Browse publications by year: 2023

  1. Richarz U, Han J, Bai YM, Yu-Hai Chen E, Chung YC, Jhanwar VG, et al.
    Medicine (Baltimore), 2023 Aug 25;102(34):e34623.
    PMID: 37653768 DOI: 10.1097/MD.0000000000034623
    BACKGROUND: Evaluate efficacy and safety of paliperidone palmitate 6-monthly (PP6M) for patients with schizophrenia in the Asian subgroup of a global, multicenter, noninferiority phase-3 study (NCT03345342).

    METHODS: Patients received paliperidone palmitate 1-monthly (PP1M, 100/150 mg eq.) or paliperidone palmitate 3-monthly (PP3M, 350/525 mg eq.) during the maintenance phase and entered a 12-month double-blind (DB) phase, wherein they were randomized (2:1) to PP6M (700/1000 mg. eq.) or PP3M (350/525 mg eq.). Subgroup analysis was performed for 90 (12.7%) patients from Asia region (India, Taiwan, Malaysia, Hong Kong, and Korea). Primary endpoint was time-to-relapse during DB phase (Kaplan-Meier estimates). Secondary endpoints were changes from baseline in Positive and Negative Syndrome Scale, Clinical Global Impression-Severity scale, Personal and Social Performance (PSP) scale score.

    RESULTS: In Asian subgroup, 91.9% (82/90) of patients completed DB phase (PP6M: 54/62 [87%]; PP3M: 28/28 [100%]). Median time-to-relapse was "not-estimable" due to low relapse rates in both groups. Estimated difference (95% confidence interval [CI]) between relapse-free patients in PP6M and PP3M groups of Asian subgroup was -0.1% [-8.5%, 8.4%] (global study population: -2.9% [-6.8%, 1.1%]). Mean change from baseline in secondary efficacy parameters was comparable between both groups, similar to the global study population. The incidence of extrapyramidal symptoms was higher in the Asian subgroup than in the global study population.

    CONCLUSION: Consistent with the global study population, PP6M was noninferior to PP3M in preventing relapse in patients with schizophrenia from the Asia region. Findings suggest the possibility of switching from PP1M/PP3M to twice-yearly PP6M without loss of efficacy and with no unexpected safety concerns.

    MeSH terms: Asian Americans; Hong Kong; Humans
  2. Varghese E, Samson RS, Albaker SA, Thomas AA, Alqarni AS, Dhanya KB
    J Pharm Bioallied Sci, 2023 Jul;15(Suppl 1):S451-S454.
    PMID: 37654276 DOI: 10.4103/jpbs.jpbs_584_22
    AIM: The present research was conducted to assess the microleakage of stainless steel crowns along with pedo jacket crowns following cementation with different luting cements.

    MATERIALS AND METHODS: A total of 60 deciduous teeth subjected to extraction were employed in this in vitro research. These 60 specimens were randomly divided into two groups: Group I: Stainless steel crowns and Group II: Pedo Jacket crowns. Both crowns were subjected to cementation using self-cure resin-modified glass ionomer (RMGI) cement as well as by means of self-adhesive universal resin cement (RelyX luting cement). The specimens were subjected to storage in distilled water at 37°C for 24 h and were subjected to 500 thermal cycles between 5°C and 55°C using a dwell span of 30 s. Individual surfaces were assessed for the amount of dye infiltration at the boundaries by the side of the tooth-cement border beneath a stereomicroscope under 50× magnifying power. At the mesial and distal surfaces, the amount of microleakage was measured in micrometers (μm), and the mean value was computed for each sample.

    RESULTS: Stainless steel crowns subject to cementation with RelyX luting cement exhibited the lowest microleakage (0.88 ± 0.78) versus self-cure RMGI cement (0.94 ± 0.78). There was no statistically significant difference found between the groups. Pedo Jacket crowns subject to cementation with RelyX luting cement exhibited the lowest microleakage (0.96. ± 0.32) while self-cure RMGI cement (1.83 ± 0.16) depicted the maximum microleakage. There was an extremely statistically noteworthy dissimilarity noted among the groups.

