CRC Hospital Shah Alam, Selangor (CRC HSAS) Newsletter
The Insiders - December 2020 Edition
Unit CRC, Tingkat 2,
Hospital Shah Alam
Persiaran Kayangan, Seksyen 7, 40000 Shah Alam,
Selangor
Contact: crc.hsas@gmail.com
This document discusses anatomy of the eyeball including its layers, segments, tear film, conjunctiva, cornea, sclera, uvea, iris, ciliary body, choroid, crystalline lens, vitreous cavity, and retina. It also discusses intraocular pressure, circulation of aqueous humour, factors that increase and decrease IOP, oculocardiac reflex including causes, effects, pathway and treatment, and oculo-respiratory reflex.
Video laryngoscopy allows clinicians to visualize the larynx indirectly by using a fiberoptic or digital laryngoscope inserted into the nose or mouth, with the images displayed on a monitor. It has several advantages over direct laryngoscopy including improved visualization of the larynx and ability to record procedures. Flexible fiberoptic laryngoscopy uses flexible optical fibers to transmit images from a distal lens and allows for nasal or oral intubation. It is very versatile but requires the patient to be awake. Various techniques can be used to anesthetize the airway for awake flexible fiberoptic intubation including topicalization, nerve blocks, and nebulization.
This document discusses geriatric anaesthesia and the age-related physiological changes that are important for anaesthesiologists to consider. It notes that aging results in a decline in organ reserve and functional capacity. Specifically, it outlines changes to the cardiovascular, respiratory, renal, neurological, and other body systems that increase perioperative risk. It emphasizes the need for thorough preoperative evaluation and optimization, careful titration of anaesthetic agents, and vigilant postoperative management given the higher risk of complications in elderly patients.
1. The document discusses tracheostomy and anaesthesia considerations for microlaryngeal surgery. It covers the definition, history, steps of the procedure, complications, types of tubes, and techniques for airway management including endotracheal intubation and jet ventilation.
2. Lasers are commonly used in microlaryngeal surgery and ENT procedures. Safety precautions are required due to the risks of burns, fires and smoke inhalation. Special endotracheal tubes coated in metal foil or other fire-resistant materials help protect the airway during laser use.
3. Careful planning is needed for airway management and ventilation during these delicate procedures to provide optimal surgical conditions while protecting the patient's air
1) Capnography refers to the measurement of carbon dioxide in exhaled gas and can be used to monitor ventilation status.
2) It was first introduced in 1943 but the early devices were large and impractical.
3) Capnography is now widely used in healthcare to monitor patients during procedures like intubation, sedation, mechanical ventilation and general anesthesia by providing information on respiratory and perfusion status.
This document discusses laryngeal paralysis, including the nerve supply and causes of paralysis of the larynx. It describes recurrent laryngeal nerve paralysis and superior laryngeal nerve paralysis, including their clinical features and treatments. Bilateral paralysis and combined (complete) paralysis are also covered. Congenital vocal cord paralysis and various phonosurgery procedures are summarized.
NIV is a form of non-invasive ventilation that delivers mechanical ventilation without using an endotracheal tube. It is commonly used for respiratory failure from COPD exacerbations, pulmonary edema, and immunosuppressed patients. NIV includes CPAP, which provides continuous positive pressure, and BiPAP, which provides two pressure levels (IPAP and EPAP). Key factors in determining success include early improvement in gas exchange and symptoms within the first few hours of treatment.
The document summarizes several ocular reflexes:
1. The oculocardiac reflex is triggered by stimulation of sensory receptors in the eye and surrounding tissues, leading to a decrease in heart rate through vagus nerve stimulation. It is a risk during eye surgeries and procedures.
2. The corneal reflex protects the eye from injury by triggering eye blinking through a trigeminal-facial nerve loop.
3. The pupillary light reflex mediates pupillary constriction in response to light through a pathway involving the optic nerves, brainstem, and parasympathetic innervation of the iris. Lesions can cause afferent or efferent pupillary defects.
This document discusses anatomy of the eyeball including its layers, segments, tear film, conjunctiva, cornea, sclera, uvea, iris, ciliary body, choroid, crystalline lens, vitreous cavity, and retina. It also discusses intraocular pressure, circulation of aqueous humour, factors that increase and decrease IOP, oculocardiac reflex including causes, effects, pathway and treatment, and oculo-respiratory reflex.
Video laryngoscopy allows clinicians to visualize the larynx indirectly by using a fiberoptic or digital laryngoscope inserted into the nose or mouth, with the images displayed on a monitor. It has several advantages over direct laryngoscopy including improved visualization of the larynx and ability to record procedures. Flexible fiberoptic laryngoscopy uses flexible optical fibers to transmit images from a distal lens and allows for nasal or oral intubation. It is very versatile but requires the patient to be awake. Various techniques can be used to anesthetize the airway for awake flexible fiberoptic intubation including topicalization, nerve blocks, and nebulization.
This document discusses geriatric anaesthesia and the age-related physiological changes that are important for anaesthesiologists to consider. It notes that aging results in a decline in organ reserve and functional capacity. Specifically, it outlines changes to the cardiovascular, respiratory, renal, neurological, and other body systems that increase perioperative risk. It emphasizes the need for thorough preoperative evaluation and optimization, careful titration of anaesthetic agents, and vigilant postoperative management given the higher risk of complications in elderly patients.
1. The document discusses tracheostomy and anaesthesia considerations for microlaryngeal surgery. It covers the definition, history, steps of the procedure, complications, types of tubes, and techniques for airway management including endotracheal intubation and jet ventilation.
2. Lasers are commonly used in microlaryngeal surgery and ENT procedures. Safety precautions are required due to the risks of burns, fires and smoke inhalation. Special endotracheal tubes coated in metal foil or other fire-resistant materials help protect the airway during laser use.
3. Careful planning is needed for airway management and ventilation during these delicate procedures to provide optimal surgical conditions while protecting the patient's air
1) Capnography refers to the measurement of carbon dioxide in exhaled gas and can be used to monitor ventilation status.
2) It was first introduced in 1943 but the early devices were large and impractical.
3) Capnography is now widely used in healthcare to monitor patients during procedures like intubation, sedation, mechanical ventilation and general anesthesia by providing information on respiratory and perfusion status.
This document discusses laryngeal paralysis, including the nerve supply and causes of paralysis of the larynx. It describes recurrent laryngeal nerve paralysis and superior laryngeal nerve paralysis, including their clinical features and treatments. Bilateral paralysis and combined (complete) paralysis are also covered. Congenital vocal cord paralysis and various phonosurgery procedures are summarized.
NIV is a form of non-invasive ventilation that delivers mechanical ventilation without using an endotracheal tube. It is commonly used for respiratory failure from COPD exacerbations, pulmonary edema, and immunosuppressed patients. NIV includes CPAP, which provides continuous positive pressure, and BiPAP, which provides two pressure levels (IPAP and EPAP). Key factors in determining success include early improvement in gas exchange and symptoms within the first few hours of treatment.
The document summarizes several ocular reflexes:
1. The oculocardiac reflex is triggered by stimulation of sensory receptors in the eye and surrounding tissues, leading to a decrease in heart rate through vagus nerve stimulation. It is a risk during eye surgeries and procedures.
2. The corneal reflex protects the eye from injury by triggering eye blinking through a trigeminal-facial nerve loop.
3. The pupillary light reflex mediates pupillary constriction in response to light through a pathway involving the optic nerves, brainstem, and parasympathetic innervation of the iris. Lesions can cause afferent or efferent pupillary defects.
Tracheostomy is an ancient surgical procedure where an opening is created in the trachea to allow for breathing. It has been performed since 3600 BC in Egypt. Modern indications include prolonged intubation, airway obstruction, difficulty managing secretions, and as an adjunct to head and neck or chest surgery where ventilation may be problematic. Potential complications range from minor bleeding or infection to serious issues like tracheal stenosis, tracheoesophageal fistula, or erosion into major blood vessels. Careful surgical technique and postoperative management can help reduce risks.
Mechanical ventilation pitfalls in asthma managementprecordialthump
Professor David Tuxen talks about mechanical ventilation pitfalls in asthma management. Topics include appropriate mechanical ventilation settings and their pathophysiological basis, as well as important complications such as dynamic hyperinflation and pneumothorax. The target audience is intensive care registrars.
This document discusses endoscopic skull base surgery and its advantages over traditional open skull surgery. It is presented by Dr. G. Sundhar Krishnan and Dr. P. Kanthamani of Krishna Eye and ENT Hospitals in Chennai. Endoscopic skull base surgery uses the nasal passages and other natural openings to access the skull base instead of external incisions or craniotomy. It provides better visualization with endoscopes and has benefits like smaller incisions, shorter hospital stays, lower morbidity rates, and better cosmetic outcomes for patients compared to traditional open skull base surgery. The document outlines the indications for endoscopic skull base surgery and provides examples of conditions it can treat as well as case studies with pre- and post
This document discusses oxygen delivery devices and respiratory physiology. It begins with the sources of atmospheric oxygen and how inspired oxygen is converted to alveolar oxygen. It then describes how arterial oxygen, tissue oxygen levels, and venous oxygen are determined. Various oxygen delivery devices are outlined, including their mechanisms, flows, concentrations and appropriate uses. Respiratory failure types and their causes are defined. Factors affecting oxygen delivery and consumption are also reviewed.
Regional Anaesthesia for the Obese PatientAmit Pawa
This talk was delivered virtually by Dr Amit Pawa on 2nd December 2021 as part of a joint webinar between the Society for Obesity and Bariatric Anaesthesia (SOBAUK) and the European Society for Perioperative Care of Obese Patients (ESPCOP).
