Displaying publications 1 - 20 of 326 in total

  1. Niek WK, Teh CSJ, Idris N, Thong KL, Ngoi ST, Ponnampalavanar SSS
    Folia Microbiol (Praha), 2021 Oct;66(5):741-749.
    PMID: 34089493 DOI: 10.1007/s12223-021-00877-x
    Biofilm formation is an important physiological process in Staphylococcus aureus (S. aureus) that can cause infections in humans. In this study, the ability of 36 methicillin-resistant S. aureus (MRSA) clinical isolates to form biofilm was studied based on genotypic and phenotypic approaches. These isolates were genotyped based on the microbial surface components recognizing adhesive matrix molecules (MSCRAMMs) and biofilm-associated genes (icaAD) via polymerase chain reactions. Phenotyping was performed based on the determination of the strength of biofilm formation of MRSA isolates in vitro. The most prevalent MSCRAMMs and biofilm-associated genes were clfA, eno, and icaD, followed by clfB. The fnbB (38.9%) and ebpS (11.1%) occurred less frequently among the MRSA isolates, while bbp and fnbA genes were absent from all isolates. The MRSA isolates were mostly moderate to strong biofilm formers, despite the heterogeneity of the MSCRAMM profiles. MRSA isolates from different infection sources (primary, catheter-related bloodstream, or secondary infections) were capable of forming strong biofilms. However, persistent bacteraemia was observed only in 19.4% of the MRSA-infected individuals. This study suggested that persistent MRSA bacteraemia in patients might not be associated with the biofilm-forming ability of the isolates.
    Matched MeSH terms: Tertiary Care Centers
  2. Koh KC
    Med J Malaysia, 2013 Aug;68(4):301-4.
    PMID: 24145256 MyJurnal
    We report a study which defined the prevalence of erectile dysfunction (ED) among men with ischaemic heart disease. We recruited 510 men with established ischemic heart disease and interviewed these men using the International Index of Erectile Dysfunction (IIEF-5) questionnaire to determine the presence and severity of ED. Presence of ED was defined as IIEF-5 score of less than 22. The mean age was 60.5 years (range 36-92 years; SD: +9.58). 461 (90.4%) men reported some degree of ED of which two third of them had moderate to severe ED. The prevalence of ED increased significantly with age. Age above 60 years was the only significant risk factor. Non-statistically significant but important risk factors included diabetes, hypertension, diuretics and oral hypoglycemic agents. ED is very common among men with ischemic heart disease. The prevalence and severity increased significantly with age above 60 years old.
    Matched MeSH terms: Tertiary Care Centers*
  3. Nor Azlin MN, Syed Aljunid SJ, Noor Azahz A, Amrizal MN, Saperi S
    Med J Malaysia, 2012 Oct;67(5):473-7.
    PMID: 23770861 MyJurnal
    This study aimed to estimate cost of in-patient medical care due to stroke in a tertiary hospital in Malaysia. A retrospective analysis of stroke patients admitted to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between January 2005 and December 2008 were conducted. Cost evaluation was undertaken from the health provider's perspective using a top-down costing approach. Mean length of stay (LOS) was 6.4 ± 3.1 days and mean cost of care per patient per admission was MYR 3,696.40 ± 1,842.17 or 16% of per capita GDP of the country. Human resources made up the highest cost component (MYR 1,343.90, SD: 669.8 or 36% of the total cost), followed by medications (MYR 867.30, SD:432.40) and laboratory services (MYR 337.90, SD:168.40). LOS and cost of care varied across different stroke severity levels (p<0.01). A regression analysis shown significant influence of stroke severity on cost of care, with the most severe stroke consumed MYR 1,598.10 higher cost than the mild stroke (p<0.001). Cost of medical care during hospital admission due to stroke is substantial. Health promotion and primary prevention activities need to take priority to minimise stroke admission in future.
    Matched MeSH terms: Tertiary Care Centers*
  4. Muhamad Yaakub Arifin
    PHC services particularly the ambulance call is traditionally a hospital-based system. Within the Kota Kinabalu area, there are 3 tertiary hospitals that provide the ambulance call service; and also provide the interfacility transfer, disaster management and medical team standby. How about the health clinics? Health clinics play a major role for primary healthcare and the interfacility transfer of patient from the health clinics to the hospital.
    Matched MeSH terms: Tertiary Care Centers
  5. D'Souza B, Suresh Rao S, Hisham S, Shetty A, Sekaran VC, Pallagatte MC, et al.
    Hosp Top, 2021 02 02;99(4):151-160.
    PMID: 33528313 DOI: 10.1080/00185868.2021.1875277
    The Coronavirus disease 2019 (COVID-19) pandemic has necessitated medical centers across the world to deliver healthcare through telemedicine. We discuss the adoption, delivery of telemedicine services at a tertiary care center and patient satisfaction involving 456 patients in south India. Most respondents had sought telemedicine care at the department of Medicine (16.23%). The maximum satisfaction was reported by patients in OBG (100%). The responses were generally positive across all the age groups. The paper offers insights on best practices adopted at the center, lessons learnt, and provides recommendations for health care systems offering telemedicine during COVID-19 times.
    Matched MeSH terms: Tertiary Care Centers
  6. Tan PP, Abdul Rahman J, Mat Noh S, Mohd Yasin I, Mohd Noor S
    Transfus Apher Sci, 2021 Dec;60(6):103280.
    PMID: 34593332 DOI: 10.1016/j.transci.2021.103280
    Matched MeSH terms: Tertiary Care Centers
  7. 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: Tertiary Care Centers/organization & administration*
  8. Vinitha P, Rohaizah B, Faiza MR
    Med J Malaysia, 2020 09;75(5):548-554.
    PMID: 32918425
    BACKGROUND: Published reports by the Social Welfare Department of Malaysia suggests that child abuse and neglect cases has been steadily increasing. There is a lack of basic data and qualitative study on child maltreatment in Malaysia.

