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Damanhuri NH, Hairi NN, Ismail M, Jeganathan R, Karalasingam SD, Nasir MJM, Soelar SA, Musa KI, Tengku Ismail TA. Spontaneous Preterm Births in Malaysia: Are There Modifiable Antenatal Risk Factors? Cureus 2024; 16:e59152. [PMID: 38680821 PMCID: PMC11055571 DOI: 10.7759/cureus.59152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/01/2024] Open
Abstract
Background Spontaneous preterm birth (SPB) is a global public health concern with devastating health effects on SPB survivors. This study aimed to determine modifiable antenatal risk factors associated with SPB among women attending government healthcare facilities in Malaysia. Methodology A retrospective record review of 49,416 national obstetrics registry data from 2015 was conducted and analyzed using binary logistic regression based on six antenatal factor divisions. Results Mothers with pre-existing diabetes had higher odds (adjusted odds ratio (aOR) = 3.09) of delivering prematurely than mothers without diabetes. Mothers with chronic hypertension with superimposed pre-eclampsia (aOR = 2.51) and gestational hypertension (aOR = 1.44) had higher odds of experiencing preterm birth than mothers with no hypertension. Underweight mothers had higher odds (aOR = 1.27) of delivering prematurely than mothers with an ideal body mass index (18.5 to <25.0 kg/m2). Mothers with moderate anemia (hemoglobin level: 7 to <9 g/dL) had higher odds (aOR = 1.18) of preterm birth than mothers with normal hemoglobin levels (≥11 g/dL). Conclusions Maternal biomarkers, such as glucose level, blood pressure, BMI, and hemoglobin level, play an important role in reducing the rate of SPB in Malaysia. This study recommends strengthening pre-pregnancy, antenatal, and postpartum care through multidisciplinary and multi-agency team collaboration, addressing both modifiable and non-modifiable risk factors and adopting a dual approach that combines preventive and curative care.
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Affiliation(s)
- Narisa H Damanhuri
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | - Noran N Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | - Maslinor Ismail
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MYS
| | | | | | | | | | - Kamarul Imran Musa
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, MYS
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Lim YC, Soelar SA, Shakor ASA, Mohamad N, Pahrol MA, Ismail R, Danaee M, Shaharudin R. Respiratory fit test panel representing population of Malaysia. BMC Pulm Med 2024; 24:122. [PMID: 38454418 PMCID: PMC10921698 DOI: 10.1186/s12890-024-02919-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/20/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The existing respiratory fit test panels (RFTPs) are based on Bivariate and Principal Component Analysis (PCA) which utilise American and Chinese head and facial dimensions. As RFTPs based on local facial anthropometric data for Malaysia are not available, this study was conducted with the aim to develop new RFTPs using Malaysian data. METHODOLOGY A cross-sectional study was conducted across Malaysia among 3,324 participants of the study of National Health and Morbidity Survey 2020 aged 18 and above. Ten head and facial dimensions were measured. Face length and face width were used to construct bivariate facial panel, whereas the scores from the first two PCA were used to develop the PCA panel. RESULTS This study showed that Malaysians have the widest upper limit for facial width. It also found that three factors could be reduced from the PCA analysis. However only 2 factors were selected with PCA 1 representing head and facial size and PCA 2 representing facial shape. Our bivariate panel could accommodate 95.0% of population, while our PCA panel accommodated 95.6%. CONCLUSION This was the first study to use Malaysian head and facial anthropometry data to create bivariate and PCA panels. Respirators constructed using these panels are likely to fit ≥ 95.0% of Malaysia's population.
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Affiliation(s)
- Yin Cheng Lim
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Selangor, 40170, Malaysia.
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Shahrul Aiman Soelar
- Clinical Research Centre, Hospital Sultanah Bahiyah, Alor Setar, Kedah, 05460, Malaysia
| | - Ameerah Su'ad Abdul Shakor
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Selangor, 40170, Malaysia
| | - Nadia Mohamad
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Selangor, 40170, Malaysia
| | - Muhammad Alfatih Pahrol
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Selangor, 40170, Malaysia
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Selangor, 40170, Malaysia
| | - Mahmoud Danaee
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603, Malaysia
| | - Rafiza Shaharudin
- Environmental Health Research Centre, Institute for Medical Research, National Institutes of Health, Ministry of Health, Setia Alam, Selangor, 40170, Malaysia
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Suan NAM, Soelar SA, Rani RA, Anuar NA, Aziz KAA, Chan HK, Cheah WK, Sani SSM, Said RM, Hassan MRA. Exploring measurement tools to optimise hospital physician distribution. Med J Malaysia 2024; 79:222-233. [PMID: 38553930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Equitable healthcare delivery is essential and requires resources to be distributed, which include assets and healthcare workers. To date, there is no gold standard for measuring the correct number of physicians to meet healthcare needs. This rapid review aims to explore measurement tools employed to optimise the distribution of hospital physicians, with a focus on ensuring fair resource allocation for equitable healthcare delivery. MATERIALS AND METHODS A literature search was performed across PubMed, EMBASE, Emerald Insight and grey literature sources. The key terms used in the search include 'distribution', 'method', and 'physician', focusing on research articles published in English from 2002 to 2022 that described methods or tools to measure hospital-based physicians' distribution. Relevant articles were selected through a two-level screening process and critically appraised. The primary outcome is the measurement tools used to assess the distribution of hospital-based physicians. Study characteristics, tool advantages and limitations were also extracted. The extracted data were synthesised narratively. RESULTS Out of 7,199 identified articles, 13 met the inclusion criteria. Among the selected articles, 12 were from Asia and one from Africa. The review identified eight measurement tools: Gini coefficients and Lorenz curve, Robin Hood index, Theil index, concentration index, Workload Indicator of Staffing Need method, spatial autocorrelation analysis, mixed integer linear programming model and cohortcomponent model. These tools rely on fundamental data concerning population and physician numbers to generate outputs. Additionally, five studies employed a combination of these tools to gain a comprehensive understanding of physician distribution dynamics. CONCLUSION Measurement tools can be used to assess physician distribution according to population needs. Nevertheless, each tool has its own merits and limitations, underscoring the importance of employing a combination of tools. The choice of measuring tool should be tailored to the specific context and research objectives.
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Affiliation(s)
- N A M Suan
- Hospital Sultanah Bahiyah, Clinical Research Center, Alor Setar, Kedah, Malaysia.