He covers the advantages and range of Regional Anaesthetic Techniques to consider when placing regional anaesthesia in patients living with obesity
Peripheral nerve blocks are gaining popularity for pain management due to advantages like less nausea, hemodynamic stability, and ability to perform surgery in patients with cardiovascular or bleeding risks. Specific nerve blocks include interscalene, supraclavicular, infraclavicular, axillary, and others. Ultrasound is often used to identify nerves and nearby structures before injection of local anesthetic, allowing effective pain relief with fewer side effects compared to general or epidural anesthesia. Proper technique and understanding of anatomy are required to perform safe and effective peripheral nerve blocks.
The document discusses post-extubation stridor, which is upper airway obstruction that can occur after a patient is extubated from a ventilator. It defines post-extubation stridor and reviews risk factors such as duration of intubation and cuff pressures. The cuff leak test is presented as a way to identify patients at risk. Studies are reviewed showing steroids given before extubation can reduce the risk of stridor. Clinically, it recommends identifying at-risk patients, performing the cuff leak test, and considering steroid treatment for high-risk patients before extubation.
Endobronchial Brachytherapy by Dr.Tinku JosephDr.Tinku Joseph
Endobronchial brachytherapy (EBBT) involves placing a radioactive source near a tumor to deliver high doses of radiation. It is used palliatively to relieve airway symptoms from large central lung tumors. EBBT spares other tissues compared to external beam radiation. It is performed by placing a radioactive Ir-192 source into the airway under bronchoscopy. EBBT is effective at improving symptoms in 70% of patients for at least 6 months and is used for NSCLC, metastases to the lungs, and recurrent tracheal stenosis. Complications are generally less than 5% and include radiation bronchitis, stenosis, and hemorrhage.
Vocal cord paralysis occurs when there is interruption of nerve impulses to the laryngeal muscles, resulting in impaired or absent movement of the vocal cords. It can be caused by issues with the recurrent laryngeal nerve, superior laryngeal nerve, or both. Unilateral paralysis may cause hoarseness while bilateral paralysis risks airway obstruction and aspiration. Treatment depends on severity and includes watchful waiting, injection augmentation, framework surgery, and in severe cases, tracheostomy. Proper evaluation involves assessing symptoms, medical history, and direct laryngeal examination along with imaging tests.
1. Laryngotracheal injuries can result from penetrating trauma like knives or guns, or blunt trauma from accidents, blows, kicks, or strangulation.
2. Injuries are classified based on location like supraglottic, glottic, subglottic, or can involve multiple areas. Pathology varies from bruising to fractures of laryngeal framework bones.
3. Clinical features include respiratory distress, hoarseness, painful swallowing, and injuries are diagnosed by examinations like laryngoscopy and imaging tests like X-rays and CT scans. Treatment involves stabilization, voice rest, antibiotics, surgery to repair injuries, and possible tracheostomy. Complications can include
Humidifier Moisture Exchange (HME) filters help humidify gases delivered to patients. They contain materials like ceramic fiber or silica gel that absorb moisture from exhaled gases and release it to inhaled gases. This process humidifies the gases and helps maintain mucosal integrity and ciliary function in the lungs. HME filters also act as microbial filters, reducing transmission of bacteria and viruses through the breathing circuit with over 99.99% efficiency. While easy to use and disposable, HME filters need replacing every 24 hours and can increase resistance to gas flow.
Explosion & fire safety in operation theatreNisar Arain
1) Fires occur when the fire triad of fuel, oxidizer, and ignition source are present simultaneously.
2) Prevention focuses on keeping the elements of the fire triad separated through minimizing flammable materials and following electrical/laser safety guidelines.
3) Management of OR fires depends on the type of fire (Class A, B, C) and involves using the appropriate fire extinguisher or blanket while following the RACE protocol of rescuing patients, sounding alarms, confining the fire, and extinguishing it.
The document provides guidelines from the American Society of Regional Anesthesia (ASRA) on placing and removing epidural catheters in patients taking anticoagulant and antiplatelet drugs. It lists recommended minimum times to wait after the last dose of various medications before catheter placement and removal, as well as when to restart anticoagulation therapy after removal. The medications are grouped into heparins, low molecular weight heparins, factor Xa and direct thrombin inhibitors, antiplatelet agents, fibrinolytics, and glycoprotein IIb/IIIa inhibitors. For each group, it provides the drug names and recommended waiting times.
The document discusses the difficult airway, including its definition, causes, assessment, and management. It defines difficult ventilation and difficult intubation. Causes can be related to the anesthesiologist, equipment, or patient factors like congenital syndromes or acquired conditions. Assessment involves history, physical exam including airway indices like Mallampati score, and radiologic evaluation. Management includes preparing a difficult airway cart and having alternate plans for securing the airway.
Idiopathic sudden sensorineural hearing loss (ISSNHL) is defined as a 30dB or greater loss in hearing in three contiguous frequencies that occurs over 72 hours or less. The cause is unknown in over 95% of cases. Common proposed causes include viral infection, vascular issues, membrane ruptures, and autoimmune problems. Diagnosis involves ruling out other identifiable causes through audiometry and blood tests. Treatment typically involves a short course of steroids, with around 50% of patients experiencing complete or partial recovery of hearing.
This document provides an overview of several ICU scoring systems used to evaluate severity of illness and predict outcomes in critically ill patients. It describes the components and scoring of systems such as APACHE, SAPS, SOFA, MODS, and LODS. APACHE uses physiological variables and chronic health factors to calculate mortality risk. SAPS and SAPS II similarly assess physiology but also include age and admission type. SOFA evaluates degree of organ dysfunction in six organ systems. MODS and LODS also score dysfunction across multiple organ systems based on laboratory and clinical findings.
Capnography is superior to capnometry as it provides a graphical display of expired carbon dioxide (CO2) levels over time, allowing analysis of the capnographic waveform. Measuring end-tidal CO2 (ETCO2) using capnography is the best non-invasive method to verify correct endotracheal tube placement and provides valuable information about ventilation, cardiac output, and metabolism. ETCO2 levels normally approximate arterial CO2 (PaCO2) but the correlation decreases with abnormalities that increase the ventilation-perfusion mismatch. Key features of the capnographic waveform include the baseline, rise and contour of the CO2 curve which can provide diagnostic clues about various clinical conditions.
1) Brain death is defined as irreversible cessation of all functions of the entire brain, including the brainstem. Tests to determine brain death include examining brainstem reflexes and performing an apnea test.
2) Organ donation provides terminally ill patients a new lease on life but organ availability is low in India. Living donors can donate renewable tissues while deceased donors are a major source of organs.
3) For organ donation to occur, all reversible causes of coma must first be excluded through testing and the diagnosis of brain death must be certified by a board of medical experts according to the law.
The document provides an overview of pulmonary function tests (PFTs), including their objectives, components, indications, interpretation, and abbreviations. Key points include:
- PFTs measure airflow, lung volumes, and diffusion capacity and include spirometry, flow volume loops, bronchodilator response testing, lung volumes, and diffusion capacity measurements.
- They are used to diagnose pulmonary conditions, assess disease severity, determine treatment responses, and evaluate patients for surgery.
- Abnormal PFT patterns include obstructive, restrictive, and mixed patterns that provide clues to underlying lung diseases.
- Interpretation involves comparing values to predicted normals and evaluating for reversibility with bronchodilators.
Only 40 years ago, the rate of technologically driven change was such that companies could re-organize efficiently and economically over considerable periods of time, but about 30 years ago this changed as the arrival of new technologies accelerated. We effectively moved from a world of slow periodic changes to one where change became a continuum. The leading-edge sectors were fast to recognize and adopt this new mode of continual adaptation driven by new technologies. This saw these ever more efficient and expansive companies dominating some sectors. For the majority, however, it seems that this transition was not recognized until relatively recently, and a so new movement was born under the banner of digitalization. This not only impacts the way people work, it affects company operations and changes markets, and it does so suddenly!.
Perhaps the most impactive and recent driver of change in this regard has been COVID which saw the adoption of video conferencing and working as a survival imperative in much less than a month. This now stands as a beacon of proof that companies, organizations, and society, can indeed change and adapt to the new at a rate previously considered impossible. The big danger for digitalization programmes now is the simple-minded view that there are singular (magic) solutions that fit every company and organization, but this is not the case. The reality is that the needs and culture of an organization are not the same and may not be uniform from top to bottom.
Manufacturing necessitates very steep hierarchical management structures and tight control to ensure the consistency of the quality of products. On the other hand, a research laboratory or design company requires a low flat management hierarchy and an apparently relaxed level of control. This is absolutely necessary to foster creativity, innovation, and invention. This presentation gives practical examples of management and organizational, extremes. We then go on to highlight the need to embrace AI and Quantum Computing over the coming decade to deal with future technologies, operating
and market complexity.
Tracheostomy is an ancient surgical procedure where an opening is created in the trachea to allow for breathing. It has been performed since 3600 BC in Egypt. Modern indications include prolonged intubation, airway obstruction, difficulty managing secretions, and as an adjunct to head and neck or chest surgery where ventilation may be problematic. Potential complications range from minor bleeding or infection to serious issues like tracheal stenosis, tracheoesophageal fistula, or erosion into major blood vessels. Careful surgical technique and postoperative management can help reduce risks.
Mechanical ventilation pitfalls in asthma managementprecordialthump
Professor David Tuxen talks about mechanical ventilation pitfalls in asthma management. Topics include appropriate mechanical ventilation settings and their pathophysiological basis, as well as important complications such as dynamic hyperinflation and pneumothorax. The target audience is intensive care registrars.
