ORCID Profile
0000-0003-3600-1315
Current Organisation
Universiti Putra Malaysia
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Publisher: Elsevier BV
Date: 10-2023
Publisher: Wiley
Date: 03-05-2022
DOI: 10.1111/JPC.16007
Abstract: Penicillin allergy accounts for the majority of all reported adverse drug reactions in adults and children. Foregoing first‐line antibiotic therapy due to penicillin allergy label is associated with an increased prevalence of infections by resistant organisms and longer hospitalisation. Clinician awareness of allergy assessment, referral indications, management of allergy and anaphylaxis is therefore vital but globally lacking. We aim to assess the knowledge of penicillin allergy, assessment and management in Western Australian health professionals. An anonymous survey was distributed to pharmacists, nurses and physicians within Western Australian paediatric and adult Hospitals, Community and General Practice. In total, 487/611 were completed and included in the statistical analysis. Only 62% (301/487) of respondents routinely assessed for patient medication allergies. Of those who assessed allergy, 9% (28/301) of respondents met the Australian standards for allergy assessment. Only 22% (106/487) of participants correctly cited all indications for management with adrenaline in anaphylaxis to antibiotics and 67% (197/292) of physicians rarely or never referred to an allergy service. Paediatric clinicians had an increased understanding of allergy assessment and anaphylaxis management. Recent penicillin allergy education within a 5‐year period led to significant improvements in allergy knowledge. Overall, knowledge, assessment and management of penicillin allergies among practitioners in Western Australia are currently inadequate in adults and paediatric clinicians to provide safe and effective clinical care. The implementation of a targeted education program for WA health professionals is urgently required and is expected to improve clinician knowledge and aid standardised penicillin assessment (de‐labelling) practices.
Publisher: Wiley
Date: 28-02-2021
DOI: 10.1111/PAN.14153
Abstract: Reasons for elective surgery cancelations and their impact vary from one institution to another. Cancelations have emotional and financial implications for patients and their families. Our service has a particularly broad and geographically erse patient population hence, we sought to examine these impacts in our service. We identified families with procedural cancelations and administered a telephone questionnaire. Survey items included the reason for and timing of cancelation, how the family was informed, the mode of transport and distance traveled to the hospital, associated leave from work, expenses, whether the child was required to fast, missed school, as well as the child's and parent's emotional responses to the cancelation, along with overall parental satisfaction with how the cancelation was handled. During our study period, a total of 7870 procedures were booked. 6734 (86%) of these were completed and 1136 (14%) were canceled, with 6% canceled on the day of surgery. In 750 (66%) of these cancelations, families were successfully contacted by telephone and agreed to participate. Of these 305 (41%) cancelations were family‐initiated and 444 (59%) were hospital‐initiated, with these hospital‐initiated cancelations occurring closer to scheduled surgery. The most common cause of cancelation was that the child could not undergo the procedure due to illness (22%) or being unable attend the hospital (14%). The greatest disruption to families and children occurred when procedures were canceled late, particularly when the cancelation occurred on the day of the planned procedure.
Publisher: Wiley
Date: 25-05-2022
DOI: 10.1111/PAN.14481
Abstract: Monitoring children's recovery postoperatively is important for routine care, research, and quality improvement. Although telephone follow‐up is common, it is also time‐consuming and intrusive for families. Using SMS messaging to communicate with families regarding their child's recovery has the potential to address these concerns. While a previous survey at our institution indicated that parents were willing to communicate with the hospital by SMS, data on response rates for SMS‐based postoperative data collection is limited, particularly in pediatric populations. We conducted a feasibility study with 50 completed pain profiles obtained from patients at Perth Children's Hospital to examine response rates. We collected and classified daily average pain (0–10 parent proxy score) on each day after tonsillectomy until pain‐free for two consecutive days. We enrolled 62 participants and recorded 50 (81%) completed pain profiles, with 711 (97.9%) of 726 requests for a pain score receiving a response. Two families (3%) opted out of the trial, and 10 (16%) were lost to follow‐up. Responses received were classified automatically in 92% of cases. No negative feedback was received, with a median (range) satisfaction score of 5 on a 5‐point Likert scale (1 = very unhappy, 5 = very happy). This methodology is likely to generalize well to other simple clinical questions and produce good response rates in further similar studies. We expect SMS messaging to permit expanded longitudinal data collection and broader investigation into patient recovery than previously feasible using telephone follow‐up at our institution.