| | - S A Soelar
- Hospital Sultanah Bahiyah, Clinical Research Center, Alor Setar, Kedah, Malaysia
| | - R A Rani
- Hospital Taiping, Clinical Research Center, Taiping, Perak, Malaysia
| | - N A Anuar
- Hospital Taiping, Clinical Research Center, Taiping, Perak, Malaysia
| | - K A A Aziz
- Hospital Kuala Lumpur, Department of Internal Medicine, Kuala Lumpur, Malaysia
| | - H K Chan
- Office of Director General, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - W K Cheah
- Hospital Taiping, Clinical Research Center, Taiping, Perak, Malaysia
| | - S S M Sani
- Hospital Kuala Lumpur, Department of Internal Medicine, Kuala Lumpur, Malaysia
| | - R M Said
- Hospital Serdang, Department of Internal Medicine, Serdang, Selangor, Malaysia
| | - M R A Hassan
- Office of Director General, Ministry of Health Malaysia, Putrajaya, Malaysia
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Zainal Abidin Z, Noor E, Mohd Nor NS, Mohamed Nazari NS, Anuar Zaini A, Azizi NZ, Soelar SA, Shahrizad MM, Abdul Halim R. Type 1 Diabetes Mellitus Patients' Self-perception of Periodontal Diseases. Eur J Dent 2023. [PMID: 38049120 DOI: 10.1055/s-0043-1772777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
OBJECTIVES The study aimed to evaluate type 1 diabetes mellitus (T1DM) patients' self-perceived periodontal health status and to identify the association between periodontal disease (PD) and DM. MATERIALS AND METHODS This cross-sectional study included 113 T1DM children between 3 and 18 years old from the Universiti Teknologi MARA and the University of Malaya. Periodontal health parameters, including plaque index, gingival index, probing pocket depth, simplified basic periodontal examination, and clinical attachment loss, were recorded. Self-perceived periodontal health status was assessed with questionnaires. STATISTICAL ANALYSIS Statistical analysis was performed to evaluate the sensitivity of the questionnaire and the relationship between T1DM and periodontal parameters. RESULTS The median age was 11.4 years. Half of them (50.4%) were females. A total of 83.5% rated their oral condition as good, whereas 27.5% reported a history of gingival bleeding. Clinical examination revealed that 48.7% had healthy gingiva, whereas 47.8% had gingivitis. The question "Do you have bleeding when brushing, flossing, or eating food?" showed good accuracy in the evaluation of PD (p < 0.001). CONCLUSION The questionnaire has a high potential to be used by medical professionals in identifying T1DM patients at risk of PD to guide nondental health care providers in making appropriate referrals to dental services.
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Affiliation(s)
- Zaridah Zainal Abidin
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Erni Noor
- Centre of Studies for Periodontology, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | - Noor Shafina Mohd Nor
- Department of Paediatrics, Laboratory and Forensic Medicine (I-PPerForM), Faculty of Medicine, Malaysia and Institute for Pathology, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
| | | | - Azriyanti Anuar Zaini
- Paediatric Department, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nurul Zeety Azizi
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Aiman Soelar
- Clinical Research Centre, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - Marshah Mohamad Shahrizad
- Kuching Division Dental Office, Sarawak State Dental Health Department, Braang Bayur Dental Clinic, Sarawak, Malaysia
| | - Rohaida Abdul Halim
- Centre of Paediatric Dentistry and Orthodontics Studies, Faculty of Dentistry, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
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Abdul Hamid MF, Ahmad A, Mohamad Jailaini MF, Soelar SA, Nik Abeed NN, Hau NB, Azmel AA, Ban A. The effect of fine-particle size and extrafine particle size inhaled corticosteroid in reducing airway resistance in asthmatic patients. Proceedings of Singapore Healthcare 2023. [DOI: 10.1177/20101058231167250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
Background Bronchial asthma is characterised by chronic inflammation of both large and small airways. Extra-fine formulation of inhaled corticosteroid (ICS) can achieve a higher peripheral lung deposition leading to improved asthma control. We investigated the effect of extra-fine and fine particle size inhaled ICS with airway resistance and severity of symptoms in asthmatic patients. Methods Prospective interventional study of outpatient asthmatics in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Subjects were grouped based on pre-existing inhalers; extra-fine and fine inhaled corticosteroid (ICS)/long acting beta agonist (LABA). Crossover was at week 7 and treatment regime continued for 7 weeks. Subjects were assessed at week 0, 6 and 13 using asthma control test (ACT) score, forced expiratory volume in 1 s (FEV1) and impulse oscillometry (IOS) Inhaler technique was assessed periodically. Results Thirty-four subjects were recruited. Median asthma duration was 20 years. Twenty subjects (58%) in fine ICS/LABA and 14 (42%) in extra-fine ICS/LABA group. Thirty-one subjects were analysed before crossver. There was a significant improvement of FEV1 in the extra-fine ICS/LABA group (1.7 ± 0.47 to 1.88 ± 0.5; p = 0.01). ACT score reduced significantly in extra-fine ICS/LABA group (23 ± 5 to 21 ± 4; p = 0.04) at week 0–6. Week 7–13 showed a significant improvement of ACT score (16.5 ± 3 to 20 ± 3; p = 0.01) and FEV1 (1.71 ± 0.96 to 1.81 ± 1.02: p = 0.01) in extra-fine ICS/LABA. There was no significant difference in (IOS) parameters between the groups. Conclusion There was an improvement of FEV1 and ACT score with extra-fine ICS/LABA with no benefit in airway resistance.
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Theyvan Balakrishnan T, Bilal A, Fitzpatrick N, Dahiya R, Soelar SA, Khalid K, Pillai A. Enhancing Consistency in Posterior Malleolus Fracture Classification: A Comprehensive Interobserver Reliability Study With 20 Raters Using the Mason & Molloy Classification. Cureus 2023; 15:e48586. [PMID: 38024046 PMCID: PMC10655162 DOI: 10.7759/cureus.48586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/01/2023] Open
Abstract
INTRODUCTION Over the past decade, there has been a growing interest in the identification and treatment of posterior malleolus fragments, driven by a better understanding of their significance. The Mason & Molloy (M&M) classification system has emerged as a valuable tool for systematically categorizing these fractures and assisting clinicians in formulating treatment. We aim to assess the interobserver reliability of the M&M classification for posterior malleolus fracture by using 20 raters. METHODOLOGY The study was conducted at a major foot and ankle referral center in Wythenshawe, Manchester, UK. Thirty-eight Computed Tomography (CT) scans were evaluated by 20 independent raters: 15 general orthopedic and trauma surgeons plus five foot and ankle surgeons. Each rater classified the posterior malleolus fracture according to M&M classification into type 1, 2A, 2B, 3, or not classifiable. Statistical analysis was done with the R software package and SPSS (v26; IBM Corp., Armonk, NY). Fleiss kappa (κ) coefficient with a 95% confidence interval (CI) was applied. RESULTS The interobserver agreement was moderate with a global κ value of 0.531 (95% CI: 0.518, 0.544). There were good agreements for identifying type 3 M&M (κ=0.785) and those that are not applicable for M&M classification (κ=0.785). There was a strong correlation between all raters in using M&M classification (Tb=0.53-0.59) except for Rater 12. CONCLUSION M&M classification remains a valuable tool to guide the management of patients with these subsets of ankle fractures.