This document discusses endoscopic skull base surgery and its advantages over traditional open skull surgery. It is presented by Dr. G. Sundhar Krishnan and Dr. P. Kanthamani of Krishna Eye and ENT Hospitals in Chennai. Endoscopic skull base surgery uses the nasal passages and other natural openings to access the skull base instead of external incisions or craniotomy. It provides better visualization with endoscopes and has benefits like smaller incisions, shorter hospital stays, lower morbidity rates, and better cosmetic outcomes for patients compared to traditional open skull base surgery. The document outlines the indications for endoscopic skull base surgery and provides examples of conditions it can treat as well as case studies with pre- and post
This document discusses oxygen delivery devices and respiratory physiology. It begins with the sources of atmospheric oxygen and how inspired oxygen is converted to alveolar oxygen. It then describes how arterial oxygen, tissue oxygen levels, and venous oxygen are determined. Various oxygen delivery devices are outlined, including their mechanisms, flows, concentrations and appropriate uses. Respiratory failure types and their causes are defined. Factors affecting oxygen delivery and consumption are also reviewed.
Regional Anaesthesia for the Obese PatientAmit Pawa
This talk was delivered virtually by Dr Amit Pawa on 2nd December 2021 as part of a joint webinar between the Society for Obesity and Bariatric Anaesthesia (SOBAUK) and the European Society for Perioperative Care of Obese Patients (ESPCOP).
He covers the advantages and range of Regional Anaesthetic Techniques to consider when placing regional anaesthesia in patients living with obesity
Peripheral nerve blocks are gaining popularity for pain management due to advantages like less nausea, hemodynamic stability, and ability to perform surgery in patients with cardiovascular or bleeding risks. Specific nerve blocks include interscalene, supraclavicular, infraclavicular, axillary, and others. Ultrasound is often used to identify nerves and nearby structures before injection of local anesthetic, allowing effective pain relief with fewer side effects compared to general or epidural anesthesia. Proper technique and understanding of anatomy are required to perform safe and effective peripheral nerve blocks.
The document discusses post-extubation stridor, which is upper airway obstruction that can occur after a patient is extubated from a ventilator. It defines post-extubation stridor and reviews risk factors such as duration of intubation and cuff pressures. The cuff leak test is presented as a way to identify patients at risk. Studies are reviewed showing steroids given before extubation can reduce the risk of stridor. Clinically, it recommends identifying at-risk patients, performing the cuff leak test, and considering steroid treatment for high-risk patients before extubation.
Endobronchial Brachytherapy by Dr.Tinku JosephDr.Tinku Joseph
Endobronchial brachytherapy (EBBT) involves placing a radioactive source near a tumor to deliver high doses of radiation. It is used palliatively to relieve airway symptoms from large central lung tumors. EBBT spares other tissues compared to external beam radiation. It is performed by placing a radioactive Ir-192 source into the airway under bronchoscopy. EBBT is effective at improving symptoms in 70% of patients for at least 6 months and is used for NSCLC, metastases to the lungs, and recurrent tracheal stenosis. Complications are generally less than 5% and include radiation bronchitis, stenosis, and hemorrhage.
Vocal cord paralysis occurs when there is interruption of nerve impulses to the laryngeal muscles, resulting in impaired or absent movement of the vocal cords. It can be caused by issues with the recurrent laryngeal nerve, superior laryngeal nerve, or both. Unilateral paralysis may cause hoarseness while bilateral paralysis risks airway obstruction and aspiration. Treatment depends on severity and includes watchful waiting, injection augmentation, framework surgery, and in severe cases, tracheostomy. Proper evaluation involves assessing symptoms, medical history, and direct laryngeal examination along with imaging tests.
1. Laryngotracheal injuries can result from penetrating trauma like knives or guns, or blunt trauma from accidents, blows, kicks, or strangulation.
2. Injuries are classified based on location like supraglottic, glottic, subglottic, or can involve multiple areas. Pathology varies from bruising to fractures of laryngeal framework bones.
3. Clinical features include respiratory distress, hoarseness, painful swallowing, and injuries are diagnosed by examinations like laryngoscopy and imaging tests like X-rays and CT scans. Treatment involves stabilization, voice rest, antibiotics, surgery to repair injuries, and possible tracheostomy. Complications can include
Humidifier Moisture Exchange (HME) filters help humidify gases delivered to patients. They contain materials like ceramic fiber or silica gel that absorb moisture from exhaled gases and release it to inhaled gases. This process humidifies the gases and helps maintain mucosal integrity and ciliary function in the lungs. HME filters also act as microbial filters, reducing transmission of bacteria and viruses through the breathing circuit with over 99.99% efficiency. While easy to use and disposable, HME filters need replacing every 24 hours and can increase resistance to gas flow.
Explosion & fire safety in operation theatreNisar Arain
1) Fires occur when the fire triad of fuel, oxidizer, and ignition source are present simultaneously.
2) Prevention focuses on keeping the elements of the fire triad separated through minimizing flammable materials and following electrical/laser safety guidelines.
3) Management of OR fires depends on the type of fire (Class A, B, C) and involves using the appropriate fire extinguisher or blanket while following the RACE protocol of rescuing patients, sounding alarms, confining the fire, and extinguishing it.
The document provides guidelines from the American Society of Regional Anesthesia (ASRA) on placing and removing epidural catheters in patients taking anticoagulant and antiplatelet drugs. It lists recommended minimum times to wait after the last dose of various medications before catheter placement and removal, as well as when to restart anticoagulation therapy after removal. The medications are grouped into heparins, low molecular weight heparins, factor Xa and direct thrombin inhibitors, antiplatelet agents, fibrinolytics, and glycoprotein IIb/IIIa inhibitors. For each group, it provides the drug names and recommended waiting times.
The document discusses the difficult airway, including its definition, causes, assessment, and management. It defines difficult ventilation and difficult intubation. Causes can be related to the anesthesiologist, equipment, or patient factors like congenital syndromes or acquired conditions. Assessment involves history, physical exam including airway indices like Mallampati score, and radiologic evaluation. Management includes preparing a difficult airway cart and having alternate plans for securing the airway.
Idiopathic sudden sensorineural hearing loss (ISSNHL) is defined as a 30dB or greater loss in hearing in three contiguous frequencies that occurs over 72 hours or less. The cause is unknown in over 95% of cases. Common proposed causes include viral infection, vascular issues, membrane ruptures, and autoimmune problems. Diagnosis involves ruling out other identifiable causes through audiometry and blood tests. Treatment typically involves a short course of steroids, with around 50% of patients experiencing complete or partial recovery of hearing.
This document provides an overview of several ICU scoring systems used to evaluate severity of illness and predict outcomes in critically ill patients. It describes the components and scoring of systems such as APACHE, SAPS, SOFA, MODS, and LODS. APACHE uses physiological variables and chronic health factors to calculate mortality risk. SAPS and SAPS II similarly assess physiology but also include age and admission type. SOFA evaluates degree of organ dysfunction in six organ systems. MODS and LODS also score dysfunction across multiple organ systems based on laboratory and clinical findings.
Capnography is superior to capnometry as it provides a graphical display of expired carbon dioxide (CO2) levels over time, allowing analysis of the capnographic waveform. Measuring end-tidal CO2 (ETCO2) using capnography is the best non-invasive method to verify correct endotracheal tube placement and provides valuable information about ventilation, cardiac output, and metabolism. ETCO2 levels normally approximate arterial CO2 (PaCO2) but the correlation decreases with abnormalities that increase the ventilation-perfusion mismatch. Key features of the capnographic waveform include the baseline, rise and contour of the CO2 curve which can provide diagnostic clues about various clinical conditions.
1) Brain death is defined as irreversible cessation of all functions of the entire brain, including the brainstem. Tests to determine brain death include examining brainstem reflexes and performing an apnea test.
2) Organ donation provides terminally ill patients a new lease on life but organ availability is low in India. Living donors can donate renewable tissues while deceased donors are a major source of organs.
3) For organ donation to occur, all reversible causes of coma must first be excluded through testing and the diagnosis of brain death must be certified by a board of medical experts according to the law.
The document provides an overview of pulmonary function tests (PFTs), including their objectives, components, indications, interpretation, and abbreviations. Key points include:
- PFTs measure airflow, lung volumes, and diffusion capacity and include spirometry, flow volume loops, bronchodilator response testing, lung volumes, and diffusion capacity measurements.
- They are used to diagnose pulmonary conditions, assess disease severity, determine treatment responses, and evaluate patients for surgery.
- Abnormal PFT patterns include obstructive, restrictive, and mixed patterns that provide clues to underlying lung diseases.
- Interpretation involves comparing values to predicted normals and evaluating for reversibility with bronchodilators.
Only 40 years ago, the rate of technologically driven change was such that companies could re-organize efficiently and economically over considerable periods of time, but about 30 years ago this changed as the arrival of new technologies accelerated. We effectively moved from a world of slow periodic changes to one where change became a continuum. The leading-edge sectors were fast to recognize and adopt this new mode of continual adaptation driven by new technologies. This saw these ever more efficient and expansive companies dominating some sectors. For the majority, however, it seems that this transition was not recognized until relatively recently, and a so new movement was born under the banner of digitalization. This not only impacts the way people work, it affects company operations and changes markets, and it does so suddenly!.
Perhaps the most impactive and recent driver of change in this regard has been COVID which saw the adoption of video conferencing and working as a survival imperative in much less than a month. This now stands as a beacon of proof that companies, organizations, and society, can indeed change and adapt to the new at a rate previously considered impossible. The big danger for digitalization programmes now is the simple-minded view that there are singular (magic) solutions that fit every company and organization, but this is not the case. The reality is that the needs and culture of an organization are not the same and may not be uniform from top to bottom.