    OBJECTIVE: The aim is to describe the pattern and demographic features of all suspected child abuse and neglect (SCAN) cases seen in a single tertiary hospital in Malaysia over a period of five years.

    METHODS: A retrospective descriptive review of children suspected of maltreatment, aged 0 to 18 years old who presented to the Hospital Serdang (HS), Selangor, Malaysia from January 2014 to December 2018 was done. A list of registered SCAN cases obtained from One Stop Crisis Centre (OSCC) HS census. Clinical information of patients was retrieved from the computerised database.

    RESULTS: In all, there were a total of 391 SCAN cases over five years with almost a 3-fold increase in the number of cases from 2014 to 2018. Physical abuse was the most common (55%) seen followed by sexual abuse (34%) and neglect (10%). There were four deaths, all involving infants <1 year old who were physically abused by babysitters. The main perpetrator in sexual abuse were people known to the victim. Ninety-three percent of patients were neglected by their biological parents and more than 2/3rd of neglect cases occurred due to inadequate supervision.

    DISCUSSION: Child maltreatment is an inevitable burden to our health system and infants are the most vulnerable group to sustain significant injuries leading to death and disabilities.

    Matched MeSH terms: Tertiary Care Centers*
  9. Janahiraman S, Aziz MN, Hoo FK, P'ng HS, Boo YL, Ramachandran V, et al.
    Pak J Med Sci, 2015 Nov-Dec;31(6):1383-8.
    PMID: 26870101 DOI: 10.12669/pjms.316.8445
    Antimicrobial resistance is a major health problem worldwide in hospitals. The main contributing factors are exposures to broad-spectrum antimicrobials and cross-infections. Understanding the extent and type of antimicrobial use in tertiary care hospitals will aid in developing national antimicrobial stewardship priorities.
    Matched MeSH terms: Tertiary Care Centers
  10. Ahmad Faidzal Othman, Mohamad NorHisham, Azmi Abdul Rahman
    Symptomatic arterial pseudoaneurysm is not an uncommon emergent
    vascular case presenting to a tertiary hospital. These are mainly associated with
    infection, iatrogenic puncture or trauma. The resultant morbidity, limb loss and
    mortality present a challenge to the surgeons managing these cases. (Copied from article).
    Matched MeSH terms: Tertiary Care Centers
  11. Sharmin S, Jahan AA, Kamal SMM, Sarker P
    Case Rep Infect Dis, 2019;2019:6219295.
    PMID: 31179137 DOI: 10.1155/2019/6219295
    Chromobacterium violaceum is a Gram-negative bacterium, found in tropical and subtropical regions. C. violaceum infection rarely occurs, but once occurs, it is associated with significant mortality due to severe systemic infection. Since the first human case from Malaysia in 1927, >150 cases of C. violaceum infection have been reported worldwide. We have described here a fatal case of C. violaceum infection in a tertiary care hospital in Dhaka, Bangladesh. To the best of our knowledge, this is the first case of C. violaceum infection in Bangladesh.
    Matched MeSH terms: Tertiary Care Centers
  12. Abubakar U, Tangiisuran B
    J Glob Antimicrob Resist, 2020 06;21:148-153.
    PMID: 31628999 DOI: 10.1016/j.jgar.2019.10.007
    OBJECTIVES: To evaluate the activities and barriers to hospital pharmacists' participation in antimicrobial stewardship programs (ASP) in Nigerian tertiary hospitals.