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Affiliation(s)
| | - Ahmad Bilal
- Trauma and Orthopedics, Wythenshawe Hospital, Manchester, GBR
| | - Niall Fitzpatrick
- Trauma and Orthopedics, Manchester NHS Foundation Trust, Manchester, GBR
| | - Rohan Dahiya
- Orthopedics and Traumatology, Wythenshawe Hospital, Manchester, GBR
| | | | - Karniza Khalid
- Biochemistry, Institute for Medical Research, National Institutes of Health, Kuala Lumpur, MYS
| | - Anand Pillai
- Trauma and Orthopedics, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, GBR
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Abidin ZZ, Halim RA, Noor E, Nor NSM, Nazari NSM, Zaini AA, Azizi NZ, Soelar SA. Knowledge and Perception of Bidirectional Relationship Between Periodontal Disease and Type 1 Diabetes Mellitus: A Questionnaire Study. J Int Soc Prev Community Dent 2023; 13:416-425. [PMID: 38124724 PMCID: PMC10729881 DOI: 10.4103/jispcd.jispcd_123_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/22/2023] [Accepted: 09/23/2023] [Indexed: 12/23/2023] Open
Abstract
Aim The bidirectional relationship between type 1 diabetes mellitus (T1DM) and inflammatory periodontal disease (PD) is globally recognized. However, oral health components are often given lower priority, and studies related to knowledge and the bidirectional association are limited. This study assesses the knowledge and perceptions of PD and its associated risk factors among T1DM patients and/or their parents. Materials and Methods Patients under 18 with T1DM at Universiti Teknologi MARA and Universiti Malaya were invited to participate. Structured interviews were conducted to assess participants' knowledge and perceptions of T1DM, and statistical analysis was performed to examine their associations using Pearson's chi-squared test and Fisher's exact test. Results A total of 113 T1DM patients, with a mean age of 11.4 ± 4, completed the interviews. Poor knowledge was observed among parents and T1DM patients (P-value = 0.007) and those who exercised regularly (P-value = 0.047). A significant association with good perception was found among individuals with uncontrolled HbA1c levels (P-value = 0.0018) and those experiencing bleeding symptoms (P-value = 0.021). Conclusions The study highlights the importance of increasing awareness, a key factor in improving oral health knowledge. Interestingly, despite poor control of clinical parameters, the population displayed good perception, suggesting a potential lack of understanding regarding disease control.
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Affiliation(s)
- Zaridah Zainal Abidin
- Centre of Studies for Paediatric Dentistry & Orthodontics, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Rohaida Abdul Halim
- Centre of Studies for Paediatric Dentistry & Orthodontics, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Erni Noor
- Centre of Studies for Periodontology, Faculty of Dentistry, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Noor Shafina Mohd Nor
- Department of Paediatrics, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Nor Shafina Mohamed Nazari
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Sungai Buloh, Selangor, Malaysia
| | - Azriyanti Anuar Zaini
- Department of Paediatric, Faculty of Medicine, Universiti Malaya, Sungai Buloh, Selangor, Malaysia
| | - Nurul Zeety Azizi
- Department of Paediatric Dentistry & Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Shahrul Aiman Soelar
- Clinical Research Centre, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
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Mohd Rhazi NA, Muneswarao J, Abdul Aziz F, Ibrahim B, Kamalludin A, Soelar SA. Can patients achieve sufficient peak inspiratory flow rate (PIFR) with Turbuhaler® during acute exacerbation of asthma? J Asthma 2023:1-5. [PMID: 36650693 DOI: 10.1080/02770903.2023.2169930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Anti-inflammatory reliever (AIR) with or without regular maintenance delivered through Turbuhaler® has been widely recommended in the GINA strategy document. These patients are not prescribed with additional reliever inhalers, but dependent on Turbuhaler® during acute asthma episodes. The peak inspiratory flow rate (PIFR) is crucial in drug delivery from a dry powder inhaler (DPI) such as Turbuhaler®. Despite its increasing usage, there are some concerns that patients on Turbuhaler® are not able to achieve adequate PIFR during acute exacerbation of asthma. OBJECTIVE This study aimed to assess the PIFR at resistance settings that matched Turbuhaler® in patients with acute exacerbation of asthma. METHODOLOGY A six-month cross-sectional study was conducted at the Emergency Department (ED) of Hospital Sultanah Bahiyah and Hospital Kulim, Kedah, Malaysia. Adult patients diagnosed with mild to moderate acute exacerbations of asthma were recruited. The PIFRs were measured using the In-Check DIAL G16 that was set to simulate the resistance of Turbuhaler® (R3). The PIFRs were assessed before (pre) and after (post) the initial bronchodilator (BD) treatment at the ED. The minimal required PIFR was defined as flow rates ≥ 30 L/min while a PIFR of 60 L/min was considered as optimal. RESULTS A total of 151 patients (81 females and 70 males) were recruited. The mean age was 37.5 years old with a range between 18 and 79 years old. The results showed that 98% (n = 148) of patients managed to achieve the minimal PIFR required for pre-BD. The mean PIFR pre-BD was 60 ± 18.5 L/min and post-BD was 70 ± 18.5 L/min. Furthermore, more than half (54%, n = 82) of the patients recorded PIFR ≥ 60 L/min during pre-BD, and about three-quarters (71%, n = 92) achieved PIFR ≥ 60 L/min post-BD. The PIFR showed a moderate correlation with peak expiratory flow rate (PEFR) (r = 0.55, 95% CI: 0.43-0.65, p < 0.001). CONCLUSION The majority of patients with asthma in the present study were able to achieve sufficient PIFR from Turbuhaler® during mild to moderate acute exacerbations.
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Affiliation(s)
- Nur Azimah Mohd Rhazi
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Jaya Muneswarao
- Pharmacy Department, Hospital Pulau Pinang, Ministry of Health Malaysia, Pulau Pinang, Malaysia
| | | | | | - Azlan Kamalludin
- Trauma and Emergency Department, Hospital Kulim, Ministry of Health Malaysia, Kedah, Malaysia
| | - Shahrul Aiman Soelar
- Clinical Research Centre, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Kedah, Malaysia
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Khalid K, Ku Md Saad S, Soelar SA, Mohamed Yusof Z, Warijo O. Exploring adolescents' practice and perspective on the use and misuse of kratom in northwest Malaysia. J Ethn Subst Abuse 2023; 22:121-132. [PMID: 33784945 DOI: 10.1080/15332640.2021.1906816] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Kratom is a plant homogenous to Southeast Asia with a long history of traditional use as medicinal herbs. However, recent years have witnessed its pervasive infiltration into international audience with growing public health concern. This cross-sectional study was conducted from 1 August 2017 till 31 August 2018 aiming to explore the practice and perspectives of kratom use and misuse among adolescents in northwest Malaysia. The study involved a self-administered questionnaire that was designed for the purpose of the study. The instrument had undergone prior validation process with a good overall internal reliability for the knowledge domain (Cronbach's alpha = 0.728) and attitude domain (Cronbach's alpha = 0.700). The questionnaire was distributed to 135 respondents involving adolescents aged 13 to 19 years old via convenience (non-kratom user) and snowball sampling (kratom users). There were 65 (47.8%) kratom users, while 70 (51.5%) were kratom-naïve. Among the kratom users, peer influence was the most common reason for them to be first involved with kratom, 26 (41.3%) whereas the reasons for kratom use quoted were to improve physical stamina, 10 (16.4%), as painkiller, 9 (14.8%), and to be accepted by peers, 7 (11.5%). Multiple logistic regression found that older age (95% CI: 0.13, 0.58; p = 0.001) and being active smokers (95% CI: 39.33, 980.63; p < 0.001) significantly predict kratom use among adolescents. The emerging trend of kratom abuse and misuse especially among the younger generation in Malaysia is raising concern and warrants social and governmental vigilance.
