Knowledge of Blood Transfusion among Nurses at Hospital Pulau Pinang: Nursing Responsibilities and Patient Management Related to Transfusion Reactions

Introduction: Nurses are generally trained on the procedures of blood transfusion during their years of service. However, the level of knowledge varies among individuals and healthcare centres. Thus, this study addresses a knowledge gap regarding nurses’ knowledge and transfusion safety in the local clinical setting. Objectives: This study aimed to determine nurses’ level of knowledge of various phases of blood transfusion and associate this knowledge with their socio-professional details. Methods: This was a cross-sectional, quantitative study. The target population was in-patient ward nurses at Hospital Pulau Pinang. The systematic random sampling method was used to select 185 nurses to participate in this study. Data were collected using a validated research questionnaire that consisted of 31 items (9 items related to socio-professional factors and 22 knowledge items). Data were analysed using descriptive and inferential analyses. Results: The overall knowledge score was moderate (mean = 70.44%, SD = 11.35). None of the nurses was able to answer all of the knowledge questions correctly. Of the participants, 72.29%, 71.75%, and 67.14% exhibited knowledge of blood bag collection and patient preparation; pre-transfusion nursing activities; and during and post-transfusion nursing responsibilities and management of transfusion reactions, respectively. Factors such as age, years of service, department, and availability of the transfusion policy in the ward significantly affected the mean knowledge scores. Conclusion: Nurses’ knowledge of blood transfusion at Hospital Pulau Pinang was moderate. More training and courses should be provided to improve their knowledge

Model aliran pembuatan keputusan berkait untuk penjagaan kesihatan penyakit kencing manis

Penyakit kencing manis adalah satu daripada penyakit kronik yang kian meningkat. Pemberian rawatan yang tepat diperlukan bagi menghasilkan keberkesanannya. Kajian lepas telah mencadangkan satu Model Aliran Pembuatan Keputusan Berkait (MAPKB) sebagai penyelesaian sistem sokongan keputusan cerdas untuk penjagaan kesihatan. Model ini dapat memberikan keputusan yang tepat dalam menentukan rawatan penyakit tertentu. Oleh itu, tujuan kajian ini adalah membangunkan model penjagaan kesihatan penyakit kencing manis berasaskan MAPKB bagi menilai ketepatan membuat keputusan yang meningkat dengan konsep MAPKB. Konsep MAPKB membolehkan jumlah data bertambah dengan pertambahan rekod data pada peringkat penjagaan yang sama, dan pertambahan rekod data dan atribut dari peringkat penjagaan sebelum atau selepasnya. Semakin bertambah data atau maklumat, semakin tepat sesuatu keputusan dapat dibuat. Data dibangunkan bagi membuat ramalan diagnosis untuk setiap peringkat penjagaan dalam perkembangan penyakit kencing manis jenis 2. Pembangunan data pada setiap peringkat penjagaan disahkan oleh pakar perubatan. Walaubagaimanapun, eksperimen dilaksana menggunakan data simulasi bagi dua peringkat penjagaan sahaja. Empat set data berlainan saiz disediakan untuk melihat perubahan ketepatan ramalan. Setiap set data mengandungi 2 set data peringkat penjagaan primer dan peringkat penjagaan sekunder dengan 4 kali perubahan jumlah atribut dari 25 hingga 58 dan jumlah rekod dari 300 hingga 11,000. Hasil eksperimen menunjukkan secara purata, algoritma J48 menunjukkan model terbaik (99%) diikuti Logistik (98%), RandomTree (95%), NaiveBayes Updateable (93%), BayesNet (84%) dan AdaBoostM1 (67%).Analisis nisbah juga menunjukkan ketepatan model ramalan telah meningkat sehingga 49%. Model MAPKB untuk penjagaan penyakit kecing manis ini telah direkabentuk dengan kriteria perubahan data secara dinamik dan berupaya membangunkan model ramalan terbaru yang dinamik dengan berkesan

Poisoning among children in Malaysia: A 10-years retrospective study.

