Tuan Hairulnizam Tuan Kamauzaman

A multicenter controlled trial on knowledge and attitude about cardiopulmonary resuscitation among secondary school children in Malaysia

BackgroundWe performed a multicenter controlled trial to assess the knowledge and attitude (KA) about cardiopulmonary resuscitation (CPR) among secondary school children in a district in Malaysia.MethodsThis was a prospective intervention study. The primary endpoint of the study was to determine the level of KA about resuscitation after CPR training. The six schools and classes from selected schools were chosen by randomization among the form three and four classes using sealed envelopes. A fully validated questionnaire consisting of three sections (sociodemographic, knowledge and attitude) was given to the pupils before and 2 weeks after the intervention. The intervention group was given a lecture, video show, pamphlet and 1-h practical session on CPR training. The control group received a placebo in order to overcome the learning effect. The maximum scores for the knowledge and attitude sections were 72 and 28, respectively. Repeated measures ANOVA analysis was used for specific objectives to determine the changes in knowledge and attitude level pre- and post-intervention for both study groups. P-values less than 0.05 were taken as significant at 95% confidence intervals.ResultsThe mean (SD) total knowledge scores for the intervention (n = 216) and control (n = 252) groups were 62.43 (13.68) and 62.29 (12.11), respectively (maximum score 72) (p > 0.05). On the other hand, the mean (SD) total attitude scores for the intervention and the control groups were 19.33 (4.51) and 17.85 (4.52), respectively (maximum score 28) (p < 0.001). There were significant differences in mean knowledge and attitude scores between the intervention and control groups with regard to time (pre- and post-intervention). The mean difference in knowledge and attitude scores between both study groups was 8.31 (p < 0.001) and 2.39 (p < 0.001), respectively.ConclusionsThe level of knowledge and attitudes of secondary school children was shown to be acceptable prior to the intervention. Furthermore, a brief CPR training program improved their level of knowledge and attitudes significantly as compared to those who had never been trained.

Early onset muscarinic manifestations after wild mushroom ingestion

Despite being a favorite delicacy, only 200–300 of the 5,000 known mushroom species have been clearly established to be safe for consumption. Cases of mushroom poisoning have been reported with diverse clinical syndromes. A syndromic classification of mushroom poisoning has recently been developed to facilitate early interventions. We present a series of five cases of mushroom poisoning with muscarinic manifestations to highlight the difficulties we faced with exact species and toxin identification and the importance of this syndromic classification. The common symptoms in our case series are blurred vision, diarrhea, vomiting, and abdominal cramps.

Factors Associated with Drug-Related Emergency Department Visits at a Teaching Hospital in Malaysia

IntroductionAdverse drug events (ADEs) are a significant health problem globally, with the emergency department (ED) being an important environment for the detection of ADEs. Data regarding drug-related visits to the ED in Malaysia are currently limited.ObjectivesThe aim of this study was to determine factors associated with prescription drug-related ED visits at a teaching hospital.MethodsA case-control study was conducted on patients who visited the ED of Hospital Universiti Sains Malaysia over a 7-week period between December 2014 and January 2015. A visit to the ED was considered drug-related if the chief presenting complaint was related to prescription drug use. Data were collected by interviewing patients, and also from the patient’s medical record. Multiple logistic regression was applied to determine the risk factors.ResultsOverall, 144 physician-identified patients with drug-related ED visits were considered as cases and 288 patients with non-drug-related complaints were selected as controls. Independent risk factors identified for drug-related ED visits were female sex (adjusted odds ratio [OR] 1.7, 95% confidence interval [CI] 1.03–2.71), currently taking regular medication (OR 3.4, 95% CI 1.87–6.05), concurrent comorbidity (OR 2.3, 95% CI 1.28–4.10), a history of drug allergy (OR 5.36, 95% CI 2.30–12.48), and recent hospital admission (OR 2.85, 95% CI 1.23–4.10). Independent risk factors were also associated with the following health problems: diabetes mellitus (OR 6.83, 95% CI 3.30–14.12), central nervous system disorders (OR 9.42, 95% CI 3.08–14.12), and cardiovascular disorders (OR 2.5, 95% CI 1.25–4.79).ConclusionsThe determinants of a drug-related ED visit at a teaching hospital are multifactorial. Interventions to prevent future occurrences should focus on those patients at risk.