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Fulltext Occupational Safety and Health Management System (OSHMS) guideline compliance among medical laboratories in Klang Valley

Anuar, I., Zahedi, F., Kadir, A., Mokhtar, A.B.

Malaysian Journal of Community Health, 2008;14(1):39-44.
MyJurnal

Background: Nowadays, most medical laboratories in Malaysia practice occupational safety and health based on standard operating procedure and sometimes ad-hoc characteristic limited to only internal use. The level of compliance of the national occupational safety and health management system (OSHMS) guidelines among medical laboratories in Malaysia is still largely unexplored.
Methods: This study was carried out on 34 medical laboratories consisting of 17 public medical laboratories and 17 private medical laboratories in Klang Valley using self-administered questionnaire based on guideline of OSHMS6. This study covered 112 medical laboratories units including pathology chemistry (18), microbiology (20), virology (7), histopathology (16), cytopathology (17), hematology (19) and 15 multi discipline medical laboratories.
Results: This study showed the level of compliance to the national OSHMS guideline among medical laboratories who are MS ISO 15189:2004 accredited & have a higher scores (p

Matched MeSH terms: Hospital Units
Treatment of institutional neurosis

Khuan TC

Med J Malaysia, 1979 Mar;33(3):209-15.
PMID: 522724
Matched MeSH terms: Hospital Units
Fulltext The use of several markers of hepatitis B infection to monitor risks of infection in a haemodialysis unit and in laboratories

Ton SH, Lopez CG

Med J Malaysia, 1981 Dec;36(4):209-11.
PMID: 7334954
Matched MeSH terms: Hospital Units*
Fulltext The prevalence of depression among elderly warded in a tertiary care centre in Wilayah Persekutuan

Mohd Sidik S, Rampal L, Hanim MA, Thong PL

Med J Malaysia, 2006 Mar;61(1):15-21.
PMID: 16708729

Depression is characterized by symptoms like disturbance in behavior, cognition and mood. This is commonly known to affect people aged 60 years and above especially those who are also afflicted with illnesses. The objectives of this study were to determine the prevalence of depression and its associated factors among the elderly in a tertiary care centre in Wilayah Persekutuan. A cross sectional study design was done. Stratified cluster sampling method was used to select the respondents. All elderly patients were selected from the orthopaedic, surgical, gynaecology and medical wards in a government hospital in Wilayah Persekutuan. A 30-item Geriatric Depression Scale questionnaire was used as a screening instrument. Out of the 246 elderly subjects, 198 were interviewed giving a response rate of 80.5%. The results showed that 54% of the elderly respondents were found to have depressive symptoms. Age (p=0.022), sex (p=0.008), ethnicity (p=0.022) and functional disabilities in bathing (p=0.001), grooming (p=0.007), dressing (p= 0.007), using the toilet (p=0.002), transferring from bed to chair and back (p=0.000), mobility (p=0.000) and climbing stairs (p=0.000) were all found to be significantly associated with depression among the elderly respondents. The outcome of this study will have an important impact on the implementation of the health policy for the elderly patients admitted to hospitals.

Matched MeSH terms: Hospital Units/utilization
Fulltext Surgical outcome of patients with hyperparathyroidism in a non-specialist surgical ward

Roslani AC, Chang NL

Med J Malaysia, 2006 Oct;61(4):410-5.
PMID: 17243517

Aim of the study was to audit patients who had undergone parathyroidectomy in University of Malaya Medical Centre (UMMC), and compare surgical outcomes with that in the literature. Data on demography, aetiology, surgical indications, pre-operative localization, surgery and complications was obtained retrospectively from medical records of patients undergoing parathyroidectomy between 1st October 2000 to 31st October 2005. Twelve patients were identified. Mean age was 50.6 years. Sixty seven percent were females. The ratio of Chinese, Malays and Indians was 7:4:1. Most surgeries were performed in the last two years (91.7%). Aetiology was mainly tertiary hyperparathyroidism (83%). All patients had pre-operative ultrasound localization. Half underwent total parathyroidectomy without autotransplantation. There were no re-do operations. Mean duration of surgery was 1.96 hours. All patients had abnormal calcium levels at some point following surgery, but 90% were normocalcaemic at last follow up. Other complications were recurrent laryngeal nerve injury (one) and wound infection (one). There were no peri-operative mortalities. The mean duration of hospital stay was 7.75 days (range 3-17 days). The median duration of follow-up was 11 months. The outcome of parathyroidectomy in UMMC is satisfactory with few major complications. Despite this, intensive effort is needed to further improve these results to match those obtained in specialist endocrine centres.