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Affiliation(s)
- Karniza Khalid
- Clinical Research Centre, Hospital Tuanku Fauziah, Perlis, Ministry of Health Malaysia
| | | | - Shahrul Aiman Soelar
- Clinical Research Centre, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Ministry of Health Malaysia
| | - Zulsafari Mohamed Yusof
- National Anti-Drug Agency (Padang Besar Branch), Padang Besar ICQS Complex, Perlis, Malaysia
| | - Othman Warijo
- Clinical Research Centre, Hospital Tuanku Fauziah, Perlis, Ministry of Health Malaysia.,Director Office, Hospital Tuanku Fauziah, Perlis, Ministry of Health Malaysia
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Lee SH, Yeoh ZX, Sachlin IS, Gazali N, Soelar SA, Foo CY, Low LL, Syed Alwi SB, Tengku Kamalden TMI, Shanmuganathan J, Zaid M, Wong CY, Chua HH, Yusuf S, Muhamad D, Devesahayam PR, Ker HB, Salahuddin Z, Mustafa M, Sawali H, Lee HG, Din S, Misnan NA, Mohamad A, Ismail MN, Periasamy C, Chow TS, Krishnan EK, Leong CL, Lim LPF, Zaidan NZ, Ibrahim MZ, Abd Wahab S, Mohd Hashim SS. Self-reported symptom study of COVID-19 chemosensory dysfunction in Malaysia. Sci Rep 2022; 12:2111. [PMID: 35136124 PMCID: PMC8826975 DOI: 10.1038/s41598-022-06029-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/21/2022] [Indexed: 01/08/2023] Open
Abstract
Alterations in the three chemosensory modalities-smell, taste, and chemesthesis-have been implicated in Coronavirus Disease 2019 (COVID-19), yet emerging data suggest a wide geographic and ethnic variation in the prevalence of these symptoms. Studies on chemosensory disorders in COVID-19 have predominantly focused on Caucasian populations whereas Asians remain understudied. We conducted a nationwide, multicentre cross-sectional study using an online questionnaire on a cohort of RT-PCR-confirmed adult COVID-19 patients in Malaysia between 6 June and 30 November 2020. The aim of our study was to investigate their presenting symptoms and assess their chemosensory function using self-ratings of perceived smell, taste, chemesthesis, and nasal blockage. In this cohort of 498 patients, 41.4% reported smell and/or taste loss when diagnosed with COVID-19, which was the commonest symptom. Blocked nose, loss of appetite, and gastrointestinal disturbances were independent predictors of smell and/or taste loss on multivariate analysis. Self-ratings of chemosensory function revealed a reduction in smell, taste, and chemesthesis across the entire cohort of patients that was more profound among those reporting smell and/or taste loss as their presenting symptom. Perceived nasal obstruction accounted for only a small proportion of changes in smell and taste, but not for chemesthesis, supporting viral disruption of sensorineural mechanisms as the dominant aetiology of chemosensory dysfunction. Our study suggests that chemosensory dysfunction in COVID-19 is more widespread than previously reported among Asians and may be related to the infectivity of viral strains.Study Registration: NMRR-20-934-54803 and NCT04390165.
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Affiliation(s)
- Shen-Han Lee
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia.
| | - Zhi Xiang Yeoh
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
| | - Ida Sadja'ah Sachlin
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
| | - Norzi Gazali
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
| | | | - Chee Yoong Foo
- Real World Insights, IQVIA Asia Pacific, Petaling Jaya, Malaysia
| | - Lee Lee Low
- Department of Medicine, Hospital Sultanah Bahiyah, Kedah, Malaysia
| | | | | | | | - Masliza Zaid
- Department of Medicine, Hospital Sultanah Aminah, Johor, Malaysia
| | - Chun Yiing Wong
- Department of Otorhinolaryngology, Hospital Umum Sarawak, Sarawak, Malaysia
| | - Hock Hin Chua
- Department of Medicine, Hospital Umum Sarawak, Sarawak, Malaysia
| | - Suhaimi Yusuf
- Department of Otorhinolaryngology, Hospital Tengku Ampuan Afzan, Pahang, Malaysia
| | - Dzawani Muhamad
- Department of Medicine, Hospital Tengku Ampuan Afzan, Pahang, Malaysia
| | | | - Hong Bee Ker
- Department of Medicine, Hospital Raja Permaisuri Bainun, Perak, Malaysia
| | - Zulkiflee Salahuddin
- Department of Otorhinolaryngology, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
| | - Mahiran Mustafa
- Department of Medicine, Hospital Raja Perempuan Zainab II, Kelantan, Malaysia
| | - Halimuddin Sawali
- Department of Otorhinolaryngology, Hospital Queen Elizabeth, Sabah, Malaysia
| | - Heng Gee Lee
- Department of Medicine, Hospital Queen Elizabeth, Sabah, Malaysia
| | - Sobani Din
- Department of Otorhinolaryngology, Hospital Sungai Buloh, Selangor, Malaysia
| | | | - Amran Mohamad
- Department of Otorhinolaryngology, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia
| | - Mohd Noor Ismail
- Department of Medicine, Hospital Sultanah Nur Zahirah, Terengganu, Malaysia
| | | | - Ting Soo Chow
- Department of Medicine, Hospital Pulau Pinang, Penang, Malaysia
| | | | - Chee Loon Leong
- Department of Medicine, Hospital Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | | | | | - Mohd Zambri Ibrahim
- Department of Otorhinolaryngology, Hospital Tuanku Fauziah, Perlis, Malaysia
| | | | - Siti Sabzah Mohd Hashim
- Department of Otorhinolaryngology, Hospital Sultanah Bahiyah, KM 6 Jalan Langgar, Alor Setar, 05450, Kedah, Malaysia
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Yusof NAM, Soelar SA. The Effect of Service Climate, Service Behavior and Service Quality on Customer Satisfaction in Muslim-Friendly Hotels. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.1643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Balasekaran N, Soelar SA, Anbarasen L, Cham CY, Rajandram R, Sia SF. Vasospasm and delayed cerebral ischaemia in patients with spontaneous subarachnoid haemorrhage (aneurysmal and pretruncal non-aneurysmal): a centre's perspective. Med J Malaysia 2021; 76:17-23. [PMID: 33510103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Spontaneous subarachnoid haemorrhage (SAH) is a significant cause of stroke and associated with high morbidity and mortality. One substantial complication of SAH is cerebral vasospasm (CV) and delayed cerebral ischemia (DCI). This study aimed to define the clinical profile in patients with SAH, CV and DCI secondary to spontaneous SAH (aneurysmal and pretruncal non-aneurysmal). MATERIALS AND METHODS We analysed 122 consecutive patients with spontaneous SAH following intracranial aneurysmal and non-aneurysmal information (including patients' pattern characterisation and their possible risk factor association to pre-operative clinical decision and long-term clinical outcome) was documented and analysed. RESULTS The main clinical presentations for spontaneous SAH following ruptured intracranial aneurysm and nonaneurysm were headache (77%) and nausea/vomiting (62.3%). The most common sites for SAH following ruptured intracranial aneurysm rupture were the anterior and posterior communicating arteries (57.5%). Hypertension was the most common cause for SAH at 64.8%. It was found 26.2% (n=32) out of the 122 patients developed CV and DCI. The mean day of vasospasm was 6.0 ± 2.8 (range: 1-14 days) Age, length of stay, nausea/vomiting and visual field defect were significantly associated (p<0.05) with vasospasm. Mortality rate was also higher in the CV group compared to the group without CV in both at discharge and at 6 months; 281 versus 278 per 1000 and 312 vs 300 per 1000, respectively. CONCLUSION CV and DCI have a significant incidence among local patients with spontaneous SAH following an intracranial aneurysmal and non-aneurysmal rupture and it is associated with substantial morbidity. Prevention, effective monitoring, and early detection are keys to successful management. Regional investigation using a multicentre cohort to analyse mortality and survival rates may aid in improving national resource management of these patients.