Manufacturing necessitates very steep hierarchical management structures and tight control to ensure the consistency of the quality of products. On the other hand, a research laboratory or design company requires a low flat management hierarchy and an apparently relaxed level of control. This is absolutely necessary to foster creativity, innovation, and invention. This presentation gives practical examples of management and organizational, extremes. We then go on to highlight the need to embrace AI and Quantum Computing over the coming decade to deal with future technologies, operating
and market complexity.
This document summarizes evidence from 27 trials involving over 10,000 participants on the safety and efficacy of clot-dissolving drugs (thrombolytics) such as alteplase for treating acute ischemic stroke. The trials compared thrombolytics administered intravenously or intra-arterially within 4.5 hours of stroke onset to placebo or no treatment. Thrombolytics were found to improve outcomes after stroke but also increase the risk of serious bleeding in the brain. While thrombolytics can restore blood flow and reduce brain damage if given promptly, the risks and benefits were shown to depend on the time since stroke onset.
Healthcare Improvement Scotland aims to continuously improve healthcare quality and safety in Scotland. It runs national improvement programs focused on areas like patient safety, healthcare associated infections, and person-centered care. Through measurement and data collection, the Scottish Patient Safety Program has demonstrated significant reductions in infection rates, improved compliance with best practices, and decreased mortality and length of stay in critical care units. The goal is to spread effective improvement strategies nationwide to benefit all Scottish patients.
SCMS Journal of Indian Management , J a n u a r y - M a r c.docxkenjordan97598
SCMS Journal of Indian Management , J a n u a r y - M a r c h , 2 011. 96
A Quarterly Journal
N i n e d e s i g n e l e m e n t s o f h o l i s t i c i n t r a p r e n e u r s h i p a r e i d e n t i f i e d a n d a r o l e m o d e l
f o r e n t r e p r e n e u r i a l f i r m s i n a g l o b a l b u s i n e s s e n v i r o n m e n t i s d e v e l o p e d w i t h a
v i e w t o a d d r e s s i n g t h e e n t r e p r e n e u r i a l r o l e s ( w h a t t a s k s a r e p e r f o r m e d ) t h a t a
f i r m h a s t o f u l f i l i n a s p e c i f i c w a y . T h i s i s d o n e v i a a s u r v e y o f t h e r e l e v a n t l i t e r a t u r e
o n i n t r a p r e n e u r s h i p i n a g l o b a l c o n t e x t . T h e r o l e m o d e l c a n b e i n t e r p r e t e d a s a
s y n t h e s i s b e t w e e n t h e i n d i v i d u a l i s t i c a n d t h e c o l l e c t i v i s t i c a p p r o a c h e s o f
i n t r a p r e n e u r s h i p f o u n d i n t h e l i t e r a t u r e . I t c a p t u r e s s e v e r a l r o l e s o f i n t r a p r e n e u r s h i p
a s i d e n t i f i e d i n t h e w o r k o f v a r i o u s a u t h o r s w i t h i n a h o l i s t i c f r a m e w o r k .
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Global Business Environment:
Holistic Intrapreneurship
Bernd P. Platzek, Dietmar Winzker, and Leon Pretorius
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This document discusses the concept of "blue ocean strategy" and uses Cirque du Soleil as an example. It notes that Cirque du Soleil was able to achieve huge revenues in a declining circus industry by creating an uncontested market space rather than competing directly. It reinvented the circus experience as an artistic, sophisticated show for adults. This allowed Cirque du Soleil to break the tradeoff between cost and differentiation, achieving both low costs and high differentiation. The document argues that strategies should focus on reconstructing market boundaries rather than competing within existing boundaries. Creating a differentiated value proposition that is difficult for others to imitate is key to success with a blue ocean strategy.
Enactus is an international non-profit organization run by student teams who create community projects to empower people and improve their quality of life. Teams develop social and environmental projects, then implement and operate them. They compete annually to present the impact of their projects to business executives. National champion teams advance to the prestigious World Cup. Enactus aims to bring about positive change in society through entrepreneurial community projects run by student teams at their universities.
Basic information on various methods of cooking and the advantages are described in details. classification of cooking methods are explained and the various medium of cooking are covered.
Dumile Brand Boutique is a full-service branding agency that focuses on building relationships between brands and their audiences. They offer customized branding solutions and brand management services to meet clients' specific needs. Their personalized approach ensures brands are managed by industry professionals committed to developing unique and relevant brand identities. Dumile Brand Boutique guarantees an authentic experience for brand building and management centered around amplifying a brand's presence.
The document discusses the key stages in the marketing process. It begins with identifying opportunities in the market through research and analysis of customer needs. The next stage involves segmenting the market and selecting target customer groups. A market analysis is then conducted to understand customers and competitors within the target market. Based on this, marketing strategies are formulated. Action plans are then developed to implement the strategies, followed by executing the plans. Finally, performance is monitored and strategies are evaluated and adjusted based on results. The goal of the marketing process is to meet customer needs effectively while maintaining competitiveness.
This is a presentation about the introduction to system and analysis design. The topic talks about what are the system development life cycle and how it works. It also talks about the professions or the team conducting a study.
Risk management and insurance at reliance life insuranceErTARUNKASHNI
This document is an internship report submitted by Tarun Kashni on risk management and insurance at Reliance Life Insurance Co. Ltd. It provides an overview of Reliance Life Insurance, including its founding, leadership, products offered, and financial details. The report discusses the importance of risk management in the insurance industry and outlines Reliance Life Insurance's vision and the scope of the internship project. It then describes the risk management process and provides examples of risk management practices in the Indian insurance industry. The research methodology section outlines how the intern collected and analyzed data through literature review, interviews, and reviewing reports to identify risks and make recommendations to strengthen Reliance Life Insurance's risk management framework.
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f r o m u n n e c e s s a r y c o n s t r a i n t s , t h e y a r e l o o k i n g t o t h e p r i v a t e s e c t o r
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CO RR ECT I N G M I SCO N C EPT IO N S
M i s o n ( ¬Pt i o n C o m m e r c i a l c o n t r a c t i n g d i f f e r s r a d i c a l l y fr o m
g o v e r n m e n t c o n t r a c t i n g s o m u c h s o t h a t p a r a l l e l s c a n n o t
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s h a r e m a n y p h a s e s , f u n c t i o n s , p r o c e d u r e s , a n d c h a l l e n ge s
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M is o n epl i o n T h e U n i f o r m C o m m e r c i a l C o d e i s a c l e a r ,
Pr e c i s e d o c u m e n t t h a t u n i f o r m l y a n d s p e c i fi c a l l y go v e .
Multi-grade schooling has a long history and was initially the most common model of elementary education. In the Philippines, the first mission schools organized classrooms with multiple grades out of necessity in remote rural communities. The multi-grade program in Philippine education (MPPE) aims to improve instruction quality in multi-grade schools through curriculum development, teacher training, and support programs like demonstration schools, learning enhancement initiatives, and recognition of exemplary multi-grade teachers.
Keynote - Jagdish Mitra - Democratizing AI - H2O AI World London 2018Sri Ambati
This talk was recorded in London on October 30th, 2018 and can be viewed here: https://youtu.be/zCOM46GuFVo
As Chief Strategy and Marketing Officer of Tech Mahindra Jagdish Mitra leads the global agenda of business growth driven by strategy, powered by Digital and manifested in brand experiences. He believes AI, automation, digital can enable us to create unique human experiences of the future and can help create a sustainable planet. Prior to this role he was the CEO of the start-up canvas M formed as a JV between TECHM and Motorola. He is a sports enthusiast, loves football and plays squash. He is founder of a Jishnu football foundation that trains and awards scholarships to high potential kids from challenged backgrounds.
Linkedin: https://www.linkedin.com/in/jagdish-mitra-b675772/
Efficient needs assessment into effective curriculum planning - ADEPIS seminarMentor
This presentation outlines how data collected through an efficient needs assessment can be used to inform programme planning in alcohol and drug education
Castlepollard Community College Coding WorkshopLucy Payne
Midlands Science is a nonprofit that works to promote STEM education in the Irish Midlands. It partnered with iConnect and Mergon to host a coding workshop for students at Castlepollard Community College using Apple's Swift Playgrounds app. The workshop introduced coding to students in a fun, interactive way. Both the principal and Mergon representative said the workshop provided an innovative learning experience that will help inspire and prepare students for the future.
“Talking Elements” We are an experiential marketing & event management agency, providing creative digital and on ground solutions.
Services we provide are:-
Event management
Brand promotion & activation
Ideation & design
Creative collaterals
Vendor management
Travel management
On 3 August 2023, the Clinical Research Centre Hospital Kuala Lumpur (CRC HKL) hosted their 6th Hospital Kuala Lumpur Research Day 2023 at the HKL Main Auditorium. This book comprises all of the accepted abstracts for oral and poster presentations.
The COVID-19 global pandemic has caused huge disruption to health system. These findings aim to highlight the immediate and long-term impact of the COVID-19 breakdown on palliative care services at the national level and the institutional level, and suggest lessons for future outbreaks.
Presented in NIH's CME on 25 May 2023.
Recording is available on Podcast and YouTube at
https://www.podpage.com/clinical-updates-in-covid-19/use-of-artificial-intelligence-drmata-system-for-the-detection-and-intervention-of-diabetic-retinopathy/
https://www.youtube.com/live/pvhV_UBeBQA?feature=share
The 15th National Conference for Clinical Research will take place from 18-20 October 2022 in Penang, Malaysia. The conference theme is "Data to Decisions" and will bring together leading experts in data science, analytics, and clinical trials to discuss utilizing research data to facilitate evidence-based policies and decision-making. It will feature presentations, poster presentations, and the Young Investigator Award. The goal is to accelerate the use of data-driven research to improve healthcare.
