Browse publications by year: 2009

  1. Mailankot M, Jayalekshmi H, Chakrabarti A, Vasudevan DM
    Indian J Clin Biochem, 2009 Jan;24(1):94-7.
    PMID: 23105814 DOI: 10.1007/s12291-009-0016-z
    To investigate reversibility of ethanol induced testicular injuries on treatment with L-ornithine-L-aspartate, male Wistar rats were treated with ethanol (1.6g/kg b.wt/day) and L-ornithine- L-aspartate (200mg/kg b.wt/ day) for 4 weeks. L-ornithine-L-aspartate effectively prevented the ethanol induced body and testes weight reduction; changes in testicular weight well correlated with body weight. Drug exhibited an ability to counteract ethanol induced oxidative challenge as it effectively reduced testicular TBARS and increased tissue ascorbic acid, GSH and activities of superoxide dismutase, catalase, GSH-Red and Se-GSH-Px. However the drug didn't show promising effect on inhibitory effect of ethanol on testicular D5, 3-beta and 17-beta HSD (hydroxy steroid dehydrogenase).
  2. Ayaz A, Saeed S, Farooq MU, Ahmad I, Ali Bahoo ML, Saeed M
    Malays J Med Sci, 2009 Jan;16(1):34-8.
    PMID: 22589646
    The efficacy and safety of oral versus vaginal misoprostol for elective induction of labor in post date multigravida with an unfavourable cervix was compared over a period of one year in the Bahawal Victoria Hospital, Bahawalpur, Pakistan. Eightyeight multigravida post date women were divided into two groups and given 50 mg misoprostol orally and 50 mg intravaginally, respectively. The induction to onset of significant uterine contractions and delivery intervals were lower in the first group (7.8 h vs. 8.9 h) when compared to (10.4 h vs. 12 h). The first group had a higher rate of Caesarean section (7% vs. 4%; p>0.05), uterine hyperstimulation (9% vs. 5%; p>0.05), uterine tachysystole (23% vs. 14%; p>0.05) and neonatal admissions to intensive care unit (12% vs. 4%; p>0.05) when compared to second group. Fifty mg oral misoprostol has the potential to induce labor as safely and effectively as the intravaginal route.
  3. Guzman MG, Vázquez S, Kouri G
    Malays J Med Sci, 2009 Jul;16(3):4-11.
    PMID: 22589659
    Dengue is considered the main arthropod-borne viral disease of humans. In the last few years, an increasing number of reports of mild and severe cases have been reported. The growing dengue incidence observed in recent years has been accompanied by reports of new observations, findings and global initiatives with an improvement in our understanding of this phenomenon. The epidemiology and new clinical classification of dengue, advances in the diagnostic and pathogenesis knowledge, and vaccine development as well as control methods including new global initiatives are summarised here.
  4. Chiu-Tsao ST, Chan M
    Biomed Imaging Interv J, 2009 Oct;5(4):e16.
    PMID: 21610987 DOI: 10.2349/biij.5.4.e16
    The authors have studied the feasibility of using three new high-sensitivity radiochromic devices in measuring the doses to peripheral points outside the primary megavoltage photon beams. The three devices were GAFCHROMIC® EBT film, prototype Low Dose (LD) Film, and prototype LD Card. The authors performed point dosimetry using these three devices in water-equivalent solid phantoms at x = 3,5,8,10, and 15 cm from the edge of 6 MV and 15 MV photon beams of 10x10 cm(2), and at depths of 0, 0.5 cm, and depth of maximum dose. A full sheet of EBT film was exposed with 5000 MU. The prototype LD film pieces were 1.5x2 cm(2) in size. Some LD films were provided in the form of a card in 1.8x5 cm(2) holding an active film in 1.8x2 cm(2). These are referred to as "LD dosimeter cards". The small LD films and cards were exposed with 500 MU. For each scanned film, a 6 mm circular area centered at the measurement point was sampled and the mean pixel value was obtained. The calibration curves were established from the calibration data for each combination of film/cards and densitometer/scanner. The doses at the peripheral points determined from the films were compared with those obtained using ion chamber at respective locations in a water phantom and general agreements were found. It is feasible to accurately measure peripheral doses of megavoltage photon beams using the new high-sensitivity radiochromic devices. This near real-time and inexpensive method can be applied in a clinical setting for dose measurements to critical organs and sensitive patient implant devices.