Matched MeSH terms: Hospital Units
Cryptococcosis in a renal unit

Kong NC, Shaariah W, Morad Z, Suleiman AB, Wong YH

Aust N Z J Med, 1990 Oct;20(5):645-9.
PMID: 2285381

Cryptococcosis is a known opportunistic infection in immunosuppressed hosts. We report our experience of all cases presenting to our Department between December 1975 and September 1988. Eight post-renal transplant patients and three systemic lupus erythematosus (SLE) patients were affected. All were receiving treatment with steroids, in association with either azathioprine or cyclosporin. The diagnosis of cryptococcal meningitis was initially based on a positive cerebrospinal fluid (CSF) cryptococcal antigen, by latex agglutination test, and subsequently confirmed by cultures. Common clinical presentations, in descending order of frequency, included headaches, fever, mental confusion, epilepsy and papilloedema. Meningism was not a prominent feature. CT brain scans were obtained in eight patients and one showed a focal lesion and one showed cerebral atrophy. Four patients also had an abnormal chest X-ray (CXR) and one had disseminated cryptococcosis. Amphotericin and 5-fluorocytosine were the mainstay of therapy, although ketoconazole alone was subsequently used in three selected patients with cure. Four early deaths occurred in patients with delayed diagnosis and treatment, usually in association with other severe concurrent infections. We conclude that awareness of cryptococcosis is essential in immunocompromised hosts presenting with headache with, or without, mental confusion or fever.

Matched MeSH terms: Hospital Units
Fulltext Prevalence of Red Blood Cell Alloimmunization among Transfused Chronic Kidney Disease Patients in Hospital Universiti Sains Malaysia

Yusoff SM, Bahar R, Hassan MN, Noor NHM, Ramli M, Shafii NF

Oman Med J, 2020 Sep;35(5):e177.
PMID: 33083035 DOI: 10.5001/omj.2020.95

Objectives: Red blood cell (RBC) immunization is a common complication in blood transfusion recipients. Patients with chronic kidney disease (CKD) eventually develop anemia, which is multifactorial, and requires regular blood transfusions, which exposes patients to the development of RBC antibodies. We sought to determine the prevalence and specificity patterns of RBC immunization and its risk factors among transfused CKD patients.
Methods: We conducted a cross-sectional study over one year from January to December 2018 in the Transfusion Medicine Unit, Hospital Universiti Sains Malaysia. A total of 249 samples were recruited from CKD patients who received a blood transfusion (at least one-pint), which only match for ABO and Rh(D) antigen. The serum was screened for the presence of the RBC antibody using the gel agglutination technique (Diamed gel cards). Samples with positive antibody screening were subjected to antibody identification.
Results: Of the 249 transfused CKD patients, 31 (12.4%) developed RBC immunization. Thirty (12%) were alloimmunized, and one (0.4%) was autoimmunized. Anti-Mia was the most common antibody (n = 14, 46.7%) among alloantibodies, followed by anti-E (n = 7, 23.3%). There was a significant association between pregnancy history with the development of antibodies whereas, no significant association was found between sociodemographic background, stage of CKD, hemodialysis status, underlying medical illness, and number of packed cell transfusions with the development of RBC antibodies.
Conclusions: One-eighth of our patient cohort had RBC alloimmunization, and the risk was increased in patients with a history of pregnancy. We propose Rhesus RBC phenotyping and to supply blood match Rhesus antigen in CKD patients, especially patients of reproductive age.

