Survival and prognostic factors of hospitalized acute myocardial infarction patients in district of Kota Bharu, Kelantan : a retrospective cohort study 2000-2003

INTRODUCTION Acute n1yocardial infarction (AMI) ren1ains a major public health problen1 in Malaysia despite advances in medical management and technology. Local prognostic data on AMI will provide an essential information for effective preventive measures. The objectives of the study were to determine the survival of hospitalized acute n1yocardial infarction patients in Kota Bharu and identify the prognostic factors that influence the risk of death. METHODOLOGY A retrospective cohort study was conducted involving 368 hospitalized AMI patients from the district of Kota Bharu who were adtnitted in two tet1iary hospital; Hospital Kota Bharu and Hospital Universiti Sains Malaysia from I st January 2000 to 3I st Decetnber 2003. Additional follow up of one year after the recruittnent of the subjects was done fron1 I st January 2004 to 3I st Decen1ber 2004. All patients who fulfilled the criteria were included in the study. Hospital tnedical records and physician clinic records \Vere reviewed by a researcher. The required inforn1ation on variables of interest and patients· survival status until 31st December 2004 was recorded into a data collection forn1. Telephone calls were also conducted to obtain the inforn1ation on survival status of son1e patients who were discharged alive but loss to follow up. RESULTS The overall cumulative survival for hospitalized AMI in Kota Bharu were 91.0 (95o/o confidence interval (CI): 87.6~ 93.5), 88.8 (95% CI: 85.2., 91.7)~ 86.6 (95o/o CI: 82.6~ 89.7) and 83.9 (95% CI: 79.6, 87.5) percent for I day, 2 days, I week and I tnonth respectively. The long-term survival rate for 6 months, I year, 2 years~ 3 years and 4 years after AMI were 80.7 (95% CI: 76.1. 84.6), 77.5 (95% CI: 72.6~ 81.7)~ 76.2 (95% CI: 71.2. 80.6)~ 71.9 (95% CI: 66.0, 76.9) and 69.2 (95% CI: 62.7~ 74.8) percent respectively. Based on Cox Proportional Hazards Regression multivariable analysis after adjusting other variables, the significant prognostic factors that influenced the risk of death in hospitalized acute myocardial infarction patients in Kota Bharu were age at diagnosis (HR=I.03. 95% CI: 1.01. 1.06). diabetes n1ellitus (HR=l.60, 95% CI: 1.03~ 2.46), left ventricular failure (HR=2.15, 95% CI: 1.38, 3.34 ). thron1bolytic therapy (HR=0.48. 95°/o CI: 0.3 L 0.73) and first contact of care (HR=0.47. 95% CI: 0.24. 0.91 ). CONCLUSION Survival rate of hospitalized AMI patients in the district of Kota Bharu was con1parable with other developed countries. All significant independent prognostic factors identified were considerably similar to other countries. except a few itnpot1ant factors such as gender and drugs prescribed on discharge. Interestingly. first site contact of n1edical care was also identified to significantly influence the risk of death of AMI in Kota Bharu

Immediate and long-term relationship between severe maternal morbidity and health-related quality of life: a prospective double cohort comparison study

Abstract Background Given the growing interest in severe maternal morbidity (SMM), the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia. Methods A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12). Results The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA) showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534) between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674) between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031), role limitations due to physical health subscale at 6-month (P = 0.019), vitality subscale at 1-month (P = 0.007) and 6-month (P = 0.008), and role limitations due to emotional problems subscales at 6-month (P = 0.008). Conclusions Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity

Tualang honey supplementation as cognitive enhancer in patients with schizophrenia

Schizophrenia is a chronic mental illness with major clusters of symptoms, including positive symptoms, negative symptoms and cognitive impairment. It is debilitating and common. It occurs in approximately 1% or nearly 21 millions of world population (WHO, 2018). Locally, the National Mental Health Registry (NMHR) at the Ministry of Health Malaysia reported an incidence rate of between 7.3 to 43.0 per 100 000 population (Malaysia, 2005). A weakening in at least one of the cognitive function domain occurred in 80% of schizophrenia patients (R. S. E. Keefe and Fenton, 2007) and cognitive impairment is a core feature. Cognitive impairment is both predictive for functional outcomes and a treatment target (Green et al., 2004)

Psychometric properties of knowledge, attitude, and practice on pharmacogenovigilance in drug safety questionnaire in medicine and pharmacy students: based on Exploratory Factor Analysis

