Displaying publications 1 - 20 of 216 in total

  1. Miravitlles M, Bhutani M, Hurst JR, Franssen FME, van Boven JFM, Khoo EM, et al.
    Adv Ther, 2023 Oct;40(10):4236-4263.
    PMID: 37537515 DOI: 10.1007/s12325-023-02609-8
    Discharge bundles, comprising evidence-based practices to be implemented prior to discharge, aim to optimise patient outcomes. They have been recommended to address high readmission rates in patients who have been hospitalised for an exacerbation of chronic obstructive pulmonary disease (COPD). Hospital readmission is associated with increased morbidity and healthcare resource utilisation, contributing substantially to the economic burden of COPD. Previous studies suggest that COPD discharge bundles may result in fewer hospital readmissions, lower risk of mortality and improvement of patient quality of life. However, evidence for their effectiveness is inconsistent, likely owing to variable content and implementation of these bundles. To ensure consistent provision of high-quality care for patients hospitalised with an exacerbation of COPD and reduce readmission rates following discharge, we propose a comprehensive discharge protocol, and provide evidence highlighting the importance of each element of the protocol. We then review care bundles used in COPD and other disease areas to understand how they affect patient outcomes, the barriers to implementing these bundles and what strategies have been used in other disease areas to overcome these barriers. We identified four evidence-based care bundle items for review prior to a patient's discharge from hospital, including (1) smoking cessation and assessment of environmental exposures, (2) treatment optimisation, (3) pulmonary rehabilitation, and (4) continuity of care. Resource constraints, lack of staff engagement and knowledge, and complexity of the COPD population were some of the key barriers inhibiting effective bundle implementation. These barriers can be addressed by applying learnings on successful bundle implementation from other disease areas, such as healthcare practitioner education and audit and feedback. By utilising the relevant implementation strategies, discharge bundles can be more (cost-)effectively delivered to improve patient outcomes, reduce readmission rates and ensure continuity of care for patients who have been discharged from hospital following a COPD exacerbation.
    Matched MeSH terms: Patient Discharge*
  2. Ahmad K
    Int J Speech Lang Pathol, 2010 Aug;12(4):317-9; discussion 329-32.
    PMID: 20590514 DOI: 10.3109/17549507.2010.483017
    Speech-language pathologists (SLPs) practising in Malaysia face similar dilemmas as their counterparts in more developed countries when it comes to deciding on discharge/termination of services for their patients. Furthermore, discharge dilemmas appear to be a frequent and inevitable part of their everyday practice. In an interview conducted for the purpose of this paper, it was clear that many SLPs found it difficult to articulate or justify the process they took to reach a decision on whether or not to terminate their services or discharge their patients. Much of the difficulty is anchored on the need to be realistic and function within the confines of limited resources. Malaysian SLPs were aware of the ideals that had to be abandoned along the way but had not allowed guilt to dissuade or discourage them from providing what they perceived as the next best available service. The not-so ideal decisions made by these SLPs may be frowned upon by international standards but must be examined within the local historical perspective of the development of the SLP profession in Malaysia. The dilemma will continue until the country produces SLPs in sufficient numbers but the profession is reminded that less-than-ideal practices may perpetuate over time into unhealthy traditions that will require major efforts to be undone.
    Matched MeSH terms: Patient Discharge*
  3. Tan PC, Norazilah MJ, Omar SZ
    Obstet Gynecol, 2013 Apr;121(4):878.
    PMID: 23635697 DOI: 10.1097/AOG.0b013e31828a7e62
    Matched MeSH terms: Patient Discharge*
  4. Kuan GL, Tee AC
    To study the role of pulse oximetry in the assessment of acute asthma in children presenting to the A&E department, 360 children who presented themselves to the A&E department were enrolled into the study. Those admitted were found to have a lower mean Sa02 of 92% compared to those discharged with Sa02 of 94% (p < 0.001). After the initial treatment at the A&E, those admitted still have a lower mean Sa02 of 94% compared to those discharged with a mean Sa02 of 96% (p < 0.001). However taking Sa02 of 92% as a predictor of admission hada sensitivity of 39% and a specificity of 80% but it had a high negative predictive value of 92%. Hence pulse oximetry alone is not sensitive for predicting admission in acute asthma in children.
    Matched MeSH terms: Patient Discharge
  5. Moissinac K, Merican H, Sukumar M, Azmi S, Raja Lope A, Tajuddin AJ, et al.
    Trop Doct, 2004 Jul;34(3):191.
    PMID: 15267066
    Matched MeSH terms: Patient Discharge/statistics & numerical data*
  6. Chen RYT, Lim JKH, Chuo AML
    Med J Malaysia, 2003 Aug;58(3):330-6.
    PMID: 14750371
