Hospital Sungai Buloh Research Articles

Drug-Related Problems in HIV Treatment Failure.

Background Antiretroviral therapy (ART) is used in human immunodeficiency virus (HIV) treatment to reduce morbidity and mortality rates among people living with the virus. The types of drug-related problems (DRPs) and their causes that contributed to HIV treatment failure were unknown. Thus, this study aimed to determine the types and causes of DRPs associated with HIV treatment failure. Methods A multicentre, retrospective cohort study was conducted at the Infectious Disease Centre of Sungai Buloh Hospital, Selangor, and Tuanku Ja'afar Hospital, Negeri Sembilan. Data were collected from patients' medical records by reviewing the medical progress notes, laboratory parameters, and treatment regimen. Pharmaceutical Care Network of Europe's (PCNE) classification system V9.1 was used to identify and classify the types and causes of DRPs. Patients were classified as having treatment failure if the HIV RNA viral load was more than 1000 copies/ml for two consecutive readings. Patients were categorized as treatment successful if there was a decrease in HIV RNA viral load suppression after six months of ART initiation and had no history of persistent HIV RNA viral load greater than 1000 copies/ml for two consecutive measurements. Data were analyzed using the chi-square test. Results The number of patients recruited for this study was 355 (treatment success group = 263, treatment failure group = 92). Almost all patients (n = 354, 99.7%) had experienced at least one DRP. A total of 811 problems and 1605 causes of DRPs were encountered. The occurrence of DRPs in the HIV treatment failure group was 5.77 DRPs per patient compared to the success group (4.08 DRPs per patient). In the treatment failure group, treatment effectiveness was identified as the most frequent domain of problems (P) (P1: n = 169, 59.93%), followed by treatment safety (P2: n = 111, 39.36%). The common domains of causes (C) include patient-related (C7: n = 367, 69.11%), other (C9: n = 105, 19.77%), and drug selection (C1: n = 49, 9.23%). Significant differences were found in several causes (C7.1, C7.10, and C9.1) between the two groups. Conclusion The occurrence of DRPs in HIV treatment failure was high, contributing to treatment effectiveness and treatment safety issues.

The Effectiveness of Brain Injury Family Intervention in Improving the Psychological Well-Being of Caregivers of Patients With Traumatic Brain Injury: Protocol for a Randomized Controlled Trial.

Globally, traumatic brain injury (TBI) is recognized as one of the most significant contributors to mortality and disability. Most of the patients who have experienced TBI will be discharged home and reunited with their families or primary caregivers. The degree of severity of their reliance on caregivers varies. Therefore, the task of delivering essential care to the patients becomes demanding for the caregivers. A significant proportion of caregivers expressed considerable burden, distress, and discontentment with their lives. Therefore, it is critical to comprehend the dynamic of TBI and caregivers to optimize patient care, rehabilitation, and administration. The effectiveness of the Brain Injury Family Intervention (BIFI) program tailored for caregivers of patients with TBI has been widely proven in Western countries. However, the impact is less clear among caregivers of patients with TBI in Malaysia. This study aims to assess the effectiveness of BIFI in reducing emotional distress and burden of care, fulfilling the needs, and increasing the life satisfaction of caregivers of patients with TBI at government hospitals in Malaysia. This is a 2-arm, single-blinded, randomized controlled trial. It will be conducted at Hospital Rehabilitasi Cheras and Hospital Sungai Buloh. In total, 100 caregivers of patients with TBI attending the neurorehabilitation unit will be randomized equally to the intervention and control groups. The intervention group will undergo the BIFI program, whereas the control group will receive standard treatment. Caregivers aged ≥18 years, caring for patients who have completed >3 months after the injury, are eligible to participate. The BIFI program will be scheduled for 5 sessions as recommended by the developer of the module. Each session will take approximately 90 to 120 minutes. The participants are required to attend all 5 sessions. A total of 5 weeks is needed for each group to complete the program. Self-reported questionnaires (ie, Beck Depression Inventory, Positive and Negative Affect Schedule, Caregiver Strain Index, Satisfaction With Life Scale, and Family Needs Questionnaire) will be collected at baseline, immediately after the intervention program, at 3-month follow-up, and at 6-month follow-up. The primary end point is the caregivers' emotional distress. The participant recruitment process began in January 2019 and was completed in December 2020. In total, 100 participants were enrolled in this study, of whom 70 (70%) caregivers are women and 30 (30%) are men. We are currently at the final stage of data analysis. The results of this study are expected to be published in 2024. Ethics approval has been obtained. It is expected that the psychological well-being of the intervention group will be better compared with that of the control group after the intervention at 3-month follow-up and at 6-month follow-up. Iranian Registry of Clinical Trials IRCT20180809040746N1; https://irct.behdasht.gov.ir/trial/33286. RR1-10.2196/53692.