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Affiliation(s)
- N Balasekaran
- University Malaya, Faculty of Medicine, Department of Surgery, Kuala Lumpur, Malaysia
| | - S A Soelar
- Hospital Kuala Lumpur, Clinical Research Centre, Biostatistics Unit, Kuala Lumpur, Malaysia
| | - L Anbarasen
- University Malaya, Faculty of Medicine, Department of Surgery, Kuala Lumpur, Malaysia
| | - C Y Cham
- University Malaya, Faculty of Medicine, Department of Surgery, Kuala Lumpur, Malaysia
| | - R Rajandram
- University Malaya, Faculty of Medicine, Department of Surgery, Kuala Lumpur, Malaysia
| | - S F Sia
- Sungai Buloh Hospital, Rehabilitation Medicine Department, Sungai Buloh, Selangor, Malaysia.
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Md Said R, Mohd Zain R, Chan HK, Soelar SA, Rusli N, Nasir NH, Zakaria R, Hassan MRA. Find the Missing Millions: Malaysia's experience with nationwide hepatitis C screening campaign in the general population. J Viral Hepat 2020; 27:638-643. [PMID: 31997563 DOI: 10.1111/jvh.13267] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/24/2019] [Accepted: 01/23/2020] [Indexed: 12/13/2022]
Abstract
Approximately 2.5% of the Malaysian population is currently living with hepatitis C virus (HCV) infection. Yet, the public awareness of the disease is limited and under-screening remains a major challenge. With the support of international non-for-profit organizations, the Ministry of Health in Malaysia recently launched a one-week nationwide hepatitis C screening campaign in conjunction with the World Hepatitis Day. For the first time, the rapid diagnostic test (RDT) for HCV screening was introduced in public health institutions. This campaign involved 49 hospitals and 38 health clinics across the country, targeting the adult general population with unknown HCV infection status. Of the 11 382 participants undergoing the RDT, 1.9% were found to be positive for hepatitis C antibody (anti-HCV) and were referred to on-site medical departments or nearby hospitals for confirmatory testing and treatment. Men, the Malay ethnic group, intranasal and injection drug users and ex-prisoners were shown to have higher odds of being positive for anti-HCV. In addition to serving as a model to educate the general population about the disease, this campaign demonstrates the feasibility of decentralizing HCV screening, particularly by promoting the use of RDT, and linking the HCV-infected patients to care in Malaysia.
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Affiliation(s)
| | - Rozainanee Mohd Zain
- Virology Unit, Infectious Disease Research Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Huan-Keat Chan
- Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar, Malaysia
| | | | - Norhayati Rusli
- Disease Control Division, Ministry of Health, Putrajaya, Malaysia
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Wan Ibrahim NR, Chan HK, Soelar SA, Azmi AN, Mohd Said R, Abu Hassan MR. Incidence, Clinico-demographic Profiles and Survival Rates of Colorectal Cancer in Northern Malaysia: Comparing Patients Above and Below 50 Years of Age. Asian Pac J Cancer Prev 2020; 21:1057-1061. [PMID: 32334470 PMCID: PMC7445994 DOI: 10.31557/apjcp.2020.21.4.1057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Indexed: 12/18/2022] Open
Abstract
Background: While the world witnesses an increasing trend of young-onset colorectal cancer (CRC), the information regarding the impact of age on CRC is limited in Malaysia. This study aimed to compare the incidence, clinic-demographic profiles and survival rates of CRC between patients above and under 50 years of age in northern Malaysia. Methods: This was a registry-based, cross-sectional study. All the CRC cases reported by 18 hospitals to the National Cancer Patient Registry - Colorectal Cancer (NCPR-CC) between January 2007 and December 2017 were included in the analysis. The patients were categorized by age into the above-50 and under-50 groups. The changes in the age-standardized incidence and mortality rates of both the age groups were determined using the time-series analysis, and the impact of age on the mortality risk was assessed using the Cox regression analysis. Results: Of the 6,172 CRC patients enrolled in the NCPR-CC, 893 (14.5%) were in the under-50 group. As compared with their older counterparts, the patients in the under-50 group were more likely to be female, be of Malay ethnicity, be non-smokers, have a family history of CRC, and present late for treatment. The age-standardized incidence and mortality rates of CRC in the under-50 group remained stable over the years, while a decreasing trend was clearly seen in the mortality rates of CRC in the above-50 group (p=0.003). Nevertheless, the two age groups also did not differ in the mortality risk (adjusted hazards ratio: 1.10; 95% CI: 0.90, 1.36). Conclusion: Young-onset CRC constituted a considerable proportion of CRC cases in Malaysia. However, in contrast with the findings of most studies, it demonstrated neither an uptrend in age-standardized incidence rates nor a higher mortality risk. Our findings suggest the need to upscale and lower the recommended age for CRC screening in Malaysia.
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Affiliation(s)
- Nik Razima Wan Ibrahim
- Gastroenterology Unit, Department of Medicine, Ampang Hospital, Ampang, Selangor, Malaysia
| | - Huan-Keat Chan
- Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar, Kedah, Malaysia
| | - Shahrul Aiman Soelar
- Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar, Kedah, Malaysia
| | - Ahmad Najib Azmi
- Faculty of Medicine and Health Sciences, Islamic Science University of Malaysia, Kuala Lumpur, Malaysia
| | - Rosaida Mohd Said
- Gastroenterology Unit, Department of Medicine, Ampang Hospital, Ampang, Selangor, Malaysia
| | - Muhammad Radzi Abu Hassan
- Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar, Kedah, Malaysia.,Sultana Bahiya Hospital, Alor Setar, Kedah, Malaysia
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Syed Soffian SS, Ahmad SB, Chan HK, Soelar SA, Abu Hassan MR, Ismail N. Management and glycemic control of patients with type 2 diabetes mellitus at primary care level in Kedah, Malaysia: A statewide evaluation. PLoS One 2019; 14:e0223383. [PMID: 31581261 PMCID: PMC6776298 DOI: 10.1371/journal.pone.0223383] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/19/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction While Kedah has recorded the highest prevalence of diabetes among all the states in Malaysia, the information on the practice and effectiveness of disease management in public health institutions remains limited. This study aimed to evaluate the management and glycemic control of patients with type-2 diabetes mellitus (T2DM) at the primary care level in Kedah. Methods All T2DM patients, who made at least one visit to any of the 58 public health clinics in Kedah during August 2016 and July 2017, were included in this study. The sample was selected from the National Diabetes Registry using the stratified random sampling method. The information on the demographic and clinical characteristics, laboratory findings and pharmacological treatment was gathered from medical records of patients. The differences in mean HbA1C levels across subgroups of each variable were tested using the general linear model. The evaluation of the appropriateness of treatment was performed based on the recommendations of the latest Clinical Practice Guidelines for T2DM. Results The patients (n = 23,557) were mainly female (63.4%), of Malay ethnicity (80.1%) and middle-aged (62.2%), with a mean duration of T2DM of 6.2±7.16 years. Only 15.6% of them had a HbA1C level <6.5%, and 28.6% did not have their HbA1C levels tested over the 12-month period. Yet, the underutilization of combination treatment (≥2 antidiabetic agents) and insulin in the patients with a poor glycemic control was evident. Retinopathy emerged as the most prevalent diabetes-related complication (12.6%). Along with those with a longer duration of T2DM, the patients who were younger, female and of Indian ethnicity were found to generally have a poorer glycemic control. Conclusion This study discloses the suboptimal T2DM management at the primary care level in Kedah, which warrants a statewide plan for improvement.
