Browse publications by year: 2016

  1. Shamini Arasalingam, Hatta Sidi, Ng Chong Guan, Srijit Das, Marhani Midin, Ramli Musa
    MyJurnal
    Introduction: Both premature ejaculation(PE) and erectile dysfunction(ED) are prevalent sexual health disorders that have been inadequately investigated in Malaysia, a multiethnic and conservative nation.The objective of the study was to study the relationship between PE and ED, and other common mental health issues, i.e. anxiety and depression in Malaysian urban population.
    Methods: The diagnosis for PE was established by clinical diagnosis using DSM-5 and ISSM definition criteria for PE, whereas a diagnosis of ED was established by the International Index of Erectile Function (IIEF) questionnaire. Anxiety and depression levels were detected from the Hospital Anxiety and Depression Scale (HADS).
    Results: Based on DSM-V and ISSM clinical diagnosis for PE, the prevalence of PE was found to be 25%. Erectile dysfunction (p = 0.035, OR = 3.315, 95% CI 1.088, 10.103) and severe anxiety (p = 0.020, OR = 7.656, 95% CI 1.383, 42.396) significantly predicted presence of PE.
    Conclusion: There was a strong association between PE and ED and between PE and anxiety. Routine examination for PE in male patients should address the issue and the management of both ED and anxiety among PE patients, especially in an urban Malaysian clinical and medical care setting.
    MeSH terms: Anxiety; Anxiety Disorders; Depression; Depressive Disorder; Humans; Erectile Dysfunction; Malaysia; Male; Mental Health; Surveys and Questionnaires; Urban Population; Prevalence; Diagnostic and Statistical Manual of Mental Disorders; Premature Ejaculation
  2. Rathor MY, Azarisman Shah MS, Hasmoni MH
    MyJurnal
    The practice of contemporary medicine has been tremendously influenced by western ideas and it is assumed by many that autonomy is a universal value of human existence. In the World Health Report 2000, the World Health Organization (WHO) considered autonomy a “universal” value of human life against which every health system in the world should be judged. Further in Western bioethics, patient autonomy and self -determination prevails in all sectors of social and personal life, a concept unacceptable to some cultures. In principle, there are challenges to the universal validity of autonomy, individualism and secularism, as most non-Western cultures are proud of their communal relations and spiritualistic ethos and, thereby imposing Western beliefs and practices as aforementioned can have deleterious consequences. Religion lies at the heart of most cultures which influences the practice patterns of medical professionals in both visible and unconscious ways. However, religion is mostly viewed by scientists as mystical and without scientific proof. Herein lies the dilemma, whether medical professionals should respect the cultural and religious beliefs of their patients? In this paper we aim to discuss some of the limitations of patient's autonomy by comparing the process of reasoning in western medical ethics and Islamic medical ethics, in order to examine the possibility and desirability of arriving at a single, unitary and universally acceptable notion of medical ethics. We propose a more flexible viewpoint that accommodates different cultural and religious values in interpreting autonomy and applying it in an increasingly multilingual and multicultural, contemporaneous society in order to provide the highest level of care possible.
    MeSH terms: Ethics, Medical; Islam; Religion
  3. Ahmed Kaid, N. A., Norbaiyah, M. B., Imad, M. A., Norazian, M. H.
    MyJurnal
    Introduction: This study aims to build a standardization method for preparation of effective powder from
    FSA and to quantify diosgenin in FSA. Methodology: One kg of FS were used in this study. Setting: BMS, KOM
    and KOP, IIUM Kuantan campus. FS were washed with distilled water to exclude any foreign matter, and
    were then air dried. FS-powder were put in distilled water in a ratio of 1 g of powder in 20 ml of distilled
    water and were shaken at room temperature for 24 hours. Ten mg of hydrolyzed extract sample was diluted
    in 10 ml volumetric flask with methanol for 15 minutes. Chromatographic estimation was performed using
    an equilibrated reverse phase Eclipse XDB-C18 column (particle size 5 µg, 4.6 mm x 150 mm). Results: One
    gram of FSA extract was hydrolyzed to produce sapogenins and 46.6% was recovered. A calibration curve
    that was constructed based on five dilutions of diosgenin standard at concentrations of 2, 5, 10, 20, 30 and
    50 ppm produced a linear graft (r = 0.999). The concentration of diosgenin in FSA extract as calculated using
    the regression analysis was found to be 29.66 µg/ml, 13.81 % w/w on dried weight basis. Conclusion:
    Preparation and standardization of effective powder from FSA are the corner stone of many scientific
    researches in IIUM and Malaysia. Diosgenin is available in the FSA in adequate concentration. The adequate
    amount of diosgenin in the FSA will guide us to do further study in the way of preparation of a natural
    product that can be used in the field of reversible anti-fertility therapy.