Pre-operative psoas muscle index, a surrogate for sarcopenia; as a predictor of post-esophagectomy complications.

Esophagectomy is the standard of care for curative esophageal cancer. However, it is associated with significant morbidity and mortality. Esophageal cancer is known to negatively affect the nutritional status of patients and many manifest cancer sarcopenia. At present, measures of sarcopenia involve complex and often subjective measurements. We assess whether the Psoas Muscle Index (PMI); an inexpensive, simple, validated method used to diagnose sarcopenia, can be used to predict adverse outcomes in patients after curative esophagectomy. Multi-centre, retrospective cohort between 2010-2020, involving all consecutive patients undergoing curative esophagectomy for esophageal cancer in University Malaya Medical Centre, Sungai Buloh Hospital, and Sultanah Aminah Hospital. The cut-off value differentiating low and normal PMI is defined as 443mm2/m2 in males and 326326mm2/m2 in females. Complications were recorded using the Clavien-Dindo Scale. There was no statistical correlation between PMI and major post-esophagectomy complications (p-value: 0.495). However, complication profile was different, and patients with low PMIs had higher 30-day mortality (21.7%) when compared with patients with normal PMI (8.1%) (p-value: 0.048). Although PMI did not significantly predict post-esophagectomy complications, low PMI correlates with higher 30-day mortality, reflecting a lower tolerance for complications among these patients. PMI is a useful, inexpensive tool to identify sarcopenia and aids the patient selection process. This alerts healthcare professionals to institute intensive physiotherapy and nutritional optimization prior to esophagectomy.

Stigma and posttraumatic growth among COVID-19 survivors during the first wave of the COVID-19 pandemic in Malaysia: a multicenter cross-sectional study.

Contracting COVID-19 can cause negative and distressing psychological sequelae, but traumatic stressors may also facilitate the development of positive psychological change beyond an individual's previous level of adaptation, known as posttraumatic growth (PTG). As a result, studies have investigated the negative effects of COVID-19 on mental health, but data on PTG among patients who have recovered from COVID-19 remains limited. This study aims to evaluate the level of PTG and its associations with stigma, psychological complications, and sociodemographic factors among COVID-19 patients 6 months post-hospitalization. A cross-sectional online survey of 152 COVID-19 patients was conducted after 6 months of being discharged from Hospital Canselor Tuanku Muhriz, MAEPS Quarantine Center, or Hospital Sungai Buloh, Malaysia. Patients completed a set of questionnaires on sociodemographic and clinical data. The Posttraumatic Growth Inventory (PTGI-SF) was used to assess the level of PTG, the Kessler Psychological Distress (K6) was used to measure the degree of psychological distress, the General Anxiety Disorder-7 (GAD-7) was used to evaluate the severity of anxiety symptoms, the Patient Health Questionnaire (PHQ-9) was used to assess the severity of depression symptoms, and the Explanatory Model Interview Catalog Stigma Scale (EMIC-SS) was used to record the degree of perceived stigma toward COVID-19. The median PTGI SF score of the respondents was 40.0 (Interquartile range 16.0). Multivariable general linear model with bootstrapping (2,000 replications) revealed factors that significantly predicted PTG, which were at the higher level of the perceived stigma score, at 37 (B = 0.367, 95% CI = 0.041 to 0.691, p = 0.026), among the Malay ethnicity (B = 12.767, 95% CI 38 = 7.541 to 17.993, p < 0.001), retirees (B = -12.060, 95% CI = -21.310 to -2.811, p = 0.011), and those with a history of medical illness (B = 4.971, 95% CI = 0.096 to 9.845, p = 0.046). Experiencing stigma contributed to patients' PTG in addition to psychosocial factors such as ethnicity, history of medical illness, and retirement.

