Displaying publications 1 - 20 of 360 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. Amrina MA, Shahidah M, Sofiah HR, Mirlia SCM, Thilakaveni R, Chong ZL, et al.
    Med J Malaysia, 2023 Jan;78(1):20-24.
    PMID: 36715186
    INTRODUCTION: Healthcare workers (HCWs) were among the first to be fully vaccinated against SARS-CoV-2. However, the antibody responses to the vaccines and potential decline among Malaysian HCW are still unclear. The objective of this study is to follow-up anti-S antibody levels among HCW vaccinated with mRNA vaccine (BTN162b2) and inactivated vaccine (CoronaVac).

    MATERIALS AND METHODS: Plasma samples were collected prevaccination, 2 weeks and 6 months post-vaccination and tested for total immunoglobulin levels using ELISA method.

    RESULTS: A small percentage of HCW (2.2%, 15/677) had elevated anti-S antibody levels in their pre-vaccination plasma samples (median 20.4, IQR 5.8), indicating that they were exposed to SARS-CoV-2 infection prior to vaccination. The mRNA vaccine significantly increased anti-S levels of both previously infected and uninfected individuals to saturation levels (median 21.88, IQR.0.88) at 2 weeks postsecond dose of the vaccine. At 6 months post-vaccination, the antibody levels appeared to be maintained among the recipients of the mRNA vaccine. However, at this time point, anti-S antibody levels were lower in individuals given inactivated vaccine (median 20.39, IQR 7.31, n=28), and interestingly, their antibody levels were similar to anti-S levels in pre-vaccination exposed individuals. Antibody levels were not different between the sexes.

    CONCLUSION: Anti-S levels differ in individuals given the different vaccines. While further study is required to determine the threshold level for protection against SARSCoV- 2, individuals with low antibody levels may be considered for boosters.

    Matched MeSH terms: Tertiary Care Centers
  8. Khor V, Sidhu S, Muhammad Afiq MFO, Pushpanathan M, Fahmy O, Khairul Asri MG, et al.
    Singapore Med J, 2024 Mar 01;65(Suppl 1):S35-S40.
    PMID: 35139632 DOI: 10.11622/smedj.2022008
    Matched MeSH terms: Tertiary Care Centers
  9. 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*
  10. 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*
  11. 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
  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. 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
  14. 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
  15. Ameen SA, Norasyikin AW, Dina HN, Zara MNF, Tyler R, Asma A
    Int Tinnitus J, 2022 Dec 01;26(2):89-94.
    PMID: 36724354 DOI: 10.5935/0946-5448.20220013
    OBJECTIVES: To determine the prevalence of tinnitus in Type 1 Diabetes Mellitus (T1DM) patients, to evaluate its severity and to correlate it with estimated Glomerular Filtration Rate (eGFR) as well as glycaemia control (HbA1c).

    MATERIAL AND METHODS: We performed a questionnaire-based cross-sectional study at Hospital Canselor Tuanku Muhriz (HCTM) from a period of 15 months. A total of 133 T1DM patients who fulfilled our study's criteria were subjected to otoscopy examination, tuning fork test and free field voice test. The mini-Tinnitus Questionnaire (TQ) was used to assess the severity of tinnitus. We were careful to categorize the perceived duration of tinnitus.

    RESULTS: The prevalence of tinnitus among T1DM patients was 24.1% (32/133 patients). Out of 32 patients, approximately 78.1% (25 patients) had a compensated level of tinnitus distress and the remaining 21.9% (7/32) had moderate tinnitus. The duration of tinnitus ranged from 2 seconds to 2 minutes, whıch was ringing and intermittent in nature. The HbA1c and estimated Glomerular Filtration Rate (eGFR) were higher in tinnitus compared to the non-tinnitus group. There was no significant correlation between the severity of tinnitus and HbA1c level or eGFR.

    CONCLUSIONS: Our study concluded that tinnitus amongst T1DM patients was likely to be non-pathological in view of its short duration with minimal to no distress to the sufferers. An elevated HbA1c may increase the risk of developıng tinnitus.

    Matched MeSH terms: Tertiary Care Centers
  16. Razak I, Hari K, Syakirah Z, Saiful M, Shahrul H
    Med J Malaysia, 2023 Jan;78(1):35-38.
    PMID: 36715189
    INTRODUCTION: The COVID-19 pandemic is unprecedented. Amongst those who contracted COVID-19, a number required intubation and prolonged ventilation. This increased the number of ventilated patients in the hospital and increased the requirement for tracheostomy of severe COVID-19 patients. Our objective is to study the outcome of patients with COVID-19 who underwent tracheostomy.