    MeSH terms: Methanol; Calibration; Chromatography; Diosgenin; Fertility; Hydrolysis; Malaysia; Particle Size; Powders; Reference Standards; Regression Analysis; Sapogenins; Temperature; Water
  4. Md. Muziman Syah, M. M., Mutalib, H. A., Sharanjeet Kaur, M. S., Khairidzan Khairidzan, M. K.
    MyJurnal
    Introduction: The purpose of this study was to evaluate inter-session repeatability, inter-examiner
    reproducibility and inter-device agreement of corneal power measurements from manual keratometer,
    autokeratometer, topographer, Pentacam high resolution and IOLMaster. Methods: Two sets of mean
    corneal power measurements (n=40) were compared for inter-session repeatability and inter-examiner
    reproducibility in each instrument. Repeatability and reproducibility were evaluated by within-subject
    standard deviation (Sw), coefficient of variation (COV) and intraclass correlation coefficient (ICC). A oneway
    repeated measures analysis of variance was conducted to compare differences in the corneal power
    between each instrument pair. The Bland and Altman analysis and Pearson’s correlation were employed to
    assess agreement and determine strength of relationship between measurements. Results: There were no
    significant differences in mean corneal power measurements between 2 different visits (p > 0.05). The Sw
    and COV values between 2 visits were lower than 0.09 D and 0.20 % respectively. The ICCs were stronger
    than 0.99 in all instruments. For reproducibility of each instrument, differences of the measurements
    between 2 different examiners were also insignificant (p > 0.05). The Sw and COV values between 2
    examiners were lower than 0.11 D and 0.23 % respectively. The ICCs were 0.99 and above in all instruments.
    The 95% limit of agreement between instruments ranged from -0.29 to 1.13 D and the r-values were stronger
    than 0.84. Conclusion: The corneal power measurements using these 5 instruments were repeatable and
    reproducible. These instruments can also be used interchangeably, however the topographer should be used
    with caution.
    MeSH terms: Alkynes; Analysis of Variance; Cholecalciferol; Cornea; Reproducibility of Results; Corneal Topography
  5. Ong YS, Saiful Yazan L, Ng WK, Noordin MM, Sapuan S, Foo JB, et al.
    Int J Nanomedicine, 2016 11 09;11:5905-5915.
    PMID: 27877037
    BACKGROUND: Thymoquinone (TQ), the predominant active lipophilic component in Nigella sativa seed oil, has a variety of pharmacological properties such as anticancer activities. However, translation of TQ to clinical phase is still not possible due to its hydrophobic properties. This problem can be solved by encapsulating it in nanoformulations to enhance its pharmacological properties. In our previous study, TQ has been successfully encapsulated in a nanostructured lipid carrier (hereinafter referred to as TQNLC) with excellent physiochemical properties such as high encapsulation efficiency, high drug-loading capacity, particle diameter less than 100 nm, and stability up to 2 years. In vitro studies also proved that TQNLC exhibited antiproliferative activity toward breast and cervical cancer cell lines. However, no toxicity profile related to this formulation has been reported. In this study, we determine and compare the in vivo toxicity of both TQNLC and TQ.

    MATERIALS AND METHODS: The in vivo toxicity (acute and subacute toxicity) study was carried out by oral administration of TQNLC and TQ to BALB/c mice. Animal survival, body weight, organ weight-to-body weight ratio, hematological profile, biochemistry profile, and histopathological changes were analyzed.