Predictors of discontinuation of antiretroviral therapy among HIV-infected adults at Hospital Sungai Buloh: A 10-year retrospective cohort study

Predictors of discontinuation of antiretroviral therapy among HIV-infected adults at Hospital Sungai Buloh: A 10-year retrospective cohort study

Longitudinal study of olfactory dysfunction among COVID-19 patients in a single tertiary centre in Malaysia

Aim: The aim of the study was to outline the longitudinal outcomes of olfactory dysfunction amongst patients with coronavirus disease 2019 (COVID-19) in a single tertiary centre in Malaysia. Materials and methods: Adults patients who tested positive for COVID-19 via reverse transcription-polymerase chain reaction and were admitted to Hospital Sungai Buloh, Malaysia, were recruited in this study. The patients completed a questionnaire via telephone interview comprising the following details: age, sex, ethnicity, comorbidities, general and otorhinolaryngological symptoms, and onset and duration of olfactory and gustatory dysfunction. The patients with persistent olfactory and gustatory dysfunction at the time of the initial interview were followed up every 3 to 5 days until resolution. Results: A total 185 patients were included in this study out of 378 patients contacted. Ninety patients reported olfactory dysfunction symptoms, with 59 of them complaining of anosmia. The mean age of the participants was 39.52 years (age range: 18–66 years). More than half of the patients with olfactory dysfunction had no comorbidities (55.56%). Of the 90 patients with olfactory dysfunction, 66 patients (73.3%), including 40 males and 26 females, regained their olfactory function completely within 2 weeks. The remaining 24 patients were contacted after 4, 8, and 12 weeks. Ten patients (11.1%) were found to have recovered their sense of smell after one month, while 5 patients (5.56%) recovered within 2 months, and 1 patient (1.11%) recovered in 3 months. Conclusion: Complete recovery was noted in 73% of the patients within a period of 2 weeks, whereas persistence of symptoms was noted in 6 patients (6.67%) after 3 months.

Characteristics and outcomes of SARS-CoV-2 positivity in neonates born to mothers with COVID-19 in Klang Valley, Malaysia: a retrospective observational study

ObjectiveThe aim of this study was to analyze the clinical characteristics of neonates born to mothers with coronavirus disease 2019 (COVID-19), along with the incidence and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) positivity in Klang Valley, Malaysia. MethodsThe clinical records of all neonates born to mothers with COVID-19 who were admitted to Sungai Buloh Hospital, Selangor, Malaysia from October 1, 2020 to September 30, 2021 were reviewed retrospectively. Data collected included demographic details and the incidence, risk factors, and clinical outcomes of neonates with SARS-CoV-2 positivity. ResultsA total of 766 neonates from 753 mothers with COVID-19 were included. Overall, 23 (3%) neonates tested positive by nasopharyngeal swab SARS-CoV-2 PCR taken within the first 8 days of life. There were three (0.4%) confirmed and four (0.5%) probable neonatal infections acquired intrapartum, seven (0.9%) confirmed neonatal infections acquired postpartum, and nine (1.2%) cases that did not fit within the classification. The rate of preterm delivery was 25% among all neonates born to mothers with COVID-19 and 39.1% among SARS-CoV-2-positive neonates. Of the SARS-CoV-2-positive neonates, 43.5% required ventilatory support. Factors identified to have a significant association with neonate SARS-CoV-2 positivity included maternal antepartum hemorrhage (odds ratio (OR) 7.33, P = 0.014), place of delivery in a non-designated COVID-19 center (OR 7.64, P < 0.001), exposure to the mother post-delivery (OR 4.13, P = 0.014), and a higher 5-minute Apgar score (score 6–10; OR 0.20, P = 0.0037). ConclusionsThis study identified a risk of SARS-CoV-2 transmission from mothers with COVID-19 to their offspring, with infection acquired predominantly postpartum. A higher incidence of preterm delivery and ventilatory support were observed among SARS-CoV-2-positive neonates.

