Martin's Formula As the Most Suitable Method for Estimation of Low-Density Lipoprotein Cholesterol in Indian Population.

Background Because of cost effectiveness, most of the laboratories in India estimate low-density lipoprotein cholesterol (LDL-C) levels with the Friedewald's formula. There were many shortcomings of the Friedewald's formula. Recently, Martin and colleagues have derived a new formula for calculating LDL-C. The present study was undertaken to calculate LDL-C using various formulae (Friedewald's formula, Anandaraja's formula, and Martin's formula) and to compare directly measured LDL-C (D-LDL-C) with calculated LDL-C at various ranges of triglyceride (TG) concentration. Materials and Methods The present study compared LDL-C measured by Martin's formula, Friedewald's formula, and Anandaraja's formula with D-LDL-C in 280 outpatient fasting samples between the age groups of 18 and 50 years. Depending on the TG values, study samples were divided into four groups. Group 1: less than 200 mg/dL; Group 2: 200 to 300 mg/dL; Group 3: 300 to 400 mg/dL; and Group 4: more than 400 mg/dL. Results Martin's formula shows highest correlation with r -value of 0.9979 compared with Friedewald's (0.9857) and Anandaraja's (0.9683) r -values. The mean difference was least for Martin's formula (0.31 ± 3.53) compared with other formulae. Among all the groups, percentage of error was least for Martin's formula (0.23%). Martin's LDL-C shows highest concordance (90.90%) compared with Friedewald's (79.60%) and Anandaraja's formulae (82.90%). Conclusion Among all the groups, Martin's formula shows highest correlation, least percentage of error, highest concordance, and least mean differences. At all TG levels, Martin's formula is the best formula compared with the Friedewald's formula and Anandaraja's formula.

Study on personality dimension negative emotionality affecting academic achievement among Malaysian medical students studying in Malaysia and overseas.

Personality dimension negative emotionality is known to be associated with academic achievement. The present study focuses on the influence of negative emotionality (neuroticism) on the medical students' academic achievements. The main objective of this study was to ascertain the negative emotionality scores among the first year Malaysian medical students studying in Malaysia and India, further to find out the association between negative emotionality and their academic achievements. The current study sample includes 60 first year Malaysian medical students from Universiti Sultan Zainal Abidin, Malaysia, and USM-KLE IMP, Belgaum, India. They were selected by convenient sampling technique. The Medico-Psychological questionnaire was used to find out the negative emotionality scores among the students and these scores were compared with academic scores. The data were analyzed using SPSS- 20. Thus, the study result goes with the prediction that there is a significant correlation between academic achievement and negative emotionality. We concluded that negative emotionality has a negative impact on medical student's academic achievement regardless of the fact whether they study in their own country or overseas.

Hand decontamination practices and the appropriate use of gloves in two adult intensive care units in Malaysia.

BACKGROUND: Hand decontamination is a critical infection control practice in the prevention of nosocomial infection. This study was conducted to observe the hand hygiene practices of nurses and doctors in two intensive care units (ICUs) in Malaysia. METHODOLOGY: Staff members were observed during patient contacts, and their hand washing techniques and hand hygiene practices were monitored. Five contact periods were observed for staff members while they cared for their assigned patients. Hand hygiene practices before and after patient contacts were categorized as clean uncontaminated, clean recontaminated, new gloves, and unchanged contaminated gloves. Compliance to hand-washing steps and time taken for hand washing were analyzed. Appropriate use of gloves based on CDC criteria also was assessed. RESULTS: Compliance to hand hygiene practices was 70% before each patient contact. Staff members did not completely adhere to the hand-washing steps. The average time taken to wash hands was 20 seconds, and the necessary steps (rubbing palm over dorsum; rubbing fingers interlaced, and rotational rubbing of thumbs) were practiced minimally by all staff. Hand washing protocol was generally followed by all staff (100%). Alcohol hand rubs were available but were used moderately (60%); when used, staff members did not wait for the alcohol to dry. Only 4% of staff changed contaminated gloves between patients. CONCLUSIONS: Hand hygiene compliance by ICU staff members needs to be improved. Improving adherence to correct hand hygiene techniques will require effective education programs and behavioral modification techniques. Moreover, hand hygiene guidelines must be incorporated into new staff orientation programs and the continuing education curriculum in the two hospitals studied.

Ventilator-associated nosocomial pneumonia in intensive care units in Malaysia.

BACKGROUND: The outcome indicator of nosocomial infection (NI) in the intensive care unit (ICU) is used to benchmark the quality of patient care in Malaysia. We conducted a three-year prospective study on the incidences of ventilator-associated pneumonia (VAP), risk factors, and patterns of the microorganisms isolated in three ICUs. METHODOLOGY: A follow-up in prospective cohort surveillance was conducted on patients admitted to an adult medical-surgical ICU of a university hospital and two governmental hospitals in Malaysia from October 2003 to December 2006. VAP was detected using CDC criteria which included clinical manifestation and confirmed endotracheal secretion culture results. RESULTS: In total, 215 patients (2,306 patient-days) were enrolled into the study. The incidence of ICU-acquired device-related NI was 29.3 % (n = 63). The device-related VAP infection rate was 27.0 % (n = 58), with a mechanical ventilator utilization rate of 88.7%. The death rate due to all ICU-acquired NI including sepsis was 6.5%. The most common causative pathogen was Klebsiella pneumoniae (n = 27). Multivariate analysis using Cox regression showed that the risk factors identified were aspiration pneumonia (HR = 4.09; 95% CI = 1.24, 13.51; P = 0.021), cancer (HR = 2.51; 95% CI = 1.27, 4.97; P = 0.008), leucocytosis (HR=3.43; 95% CI= 1.60, 7.37; P=0.002) and duration of mechanical ventilation (HR=1.04; 95% CI = 1.00, 1.08; P = 0.030). Age, gender and race were not identified as risk factors in the multivariable analysis performed. CONCLUSION: The incidence of VAP was comparable to that found in the National Nosocomial Infection Surveillance (NNIS) System report of June 1998. The incidence of VAP was considered high for the three hospitals studied.