    RESULTS: In acute toxicity, TQ that is loaded in nanostructured lipid carrier (NLC) was found to be less toxic than pure TQ. It can be concluded that encapsulation of TQ in lipid carrier minimizes the toxicity of the compound. In the subacute toxicity study, oral administration of 100 mg/kg of TQNLC and TQ did not cause mortality to either male or female but resulted in toxicity to the liver. It is postulated that long-term consumption of TQNLC and TQ may cause toxicity to the liver but not to the extent of altering the functions of the organ. For both treatments, the no observed adverse effect level (NOAEL) was found to be 10 mg/kg/d for mice in both sexes.

    CONCLUSION: For long-term oral consumption, TQ and TQNLC at a dose of 10 mg/kg is safe in mice and does not exert any toxic effect. The results provide safety information of TQNLC, which would further help researchers in clinical use.

    MeSH terms: Animals; Drug Compounding; Female; Humans; Lipids/chemistry*; Liver/drug effects; Male; Mice, Inbred BALB C; Seeds/chemistry; Benzoquinones/pharmacology; Benzoquinones/toxicity*; Benzoquinones/chemistry*; Toxicity Tests, Acute; Nigella sativa/chemistry; Cell Line, Tumor; Cell Proliferation/drug effects; Nanostructures/chemistry*; Mice
  6. Khan MU, Ahmad A, Malik S, Balkrishnan R
    Res Social Adm Pharm, 2016 11 18;13(2):399.
    PMID: 27884658 DOI: 10.1016/j.sapharm.2016.10.019
    MeSH terms: Automation*; Humans; India; Pharmaceutical Services/standards; Pharmacists*; Pharmacy Service, Hospital/organization & administration; Drug Prescriptions
  7. EAS Familial Hypercholesterolaemia Studies Collaboration, Vallejo-Vaz AJ, Akram A, Kondapally Seshasai SR, Cole D, Watts GF, et al.
    Atheroscler Suppl, 2016 Dec;22:1-32.
    PMID: 27939304 DOI: 10.1016/j.atherosclerosissup.2016.10.001
    The potential for global collaborations to better inform public health policy regarding major non-communicable diseases has been successfully demonstrated by several large-scale international consortia. However, the true public health impact of familial hypercholesterolaemia (FH), a common genetic disorder associated with premature cardiovascular disease, is yet to be reliably ascertained using similar approaches. The European Atherosclerosis Society FH Studies Collaboration (EAS FHSC) is a new initiative of international stakeholders which will help establish a global FH registry to generate large-scale, robust data on the burden of FH worldwide.
    MeSH terms: Cooperative Behavior; Humans; Hyperlipoproteinemia Type II/diagnosis; Hyperlipoproteinemia Type II/genetics; Hyperlipoproteinemia Type II/mortality; Hyperlipoproteinemia Type II/therapy*; International Cooperation*; Organizational Objectives; Registries*; Research Design*; Information Storage and Retrieval; Treatment Outcome; Access to Information; Data Mining
  8. Hasan SS, Thiruchelvam K, Ahmed SI, Clavarino AM, Mamun AA, Kairuz T
    Asian J Psychiatr, 2016 Oct;23:56-63.
    PMID: 27969080 DOI: 10.1016/j.ajp.2016.07.005
    Anxiety and depression are more common among females and those experiencing diabetes and menopause. Menopausal symptoms experienced by women can vary tremendously from population to population; therefore, there is a need to investigate these symptoms and associated risk factors in different communities. This study investigated the differences in psychological health and menopause-specific quality of life (MENQOL) between women with and without diabetes type 2 (T2DM) in Malaysia. Women with T2DM (n=320) were matched by age range to controls without T2DM (n=320). Data were collected from March 2012 to January 2013. Delusions Symptoms States Inventory (DSSI) instrument was used to identify symptoms of depression and anxiety. Women with diabetes had higher depressive (11.8% versus 8.4%) and anxiety (8.4% versus 6.6%) symptoms compared to women without diabetes. In both groups, the most common menopausal symptom was aches (muscles and joints). Women without diabetes had significantly higher scores for the sexual domain compared to women with diabetes (4.20 versus 3.21, p=0.001). The odds that a postmenopausal woman with diabetes was depressed or anxious on the DSSI scale increased significantly when the MENQOL score on the physical, vasomotor, and psychosocial domains increased by one unit. Both diabetes and psychological problems have negative impact on MENQOL. Our findings support the view of screening postmenopausal women with diabetes for depressive and anxiety, to improve overall quality of life.
