1
|
Marzuki NM, Jaeb MZM, Ban A, Ismail AI, Ali IAH, Razali NM, Samsudin A, Nasaruddin MZ, Rahman RA, Zim MAM, Kassim R, Lam YF, Tarekh NA, Ibrahim A, Kapse SV. Personalised management of Chronic Obstructive Pulmonary Disease (COPD): Malaysian consensus algorithm for appropriate use of inhaled corticosteroid (ICS) in COPD patients. Med J Malaysia 2020; 75:717-721. [PMID: 33219183] [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: 06/11/2023]
Abstract
BACKGROUND Regarding the long-term safety issues with the use of inhaled corticosteroids (ICS) and the clinical predominance of dual bronchodilators in enhancing treatment outcomes in chronic obstructive pulmonary disease (COPD), ICS is no longer a "preferred therapy" according to the Global Initiative for Chronic Obstructive Lung Disease except on top of a dual bronchodilator. This has necessitated a change in the current therapy for many COPD patients. OBJECTIVE To determine a standardised algorithm to reassess and personalise the treatment COPD patients based on the available evidence. METHODS A consensus statement was agreed upon by a panel of pulmonologists in from 11 institutes in Malaysia whose members formed this consensus group. RESULTS According to the consensus, which was unanimously adopted, all COPD patients who are currently receiving an ICS-based treatment should be reassessed based on the presence of co-existence of asthma or high eosinophil counts and frequency of moderate or severe exacerbations in the previous 12 months. When that the patients meet any of the aforementioned criteria, then the patient can continue taking ICS-based therapy. However, if the patients do not meet the criteria, then the treatment of patients need to be personalised based on whether the patient is currently receiving long-acting beta-agonists (LABA)/ICS or triple therapy. CONCLUSION A flowchart of the consensus providing a guidance to Malaysian clinicians was elucidated based on evidences and international guidelines that identifies the right patients who should receive inhaled corticosteroids and enable to switch non ICS based therapies in patients less likely to benefit from such treatments.
Collapse
Affiliation(s)
- N M Marzuki
- Institut Perubatan Respiratori, Kuala Lumpur, Malaysia
| | - M Z M Jaeb
- Hospital Raja Perempuan Zainab II (HRPZ II), Department of Medicine, Kota Bharu, Kelantan, Malaysia
| | - A Ban
- Universiti Kebangsaan Malaysia Medical Centre, Department of Medicine, Kuala Lumpur, Malaysia
| | - A I Ismail
- Universiti Teknologi MARA, Faculty of Medicine, Selangor, Malaysia
| | - I A H Ali
- Hospital Pulau Pinang, Department of Respiratory Medicine, Pulau Pinang, Malaysia
| | - N M Razali
- Hospital Sultanah Nur Zahirah, Department of Respiratory Medicine, Kuala Terengganu, Terengganu, Malaysia
| | - A Samsudin
- Hospital Sultanah Nur Zahirah, Department of Respiratory Medicine, Kuala Terengganu, Terengganu, Malaysia
| | - M Z Nasaruddin
- Hospital Serdang, Department of Respiratory Medicine, Selangor, Malaysia
| | - R A Rahman
- Department of Respiratory Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - M A M Zim
- Universiti Teknologi MARA, Faculty of Medicine, UiTM Selayang campus, Selangor, Malaysia
| | - R Kassim
- Hospital Sultanah Bahiyah, Department of Respiratory Medicine, Alor Setar, Kedah, Malaysia
| | - Y F Lam
- Hospital Raja Permaisuri Bainun, Department of Respiratory Medicine, Ipoh, Perak, Malaysia
| | - N A Tarekh
- Department of Respiratory Medicine, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
| | - A Ibrahim
- Hospital Tengku Ampuan Afzan, Department of Respiratory Medicine, Kuantan, Pahang, Malaysia
| | - S V Kapse
- Novartis Corporation (Malaysia) Sdn Bhd, Medical Affairs Department, Petaling Jaya, Selangor, Malaysia.