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Affiliation(s)
| | | | - Huan-Keat Chan
- Clinical Research Center, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah, Malaysia
| | - Shahrul Aiman Soelar
- Clinical Research Center, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah, Malaysia
| | - Muhammad Radzi Abu Hassan
- Clinical Research Center, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah, Malaysia
| | - Norhizan Ismail
- State Health Department, Ministry of Health Malaysia, Alor Setar, Kedah, Malaysia
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Zainal H, Dahlui M, Soelar SA, Su TT. Cost of preterm birth during initial hospitalization: A care provider's perspective. PLoS One 2019; 14:e0211997. [PMID: 31237874 PMCID: PMC6592503 DOI: 10.1371/journal.pone.0211997] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/06/2019] [Indexed: 11/18/2022] Open
Abstract
Preterm birth incidence has risen globally and remains a major cause of neonatal mortality despite improved survival. Demand and cost of initial hospitalization has also increased. This study assessed the cost of preterm birth during initial hospitalization from care provider perspective in neonatal intensive care units (NICU) of two hospitals in the state of Kedah, Malaysia. It utilized universal sampling and prospectively followed up preterm infants till discharge. Care provider cost was assessed using mixed method of top down approach and activity based costing. A total of 112 preterm infants were recruited from intensive care (93 infants) and minimal care (19 infants) units. Majority were from the moderate (23%) and late (36%) preterm groups followed by very preterm (32%) and extreme preterm (9%). Median cost per infant increased with level of care and degree of prematurity. Cost was dominated by overhead (fixed) costs for general (hospital), intermediate (clinical support services) and final (NICU) cost centers where it constituted at least three quarters of admission cost per infant while the remainder was consumables (variable) cost. Breakdown of overhead cost showed NICU specific overhead contributing at least two thirds of admission cost per infant. Personnel salary made up three quarters of NICU specific overhead. Laboratory investigation was the cost driver for consumables. Gender, birth weight and length of stay were significant factors and cost prediction was developed with these variables. This study demonstrated the inverse relation between resource utilization, cost and prematurity and identified personnel salary as the cost driver. Cost estimates and prediction provide in-depth understanding of provider cost and are applicable for further economic evaluations. Since gender is non-modifiable and reducing LOS alone is not effective, birth weight as a cost predictive factor in this study can be addressed through measures to prevent or delay preterm birth.
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Affiliation(s)
- Hadzri Zainal
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| | - Maznah Dahlui
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Public Health, University of Airlangga, Surabaya, Indonesia
| | | | - Tin Tin Su
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- South East Asia Community Observatory, Jeffery Cheah School of Medicine and Health Sciences, Monash University, Subang Jaya, Malaysia
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Chan HK, Soelar SA, Md Ali SM, Ahmad F, Abu Hassan MR. Trends in Vaccination Refusal in Children Under 2 Years of Age in Kedah, Malaysia: A 4-Year Review From 2013 to 2016. Asia Pac J Public Health 2018; 30:137-146. [PMID: 29292654 DOI: 10.1177/1010539517751312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current study examined how the trends in childhood vaccination refusal in Kedah, Malaysia, changed over a 4-year period (2013-2016). Data contributed by 60 public health centers were used to determine the annual incidence rates (per 1000 newborns) of vaccination refusal, and to identify the reasons for refusal among the mothers. The trend analysis revealed a 2.2-times increment in the incidence rates of vaccination refusal from 4.72 in 2013 to 10.51 in 2015, followed by a 52.2% reduction to 5.02 in 2016 ( P = .046). Besides, the proportion of mothers who refused vaccination because of religious belief reduced from 78% between 2013 and 2015 to 67.1% in 2016 ( P = .005). Overall, the finding confirms the positive impact of the educational and religious interventions introduced by the State Health Department of Kedah since January 2016; nonetheless, efforts to strengthen the existing strategies and thereby to maximize the vaccination coverage in Kedah are warranted.
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Affiliation(s)
- Huan-Keat Chan
- 1 Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - Shahrul Aiman Soelar
- 1 Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - Siti Maisarah Md Ali
- 1 Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
| | - Faizah Ahmad
- 1 Clinical Research Center, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia
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Ganeshan M, Bujang MA, Soelar SA, Karalasingam SD, Suharjono H, Jeganathan R. Importance of Adopting BMI Classifications Using Public Health Action Points to Delineate Obstetric Risk Factors Resulting in Worsening Obstetric Outcomes Among Asian Population. J Obstet Gynaecol India 2017; 68:173-178. [PMID: 29895995 DOI: 10.1007/s13224-017-1000-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 04/20/2017] [Indexed: 11/24/2022] Open
Abstract
Aims The aim of this study is to compare obstetric outcomes between overweight and class 1 obesity among pregnant women in their first pregnancy based on WHO's BMI cut-offs and the potential public health action points identified by WHO expert consultations specific for high-risk population such as Asians. Methods This is a retrospective cohort review of data obtained from the Malaysian National Obstetrics and Gynaecology Registry between the year 2010 and year 2012. All women in their first pregnancy with a booking BMI in their first trimester were included in this study. The association between BMI classifications as defined by the WHO cut-offs and the potential public health action points identified by WHO expert consultations towards adverse obstetric outcomes was compared. Results A total of 88,837 pregnant women were included in this study. We noted that the risk of adverse obstetric outcomes was significantly higher using the public health action points identified by WHO expert consultations even among the overweight group as the risk of stillbirths was (OR 1.2; 95% CI 1.0,1.4), shoulder dystocia (OR 1.9; 95% CI 1.2,2.9), foetal macrosomia (OR 1.8; 95% CI 1.6,2.0), caesarean section (OR 1.9; 95% CI 1.8,2.0) and assisted conception (OR 1.9; 95% CI 1.6,2.1). Conclusion A specifically lower BMI references based on the potential public health action points for BMI classifications were a more sensitive predictor of adverse obstetric outcomes, and we recommend the use of these references in pregnancy especially among Asian population.
