International Medical Journal Malaysia最新文献_第9页

The Impact of Fluid Balances in the First 48 Hours on Mortality in the Critically Ill Patients 危重病人前48小时体液平衡对死亡率的影响

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V15I1.401

A. Ralib, N. Hamzah, Majdiah Syahirah Nasir, M. Nor

{"title":"The Impact of Fluid Balances in the First 48 Hours on Mortality in the Critically Ill Patients","authors":"A. Ralib, N. Hamzah, Majdiah Syahirah Nasir, M. Nor","doi":"10.31436/IMJM.V15I1.401","DOIUrl":"https://doi.org/10.31436/IMJM.V15I1.401","url":null,"abstract":"Introduction: There has been increasing evidence of detrimental effects of cumulative positive fluid balance in critically ill patients. The postulated mechanism of harm is the development of interstitial oedema, with resultant increase morbidity and mortality. We aim to assess the impact of positive fluid balance within the first 48 hours on mortality in our local ICU population. Methods: This was a secondary analysis of a single centre, prospective observational study. All ICU patients more than 18 years were screened for inclusion in the study. Admission of less than 48 hours, post-elective surgery and ICU readmission were excluded. Cumulative fluid balance either as volume or percentage of body weight from admission was calculated over 6, 24 and 48 hour period from ICU admission. Results: A total of 143 patients were recruited, of these 33 died. There were higher cumulative fluid balances at 6, 24 and 48 hours in non-survivors compared to survivors. However, after adjusted for severity of illness, APACHE II Score, they were not predictive of mortality. Sensitivity analysis on sub-cohort of patients with acute kidney injury (AKI) showed only an actual 48-hour cumulative fluid balance was independently predictive of mortality (1.21 (1.03 to 1.42)). Conclusions: Cumulative fluid balance was not independently predictive of mortality in a heterogenous group of critically ill patients. However, in subcohort of patients with AKI, a 48-hour cumulative fluid balance was independently predictive of mortality. An additional tile is thus added to the mosaic of findings on the impact of fluid balance in a hetergenous group of critically ill patients, and in sub-cohort of AKI patients.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"15 1","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41724809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Hemorrhagic Thoracic Spinal Epidural Angiolipoma: A Case Report 出血性胸椎硬膜外血管脂肪瘤1例

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V13I1.497

Mohamed Saufi B. Awanga, K. Chan, Z. Zamzuri, Ar Ralib, A. Azlina

引用次数: 2

IIUM Teaching Hospital: The Way Forward? 教学医院:未来之路?

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V13I1.485

A. H. Zulkifly

引用次数: 4

A Retrospective Review of 25 cases of Lethal Fetal Anomalies 25例致命胎儿畸形的回顾性分析

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V15I1.402

D. Abdulwahab, I. Hamizah, N. Zalina, S. Yong, A. Mokhtar

{"title":"A Retrospective Review of 25 cases of Lethal Fetal Anomalies","authors":"D. Abdulwahab, I. Hamizah, N. Zalina, S. Yong, A. Mokhtar","doi":"10.31436/IMJM.V15I1.402","DOIUrl":"https://doi.org/10.31436/IMJM.V15I1.402","url":null,"abstract":"Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25 women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9 years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%) women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus. Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various maternal morbidities, in this case series , which could have been prevented if they were diagnosed and terminated at early trimester. A new direction is needed in our local practice.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"15 1","pages":"19-23"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44707306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A case of eosinophilic granulomatosis with polyangiitis (churg-strauss, EGPA) presenting with relapsed mononeuritis multiplex 嗜酸性肉芽肿病合并多血管炎(churg-strauss, EGPA) 1例，表现为复发性多发性单神经炎

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V13I1.496

Hilmi Abdullah, M. Ainon

引用次数: 0

Prediction model for peak expiratory flow among children in Kocaeli, Turkey 土耳其Kocaeli儿童呼气流量峰值预测模型

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V7I2.782

Z. Gundogdu, O. Gundogdu

引用次数: 1

A Comparative Study on the Inter-Session and Inter-Examiner Reliability of Corneal Power Measurement Using Various Keratometry Instruments 不同角膜测量仪测量角膜屈光力的会话间和检查者间可靠性的比较研究

