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Fulltext Is it as dangerous as it looks?

Che Ibrahim NH, Md Shukri N

Malays Fam Physician, 2017;12(1):35-36.
PMID: 28503274 MyJurnal

A common bony protrusion that occurs over the hard palate is sometimes mistaken for a malignancy especially when it is large. This bony growth is a torus palatinus (TP), which is a benign bony prominence over the hard palate. It occurs most commonly in bilateral multiple form, and is often located at the canine to premolar area. A basic knowledge of the assessment and management of TP is important, particularly for the first-line family physician to ensure that the correct information is given to the patient.
Fulltext Workforce Mobilization From the National Institutes of Health for the Ministry of Health Malaysia: A COVID-19 Pandemic Response

Muhammad Nur Amir AR, Binti Amer Nordin A, Lim YC, Binti Ahmad Shauki NI, Binti Ibrahim NH

Front Public Health, 2021;9:574135.
PMID: 33643985 DOI: 10.3389/fpubh.2021.574135

The COVID-19 pandemic that emerged in 2019 has inflicted numerous clinical and public health challenges worldwide. It was declared a public health emergency by the World Health Organization and activated response teams at almost all Malaysian healthcare facilities. Upon activation of the National Crisis Preparedness and Response Center in January 2020, the National Institutes of Health Malaysia established a COVID-19 operation room at the facility level to address the rise in COVID-19 infection cases each day. The National Institutes of Health COVID-19 operation room committee formed a workforce mobilization team for an effective and efficient mobilization system to fulfill requests received for human resource aid within the Ministry of Health Malaysia facilities. Selected personnel would be screened for health and availability before mobilization letters and logistics arrangements if necessary. The workforce from the National Institutes of Health, consisting of various job positions, were mobilized every week, with each deployment cycle lasting 2 weeks. A total of 128 personnel from the six institutes under the National Institutes of Health were mobilized: tasks included fever screening, active case detection, health management at quarantine centers, and management of dead bodies. A well-organized data management system with a centralized online system integration could allow more rapid deployment and answer some of the key questions in managing a similar pandemic in the future. With improving infected COVID-19 cases throughout the country, the National Institutes of Health COVID-19 operation room was effectively closed on June 15, 2020, following approval from the Deputy Director-General of Health.
Fulltext Economic Evaluations on Antimicrobial Stewardship Programme: A Systematic Review

Ibrahim NH, Maruan K, Mohd Khairy HA, Hong YH, Dali AF, Neoh CF

J Pharm Pharm Sci, 2017;20(1):397-406.
PMID: 29145934 DOI: 10.18433/J3NW7G

PURPOSE: To systematically review studies on cost-effectiveness of implementing Antimicrobial stewardship programmes (ASP) in the hospital setting.
METHODS: A systematic literature search was performed using electronic databases, such as EMBASE, PubMed/Medline, CINAHL, NHS and CEA Registry from 2000 until 2017. The quality of each included study was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Economic Evaluations and Consolidated Health Economic Evaluation Reporting Standards Statement checklist.
RESULTS: Of the 313 papers retrieved, five papers were included in this review after assessment for eligibility. The majority of the studies were cost-effectiveness studies, comparing ASP to standard care. Four included economic studies were conducted from the provider (hospital) perspective while the other study was from payer (National Health System) perspective. The cost included for economic analysis were as following: personnel costs, warded cost, medical costs, procedure costs and other costs.
CONCLUSIONS: All studies were generally well-conducted with relatively good quality of reporting. Implementing ASP in the hospital setting may be cost-effective. However, comprehensive cost-effectiveness data for ASP remain relatively scant, underlining the need for more prospective clinical and epidemiological studies to incorporate robust economic analyses into clinical decisions. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
Fulltext Building health care leadership capacity in a developing country via Talent Grooming Programme (TGP): experience sharing from the Ministry of Health Malaysia

Lee KY, Ismail M, Bakit P, Zakaria N, Zakaria N, Jinah N, et al.