    CONCLUSION: The current research concluded that Pedo Jacket crowns subjected to cementation with RelyX luting cement can be regarded as an esthetically pleasing restorative alternative for numerous young patients. Applying RelyX luting cement to Pedo Jacket crowns provides a strong bolstering by composite materials that ensures the success of the therapy provided.

  3. Pillai AR, Kumar GJ, Kumar P, Nizar SA, Pendyala SK, Baig FAH
    J Pharm Bioallied Sci, 2023 Jul;15(Suppl 1):S110-S113.
    PMID: 37654296 DOI: 10.4103/jpbs.jpbs_430_22
    The goal of this study is to find a cure for the masticatory muscle disease known as hemimasticatory spasm (HMS). This retrospective investigation intends to find a more efficient therapeutic approach for HMS patients by examining the clinical effectiveness of masseteric nerve avulsion performed on HMS using a temporomandibular arthroscope. A clinical study was piloted where the subjects were treated for masseter nerve avulsion by TMJ arthroscopy. The follow-up was done till 2 years, and the subjects were evaluated for the various characteristics like difficulties, masticatory abilities, and various sounds at the joint for the various functions of the joint. The diagnosis was done using the electrophysiological electromyogram (EMG) at the designated time intervals. There was a complete remission in all the subjects. The masseter nerve avulsion was effective since the scores lowered. Within 3 years of the operation, electrophysiological EMG depicted no discharge potential with a high frequency, and the total efficiency when paired with the clinical effectiveness was deemed acceptable. The maximal masseter power between the treated and nontreated sides was comparable. The mastication, on comparing, was also as effective as the normal side; however, lower mastication was noted in the first year. The avulsed nerve tissues lacked any apparent demyelination. Masseteric nerve avulsion with temporomandibular arthroscope assistance provided acceptable and stable total effectiveness for the intervention of the hemimasticatory spasm. While the strength of the muscle of the afflicted side was only marginally reduced, its masticatory effectiveness was optimally preserved.
  4. Lavanya Priya KP, Gill S, Banik A, Marvaniya J, Marella K, Anusha Y, et al.
    J Pharm Bioallied Sci, 2023 Jul;15(Suppl 1):S132-S136.
    PMID: 37654297 DOI: 10.4103/jpbs.jpbs_436_22
    INTRODUCTION: The best treatment for the deeply carious tooth that cannot be restored is by the root canal therapy. This method has saved many patients from the loss of tooth. The common practice is either to deliver a full crown or close the access cavity with restoration. Hence in this study, the clinical longevity of the routine practice is tested for by analyzing the fracture toughness and the survival of the teeth that were restored endodontically with various materials.

    MATERIALS AND METHODS: The hospital records were retrospectively evaluated from 2000 to 2010 for a decade. The demographics as well as the survival and the failure rates noted and compared for the various types of the restorations. The number of the walls of the teeth was also compared.

    RESULTS: Thousand teeth were considered in the study. Less than 7% of teeth had coronal fractures. Of the 93% teeth that had survived, the most common restoration was Individual post (+ crown) followed by GIC, amalgams, and crowns. The mean survival of the crown+ bridge & gold restoration was highest. The mean survival was 10 ± 2 years for the restored teeth without any fractures at the coronal level. The failure was greatest for the GIC followed by amalgam, and the variations when compared with other restorations were significant. There was no significant difference for the number of the walls on the crown; however, the number of walls present was proportional to the survival rate.

    CONCLUSION: The teeth that were covered with a crown were comparatively fracture resistant and had a better survival rate compared to other restorations. GIC showed highest fracture, and the post core with crown had the best survival. Restoration of the lost crown architecture and the reinforcement are the best methods that can be followed for the survivals.

  5. Varghese E, Samson RS, Thomas A, Sam G, Hota S, Sahoo N
    J Pharm Bioallied Sci, 2023 Jul;15(Suppl 1):S463-S466.
    PMID: 37654307 DOI: 10.4103/jpbs.jpbs_637_22
    AIM: The aim of the current research was to assess the ability of different dental varnishes in averting enamel demineralization adjoining the orthodontic brackets.