Assessment of Body Fat Percentage and Its Associated Factors among Hospitalized Elderly

Introduction: Elevated body fat percentage among elderly has resulted in a significant number of morbidity and mortality. Thus, this study aimed to determine the body fat percentage and its associated factors among hospitalized elderly in Klang Valley hospitals. Methods: A total of 57 subjects aged ≥ 60 years were recruited from the geriatric wards of three Klang Valley hospitals (Hospital Sungai Buloh, Hospital Tengku Ampuan Rahimah and Hospital Kuala Lumpur) using purposive and convenience sampling. A face-to-face interview and physical examination were conducted to obtain the data on socio-demographic characteristics, medical background, anthropometric measurements, total cholesterol levels, hand-grip strength, perception towards oral health, dietary assessment and malnutrition risk. The body fat percentage was assessed using a handheld bio-electrical impedance OMRON HBF-302 and compared with Gallagher’s classification of body fat percentage. A simple descriptive statistic and correlation analysis were used to analyze the body fat percentage and its associated factors. Results: Majority of hospitalized elderly (49%) had elevated body fat percentages. Weight (p≤0.0005), BMI (p≤0.0005), and malnutrition risk (p≤0.0005) were significantly associated with the body fat percentage. Meanwhile, other variables were not significantly associated with body fat percentage in hospitalized elderly. Conclusion: Weight, BMI, and malnutrition risk were found to be significantly associated with the body fat percentage. Other variables were not significantly associated. Thus, a better understanding of factors associated with body fat percentage is necessary in managing elevated body fat percentage to reduce the risk of morbidity and mortality among hospitalized elderly.

CASE SERIES OF SPONTANEOUS EXTRAPERITONEAL HEMORRHAGE IN COVID-19 PATIENTS IN MALAYSIA

Background: COVID-19 infection is associated with thrombotic events causing micro thrombosis and venous thromboembolism. Anticoagulant treatment has been shown to reduce mortality in COVID-19 cases and is routinely used. Spontaneous extraperitoneal hemorrhage (SEH), which includes retroperitoneal, iliopsoas or rectus sheath hematomas, is a known complication of anticoagulant use. Trans arterial embolization (TAE) is a safe and minimally invasive management option to control bleeding in SEH. We report 7 cases of SEH in COVID-19 patients admitted to Hospital Sungai Buloh. This case series highlights the occurrence of SEH in COVID-19 patients, its clinical and radiological manifestations and management pathways. Case presentation: All patients were on anticoagulants and presented with abdominal pain and/or swelling with sudden drop in hemoglobin. Computed tomography angiography (CTA) showed contrast extravasation indicative of active bleed. All patients proceeded with conventional transfemoral angiography with option of TAE. TAE was utilized in 6 out of 7 cases and was successful in achieving hemostasis with no procedure related complication. Conclusion: SEH should be suspected in COVID-19 patients on anticoagulants presenting with abdominal pain or drop in hemoglobin. CTA is confirmatory and TAE offers a viable and safe treatment option.

Is There a Delay in Emergency Surgical Procedures in a Designated COVID-19 Hospital? -The Hospital Sungai Buloh (Malaysia) Experience

Introduction: The global pandemic Corona Virus Disease 2019 (COVID-19) caused by Severe acute respiratory syndrome coronavirus 2 (SARS, CoV-2) is highly contagious and has driven many hospitals including Hospital Sungai Buloh (HSB) in Malaysia to become a designated hospital exclusively for COVID-19 patients only. These patients may develop complications requiring surgical consultation and intervention which have led to concerns regarding delay in the surgical management of these patients. Currently, there is a paucity of published data worldwide with regards to whether there is a delay in the time taken to perform the intended emergency procedure that has been planned by the attending surgical team. Method: This single-centered, retrospective study aims to investigate whether there is any delay in performing emergency surgical procedures during the COVID-19 pandemic in HSB from 1/3/2020 to 30/3/2021. All the cases were categorized based on recommended priority into acute emergency, emergency, and urgent. Results: There were a total of 105 patients; 5(4.8%) acute emergency cases, 22(21.0%) emergency cases, and 78 (74% cases) required an urgent intervention of which the majority had an endoscopic procedure performed i.e., 85.9% (67 cases) compared to surgery, 14.1% (11 cases). Patients in the emergency procedure category took the longest time to intervene whereby the median time taken was 548 minutes. 50% of patients in this category were delayed. Patients in the acute emergency category had delays seen in all 5 patients, with a median of 239 minutes. On the other hand, patients in the urgent category had only 10.3% of the patients who were delayed. Conclusion: From the total of 105 patients requiring emergency surgical intervention over 12 months period during the COVID-19 pandemic, the delay was seen in 24 patients (23% of cases). Multiple factors contributing to the delay have been postulated, pertaining to the implementation of the new Standard Operating Procedure (SOP) in managing COVID-19 patients in general, which needs to be verified with further study and addressed accordingly. KEYWORDS: Corona Virus Disease 2019, COVID-19 Pandemic, Emergency surgical intervention, Managing COVID-19 patients.