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Affiliation(s)
- Muniswaran Ganeshan
- Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak Malaysia
| | - Mohamad Adam Bujang
- Clinical Research Centre, Sarawak General Hospital, Jalan Hospital, Ministry of Health Malaysia, 93586 Kuching, Sarawak Malaysia
| | - Shahrul Aiman Soelar
- 3Clinical Research Centre, Hospital Sultanah Bahiyah, Ministry of Health Malaysia, Alor Setar, Kedah Malaysia
| | | | - Harris Suharjono
- Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Sarawak Malaysia
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Muniswaran G, Soelar SA, Karalasingam SD, Bujang MA, Jeganathan R, Suharjono H. Effectiveness of selective risk based screening for Gestational Diabetes (GDM) in Malaysia: A retrospective cohort study based on the National Obstetric Registry (NOR) of Malaysia. Med J Malaysia 2017; 72:46-49. [PMID: 28255139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Gestational diabetes (GDM) has significant maternal and foetal implications. screening allows active interventions which significantly improves pregnancy outcomes. Despite World Health Organization (WHO), FIGO and National Institute of clinical Excellence (NIcE) recommendations for universal screening especially among high risk population; Malaysia currently adopts a selective risk based screening for GDM. OBJECTIVE the objective is to audit the effectiveness of the current practice of selective risk based screening in detection of GDM in Malaysia. METHODOLOGY this is a retrospective cohort study based on the National Obstetric Registry (NOR) which comprises of 14 major tertiary hospitals in Malaysia. the study period was from 1st January 2011 till 31st December 2012 and a total of 22,044 patients with GDM were analysed. Logistic regression analysis was used to calculate the crude odd ratio. RESULTS the incidence of GDM in Malaysia is 8.4%. Maternal age of ≥25, booking bMI ≥27kg/m2, booking weight ≥80kg and previous hypertension are non-significant risk of developing GDM in Malaysia. Parity 5 and more was only associated with an odds-ratio of 1.02 (95% confidence Interval: 0.90-1.17) as compared to parity below 5. the association of women with previous stillbirth with GDM was not significant. CONCLUSION current risk based screening for GDM based on maternal age, booking bMI, weight and hypertension is inappropriate. An ideal screening tool should precede disease complications, which is the novel objective of screening. Universal screening for GDM in Malaysia may be a more accurate measure, especially with regards to reducing maternal and foetal complications.
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Affiliation(s)
- G Muniswaran
- Hospital Raja Permaisuri Bainun, Obstetrics & Gynaecology, Jalan Hospital Ipoh, Perak 31400 Malaysia.
| | - S A Soelar
- Hospital Sultanah Bahiyah, Clinical Research Centre, Alor Setar, Malaysia
| | | | - M A Bujang
- Clinical Research Centre, Kuala Lumpur, Malaysia
| | - R Jeganathan
- Hospital Sultanah Aminah, Department of Obstetrics & Gynaecology, Johor Bahru, Johor, Malaysia
| | - H Suharjono
- Sarawak General Hospital, Department of Obstetrics & Gynaecology, Sarawak, Malaysia
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Yeap EJ, Rao J, Pan CH, Soelar SA, Younger ASE. Is arthroscopic assisted percutaneous screw fixation as good as open reduction and internal fixation for the treatment of displaced intra-articular calcaneal fractures? Foot Ankle Surg 2016; 22:164-169. [PMID: 27502224 DOI: 10.1016/j.fas.2015.06.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 06/04/2015] [Accepted: 06/22/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study compares the outcomes of calcaneal fracture surgery after open reduction internal fixation and plating (ORIF) versus arthroscopic assisted percutaneous screw fixation (APSF). METHODS Group I (N=12) underwent ORIF. Group II (N=15) underwent APSF. Anthropometric data, pre and post-operative stay, complications and duration off work were recorded in this retrospective case cohort study. Radiographs were analyzed for Bohler's, Gissane's angle and Sanders' classification. AOFAS Hindfoot and SF 36 scores were collected at final follow-up. RESULTS Anthropometric data, Bohler's and Gissane's angles, AOFAS and SF 36 scores were not significantly different. Pre-operative duration was 12.3 days in ORIF and 6.9 days in APSF. Post-operative duration was 7.3 days vs 3.8 days. Duration off work was 6.2 months vs 2.9 months. CONCLUSION The APSF group was able to have surgery earlier, go home faster, and return to work earlier. This study was not powered to demonstrate a difference in wound complication rates.
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Mohd Suan MA, Tan WL, Soelar SA, Cheng HP, Osman M. Jellyfish stings on Langkawi Island, Malaysia. Med J Malaysia 2016; 71:161-165. [PMID: 27770113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Jellyfish stings are the most frequently reported marine animal envenomation worldwide. However, data on jellyfish sting from Malaysia remains obscure due to inadequate research. METHODS We investigated the epidemiology, clinical features and treatment of patients presenting at the emergency department of Langkawi Hospital between January 2012 and December 2014. Secondary data on the nature of the incident, patient demographics, clinical presentation, and treatment were retrieved from the patients' medical records. Descriptive statistics were presented for all patient variables. RESULTS A total of 759 patients presented with jellyfish stings during the 3-year study period, with highest number of visits in July, October, November, and December. The mean patient age was 26.7 years (SD: 12.14), 59.4% were men, 68.1% were foreigners or international tourists, and 40.4% were stung between 12.00 p.m. and 6:59 p.m. At least 90 patients presented with mild Irukandji or Irukandji-like syndromes. Most of the jellyfish stings occurred at Chenang Beach (590 reported cases), followed by Tengah Beach and Kok Beach. Most patients were treated symptomatically, and no deaths following a jellyfish sting was reported during the study period. CONCLUSION There is a need for public health interventions for both local and international tourists who visit Langkawi Island. Preventive steps and education on initial treatment at the incident site could elevate public awareness and decrease the adverse effects of jellyfish stings.
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Affiliation(s)
- M A Mohd Suan
- Sultanah Bahiyah Hospital, Clinical Research Center, KM 6, Jalan Langgar, 05460 Alor Setar, Kedah, Malaysia.
| | - W L Tan
- Sultanah Bahiyah Hospital, Clinical Research Center, KM 6, Jalan Langgar, 05460 Alor Setar, Kedah, Malaysia
| | - S A Soelar
- Sultanah Bahiyah Hospital, Clinical Research Center, KM 6, Jalan Langgar, 05460 Alor Setar, Kedah, Malaysia
| | - H P Cheng
- Langkawi Hospital, Emergency Department, Jalan Padang Mat Sirat, Langkawi, Kedah, Malaysia
| | - M Osman
- Langkawi Hospital, Emergency Department, Jalan Padang Mat Sirat, Langkawi, Kedah, Malaysia
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Tan WL, Soelar SA, Mohd Suan MA, Hussin N, Cheah WK, Verasahib K, Goh PP. LEPTOSPIROSIS INCIDENCE AND MORTALITY IN MALAYSIA. Southeast Asian J Trop Med Public Health 2016; 47:434-440. [PMID: 27405126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Leptospirosis is endemic in Southeast Asia, Central and South America, the Caribbean, and Oceania. Malaysia was categorized as a probable endemic country without any available data. Thus, this study was conducted to determine incidence, case fatality rate and mortality rate of leptospirosis. Leptospirosis is a notifiable disease in Malaysia since 2010 whereby probable or confirmed cases must be notified to relevant health district office. There were 3,665 and 4,457 probable and laboratory confirmed leptospirosis cases notified in 2012 and 2013, respectively. In the 2-year period, the most common age group of patients was 19 years old or less (23.3%) with male:female ratio of 2.61:1. Students consisted about 16.9% of patients, followed by agriculture-based or plantation workers (14.7%). Overall age-standardized incidence rate of leptospirosis in Malaysia for 2012 and 2013 was 29.02 per 100,000. Overall case fatality rate was 1.47% for 2-year period and overall age-standardized mortality rate was 0.45 per 100,000. Leptospirosis is an emerging public health concern in Malaysia and may pose a significant health impact and burden to the nation in the coming years if not well controlled.
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Abu Hassan MR, Ismail I, Mohd Suan MA, Ahmad F, Wan Khazim WK, Othman Z, Mat Said R, Tan WL, Mohammed SRNS, Soelar SA, Nik Mustapha NR. Incidence and mortality rates of colorectal cancer in Malaysia. Epidemiol Health 2016; 38:e2016007. [PMID: 26971697 PMCID: PMC5081307 DOI: 10.4178/epih.e2016007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 03/09/2016] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity. METHODS The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. RESULTS The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05). CONCLUSIONS CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.