The 14th National Conference for Clinical Research 2021 was organized by the Institute for Clinical Research and supported by the National Institutes of Health and Clinical Research Malaysia. The conference was held virtually from August 18-20, 2021 with the theme of "Niche to Norm". It featured keynotes and presentations on precision medicine, clinical trials, and digital health. Over 179 abstracts were accepted for the conference covering various areas of clinical research.
Introducing the Clinical Research Centre (CRC) Hospital Tuanku Fauziah, Kangar, Perlis. A brief history, as well as an introduction to the scientific activities and accomplishments of CRC Hospital Tuanku Fauziah's health care providers.
Melaka Research Day 2023
Benefitting Society by Translating Research into Practice
Date: 9 May 2023
Venue: Auditorium MITC, Melaka
Co-organised by Melaka State Health Department, Melaka Hospital and Clinical Research Centre (CRC) Hospital Melaka, Clinical Research Malaysia, Pertubuhan Pendidikan Perubatan Lepasan Ijazah Hospital Melaka.
This document summarizes research activities from the Perak State Research Meeting 2022. It discusses several studies conducted by the Clinical Research Centres in Perak, including a study evaluating if Ipoh is an age-friendly city, a terminated randomized controlled trial of ivermectin for COVID-19 post-exposure prophylaxis, and a study of pulmonary thromboembolic disease in COVID-19 patients. It also provides an overview of upcoming plans and goals for research in 2023.
Dr Aziz Amir from CRC HKL was named 2nd runner up in the Pertandingan Menulis Nota Hati competition, which was organised by Dewan Bahasa dan Pustaka Malaysia & Perpustakaan Kementerian Kesihatan Malaysia.
Congratulations, Dr Aziz!
The Orang Asli, although a minority in the Peninsula of Malaysia, are the original people of our land. It is often extremely difficult to reach some Orang Asli communities. Hence, the Flying Doctor Service is extremely important. Only helicopters can reach remote locations and meet the needs of these wonderful people. A service like the Flying Doctor Service that reaches the ‘unreached’ community is essential and a Lifeline to our Orang Asli people.
This newsletter provides an overview of the Clinical Research Centre at Sarawak General Hospital (CRCSGH) including its current status, research collaborations and achievements, and future perspectives.
CRCSGH's physiology laboratory is currently involved in 7 industry-sponsored and 8 investigator-initiated research studies. The laboratory conducts various cardiovascular, respiratory and neurological tests and is working towards ISO accreditation.
Research collaborations between CRCSGH and local and international clinicians have led to publications in peer-reviewed journals and conference presentations. Future plans include establishing more strategic partnerships and conducting impactful research on common local conditions like hypertension and diabetes.
The newsletter also provides updates on events at CRCSGH including visits from government agencies
The document outlines recommendations to strengthen mental health and psychosocial support (MHPSS) systems and services for children and adolescents in the East Asia and Pacific region. It identifies three packages of priority actions: 1) Accessible and responsive services for mental health conditions, 2) Prevention of mental health conditions in the immediate social context, and 3) Mental health promotion through an enabling and safe environment. For each package, it recommends priority actions in the short term (2 years), midterm (2-5 years), and long term (5 years). It also identifies the leading and supporting roles and responsibilities of different sectors including health, education, social welfare, and justice.
The mental health of children and adolescents aged 0–18 years is one of the most neglected health issues globally. To address the mental health and psychosocial well-being of children and adolescents, there is a need for a holistic and tiered approach to MHPSS. This report documents the application of the conceptual framework in Malaysia and provides country specific recommendations for strengthening the provision of MHPSS for children and adolescents.
This document provides information about the Clinical Research Centre at Hospital Tuanku Ja'afar Seremban (CRC HTJS) in Malaysia. It begins with welcoming readers to the inaugural issue of the CRC Seremban Bulletin. It then provides background on CRC HTJS, including its vision, mission and the services it provides to support clinical research. The rest of the document consists of articles on various topics related to clinical research, including infographics on the National Medical Research Register process, interviews with local researchers, summaries of research projects and CRC activities. It aims to share information on current developments in local clinical research initiatives.
Hand, foot and mouth disease #HFMD, and #monkeypox are virus infections presenting with different types of vesicular lesions and clinical course. This document provided a quick explanation of the differences between hand, foot and mouth disease (HFMD) and Monkeypox.
This document provides answers to frequently asked questions about the "Long COVID in Malaysia: A Longitudinal Prospective Cohort Study". The study, approved by the Medical Research and Ethics Committee, aims to assess prolonged symptoms and complications in COVID-19 recoveries. Participants will receive notifications through MySejahtera to complete surveys at initial infection and 1, 3, and 6 months post-infection. Participation involves minimal risk and helps improve long-term COVID-19 management, while ensuring confidentiality of participant information.
Pengenalan dan soalam lazim
Kementerian Kesihatan Malaysia sedang membuat kajian untuk mengetahui lebih lanjut tentang kesan jangka panjang COVID-19 terhadap tubuh manusia.
Orang yang layak akan menerima pemberitahuan melalui SMS dan aplikasi MySejahtera.
This guideline provides organised and systematic information on research procedures and requirements as well as research framework and principles that can comprehensively guide the researchers on the conduct of research in the Ministry of Health (MOH) facilities and institutions.
NIH Guidelines for Conducting Research in Ministry of Health Institutions & Facilities, 3rd Edition (2021). National Institutes of Health, Ministry of Health Malaysia.
ISBN: 978-967-5340-30-7
This bulletin is a publication of the CRC networks in Perak (Hospital Raja Permaisuri Bainun Ipoh, Hospital Seri Manjung and Hospital Taiping).
This issue emcompasses various research articles written by CRC staff, a research scope write-up to emphasize on the research focus this coming year, programmes conducted in 2021 as well as upcoming events across the CRC Perak Network this year.
(e-ISSN Number: 2682-7867).
More from Institute for Clinical Research (ICR) (20)
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
1. 2020 WRAPPED UP
The year 2020 has been a roller coaster ride for every person in
our country and even globally. It started as straightforward as it
could and the elation was felt on what this year could give.
Then, the pandemic occurred.
Covid-19 outbreak started in Wuhan City, China that belong to
the family of virus that cause Severe Acute Respiratory
Syndrome (SARS). Quarantine and lockdown are crucial in order
to control the outbreak. However, CRC HSAS managed to pursue
some program successfully and by following the government
SOPs during this pandemic.
I S S U E D E C E M B E R 2 0 2 0
THE
INSIDERS
C R C H S A S
N E W S L E T T E R
TABLE OF
CONTENTS
Welcoming Words • P. 2
About CRC HSAS • P. 3
2020 Events • P. 4 - 6
Down The Memory Lane • P. 7
B Y A N A S A H Z A R U D D I N
Research Week 2020 • P. 8 - 10
Research Personality • P. 11 - 13
Internship Programme • P. 14
Puzzle O'Clock • P. 15
Upcoming Events • P. 16
1
A C C E S S O U R
N E W S L E T T E R
W E B S I T E
2. D R . R U Z I T A B I N T I O T H M A N
D R . H J H N O R F A R I Z A B I N T I N G A H
FROM THE
DIRECTOR' S DESK
A MESSAGE FROM THE
CHIEF
Assalamualaikum & Salam Sejahtera.
CRC HSAS serves as a local coordination centre for research
activities and training related to research. It has become a
One Stop Centre to meet all the clinical research solution.
Operating since May 2016, Hospital Shah Alam is committed
to contribute and enhance health care by promoting and
supporting the importance, quality, safety and efficiency of
clinical research. Its core functions are to promote research
activities of both Industry Sponsored Research (ISR) and
Investigator Initiated Research (IIR), facilitates feasibility
studies, Investigator Initiated Research (IIR) and conduct
research related trainings. It is my great pleasure to be part
of CRC Hospital Shah Alam. I do hope there will be an
increasing trend of Investigator Initiated Research and
Investigator Sponsored Research in upcoming years. I hope
many will benefit from this issue and are inspired by the
achievements of our fellow colleagues. Let’s strive harder to
achieve our vision and mission of CRC Shah Alam as well
continuously serving the contributions in all clinical aspects.
Assalamualaikum and Salam Sejahtera.
It is of utmost important that we as clinicians understand the importance of
research undertaking. Research opportunities occur every day across our
healthcare system. Health professionals, whilst in pursuit of clinical
excellence, should be actively involved in research undertaking. Research
can establish new drugs and products for the treatment of disease, change
how the medical community approaches a disease, and much more.
Moreover, community-based research can make important contributions
toward understanding how local environments impact the health status of a
population. Community-based research is necessary to remove the various
social, cultural, and logistical barriers that confound the well-intentioned
efforts of many public health programs. In addition to achieve the greater
knowledge around health, such research has the simultaneous ability to
empower communities worldwide through collaboration and partnership. As
the field of community-based health research continues to grow, student
researchers have the potential to make important contributions. With the
help of CRC, a continuous commitment is established, that encourages and
supports every research journey. I hope HSAS can increase its research
activities. I also would like to congratulate those whom had greatly
contributed to the activities and continue to increase HSAS publications and
presentations at local, national and international arena as well.
