypercholesterolaemia. In addition, patients with raised laboratory plasma glucose without a know history of diabetes mellitus, were studied to see if these had been further evaluation. The overall prevalence of diabetes in our hospital was 25.% with the highest prevalence found (37.8%) on medical wards. 10.5% of admissions were due directly to diabetes and a further 58.9% of patients were admitted with illness which were significant related to diabetes. Overall testing rates for HbA31c, proteinuria, and hypercholesterolaemia were less than ideal (51.6, 73.4 and 45.% respectively). Less than 50% of patients without previously diagnosed diabetes but with high plasma glucose values had further evaluation for diabetes. In conclusion, this study has detected a high overall prevalence of diabetes among inpatients in an urban Malaysian hospital. Rates of testing for HbA51c, proteinuria, and hypercholesterolaemia, are disappointingly low, as is further evaluation of patients without known diabetes, but with elevated glucose values. More effective measures to improve the delivery of inpatient diabetes care are needed.
    Matched MeSH terms: Hospitals, Teaching
  7. Todd D
    Ann Acad Med Singap, 1987 Apr;16(2):366-9.
    PMID: 3688816
    With the rapid advances in medical science and increasing complexities of patient care, the need for continuing medical education (CME) is widely accepted by the profession. CME follows general and higher professional training, and should be a life long process. Teaching hospitals and postgraduate professional institutions play vital roles in organising, promoting, and monitoring this activity. CME directorates should be established. University authorities must recognise the important role of medical teachers in postgraduate and continuing medical education, and the staff establishment and terms of service should be held regularly. Medical libraries should have easy borrowing facilities. Self-assessment and audio-visual material are particularly helpful to the busy practitioner and inexpensive local or regional journals of quality can provide pertinent and up-to-date information. All charges for attending scientific meetings and educational material should be tax deductible or subsidized. The effectiveness of CME is difficult to assess and participation is almost impossible to enforce. Much depends on the standard of medical practice wanted by society. Recertification of general practitioners or specialists poses many problems. On the other hand, completion of self-assessment programmes, active participation at medical meetings, contributions to scientific literature, and membership of medical societies with built-in peer review could be monitored and regularly used to evaluate professional status.
    Matched MeSH terms: Hospitals, Teaching
  8. Cumberworth M
    Nurs Mirror Midwives J, 1972 Aug 11;135(6):42-3.
    PMID: 4484275
    Matched MeSH terms: Hospitals, Teaching
  9. Krishnasamy K, Zakaria MI, Tan MP, Chinna K, Narayanan V, Hasnan N
    Disaster Med Public Health Prep, 2023 Sep 25;17:e494.
    PMID: 37746761 DOI: 10.1017/dmp.2023.141
    Matched MeSH terms: Hospitals, Teaching
  10. Chan PW, Hussain S, Ghani NH, Debruyne JA, Liam CK
    PMID: 12693597
    A pilot study to evaluate the direct cost of treating 51 adults and 50 children with bronchial asthma was conducted. All aspects of the medical care provided over a 6-month period were considered. The mean treatment costs per month were US dollars 22.97 (adults) and US dollars 15.56 (children). The cost of maintenance therapy accounted for 55.5% and 73.4% of the total direct cost treatment for adults and children respectively. Only 27 (52.9%) adults and 17 (34.0%) children paid for their inhaled prophylactic drugs, amounting to 12.3% of the total maintenance therapy costs. Thirteen (25.4%) adults and 9 (18.0%) children were using alternative therapy at a monthly cost of US dollars 41.50 and US dollars 16.77 respectively. A substantial proportion of the direct cost of asthma treatment is heavily subsidized in Malaysia. Adequate attention to the allocation of the health budget, to ensure the optimal provision of health care, is warranted.
    Matched MeSH terms: Hospitals, Teaching/economics*
  11. Alfizah H, Norazah A, Nordiah AJ, Lim VKE
    Med J Malaysia, 2002 Sep;57(3):319-28.
    PMID: 12440272 MyJurnal
    Methicillin-resistant Staphylococcus aureus (MRSA) has been prevalent in our hospital over the last three years. Differentiation among MRSA strains by DNA typing in addition to antibiotic resistance pattern surveillance is crucial in order to implement infection control measures. The aim of this study was to characterize MRSA isolates from patients admitted to Hospital Universiti Kebangsaan Malaysia (HUKM) by phenotypic (analyses of antibiotic susceptibility pattern) and genotypic (PFGE) techniques to determine the genetic relatedness of the MRSA involved and to identify endemic clonal profiles of MRSA circulating in HUKM. Seventy one MRSA strains collected between January to March 2000 from patients from various wards in HUKM were tested for antimicrobial resistance and typed by pulsed-field gel electrophoresis (PFGE). Four major types of PFGE patterns were identified (A, B, C and D) among MRSA strains. Two predominant PFGE types were recognised, Type A (59.2%) and Type B (33.8%). Most of these strains were isolated from ICU, Surgical wards and Medical wards. MRSA strains with different PFGE patterns appeared to be widespread among wards. Strains with the same antibiotype could be of different PFGE types. Most of isolates were resistant to ciprofloxacin, erythromycin, gentamicin and penicillin. One isolate with a unique PFGE pattern Type D and susceptible to gentamicin was identified as a different clone. Some isolates obtained from the same patient showed different PFGE subtypes suggesting that these patients were infected/colonized with multiple MRSA strains. PFGE analysis suggests that MRSA strains with different PFGE types was propagated within our hospital. The relationship between antibiotic susceptibility and PFGE patterns was independent. The ability of PFGE technique in differentiating our MRSA strains make it a method of choice for investigating the source, transmission and spread of nosocomial MRSA infection, and thus an appropriate control programme can be implemented to prevent the spread of MRSA infection.
    Matched MeSH terms: Hospitals, Teaching*
  12. Cheah PL, Looi LM, Horton S
    Am J Clin Pathol, 2017 12 20;149(1):1-7.
    PMID: 29267843 DOI: 10.1093/ajcp/aqx088
    Objective: To examine the cost of operating an anatomic pathology laboratory in a teaching hospital in Malaysia. Once the cost is determined, compare it with the costs of operating other laboratories in the same hospital, and operating anatomic pathology laboratories in other countries.