  5. Rahmani A, Jinap S, Soleimany F
    Compr Rev Food Sci Food Saf, 2009 Jul;8(3):202-251.
    PMID: 33467794 DOI: 10.1111/j.1541-4337.2009.00079.x
      Mycotoxin toxicity occurs at very low concentrations, therefore sensitive and reliable methods for their detection are required. Consequently, sampling and analysis of mycotoxins is of critical importance because failure to achieve a suitable verified analysis can lead to unacceptable consignments being accepted or satisfactory shipments unnecessarily rejected. The general mycotoxin analyses carried out in laboratories are still based on physicochemical methods, which are continually improved. Further research in mycotoxin analysis has been established in such techniques as screening methods with TLC, GC, HPLC, and LC-MS. In some areas of mycotoxin method development, immunoaffinity columns and multifunctional columns are good choices as cleanup methods. They are appropriate to displace conventional liquid-liquid partitioning or column chromatography cleanup. On the other hand, the need for rapid yes/no decisions for exported or imported products has led to a number of new screening methods, mainly, rapid and easy-to-use test kits based on immuno-analytical principles. In view of the fact that analytical methods for detecting mycotoxins have become more prevalent, sensitive, and specific, surveillance of foods for mycotoxin contamination has become more commonplace. Reliability of methods and well-defined performance characteristics are essential for method validation. This article covers some of the latest activities and progress in qualitative and quantitative mycotoxin analysis.
    MeSH terms: Chromatography, High Pressure Liquid; Chromatography, Liquid; Drug Contamination; Laboratories; Longitudinal Studies; Mycotoxins; Reproducibility of Results; Mycotoxicosis; Tandem Mass Spectrometry
  6. Elgadir MA, Bakar J, Zaidul ISM, Rahman RA, Abbas KA, Hashim DM, et al.
    Compr Rev Food Sci Food Saf, 2009 Jul;8(3):195-201.
    PMID: 33467796 DOI: 10.1111/j.1541-4337.2009.00078.x
      This review article highlights the thermal behaviors of selected starches that were studied using differential scanning calorimetery (DSC) with data shown in various research publications. The starches of sago, potato, sweet potato, cassava, yam, and corn are included in this overview. Our examinations indicate that thermal properties are highly affected by the type of starch, its amylose/amylopectin content, and the presence of other food ingredients such as sugar, sodium chloride, water, milk, hydrocolloids, and meat. When the heating temperatures of the starches were increased, the DSC measurements also showed an increase in the temperatures of the gelatinization (onset [To ], peak [Tp ], and conclusion [Tc ]). This may be attributed to the differences in the degree of crystallinity of the starch, which provides structural stability and makes the granule more resistant to gelatinization.
    MeSH terms: Amylopectin; Amylose; Animals; Manihot; Colloids; Zea mays; Heating; Meat; Milk; Solanum tuberosum; Sodium Chloride; Starch; Temperature; Water; Ipomoea batatas; Dioscorea
  7. Merican AM, Amis AA
    J Biomech, 2009 Jul 22;42(10):1539-1546.
    PMID: 19481211 DOI: 10.1016/j.jbiomech.2009.03.041
