1.The Effectiveness Of A Navigation System For Ambulance Service In Kuala Lumpur, Malaysia
Ahmad Khaldun Ismail ; Yap Yah Yun ; Gita Mahardhika ; Ainun Abdul Ghani ; Nurul Saadah Ahmad ; Abdul Karim Mustafa ; Shamsuriani Md Jamal ; Rosdiadee Nordin ; Nasharuddin Zainal
Malaysian Journal of Public Health Medicine 2018;18(Special Volume (1)):166-173
The response and transport intervals of an ambulance dispatch are affected by various factors. The present ambulance
system relies on the driver’s experience, knowledge of local road map and estimations of directions. These may
contribute to delays, misdirection and inefficient utilization of resources. The objectives of this study were to assess the
effects of GPS navigation device on the response and transport time intervals of an ambulance service operating in urban
setting. This was a three-month experimental study involving simulated ambulance dispatch based in a hospital. A total
of 50 simulated cycles were constructed. Travel time, arrival time and distance were documented from each cycle. The
median actual response time using map and GPS navigation device was 11.82 min and 10.47 min respectively. The median
actual transport time using map and GPS navigation device was 11.00 min and 10.74 min respectively. The differences in
response time and transport time between map and GPS navigation were not statistically significant (p= 0.215 and
p=0.710). The application of GPS reduced the error value between estimated and actual response time by 8.73%. It also
reduced the mean error value between estimated and actual transport time by 1.42%. The result shows that the GPS
navigation device allowed for more accurate travel time estimation and its application in an urban setting such as Kuala
Lumpur has the potential to reduce ambulance response time.
Emergency
;
GPS navigation
;
Prehospital care
;
Response time
;
Transport time
2.The Effectiveness of a Navigation System for Ambulance Service in Kuala Lumpur, Malaysia
Ahmad Khaldun ISMAIL ; Yap Yah YUN ; Ainun Abdul GHANI ; Nurul Saadah AHMAD ; Abdul Karim MUSTAFA ; Shamsuriani Md JAMAL
Malaysian Journal of Public Health Medicine 2018;Special Volume(1):166-173
The response and transport intervals of an ambulance dispatch are affected by various factors. The present ambulance system relies on the driver’s experience, knowledge of local road map and estimations of directions. These may contribute to delays, misdirection and inefficient utilization of resources. The objectives of this study were to assess the effects of GPS navigation device on the response and transport time intervals of an ambulance service operating in urban setting. This was a three-month experimental study involving simulated ambulance dispatch based in a hospital. A total of 50 simulated cycles were constructed. Travel time, arrival time and distance were documented from each cycle. The median actual response time using map and GPS navigation device was 11.82 min and 10.47 min respectively. The median actual transport time using map and GPS navigation device was 11.00 min and 10.74 min respectively. The differences in response time and transport time between map and GPS navigation were not statistically significant (p= 0.215 and p=0.710). The application of GPS reduced the error value between estimated and actual response time by 8.73%. It also reduced the mean error value between estimated and actual transport time by 1.42%. The result shows that the GPS navigation device allowed for more accurate travel time estimation and its application in an urban setting such as Kuala Lumpur has the potential to reduce ambulance response time.
3.Natural history of asymptomatic gallstones: differential behaviour in male and female subjects
Suneet Sood ; Than Winn ; Suraiya Ibrahim ; Anisha Gobindram ; A. Allirani V Arumugam ; Norain Che Razali ; Putri Yasmin ; Norul Hidayu ; Hasri Sani ; Mohd Habib Mustafa ; Anis Fatinah ; Ambigga Devi ; Athifah Abdul Karim ; Kadhim Jawad Obaid ; Nor Hashim Haron ; Henry Fitjerald ; Marymol Koshy
The Medical Journal of Malaysia 2015;70(6):341-345
Objective: The natural history of asymptomatic (silent)
gallstones has been inadequately studied. Existing
information derives from studies based on oral
cholecystography or relatively small sample sizes. We
planned a retrospective cohort study in subjects with
gallstones to determine conversion rates from
asymptomatic to symptomatic.
Methods: We extracted data from computerised databases
of one government hospital and two private clinics in
Malaysia. Files were scrutinised to ensure that criteria for
asymptomatic gallstones were fulfilled. Patients were called
on telephone, further questioned to confirm that the
gallstones at detection were truly asymptomatic, and asked
about symptoms that were consistent with previously
defined criteria for biliary colic. Appropriate ethical
clearances were taken.
Results: 213 (112 males) patients fulfilled the criteria for
asymptomatic gallstones and could be contacted. 23 (10.8%)
developed pain after an average follow up interval of 4.02
years (range 0.1-11 years). Conversion rates from
asymptomatic to symptomatic gallstones were high in the
first two years of follow up, averaging 4.03±0.965 per year.
Over time the conversion rates slowed, and by year 10 the
annual conversion rate averaged only 1.38±0.29. Conversion
rates were much higher for females compared to males (F:M
hazard ratio 3.23, SE 1.54, p>z 0.014). The lifetime risks for
conversion approached 6.15% for males, and 22.1% for
females.
Conclusion: In conclusion, asymptomatic gallstones are
much more likely to convert to symptomatic in females than
in males. Males in whom asymptomatic stones are
discovered should be advised conservative treatment.
Surgery may be preferable to conservative management if
the subject is a young female.