2
3. T o s u p p o r t a n d f a c i l i t a t e r e s e a r c h a c t i v i t i e s i n t h e h o s p i t a l
t h r o u g h t h e p r o v i s i o n o f :
D a t a b a s e o f c l i n i c i a n s i n t e r e s t e d i n r e s e a r c h – b y
i n t e r e s t a r e a s , t r a c k r e c o r d o n I n d u s t r y S p o n s o r e d
R e s e a r c h ( I S R ) f o r I n v e s t i g a t o r I n i t i a t e d R e s e a r c h ( I I R )
a n d p u b l i c a t i o n s
T e c h n i c a l s u p p o r t s u c h a s s t a t i s t i c a l a n a l y s i s
A d m i n i s t r a t i v e s u p p o r t s u c h a s p r o v i d i n g r e s e a r c h
a s s i s t a n t s a n d s t u d y c o o r d i n a t o r s
F a c i l i t y s u p p o r t s s u c h a s I T , s t a t i s t i c a l s o f t w a r e a n d
o t h e r s a n d w o r k s t a t i o n
T o a s s i s t i n t h e r e g i s t r a t i o n o f r e s e a r c h p r o t o c o l t o N M R R
( N a t i o n a l M e d i c a l R e s e a r c h R e g i s t e r ) a n d a p p l i c a t i o n o f
g r a n t s f o r r e s e a r c h
T o p a r t i c i p a t e i n c l i n i c a l t r i a l s a n d o t h e r s r e s e a r c h i n i t i a t e d
o r c o o r d i n a t e d b y t h e n a t i o n a l I C R
T o p r o m o t e r e s e a r c h t h r o u g h c a p a c i t y b u i l d i n g i n t h e
f o l l o w i n g w a y s :
C o n d u c t c o u r s e s s u c h a s G o o d C l i n i c a l P r a c t i c e ( G C P ) ,
G o o d R e s e a r c h P r a c t i c e ( G R P ) , r e s e a r c h m e t h o d o l o g y a n d
b i o s t a t i s t i c s
C o n d u c t r e g u l a r i n - h o u s e C o n t i n u o u s P r o f e s s i o n a l
D e v e l o p m e n t ( C P D )
R u n r e s e a r c h c l i n i c s – p r o v i d e c o n s u l t a t i o n o n r e s e a r c h
m e t h o d o l o g y , s t u d y d e s i g n , p r o t o c o l a n d s t a t i s t i c a l a n a l y s i s
H a v e m e n t o r i n g p r o g r a m m e f o r c l i n i c i a n s a n d o t h e r m e d i c a l
p r o f e s s i o n a l s i n t e r e s t e d i n r e s e a r c h
ABOUT CLINICAL
RESEARCH
CENTRE HSAS
VISION
MISSION
GOALS
OBJECTIVE
T o b e c o m e a l e a d i n g c l i n i c a l
r e s e a r c h i n s t i t u t i o n i n A s i a
T o i m p r o v e p a t i e n t s ’ h e a l t h
o u t c o m e s t h r o u g h e t h i c a l a n d
q u a l i t y c l i n i c a l r e s e a r c h
T o b e c o m e a c l i n i c a l i n s t i t u t i o n t h a t
e n c o u r a g e s h i g h i m p a c t , g o o d
q u a l i t y a n d e t h i c a l c l i n i c a l r e s e a r c h
t h a t c a n i m p r o v e p a t i e n t s ’ h e a l t h
o u t c o m e s
C o o r d i n a t e r e s e a r c h a c t i v i t i e s b y
c o n t i n u o u s l y i m p r o v i n g o u r r e s e a r c h
c a p a c i t y i n a c h i e v i n g t h e K e y
P e r f o r m a n c e I n d i c a t o r o f M i n i s t r y o f
H e a l t h
E s t a b l i s h a r e s e a r c h i n s t i t u t i o n
w h i c h i s w e l l k n o w n t h r o u g h o u t
M a l a y s i a a n d i n t e r n a t i o n a l l y
CRC TAGLINE
"Research that Matters to Patients"
MAIN FUNCTION
RESEARCH POLICY
P a t i e n t s h a v e t h e r i g h t t o c h o o s e
w h e t h e r o r n o t t o p a r t i c i p a t e i n a n y
r e s e a r c h o r c l i n i c a l t r i a l
R e s e a r c h e r s n e e d t o o b t a i n p a t i e n t
c o n s e n t b e f o r e e n g a g i n g i n c l i n i c a l
r e s e a r c h , i n v e s t i g a t i o n a n d c l i n i c a l
t r i a l s
I n f o r m a t i o n t h a t s h o u l d b e p r o v i d e d t o
t h e p a t i e n t a n d t h e p a t i e n t ' s f a m i l y t o
a s s i s t t h e p a t i e n t i n m a k i n g t h e
d e c i s i o n t o p a r t i c i p a t e i n t h e s t u d y
i n c l u d e :
I n v e s t i g a t i o n p r o c e d u r e
B e n e f i t s a n d r i s k s
C o n s e n t r e q u i r e m e n t s o f p a t i e n t s
( W i t h d r a w a l f r o m r e s e a r c h )
S u s p e n s i o n o r t e r m i n a t i o n o f
i n v e s t i g a t i o n
CRC HOSPITAL SHAH ALAM LOGO
3
4. Good Clinical Practice (GCP) is an international
ethical and scientific quality standard for
designing, conducting, recording and reporting
clinical trials that involve the participation of
human subjects. This workshop was held for the
purpose of giving training and certify those who
passed the examinations at the end of this
workshop. It has since become a requirement for
researchers in Malaysia to be certified with GCP
especially those who are involved in studies
involving human subjects. These annual
workshops on GCP were opened to accept
participants from throughout the district as well
as state.
20
20
EVENTS
MAIN EVENTS THROUGH 2020
B Y S H A F I Q A H Z A W A N I B I N T I M O H D R O D Z I
On the year 2020, CRC HSAS managed to
conduct and involved in 6 programs and events
starting from the month of July until November.
These event were done mostly during the Recovery
Movement Control Order (RMCO) phase with strict
protocol and SOPs observed by the organizer.
Besides, some of the event were done virtually in
order to proceed in the new normal.
‘GOOD CLINICAL PRACTICE’
(GCP) WORKSHOP
Date: 10th -12th August 2020
Venue: Auditorium, Aras 2, Management
Department, Hospital Shah Alam
Introduction to biostatistics and excel workshop
was held to guide the researchers on the right
statistical analysis following the standards set by
the Ministry of Health Malaysia as well exposed
them to the data and statistical management.
This workshop also aims to encourage the
medical officers in conducting the research to
further their studies to the higher level.
INTRODUCTION TO BIOSTATISTICS
AND EXCEL WORKSHOP
Date: 25th – 26th August 2020
Venue: Smart Room, Hospital Shah Alam
Speaker: Miss Nadiah binti Sa’at
(Statistician)
4
5. 13th National Conference for Clinical Research (e-NCCR) was held virtually. ICR showcased
the meaningful advancements in digital health and clinical research that had provided the
base for clinical trials and highlighted the accomplishments of research centres at NIH to
fellow researchers and clinicians, related to COVID-19. This event was hosted by the National
Institutes of Health (NIH). Aptly themed "Conference Of Very Important Disease (COVID-19)",
the conference aims to focus on disruptive technologies, interdisciplinary Digital Health
research and coordinate efforts to advance research in fighting against the pandemic that
affected the entire global. Delegates were able to explore possibilities and glean new
insights for eHealth, mHealth, Big data, IoMT and AI in curbing COVID-19. The NCCR research
e-Poster display session provided an opportunity for clinicians and researchers within the
Ministry of Health, Academia, Industry and Private hospitals to share their research findings
and discuss trends that will shape the future of healthcare in this difficult time.
Shah Alam Research Day is an annual event
organized by Clinical Research Centre (CRC)
Shah Alam Hospital. The increasing involvement
of the hospital staffs in research activities every
year shows promising improvement for this
hospital. In this modern world, research is very
crucial to improve the field of medicine for the
benefits of patients. Thus, this event was held to
provide the base for medical professionals from
various categories to explore in research world.
Besides that, this event aims to promote
awareness in research field through sharing from
medical specialists of ICR (Institute of Clinical
Research), Ministry of Health and other
educational institutes. This event also motivates
Statistical Consultation Clinic was organized by
CRC Unit Shah Alam Hospital to give exposure to
the medical professionals in research methodology,
clinical data management and basic statistics while
encouraging them to involve actively in research
activities. This consultation clinic was held and
periodically to discuss regarding research
conducted especially on statistical issues with the
expertise.
SHAH ALAM RESEARCH WEEK
2020
STATISTICAL CONSULTATION
CLINIC
Date: 19th – 23rd October 2020
Venue: Auditorium, Hospital Shah Alam
13TH E-NATIONAL CONFERENCE FOR CLINICAL RESEARCH
(E-NCCR)
Session 1: 14th July 2020
Session 2: 17th August 2020
Session 3: 15th September 2020
Session 4: 13th October 2020
more on research activities and generation of
case reports that leads to more research and
registration in National Medical Research
Registry website.
Speaker: Dr. Sharmini Selvarajah, Consultant
Clinical Epidemiologist.
MBBS (UM), Master in Public Health (Hons),
Master of Science in Clinical Epidemiology, PhD
(Utrecht, Netherlands)
Date: 24th – 26th October 2020
5
6. The participants able to understand the types of study design and learned on deciding the right keywords for
research topic. Besides, this CME gives understanding on the factors that influence the research subjects as well
the results. Types of bias in research also being introduced to the participants so the study can be conducted with
very minimal bias. After designing the study, the participants learned on developing the research proposal before
proceed to the next stage in research. In developing research proposal, the participants able to gain full
knowledge of creating the complete proposal based on the requirements needed.
CME SERIES 4: SAMPLE SIZE CALCULATION
This CME was held for the purpose to give exposure to the medical professionals on the protocols or manuscripts
review correctly for experimental research such as in clinical trials. It provides the marking scheme for research
protocols; thus, the participants were able to understand clearly the components required in study protocol
review. They also involved in reviewing the actual study protocols.
This CME introduced descriptive statistics such as mean
and standard deviation to the participants as well
understanding the role of relative risk and absolute risk
in research. The participants also learned on the right
way to calculate odds ratio, hazards ratio, P-value and
confidence interval for their research. Generally, this
CME gives benefits to the participants on learning the
statistical measure and understanding the treatment
results.