    The iliotibial band (ITB) has an important role in knee mechanics and tightness can cause patellofemoral maltracking. This study investigated the effects of increasing ITB tension on knee kinematics. Nine fresh-frozen cadaveric knees had the components of the quadriceps loaded with 175 N. A Polaris optical tracking system was used to acquire joint kinematics during extension from 100 degrees to 0 degrees flexion. This was repeated after the following ITB loads: 30, 60 and 90 N. There was no change with 30 N load for patellar translation. On average, at 60 and 90 N, the patella translated laterally by 0.8 and 1.4mm in the mid flexion range compared to the ITB unloaded condition. The patella became more laterally tilted with increasing ITB loads by 0.7 degrees, 1.2 degrees and 1.5 degrees for 30, 60 and 90 N, respectively. There were comparable increases in patellar lateral rotation (distal patella moves laterally) towards the end of the flexion cycle. Increased external rotation of the tibia occurred from early flexion onwards and was maximal between 60 degrees and 75 degrees flexion. The increase was 5.2 degrees, 9.5 degrees and 13 degrees in this range for 30, 60 and 90 N, respectively. Increased tibial abduction with ITB loads was not observed. The combination of increased patellar lateral translation and tilt suggests increased lateral cartilage pressure. Additionally, the increased tibial external rotation would increase the Q angle. The clinical consequences and their relationship to lateral retinacular releases may be examined, now that the effects of a tight ITB are known.
    MeSH terms: Adult; Aged; Aged, 80 and over; Biomechanical Phenomena; Fascia/physiology; Female; Femur/physiology; Humans; Ilium/physiology; Knee Joint/physiology*; Male; Middle Aged; Patella/physiology; Rotation; Stress, Mechanical; Tibia/physiology; In Vitro Techniques
  8. Coene KL, Roepman R, Doherty D, Afroze B, Kroes HY, Letteboer SJ, et al.
    Am J Hum Genet, 2009 Oct;85(4):465-81.
    PMID: 19800048 DOI: 10.1016/j.ajhg.2009.09.002
    We ascertained a multi-generation Malaysian family with Joubert syndrome (JS). The presence of asymptomatic obligate carrier females suggested an X-linked recessive inheritance pattern. Affected males presented with mental retardation accompanied by postaxial polydactyly and retinitis pigmentosa. Brain MRIs showed the presence of a "molar tooth sign," which classifies this syndrome as classic JS with retinal involvement. Linkage analysis showed linkage to Xpter-Xp22.2 and a maximum LOD score of 2.06 for marker DXS8022. Mutation analysis revealed a frameshift mutation, p.K948NfsX8, in exon 21 of OFD1. In an isolated male with JS, a second frameshift mutation, p.E923KfsX3, in the same exon was identified. OFD1 has previously been associated with oral-facial-digital type 1 (OFD1) syndrome, a male-lethal X-linked dominant condition, and with X-linked recessive Simpson-Golabi-Behmel syndrome type 2 (SGBS2). In a yeast two-hybrid screen of a retinal cDNA library, we identified OFD1 as an interacting partner of the LCA5-encoded ciliary protein lebercilin. We show that X-linked recessive mutations in OFD1 reduce, but do not eliminate, the interaction with lebercilin, whereas X-linked dominant OFD1 mutations completely abolish binding to lebercilin. In addition, recessive mutations in OFD1 did not affect the pericentriolar localization of the recombinant protein in hTERT-RPE1 cells, whereas this localization was lost for dominant mutations. These findings offer a molecular explanation for the phenotypic spectrum observed for OFD1 mutations; this spectrum now includes OFD1 syndrome, SGBS2, and JS.
    MeSH terms: Animals; Eye Proteins/genetics*; Family Health; Female; Humans; Genetic Linkage; Lod Score; Male; Microtubule-Associated Proteins/genetics*; Mutation*; Proteins/genetics*; Sex Factors; Syndrome; X Chromosome*; Rats, Wistar; Two-Hybrid System Techniques; Rats
  9. Sylvia S, Kakarlapudi SV, Vollala VR, Potu BK, Jetti R, Bolla SR, et al.
    Cases J, 2009 Feb 02;2(1):114.
    PMID: 19187540 DOI: 10.1186/1757-1626-2-114
    BACKGROUND: The testicular arteries normally arise from the abdominal aorta. There are reports about the variant origin of these arteries. Accessory renal arteries are also a common finding but their providing origin to testicular arteries is an important observation. The variations described here are unique and provide significant information to surgeons dissecting the abdominal cavity.