    MeSH terms: Adult; Aged; Anxiety/psychology*; Depression/psychology*; Diabetes Mellitus, Type 2/psychology*; Female; Humans; Malaysia; Menopause/psychology*; Middle Aged; Quality of Life/psychology*
  9. Isa SN, Ishak I, Ab Rahman A, Mohd Saat NZ, Che Din N, Lubis SH, et al.
    Asian J Psychiatr, 2016 Oct;23:71-77.
    PMID: 27969083 DOI: 10.1016/j.ajp.2016.07.007
    Families caring for children with disabilities face particular challenges and demands compared to those caring for children without disabilities. Evidence suggests that there is considerable variation in how caregivers of children with disabilities adapt to their caregiving demands and stressors. The different adaptations to the children with disabilities may cause different impacts on the health and well-being of caregivers. This paper provides a brief overview of the literature on the impact of caring for children with disabilities on the health and quality of life of caregivers and the factors related to the health outcomes and quality of life. A literature search was conducted by using various electronic databases, including PsychINFO, ScienceDirect, ProQuest, and MEDLINE using specific key terms. Thirty-one articles published in peer-review journals from the last six years (2009-2014) were reviewed. Most of the studies were quantitative studies. Factors discussed that impact on caregivers' health and quality of life include the caregivers' sociodemographic background and child's disability-related factors. Several mediators and moderators including coping strategies, social support, parental stress, self-esteem and self-efficacy are described in this paper. This review highlighted the importance of these factors to better understand the complex nature of stress processes and the caregivers' adaptations to their children's disabilities.
    MeSH terms: Adult; Child; Health Status*; Humans; Quality of Life*; Caregivers*; Disabled Children*
  10. Goay YX, Chin KL, Tan CL, Yeoh CY, Ja'afar JN, Zaidah AR, et al.
    Biomed Res Int, 2016;2016:8905675.
    PMID: 27975062
    Salmonella Typhi (S. Typhi) causes typhoid fever which is a disease characterised by high mortality and morbidity worldwide. In order to curtail the transmission of this highly infectious disease, identification of new markers that can detect the pathogen is needed for development of sensitive and specific diagnostic tests. In this study, genomic comparison of S. Typhi with other enteric pathogens was performed, and 6 S. Typhi genes, that is, STY0201, STY0307, STY0322, STY0326, STY2020, and STY2021, were found to be specific in silico. Six PCR assays each targeting a unique gene were developed to test the specificity of these genes in vitro. The diagnostic sensitivities and specificities of each assay were determined using 39 S. Typhi, 62 non-Typhi Salmonella, and 10 non-Salmonella clinical isolates. The results showed that 5 of these genes, that is, STY0307, STY0322, STY0326, STY2020, and STY2021, demonstrated 100% sensitivity (39/39) and 100% specificity (0/72). The detection limit of the 5 PCR assays was 32 pg for STY0322, 6.4 pg for STY0326, STY2020, and STY2021, and 1.28 pg for STY0307. In conclusion, 5 PCR assays using STY0307, STY0322, STY0326, STY2020, and STY2021 were developed and found to be highly specific at single-gene target resolution for diagnosis of typhoid fever.
    MeSH terms: Genes, Bacterial*; Salmonella typhi/genetics*; Sensitivity and Specificity; Species Specificity; Typhoid Fever/diagnosis*; Typhoid Fever/genetics; Typhoid Fever/microbiology*; Biomarkers/metabolism*; Polymerase Chain Reaction/methods*
  11. Hussain H, Chong NF
    Biomed Res Int, 2016;2016:8041532.