Publisher: Wiley
Date: 20-12-2021
DOI: 10.1111/PAN.14377
Abstract: Pediatric surgery cases are increasing worldwide. Within pediatric anesthesia, perioperative respiratory adverse events are the most common precipitant leading to serious complications. They can have intraoperative impact on the surgical procedure itself, lead to premature case termination and in addition may have postoperative impact resulting in longer hospitalization stays and costs. Although most perioperative respiratory adverse events can be promptly detected and managed, and will not lead to any sequelae, the risk of life‐threatening progression remains. The incidence of respiratory adverse events increases in children with comorbid respiratory and/or nonrespiratory illnesses. Optimized perioperative patient care, risk‐stratified care level choice, and practitioners with appropriate training allow for risk mitigation. This review will discuss patient and surgical risk factors with a focus on common patient comorbid illnesses and review scoring systems to quantify risk.
Publisher: Wiley
Date: 17-10-2022
DOI: 10.1111/PAN.14564
Abstract: Consumer‐driven research is increasingly being prioritized. Our aim was to partner with consumers to identify the top 10 research priorities for pediatric anesthesia and perioperative medicine. The ACORN (Anesthesia Consumer Research Network) was formed to collaborate with children and families across Australia. A prospective online survey was developed to generate research ideas from consumers. The survey was developed in Qualtrics, a survey research platform. Consumers were invited to participate through poster advertising, social media posts, via consumer networks at participating hospitals and in addition 35 national consumer atient representative organizations were approached. We also conducted a similar idea generating survey for clinicians through email invitation and via Twitter. A second round of surveys was conducted to prioritize the long list of research questions and a shortlist of priorities developed. A single consensus meeting was held, and a final consensus list of top 10 priorities emerged. A total of 281 research ideas were submitted between 356 consumers in the idea generating survey and from four consumer atient representative groups. Seventy‐five clinicians responded to the clinician idea generation survey. This was consolidated into 20 research ideas/themes for the second survey for each group. 566 responses were received to the consumer prioritization top 10 survey and 525 responses to the clinician survey. The consensus meeting produced the final 10 consumer research priorities. This study has given Australian consumers the opportunity to shape the anesthesia and perioperative medicine research agenda for pediatric patients both nationally and internationally.
Publisher: Wiley
Date: 12-09-2021
DOI: 10.1111/PAN.14288
Publisher: Wiley
Date: 16-12-2021
DOI: 10.1111/PAN.14376
Abstract: Perioperative respiratory adverse events are the most common cause of critical events in children undergoing anesthesia and surgery. While many risk factors remain unmodifiable, there are numerous anesthetic management decisions which can impact the incidence and impact of these events, especially in at‐risk children. Ongoing research continues to improve our understanding of both the influence of risk factors and the effect of specific interventions. This review discusses anesthesia risk factors and outlines strategies to reduce the rate and impact of perioperative respiratory adverse events with a chronologic based inquiry into anesthetic management decisions through the perioperative period from premedication to postoperative disposition.
Publisher: Wiley
Date: 11-02-2021
DOI: 10.1111/PAN.14134
Publisher: Universitas Airlangga
Date: 30-01-2023
DOI: 10.20473/JKL.V15I1.2023.16-26
Abstract: Introduction: Jakarta has recorded heightened air pollution for years, and particulate matter (PM10) is one of the pollutants that could bring health burden in population. This study described the distribution of PM10 as well as analysed the correlation with meteorological parameters during 2020–2021 in Jakarta Province. Methods: Air quality standard index daily data from January 1st 2020 to March 31st 2021 was retrieved from the official data portal (data.jakarta.go.id/). The Spearman Rank correlation was employed to understand the correlation between PM10 Index with meteorological factors. Autoregressive Integrative Moving Average (ARIMA) model was constructed and Akaike Information Criterion (AIC) selected the model. Cross-correlation analysis explored the association between PM10 with meteorological parameters at multiple time lags. Results and Discussion: PM10 Index started to increase in April 2020 and reached its peak in August 2020. PM10 was positively correlated with temperature (p-value .05, R2: 0.134), but it was negatively correlated with humidity and wind speed (p-value .05, R2: -0.392 and -0.129). The high cross-correlation coefficients were found between PM10 and temperature at lag 0, humidity at lag 1 and wind speed at lag 1 (rho: 0.42, -0.38 and -0.24). The time series model ARIMA with parameter (p,d,q) (1,1,1) describes the fluctuation of PM10 index data with AIC 3552.75. Conclusion: PM10 concentration in Jakarta is significantly correlated with meteorological factors. The implementation of social restriction in Jakarta need to be supported by pollution control in the neighbouring areas in order to be able to reduce PM10 pollution level.