Isolated posterior cerebral artery dissecting aneurysm presenting as an unconventional intracerebral hemorrhage

Neurology and Clinical NeuroscienceVolume 10, Issue 2 p. 111-112 LETTER TO THE EDITOR Isolated posterior cerebral artery dissecting aneurysm presenting as an unconventional intracerebral hemorrhage Tien Lee Ong, Corresponding Author Tien Lee Ong [email protected] orcid.org/0000-0002-9804-6538 Division of Neurology, Medical Department, Sungai Buloh Hospital, Jalan Hospital, Ministry of Health, Sungai Buloh, Malaysia Correspondence Tien Lee Ong, Division of Neurology, Medical Department, Sungai Buloh Hospital, Jalan Hospital, Ministry of Health, 47000 Sungai Buloh, Selangor, Malaysia. Email: [email protected]Search for more papers by this authorYue Hui Lau, Yue Hui Lau Neurology Department, Hospital Kuala Lumpur, Ministry of Health, Kuala Lumpur, MalaysiaSearch for more papers by this authorArvin Rajadurai, Arvin Rajadurai Radiology Department, Hospital Sungai Buloh, Jalan Hospital, Ministry of Health, Sungai Buloh, MalaysiaSearch for more papers by this authorSapiah Sapuan, Sapiah Sapuan Division of Neurology, Medical Department, Sungai Buloh Hospital, Jalan Hospital, Ministry of Health, Sungai Buloh, MalaysiaSearch for more papers by this author Tien Lee Ong, Corresponding Author Tien Lee Ong [email protected] orcid.org/0000-0002-9804-6538 Division of Neurology, Medical Department, Sungai Buloh Hospital, Jalan Hospital, Ministry of Health, Sungai Buloh, Malaysia Correspondence Tien Lee Ong, Division of Neurology, Medical Department, Sungai Buloh Hospital, Jalan Hospital, Ministry of Health, 47000 Sungai Buloh, Selangor, Malaysia. Email: [email protected]Search for more papers by this authorYue Hui Lau, Yue Hui Lau Neurology Department, Hospital Kuala Lumpur, Ministry of Health, Kuala Lumpur, MalaysiaSearch for more papers by this authorArvin Rajadurai, Arvin Rajadurai Radiology Department, Hospital Sungai Buloh, Jalan Hospital, Ministry of Health, Sungai Buloh, MalaysiaSearch for more papers by this authorSapiah Sapuan, Sapiah Sapuan Division of Neurology, Medical Department, Sungai Buloh Hospital, Jalan Hospital, Ministry of Health, Sungai Buloh, MalaysiaSearch for more papers by this author First published: 28 January 2022 https://doi.org/10.1111/ncn3.12582Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume10, Issue2March 2022Pages 111-112 RelatedInformation

POS-864 OUTCOMES OF ACUTE KIDNEY INJURY REQUIRING DIALYSIS AMONGST CORONAVIRUS DISEASE 2019 (COVID-19) PATIENTS: A SINGLE CENTRE EXPERIENCE

The incidence of AKI in patients with COVID-19 have been substantially high, however, local data on long term outcomes have been lacking. Therefore, we aimed to look at such outcomes among our cohort of patients, who were admitted to Hospital Sungai Buloh, the state COVID referral center over a 1 year period.