    PMID: 27995143
    The combined overlap extension PCR (COE-PCR) method developed in this work combines the strengths of the overlap extension PCR (OE-PCR) method with the speed and ease of the asymmetrical overlap extension (AOE-PCR) method. This combined method allows up to 6 base pairs to be mutated at a time and requires a total of 40-45 PCR cycles. A total of eight mutagenesis experiments were successfully carried out, with each experiment mutating between two to six base pairs. Up to four adjacent codons were changed in a single experiment. This method is especially useful for codon optimization, where doublet or triplet rare codons can be changed using a single mutagenic primer set, in a single experiment.
    MeSH terms: Codon/genetics*; DNA/genetics*; Mutation/genetics*; Mutagenesis, Site-Directed/methods*; Base Pair Mismatch/genetics*; Multiplex Polymerase Chain Reaction/methods*
  12. Rad MA, Tijjani AS, Ahmad MR, Auwal SM
    Sensors (Basel), 2016 Dec 23;17(1).
    PMID: 28025571 DOI: 10.3390/s17010014
    This paper proposes a new technique for real-time single cell stiffness measurement using lead zirconate titanate (PZT)-integrated buckling nanoneedles. The PZT and the buckling part of the nanoneedle have been modelled and validated using the ABAQUS software. The two parts are integrated together to function as a single unit. After calibration, the stiffness, Young's modulus, Poisson's ratio and sensitivity of the PZT-integrated buckling nanoneedle have been determined to be 0.7100 N·m-1, 123.4700 GPa, 0.3000 and 0.0693 V·m·N-1, respectively. Three Saccharomyces cerevisiae cells have been modelled and validated based on compression tests. The average global stiffness and Young's modulus of the cells are determined to be 10.8867 ± 0.0094 N·m-1 and 110.7033 ± 0.0081 MPa, respectively. The nanoneedle and the cell have been assembled to measure the local stiffness of the single Saccharomyces cerevisiae cells The local stiffness, Young's modulus and PZT output voltage of the three different size Saccharomyces cerevisiae have been determined at different environmental conditions. We investigated that, at low temperature the stiffness value is low to adapt to the change in the environmental condition. As a result, Saccharomyces cerevisiae becomes vulnerable to viral and bacterial attacks. Therefore, the proposed technique will serve as a quick and accurate process to diagnose diseases at early stage in a cell for effective treatment.
    MeSH terms: Lead/chemistry*; Saccharomyces cerevisiae; Titanium/chemistry*; Zirconium/chemistry*; Finite Element Analysis*; Nanostructures/adverse effects; Nanostructures/chemistry*; Elastic Modulus/drug effects
  13. Woi PJ, Kaur S, Waugh SJ, Hairol MI
    F1000Res, 2016;5:1961.
    PMID: 28184281 DOI: 10.12688/f1000research.9410.1
    The human visual system is sensitive in detecting objects that have different luminance level from their background, known as first-order or luminance-modulated (LM) stimuli. We are also able to detect objects that have the same mean luminance as their background, only differing in contrast (or other attributes). Such objects are known as second-order or contrast-modulated (CM), stimuli. CM stimuli are thought to be processed in higher visual areas compared to LM stimuli, and may be more susceptible to ageing. We compared visual acuities (VA) of five healthy older adults (54.0±1.83 years old) and five healthy younger adults (25.4±1.29 years old) with LM and CM letters under monocular and binocular viewing. For monocular viewing, age had no effect on VA [F(1, 8)= 2.50, p> 0.05]. However, there was a significant main effect of age on VA under binocular viewing [F(1, 8)= 5.67, p< 0.05].  Binocular VA with CM letters in younger adults was approximately two lines better than that in older adults. For LM, binocular summation ratios were similar for older (1.16±0.21) and younger (1.15±0.06) adults. For CM, younger adults had higher binocular summation ratio (1.39±0.08) compared to older adults (1.12±0.09). Binocular viewing improved VA with LM letters for both groups similarly. However, in older adults, binocular viewing did not improve VA with CM letters as much as in younger adults. This could reflect a decline of higher visual areas due to ageing process, most likely higher than V1, which may be missed if measured with luminance-based stimuli alone.