    Medical audit is vital to ensure continuous quality assurance and quality improvements. We did a retrospective study to ascertain the adequacy of clinical documentation and the factors hindering early discharge after an acute stroke in a restructured hospital. The medical records of all patients with acute stroke who died or were discharged from a restructured hospital in Singapore in January and February 1999 were reviewed retrospectively. Demographic data and the presence or absence of clinical documentation were noted. Factors hindering the discharge of patients at Day 5, Day 10 of stroke and at final discharge were noted and classified into: stroke-related, complications of stroke, medical-related and social factors. There were 101 patients in the study cohort, 55 males (54.5%) and 46 females (45.5%). The mean age was 67.9 years (SD 12.3). Documentation in Barthel scores (0%), presence of depression (0%), mental scores (1.0%), visual problems (10.0%), bladder continence (39.6%), admission functional status (37.6%) and dysphagia (52.5%) were deficient. The mean length of stay (LOS) was 13.0 (SD 14.2) days. The main factor hindering discharge at Day 5 (90.4%), Day 10 (95.2%) and at final discharge (82.1%) was stroke-related problems. Poor function (60.3%) and dysphagia (15.8%) were the 2 most common stroke-related problems hindering final discharge. Complications of stroke, medical-related problems and social reasons hindered final discharge in 10.8%, 17.8% and 2.9% of patients respectively. This audit revealed inadequacy in clinical documentation in patients with acute stroke. The main hindrance to final discharge of patients was stroke-related problems. The 2 most important stroke-related problems were poor function and dysphagia.
    Matched MeSH terms: Patient Discharge*
  7. Mashaida Md Sharif, Musab Abdul Razak
    The incident involving hydrogen release in industry has become a major concern since numerous incidents were observed to have occured over the years. This paper is designed to do the consequence modelling and analysis using PHAST Simulator for the release rate, potential fire and vulnerability to human by lethality versus probit simulated at 5 mm, 35 mm and 70 mm leak scenarios and three types of atmospheric stability at hydrogenation plant in Telok Panglima Garang. The simulation was carried out by inputting data of leak scenario, meteorological data, material data and process data related to the hydrogenation plant. The simulation results were analyzed and discussed on the discharge rate, dispersion concentration and effect of jet fire such as flame length, downwind distance and lethality for radiation intensity level of 4 kW/m2 , 12.5 kW/m2 and 37.5 kW/m2 . Based on the results, the discharge rate and radiation intensity are dependent on the leak sizes regardless of the different atmospheric conditions. However, the dispersion is dependent on both atmospheric stability and leak sizes. Lastly, the lethality and area of impact are simulated from the radiation intensity produced by the jet fire for each leak size. To conclude, adoption of PHAST software is vital for consequence modelling as this software is able to illustrate the outcomes of hazards due to loss of containment and with this will enable related personnel to respond effectively to any hazardous incidents. As a recommendation, hydrogen fixed gas detectors are proposed for installations at specific location after taking into account the smallest leak that may happen which is at 5 mm leak size.
    Matched MeSH terms: Patient Discharge
  8. Sallehuddin H, Ong T
    Age Ageing, 2021 02 26;50(2):356-357.
    PMID: 33219680 DOI: 10.1093/ageing/afaa241
    Matched MeSH terms: Patient Discharge
  9. Abdullah JM, Rafiqul Islam M
    Malays J Med Sci, 2012 Oct;19(4):1-5.
    PMID: 23613643
    Telemetric EEG in the rat's brain has been used for experiments which tests the effects of an antiepileptic compound on it's antiseizures activity. A simple classification correlating epileptiform discharge and Racine's behavioral activity is discussed.
    Matched MeSH terms: Patient Discharge
  10. Zainal, N.Z.
    Most general hospitals in the country have a psychiatric department. According to the Malaysia Mental Health Regulations 2010, "a psychiatric facility shall ensure that each patient has a care plan for the management of the patient during the treatment and upon discharge of the patient". However not every psychiatric department has a trained consultation-liaison psychiatrist. In Malaysia there are only a few numbers of psychiatrists that have undergone a formal sub-specialty training in Consultation-Liaison Psychiatry.
    Matched MeSH terms: Patient Discharge
  11. Wong TX, Chen ST, Ong SH, Shyam S, Kandasami P, Chee WSS
    Trials, 2021 Nov 03;22(1):767.
    PMID: 34732233 DOI: 10.1186/s13063-021-05716-5
    BACKGROUND: While it is well established that perioperative use of oral nutrition supplement (ONS) improves nutrition status among severely malnourished surgical cancer patients, the evidence requires further substantiation for non-severely malnourished patients with cancer. This protocol paper presents the rationale and design of a randomised controlled trial to evaluate the effectiveness of preoperative as well as an extended 90-day postoperative use of ONS on nutritional and clinical outcomes among patients undergoing elective surgery for breast and colorectal cancer.