CME SERIES 1: UNDERSTANDING
CLINICAL TRIAL RESULTS
CME SERIES 2: UNDERSTANDING BASIC STUDY DESIGN AND DEVELOPING
RESEARCH PROPOSAL
Date: 14th July 2020
Date: 13th October 2020
Date: 17th August 2020
CME SERIES 3: STUDY PROTOCOL REVIEW
This CME was held for the purpose to give exposure to the medical
professionals on the protocols or manuscripts review correctly for
experimental research such as in clinical trials. It provides the
marking scheme for research protocols; thus, the participants were
able to understand clearly the components required in study protocol
review. They also involved in reviewing the actual study protocols.
CME SERIES 5: INTRODUCTION TO BASIC SPSS AND
INFERENTIAL ANALYSIS
This CME provides guidance to the researchers in inferential statistics
and deciding the right test for analysis using SPSS based on the type
of research. This CME was held virtually for 3 days. The topics include
introduction to SPSS, statistical concept, data management, selecting
commonly statistic test, table output, Reliability Test, Normality Test,
and inferential statistic test. From this CME, the researchers able to
analyze and infer their study result with the correct statistical test.
Date: 24th - 26th November 2020
Date: 13th October 2020
6
7. DOWN
THE
MEMORY
LANE R
E
S
E
A
R
C
H
D
A
Y
2017
Clinical Research Centre (CRC) and Department of
Ophthalmology of Hospital Shah Alam were held a national
level ‘OPHTHALMOLOGY RESEARCH DAY 2017’ on 17th and
18th August 2017. The research day was held to encourage
the medical officers and medical experts from Department
of Ophthalmology in hospitals throughout Malaysia to
involve in conducting research. The main purpose of the
research day was to foster a culture of research among
medical officers and medical experts in the Department of
Ophthalmology by providing a site to explore the world of
research. CRC managed to promote and cultivate
awareness as research is a leader in better health services.
2018
Selangor Central Zone Cluster Hospital Clinical Research
Centre Unit had organized ‘7th Selangor Research Week
2018’ on 1st-5th October 2018. It was the first event
organized by three hospitals in Selangor, namely Hospital
Tengku Ampuan Rahimah, Hospital Banting and Hospital
Shah Alam. The research day was filled with various
activities such as talks involving various disciplines
including Nursing, Pharmacy and Public Health, research
workshops as well as oral and poster presentation
competition. This event had been a site for specialists and
health officers, dental, pharmacy and allied health
categories such as nurses, assistant medical officers,
therapists etc. to explore the world of research. Indirectly,
the research day had been a medium to promote and
increase awareness of research through talks by the
expertise in order to foster the spirit of conducting
research to those who intend to further their studies in
undergraduate level.
2019
Hospital Shah Alam played an important role in organizing
Selangor Research Week collaborating with Hospital
Tengku Ampuan Rahimah. It was a successful event as it
gave a positive impact to the Hospital Shah Alam staff to
engage and learn more about research. Indirectly, this
research week could be a platform to promote and
increase awareness of research through talks by the
expertise. Nevertheless, it could foster the spirit of
conducting case study and report as well as further
encourage the registration of case reports and studies
through National Medical Research Registry (NMRR)
B Y N A Z I F I B I N T I Y U N U S
7
8. DAY 1
19TH OCTOBER
E-POSTER LAUNCHING
DAY 2
20TH OCTOBER
E-POSTER REVIEW
QUIZ COMPETITION
DAY 3
21ST OCTOBER
E-POSTER REVIEW
TOP 10 POSTER COMPETITION
TOP 10 VIEWERS FAVOURITE COMPETION (VIRTUAL)
DAY 4
22ND OCTOBER
TOP 10 VIEWERS FAVOURITE COMPETION (VIRTUAL)
DAY 5
23RD OCTOBER
ANNOUNCEMENT OF WINNER VIA RESEARCH DAY
OFFICIAL WEBSITE
1 PM - 2 PM
8 AM - 5 PM
8 AM - 10 AM
10 AM - 12 PM
12 PM - 5 PM
12 PM - 5 PM
12 PM - 5 PM
8
9. 20
20
2020
20
20
AZAD ERYANI BINTI MOHD ADAM
P47: A RARE CASE OF BRACHIAL PLEXUS SCHWANNOMA - A CASE
REPORT IN HOSPITAL SHAH ALAM
P13: TRAUMATIC COMPLICATIONS OF TRADITIONAL POST - NATAL
MASSAGE
JEGADEESBARI A/P GANAPATHY
P24: THE RELATIONSHIP BETWEEN RESTORATIVE DENTISTRY INDEX
OF TREATMENT NEED(RDITN) ENDODONTIC SCORE AND ORAL
HEALTH QUALITY OF LIFE, POST COMPLETE ROOT CANAL
TREATMENT- A PROSPECTIVE, COHORT STUDY
SHANTINA THEAJAH
DR. FATI MAH BI NTI ABDULLAH
DR. LIM PEI PEI
MOHD AIRYSHERMIL FARHAN BIN MOHD ANUAR
P37: ARTERIO-VENOUS MALFORMATION OF THE HAND. IS LOSING A
FINGER AN OPTION?
RESEARCH WEEK
RESEARCH WEEK
RESEARCH WEEK
9
10. 1ST
TO ACCESS MORE POSTER AND
ABSTRACT, VISIT OUR OFFICIAL
NEWSLETTER'S WEBSITE
1 0
11. I was first involved in doing research many years ago as I was completing
my diploma’s FYP. I was chosen as participant in poster presentation for
my diploma’s FYP at UiTM. I started to develop a keen interest in research
since I have been exposed to final year research project during my study
years. I am working full-time as occupational therapist at hospital and in
the meantime, I also taking my degree as part-time. In order for me to
conduct my degrees research project, I have to deal with Clinical
Research Centre (CRC) and hospital because I need to monitor the
patients from that hospital. I managed to present my degree’s FYP under
Occupational Therapy Conference at Pulau Redang and has awarded as
first place. This award motivates me and sparked my interest to present
more research papers including short reports and case studies after that. I
also grabbed the opportunities to present all my research papers during
my study years in conference that was held during that time.
In my opinion, as an occupational therapist, we need a scientific clinical
evidence to practice towards patients. Failing to have a scientific clinical
evidence will produce unreliable and non-standardized practice towards
patients which results in poorer quality. It is a requirement for any medical
officers or allied-health professionals to practice according to evidence-
based practice (EBP). Evidence-based practice encompasses both
scientific and local evidence such as diagnostic patient information,
situational information including cost and time constraints, and the
provider’s judgement and experience to achieve the best outcome. In
therapist context, clinical evidence-based practice is very crucial to
follow up the patient’s performance and deliver the best quality treatment
to the patients.
The most challenging part during my research journey is time
management. As I working during office hours from 8 am – 5 pm, so I can
only commit on my research study after office hours and weekend. It is not
an easy journey but the study will be conducted completely by having a
good teammates, continuous commitment and being a hardworking
researcher. Since I am conducting my research as part-time, hence I
personally think that teamwork during the research journey is utmost
important. By having a great teammates that are well-cooperated, this
can produce many inputs from different point of views to enhance the
quality of the research. When it’s time to focus on my research, I will
commit very well and deliver continuous efforts to complete my study as
well seeking for research knowledge diligently by attending classes and
seminars. Thus, by portraying these attributes, it will overcome the
challenges during the research journey.
R
E
S
E
A
RCH PERSON
A
L
I
T
Y
W h a t f i r s t s p a r k e d y o u r i n t e r e s t i n r e s e a r c h ?
I n y o u r o p i n i o n , a s a n o c c u p a t i o n a l t h e r a p i s t , w h a t i s t h e
i m p o r t a n c e o f r e s e a r c h i n y o u r p r a c t i c e ?
W h a t i s y o u r a c h i e v e m e n t s i n r e s e a r c h t h r o u g h o u t y o u r
c a r e e r ?
Best Poster Presentation at Malaysia Occupational Therapy
Conference 2016 (First Place)
Participate in Oral Presentation at Malaysia Occupational Therapy
National Conference, 2018.
Participate in Selangor Research Week, 2018.
Participate in 12th Allied Health Scientific Conference, 2018
W h a t a r e t h e c h a l l e n g e s t h a t y o u h a v e e x p e r i e n c e d d u r i n g
y o u r r e s e a r c h j o u r n e y a n d h o w y o u o v e r c o m e i t ?
MOHD AZAM BIN ABDUL
HALIM
M r . M o h d A z a m b i n A b d u l H a l i m i s a
M e d i c a l R e h a b i l i t a t i o n O f f i c e r i n
U n i v e r s i t i P u t r a M a l a y s i a T e a c h i n g
H o s p i t a l . H e s t a r t e d h i s s t u d y a t
C o l l e g e o f A l l i e d H e a l t h S c i e n c e ,
S u n g a i B u l o h i n D i p l o m a o f A p p l i e d
R e h a b i l i t a t i o n O c c u p a t i o n a l
T h e r a p y w h e r e h e e a r n e d t h e B e s t
T r a i n e e A w a r d a n d B e s t A c a d e m i c
A w a r d . T h e n , h e o b t a i n e d h i s
B a c h e l o r D e g r e e i n A p p l i e d
R e h a b i l i t a t i o n i n O c c u p a t i o n a l
T h e r a p y w i t h h o n o u r s i n T e e s i d e
U n i v e r s i t y , U n i t e d K i n g d o m . M r . A z a m
c o n t i n u e h i s p o s t g r a d u a t e s t u d y i n
M a s t e r o f O c c u p a t i o n a l T h e r a p y i n
D e v e l o p m e n t a l D i s a b i l i t y a t U n i v e r s i t i
T e k n o l o g i M a r a , P u n c a k A l a m ( U i T M )
a n d c u r r e n t l y e n r o l l i n g a s a
c a n d i d a t e f o r D o c t o r o f P h i l o s o p h y i n
O c c u p a t i o n a l T h e r a p y a t U i T M P u n c a k
A l a m . H e s t a r t e d h i s c a r e e r a s
o c c u p a t i o n a l t h e r a p i s t a t H o s p i t a l
S u l t a n a h B a h i y a h , A l o r S e t a r , K e d a h
i n 2 0 1 2 a n d t r a n s f e r t o a f e w
h o s p i t a l s t h r o u g h o u t t h e y e a r s u n t i l
2 0 2 1 a t H o s p i t a l S h a h A l a m ,
S e l a n g o r .