    MATERIALS AND METHODS: Seventy-five premolars devoid of dental caries that were subjected to extraction for orthodontic purposes were employed in this research. The surface of enamel was etched with 37% phosphoric acid and subjected to primer application. Individual brackets were placed on the midregion of the buccal surfaces of the premolars with Transbond™ XT adhesive. Postbracket bonding, the dry premolar tooth samples were set aside cautiously. The samples were then allocated to three groups: Group I: Duraphat Varnish, Group II: Clinpro XT Varnish, and Group III: Profluorid Varnish. Every sample was independently subjected to immersion in demineralizing solution for a period of 96 h at 37°C in an incubator. Areas of demineralization were evaluated by documenting the microhardness along the severed surface using a microhardness tester equipped with a Vickers diamond.

    RESULTS: The highest surface microhardness was noted with Profluorid Varnish group at 328.48 ± 1.12 in pursuit by Clinpro XT Varnish group at 322.08 ± 0.04 as well as Duraphat Varnish group at 307.42 ± 0.28 with a statistically noteworthy dissimilarity amid the groups.

    CONCLUSION: In conclusion, the three varnishes employed had an influence on the prevention of enamel demineralization surrounding the orthodontic brackets. Profluorid varnish however exhibited maximum efficiency in avoiding enamel demineralization versus Clinpro XT varnish as well as Duraphat varnish group.

  6. Perti S, Mansuri S, Pilli J, Kaur A, Alwithanani N, Kondreddy K
    J Pharm Bioallied Sci, 2023 Jul;15(Suppl 1):S187-S191.
    PMID: 37654361 DOI: 10.4103/jpbs.jpbs_450_22
    INTRODUCTION: Recurrent abutment substitutions may physically irritate the mucosal (soft tissue) barrier, which may cause additional toxic irritants and germs to enter the mucosal implant barrier and weaken the tissues surrounding implant. The creation of a "definitive abutment" may lessen the likelihood of tissue losses around the implant. Determining the characters of the peri-implant tissue after the placement of the definitive abutments and multiple abutment replacement was the goal of this study.

    MATERIALS AND PROCEDURES: Forty missing teeth were replaced with implants in matched subjects. Parameters assessed were "distance of cement enamel junction to alveolar crest and distance of CEJ to gingival margin; bleeding on probing, Sulcus probing depth, and peri-implant marginal bone loss." Subjects were randomly assigned for the two groups of intervention. All the measurements were documented at designated timelines and compared for the statistical variance where P < 0.05 was considered as significant.

    RESULTS: In the control and test groups, the peri-implant marginal bone level rose from baseline to 3 months. There were no appreciable differences between the CEJ-AC and CEJ-GM groups when the clinical and radiographic parameters of each group were evaluated. Throughout all of the time points, the soft tissue borders in both groups remained comparably steady.

    CONCLUSION: The study's findings suggest that using implants with definite abutments is more advantageous for obtaining better maintenance in terms of the health of the tissues that surround the implants.

  7. Karpathak S, Mansuri S, Dev SV, Pilli J, Alwithanani N, Kondreddy K
    J Pharm Bioallied Sci, 2023 Jul;15(Suppl 1):S183-S186.
    PMID: 37654403 DOI: 10.4103/jpbs.jpbs_449_22
    INTRODUCTION: In many oral procedures that involve the implants, hair implantations, "Platelet-Rich Fibrin Membrane (PRF)" is commonly applied. The advantages are many. In this study, the mechanical resistance of PRF under resistance pull on a longitudinal axis was assessed and compared.

    MATERIAL AND METHODS: For the current in vitro study, 60 volunteers donated each 10 ml of their blood and hence a total volume of 600 ml of blood was procured that was analyzed for the current study. The total volume was grouped to three groups where they receive three resistance centrifugation forces of "F-200,600,800 m/s²." In each group, 20 samples were tested for each level of the G-resistance. Each group was further divided as two subgroups of different times of wait, where they were centrifuged at baseline time and after a stand of 30 minutes. On universal testing equipment, the PRF membranes were mechanically tensioned in order to determine each membrane's resistance force. These values were compared for any statistical variance using appropriate statistical tools keeping P < 0.05.