    METHODS: Patients with primary breast and colorectal cancer undergoing elective surgery are recruited from two tertiary hospitals. Eligible patients are assigned into one of the three intervention arms: (i) Group SS will receive ONS in addition to their normal diet up to 14 days preoperatively and postoperatively up to discharge; (ii) Group SS-E will receive ONS in addition to their normal diet up to 14 days preoperatively, postoperatively up to discharge and for an extended 90 days after discharge; and (iii) Group DS will receive ONS in addition to their normal diet postoperatively up to discharge from the hospital. The ONS is a standard formula fortified with lactium to aid in sleep for recovery. The primary endpoints include changes in weight, body mass index (BMI), serum albumin and prealbumin levels, while secondary endpoints are body composition (muscle and fat mass), muscle strength (handgrip strength), energy and protein intake, sleep quality, haemoglobin, inflammatory markers (transferrin, high sensitivity C-reactive protein, interleukin-6), stress marker (saliva cortisol), length of hospital stay and postoperative complication rate.

    DISCUSSION: This trial is expected to provide evidence on whether perioperative supplementation in breast and colorectal cancer patients presenting with high BMI and not severely malnourished but undergoing the stress of surgery would be beneficial in terms of nutritional and clinical outcomes.

    TRIAL REGISTRATION: ClinicalTrial.gov NCT04400552. Registered on 22 May 2020, retrospectively registered.

    Matched MeSH terms: Patient Discharge
  12. Abdul Rahman N', Nurumal MS, Awang MS, Mohd Shah ANS
    Australas Emerg Care, 2020 Dec;23(4):240-246.
    PMID: 32713770 DOI: 10.1016/j.auec.2020.06.005
    INTRODUCTION: Emergency departments (EDs) routinely provide discharge instructions due to a large number of patients with mild traumatic brain injury (mTBI) being discharged home directly from ED. This study aims to evaluate the quality of available mTBI discharge instructions provided by EDs of Malaysia government hospitals.

    METHODS: All 132 EDs were requested for a copy of written discharge instruction given to the patients. The mTBI discharge instructions were evaluated using the Patient Education Materials Assessment-Printable Tool (PEMAT-P) for understandability and actionability. Readability was measured using an online readability tool of Malay text. The content was compared against the discharge instructions recommended by established guidelines.

    RESULTS: 49 articles were eligible for the study. 26 of the articles met the criteria of understandability, and 3 met the criteria for actionability. The average readability level met the ability of average adult. Most of the discharge instructions focused on emergency symptoms, and none contained post-concussion features.