| |
Collapse
|
2
|
Lee SY, Abdullah LC, Rahman RA, Abas F, Chong GH. STABILITY AND TOXICITY PROFILE OF SOLUTION ENHANCED DISPERSION BY SUPERCRITICAL FLUIDS (SEDS) FORMULATED Andrographis paniculata EXTRACT. Braz J Chem Eng 2019. [DOI: 10.1590/0104-6632.20190362s20180395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - R. A. Rahman
- University Putra Malaysia, Malaysia; University Putra Malaysia, Malaysia
| | - F. Abas
- University Putra Malaysia, Malaysia
| | - G. H. Chong
- University Putra Malaysia, Malaysia; University Putra Malaysia, Malaysia
| |
Collapse
|
3
|
Abas AA, Rahman RA, Yahya N, Kamaruzaman E, Zainuddin K, Manap NA. Occupational radiation exposure to anesthetists from fluoroscopic projections during orthopedic operative procedures. Clin Ter 2014; 165:e253-7. [PMID: 25203339 DOI: 10.7417/ct.2014.1739] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The role of anesthetists during orthopedic fluoroscopic procedures exposes them to radiation. We conducted a prospective, descriptive study to estimate the radiation exposure to anesthetists during procedures over a six-month period in the orthopedic trauma operating theatres which had the most fluoroscopic usage. MATERIALS AND METHODS Thermoluminescent dosimeter (TLD) chips were placed two metres away from the radiation source, in three positions to simulate the anesthetist's position in the operating theatre during the fluoroscopic procedures as well as their radiation safety practices. The three positions were above the lead gown, behind the lead gown and behind the protective lead screen. The fourth TLD chip was assigned as a control measure to account for background radiation. The radiation exposure was measured at every end of each month during the period of six consecutive months. The TLD chips were sent to the Malaysian Institute for Nuclear Technology (MINT) for the analysis. RESULTS From the study, the annual exposure without a protective shield at a 2 metre distance from the projection source was estimated to be 0.70 milliSievert (mSv)/year. With the use of lead gowns and protective lead screens, the annual exposure was estimated to be 0.08 mSv / year. All the radiation levels measured were within the maximum permissible dose of 50 mSv / year. CONCLUSIONS During fluoroscopic assisted orthopedic procedures, the anesthetists in UKMMC are exposed to a small amount of radiation which is well below the annual maximum permissible limit as determined by local and international regulatory bodies.
Collapse
Affiliation(s)
- A A Abas
- Rockingham General Hospital, Elanora Drive, Cooloongup WA 6168, Australia
| | - R A Rahman
- Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - N Yahya
- Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - E Kamaruzaman
- Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - K Zainuddin
- Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - N A Manap
- Department of Anaesthesiology and Intensive Care, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| |
Collapse
|
4
|
Hassan SA, Rahman RA, Huda N, Wan Bebakar WM, Lee YY. Hospital-acquired Clostridium difficile infection among patients with type 2 diabetes mellitus in acute medical wards. J R Coll Physicians Edinb 2014; 43:103-7. [PMID: 23734349 DOI: 10.4997/jrcpe.2013.203] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Clostridum difficile (C. difficile) infection is increasingly seen among hospitalised patients with type 2 diabetes mellitus but its rate and associated risk factors are not known. We aimed to determine the rate and characteristics of hospital-acquired C. difficile infection in subjects with type 2 diabetes mellitus admitted into acute medical wards. METHODS Our prospective cross-sectional study involved 159 patients with established type 2 diabetes mellitus admitted into acute medical wards who developed a hospital-acquired C. difficile infection. Stools were tested for C. difficile toxins using a toxin A/B kit and a toxin A kit. Clinical features, laboratory findings, types of antibiotics, and use of a proton pump inhibitor were examined for their association with the infection. RESULTS Thirteen subjects were positive for toxin A and one for toxin B. Using univariable analysis, we found that patients with type 2 diabetes mellitus and hospital acquired C. difficile infection were younger (mean 53.8 years, p=0.02), had diarrhoea and abdominal pain (p=0.001) but no fever. Sepsis (p=0.02) and use of a proton pump inhibitor (p=0.01) were more commonly implicated as the cause of the infection. Of the various types of antibiotics prescribed, carbapenem (28.6% vs 4.1%, p=0.01) and metronidazole (42.9% vs 19.3%, p=0.04) were significantly associated with hospital acquired C. difficile infection. CONCLUSIONS Patients with type 2 diabetes mellitus admitted into acute medical wards and who developed hospital-acquired C. difficile infection have distinct characteristics.
Collapse
Affiliation(s)
- S A Hassan
- Department of Medical Microbiology and Parasitology, Universiti Sains Malaysia, Kelantan, Malaysia.
| | | | | | | | | |
Collapse
|
5
|
Hussaini HM, Rahman NA, Rahman RA, Nor GM, Ai Idrus SM, Ramli R. Maxillofacial trauma with emphasis on soft-tissue injuries in Malaysia. Int J Oral Maxillofac Surg 2007; 36:797-801. [PMID: 17630250 DOI: 10.1016/j.ijom.2007.04.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2005] [Revised: 12/08/2006] [Accepted: 04/09/2007] [Indexed: 10/23/2022]
Abstract
Soft-tissue injuries with or without facial bone involvement are the most common presentation following maxillofacial trauma. The objective of this study was to look at the distribution, pattern and type of soft-tissue injury in relation to aetiology. Records of patients over a period of 5 years (1998-2002), who sustained maxillofacial injuries and were treated at Kajang Hospital, a secondary referral hospital, were reviewed. Out of 313 patients with maxillofacial injuries, 295 patients sustained soft-tissue injuries. Males (79%) between 21 and 30 years old (34%) were the majority of patients. Road-traffic accident was the main cause of soft-tissue injuries (75%) with motorcycle accident being the most frequent (40%). The upper lips (23%) and the lower lips (18%) were the most common extraoral site involved, while the labial mucosa and sulcular areas, both accounting for 21%, were the most common intraoral sites. Stringent road-traffic regulations should be practiced in developing countries, as morbidity arising from road-traffic accidents poses a national economic and social problem.