    MeSH terms: Adult; Aged; Aging; Humans; Middle Aged; Vision, Ocular; Visual Acuity; Young Adult
  14. Md. Muziman Syah, M.M., Mutalib, H. A., Sharanjeet Kaur, M. S., Khairidzan, M. K.
    MyJurnal
    Introduction: The purpose of this study was to derive a modified equation for contact lens method (CLM) in
    calculating post myopic laser refractive surgery corneal power. Methods: A total of 93 subjects who
    underwent myopic laser refractive surgery at IIUM Eye Specialist Clinic were recruited. The accuracy of
    postoperative corneal power using the standard CLM and newly-derived contact lens modified method
    (CLMmod) were compared to the standard comparison method ; the historical method (HM). The CLMmod
    equation was derived by adjusting postoperative corneal power of CLM according to amount of refractive
    change. Results: The mean postoperative corneal power using standard CLM was significantly higher than
    HM (mean difference: -0.24 D, p < 0.001). Fifty seven percent (n = 53 eyes) of the standard CLM results were
    within ±0.50 D of HM results. The difference between postoperative corneal power using standard CLM and
    HM increased significantly with the amount of refractive change (r = 0.835; p < 0.001). The mean
    postoperative corneal power of CLMmod showed that there was no statistical significant difference compared
    to the HM results (mean difference: 0.00 D, p= 0.964). Eighty eight percent (n = 82 eyes) of the CLMmod
    results were within ±0.50 D of HM results with improvement of 31% from the standard CLM results.
    Conclusion: The CLMmod equation provides more accurate calculation in determining post myopic laser
    refractive surgery corneal power. In near future, this modified equation can be used as an alternative
    equation to calculate postoperative corneal power when the preoperative data is unavailable.
    MeSH terms: Contact Lenses; Cornea; Myopia; Refractive Surgical Procedures
  15. Kamaluddin, M.R., Hassan, S.K., Dharmalingam, T. K.
    MyJurnal
    Introduction: Despite general acknowledgement of the importance in assessing family needs in critical care
    patients, there is no psychometric instrument to measure the family needs within Malaysian settings. This
    study aimed to perform factorial validation and establish psychometric properties of Malay translated
    Critical Care Family Need Inventory (CCFNI-M) for Malaysians. Methods: This study consisted of four
    protocols: Forward-Backward translation, validity, internal reliability and inter domain correlations phases.
    The factorial validation of the CCFNI-M was based on its administration to 109 family members of critical
    care patients admitted to the Intensive Care Unit of Hospital Universiti Sains Malaysia, Kelantan, Malaysia.
    At validity phase, factorial validation was performed using Exploratory Factor Analysis using Principal
    Component Analysis with Varimax rotation. The internal consistency and inter domain correlations were
    calculated using Cronbach’s alpha and Pearson correlation coefficient respectively. Results: Preliminary
    analyses reported the suitability of data for factorial validation. With reference to the original CCFNI, five
    factors were extracted which explained 49.4% of the total variance. After removal of several items for
    different reasons, the final items in CCFNI-M were 42. The internal consistency values for five dimensions
    ranged from 0.72 to 0.87 with inter domain correlation values (r) among the dimensions ranged between
    0.36 and 0.61. Conclusion: The high measures of factorial validity, internal consistency and inter domain
    correlations values of the CCFNI-M make it suitable measure for assessing the family needs of critical care
    patients.
    MeSH terms: Critical Care; Factor Analysis, Statistical; Humans; Intensive Care Units; Malaysia; Psychometrics; Rotation; Translating; Translations; Reproducibility of Results
  16. Ramli, M., Mohd Aznan, M.A., Maliya. S., Muhamad Shaiful Lizam, M.A., Muhammad Salman, M.H., Mohamad Faqihuddin, H., et al.