    CONCLUSION: Majority of the discharge instructions provided were appropriate for average people to read but difficult to understand and act upon. Important information was neglected in most discharge instructions. Thus, revision and future development of mTBI discharge instruction should consider health literacy demand and cognitive ability to process such information.

    Matched MeSH terms: Patient Discharge/standards*; Patient Discharge/statistics & numerical data
  13. Nur Shazweena Samsudin, Jami, Mohammed Saedi, Kabbashi, Nassereldeen Ahmed
    sugar industry is one of the industries that produce a high amount of
    pollutant since its wastewater contains high amount of organic material, biochemical
    oxygen demand (bod) and chemical oxygen demand (cod). if this waste is
    discharged without a proper treatment into the watercourse, it can cause problem to aquatic
    life and environment. for the primary treatment process, sugar wastewater can be treated
    by using chemical precipitation method which involves coagulation process. currently,
    ferric chloride has been used as the coagulant but it consumes more alkalinity and
    corrosive. in this study, the suitable coagulant to be used to treat the wastewater from sugar
    industry and the optimum conditions to achieve high percentage removal of cod was
    determined. the characteristic of the wastewater was firstly determined. then, the most
    suitable coagulant to be used for the treatment was studied by determining their efficiency
    to reduce cod and tss in the wastewater at different dosages. aluminium sulphate
    (alum), ferric chloride and polyaluminium chloride (pac) were chosen to be studied for
    suitable coagulant. The optimum condition of the coagulant (ph, coagulant dosage, fast
    mixing speed) was determined by using design expert software. results showed that alum
    can be used to effectively remove 42.9% of cod and 100% of tss at high dosage (50
    mg/l). the optimum condition of alum was at ph 5.2, 10 mg/l of alum and 250 rpm of
    mixing speed. this shows that at optimum condition, alum can be used to treat wastewater
    from sugar industry.
    Matched MeSH terms: Patient Discharge
  14. Rudi NN, Muhamad MS, Te Chuan L, Alipal J, Omar S, Hamidon N, et al.
    Heliyon, 2020 Sep;6(9):e05049.
    PMID: 33033772 DOI: 10.1016/j.heliyon.2020.e05049
    Manganese has recently been a topic of interest among researchers, particularly when 1,752 million tonnes of manganese are expected to be produced by the steel industry in 2020. Manganese discharges from industrial effluents have increased manganese contamination in water sources. Its concentrations of more than 0.2 mg/L in the water sources could have negative impacts on human health and the aquatic ecosystem. Thereby, the available water treatment processes face challenges in effectively removing manganese at low cost. In response to these challenges, adsorption has emerged as one of the most practical water treatment processes for manganese removal. In particular, agricultural waste adsorbents received a lot of attention owing to their low cost and high efficiency (99%) in the removal of manganese. Therefore, this paper reviews the removal of manganese by adsorption process using agricultural waste adsorbents. The factors affecting the adsorption process, the mechanisms, and the performances of the adsorbents are elucidated in detail.
    Matched MeSH terms: Patient Discharge
  15. Barambu NU, Bilad MR, Bustam MA, Huda N, Jaafar J, Narkkun T, et al.
    Polymers (Basel), 2020 Oct 29;12(11).
    PMID: 33137888 DOI: 10.3390/polym12112519
    The discharge of improperly treated oil/water emulsion by industries imposes detrimental effects on human health and the environment. The membrane process is a promising technology for oil/water emulsion treatment. However, it faces the challenge of being maintaining due to membrane fouling. It occurs as a result of the strong interaction between the hydrophobic oil droplets and the hydrophobic membrane surface. This issue has attracted research interest in developing the membrane material that possesses high hydraulic and fouling resistance performances. This research explores the vapor-induced phase separation (VIPS) method for the fabrication of a hydrophilic polysulfone (PSF) membrane with the presence of polyethylene glycol (PEG) as the additive for the treatment of oil/water emulsion. Results show that the slow nonsolvent intake in VIPS greatly influences the resulting membrane structure that allows the higher retention of the additive within the membrane matrix. By extending the exposure time of the cast film under humid air, both surface chemistry and morphology of the resulting membrane can be enhanced. By extending the exposure time from 0 to 60 s, the water contact angle decreases from 70.28 ± 0.61° to 57.72 ± 0.61°, and the clean water permeability increases from 328.70 ± 8.27 to 501.89 ± 8.92 (L·m-2·h-1·bar-1). Moreover, the oil rejection also improves from 85.06 ± 1.6 to 98.48 ± 1.2%. The membrane structure was transformed from a porous top layer with a finger-like macrovoid sub-structure to a relatively thick top layer with a sponge-like macrovoid-free sub-structure. Overall results demonstrate the potential of the VIPS process to enhance both surface chemistry and morphology of the PSF membrane.
