ORCID Profile
0000-0002-0380-1335
Current Organisations
Tsinghua University
,
Faculty of Public Health, Kuwait University
,
International Medical University
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Publisher: Informa UK Limited
Date: 08-2019
DOI: 10.2147/CEOR.S209108
Publisher: Elsevier BV
Date: 2007
DOI: 10.1016/J.ANNEMERGMED.2006.08.019
Abstract: The trauma services provided by 6 hospitals operating at 2 levels of care (4 secondary or district general hospitals and 2 tertiary care hospitals) in Malaysia are compared in terms of mortality and disability for direct admissions to emergency departments to test the hypothesis that care at a tertiary care hospital is better than at a district general hospital. All cases were recruited prospectively for 1 year. The hospitals were purposefully selected as typical for Malaysia. There are 3 primary outcome measures: death, musculoskeletal impairment, and disability at discharge. Adjustment was made for potential covariates and within-hospital clustering by using multivariable random-effects logistic regression analysis. For direct admissions, logistic-regression-identified odds of dying were associated with older age (>55 years), odds ratio (OR) 1.9 (95% confidence interval [CI] 1.3 to 2.8) head injury, OR 2.7 (95% CI 1.9 to 3.9) arrival by means other than ambulance, OR 0.6 (95% CI 0.4 to 0.8) severe injuries (Injury Severity Score >15) at a district general hospital, OR 45.2 (95% CI 27.0 to 75.7) severe injuries at a tertiary care hospital, OR 11.2 (95% CI 7.3 to 17.3) and admission to a tertiary care hospital compared to a district general hospital if severely injured (Injury Severity Score >15), OR 0.2 (95% CI 0.1 to 0.4). Admission to a tertiary care hospital was associated with increased odds of disability (OR 1.9 95% CI 1.5 to 2.3) and musculoskeletal impairment (OR 3.5 95% CI 2.7 to 4.4) at discharge. Care at a tertiary care hospital was associated with reduced mortality (by 83% in severe injuries), but with a higher likelihood of disability and impairment, which has implications for improving access to trauma services for the severely injured in Malaysia and other low- and middle-income settings.
Publisher: Elsevier BV
Date: 2020
Publisher: Scientific Scholar
Date: 10-2013
Abstract: Context: Poststroke care in developing countries is inundated with poor concordance and scarce specialist stroke care providers. A primary care‑driven health service is an option to ensure optimal care to poststroke patients residing at home in the community. Aims: We assessed outcomes of a pilot long‑term stroke care clinic which combined secondary prevention and rehabilitation at community level. Settings and Design: A prospective observational study of stroke patients treated between 2008 and 2010 at a primary care teaching facility. Subjects and Methods: Analysis of patients was done at initial contact and at 1‑year post treatment. Clinical outcomes included stroke risk factor(s) control, depression according to Patient Health Questionnaire (PHQ9), and level of independence using Barthel Index (BI). Statistical Analysis Used: Differences in means between baseline and post treatment were compared using paired t‑tests or Wilcoxon‑signed rank test. Significance level was set at 0.05. Results: Ninety‑one patients were analyzed. Their mean age was 62.9 [standard deviation (SD) 10.9] years, mean stroke episodes were 1.30 (SD 0.5). The median interval between acute stroke and first contact with the clinic 4.0 (interquartile range 9.0) months. Mean systolic blood pressure decreased by 9.7 mmHg (t = 2.79, P = 0.007), while mean diastolic blood pressure remained unchanged at 80mmHg (z = 1.87, P = 0.06). Neurorehabilitation treatment was given to 84.6% of the patients. Median BI increased from 81 (range: 2−100) to 90.5 (range: 27−100) (Z = 2.34, P = 0.01). Median PHQ9 scores decreased from 4.0 (range: 0−22) to 3.0 (range: 0−19) though the change was not significant (Z= −0.744, P = 0.457). Conclusions: Primary care‑driven long‑term stroke care services yield favorable outcomes for blood pressure control and functional level.