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V15I1.409

Muziman Syah Mustafa, H. A. Mutalib, Sharanjeet Kaur Ms, Khairidzan Mk

{"title":"A Comparative Study on the Inter-Session and Inter-Examiner Reliability of Corneal Power Measurement Using Various Keratometry Instruments","authors":"Muziman Syah Mustafa, H. A. Mutalib, Sharanjeet Kaur Ms, Khairidzan Mk","doi":"10.31436/IMJM.V15I1.409","DOIUrl":"https://doi.org/10.31436/IMJM.V15I1.409","url":null,"abstract":"Introduction : The purpose of this study was to evaluate inter-session repeatability, inter-examiner reproducibility and inter-device agreement of corneal power measurements from manual keratometer, autokeratometer, topographer, Pentacam high resolution and IOLMaster. Methods : Two sets of mean corneal power measurements ( n =40) were compared for inter-session repeatability and inter-examiner reproducibility in each instrument. Repeatability and reproducibility were evaluated by within-subject standard deviation (Sw), coefficient of variation (COV) and intraclass correlation coefficient (ICC). A one-way repeated measures analysis of variance was conducted to compare differences in the corneal power between each instrument pair. The Bland and Altman analysis and Pearson’s correlation were employed to assess agreement and determine strength of relationship between measurements. Results : There were no significant differences in mean corneal power measurements between 2 different visits ( p > 0.05). The Sw and COV values between 2 visits were lower than 0.09 D and 0.20 % respectively. The ICCs were stronger than 0.99 in all instruments. For reproducibility of each instrument, differences of the measurements between 2 different examiners were also insignificant ( p > 0.05). The Sw and COV values between 2 examiners were lower than 0.11 D and 0.23 % respectively. The ICCs were 0.99 and above in all instruments. The 95% limit of agreement between instruments ranged from -0.29 to 1.13 D and the r- values were stronger than 0.84. Conclusion : The corneal power measurements using these 5 instruments were repeatable and reproducible. These instruments can also be used interchangeably, however the topographer should be used with caution.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":"15 1","pages":"69-74"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49578533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Pharmacogenomics Based Practice in Malaysia: The Attitude, Knowledge and Adoption by the Healthcare Professionals 马来西亚基于药物基因组学的实践:医疗保健专业人员的态度、知识和采用

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V13I1.491

Salleh MZa, Teh LKa

{"title":"Pharmacogenomics Based Practice in Malaysia: The Attitude, Knowledge and Adoption by the Healthcare Professionals","authors":"Salleh MZa, Teh LKa","doi":"10.31436/IMJM.V13I1.491","DOIUrl":"https://doi.org/10.31436/IMJM.V13I1.491","url":null,"abstract":"ABSTRACT Introduction: Knowledge, attitude as well as adoption of pharmacogenomics in clinical practice among the pharmacists and physicians in Malaysia have not been reported. This cross-sectional study explores various facets of the two professions as related to pharmacogenomics to determine the need and preferred method to improve education among them. This study also aims to identify the current state of pharmacogenomics practice in Malaysia to help identify barrier and solution to reap advantages from pharmacogenomics practices. Methods: A questionnaire consisting of 38 questions in five parts was adopted and validated. It explores the respondents’ characteristics, attitude, knowledge, adoption and education. It was distributed online to 1500 pharmacists and physicians over five months. Results: Pharmacists differed from the physicians in terms of attitude, knowledge, adoption and education. Overall, adoption rate of pharmacogenomics was found to be low but its anticipation for future adoption is high, and benefits were reported by healthcare professionals who have used the test in a clinical setting. Majority of respondents had poor to fair knowledge and nearly half have had no prior formal teaching on pharmacogenomics. Interest in the education is very high, and most of them preferred to learn pharmacogenomics via continuous professional education programs. Conclusion: Pharmacogenomics is a field that promises many benefits, but to reap these benefits require its implementation in clinical setting. Pharmacists and physicians need to be equipped with adequate knowledge and positive attitude towards pharmacogenomics. KEYWORDS: Pharmacogenomics, education, attitude, health practitioners","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44279595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

Pattern of Organisms and Antibiotics Used in Treating Diabetes Foot Infection 治疗糖尿病足部感染的微生物类型和抗生素

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V15I1.403

M. Bujang, J. Joehaimey, Kamilov Mk, Sp Jaya Purany, I. Saadon, P. CheeHuan

引用次数: 1

Suggestive Evidence of Slc2a9 Polymorphisms Association in Gouty Malay Males Slc2a9多态性与高脂马来男性相关的提示性证据

International Medical Journal Malaysia Pub Date : 2020-11-09 DOI: 10.31436/IMJM.V14I2.432

W. Taib

引用次数: 1