Leadersh Health Serv (Bradf Engl), 2022 Nov 11;ahead-of-print(ahead-of-print):219-35.
PMID: 36350129 DOI: 10.1108/LHS-06-2022-0071

PURPOSE: Formal structured leadership training is increasingly incorporated as a regular fixture in developed nations to produce competent leaders to ensure the provision of quality patient care. However, most low- and middle-income countries (LMICs) rely on one-off external training opportunities for selected individuals as they lack the necessary resources to implement long-term training for a wider pool of potential health care leaders. This case study shares the establishment process of the Talent Grooming Programme for technical health care professionals (TGP), a three-year in-house leadership training programme specially targeted at potential health care leaders in Malaysia.
DESIGN/METHODOLOGY/APPROACH: This case study aims to share a comprehensive overview of the ideation, conceptualisation and implementation of TGP. The authors also outlined its impact from the individual and organisational perspectives, besides highlighting the lessons learned and recommendations for the way forward.
FINDINGS: TGP set out to deliver experiential learning focusing on formal training, workplace experiences, practical reflection and mentoring by supervisors and other esteemed leaders to fulfil the five competency domains of leadership, organisational governance, communication and relationship, professional values and personal values. The successes and challenges in TGP programme delivery, post-training assessment, outcome evaluation and programme sustainability were outlined.
PRACTICAL IMPLICATIONS: The authors' experience in setting up TGP provided valuable learning points for other leadership development programme providers. As for any development programme, a continuous evaluation is vital to ensure its relevance and sustainability.
ORIGINALITY/VALUE: Certain aspects of TGP establishment can be referenced and modified to adapt to country-specific settings for others to develop similar leadership programme, especially those in LMICs.
Progression of the Pathway for Public Health Care during the COVID-19 Outbreak at District Health Office

Khamis N, Saimy IS, Ibrahim NH, Badaruddin NK, Mohd Hassan NZA, Kusnin F, et al.

Int J Environ Res Public Health, 2021 Oct 07;18(19).
PMID: 34639833 DOI: 10.3390/ijerph181910533

Public health activities under district health offices (DHOs) play a major role in Malaysia's fight against COVID-19. This article aims to describe and illustrate the public health activity pathway in combating the COVID-19 pandemic, and a team of public health workers who are familiar with DHO work settings was created in April 2020 for that purpose. Review of documents and the Ministry of Health's updates was carried out, followed by a series of discussions with stakeholders. Based on the steps in the outbreak investigation tasks, the flow of activities from January to May 2020 was listed in line with the phases of the country's National Movement Control Order 2020. Results show that the activities can be classified into three different sections-namely, the main action areas, category of cases, and level of care. The main process flow of activities comprised the case management and support activities. Case management flow was split into tasks for patients under investigation and persons under surveillance, while the support services existed throughout the phases. The pathways illustrate that the progression of the pandemic translated directly to changes in the pattern of activities, with additional subgroups of activities in accordance with all imposed guidelines.
Fulltext Pathological complete response in an advance stage IIIB non-small cell lung cancer secondary to neoadjuvant osimertinib targeted therapy: A case report and review of literature

Soo CI, Ong DB, Chin KK, Sia LC, Munusamy V, Ibrahim NH, et al.

Respirol Case Rep, 2023 Jul;11(7):e01181.
PMID: 37350988 DOI: 10.1002/rcr2.1181

Neoadjuvant chemotherapy is a therapeutic option for potentially resectable non-small cell lung cancer (NSCLC). The role of neoadjuvant targeted therapy (NTT) remains less explored. This case highlights the use of neoadjuvant osimertinib in a case of advanced NSCLC. A 67-year-old woman had a left lower lobe lung mass measuring 5.0 × 5.1 × 7.0 cm with an enlarged subcarinal lymph node (LN) on her positron emission tomography scan. Following biopsy, a diagnosis of stage IIIB N2 (cT3N2M0) EGFR exon 19 deletion mutation-positive lung adenocarcinoma was established. NTT using osimertinib 80 mg once daily was commenced. Subsequent re-imaging at 3 months (ycT2bN2M0), 6 months (ycT1cN2M0) and 9 months showed tumour downstaging and resolution of the subcarinal LN (ycT1cN0M0). She underwent left lower lobectomy with systematic nodal dissection. All surgical specimens demonstrated no evidence of malignant cells (ypT0N0). Osimertinib could be the preferred NTT for potentially resectable NSCLC.
Fulltext Common driver mutations and programmed death-ligand 1 expression in advanced non-small cell lung cancer in smokers and never smokers

Liam CK, Yew CY, Pang YK, Wong CK, Poh ME, Tan JL, et al.