    MATERIALS AND METHODS: This study is a novel retrospective study in a tertiary centre in Malaysia. Case notes of COVID- 19 patients who underwent tracheostomy in Hospital Ampang were collected using the electronic Hospital Information System. Data were analysed using the SPSS system.

    RESULTS: From a total of 30 patients, 15 patients survived. All patients underwent either open or percutaneous tracheostomy. The median age is 53 (range: 28-69) with a significant p-value of 0.02. Amongst comorbidities, it was noted that diabetes mellitus was significant with a p-value of 0.014. The median time from the onset of COVID-19 to tracheostomy is 30 days. The median duration of intensive care unit (ICU) stay is 30.5 days, with the median duration of hospital length of stay of 44 days (p = 0.009 and <0.001, respectively). No complications that contributed to patient death were found. Survivors had a median of 29.5 days from tracheostomy to oxygen liberation.

    CONCLUSION: Tracheostomy in COVID-19 patients that requires prolonged ventilation is unavoidable. It is a safe procedure and mortality is not related to the procedure. Mortality is primarily associated with COVID-19.

    Matched MeSH terms: Tertiary Care Centers
  17. Chang CE, Khan RA, Tay CY, Thangaiyah B, Ong VST, Pakeer Oothuman S, et al.
    PLoS One, 2023;18(3):e0282342.
    PMID: 36867615 DOI: 10.1371/journal.pone.0282342
    BACKGROUND: Clinical pharmacy plays an integral role in optimizing inpatient care. Nevertheless, prioritising patient care remains a critical challenge for pharmacists in a hectic medical ward. In Malaysia, clinical pharmacy practice has a paucity of standardized tools to prioritise patient care.

    AIM: Our aim is to develop and validate a pharmaceutical assessment screening tool (PAST) to guide medical ward pharmacists in our local hospitals to effectively prioritise patient care.

    METHOD: This study involved 2 major phases; (1) development of PAST through literature review and group discussion, (2) validation of PAST using a three-round Delphi survey. Twenty-four experts were invited by email to participate in the Delphi survey. In each round, experts were required to rate the relevance and completeness of PAST criteria and were given chance for open feedback. The 75% consensus benchmark was set and criteria with achieved consensus were retained in PAST. Experts' suggestions were considered and added into PAST for rating. After each round, experts were provided with anonymised feedback and results from the previous round.

    RESULTS: Three Delphi rounds resulted in the final tool (rearranged as mnemonic 'STORIMAP'). STORIMAP consists of 8 main criteria with 29 subcomponents. Marks are allocated for each criteria in STORIMAP which can be combined to a total of 15 marks. Patient acuity level is determined based on the final score and clerking priority is assigned accordingly.

    CONCLUSION: STORIMAP potentially serves as a useful tool to guide medical ward pharmacists to prioritise patients effectively, hence establishing acuity-based pharmaceutical care.

    Matched MeSH terms: Tertiary Care Centers
  18. Poh KY, Jackson N
    Malays J Pathol, 2023 Aug;45(2):187-194.
    PMID: 37658528
    INTRODUCTION: Inappropriate use of blood and blood products has been well reported from many countries including Malaysia and may be due to a deficit of transfusion medicine (TM) knowledge. This study is aimed to assess TM knowledge among clinicians in a tertiary hospital.

    MATERIALS AND METHODS: The validated exam developed by the BEST collaborative group was used to assess TM knowledge of doctors, from junior residents up to senior specialists. Scores of 42%, 62%, and 82%, corresponding to basic, intermediate, and expert levels of knowledge, respectively. Convenience sampling was done from eight blood-using departments at University Malaya Medical Centre. The Kruskal-Wallis test was used to compare the candidates' exam scores between different variables.

    RESULTS: A total of 184 doctors were assessed. The overall mean score was 40.1% (SD 12.7%). The most senior doctors had a significantly lower mean score compared with resident trainees and specialists. Doctors from haematology, anesthesiology, and internal medicine had significantly higher scores (51%, 47.4%, and 46.4% respectively, p<0.05). No correlations were found between the exam scores and the self-reported amount, or quality of prior TM teaching, nor with the year of postgraduate training. Participants did poorly on questions related to transfusion reactions, especially the question on transfusion-related acute lung injury.

    CONCLUSION: Inadequate transfusion medicine knowledge was found across all the departments and levels of appointment. It is concerning that the most senior decision-making doctors had especially poor knowledge. TM training is needed by all residents, and regular updates should be given to established specialists.

    Matched MeSH terms: Tertiary Care Centers
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