    Methods: Cost and workload data were obtained from hospital records for 2015. Time allocation of staff between laboratory testing and other activities was determined using assumptions from published workload studies.

    Results: The laboratory received 20,093 cases for testing in 2015, and total expenditures were US $1.20 million, ie, $61.97 per case. The anatomic pathology laboratory accounted for 5.2% of the laboratory budget at the hospital, compared to 64.3% for the clinical laboratory and 30.5% for the microbiology laboratory. We provide comparisons to a similar laboratory in the United States.

    Conclusions: Anatomic pathology is more costly than other hospital laboratories due to the labor-intensive work, but is essential, particularly for cancer diagnoses and treatment.

    Matched MeSH terms: Hospitals, Teaching/economics
  13. Saiboon IM, Singmamae N, Jaafar MJ, Muniandy BK, Sengmamae K, Hamzah FA, et al.
    Saudi Med J, 2014 Jul;35(7):718-23.
    PMID: 25028229
    To evaluate the effectiveness of a new patient flow system, `The Red Box` on the quality of patient care in respect of the time taken for the care to be delivered to the patient.
    Matched MeSH terms: Hospitals, Teaching/organization & administration*
  14. Hoe KS, Karis BM
    Med J Malaysia, 2002 Jun;57(2):145-53.
    PMID: 24326644
    The aim of this study was to investigate the attitudes and desire of Malaysian patients for information about anaesthesia and compare the result to that of other similar studies in other countries namely Scotland, Canada, Australia and denMark. Two hundred and forty patients undergoing elective surgery were asked to complete a preoperative quentionnaire examining their desire for information relating to anaesthesia. As in all countries compared, most Malaysian patients were interested to know the time they could start to mobilize from the bed and the time to commence normal oral intake postoperatively. Information related to postoperative pain and pain relief was also highly desired. However, patients showed less interest towards information about perioperative anaesthetic or surgical procedures and drug used. Unlike Australian patients, the Malaysian patients showed less interest about perioperative complications. As in other countries, patients under the age of 50 years had a greater desire for information than those who were older. However there was no difference in desire for information between male and female patients. Patients who have had previous anaesthesia would ask more information compared to those who had none.
    Matched MeSH terms: Hospitals, Teaching
  15. Norsidah AM, Yahya N, Adeeb N, Lim AL
    Med J Malaysia, 2001 Mar;56(1):58-64.
    PMID: 11503298
    Ambulatory or day care surgery is still in its infancy in this part of the world. Our newly built university affiliated hospital started its Day Surgery Centre in February 1998. It is the first multidisciplinary ambulatory surgery centre in a teaching hospital in the country. It caters for Orthopaedic surgery, Urology, Plastic surgery, Otorhinolaryngology, General surgery, Paediatric surgery and Ophthalmology. We have done 2,604 cases and our unanticipated admission rate is less than 2%. There has been no major morbidity or mortality. The problems of setting up a multidisciplinary ambulatory centre in a teaching hospital are discussed.
    Matched MeSH terms: Hospitals, Teaching
  16. Bala Krishnian, M., Leong, J.W.S., Lye, M.S., Johar, M.J., Ismail, M.S.
    Medicine & Health, 2015;10(1):32-36.
    MyJurnal