Publisher: Wiley
Date: 29-11-2022
DOI: 10.1111/PAN.14341
Abstract: When performing computerized tomography chest imaging in children, obtaining high quality, motion‐free images is important in the accurate diagnosis of underlying pathology. General anesthesia is associated with the development of atelectasis, which can impair accurate diagnosis by obscuring or altering the appearance of the lung parenchyma or airways. Recruitment maneuvers, performed by anesthesiologists, can be used to effectively re‐expand atelectatic lung. The computerized tomography chest imaging in 44 children aged between 2 months and 7 years, undergoing serial imaging for monitoring of cystic fibrosis, were reviewed and graded for atelectasis. The first scan performed on each child was performed with a supraglottic airway device and a non‐standardized recruitment maneuver. The second scan on each child was performed with a cuffed endotracheal tube and a standardized recruitment maneuver. When a supraglottic airway device and a non‐standardized recruitment maneuver were used, 77% of patients demonstrated atelectasis of any degree on their computerized tomography chest imaging, compared with only 39% when a cuffed endotracheal tube and standardized recruitment maneuver were used. The percentage of computerized tomography chest scans that were scored acceptable (with either a total combined lung atelectasis score of 0 or 1) improved from 37% to 75% when a cuffed endotracheal tube and standardized recruitment maneuver were used. In particular, the mean atelectasis score for both lungs improved from 2.91 (SD ± 2.6) to 1.11 (SD ± 1.9), with a mean difference of 1.8 (95% CI 0.82–2.77 p : .0004). The use of a cuffed endotracheal tube and a standardized recruitment maneuver is an effective way to reduce atelectasis as a result of general anesthesia. Anesthesiologists can actively contribute toward improved image quality through their choice of airway and recruitment maneuver.
Publisher: Wiley
Date: 18-04-2021
DOI: 10.1111/PAN.14187
Abstract: A previous cohort of adenotonsillectomy patients at our institution demonstrated moderate‐severe post‐tonsillectomy pain scores lasting a median (range) duration of 6 (0–23) days and postdischarge nausea and vomiting affecting 8% of children on day 1 following surgery. In this subsequent cohort, we evaluate the impact of changes to our discharge medication and parental education on post‐tonsillectomy pain and recovery profile. In this follow‐on, prospective observational cohort study, all patients undergoing tonsillectomy at our institution during the study period were discharged with standardized analgesia. Parents received a revised education package and a medication diary which were not provided to the previous cohort. Pain scores, rates of nausea and vomiting, medication usage and unplanned representation rates were collected by telephone from parents. Sixty‐nine patients were recruited. Moderate‐severe pain lasted a median (range) of 5 (0–12) days. Twenty‐nine (42%) had pain scores ≥4/10 beyond postoperative day 7. By postoperative day 5, only 37 (53%) parents continued to administer regular analgesia. The median number of oxycodone doses used was 5 (0–22), and only 28 (41%) parents had disposed of leftover oxycodone within 1 month of surgery. Twenty‐four (35%) patients experienced nausea or vomiting postdischarge. The median (range) time for return to normal activities was 6 (0–14) days. Thirty‐two/sixty‐nine (46%) patients had unplanned medical representations. Most occurred between postoperative day 5 and 7. Pain contributed to 16 (35%) representations. Despite extensive changes to our discharge protocols parents continued to report a prolonged period of pain, post operative nausea and vomiting, and behavioral changes. Further work is required to examine barriers to compliance with simple analgesia and education in appropriate methods of opioid disposal.