    MyJurnal
    Introduction: Lack of knowledge and negative attitude towards HIV/AIDS may be the risk factors for HIV infection among transsexuals. Research on knowledge and attitude towards HIV infection in transsexual communities is very limited at both local and international levels. This study aimed to assess the knowledge and attitude towards HIV infection among the male-to-female transsexual community in Kuantan, Pahang.
    Methods: A cross-sectional study was carried out from July to August 2014 among 33 male-to-female transsexuals in Kuantan, Pahang. Convenience sampling was used. Participants who gave consent answered a self-administered questionnaire. Data obtained was analyzed with descriptive statistics, χ2-test, and independent sample t test.
    Results: The majority of the subjects in this study were 29 years and below (48.5%), Muslims (93.9%), and had completed up to secondary education (60.6%). Most of them were sex workers (60.6%), and had relatively low income (no income to RM 3000, mean of RM1528). A total of 87.9% of the subjects demonstrated good knowledge and also positive attitude towards HIV/AIDS. Level of education was significantly associated with scores in knowledge (p=0.01).
    Conclusions: Despite the positive outcome from this study, misconceptions towards HIV/AIDS still exist among transsexuals. Education and interventions from multiple directions on HIV/AIDS are essential to deliver the correct information to this population, so as to emphasize prevention, early detection, and holistic medical care. Transsexuals also require attention from religious bodies and non-governmental organizations to help them in employment, financial, spiritual, and psycho-social issues.
    MeSH terms: Acquired Immunodeficiency Syndrome; Attention; Cross-Sectional Studies; Educational Status; Employment; Female; Income; Islam; Health Knowledge, Attitudes, Practice; Male; Organizations; Poverty; Surveys and Questionnaires; Residence Characteristics; Risk Factors; Sexual Behavior; HIV Infections; Transgender Persons
  17. Amjad, N.M., Karim, K.A., Naing Soe, Y.
    MyJurnal
    Introduction: The goal of palliative care is the provision of the best quality of life (QOL) for terminally ill
    and dying patients. Advances in medical treatment has seen an increase in overall survival of all stages of
    malignant diseases. This includes advanced and/or inoperable malignancies where management is mainly
    palliative involving different modalities. Methods: We designed a cross-sectional descriptive study of
    surgical patients in a palliative care unit in a 1000-bedded teaching hospital in Kuantan, Malaysia.
    Objectives of this study are: to study the demographic characteristics and indications for admission of
    surgical patients in palliative care unit, to study the options of treatment modalities and their
    complications, to identify the barriers in decision making in surgical treatment and finally to objectively
    assess the quality of life of these patients by utilizing QUALITY OF LIFE (WHOQOL) –BREF –questionnaire.
    Results: One hundred and one eligible patients (53%) male, (47%) female of mean age of 54yrs, majority
    Malay and Chinese patients were included in the study. All patients had malignancies and they were Breast
    (30%), Lower gastrointestinal (GI) (24%), (18%) upper GI, (15%) hepato-biliary, and (7%) pancreatic cancers.
    Thirty two percents of patients had emergency treatment while the rest had supportive treatment. Barriers
    to decision making were mainly due to patient factors in 71%, while 12% was due to the disease presenting
    at an advanced stage and 15% due to limitation of care. The final results of overall quality of life rating
    were shown as poor (1%), neither poor nor good (42%), good (52%) and very good (2%). Conclusions:
    Palliative care and end of life decision making from surgical point of view is a delicate issue. Like all other
    fields in medicine, palliative care must be evidence-based with specific goal directed therapy. Our study
    shows that we are able to positively impact the quality of life in more than two thirds of our patients. Our
    aim is to achieve 100% success. As such, it is imperative to inculcate the goal of palliative care to all grades
    of health care personnel. ‘To cure sometimes, To relieve often, To comfort always’ should not be mere
    words.
