BackgroundRoad traffic injury (RTI) contributes to major morbidity and mortality in both developed and developing countries. Most of the injuries are caused by road-related injuries that specifically relate to motorcycle crash. We attempted to conduct a short survey to determine the magnitude of burden related to motorcycle-related RTIs in Malaysia. We hypothesize that motorcycle-related RTI in Malaysia contributes significantly to the health burden in the country.MethodsThe cross-sectional survey involves data searching related to RTI in Malaysia from the relevant agencies such as the Ministry of Health Malaysia, Royal Police Force, and Malaysia Institute of Road Safety Research (MIROS) through their official websites and PubMed search. The three agencies are well established and recognized by the Malaysian government in dealing with data collection for the injury nationwide. The primary aim is to determine the prevalence of motorcycle-related RTI, and secondary outcomes are the overall mortality and the contributing factors.ResultsOf the cause of trauma, 80 % is due to RTI, and the most vulnerable road users such as pedestrians and motorcyclists are affected the most. Of all RTI, 70 % is contributed by the motorcycle crash, and there are a significant number of deaths for both rider and pillion rider of the motorcycle than for other types of vehicles. Human error is the main reason to be blamed, specifically the attitude of the riders on the road.ConclusionsTrauma is one of the common reasons for death and hospitalization in Malaysia. Motorcycle-related RTI in Malaysia contributes significantly to the health burden in Malaysia. The Malaysian government and non-government agencies have worked together seriously in implementing a preventive measure to reduce the incidence and aftermath of motorcycle-related RTI. However, data is still lacking, and every effort is made to increase the amount of research in the field.Strengths of the article are as follows:Latest alarming data on motorcycle-related injuries in the developing country.The data is collected from multi-agencies recognized by ministries in the country.Very limited publication specifically on motorcycle-related injuries is available.Limitations of the article are as follows:The data is only from one country.The statistical data is gathered from a variety of sources, i.e., relevant agencies and authorities and website of the involved ministries.
Introduction: Suboptimal management of asthma can lead to increase morbidity and mortality. Unfortunately, this has become global issue and approximately 40% of asthmatic patients received suboptimal management in emergency department. Therefore, this study aimed to develop a tool to assess knowledge and clinical reasoning of healthcare providers on acute asthmatic management in emergency setting. Method: The tool was developed via three phases: (a) domain identification, (b) domain blueprinting based the Global Initiative of Asthma (GINA) and the British Thoracic Society (BTS) guidelines, and (c) item generation for each domain for assessing knowledge and clinical reasoning. Three forms of validity evidence related to content, response process and internal structure were appraised. Content validity index (CVI), face validity index (FVI), and intraclass correlation coefficient (ICC) estimate the content validity, response process and internal structure of the tool. Results: A new tool was developed, named as Knowledge and Clinical Reasoning of Acute Asthma Management in Emergency Department (K-CRAMED), which assesses knowledge and clinical reasoning on three domains related to management of acute asthma -diagnosis, treatment and disposition. CVI values for the three domains were more than 0.83. FVI values for the three domains among doctors and paramedics were at least 0.83. The ICC between scores given by emergency specialists was 0.989 (CI 95% 0.982, 0.994, p-value < 0.001). Conclusion: The newly developed tool, named as K-CRAMED, is a valid tool to assess knowledge and clinical reasoning of healthcare providers who manage patients with acute asthma. Further validation is required to verify its validity in other setting.
Diabetes Melitus (DM) merupakan salah satu kelompok penyakit metabolik dan kronis dengan karakteristik hiperglikemia yang terjadi karena kelainan sekresi insulin, kerja insulin atau keduaduanya yang membutuhkan perawatan medis dan pendidikan pengelolaan mandiri untuk mencegah komplikasi akut jangka panjang (Nian, 2017). Tujuan penelitian ini adalah Mendeskripsikan hubungan kualitas tidur dengan kadar glukosa darah Puasa pada pasien DM tipe II di PKM Kassi-Kassikota Makassar. Manfaat : Meningkatkan pengetahuan pada Penderita DM Tipe II yang mengalami gangguan Kwalitas dan Pola Tidur shari-hari Meningkatkan pengetahuan pada Penderita DM Tipe II yang mengalami gangguan Kwalitas dan Pola Tidur shari-hari Metode : Pada penelitian ini menggunakan desain cross sectional, jenis penelitian ini menggunakan metode analitik yaitu metode penelitian yang dilakukan dengan tujuan untuk mengetahui hubungan antara Kualitas tidur dengan kadar glukosa darah puasa pada pasien DM Tipe II. Sampel menggunakan purposive sampling dengan menggunakan rumus Slovin dengan jumlah sampel 55 orang yaitu seluruh pasien DM tipe 2 yang menjalani rawat jalan di PKM Kassi-Kassi Kota Makassar. Hasil Uji Statistik Chi Square diperoleh p value 0,000 < 0,05.sehingga peneliti berasumsi bahwa ada hubungan antara kualitas tidur dengan kadar glukosa darah pada pasien DM Type 2 di Puskesmas Kassi-Kassi Makassar. Kesimpulan yaitu terdapat hubungan kualitas tidur dengan kadar glukosa darah pada pasien diabetes melitus tipe 2 di Puskesmas Kassi-Kassi Makassar. Saran dapat dijadikan sebagai salah satu acuhan bagi pasien diabetes melitus tipe 2 untuk meningkatkan kualitas tidur dan menjaga kadar glukosa darah puasa
BackgroundParecoxib sodium is the first parenteral COX-2 inhibitor used for pain management licensed for postoperative pain. However, no study has assessed the usage of parecoxib for acute traumatic pain in the emergency department (ED). The objective of this study was to investigate a potential alternative analgesic agent in the ED by determining the mean reduction of pain score between acute traumatic pain patients who were administered with intravenous (IV) parecoxib sodium versus IV morphine sulfate. The onset of perceptible analgesic effect and side effects were also evaluated.MethodsA randomized, double-blinded study comparing IV parecoxib 40 mg versus IV morphine at 0.10 mg/kg was conducted in adult patients presented with acute traumatic pain with numeric rating scale (NRS) of 6 or more within 6 hours of injury. Patients were randomized using a computer-generated randomization plan. Drug preparation and dispensing were performed by a pharmacist. Periodic assessment of blood pressure, pulse rate, oxygen saturation, and NRS were taken at 0, 5, 15, and 30 minute intervals after the administration of the study drug. The primary outcome was the reduction of NRS. Side effect and drug evaluation was conducted within 30 minutes of drug administration.ResultsThere was no statistically significant difference in the reduction of mean NRS between patients in the IV parecoxib group or IV morphine group (P = 0.095). The mean NRS for patients treated with IV morphine were 7.1 at 0 minutes, 4.5 at 5 minutes, 3.1 at 15 minutes, and 2.0 at 30 minutes. Whereas mean NRS for patients who received IV parecoxib were 7.8 at 0 minutes, 5.7 at 5 minutes, 4.7 at 15 minutes, and 3.9 at 30 minutes. The onset of perceptible analgesic effects could be seen as early as 5 minutes. Dizziness was experienced in 42.9% of patients who received IV morphine compared to none in the parecoxib group.ConclusionsThere was non-significant trend toward superiority of IV morphine over IV parecoxib. Looking at its effectiveness and the lack of opioid-related side-effects, the usage of IV parecoxib sodium may be extended further to a variety of cases in the ED.
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