1.The Needs of Malaysian Family Members of Critically Ill Patients Treated in Intensive Care Unit, Hospital Universiti Sains Malaysia
T. Kumaravadivel Dharmalingam ; Mohammad Rahim Kamaluddin ; Shamsul Kamalrujan Hassan ; Rhendra Hardy Mohammad Zaini
Malaysian Journal of Medicine and Health Sciences 2016;12(2):9-17
Background: The needs of intensive care patient’s family
members are often neglected. Many healthcare practitioners do
not realize that meeting the family needs in the intensive care
settings actually may improve outcome for their patients and
enable the family members to cope and deal with the patient’s
hospitalization period effectively. With this in mind, the present
study aimed to address the needs of Malaysian family members
of intensive care unit patients. Methods: This cross-sectional
survey was conducted among family members of Intensive Care
Unit of Hospital Universiti Sains Malaysia, Malaysia. A total of
60 family members were recruited using a convenience sampling
manner. A Malay validated Critical Care Family Needs
Inventory was used to identify the family needs among the
respondents. Descriptive statistics as well as mean comparison
analyses were employed to achieve the study. Results: The
findings showed that family members ranked Assurance items as
the most important needs. In terms of subscales scores,
Assurance and Information evidenced higher mean scores
compared to other dimensions. All the family need dimensions
had positive and significant associations with one another. The
highest correlation was noted among Comfort – Support pair,
r(58) = 0.73, p < 0.001. No significant differences in the mean
values found across gender, history of admission and types of
relationships. In contrast, significant mean difference was
observed across level of education. Conclusion: Identifying the
needs of family members in the intensive care unit is imperative
as it raises awareness and contributes knowledge in terms of
family needs to healthcare providers, policy makers, medical
social workers and general public.
Critical Care
2.Novel Usage of Dexmetomidine In A Paediatric Patient With Giant Tongue Haemangioma
Mohd Zulfakar Mazlan ; Shamsul Kamalrujan Hassan ; Laila Abd Mukmin ; Mohd Hasyizan Hassan ; Huda Zainal Abiddin ; Irfan Mohamad ; Chandran Nadarajan ; Rubinderan Muthusamy ; Chong Soo Eu
Malaysian Journal of Medicine and Health Sciences 2016;12(2):53-55
Giant haemangioma of the tongue is a disease which can
obstruct the oropharyngeal airway and is presented with
obstructive symptoms. Due to its vascularity, inserting
laryngoscope for intubation can cause high risks, such as
inducing bleeding. Hypoxia and excessive bleeding must be
anticipated while securing the airway. We present a case of
novel usage of dexmetomidine as a conscious sedation agent for
awake fibre optic intubation in a 9-year-old child with
obstructive symptoms secondary to a huge tongue
haemangioma, who was presented for interventional
sclerotherapy of the lesion.
Tongue
3.A Comparison Between Measured Maxillopharyngeal Angle On Lateral Cervical Radiograph with Modified Mallampati Classification In Predicting Difficult Larnygoscopy: A Blinded Interventional Study
Mohamad Hasyizan HASSAN ; Eng Ming FUNG ; Rhendra Hardy Mohd Zaini ; Shamsul Kamalrujan HASSAN ; Praveena SEEVAUNNAMTUM ; Mohd Zulfakar MAZLAN ; Nik Abdullah Nik Mohamad
Malaysian Journal of Medicine and Health Sciences 2018;14(2):51-56
Background: Existing techniques of predicting difficult laryngoscopy are inadequate requiring evaluation of Maxillopharyngeal Angle (MP-A) on lateral cervical radiograph described. Objectives: This study aimed to compare MP-A test with Modified Mallapati Test (MMT) in predicting their diagnostic values and Area Under Curve of Receiver Operating Characteristic Curve (AUCROCC) of both test. Methods: This is a double blinded interventional study of 93 patients. Each patient’s MMT score was assessed during preoperative assessment and subsequent MP-A test done by obtaining lateral cervical radiograph with the head in neutral position. Laryngeal view was assessed using Cormack-Lehane grade after induction of anesthesia, was used as reference standard to determine the diagnostic values of MMT and MP-A respectively. Results: The MP-Acompared to MMT in predicting difficult larngoscopy had higher sensitivity (77.78 vs 44.44) specificity (88.10 vs 67.86) and accuracy (87.10 vs 65.59) with higher Odd Ratio(26.12 vs 1.68). The AUCROCC was significantly higher in MP-A test 0.83(95%CI: 0.67, 0.99) (P = 0.001) vs MMT 0.56(95%CI: 0.36, 0.76) (P = 0.546) with LR+ of 6.53 vs 1.38. Conclusion: The Maxillopharyngeal Angle test was superior in predicting difficult laryngoscopy as compared to Modified Mallampati Test.difficult intubation
4.Does Epidural During Labour Lead To Chronic Low Backpain? A Malaysian Retrospective Study
Muhamad Rafiqi Hehsan ; Wan Fadzlina Wan Muhd Shukeri ; Shamsul Kamalrujan Hassan ; Hoo Pek Sung
Malaysian Journal of Medicine and Health Sciences 2022;18(No.1):151-155
Introduction: The question as to whether epidural analgesia during labour can cause chronic low backpain has become a concern lately but this association has not been tested locally and remains controversial. This retrospective
study aimed to ascertain the relationship between labour epidural analgesia and development of subsequent chronic
low backpain. Methods: We contacted 200 primiparous women who had delivered by normal vaginal delivery via
telephone at six months after delivery. While 100 of them had previously received epidural analgesia for labour,
the other 100 had not. The women had to quantify their backpain by yes/no responses, numeric rating score, and
impairment of daily function. Both the epidural and the non-epidural groups were compared using independent t-test
and Chi-squared test while logistic regression was used to control for confounding factors. Results: The two groups
had similar baseline characteristics except for body mass index, employment status and labour duration. The women
who received epidural analgesia had significantly higher prevalence of low backpain at six months after delivery
than those who had not (28% versus 9%, P = 0.001). However, the two groups did not show any difference in terms
of numeric rating score or level of impairment of daily function. The low back pain at six months (epidural versus
non-epidural) had an adjusted odds ratio of 8.1 (95% confidence interval 2.7 to 24.0, P <0.001). Conclusion: While
epidural analgesia during labour was shown to be associated with chronic low back pain, this association may not
be causal, suggesting the need for a randomized-controlled study in this area.