    Globally, stroke is the commonest cause of long-term disability. The residual disabilities among post stroke patients affect their daily living activities. The aim of rehabilitation therapy is to help stroke survivors to gain back their functional ability. The present study aimed to determine the relationship between post stroke duration with functionality status of post-stroke survivals at a teaching hospital in Kuala Lumpur. A cross-sectional study involved one hundred nine five post stroke patients who attended the Rehabilitation Clinic over a 4-month period. The data on post stroke duration was reveale from patient’s cleckship. Their functional status was assessed with Modified Barthel Index (MBI). Results showed the mean age of participants was 61 years (SD=13.86, range:22-87 years), with 118 males and 81 females having a median duration of 12 months post-stroke (range: 1-79 months). The prevalence 123 (63.1%) of stroke survivors are found to be dependent in their daily living activity. A Chi-square test for independence indicated there was significant relationship between post-stroke duration with levels of functioning, χ2 (2 , n=195) = 6.455, p<0.05,phi = 0.182. Patients in post-stroke duration of 13-24 months were independent (52.1) than ≤ 12 months and ≥ 24 months.
    Keywords: functional status, post-stroke disability, mbi, activities of daily living, rehabilition therapy

    Study site: rehabilitation clinic , Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Hospitals, Teaching
  17. Zakaria N, Ramli R
    Neuropsychiatr Dis Treat, 2018;14:117-128.
    PMID: 29343963 DOI: 10.2147/NDT.S115261
    Background: Psychiatric patients have privacy concerns when it comes to technology intervention in the hospital setting. In this paper, we present scenarios for psychiatric behavioral monitoring systems to be placed in psychiatric wards to understand patients' perception regarding privacy. Psychiatric behavioral monitoring refers to systems that are deemed useful in measuring clinical outcomes, but little research has been done on how these systems will impact patients' privacy.

    Methods: We conducted a case study in one teaching hospital in Malaysia. We investigated the physical factors that influence patients' perceived privacy with respect to a psychiatric monitoring system. The eight physical factors identified from the information system development privacy model, a comprehensive model for designing a privacy-sensitive information system, were adapted in this research. Scenario-based interviews were conducted with 25 patients in a psychiatric ward for 3 months.

    Results: Psychiatric patients were able to share how physical factors influence their perception of privacy. Results show how patients responded to each of these dimensions in the context of a psychiatric behavioral monitoring system.

    Conclusion: Some subfactors under physical privacy are modified to reflect the data obtained in the interviews. We were able to capture the different physical factors that influence patient privacy.

    Matched MeSH terms: Hospitals, Teaching
  18. Kam CA
    Singapore Med J, 1978 Jun;19(2):106-8.
    PMID: 751183
    A system of tutorials preparing students for the Primary F.F.A.R.A.C.S. examination is described. It is suggested that this system would be suitable for teaching students in a peripheral training hospital.
    Matched MeSH terms: Hospitals, Teaching
  19. Mad Tahir NS, Ismail A, Aljunid SM, Abdul Aziz AF, Azzeri A, Alkhodary AA
    PLoS One, 2023;18(11):e0294260.
    PMID: 37971972 DOI: 10.1371/journal.pone.0294260
    BACKGROUND: Influenza is a contagious respiratory illness that can cause life-threatening complications among high-risk groups. Estimating the economic burden of influenza is essential to guide policy-making on influenza vaccination programmes, especially in resource-limited settings. This study aimed to estimate the economic burden of influenza on older adults (those aged ≥60 years) in Malaysia from the provider's perspective.

