Displaying publications 1 - 20 of 279 in total

  1. 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*
  2. 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*
  3. 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
  4. 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*
  5. 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
  6. 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
  7. 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
  8. 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*
  9. 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
  10. 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
  11. 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
  12. 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
  13. Wo, Su Woan, Lai, Pauline Siew Mei, Ong, Lai Choo, Low, Wah Yun, Lim, Kheng Seang, Tay, Chee Geap, et al.
    Neurology Asia, 2016;21(3):235-245.
    Objective: To determine the validity and reliability of the Chinese parent proxy and child self-report
    health related quality of life measure for children with epilepsy (CHEQOL-25) in Malaysia. Methods:
    Face and content validity of the Chinese parent proxy and child self-report CHEQOL-25 was verified
    by an expert panel, and piloted in five children with epilepsy (CWE). The Chinese CHEQOL-25 was
    then administered to 40 parent proxies and their CWE (aged 8-18 years), from two tertiary hospitals,
    at baseline and 2 weeks later. Results: Forty parents and their CWE were recruited. Cronbach’s alpha
    for each subscale ranged from 0.56-0.83. At test-retest, the interclass correlation for all items ranged
    from 0.68-0.97. Items 8 and 25 were removed as their corrected item-total correlation values were
    Matched MeSH terms: Tertiary Care Centers
  14. Aniza Ismail, Ahmad Taufik Jamil, Ahmad Fareed A Rahman, Jannatul Madihah Abu Bakar, Natrah Mohd Saad, Hussain Saadi
    Hospital Information System (HIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. This study is to describe those aspects of the implementation of hospital information system in three tertiary hospitals in Klang Valley; Serdang Hospital, Selayang Hospital and University Kebangsaan Malaysia Medical Centre (UKMMC). A qualitative study was conducted to obtain views on information system development and implementation in the hospitals mentioned above. In-depth interviews with personnel representing both the system providers and the end-users were done guided by a questionnaire. The results of the interviews were categorized into few themes namely the system development, human resource, scope of implementation, support system, user-friendly, training, hardware and security. There were differences in hospital information system development and implementation in the three hospitals. Each system has its own strengths and weaknesses that make it unique. In developing HIS, its important to ensure the system can work effectively and efficiently. Quality human resource, good support system, user-friendly and adequate training of the end-user will determine the success of implementation of HIS. Upgrading of hardware and software as needed is the basis to keep up with the pace of technology advancement and increasing number of patients. It is hoped that HIS will be implemented in all other hospitals with effective integration and networking.
    Matched MeSH terms: Tertiary Care Centers
  15. Ho, S.E., Koo, Y.L., Ismail, S., Hing, H.L., Widad, O., Chung, H.T., et al.
    Medicine & Health, 2013;8(2):73-80.
    Decision making in nursing is one of the most important skills nurses must apply and utilize in their nursing practice. The aim of this study was to determine the perception of clinical decision making ability among nursing students. A descriptive cross-sectional study was conducted in a tertiary hospital. A total of 54 nursing students were recruited using a modified version of Clinical Decision Making in Nursing Scale (CDMNS) adapted from Jenkins (1985). The findings showed good CDMNS score with mean and standard deviation of (124.24±12.713). The four sub-scales of CDMNS were: searching for alternative (33.24±4.821), canvassing (28.74±3.514), evaluation and re-evaluation (31.43±3.922), searching for information (30.83±4.765). Nineteen (35%) of the participants chose nursing as their first choice, whereas 35 participants (65%) did not. Thirthy seven (69%) participants were satisfied with their nursing competency, 17 (31%) were unsatisfied. There were significant differences between searching for alternatives, evaluation and re-evaluation, and nursing as their first choice (p=