Clinical and epidemiological characteristics of children with COVID-19 in Selangor, Malaysia

ObjectiveTo describe the clinical and epidemiological characteristics of children diagnosed with coronavirus disease 2019 (COVID-19) at Hospital Sungai Buloh, Selangor, Malaysia. MethodsA retrospective observational study was performed on children aged <12 years diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection between January 25 and December 31, 2020. A comparative analysis was undertaken between asymptomatic and symptomatic children, as well as a sub-analysis of their caretakers’ COVID-19 status. ResultsA total of 1498 children were included, 48.7% female and 51.3% male. Their mean age was 5.6 years (standard deviation 3.5 years). Overall, 82.3% were detected through contact tracing of positive family members or from the same household. Fifty-seven percent were asymptomatic. The most common symptoms reported were fever, nasal congestion/rhinorrhoea, and cough. Compared to asymptomatic children, those who were symptomatic had higher reported comorbidities, lower total white blood cell (WBC), absolute lymphocyte, and absolute neutrophil counts, raised C-reactive protein (CRP), and raised aspartate transaminase (P < 0.05). The median duration of illness was 10 days (interquartile range 3 days). Overall outcomes were good. Only 19 (8.2%) negative caretakers seroconverted prior to discharge. ConclusionsThe majority of the children in the State of Selangor experienced mild COVID-19 illness in 2020, and they did not appear to be key drivers in the transmission of the disease.

Incidence of adverse reaction of drugs used in COVID-19 management: a retrospective, observational study

BackgroundAn urgent need for coronavirus infectious disease (COVID-19) treatment has resulted in off-label drug use. Although previous studies had investigated the adverse drug reaction (ADR) of the medications for COVID-19 in their respective local settings, the safety profile in a Malaysian setting remains unknown. Our study aims to establish the incidence of ADR for drugs used in COVID-19 management in a Malaysian tertiary hospital.MethodsThis retrospective observational study enrolled patients started on drugs for COVID-19 in Sungai Buloh Hospital from 1 March 2020 to 31 May 2020. The clinical staging of COVID-19 patients was decided by the treating physician in accordance with the Clinical Management of Confirmed COVID-19 Case in Adults (Annex 2E). Suspected ADRs were evaluated with a trigger tool of pre-defined laboratory values or the adverse events listed in the registered product insert. Causality assessment was conducted when an ADR was suspected using the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) system, and only cases classified as certain, probable and possible ADR were considered. Data analysis was completed with descriptive, univariate and multivariate analysis.ResultsThe study (N = 1,080) identified 217 patients (20.1%) who experienced ADR, with 246 adverse events detected. Most events were related to the gastrointestinal (43.5%), hepatobiliary (36.2%) and cardiac (16.3%) systems. The most commonly suspected drugs were atazanavir (52.7%), chloroquine (36.8%) and lopinavir/ritonavir (34.6%). The independent risk factors of ADR were female (adjusted odds ratio (OR): 1.53; 95% CI 1.06–2.20; P = 0.024), diagnosis of COVID-19 stage 3 (adjusted OR: 2.58; 95% CI 1.20–5.55; P = 0.015) and stage 4 (adjusted OR: 4.17; 95% CI 1.79–9.73; P = 0.001), and the number of COVID-19 drugs (adjusted OR: 3.34; 95% CI 2.51–4.44; P < 0.001). Only 49 adverse events (19.9%) were manually reported by healthcare professionals, with hyperbilirubinaemia (65.3%) and QT prolongation (28.6%) most frequently reported.ConclusionMedications used in COVID-19 management had resulted in one in five patients experiencing ADR. Our study has provided an overview on incidence of ADR for off-label use of medications used in COVID-19 management, which suggests a similar safety profile when used for FDA-approved indications.