Collapse
Affiliation(s)
- H M Hussaini
- Department of Oral Pathology & Oral Medicine, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | | | | | | |
Collapse
|
6
|
Abstract
Susuk, or charm needles, are inserted and worn subcutaneously in the face and other parts of the body, as they are believed to enhance beauty and youth, and for many other reasons such as treatment of headache, aches and pains in the joints, back or abdomen. The practice of inserting susuk is a traditional belief, genuinely cultural and superstitious, and common in the south-east Asian region. We present 13 cases of susuk, which was found incidentally on the radiographs as the patients came for various types of treatment at our centre.
Collapse
Affiliation(s)
- M M Nor
- Department of Orthodontics, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | | | | |
Collapse
|
7
|
Latip RA, Baharin BS, Che Man YB, Rahman RA. Effect of adsorption and solvent extraction process on the percentage of carotene extracted from crude palm oil. J AM OIL CHEM SOC 2001. [DOI: 10.1007/s11746-001-0224-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. A. Latip
- ; Department of Food Technology, Faculty of Food Science and Biotechnology; Universiti Putra Malaysia; 43400 UPM Serdang Malaysia
| | - B. S. Baharin
- ; Department of Food Technology, Faculty of Food Science and Biotechnology; Universiti Putra Malaysia; 43400 UPM Serdang Malaysia
| | - Y. B. Che Man
- ; Department of Food Technology, Faculty of Food Science and Biotechnology; Universiti Putra Malaysia; 43400 UPM Serdang Malaysia
| | - R. A. Rahman
- ; Department of Food Technology, Faculty of Food Science and Biotechnology; Universiti Putra Malaysia; 43400 UPM Serdang Malaysia
| |
Collapse
|
8
|
Jesudasan RA, Rahman RA, Chandrashekharappa S, Evans GA, Srivatsan ES. Deletion and translocation of chromosome 11q13 sequences in cervical carcinoma cell lines. Am J Hum Genet 1995; 56:705-15. [PMID: 7887426 PMCID: PMC1801173] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Molecular genetic studies on HeLa cell-derived nontumorigenic and tumorigenic hybrids have previously localized the HeLa cell tumor-suppressor gene to the long arm of chromosome 11. Extensive molecular and cytogenetic studies on HeLa cells have shown chromosome band 11q13 to be rearranged in this cell line. To determine whether q13 rearrangement is a nonrandom event in cervical carcinomas, six different human papilloma virus (HPV)-positive (HeLa, SiHa, Caski, C4-I, Me180, and Ms751) and two different HPV-negative (C33A and HT3) cell lines were studied. Long-range restriction mapping using a number of q13-specific probes showed molecular rearrangements within 75 kb of INT2 probe in three HPV-positive cell lines (HeLa, SiHa, and Caski) and in an HPV-negative cell line (HT3). FISH using an INT2 YAC identified a breakpoint within the sequences spanned by this YAC in two of the cell lines, HeLa and Caski. INT2 cosmid derived from this YAC showed deletion of cosmid sequences in two other cell lines, SiHa and C33A. These two cell lines, however, retained cosmid sequences of Cyclin D1, a probe localized 100 kb proximal to INT2. Deletions being the hallmark of a tumor-suppressor gene, we conclude that the 100-kb interval between the two cosmids might contain sequences of the cervical carcinoma tumor-suppressor gene.
Collapse
Affiliation(s)
- R A Jesudasan
- Department of Surgery, UCLA School of Medicine, Veterans Administration Medical Center 90073
| | | | | | | | | |
Collapse
|
9
|
Lim TO, Ngah BA, Rahman RA, Suppiah A, Ismail F, Chako P, Na HH. The Mentakab hypertension study project. Part V--Drug compliance in hypertensive patients. Singapore Med J 1992; 33:63-6. [PMID: 1598610] [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: 12/27/2022]
Abstract
Poor compliance with drug treatment is a barrier to effective management of hypertension. Drug compliance behaviour of 168 patients were studied, their drug compliance was measured by the pill-counting method. The prevalence of non-compliance with medication was 26%. Thirteen variables were examined for their association with compliance; these were age, sex, duration of hypertension since diagnosis, adequacy of blood pressure control, complexity of drug regimen and side-effect of drug, history of previous admission for hypertension related reason, patient's knowledge of hypertensive complications, patient's belief that drug was 'panas' or 'san', previous use of traditional treatment for hypertension, patient's fatalistic attitude, their social support and satisfaction with the health services. None of these variables were significantly related to compliance (p greater than 0.05) except adequacy of blood pressure control. The performance of patient self-report was compared with pill-count as a measure of drug compliance; it was poorly predictive of non-compliance (sensitivity = 71%, specificity = 50%). An inverse relationship was found between non-compliance with medication and patient subsequent drop-out rate. Patients who were compliant were more likely to remain on treatment and vice versa. As a measure of drug compliance, detection of drop-out compared well with pill-count (sensitivity 97%, specificity 66%, positive predictive value 89%, negative predictive value 88%).
Collapse
Affiliation(s)
- T O Lim
- Medical Unit, Mentakab District Hospital, Pahang, Malaysia
| | | | | | | | | | | | | |
Collapse
|