The objective of this study is to determine the incidence of microbial contamination on medical students’ white coats, the way they handle and clean their white coats and their perception towards contamination. For this purpose, cross sectional survey of the bacterial contamination of white coats in a medical college has been carried out in 3 different locations; Royal College of Medicine, Perak, University of Kuala Lumpur and a private college attached to Ipoh General Hospital. It was found that the incidence of Staphylococus aureus, was 32% on short-sleeved and 54% on long-sleeved white coats. Bacillus species was the second most common type of bacteria found. Male collars and female pockets had higher microbial contaminations (p=0.01, 0.03 respectively). Clinical students’ white coats were significantly less contaminated than non-clinical students (p=0.001) although they tend to wear it for a longer period (5.75 ± 2.19 h vs. 2.32 ± 0.81 h) (p=0.001). Clinical students owned more short-sleeved coats (p=0.001) and washed their coats more often (p=0.01) than non-clinical ones. More than eighty one percent of clinical students wear their white coats in the college the majority of whom were females (p=0.005). Perception of clinical and non-clinical students towards white coat contamination was similar. Medical students’ white coats are contaminated with bacteria and they are potentially source of cross infection. Student’s way of handling and washing white coats should be corrected by issuing and following standard guidelines. Students should be bared from wearing white coats in non-clinical areas. Washing hands and using plastic aprons is highly recommended before examining wounds

Objective: This study aims to identify predictors of 72-hour mortality in patients with diabetic ketoacidosis (DKA). Methodology: In this retrospective cohort study, data were obtained from medical records of adult patients with DKA in Cipto Mangunkusumo General Hospital from January 2011 to June 2017. Associations of predictors (age, type of diabetes, history of DKA, comorbidities, level of consciousness, renal function, bicarbonate, potassium, lactate, betahydroxybutyrate levels, and anion gap status) and 72-hour mortality were analyzed. The mortality prediction model was formulated by dividing the coefficient B by the standard error for all variables with p<0.05 in the multivariate analysis. Results: Eighty-six of 301 patients did not survive 72 hours after hospital admission. Comorbidities (HR 2.407; 95% CI 1.181–4.907), level of consciousness (HR 10.345; 95% CI 4.860–22.019), history of DKA (HR 2.126; 95% CI 1.308–3.457), and lactate level (HR 5.585; 95% CI 2.966–10.519) were significant predictors from multivariate analysis and were submitted to the prediction model. The prediction model had good performance. Patients with total score less than 3 points were at 15.41 % risk of mortality, 3 – 4 points were 78.01% and 5 – 6 points were 98.22% risk of mortality. Conclusion The 72-hour mortality rate in Cipto Mangunkusumo General Hospital was 28.57%. The mortality prediction model had a good performance and consisted of comorbidities, history of DKA, level of consciousness and lactate level.
Mortality ; Diabetic Ketoacidosis

Introduction: HIV is the leading cause of mortality and morbidity worldwide. There are two types of HIV, HIV-1, and HIV-2, which are geographically different in epidemiology and determinants. Objective: To determine the epidemiology and determinants of HIV-1 and HIV-1&2 in the three tertiary hospitals of Eastern Peninsular Malaysia. Method: A cross-sectional study of confirmed serologically HIV-1 and HIV-1&2 from January 2016 until December 2018. SPSS analysed all collected data, descriptive statistics for sociodemographic data and Pearson chi-square for the association between type of HIV with HCV, HBV, syphilis, and tuberculosis. In identifying the risk factor associated with HIV-1&2, several variables were tested by the Multiple Logistic Regression Model. A P-value of <0.05 was considered statistically significant. Results: Out of 519 serologically diagnosed HIV, 344 (66.28%) were HIV-1, and 175 (33.72%) were HIV-1&2. HIV positive were highly distributed in Malay male in both groups. Most HIV-1 patients were single, unemployed, and presented with tuberculosis. HIV-1&2 were single and employed, mostly asymptomatic at diagnosis. The commonest mode of transmission for HIV-1 was by sexual contact (31.87%), whereas IVDU (13.63%) in HIV-1&2. Co-infection with tuberculosis (P=0.005) and HCV (P<0.001) were significantly higher in HIV-1 as compared to HIV-1&2. IVDU was a significant determinant to develop HIV-1&2 (Adjusted OR: 3.5, 95% CI=1.875-5.227, P<0.001). Conclusion: HIV-1&2 was high in this study. Patients with HIV-1&2 present in less severe symptoms compared to the patient with HIV-1. A further molecular diagnostic study should be tested to confirm the type of HIV.