Matched MeSH terms: Hospital Units
Fulltext Survival of Children with Acute Leukaemia: A Single Centre Experience

Ariffin Nasir, Nor Fadhilah Zahari, Fahisham Taib, Norsarwany Mohamad

Malaysian Journal of Paediatrics and Child Health, 2020;26(1):4-13.
MyJurnal

Introduction: Acute leukaemia in children accounts for 25-30% of malignant diagnosis. Survival from acute leukaemia continue to improve. Treatment outcome depends on factors like gender, age at diagnosis, parental education, the initial total white cell count (TWC), cerebrospinal fluids (CSF) infiltration, immunophenotype and treatment response. Objectives: The objectives were to evaluate the survival of children with acute leukaemia who received chemotherapy and identify relevant factors. Methodology: The study was a retrospective record review at the Paediatric Oncology Unit, Hospital Universiti Sains Malaysia (Hospital USM). The data collected depending on pre-set research proforma from the year 1990 to 2010. Survival analysis of each type of leukaemia was completed using multiple Cox regression model. Results: A total of 334 cases were identified, only 283 patients received treatment at Hospital USM. There were 224 patients with acute lymphoblastic leukaemia (ALL) and 59 with acute myeloid leukaemia (AML). Overall survival (OS) rate at 3 months for ALL and AML were 89.3% and 72.9% respectively. The event-free survival (EFS) rate for ALL at 1, 3, and 5 years were 69.6%, 54.1% and 47.8% respectively. For AML, the EFS rate at 1, 3, and 5 years were 52.0%, 42.4% and 38.1% respectively. Multiple Cox regression model showed children’s age at diagnosis and early response to steroid therapy were the most significant prognostic factors for ALL survival, whereas the spleen size and treatment protocol were the most significant prognostic factors for AML. Conclusion: Survival rate in this study was comparable to developing countries. ALL had better outcome compared to AML.

Matched MeSH terms: Hospital Units
Reduction of central-line-associated bloodstream infection (CLABSI) in resource limited, nonintensive care unit (ICU) settings

Poh KW, Ngan CH, Wong JY, Ng TK, Mohd Noor N

Int J Health Care Qual Assur, 2020 Feb 25;ahead-of-print(ahead-of-print).
PMID: 32108452 DOI: 10.1108/IJHCQA-11-2019-0195

PURPOSE: There was limited study available on successful intervention for central-line-associated bloodstream infection (CLABSI) done at nonintensive care unit (ICU) and resources-limited setting. The objective of this study was to design, implement and evaluate a strategy to reduce CLABSI rate in non-ICU settings at general medical wards of Hospital Tuanku Ja'afar Seremban.
DESIGN/METHODOLOGY/APPROACH: Preinterventional study was conducted in one-month period of January 2019, followed by intervention period from February to March 2019. Postintervention study was conducted from April to July 2019. The CLABSI rates were compared between pre and postintervention periods. A multifaceted intervention bundle was implemented, which comprised (1) educational program for healthcare workers, (2) weekly audit and feedback and (3) implementation of central line bundle of care.
FINDINGS: There was a significant overall reduction of CLABSI rate between preintervention and postintervention period [incidence rate ratio (IRR) of 0.06 (95 percent CI, 0.01-0.33; P = 0.001)].
PRACTICAL IMPLICATIONS: CLABSI rates were reduced by a multifaceted intervention bundle, even in non-ICU and resource-limited setting. This includes a preinterventional study to identify the risk factors followed by a local adaption of the recommended care bundles. This study recommends resources-limited hospitals to design a strategy that is suitable for their own local setting to reduce CLABSI.
ORIGINALITY/VALUE: This study demonstrated the feasibility of a multifaceted intervention bundle that was locally adapted with an evidence-based approach to reduce CLABSI rate in non-ICU and resource-limited setting.