Publisher: Springer Science and Business Media LLC
Date: 13-01-2017
Publisher: Informa UK Limited
Date: 2012
DOI: 10.1586/ERI.11.155
Abstract: Natural disasters may lead to infectious disease outbreaks when they result in substantial population displacement and exacerbate synergic risk factors (change in the environment, in human conditions and in the vulnerability to existing pathogens) for disease transmission. We reviewed risk factors and potential infectious diseases resulting from prolonged secondary effects of major natural disasters that occurred from 2000 to 2011. Natural disasters including floods, tsunamis, earthquakes, tropical cyclones (e.g., hurricanes and typhoons) and tornadoes have been secondarily described with the following infectious diseases including diarrheal diseases, acute respiratory infections, malaria, leptospirosis, measles, dengue fever, viral hepatitis, typhoid fever, meningitis, as well as tetanus and cutaneous mucormycosis. Risk assessment is essential in post-disaster situations and the rapid implementation of control measures through re-establishment and improvement of primary healthcare delivery should be given high priority, especially in the absence of pre-disaster surveillance data.
Publisher: Informa UK Limited
Date: 18-10-2013
Publisher: American Physical Society (APS)
Date: 22-03-2021
Publisher: Elsevier BV
Date: 09-2019
Publisher: MDPI AG
Date: 10-01-2018
DOI: 10.3390/EN11010168
Publisher: Elsevier BV
Date: 10-2017
Publisher: Cold Spring Harbor Laboratory
Date: 11-01-2019
DOI: 10.1101/518225
Abstract: The main aim of this study is to identify the direct cost and economic burden of hypoglycaemia among patients with Type II diabetes mellitus in Malaysia. The incurred cost for hypoglycaemia among patients admitted to University Kebangsaan Malaysia Medical Centre (UKMMC) was explored from a cross sectional study. 20-79 year patients discharged between Jan 2010 to Sept 2015 and having an ICD-10 code of hypoglycaemia as a primary diagnosis in the casemix database were included in the study. Costing analysis from the perspective of health providers was completed using step-down approach. Data related to hospital cost were collected using hospital-costing template, based on three levels of cost centres. The costing data from UKMMC was used to estimate the national burden of hypoglycaemia among type II diabetics for the whole country. Of 244 diabetes patients admitted primarily for hypoglycaemia to UKMMC, 52% were female and 88% were over 50 years old. The cost increased with severity. Managing a hypoglycaemic case requires 5 days (median) of inpatient stay with a range of 2-26 days and costs RM 9,083 (USD 2,323). 30% of the cost came from the ward services cost (final cost centre), 16% of the cost came from ICU services and 15% from pharmacy services(secondarylevel cost centres). Based on the prevalence of hypoglycaemia-related admissions of 3.2%, the total cost of care for hypoglycaemia among adult diabetes in Malaysia is estimated to be RM 117.4 (USD 30.0) million, which is translated as 0.5% of Ministry of Health budget. Hypoglycaemia imposes substantial economic impact even without the direct and indirect cost incurred by patients and other cost of complications. Proper diabetic care and health education is needed in diabetic management to reduce episodes of hypoglycaemia.
Publisher: Elsevier BV
Date: 12-2019
Publisher: Wiley
Date: 28-06-2011
DOI: 10.1111/J.1440-1843.2011.01975.X
Abstract: Although there are growing concerns about the global epidemic of asbestos-related diseases (ARD), the current status of asbestos use and ARD in Asia is elusive. We conducted a descriptive analysis of available data on asbestos use and ARD to characterize the current situation in Asia. We used descriptive indicators of per capita asbestos use (kilograms per capita per year) and age-adjusted mortality rates (AAMR, persons per million population per year) by country and for the region, with reference to the world. The proportion of global asbestos use attributed to Asia has been steadily increasing over the years from 14% (1920-1970) to 33% (1971-2000) to 64% (2001-2007). This increase has been reflected in the absolute level of per capita use across a wide range of countries. In contrast, 12 882 ARD deaths have been recorded cumulatively in Asia, which is equivalent to only 13% of the cumulative number of ARD deaths in the world during the same period. The highest AAMR were recorded in Cyprus (4.8), Israel (3.7) and Japan (3.3), all of which have banned asbestos use. There is a paucity of information concerning the current situation of ARD in Asia. The marked increase in asbestos use in Asia since 1970, however, is likely to trigger a surge of ARD in the immediate decades ahead.