BackgroundPoisoning commonly occurs among children due to their curiosity, where they tend to explore and investigate their surroundings. They frequently put what they find into their mouths as they do not understand the danger and probably cannot read the warning label. As this issue has not been extensively studied in Malaysia; hence, a retrospective analysis of records was carried out to determine the profile of phone call enquiries regarding poisoning among children at the National Poison Centre (NPC).MethodologyThe records of all cases of poisoning among children below the age of 18 years were retrospectively reviewed over a period of 10 years from 2006 to 2015. The data on the cases were analysed according to age group and gender, the circumstances and the toxic agent implicated in the poisoning.ResultsDuring the 10-year study period, 13,583 calls that met the criteria for this study were referred to the NPC. Of these calls, 62.2% involved children between the age of 0 to 5 years, 9% were children aged between 6 to 12 years, and 28.8% were children between 13 to 18 years. Unintentional poisoning accounted for 96.7% of the incidents involving children between the age of 0 to 5 years, although among the children who were between the age of 13 to 18 years, 76% of the cases were intentional. In all the cases involving children, pharmaceutical agents were the most frequent source of the poisoning. More than 95% of the cases were exposed to poisoning through the oral route.ConclusionPoisoning in children between the age of 0 to 5 years was mainly unintentional, while poisoning in children between the age of 13 to 18 years was mainly intentional, where pharmaceutical and household agents were responsible for more than two-thirds of the poisoning cases. Most of these incidents could have been prevented if protective measures, such as child-resistant enclosures, had been implemented and if the parents and guardians had been educated about preventive measures, such as keeping poisoning agents out of the reach of children

Analysis of Common Beta-Thalassemia (β-Thalassemia) Mutations in East Java, Indonesia

Background: The frequency of the beta-thalassemia (β-thalassemia) gene in Indonesia ranges from 3 to 10%. However, in the East Java province, there is still limited information on the prevalence of β-thalassemia mutations in clinically diagnosed beta-thalassemia patients of East Java. Therefore, this study aimed to characterize β-thalassemia mutations in selected patients in the East Java province of Indonesia. Methods: This is an analytical observational study. Diagnosis of β-thalassemia was based on clinical presentation, complete blood count (CBC), and hemoglobin (Hb) electrophoresis. Blood specimens taken from each patient in three ethylenediaminetetraacetic acid (EDTA) tubes were analyzed for CBC and Hb electrophoresis and processed for DNA extraction and subsequent polymerase chain reaction (PCR). Detection of mutations in Hemoglobin Subunit Beta (HBB) gene exons 1–3 of the β-thalassemia gene as the common mutation in Indonesia was done using PCR followed by Sanger sequencing. Results: In total, 33 (n = 33) participants were involved in this study with ages ranging from 5 to 17 years comprising 19 women and 14 men. Their ethnic origins were Javanese (n = 30) and Chinese (n = 3). CBC results showed that mean ± standard deviation (SD) for Hb, red blood cell (RBC), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and red cell distribution width (RDW)-CV were 81.2 ± 7.0 g/L; 3.40 ± 0.39 × 109/L; 71.05 ± 5.72 fL; 24.12 ± 2.45 pg; 33.91 ± 1.47 g/dl; 24.38 ± 6.02%, respectively. Hb electrophoresis revealed that 5 out of 33 participants had beta-thalassemia and 28 out of 33 participants had hemoglobinopathy (Hb) E/beta-thalassemia. Results of Sanger sequencing showed the following genotype variations in the samples: 12 (36.4%) with βCD26/βIVS−I−5; 6 (18.2%) with βCD26/βCD35; 3 (9.1%) with βCD26/βIVS−I−2; 2 (6.1%) with βCD27/28/βCD40; 2 (6.1%) with βIVS−I−1/βCAP+1; and βCD26/βIVS−I−1; βIVS−I−5/βCAP+1; βIVS−I−5/βCD35; βCD26/βCD37; βCD26/βCD15; βCD26/βCD40; and βIVS−I−5/βCD19 in 1 (3%) sample, respectively, and 1 (3%) had no abnormality detected in sequencing even though electrophoresis showed abnormality in the migration pattern. The βCD26/βIVS−I−5 mutation was found in samples that were noted to have Hb E/beta-thalassemia on Hb electrophoresis. Conclusion: The underlying genetic variations are heterogeneous in thalassemia patients in East Java, where 12 variants were found. The most common variant was βCD26/βIVS−I−5, which all accounted for Hb E/beta-thalassemia on Hb electrophoresis. Furthermore, 28 out of 33 participants had hemoglobinopathy (Hb) E/beta-thalassemia