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.CHEMOSPHERE.2016.09.051
Abstract: In recent years, environmental concerns over ultra-trace levels of steroid estrogens concentrations in water s les have increased because of their adverse effects on human and animal life. Special attention to the analytical techniques used to quantify steroid estrogens in water s les is therefore increasingly important. The objective of this review was to present an overview of both instrumental and non-instrumental analytical techniques available for the determination of steroid estrogens in water s les, evidencing their respective potential advantages and limitations using the Need, Approach, Benefit, and Competition (NABC) approach. The analytical techniques highlighted in this review were instrumental and non-instrumental analytical techniques namely gas chromatography mass spectrometry (GC-MS), liquid chromatography mass spectrometry (LC-MS), enzyme-linked immuno sorbent assay (ELISA), radio immuno assay (RIA), yeast estrogen screen (YES) assay, and human breast cancer cell line proliferation (E-screen) assay. The complexity of water s les and their low estrogenic concentrations necessitates the use of highly sensitive instrumental analytical techniques (GC-MS and LC-MS) and non-instrumental analytical techniques (ELISA, RIA, YES assay and E-screen assay) to quantify steroid estrogens. Both instrumental and non-instrumental analytical techniques have their own advantages and limitations. However, the non-instrumental ELISA analytical techniques, thanks to its lower detection limit and simplicity, its rapidity and cost-effectiveness, currently appears to be the most reliable for determining steroid estrogens in water s les.
Publisher: Wiley
Date: 24-11-2022
DOI: 10.1111/PAN.14335
Abstract: General anesthesia is associated with development of pulmonary atelectasis. Children are more vulnerable to the development and adverse effects of atelectasis. We review the physiology and risk factors for the development of atelectasis in pediatric patients under general anesthesia. We discuss the clinical significance of atelectasis, the use and value of recruitment maneuvers, and other techniques available to minimize lung collapse. This review demonstrates the value of a recruitment maneuver, maintaining positive end‐expiratory pressure (PEEP) until extubation and lowering FiO 2 where possible in the daily practice of the pediatric anesthetist.
Publisher: Wiley
Date: 21-11-2021
DOI: 10.1111/PAN.14334
Abstract: Sedation and anesthesia are widely used to relieve pain and ensure cooperation during elective diagnostic and medical procedures in the pediatric population. However, there is currently limited evidence about the recovery trajectory following deep sedation or general anesthesia for such procedures in children. The primary aim was to describe the severity and duration of pain, nausea, and vomiting after common diagnostic and medical procedures. Secondary outcomes include return to baseline functioning and incidence of medical re‐presentation. Recruitment was achieved postprocedurally by telephone interview with parents or legal guardians of patients who underwent botox injection, bronchoscopy, either or both a colonoscopy or upper gastrointestinal endoscopy, or MRI scan. Daily pain scores, nausea and vomiting, administration of at‐home analgesia, and any adverse events requiring medical attention were obtained. Children were followed until pain completely resolved and baseline activity resumed. A total of 307 patients were included (50 botox injection, bronchoscopy and MRI 48 colonoscopy, 58 upper gastrointestinal endoscopy, 51 colonoscopy plus upper gastrointestinal endoscopy). Parental‐rated pain scores peaked on day of procedure across all groups and decreased over time, with most children resuming normal activity within 1 day postprocedure. Pain was mostly mild and resolved quickly in botox injection (10% moderate to severe and 22% mild), bronchoscopy (8% and 10%, respectively), and MRI (2% mild) patients. Combined upper gastrointestinal endoscopy and colonoscopy was associated with greatest pain severity (29% moderate to severe and 20% mild). Highest rates of nausea and/or vomiting were observed in colonoscopy (23%), upper gastrointestinal endoscopy (28%), and combined procedure groups (20%). At‐home simple analgesia was administered in 21% of patients. Unplanned medical re‐presentations were infrequent across all groups. This study demonstrates that the recovery trajectory following procedural sedation and anesthesia is short, with minimal requirement for additional medical attention. These findings will aid in alleviating parental anxiety and encourage utilization of regular simple analgesia.