    CASE PRESENTATION: During routine dissection classes of abdominal region of a 60-year-old male cadaver, we observed bilateral variant testicular arteries and double renal arteries.

    CONCLUSION: Awareness of variations of the testicular arteries such as those presented here becomes important during surgical procedures like varicocele and undescended testes.

  10. Ciraj AM, Vinod P, Sreejith G, Rajani K
    Indian J Pathol Microbiol, 2009 1 13;52(1):49-51.
    PMID: 19136780
    INTRODUCTION: Clinical failure of clindamycin therapy has been reported due to multiple mechanisms that confer resistance to macrolide, lincosamide and streptogramin antibiotics. This study was undertaken to detect the presence of inducible clindamycin resistance among clinical isolates of staphylococci.

    MATERIALS AND METHODS: The detection of inducible clindamycin resistance was performed by D-test using erythromycin and clindamycin discs as per CDC guidelines.

    RESULTS: Among the 244 clinical isolates of staphylococci studied, 32 (13.1%) showed inducible clindamycin resistance and belonged to the MLSBi phenotype. Among the MLS B i phenotypes, 10 isolates were methicillin-resistant Staphylococcus aureus (38.4% of the total MRSA), 16 were methicillin-sensitive Staphylococcus aureus (12.9% of the total MSSA) and 6 were coagulase-negative staphylococci (6.3% of the total CONS).

    CONCLUSION: The test for inducible resistance to clindamycin should be included in the routine antibiotic susceptibility testing, as it will help in guiding therapy.