Matched MeSH terms: Hospital Units
An observational study of drug administration errors in a Malaysian hospital (study of drug administration errors)

Chua SS, Tea MH, Rahman MH

J Clin Pharm Ther, 2009 Apr;34(2):215-23.
PMID: 19250142 DOI: 10.1111/j.1365-2710.2008.00997.x

Drug administration errors were the second most frequent type of medication errors, after prescribing errors but the latter were often intercepted hence, administration errors were more probably to reach the patients. Therefore, this study was conducted to determine the frequency and types of drug administration errors in a Malaysian hospital ward.

Matched MeSH terms: Hospital Units
Antimicrobial susceptibility pattern of clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital

Raja NS, Singh NN

J Microbiol Immunol Infect, 2007 Feb;40(1):45-9.
PMID: 17332906

BACKGROUND AND PURPOSE: Pseudomonas aeruginosa is an important cause of morbidity and mortality in hospitalized, critically ill patients and patients with underlying medical conditions such as cystic fibrosis, neutropenia, and iatrogenic immunosuppression. The prevalence of multiresistant P. aeruginosa isolates has been increasing. The aim of this study was to determine the antimicrobial susceptibility patterns in P. aeruginosa strains isolated at a university teaching hospital in Kuala Lumpur, Malaysia.
METHODS: The Laboratory Information System of the microbiology department was retrospectively reviewed to determine the susceptibility patterns of P. aeruginosa isolates to anti-pseudomonal antibiotics, from January to June 2005. Disk diffusion methods were employed and results were interpreted according to National Committee for Clinical Laboratory Standards guidelines.
RESULTS: 505 clinical isolates of P. aeruginosa were tested. Major sources of these isolates included respiratory tract, wound, urine and blood. The rates of antimicrobial resistance of isolates were 6.73% to amikacin, 12.9% to gentamicin, 10.1% to netilmicin, 10.9% to ceftazidime, 11.3% to ciprofloxacin, 9.9% to imipenem, 10.8% to piperacillin, 9.4% to piperacillin-tazobactam and 0% to polymyxin B. Of the 505 isolates, 29 (5.74%) were found to be multidrug-resistant; these were most commonly isolated from respiratory tract specimens of patients in surgical units, followed by respiratory tract specimens in patients in medical units.
CONCLUSIONS: The data in this study showed low rates of antibiotic resistance among P. aeruginosa isolates. Combinations of aminoglycosides plus beta-lactams or quinolones should be the appropriate choice for empirical therapy in P. aeruginosa infections. Active antibiotic susceptibility testing and surveillance should be continued in order to curtail the problem of antibiotic resistance.

Matched MeSH terms: Hospital Units
Antibiotic resistance patterns in nosocomial gram-negative bacterial infections in units with heavy antibiotic usage

Ariffin H, Navaratnam P, Kee TK, Balan G

J Trop Pediatr, 2004 Feb;50(1):26-31.
PMID: 14984166

The pattern of antibiotic resistance amongst gram-negative bacteria (GNB) in paediatric units, which have heavy empirical usage of broad-spectrum antibiotics, was studied prospectively over a 6-month period. A total of 200 consecutive, non-duplicate gram-negative isolates were obtained from 109 patients admitted to intensive care and oncology units in two hospitals. The commonest isolates were Klebsiella spp (36.5 per cent) and Pseudomonas (20.0 per cent). The isolates showed lower susceptibility rates to the third-generation cephalosporins (47-62 per cent) compared with cefepime (91 per cent), imipenem (90 per cent) and ciprofloxacin (99 per cent). Fifty-four (52.8 per cent) Klebsiella and Escherichia coli isolates were determined to be extended-spectrum beta-lactamase (ESBL) producing strains. Antibiotics found to be effective against ESBL-producers were imipenem and ciprofloxacin. The high resistance rate amongst GNB to third-generation cephalosporins is a likely consequence of heavy empirical usage of this group of antibiotics. The carbapenems and quinolones remain useful agents in the management of patients admitted to these units.

Matched MeSH terms: Hospital Units

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