Publisher: Springer Science and Business Media LLC
Date: 19-12-2018
DOI: 10.1038/S41598-018-36154-0
Abstract: Data on post stroke outcomes in developing countries are scarce due to uncoordinated healthcare delivery systems. In Malaysia, the national stroke clinical practice guideline does not address transfer of care and longer term post stroke care beyond tertiary care. Hence, post stroke care delivery may be delivered at either tertiary or primary care facilities. This study aimed at describing patients’ characteristics and outcomes of post stroke care delivered by the primary care teams at public primary care healthcentres across Peninsular Malaysia. Multi staged s ling was done to select public primary care health centres to recruit post stroke patients. At each health centre, convenience s ling was done to recruit adult patients (≥18 years) who received post stroke care between July-December 2012. Baseline measurements were recorded at recruitment and retrospective medical record review was done simultaneously, for details on medical and / or rehabilitation treatment at health centre. Changes in the measurements for post stroke care were compared using paired t-tests and Wilcoxon Rank test where appropriate. Total of 151 patients were recruited from ten public primary care healthcentres. The mean age at stroke presentation was 55.8 ± 9.8 years. Median duration of follow up was 2.3 (IQR 5.1) years. Majority co-resided with a relative (80.8%), and a family member was primary caregiver (75.%). Eleven percent were current smokers. Almost 71.0% of patients achieved BP ≤ 140/90 mmHg. Only 68.9% of the patients had been referred for neurorehabilitation. Percentage of recorded data was highest for blood pressure (88.1%) while lowest was HbA1c (43.0%). For clinical outcomes, systolic and diastolic blood pressure, triglyceride level and calculated GFR (eGFR) showed statistically significant changes during follow up (p 0.05). Post stroke care at public primary care healthcentres showed benefits in stroke risk factors control (i.e. hypertension and dyslipidaemia) but deterioration in renal function. A more structured coordination is needed to optimise post stroke care beyond acute phase management for patients who reside at home in the community.
Publisher: Elsevier BV
Date: 06-2019
Publisher: Australasian College of Health Service Management
Date: 25-07-2022
DOI: 10.24083/APJHM.V17I2.1455
Abstract: Introduction: The clinical pathway (CP) is one of the most recommended tools for ensuring the best quality of care and has been proven to reduce the cost and time spent in hospital. The development of a CP for influenza is crucial, especially for the elderly, as they are vulnerable to influenza-related complications. The main aim of this study was to provide a comprehensive protocol for each component of influenza management among the elderly in Malaysia. Methods: An expert group meeting was conducted involving family medicine specialists, public health specialists, geriatricians, respiratory physicians and infectious disease physicians. The CP was designed following a 6-step protocol: 1) Selection of expert panel, 2) discussion and information gathering, 3) development of CP draft, 4) refinement of CP draft, 5) implementation of CP, and 6) finalisation of CP. The CP for influenza was designed based on service type and disease severity. Results: The panel described both outpatient and inpatient CPs for managing elderly patients with influenza. The outpatient CP covered mild and moderate influenza cases, while the inpatient CP addressed the management of moderate and severe influenza. The estimated length of hospital stay for moderate and severe influenza cases with pneumonia was 6 and 14 days, respectively. Conclusions: The CP for influenza supports existing treatment according to illness severity leveraged on current clinical practice guidelines and the best-care practices in primary and tertiary care settings. Continuous use of the CP is required to assess its effectiveness, thereby enabling optimisation of the healthcare process in influenza treatment.
Publisher: Public Library of Science (PLoS)
Date: 25-10-2019
Publisher: University of Queensland Library
Date: 2020
Location: United Kingdom of Great Britain and Northern Ireland
Location: China
No related grants have been discovered for Syed Mohamed Aljunid.