    Study site: Nursing students, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Tertiary Care Centers
  16. Dahlui, M., Hishamshah, M.I., Rahman, A.J. A, Shamsuddin, K., Aljunid, S.M.
    A cost-utility analysis was performed desferrioxamine treatment in thalctssaemia patients at two tertiary hospitals in Malaysia in 2004. A hundred and twelve transfusion dependent thalassaemia patients were grouped according to the status of desferrioxamine; optimum and sulwptimum. Cost analysis was from a patient and hospital perspectives while Quality Adjusted Life Years (QALYs) was the health outcome of choice. Incremental Cost·Effectiveness Ratio (ICER) was also stipulated to show the difference in cost for an additional QALY if patient currently on suboptimum desferrioxamine to switch using optimum desferrioxamine. Results on cost analysis showed the mean cost of treatment for thalassaemia patients on optimum desferrioxamirie was higher than those on sub·optimum desferrioxamine; (RM14, 775.00+SDRM4,737.00 and RM10,780+RM3,655, respectively). QALYs were 19.186+6.591 and 9.859+5275 in the optimum and suboptirnum group, respectively. Costutility analysis showed the cost per QALYs in optimum desferrioxamine group was RM59,045.00 compared to RM44,665.00 in suboptimum desferrioxamine group. ICER of patients on sub-optimum desferrioxamine switching to optimum desferrioxarnine was only RM420.39. Sensitivity analysis showed that the results were robust in the best and worst scenarios. In conclusion, although it is expensive for thalassaemia patients to use optimum desferrioxamine compared to sub-optimum desferrioxamine, the cost per QALYs gained was undoubtedly low.
    Matched MeSH terms: Tertiary Care Centers
  17. Al-Edrus, S. A., Suhaimi, S. N., Noor Azman, A. R., Latif, A. Z., Sobri, M.
    Introduction: An arteriovenous malformation (AVM) is an abnormal collection of blood vessels in which arterial blood flows directly into the draining vein without the normal interposed capillaries. The Spetzler-Martin grading system has been widely accepted worldwide to estimate the pretreatment risks and predict the outcome of patients with intracranial AVM. In Malaysia, we still do not have the baseline data of this grading system. Methods: A total of 33 patients from a tertiary referral hospital diagnosed with intracranial AVM based on neuroimaging findings over a 4-year period were studied. Medical
    records were traced and neuroimaging findings were analysed. The AVMs were graded according to the Spetzler-Martin grading system and Fisher’s exact test was used to assess statistical difference between the grades of the AVM and management plan for the patients. Results: Four patients were graded as Grade 1, 9 patients as Grade II, 10 patients as Grade III, 6 patients as Grade IV and 4 patients as Grade V. Ten patients were treated conservatively; six patients underwent surgery and embolisation respectively. Four patients underwent radiosurgery and a combination of embolisation while surgery and radiosurgery were given to 5 patients and 2 patients respectively. Statistically significant difference (p=0.016) was found between the Spetzler-Martin grading system and the management of intracranial AVMs. Conclusion: The management decision was not made based on the
    grading of the AVMs. It is recommended that all AVM patients be routinely graded according to this system prior to treatment.
    Matched MeSH terms: Tertiary Care Centers
  18. Ang WJ, Md Kadir SZ, Fadzillah AJ, Zunaina E
    Cureus, 2017 Feb 17;9(2):e1035.
    PMID: 28357167 DOI: 10.7759/cureus.1035
    We report three patients with corneal bee sting at our tertiary care center in a three-year period starting from 2014 to 2016. All patients sustained a bee sting injury to the cornea. All patients received early preoperative topical antibiotics, topical cycloplegic and intensive topical steroids. However, the timing of the initial presentation, the duration, and the location of the retained stinger differed in each case leading to different postsurgical outcomes.
    Matched MeSH terms: Tertiary Care Centers
  19. Aftab RA, Khan AH, SYed Sulaiman SA, Ali I, Hassali A, Saleem F
    Turk J Med Sci, 2016 Nov 17;46(5):1300-1305.
    PMID: 27966326 DOI: 10.3906/sag-1405-45
    BACKGROUND/AIM: Multiple asthma guidelines have been developed to reduce asthma mortality, morbidity, and cost associated with asthma worldwide. In Malaysia, within this context, it is relatively unknown to what extent doctors adhere to the asthma guidelines. This study aimed to assess guideline adherence and calculate the cost of adhered and nonadhered prescriptions by medical doctors in a public tertiary health care facility.
    MATERIALS AND METHODS: A cross-sectional study was carried out at Hospital Pulau Pinang, Malaysia. One hundred and eighty patients, a total of 30 patients per doctor, were enrolled to assess guideline adherence. The patients were followed for a second visit to assess their lung function. The costs of adhered and nonadhered prescriptions were calculated.
    RESULTS: One hundred and forty-three patients (79%) received guideline (Global Initiative for Asthma 2011)-adhering pharmacotherapy. In the majority of patients (n = 133, 73.9%) asthma control was classified as partially controlled. There was no significant association observed between patient asthma control and patient demographics; however, there was a significant difference (P < 0.001) between lung function values from the first and second visits. The cost of adhered prescription was higher (70.1 Malaysian ringgit) than that of nonadhered prescription (13.74 Malaysian ringgit).
    CONCLUSION: Fair levels of guideline adherence were observed. Emphasis should be placed on identifying appropriate cost-effective medication regimens based on patient asthma control and constant feedback from patients.
    Study site: Respiratory clinic, Hospital Pulau Pinang, Pulau Pinang, Malaysia
    Matched MeSH terms: Tertiary Care Centers
  20. Rehman IU, Munib S, Ramadas A, Khan TM
    PLoS One, 2018;13(11):e0207758.
    PMID: 30496235 DOI: 10.1371/journal.pone.0207758
    BACKGROUND: The prevalence of chronic kidney disease-associated pruritus (CKD-aP) varies from 22% to 84% among patients receiving hemodialysis. It occurs more frequently at night, and often affects patient's sleep quality. CKD-aP is often unreported by patients, and many do not receive effective treatment. There is, however, a paucity of available data on the prevalence and impact of CKD-aP on patients receiving hemodialysis in Pakistan.

    METHODS: A multicenter cross-sectional study was undertaken from July 2016 to April 2017 at a tertiary care hospitals in Pakistan.

    RESULTS: 354 patients undergoing hemodialysis were studied. 35.6% had CKD for 1-2 years, and 42.4% were receiving hemodialysis for 1-2 years. The prevalence of pruritus was 74%. The median [interquartile range] score for pruritus was 10.0 (out of possible 25) [8.0-12.0]; while the median [interquartile range] Pittsburgh Sleep Quality Index (PSQI) score was 8.0 (out of possible 21) [7.0-10.0]'. Pruritus was significantly correlated with the sleep score (r = 0.423, p<0.001). The results of the multivariate linear regression revealed a positive association between pruritus and age of patients (β = 0.031; 95% CI = 0.002-0.061; p = 0.038) and duration of CKD (β = -0.013; 95% CI = -0.023 --0.003; p = 0.014). Similarly there was a positive association between sleep score and duration of CKD (β = 0.010; 95% CI = 0.002-0.019; p = 0.012) and pruritus (β = 0.143; 95% CI = 0.056-0.230; p = 0.001).

    CONCLUSIONS: Chronic kidney disease-associated pruritus is very common in patients receiving hemodialysis in Pakistan. Pruritus is significantly associated with poor sleep quality.

    Matched MeSH terms: Tertiary Care Centers
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