    METHODS: A cross-sectional nationwide online survey was conducted over a 6-week period between May and June 2019. Invitation was sent to all the Heads of pharmacy department or pharmacists in charge of infectious diseases (ID) or antimicrobial pharmacists in tertiary hospitals in Nigeria. A validated questionnaire that consist of 24-items was used for data collection.

    RESULTS: Forty-five hospitals were invited and 37 completed the survey (response rate, 82.2%). Five (13.5%) hospitals had a formal antimicrobial stewardship (AMS) team, with each of them having pharmacist representation. Regardless of the existence of an AMS team, hospital pharmacists have implemented AMS strategies, including evaluation of the appropriateness of antimicrobial prescriptions (54.1%) and monitoring of antimicrobial consumption (48.6%). The most common barriers to pharmacists' involvement in ASP were lack of training in AMS and ID (51.4%), lack of pharmacists with ID specialisation (40.5%) and lack of support from hospital administrators (37.8%). The majority of the pharmacists recommended training in AMS and ID (100%), participation on ward rounds (89.2%) and employment of more pharmacists (73%) as strategies to improve pharmacists' participation in ASP.

    CONCLUSIONS: Hospital pharmacists are actively involved in AMS activities despite the lack of established AMS teams in most tertiary hospitals in Nigeria. However, lack of training and personnel were major barriers to pharmacist's involvement in ASP.

    Matched MeSH terms: Tertiary Care Centers
  13. Ang ZY, Cheah KY, Abdullah NB, Samsuri SB, Lee SH, Yem AW, et al.
    J Oncol Pharm Pract, 2020 Sep;26(6):1306-1317.
    PMID: 31810422 DOI: 10.1177/1078155219891209
    PURPOSE: To identify the cost and reasons of returned parenteral chemotherapy regimens at a tertiary hospital in Kuala Lumpur, Malaysia.

    METHODS: Data were retrospectively extracted from all the Chemotherapy Return Forms in 2016, which is a compulsory documentation accompanying each return of parenteral chemotherapy regimen. The following data were extracted: patient's diagnosis, gender, location of treatment (i.e. ward/daycare clinic), start date of chemotherapy regimen, type of cytotoxic drug returned, dose of cytotoxic drug returned, number of cytotoxic drug preparations returned and reason for return as well as whether the returned cytotoxic drug preparations could be re-dispensed. The cost of wastage was calculated based on the cost per mg (or per unit) of the particular returned cytotoxic drug.

    RESULTS: One hundred and fifty-nine cases of returned chemotherapy regimen comprising of 231 parenteral cytotoxic drug preparations were analysed. The total cost of returned chemotherapy regimen for 2016 was €3632, with €756 (20.8%) worth of chemotherapy regimens returned due to preventable reasons and €2876 (79.2%) worth of chemotherapy regimens returned due to non-preventable reasons. Approximately 50% of cases returned chemotherapy regimen were due to deterioration of patient's clinical condition and another 24.5% of cases of returned chemotherapy regimen were attributed to adverse drug reactions.

    CONCLUSION: Wastage associated to non-preventable reasons such as adverse drug reactions and preventable causes like refusal of patients can be further reduced by using newer healthcare innovations and establishment of written institutional protocols or standard operating procedures as references for in-charge healthcare personnel when cytotoxic drug-related issues occur. Adoption of cost-saving strategies that have been proven by studies could further improve current cost containment strategies.

    Matched MeSH terms: Tertiary Care Centers/economics; Tertiary Care Centers/trends*
  14. Hassan NH, Aljunid SM, Nur AM
    BMC Health Serv Res, 2020 Oct 14;20(1):945.
    PMID: 33054861 DOI: 10.1186/s12913-020-05776-4
    BACKGROUND: The current healthcare sector consists of diverse services to accommodate the high demands and expectations of the users. Nursing plays a major role in catering to these demands and expectations, but nursing costs and service weights are underestimated. Therefore, this study aimed to estimate the nursing costs and service weights as well as identify the factors that influence these costs.

    METHODS: A retrospective cross-sectional descriptive study was conducted at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using 85,042 hospital discharges from 2009 to 2012. A casemix costing method using the step-down approach was used to derive the nursing costs and service weights. The cost analysis was performed using the hospital data obtained from five departments of the UKMMC: Finance, Human Resource, Nursing Management, Maintenance and Medical Information. The costing data were trimmed using a low trim point and high trim point (L3H3) method.