THE MENOPAUSAL, DEPRESSIVE SYMPTOMS AND RELIGIOSITY AMONG WOMEN ATTENDING THE GYNAECOLOGY CLINIC IN A PUBLIC HOSPITAL

Menopause is a normal development in women’s lives. Having depressive symptoms during the menopausal transition can be managed, and in many health conditions, religiosity may play an important role in reducing the severity. The objective of this study was to determine menopausal, depressive symptoms and religiosity among women attending the Gynaecology Clinic in a Public Hospital. A cross-sectional study was done at Hospital Sungai Buloh involving 232 women aged 40-60 years from January 2020 to March 2020. The Menopause Rating Scale (MRS), the Centre for Epidemiology Studies-Depression Scale-Revised (CESD-R), the Duke Religious Index (DUREL) and socio-demographic data were used as research tools in this study. The respondents were categorised as premenopausal (n=98, 42.2%), perimenopausal (n=81, 34.9%) and postmenopausal (n=53, 22.8%). The highest percentage of menopausal symptoms were muscle discomfort (56.5%), sleeping problems and lethargy (54.3%). The prevalence of depressive symptoms was 19.2%, and the results showed that unmarried women were more depressed compared to married women (p&lt;0.05). The overall religiosity level of respondents was high (23.09±2.52). The logistic regression analysis showed that as urogenital problems arise, their depressive symptoms will also increase (p&lt;0.05). Women who are transitioning to menopause should be assessed continuously for the severity of urogenital problems as it can impact their psychological and emotional well-being, and depressive symptoms should be assessed thoroughly especially among unmarried women.

The Sungai Buloh experience: A retrospective study in olfactory and gustatory disturbance in COVID-19

Introduction: Olfactory and gustatory disturbance has been recognized as one of the COVID-19 symptoms. The prevalence of the symptoms may vary between region globally and multiple factors may have contributed to the development of the symptoms. Objective: To identify the prevalence of olfactory and gustatory disturbance in patients with COVID-19 in Sungai Buloh centres. Methods: This retrospective study, conducted for a month – April/May 2020, recruited 201 COVID-19 patients from Hospital Sungai Buloh (HSB), National Leprosy Control Centre (NLCC), and Institut Latihan Kejururawatan Kebangsaan Malaysia (ILKKM) who met the inclusion criteria. Socio-clinical data were collected from ‘ehis’ electronic system database and anosmia clerking sheet, designed for the study. Statistical analyses were performed using IBM-SPSS statistical software version 26. Results: This study reported 14.9% of patients diagnosed with COVID-19 experienced olfactory and/or gustatory disturbances, where the mean age is 33 years, and patients predominantly male (70%) and asymptomatic of COVID-19 symptoms (70%). Some patients (4.5%) had olfactory and/or gustatory disturbance in the absence of other symptoms, and 10.4% reported olfactory and/or gustatory disturbances with other COVID-19 symptoms. Logistic regression showed an association between developments of olfactory and/or gustatory disturbances with symptomatic of COVID-19 symptoms, smoking status, and nationality. Conclusion: New onset of olfactory and/or gustatory disturbances during the COVID-19 pandemic is a good screening tool for early detection of COVID-19 in the absence of other symptoms. Patients who are symptomatic of COVID-19 symptoms, smoker and Malaysian may have a higher risk of developing olfactory and/or gustatory disturbances in COVID-19.

Recommendations on Otorhinolaryngology Procedural-Based Services During COVID-19 Pandemic

The current COVID-19 pandemic has forced many clinical disciplines to evolve to function safely and still provide the necessary care. Otorhinolaryngology (ORL) is a field that has been greatly affected by this highly transmissible viral pathogen. Aerosolizing procedures, proximity examination and other common procedures must be revamped to suit current time. The usual norm ORL procedures need also be altered to incorporate safeguards to protect both patient and healthcare workers. This recommendation for current practices aims to give a practical approach to modify current practices to maintain safety during the pandemic. These recommendations are the consensus amongst ORL practitioners in Hospital Sungai Buloh which is the designated COVID-19 centre for Malaysia’s central region and is currently being practised.