    MeSH terms: Cross-Sectional Studies; Decision Making; Emergency Treatment; Female; Goals; Hospitals, Teaching; Humans; Malaysia; Male; Middle Aged; Palliative Care; Pancreatic Neoplasms; Patients; Quality of Life; Surveys and Questionnaires; Terminally Ill
  18. Goh, K.L., Zamzuri, Z., Mohd Ariff, S., Mohamed Azril, M.A.
    MyJurnal
    Introduction: Application of dynamic hip screw (DHS) implant for the treatment of unstable intertrochanteric fractures continues to raise concern related to risk of lag screw cut-out with or without subsequent damage to the acetabulum. Measurement of tip-apex distances (TAD) has been recommended to guide the optimal placement of lag screw and to predict subsequent risk of screw cut-out. In this study, the value of TAD was evaluated to verify its usefulness.
    Methods: This is a retrospective study of 33 consecutive patients with intertrochanteric fracture treated with DHS. Demographic data of the patients were traced from their case notes. Post-operative radiographs were reviewed by focusing on measurement of TAD on anteroposterior and lateral radiographs. Radiographs at one year follow-up were reviewed to depict any fixation-related failure or complication.
    Results: Fifty two percent of patients did not achieved the recommended TAD of ≤ 25mm. The mean post-operative TAD was 25.9mm and elderly patients were likely to achieve TAD of ≤ 25mm. The overall complication rate of 6% was attributed to screw cut-out in two cases. The unstable left-sided fracture was identified to be a potential risk for screw cut-out or migration.
    Conclusion: TAD is a valuable measurement to guide optimal placement of lag screw during DHS fixation of intertrochanteric fracture.
    KEYWORDS: Intertrochanteric fracture, dynamic hip screw, tip-apex distance, screw cut-out
    MeSH terms: Acetabulum; Aged; Bone Screws; Demography; Follow-Up Studies; Hip Fractures; Hip Prosthesis; Humans; Retrospective Studies; Orthopedic Procedures
  19. Joehaimey, J., M. Anwar Hau A., Kamil, M.K., Jaya Purany, S.P., Saadon, I., Chee Huan, P., et al.
    MyJurnal
    Introduction: The aim of this study is to determine the most common organisms isolated in diabetic foot infection and the most utilised antibiotic regimes as the first line of treatment.
    Methods: This is a retrospective record review of the National Orthopaedic Registry Malaysia among diabetes mellitus type 2 patients who had foot infections. All identified cases admitted to 18 government hospitals in Malaysia from the 1st January 2008 until the 31st December, 2009 were included in the study.
    Results: A total of 416 patients were included in the study. The most common organisms cultured were Proteus species (17.5%), Klebsiella species (17.1%) and Staphylococcus aureus (17.9%), while the most commonly used antibiotic was ampicillin/sulbactam (67.5%). None of the patients was appropriately treated with metronidazole, cefoperazone or fucidic acid. All patients were given appropriate antibiotics to treat Serratia infection.
    Conclusion: Significant number of patients with diabetic foot infections were not treated using appropriate antibiotics as the first line treatment.
    MeSH terms: Ampicillin; Anti-Bacterial Agents; Cefoperazone; Diabetes Mellitus, Type 2; Government; Humans; Klebsiella; Malaysia; Metronidazole; Orthopedics; Proteus; Registries; Retrospective Studies; Staphylococcus aureus; Sulbactam; Serratia Infections; Diabetic Foot
  20. Dalia, F.A., Hamizah, I., Zalina, N., Yong, S.L., Mokhtar, A.
    MyJurnal
    Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and
    maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25
    women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on
    patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were
    found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound
    and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9
    years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and
    mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%)
    women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight
    (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or
    aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal
    delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to
    emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus.
    Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained
    placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital
    stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various
    maternal morbidities, in this case series , which could have been prevented if they were diagnosed and
    terminated at early trimester. A new direction is needed in our local practice.
    MeSH terms: Abortion, Induced; Adult; Blood Transfusion; Counseling; Endometritis; Female; Fetus; Gestational Age; Postpartum Hemorrhage; Humans; Hysterectomy; Labor, Obstetric; Medical Records; Placenta; Pregnancy; Pregnancy Outcome; Retrospective Studies; Uterine Rupture; Hysterotomy; Delivery, Obstetric; Postpartum Period; Delayed Diagnosis; Tertiary Care Centers
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