Integration of Pharmacogenomics and Pharmacovigilance in the curricula of future healthcare professionals isessential towards individualized medicine and drug safety. Researchers are lacking in Knowledge, attitude and practice regarding pharmacogenovigilance in drug safety among Malaysian future health professionals. Thisstudy is to develop and validate a reliable questionnaire for evaluation of knowledge, attitude and practice of future Doctors and Pharmacists concerning Pharmacogenovigilance in drug safety. A 49-item self-administeredquestionnaire was developed from the literature. The content was validated by a panel of relevant expertsfollowed by face validity. A pilot study on 100 respondents was conducted for reliability, followed by a crosssectional study involving 247 participants in factor analysis. The content validity index of the wholequest ionnaire was 0.8%. The overall Cronbach‟s Alpha was 0.8, with P<0.001. 67.4% of the total variance wasexplained by 13 factors, and we can conclude that the questionnaire is a valid and reliable instrument

Validation of the Malay Version of the Inventory of Functional Status after Childbirth Questionnaire

Objective. This study was designed to examine the psychometric properties of Malay version of the Inventory of Functional Status after Childbirth (IFSAC). Design. A cross-sectional study. Materials and Methods. A total of 108 postpartum mothers attending Obstetrics and Gynaecology Clinic, in a tertiary teaching hospital in Malaysia, were involved. Construct validity and internal consistency were performed after the translation, content validity, and face validity process. The data were analyzed using Analysis of Moment Structure version 18 and Statistical Packages for the Social Sciences version 20. Results. The final model consists of four constructs, namely, infant care, personal care, household activities, and social and community activities, with 18 items demonstrating acceptable factor loadings, domain to domain correlation, and best fit (Chi-squared/degree of freedom = 1.678; Tucker-Lewis index = 0.923; comparative fit index = 0.936; and root mean square error of approximation = 0.080). Composite reliability and average variance extracted of the domains ranged from 0.659 to 0.921 and from 0.499 to 0.628, respectively. Conclusion. The study suggested that the four-factor model with 18 items of the Malay version of IFSAC was acceptable to be used to measure functional status after childbirth because it is valid, reliable, and simple

Adulterated stingless bee honey identification using VIS-NIR spectroscopy technique

The objective of this study was to study the ability of the VIS-NIR spectroscopy to classify the pure and adulterated stingless bee honey across the wavelength range of 450–969 nm using an optical spectrometer. The physicochemical properties such as soluble solid content (SSC) and moisture content (refractive index, RI) of pure and adulterated honey has also been investigated using a refractometer. The result showed that pure stingless bee honey has the highest transmittance rate, SSC and RI value compared to adulterated honey. There are significant differences (P < 0.0001) in the transmittance rate, SSC and RI of stingless bee honey over five different types of treatments. The results also showed that VIS-NIR data were good in classifying the samples into different treatments with 99.33% accuracy rate. About thirty-four wavelengths were found to be the most significant to discriminate the different treatments by principal component analysis (PCA) and linear discriminant analysis (LDA) techniques

Validation of a new questionnaire assessing the health impact of divorce on women: An exploratory factor analysis

The aim of this study was to develop a new validated questionnaire to assess the health impact of divorce on women. A cross sectional study was undertaken in a district in Terengganu, using a newly developed self-administered Malay language questionnaire comprising of six domains and 82 items. The questionnaire was constructed based on the literature review and discussions with experts. Exploratory factor analysis was applied in construct validity and internal consistency was used for reliability analysis. A total of 51 respondents were involved in this study. All the consented divorcees were Malays. The mean (SD) age for the divorced women was 35.8 (10.00). Majority (82.4%) of them had secondary education. All the final three domains demonstrated Keiser-Meyer-Olkin (KMO) of more than 0.6, significant Bartlett’s test of Sphericity and Cronbach’s alpha of more than 0.80. The overall Cronbach’s alpha was excellent (0.920). The final questionnaire consisted of two domains. Factor loading for all items in each subdomains were satisfactory. The final functional somatic symptoms domain consisted of 6 subdomains and 19 items with factor loading from 0.402 to 0.914. For emotional instability domain, the final items were 13 items with factor loading from 0.548 to 0.878. The questionnaire was valid and reliable to be used for functional somatic symptoms and emotional instability domains. It is useful to assess the health impact and related intervention of divorced women. A confirmatory factor analysis may further confirm the final model