    RESULTS: The highest nursing cost and service weights for medical cases were from F-4-13-II (bipolar disorders including mania - moderate, RM6,129; 4.9871). The highest nursing cost and service weights for surgical cases were from G-1-11-III (ventricular shunt - major, RM9,694; 7.8880). In obstetrics and gynaecology (O&G), the highest nursing cost and service weights were from O-6-10-III (caesarean section - major, RM2,515; 2.0467). Finally, the highest nursing cost and service weights for paediatric were from P-8-08-II (neonate birthweight > 2499 g with respiratory distress syndrome congenital pneumonia - moderate, RM1,300; 1.0582). Multiple linear regression analysis showed that nursing hours were significantly related to the following factors: length of stay (β = 7.6, p 

    Matched MeSH terms: Tertiary Care Centers/economics*; Tertiary Care Centers/organization & administration
  15. Bux S, Mohd Ramli N, Ahmad Sarji S, Kamarulzaman A
    Biomed Imaging Interv J, 2010 Oct-Dec;6(4):e35.
    PMID: 21611071 MyJurnal DOI: 10.2349/biij.6.4.e35
    This is a retrospective descriptive study of the chest imaging findings of 118 patients with confirmed A(H1N1) in a tertiary referral centre. About 42% of the patients had positive initial chest radiographic (CXR) findings. The common findings were bi-basal air-space opacities and perihilar reticular and alveolar infiltrates. In select cases, high-resolution computed tomography (CT) imaging showed ground-glass change with some widespread reticular changes and atelectasis.
    Matched MeSH terms: Tertiary Care Centers
  16. Norhayati MN, Nik Hazlina NH, Sulaiman Z, Azman MY
    BMC Public Health, 2016;16(1):229.
    PMID: 26944047 DOI: 10.1186/s12889-016-2895-2
    Severe maternal conditions have increasingly been used as alternative measurements of the quality of maternal care and as alternative strategies to reduce maternal mortality. We aimed to study severe maternal morbidity and maternal near miss among women in two tertiary hospitals in Kota Bharu, Kelantan, Malaysia.
    Matched MeSH terms: Tertiary Care Centers
  17. Yoong, Wilkinson Jian Tan, Jo Wearn Yeap, Sharifah Sulaiha Syed Aznal
    Background: Peripheral venous catheterisation is indispensable in modern practise of medicine. The indications of venous access should be weighed against the risk of complications, the commonest being thrombophlebitis. Thrombophlebitis causes patient discomfort and the need for new catheter insertion and risk of developing further widespread infections. Methodology: This observational study was conducted on adult patients admitted to the surgical and medical ward of a tertiary hospital in Negeri Sembilan Malaysia in 2011. Four researchers visited patients daily and examined for signs of thrombophlebitis; warmth, erythema, swelling, tenderness or a palpable venous cord. Risks factors that were studied in this research were patient/s age and gender, duration of catheterization, use of catheter for infusion, size of catheter, site of catheter insertion and types of infusate. Thrombophlebitis was graded using a scale adapted from Bhandari et al. (1979). Results: In total, 428 patients were recruited with an incidence rate of thrombophlebitis of 35.2%. Among those who developed thrombophlebitis, 65% had mild thrombophlebitis, 19% moderate and 8% severe thrombophlebitis. Results showed that female patients had a significant increased risk of developing thrombophlebitis. Also risk increased significantly with increased duration of catheterization and usage of the catheter for infusion. The age of a patient, types of infusate use, size of catheter and site of catheter insertion did not significantly influence the development of thrombophlebitis. Conclusion: The study showed that risk of developing thrombophlebitis is significantly increased among female patients, and also with increased duration of catheterization and use of the peripheral venous catheter for infusion. We recommended elective replacement of catheter every 72 hours and daily examination of catheters for signs of thrombophlebitis by a healthcare personnel.
    Matched MeSH terms: Tertiary Care Centers
  18. Hoo FK, Foo YL, Lim SM, Ching SM, Boo YL
    Pak J Med Sci, 2016 Jul-Aug;32(4):841-845.
    PMID: 27648025
    Acute coronary syndrome (ACS) is one of the leading cause of morbidity and mortality worldwide. It is relatively uncommon in young adults as compared to the older population. Our objective was to assess the prevalence, demographic distribution, and risk factors for acute coronary syndrome (ACS) in patients less than 45 years of age admitted to a Malaysian tertiary care centre.
    Matched MeSH terms: Tertiary Care Centers
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