    MeSH terms: Anti-Bacterial Agents/pharmacology*; Clindamycin/pharmacology*; Erythromycin/pharmacology; Humans; Microbial Sensitivity Tests/methods; Staphylococcal Infections/microbiology*; Staphylococcus/drug effects*; Staphylococcus/isolation & purification; Staphylococcus aureus; Drug Resistance, Bacterial*
  11. Sullivan JS, Selleck PW, Downton T, Boehm I, Axell AM, Ayob Y, et al.
    J Mol Genet Med, 2009 Dec 23;3(2):217-24.
    PMID: 20076794
    With antigenically novel epidemic and pandemic influenza strains persistently on the horizon it is of fundamental importance that we understand whether heterosubtypic antibodies gained from exposures to circulating human influenzas exist and can protect against emerging novel strains. Our studies of IVIG obtained from an infection-naive population (Australian) enabled us to reveal heterosubtypic influenza antibodies that cross react with H5N1. We now expand those findings for an Australian donor population to include IVIG formulations from a variety of northern hemisphere populations. Examination of IVIGs from European and South East-Asian (Malaysian) blood donor populations further reveal heterosubtypic antibodies to H5N1 in humans from different global regions. Importantly these protect against highly pathogenic avian H5N1 infection in vitro, albeit at low titres of inhibition. Although there were qualitative and quantitative differences in binding and protection between globally different formulations, the heterosubtypic antibody activities for the respective IVIGs were in general quite similar. Of particular note because of the relative geographic proximity to the epicentre of H5N1 and the majority of human infections, was the similarity in the antibody binding responses between IVIGs from the Malayan peninsula, Europe and Australia. These findings highlight the value of employing IVIGs for the study of herd immunity, and particularly heterosubtypic antibody responses to viral antigens such as those conserved between circulating human influenzas and emerging influenza strains such as H5N1. They also open a window into a somewhat ill defined arena of antibody immunity, namely heterosubtypic immunity.
  12. Wan Bebakar WM, Ismail M, Sharif J
    Citation: Wan Bebakar WM, Ismail M, Sharif J. Preliminary report of an audit of diabetes control and management (DRM-ADCM) July to December 2008. Kuala Lumpur: Diabetes Registry Malaysia; 2009
    MeSH terms: Diabetes Mellitus; Humans; Malaysia; Medical Audit; Registries
  13. Abdul Kadir A, Mohammad Daud MN, Yaacob MJ, Nik Hussain NH
    Objective: To determine the prevalence of depressive symptomatology in early postnatal period and its relationship with obstetric risk factors. Material and Methodology: This is a cross sectional study involving 293 women from postnatal ward Hospital Universiti Sains Malaysia (HUSM), Malaysia. They were screened for depression at day 1 to day 5 postpartum and 4 to 6 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). At the first visit, the women completed questionnaires on socio-demography and obstetric risk factors and Brief Patient Health Questionnaire (BPHQ-9). At the second visit which is 4-6 weeks postpartum, they only completed EPDS. Results: Two hundred and ninety-three women successfully completed the study (100% response rates). The prevalence of PND at 4-6 weeks postpartum using the EPDS score of 12 or more was 27.3%. Women with the history of abortion (p < 0.05) and early postnatal depression (p < 0.05) was significantly associated with PND. Conclusion: Postnatal depression among women in Hospital USM was more common compared to previously reported series in Malaysia. Women with the history of abortion and early postnatal depression were significantly associated with PND. © 2009 Japan International Cultural Exchange Foundation.
    MeSH terms: Adult; Cross-Sectional Studies; Hospitals, University; Humans; Inpatients; Malaysia; Malaysia/ethnology; Risk Factors; Women; Prevalence; Depression, Postpartum; Postpartum Period
  14. Tan HM
    DOI: 10.1111/j.1442-2042.2009.02295.x
    MeSH terms: China; Depression; Health Education; Erectile Dysfunction; Japan; Korea; Malaysia; Quality of Life; Sexual Behavior; Taiwan; Comorbidity
  15. Hassali MA, Shafie AA, Khalid Y, Hari R
    The aim of this study is to evaluate the knowledge and perceptions of diabetics and non-diabetics at Universiti Sains Malaysia (USM) main campus towards erectile dysfunction (ED). A cross-sectional survey using 40 items questionnaire was conducted in USM main Campus and at the Diabetic Clinic in the main campus. By the end of the study period a total of 200 individuals were surveyed, 52 of them were diabetics and the rest were non-diabetics. The mean total knowledge score obtained by diabetics was significantly higher, (63.7% of the maximum possible total knowledge score) than non-diabetics score (53.8 % of the maximum possible total knowledge score), P=0.002. Diabetics scored significantly lower regarding perception towards sexual activity, (65.1% of the maximum possible score) than non diabetics (70% of the maximum possible score), P=0.012. Diabetic patients scored none significantly higher scores regarding perception towards effect of ED on quality of life, (61.3% of the maximum possible score) compared with non-diabetics (59.7 % of the maximum possible score) P=0.332. Overall, the finding of this study suggested that health care professionals should be more proactive in disseminating health information about ED to the public in order to increase their knowledge and awareness on the disease.
    MeSH terms: Adult; Ambulatory Care Facilities; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Humans; Erectile Dysfunction; Health Knowledge, Attitudes, Practice; Malaysia; Male; Quality of Life; Sexual Behavior; Universities
  16. Yahya NK, Afzal N, Daud KM
    Objectives: To evaluate the frequency of HLA Class II antigens in Malays with SLE in order to determine their role in disease susceptibility and association with clinical manifestations.
    Design: Cross-sectional study
    Methods: Fifty-four SLE patients from Malay ethnic attending Physician Clinic at Hospital Universiti Sains Malaysia were enrolled into the study. Demographic and clinical findings were obtained from medical records. HLA typing of class II antigens were carried out using MicroSSP Class II generic (DRB/ DQB) from One Lambda Inc. Controls were from ethnically matched healthy individuals.
    Results: A univariate analysis confirmed the association between HLA-DR15 with SLE compared to healthy control group; and was maintained using multiple logistic regression model (P corr = 0.002, adjusted OR = 5.513). There was a weak decrease of HLA-DR4 which was not significant after corrections for multiple comparisons made. DR7 was found to be significantly increased in patients with malar rash. There was positive association of DR15 with arthritis in patients compare to those without.
    Conclusion: Our data support the role of HLA Class II genes in conferring SLE susceptibility.
    Study site: Physician Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    MeSH terms: Adolescent; Adult; Alopecia; Arthritis; Female; Gene Frequency; Hospitals, University; Lupus Erythematosus, Systemic*; Malaysia; Malaysia/ethnology; Male; Outpatient Clinics, Hospital
  17. Narayanan SN, Kumar RS, Potu BK, Nayak S, Mailankot M
    Clinics (Sao Paulo), 2009;64(3):231-4.
    PMID: 19330250
    INTRODUCTION: With the tremendous increase in number of mobile phone users world wide, the possible risks of this technology have become a serious concern.