Publisher: Wiley
Date: 28-11-2023
DOI: 10.1111/PAN.14603
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.CHEMOSPHERE.2022.134026
Abstract: Microplastics have become a global concern, and soil acts as a major sink for plastic pollution. Due to rapid development of soil microplastics research, various analysis methods have been developed, but require proper consistency and standard procedures. The objective of this study was to appraise a quality assessment concerning soil microplastics from a methodological perspective. Nine studies were selected for the quality assessment exercise based on methodological investigations on soil microplastics and were evaluated based on the adapted Criteria for Reporting and Evaluating Ecotoxicity Data (CRED) method. The highest score obtained by an in idual study was 21 while the lowest was 14, leaving a wide score gap which indicated inconsistency amongst the studies. Criterion with the highest average score of 2.0 was obtained for s le size and data reporting. The lowest average score of 0.89 was for the negative control. In conclusion, the total average scores for all eleven criteria were 1.56. Current quality assessment perceived that there was room for improvement and betterment of quality assurance for studies on microplastics and a form of guideline on methodological aspects of soil microplastics studies. It was suggested that future microplastics studies should methodically include quality assurance/quality control (QA/QC) protocols in every process to ensure that good quality data is produced and applied in the risk assessment process.
Publisher: Springer Science and Business Media LLC
Date: 28-03-2012
Publisher: Springer Science and Business Media LLC
Date: 03-10-2017
DOI: 10.1007/S10646-017-1857-5
Abstract: Steroid estrogens such as 17β-Estradiol (E
Publisher: Informa UK Limited
Date: 18-07-2018
Publisher: Wiley
Date: 04-12-2022
DOI: 10.1111/PAN.14608
Abstract: Perioperative pain management impacts patient morbidity, quality of life, and hospitalization cost. In children, it impacts not only the child, but the whole family. Adjuncts for improved perioperative analgesia continue to be sought to minimize adverse side effects associated with opioids and for those in whom regional or neuraxial anesthesia is not suitable. The use of ketamine and alpha agonists may be useful in these settings but have noted adverse effects including hallucinations, hemodynamic instability, and excessive sedation. One alternative is intravenous lidocaine. Despite its off‐label use, intravenous lidocaine has demonstrated anti‐neuropathic, anti‐hyperalgesic, and anti‐inflammatory actions and is an emerging technique. Multiple studies in adults have demonstrated beneficial effects of perioperative intravenous lidocaine including improved perioperative analgesia with reduced postoperative opioid use, improved gastrointestinal function, earlier mobilization, and reduction in hospital length of stay. Despite the limited pediatric literature, some of these findings have been replicated. Large‐scale trials providing evidence for the pediatric pharmacokinetics and high‐quality safety data with respect to intravenous lidocaine are still however lacking. To date, dose ranges studied in the pediatric population have not been associated with serious side effects and current data suggests perioperative intravenous lidocaine in a subgroup of pediatric surgical patients seems well‐tolerated and beneficial.
Publisher: Informa UK Limited
Date: 09-06-2015
Publisher: Wiley
Date: 02-08-2023
DOI: 10.1111/PAN.14738
Abstract: Fasting for surgery is a routine step in the preoperative preparation for surgery. There have however been increasing concerns with regard to the high incidence of prolonged fasting in children, and the subsequent psycho‐social distress and physiological consequences that this poses. Additionally, the past few years have yielded new research that has shown significant inter‐in idual variation in gastric emptying regardless of the length of the fast, with some patients still having residual gastric contents even after prolonged fasts. Additionally, multiple large‐scale studies have shown no long‐term sequalae from clear fluid aspiration, although two deaths from aspiration have been reported within the large Wake Up Safe cohort. This has led to a change in the recommended clear fluid fasting times in multiple international pediatric societies similarly, many societies continue to recommend traditional fasting times. Multiple fasting strategies exist in the literature, though these have mostly been studied and implemented in the adult population. This review hopes to summarize the recent updates in fasting guidelines, discuss the issues surrounding prolonged fasting, and explore potential tolerance strategies for children.
No related grants have been discovered for David Sommerfield.