1 1
12. W h a t i s y o u r a d v i c e s t o e n c o u r a g e m o r e
h e a l t h c a r e p r o f e s s i o n a l s o r o t h e r p e o p l e t o
i n v o l v e i n r e s e a r c h f i e l d ?
Participating in research field is essential for every medical
practitioner as it will transform one to be a more medically
matured and knowledgeable practitioner. Medical research
goal is to develop new medicines or medical procedures or
improving the application of those already available. This
can be done by seeking a knowledge through research.
Hence, by doing research, it can provide important
information about disease trends and risk factors, outcomes
of treatment or public health interventions, functional
abilities, patterns of care, and health care costs and use.
The different approaches to research provide
complementary insights. Besides, having first-hand
experience with new treatment during the development
phase will provide confidence in using the treatment when it
is marketed and knowledgeable when it comes in explaining
to the patients. Moreover, research can improve the readily
treatment to the newest technique for patient’s quality and
recovery. We can read research papers to find the updated
treatment, however as medical practitioner, we need to
conduct a well-design clinical trials itself in order to assess
and monitor the patient’s performance.
I wish research field in Malaysia should be introduced
early to all healthcare professionals so it will become
a requirement for a medical practitioner to conduct
clinical trials in their field of practice. Besides, in non-
medical aspect, research and development field
should be expanded widely so it can provide more job
opportunities for others to involve. I wish to see the
growth of IIR and ISR, and more research should be
done in this country for benefits of the patients and
hospitals. Malaysians are certainly capable of
conducting high quality clinical trials. However, we
need to establish our reputation in research, nurture
and develop a pool of future researchers who are
passionate and well-trained. We also need more high
impact research that changes clinical care and public
health. I personally feel that it is now the right time
for Malaysia to develop infrastructures and resources
for the conduct of clinical research as this is the only
way forward. More incentives also should be given to
the companies that conduct clinical research and to
the investigators that participate in research.
I n t h e n e x t 1 0 y e a r s , w h e r e d o y o u w i s h t o
s e e M a l a y s i a i n t h e f i e l d o f r e s e a r c h ?
The first thing to be a good researcher are discipline and ethical since we are dealing with humans. A good
researchers must be sincere. Usually, the person who is sincere in carrying out their work would also be a highly-
disciplined and honest character. For a good researcher, research integrity is an aspect of moral character. It involves
above all, a commitment to intellectual honesty and responsibility for a range of practices that characterize
responsible research conduct. Besides that, a good researcher is usually the one that is very curious, very inquisitive
and also very observant. The researchers should be motivated by their curiosity, as well have the urge and sincere
need in finding the explanation to their observation and curiosity. The fuel is your curiosity, the tool is your
observation. In the other hand, being passionate towards research is definitely one of the attributes that makes a
good researcher. Passion towards the review papers, research methodology, statistical and passion in seeking the
answers to the curiosity. All in all, become a good research will eventually produce the best quality of research with
the highest degree of scientific and ethical standards.
W h a t d o y o u t h i n k m a k e s a ‘ g o o d r e s e a r c h e r ’ ?
1 2
13. R
E
S
E
A
RCH PERSON
A
L
I
T
Y
W h a t f i r s t s p a r k e d y o u r i n t e r e s t i n r e s e a r c h ?
I started to have interest in research when I was pursuing my master. From that
moment, my interest to conduct research grows deeper and deeper. In my previous
degree, research was not compulsory at that time. So, my research exposure was
started when I pursued my master. Since then, I started to get involved more in
research.
I n y o u r o p i n i o n , a s a p h a r m a c i s t w h a t i s t h e i m p o r t a n c e o f
r e s e a r c h i n y o u r p r a c t i c e ?
Pharmacy is a budding profession. By doing research, we can improve the patient
outcome, the quality and safety of the healthcare as well as medication safety.
Doing research may help to develop the profession. By doing research, we can even
change and improve the policies.
W h a t i s y o u r a c h i e v e m e n t s i n r e s e a r c h t h r o u g h o u t y o u r
c a r e e r ?
W h a t a r e t h e c h a l l e n g e s t h a t y o u h a v e e x p e r i e n c e d d u r i n g
y o u r r e s e a r c h j o u r n e y a n d h o w y o u o v e r c o m e i t ?
The biggest challenge for me while conducting research is no protected or
allocated time to focus on research. Research never part with our call-duties. It
based on your time management. There were no specific hours to sit and focus on
your research. This can cause people to produce poor quality and not meaningful
research. Even worst, duplicate study might be produced by an irresponsible
person. Therefore, the person who want to conduct research needs to have high-
interest or passionate towards conducting research. Only then, the person will have
his own initiative to spend his time focusing on research. I hope the stakeholders
can cooperate with our daily duties to state the specific time to do research.
W h a t d o y o u t h i n k m a k e s a ‘ g o o d r e s e a r c h e r ’ ?
Along my research journey, two of my research were published (Intravenous
Medication Errors: Incidence Contributing Factors and Potential Clinical Outcome
and Development and Validation of questionnaire to assess parents’ perception
towards childhood vaccine). I managed to get Best Research Award (JKNS 2018) for
Intravenous Medication Errors: Incidence Contributing Factors and Consolation
Prize at 10th National R&D Conference for Development and Validation of
questionnaire to assess parents’ perception towards childhood vaccine. Besides
that, my other researches were only presented and written.
W h a t i s y o u r a d v i c e s t o e n c o u r a g e m o r e h e a l t h c a r e
p r o f e s s i o n a l s o r o t h e r p e o p l e t o i n v o l v e i n r e s e a r c h f i e l d ?
One of the traits that should be in a good researcher is hard working. Passionate
and hard working are the traits that must go hand in hand to produce a good
researcher. Another trait is creative. A good researcher needs to be creative in
order to transform the idea into research protocols. Patience is another vital trait
that should be instilled in yourself. Last but not least, a good researcher must be
ethical. Curiosity also can create a good researcher. For example, i always curious
on how to solve a certain issue. From that, these traits can develop yourself to be a
good researcher and at the same time you can serve and improve your department
and profession.
Apart from the challenges that we faced such as no ample time to do research and
lack of experience in research field, the most vital point for infant researcher is to
choose the interest field before conducting the study. You will never easily give up
when something goes wrong while you are conducting the research. That will be a
good start for them to succeed in research. Another point is to enjoy your research
journey along with the team. Be interactive with the teammates while having
discussion to exchange great ideas. Do not easily give up and surrender when
something goes wrong.
I n t h e n e x t 1 0 y e a r s , w h e r e d o y o u w i s h t o s e e M a l a y s i a i n
t h e f i e l d o f r e s e a r c h ?
I hope that the stakeholders can see there is the need to produce a good quality
research. Guidance should be constantly provided to the infant researchers in
order to produce a good quality research. If there is endless effort from both
parties, we can expect Malaysia to be the top country in research field.
M r s . J o s e p h i n e H e n r y B a s i l i s a
R e g i s t e r e d P h a r m a c i s t c u r r e n t l y i n
H o s p i t a l S h a h A l a m , S e l a n g o r . S h e
p u r s u e d h e r B a c h e l o r D e g r e e i n
P h a r m a c y a t U n i v e r s i t i S a i n s M a l a y s i a
( U S M ) a n d g r a d u a t e d i n 2 0 0 6 . L a t e r ,
s h e b e g a n h e r p o s t g r a d u a t e s t u d y i n
M a s t e r o f P h a r m a c y i n C l i n i c a l
P h a r m a c y d u r i n g 2 0 1 1 . S h e s t a r t e d
h e r c a r e e r a s a p h a r m a c i s t i n 2 0 0 6
a s P r o v i s i o n a l R e g i s t e r e d P h a r m a c i s t
i n H o s p i t a l B u k i t M e r t a j a m , P u l a u
P i n a n g . A f t e r a y e a r o f c o m p u l s o r y
p r o v i s i o n a l p e r i o d , s h e o b t a i n e d t h e
o f f i c i a l R e g i s t e r e d P h a r m a c i s t a n d
w o r k i n g a t t h e g o v e r n m e n t c l i n i c i n
P u l a u P i n a n g . B e f o r e s t e p p i n g i n s i d e
a s a p h a r m a c i s t i n H o s p i t a l S h a h
A l a m , s h e a l s o w o r k e d a t K l i n i k
K e s i h a t a n K e l a n a J a y a & S e r i
K e m b a n g a n b e f o r e w o r k i n g i n
H o s p i t a l S h a h A l a m
JOSEPHINE HENRY
BASIL
1 3
14. 1 4
CRC HSAS
INTERNSHIP PROGRAMME
OBJECTIVE
Exposure to real working environment and application of
knowledge through hands-on experience
OUTCOMES
An opportunity to experience a clinical research-based organization
Learning a lot of new skills regarding research and non-research
related
Able to enhance interpersonal skills such as conflict management,
teamwork and decision-making skill.