    OBJECTIVE: We tested the effects of mobile phone exposure on spatial memory performance.

    MATERIALS AND METHODS: Male Wistar rats (10-12 weeks old) were exposed to 50 missed calls/day for 4 weeks from a GSM (900/1800 MHz) mobile phone in vibratory mode (no ring tone). After the experimental period, the animals were tested for spatial memory performance using the Morris water maze test.

    RESULTS: Both phone exposed and control animals showed a significant decrease in escape time with training. Phone exposed animals had significantly (approximately 3 times) higher mean latency to reach the target quadrant and spent significantly (approximately 2 times) less time in the target quadrant than age- and sex-matched controls.

    CONCLUSION: Mobile phone exposure affected the acquisition of learned responses in Wistar rats. This in turn points to the poor spatial navigation and the object place configurations of the phone-exposed animals.

    MeSH terms: Animals; Male; Memory/physiology; Memory/radiation effects*; Microwaves/adverse effects*; Reaction Time; Spatial Behavior/physiology; Spatial Behavior/radiation effects*; Rats, Wistar; Maze Learning/radiation effects*; Cell Phones*; Rats
  18. Mailankot M, Kunnath AP, Jayalekshmi H, Koduru B, Valsalan R
    Clinics (Sao Paulo), 2009;64(6):561-5.
    PMID: 19578660
    INTRODUCTION: Mobile phones have become indispensable in the daily lives of men and women around the globe. As cell phone use has become more widespread, concerns have mounted regarding the potentially harmful effects of RF-EMR from these devices.

    OBJECTIVE: The present study was designed to evaluate the effects of RF-EMR from mobile phones on free radical metabolism and sperm quality.

    MATERIALS AND METHODS: Male albino Wistar rats (10-12 weeks old) were exposed to RF-EMR from an active GSM (0.9/1.8 GHz) mobile phone for 1 hour continuously per day for 28 days. Controls were exposed to a mobile phone without a battery for the same period. The phone was kept in a cage with a wooden bottom in order to address concerns that the effects of exposure to the phone could be due to heat emitted by the phone rather than to RF-EMR alone. Animals were sacrificed 24 hours after the last exposure and tissues of interest were harvested.

    RESULTS: One hour of exposure to the phone did not significantly change facial temperature in either group of rats. No significant difference was observed in total sperm count between controls and RF-EMR exposed groups. However, rats exposed to RF-EMR exhibited a significantly reduced percentage of motile sperm. Moreover, RF-EMR exposure resulted in a significant increase in lipid peroxidation and low GSH content in the testis and epididymis.

    CONCLUSION: Given the results of the present study, we speculate that RF-EMR from mobile phones negatively affects semen quality and may impair male fertility.