    Matched MeSH terms: Patient Discharge
  16. Lin XR, Kwon E, Hung C, Huang CW, Oh WD, Lin KA
    J Colloid Interface Sci, 2021 Feb 15;584:749-759.
    PMID: 33176929 DOI: 10.1016/j.jcis.2020.09.104
    As sulfosalicylic acid (SUA) is extensively used as a pharmaceutical product, discharge of SUA into the environment becomes an emerging environmental issue because of its low bio-degradability. Thus, SO4--based advanced oxidation processes have been proposed for degrading SUA because of many advantages of SO4-. As Oxone represents a dominant reagent for producing SO4-, and Co is the most capable metal for activating Oxone to generate SO4-, it is critical to develop an effective but easy-to-use Co-based catalysts for Oxone activation to degrade SUA. Herein, a 3D hierarchical catalyst is specially created by decorating Co3O4 nanocubes (NCs) on macroscale nitrogen-doped carbon form (NCF). This Co3O4-decorated NCF (CONCF) is free-standing, macroscale and even squeezable to exhibit interesting and versatile features. More importantly, CONCF consists of Co3O4 NCs evenly distributed on NCF without aggregation. The NCF not only serves as a support for Co3O4 NCs but also offers additional active sites to synergistically enhance catalytic activities towards Oxone activation. Therefore, CONCF exhibits a higher catalytic activity than the conventional Co3O4 nanoparticles for activating Oxone to fully eliminate SUA in 30 min with a rate constant of 0.142 min-1. CONCF exhibits a much lower Ea value of SUA degradation (35.2 kJ/mol) than reported values, and stable catalytic activities over multi-cyclic degradation of SUA. The mechanism of SUA degradation is also explored, and degradation intermediates of SUA degradation are identified to provide a possible pathway of SUA degradation. These features validate that CONCF is certainly a promising 3D hierarchical catalyst for enhanced Oxone activation to degrade SUA. The findings obtained here are also insightful to develop efficient heterogeneous Oxone-activating catalysts for eliminating emerging contaminants.
    Matched MeSH terms: Patient Discharge
  17. Yusoff NFM, Idris NH, Din MFM, Majid SR, Harun NA, Rahman MM
    Sci Rep, 2020 Jun 08;10(1):9207.
    PMID: 32513958 DOI: 10.1038/s41598-020-66148-w
    Currently, the development of the sodium-ion (Na-ion) batteries as an alternative to lithium-ion batteries has been accelerated to meet the energy demands of large-scale power applications. The difficulty of obtaining suitable electrode materials capable of storing large amount of Na-ion arises from the large radius of Na-ion that restricts its reversible capacity. Herein, Mn2O3 powders are synthesised through the thermal conversion of MnCO3 and reported for the first time as an anode for Na-ion batteries. The phase, morphology and charge/discharge characteristics of Mn2O3 obtained are evaluated systematically. The cubic-like Mn2O3 with particle sizes approximately 1.0-1.5 µm coupled with the formation of Mn2O3 sub-units on its surface create a positive effect on the insertion/deinsertion of Na-ion. Mn2O3 delivers a first discharge capacity of 544 mAh g-1 and retains its capacity by 85% after 200 cycles at 100 mA g-1, demonstrating the excellent cyclability of the Mn2O3 electrode. Therefore, this study provides a significant contribution towards exploring the potential of Mn2O3 as a promising anode in the development of Na-ion batteries.
    Matched MeSH terms: Patient Discharge
  18. Payus AO, Ibrahim A, Mustafa N
    Open Access Maced J Med Sci, 2018 Nov 25;6(11):2136-2138.
    PMID: 30559876 DOI: 10.3889/oamjms.2018.317
    BACKGROUND: Anaphylaxis often misdiagnosed and treated as acute asthma, especially when it has a predominant respiratory symptom, and there are no obvious precipitants or previous allergic history. This morbid outcome is preventable if the level of suspicion for anaphylaxis is high among healthcare provider when treating a patient who is not responding to the standard management of acute asthma. A proportion of anaphylactic patient shows a biphasic reaction which potentially fatal when it is under-anticipated and prematurely discharge without adequate observation period after the recovery of the initial episode.