    METHODS: The main data source in this study was the MY-DRG Casemix database of a teaching hospital in Malaysia. Cases with principal and secondary diagnoses coded in the International Classification of Diseases version 10 (ICD-10) as J09, J10.0, J10.1, J10.8, J11.0, J11.1, J11.8, J12.8, and J12.9, which represent influenza and its complications, were included in the study. The direct cost of influenza at all severity levels was calculated from the casemix data and guided by a clinical pathway developed by experts. The effect of the variations in costs and incidence rate of influenza for both the casemix and clinical pathway costing approaches was assessed with sensitivity analysis.

    RESULTS: A total of 1,599 inpatient and 407 outpatient influenza cases were identified from the MY-DRG Casemix database. Most hospitalised cases were aged <18 years (90.6%), while 77 cases (4.8%) involved older people. Mild, moderate, and severe cases comprised 56.5%, 35.1%, and 8.4% of cases, respectively. The estimated average annual direct costs for managing mild, moderate, and severe influenza were RM2,435 (USD579), RM6,504 (USD1,549), and RM13,282 (USD3,163), respectively. The estimated total annual economic burden of influenza on older adults in Malaysia was RM3.28 billion (USD782 million), which was equivalent to 10.7% of the Ministry of Health Malaysia budget for 2020. The sensitivity analysis indicated that the influenza incidence rate and cost of managing severe influenza were the most important factors influencing the total economic burden.

    CONCLUSIONS: Overall, our results demonstrated that influenza imposes a substantial economic burden on the older Malaysian population. The high cost of influenza suggested that further efforts are required to implement a preventive programme, such as immunisation for older people, to reduce the disease and economic burdens.

    Matched MeSH terms: Hospitals, Teaching
  20. Kamala Nathan M, Jasni AS, Zakariah SZ, Tengku Jamaluddin TZM, Mohd Isa M, Ibrahim R
    J Med Microbiol, 2023 Jul;72(7).
    PMID: 37432079 DOI: 10.1099/jmm.0.001732
    Background. Skin is a reservoir for millions of micro-organisms, all of which make up the skin microbiota. Hospitals have been identified as a favourable environment for transmitting micro-organisms and thus, it is important to know the distribution of skin microbiota among healthcare workers (HCWs), as such findings may provide baseline information for the distribution of skin microbiota in hospitals.Hypothesis. There is no significant association between the factors (age, gender, type of skin microenvironment, hand hygiene practices, usage of skin care products, current healthcare practices and previous workplace) and the distribution of the skin microbiota among HCWs.Aim. The study aims to identify type of skin microbiota and associated factors (age, gender, type of skin microenvironment, hand hygiene practices, use of skincare products, current healthcare practice, and previous workplace) that influence the growth of skin microbiota.Method. About 102 bacterial isolates were obtained from the skin of 63 healthcare workers in a newly opened teaching hospital, namely Hospital Pengajar Universiti Putra Malaysia (HPUPM). All isolated bacteria were subjected to phenotypic identification according to standard microbiological procedures.Results. The most common isolated skin microbiota were Gram-positive bacteria (84.3%), followed by Gram-negative bacteria (15.7%). A Chi-square test of independence was used to analyse the above factors and there was a significant association between the type of skin microenvironment and the distribution of skin microbiota (P=0.03) (type of skin microenvironment influences the distribution of skin microbiota).Conclusion. Coagulase-negative Staphylococcus spp. was the most common bacteria isolated from the skin of the healthcare workers. Even though coagulase-negative staphylococci (CoNS) are low pathogenic bacteria, but it may cause serious infection in high risk group of patients. Therefore, it is important to emphasize on the good hand hygiene practices and implement strict infection control measures to minimize the risk of HAI in newly opened hospitals.
    Matched MeSH terms: Hospitals, Teaching
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