    MeSH terms: Animals; Disease Models, Animal; Electromagnetic Fields/adverse effects*; Glutathione/radiation effects; Male; Radio Waves/adverse effects*; Sperm Motility/radiation effects*; Spermatozoa/radiation effects; Lipid Peroxidation/radiation effects; Rats, Wistar; Oxidative Stress/radiation effects*; Cell Phones*; Rats
  19. Kamaliah MN, Jaafar S, Ehsan FZ, Safiee I, Ismail F, Mohd Saleh N, et al.
    DOI: 10.1186/1472-6963-9-S1-A7
    Introduction. Malaysian health care is a parallel system with both public and private sectors. The MOH (Ministry of Health) is the main provider of health services in the country, delivering comprehensive medical, health, dental and pharmaceutical services at primary, secondary and tertiary levels of care. The public health services are heavily subsidized by the government. The practice of financial distribution within the Ministry of Health of Malaysia has traditionally been dependent on historical information, i.e., looking at past performance. Any additional increment has been based on arbitrary predictions of the consumer index or inflation. A more appropriate distribution would be based not only on the volume of patients, but also on the morbidity profiles of these populations. Because of the development of the TPC (Tele-Primary Care) electronic system, considerable data is now collected, and there exists a vast potential for data-mining. One potential area of study is to account for the differences in the health status of populations and their anticipated need for healthcare services. An earlier project demonstrated that the TPC dataset provides viable data that can be used for understanding differences in case mix and resource need by various population sub-groups. This was the first step in a multi-stage process to demonstrate the benefits of integrating case mix into the Malaysian healthcare system. As a result of the first project, an increased understanding of the TPC database was gained, which is providing usable data. However, to make full and effective use of TPC, a resource-use measure based on micro-costing information needed to be developed and validated. This project evaluated the plausibility of recently developed cost measures. This new resource-use measure would enable a clearer understanding of the resource consumption based on the morbidity profile of populations across regions, as well as individual clinics.
    Methods. The primary sources of data for this project came from public, primary care clinics using the TPC system; an alternative electronic system; a small group practice of private primary care clinics using a separate electronic system; and the network of a private medical insurance group with nationwide enrollees. The objective of the project was, first, to take the analyses a step further by incorporating new data input streams from private providers, and then to validate that the newly developed micro-costing information was meaningful. In addition, the project sought to assess the ability to link patient information across different providers, re-analyze the results from Phase 1 using the new resource measure, and then develop a program targeted at improving data quality. Lastly, the aim was to compare differences in service delivery patterns between TPC facilities and providers to assess the efficiency of resource use.
    Results. a) The success of the coding-quality training programs to ensure continually improved data quality in TPC over time was demonstrated. The data quality is sufficiently high to create more sophisticated models. Models to identify "high risk" patients or "high cost" patients are already possible.
    b) The ACG system has been proven to work with Malaysian TPC data, and the micro-costing data works for the TPC population and allows us to better understand differences in resource allocation/need. The 2008 Total Visits model is extremely predictive. However, the cost data for health clinics needs to be improved before the Total Cost can be used to predict costs with the same predictive ability as the Total Visit models.
    c) The analyses of the UPIN's (Unique Patient Identification Number) ability to link data to better capture the services being provided from multiple providers show that existing challenges are surmountable. A better understanding of the differences in service delivery in public vs. private sectors is imperative before a national capitation scheme is possible.
    d) The profiling of providers on a regional basis as the initial step to determining the viability of a morbidity-based capitation formula was successful.
    Conclusions. The initial project successfully demonstrated the ability of Malaysia to apply readily available diagnostic and other clinical information to develop state-of-the-art case-mix measures relevant to medical and fiscal management activities using the TPC database. It also offered an example of how risk adjustment tools can be used to monitor the TPC data collection process. The ACG system has been proven to work with Malaysian data, and it works very well for Total Visits where they can now be used to predict Total Visits with a very high certainty. Where the data quality has improved, the predictive modeling has improved in tandem. The data quality is sufficiently high to create more sophisticated models. Models to identify “high risk” patients or “high cost” patients are already possible.
  20. ISBN: 978-967-5322-02-0
    Citation: Buku Panduan Keselamatan Makmal Perubatan Klinik Kesihatan. Putrajaya: Bahagian Pembangunan Kesihatan Keluarga, Kementerian Kesihatan Malaysia; 2009

    Translation:
    Guideline on medical laboratory safety in health clinic. Putrajaya: Family Health Development Division, Ministry of Health, Malaysia; 2009
    MeSH terms: Ambulatory Care Facilities; Containment of Biohazards; Humans; Laboratories; Malaysia; Safety; Guidelines as Topic; Safety Management
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