    CASE REPORT: Here, we present a case of a young man who has childhood asthma with the last attack more than 10 years ago presented with symptoms suggestive of acute exacerbation of bronchial asthma. As the symptoms failed to improve after standard asthma management, anaphylaxis was suspected, and he was given intramuscular adrenaline 0.5 mg which leads to symptom improvement. However, he developed another attack shortly after improvement while under observation.

    CONCLUSION: The objective of this case report is to emphasise the importance of keeping anaphylaxis in mind whenever a patient has treatment-refractory asthma, and also the anticipation of biphasic reaction that warrants adequate observation period especially those who are likely to have developed it.

    Matched MeSH terms: Patient Discharge
  19. George D, Supramaniam ND, Hamid SQA, Hassali MA, Lim WY, Hss AS
    Pharm Pract (Granada), 2019 08 21;17(3):1501.
    PMID: 31592290 DOI: 10.18549/PharmPract.2019.3.1501
    Background: Patients requiring medications during discharge are at risk of discharge medication errors that potentially cause readmission due to medication-related events.

    Objective: The objective of this study was to develop interventions to reduce percentage of patients with one or more medication errors during discharge.

    Methods: A pharmacist-led quality improvement (QI) program over 6 months was conducted in medical wards at a tertiary public hospital. Percentage of patients discharge with one or more medication errors was reviewed in the pre-intervention and four main improvements were developed: increase the ratio of pharmacist to patient, prioritize discharge prescription order within office hours, complete discharge medication reconciliation by ward pharmacist, set up a Centralized Discharge Medication Pre-packing Unit. Percentage of patients with one or more medication errors in both pre- and post-intervention phase were monitored using process control chart.

    Results: With the implementation of the QI program, the percentage of patients with one or more medication errors during discharge that were corrected by pharmacists significantly increased from 77.6% to 95.9% (p<0.001). Percentage of patients with one or more clinically significant error was similar in both pre and post-QI with an average of 24.8%.

    Conclusions: Increasing ratio of pharmacist to patient to complete discharge medication reconciliation during discharge significantly recorded a reduction in the percentage of patients with one or more medication errors.

    Matched MeSH terms: Patient Discharge
  20. Che Mat CMH, Mustapha F, Noor RM, Ramli R, Mohamad I
    Medeni Med J, 2020;35(4):344-348.
    PMID: 33717628 DOI: 10.5222/MMJ.2020.01057
    Mucocele is a mucous filled benign cystic lesion. It develops due to obstruction of any natural os-tium of the paranasal sinus. Even though being benign, it has capability to erode and cause thinning the adjacent bony structures. Isolated intraorbital mucocele without paranasal sinus disease is a rare condition. We present a 39-year-old female patient with right medial canthal swelling without any nasal symptoms, and normal nasoendoscopic finding. Imaging revealed the lesion as a right ethmoidal mucocele with normal paranasal sinuses. However intraoperatively, it was an isolated intraorbital lesion, lateral to lamina papyracea with thick-yellowish mucin discharge.
    Matched MeSH terms: Patient Discharge
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