BMC Cancer, 2023 Jul 14;23(1):659.
PMID: 37452277 DOI: 10.1186/s12885-023-11156-y

BACKGROUND: In non-small cell lung cancer (NSCLC), there may be a relationship between programmed death-ligand 1 (PD-L1) expression, driver mutations and cigarette smoking.
METHODS: In this single-center retrospective study, the relationship between common driver mutations (EGFR mutation and ALK rearrangement) and PD-L1 expression in advanced NSCLC according to the patients' smoking history was examined. Light, moderate and heavy smokers had smoked
Validation study on a prediction formula to estimate the weight of children & adolescents with special needs aged 2-18 years old

Ibrahim NH, Kassim N, Othman S, Omar A, Shaari N, Awiskarni AA, et al.

J Health Popul Nutr, 2023 Nov 20;42(1):129.
PMID: 37986125 DOI: 10.1186/s41043-023-00464-5

BACKGROUND: This study aims to validate two predictive formulas of weight estimating strategies in children with special needs, namely the Cattermole formula and the Mercy formula.
METHODOLOGY: A cross-sectional study with a universal sampling of children and adolescents with special needs aged 2-18 years old, diagnosed with cerebral palsy, down syndrome, autism and attention-deficit/hyperactivity disorder was conducted at Community-Based Rehabilitation in Central Zone Malaysia. Socio-demographic data were obtained from files, and medical reports and anthropometric measurements (body weight, height, humeral length, and mid-upper arm circumference) were collected using standard procedures. Data were analysed using IBM SPSS version 26. The accuracy of the formula was determined by intraclass correlation, prediction at 20% of actual body weight, residual error (RE) and root mean square error (RMSE).
RESULT: A total of 502 children with a median age of 7 (6) years were enrolled in this study. The results showed that the Mercy formula demonstrated a smaller degree of bias than the Cattermole formula (PE = 1.97 ± 15.99% and 21.13 ± 27.76%, respectively). The Mercy formula showed the highest intraclass correlation coefficient (0.936 vs. 0.858) and predicted weight within 20% of the actual value in the largest proportion of participants (84% vs. 48%). The Mercy formula also demonstrated lower RE (0.3 vs. 3.6) and RMSE (3.84 vs. 6.56) compared to the Cattermole formula. Mercy offered the best option for weight estimation in children with special needs in our study population.
Fulltext Fatty Acid Composition of Selected Street Foods Commonly Available in Malaysia

Zainal Arifen ZN, Shahril MR, Shahar S, Mohamad H, Mohd Yazid SFZ, Michael V, et al.

Foods, 2023 Mar 14;12(6).
PMID: 36981160 DOI: 10.3390/foods12061234

Despite growing evidence of increased saturated and trans fat contents in street foods, little is known about their fatty acid (FA) compositions. This study aimed to analyse the saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), polyunsaturated fatty acids (PUFAs), and trans fatty acids (TFAs) content of 70 selected and most commonly available street foods in Malaysia. The street foods were categorised into main meals, snacks, and desserts. TFAs were not detected in any of the street foods. Descriptively, all three categories mainly contained SFAs, followed by MUFAs, and PUFAs. However, the one-way ANOVA testing showed that the differences between each category were insignificant (p > 0.05), and each FA was not significantly different (p > 0.05) from one to another. Nearly half of the deep-fried street foods contained medium to high SFAs content (1.7 g/100 g-24.3 g/100 g), while the MUFAs were also high (32.0-44.4%). The Chi-square test of association showed that the type of preparation methods (low or high fat) used was significantly associated (p < 0.05) with the number of SFAs. These findings provide valuable information about fat composition in local street foods for the Malaysian Food Composition Database and highlight the urgency to improve nutritional composition.