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Affiliation(s)
- Muhammad Radzi Abu Hassan
- Department of Medicine, Sultanah Bahiyah Hospital, Alor Setar, Malaysia.,Clinical Research Centre, Sultanah Bahiyah Hospital, Alor Setar, Malaysia
| | - Ibtisam Ismail
- Clinical Research Centre, Sultanah Bahiyah Hospital, Alor Setar, Malaysia
| | | | - Faizah Ahmad
- Clinical Research Centre, Sultanah Bahiyah Hospital, Alor Setar, Malaysia
| | | | - Zabedah Othman
- Department of Radiotherapy and Oncology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | | | - Wei Leong Tan
- Clinical Research Centre, Sultanah Bahiyah Hospital, Alor Setar, Malaysia
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Hassan MRA, Suan MAM, Soelar SA, Mohammed NS, Ismail I, Ahmad F. Survival Analysis and Prognostic Factors for Colorectal Cancer Patients in Malaysia. Asian Pac J Cancer Prev 2016; 17:3575-3581. [PMID: 27510011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Cancer survival analysis is an essential indicator for effective early detection and improvements in cancer treatment. This study was undertaken to document colorectal cancer survival and associated prognostic factors in Malaysians. MATERIALS AND METHODS All data were retrieved from the National Cancer Patient Registry Colorectal Cancer. Only cases with confirmed diagnosis through histology between the year 2008 and 2009 were included. Retrieved data include sociodemographic information, pathological features and treatment received. Survival curves were plotted using the KaplanMeier method. Univariate analysis of all variables was then made using the Logrank test. All significant factors that influenced survival of patients were further analysed in a multivariate analysis using Cox' regression. RESULTS Total of 1,214 patients were included in the study. The overall 3 and 5year survival rates were 59.1% and 48.7%, respectively. Patients with localized tumours had better prognosis compared to those with advanced stage cancer. In univariate analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p=0.001) were found to be predictors of survival. None of the sociodemographic characteristics were found to exert any influence. In Cox regression analysis, staging at diagnosis (p<0.001), primary tumour size (p<0.001), involvement of lymph nodes (p<0.001) and treatment modalities (p<0.001) were determined as independent prognostic factors of survival after adjusted for age, gender and ethnicity. CONCLUSIONS The overall survival rate for colorectal cancer patients in Malaysia is similar to those in other Asian countries, with staging at diagnosis, primary tumor size, involvement of lymph node and treatment modalities having significant effects. More efforts are needed to improve national survival rates in future.
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Affiliation(s)
- Muhammad Radzi Abu Hassan
- Clinical Research Center, Clinical Research Center, Hospital Sultanah Bahiyah, Kedah, Malaysia Email :
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Ng KF, Choo P, Paramasivam U, Soelar SA. Reduction of intubation rate during newborn resuscitation after transition from self-inflating bag to T-piece resuscitator. Med J Malaysia 2015; 70:228-231. [PMID: 26358019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
INTRODUCTION T-piece resuscitator (TPR) has many advantages compared to self-inflating bag (SIB). Early Continuous Positive Airway Pressure (CPAP) during newborn resuscitation (NR) with TPR at delivery can reduce intubation rate. METHODS We speculated that the intubation rate at delivery room was high because SIB had always been used during NR and this can be improved with TPR. Intubation rate of newborn <24 hours of life was deemed high if >50%. An audit was carried out in June 2010 to verify this problem using a check sheet. RESULTS 25 neonates without major congenital anomalies who required NR with SIB at delivery were included. Intubation rate of babies <24 hours of life when SIB was used was 68%. Post-intervention audit (August to November 2010) on 25 newborns showed that the intubation rate within 24 hours dropped to 8% when TPR was used. Proportion of intubated babies reduced from 48.3% (2008-2009) to 35.1% (2011-2012), odds ratio 0.58 (95% CI 0.49-0.68). Proportion of neonates on CPAP increased from 63.5% (2008-2009) to 81.0% (2011-2012), odds ratio 2.44 (95% CI 2.03-2.93). Mean ventilation days fell to below 4 days after 2010. Since then, all delivery standbys were accompanied by TPR and it was used for all NR regardless of settings. There was decline in intubation rate secondary to early provision of CPAP with TPR during NR. Mean ventilation days, mortality and length of NICU stay were reduced. CONCLUSION This practice should be adopted by all hospitals in the country to achieve Millennium Development Goal 4 (2/3 decline of under 5 mortality rate) by 2015.
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Affiliation(s)
- K F Ng
- Tuanku Jaafar Hospital, Department of Paediatrics, Jalan Dr Muthu, 70300 Seremban, Negeri Sembilan, Malaysia.
| | - P Choo
- Tuanku Jaafar Hospital, Department of Paediatrics, Jalan Dr Muthu, 70300 Seremban, Negeri Sembilan, Malaysia
| | - U Paramasivam
- Tuanku Jaafar Hospital, Department of Paediatrics, Jalan Dr Muthu, 70300 Seremban, Negeri Sembilan, Malaysia
| | - S A Soelar
- Hospital Kuala Lumpur, Unit, Clinical Research Centre, Kuala Lumpur, Malaysia
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Mohd Suan MA, Tan WL, Soelar SA, Ismail I, Abu Hassan MR. Intestinal obstruction: predictor of poor prognosis in colorectal carcinoma? Epidemiol Health 2015; 37:e2015017. [PMID: 25868638 PMCID: PMC4459110 DOI: 10.4178/epih/e2015017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 03/30/2015] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The goal of this study was to assess the relationship between intestinal obstruction and the prognosis of colorectal carcinoma. METHODS Data pertaining to 4,501 colorectal carcinoma patients were extracted from the national colorectal registry and analysed. Survival analysis was performed using the Kaplan-Meier method. The log-rank test was used to compare the survival rate between patients with intestinal obstruction and those without intestinal obstruction. The p-values<0.05 were considered to indicate statistical significance. Simple Cox proportional hazards regression analysis was used to estimate the crude hazard ratio of mortality from colorectal cancer. RESULTS Intestinal obstruction was reported in more than 13% of patients. The 3-year survival rate after treatment was 48.3% (95% confidence interval [CI], 43.9 to 52.8) for patients with intestinal obstruction (n=593) and 54.9% (95% CI, 53.1 to 56.6) for patients without intestinal obstruction (n=3,908). The 5-year survival rate for patients with intestinal obstruction was 37.3% (95% CI, 31.9 to 42.8), which was lower than that of patients without intestinal obstruction (45.6%; 95% CI, 43.5 to 47.7). After adjusting the hazard ratio for other prognostic variables, intestinal obstruction had a statistically significant negative correlation with the survival rate of colorectal cancer patients, with an adjusted hazard ratio of 1.22 (p=0.008). CONCLUSIONS The presence of intestinal obstruction is associated with a lower survival rate among colorectal cancer patients.
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Affiliation(s)
| | - Wei Leong Tan
- Clinical Research Center, Sultanah Bahiyah Hospital, Kedah, Malaysia
| | | | - Ibtisam Ismail
- Clinical Research Center, Sultanah Bahiyah Hospital, Kedah, Malaysia
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