Improved Aedes/dengue field surveillance using Gravid Oviposition Sticky trap and dengue NS1 tests: Epidemiological, entomological outcomes and community acceptance

The aim of this study is to investigate the feasibility and outcomes of using Gravid Oviposition Sticky (GOS) trap and dengue NS1 antigen tests for indoor and outdoor dengue/Aedes surveillance in the field. A one-year community-based study was carried out at Sungai Buloh Hospital Quarters, Selangor, Malaysia. GOS traps were first placed outdoors in three apartment blocks (Anggerik, Bunga Raya and Mawar). Beginning 29th week of the study, indoor traps were set in two apartment units on every floor in Anggerik. All female Aedes mosquitoes caught were tested for the presence of dengue NS1 antigen. Dengue seroprevalence and knowledge, attitude and practices on dengue prevention of the community and their reception to the surveillance approach were also assessed. Dengue-positive mosquitoes were detected at least 1 week before a dengue onset. More mosquitoes were caught indoors than outdoors in block Anggerik, but the total number of mosquitoes caught in all 3 blocks were similar. There was a significant difference in distribution of Ae. aegypti and Ae. albopictus between the 3 blocks. 66.1% and 3.4% of the community were positive for dengue IgG and IgM, respectively. Most respondents think that this surveillance method is Good (89%) and support its use nationwide. Dengue case ratio in the study apartment blocks decreased from year 2018 to 2019. This study demonstrated the practicality of performing proactive dengue/Aedes surveillance inside apartment units using the GOS traps. This surveillance method can be performed with immediate result output in the field.

Methanol poisoning in Klang Valley, Malaysia: Autopsy case series

IntroductionDespite its rarity and sporadic occurrence, methanol poisoning may result in devastating consequences to the victims including death. MethodWe report a series of methanol poisoning cases following an outbreak in Klang Valley, Malaysia. Victims were presented as either brought-in-dead or died during hospitalization. Medico-legal autopsy was performed at the Department of Forensic Medicine, Hospital Sungai Buloh in all cases. We sought to establish epidemiology, survival period, level of methanol, autopsy, and neuropathology findings of the cases. ResultsSixteen deaths from methanol poisoning were retrospectively reviewed during a two-month period from September to October 2018. Majority of cases (81 %) were pronounced dead in hospital. Male victims predominated and more than 90 % were young productive adults. Ninety percent of the victims were immigrants. Intoxication symptoms developed within hours of ingestion and almost half of fatalities occurred within 3 days. Significant levels of methanol were detected from blood and other bodily fluids. Autopsy findings of early deaths were minimal and non-specific while delayed death cases within seven days to two weeks showed several morphological changes in the brain. Almost all cellular constituents of the nervous system were affected. Neuronal degeneration predominated in all lobes while axonal dystrophy was less commonly detected within the temporal region. ConclusionMany methanol poisoning victims became symptomatic within 24 h of ingestion. The severity of neuropathological changes correlated well with the period of survival which warrants in-depth studies particularly within areas of brain cellular response towards different levels of methanol toxicity.

Survival and Prognostic Factors of HIV-positive Patients after Antiretroviral Therapy Initiation at a Malaysian Referral Hospital.

Background:Antiretroviral therapy (ART) has transformed the management of human immunodeficiency virus (HIV) infection and significantly improved survival rates, but there is lack of such survival data from Malaysia.Objective:The objective was to determine the survival rates and prognostic factors of survival in HIV-infected adults treated with ART in Malaysia.Materials and Methods:This retrospective cohort study considered all HIV-positive adult patients registered in Sungai Buloh Hospital, a major referral center in Malaysia, between January 1, 2007 and December 31, 2016. Then, patients were selected through a systematic sampling method. Demographic, clinical, and treatment data were extracted from electronic medical records. Person–years at risk and incidence of mortality rate per 100 person–years were calculated. The Kaplan–Meier survival curve and log-rank test were used to compare the overall survival rates. Cox proportional hazards regression was applied to determine the prognostic factors for survival.Results:A total of 339 patients were included. The estimated overall survival rates were 93.8%, 90.4%, 84.9%, and 72.8% at 1, 3, 5, and 10 years, respectively, from ART initiation. The results of multiple Cox proportional hazard regression indicated that anemic patients were at a 3.76 times higher risk of mortality (95% confidence interval [CI]: 1.97–7.18; P < 0.001). The hazard risk was 2.09 times higher for HIV patients co-infected with tuberculosis (95% CI: 1.10, 3.96; P = 0.024).Conclusion:The overall survival rates among HIV-infected adults in this study are higher than that from low-income countries but lower than that from high-income countries. Low baseline hemoglobin levels of <11 g/dL and tuberculosis co-infection were strong prognostic factors for survival.