    RESULTS: Any applied force had no statistically significant effect on the centrifugation duration for membrane resistance. When the resistance was applied for the PRP samples immediately after they were procured, no significant variation was seen at all the grades of the centrifugation forces; consequently, the T30 group showed a statistically significant variance for the centrifugation forces applied (P = 0.04), with the highest value when the greatest force was applied. According to the results, the centrifugation waiting period could be determined based on the application requirement.

    CONCLUSION: For immediate membrane usage, the centrifugation had no effect on resistance; however, after 30 minutes, a membrane with greater resistance was produced by applying more force.

  8. Varghese E, Awasthi N, Kakarla P, Mailankote S, Mishra D, John NK
    J Pharm Bioallied Sci, 2023 Jul;15(Suppl 1):S434-S437.
    PMID: 37654422 DOI: 10.4103/jpbs.jpbs_490_22
    AIM: The aim of this research was to assess the damage to root dentin that arises from retreatment with different engine-driven NiTi retreatment files employing micro-computed tomography.

    MATERIALS AND METHODS: Sixty mandibular premolar teeth having a single root and root canal that were recently extracted were gathered and stored. The specimens were de-coronated at the cementoenamel junction under water irrigation to achieve a homogeneous root length of 16 millimeters. Gutta-percha cones were coated with sealants and placed within the radicular canal till the WL. All sixty premolars were randomly assigned to one of the following three groups, with every group comprising 20 sample teeth each. Group 1: MTwo Retreatment files, Group 2: ProTaper Universal Retreatment files, Group 3: Edge File XR Retreatment rotary files. The quantity of root dentinal injury was estimated by deducting the dentin volume (mm3) in the pre- and post-therapy micro-CT scans at apical, middle, and cervical 3rd points.

    RESULTS: An intra-group comparative scrutiny showed that lower radicular dentinal injury was noted at apical 3rd (0.31 ± 0.16, 0.62 ± 0.02) in Edge File XR Retreatment file system and MTwo Retreatment file system in that order. The statistically significant disparity was seen amid the MTwo Retreatment file, Edge File XR Retreatment file system and ProTaper Universal Retreatment file, Edge File XR Retreatment file system with P value of 0.001on intergroup assessment.

    CONCLUSION: In spite of the limitations that this research had, it was inferred that each assessed file system proficiently eradicated the obturated material through the retreatment procedure performed. In addition, it was seen that the Edge File XR group showed lesser root dentin damage in contrast to MTwo and ProTaper Universal file systems.

  9. Ariaratnam S, Kee CC, Krishnapillai AD, Sanaudi R, Tohit NM, Ho KB, et al.
    Tob Induc Dis, 2023;21:109.
    PMID: 37654502 DOI: 10.18332/tid/169682
    INTRODUCTION: Literature exploring smoking status and its association with depression among the elderly population using nationwide data in Malaysia is limited. Hence, a nationwide survey to determine the prevalence of smoking and depression among the elderly (aged ≥60 years) population was undertaken.

    METHODS: This secondary dataset analysis used data from the National Health and Morbidity Survey (NHMS) 2018. Data from 3914 participants were collected on elderly health in the Malaysian population. Sociodemographic characteristics were recorded. Smoking status was grouped as current smokers, former smokers, and non-smokers. A validated Malay language version of the Geriatric Depression Scale (M-GDS-14) was used to screen for depression among the elderly.

    RESULTS: There was a significant association between smoking status with location, gender, employment status, marital status, ethnicity, education level, income, and depression. Current smokers are significantly higher in rural than urban areas. Among depressed participants, 65.7%, 17.1% and 17.2% were non-smokers, former smokers and current smokers, respectively. Multiple logistic regression showed that single (unmarried/separated/ divorced/widowed) participants were more likely to be depressed compared to married participants (AOR=1.68; 95% CI: 1.16-2.43). Whilst unemployed participants were more likely to be depressed than those who were employed (AOR=1.72; 95% CI: 1.22-2.44). Other Bumiputras were more likely to have depression compared to Malay, Chinese and Indian participants. Participants without formal education were more likely to be depressed compared to those having tertiary education. These participants have a 2-fold increased risk of depression (AOR=2.13; 95% CI: 1.02-4.45). Participants whose monthly salaries were <2000 MYR (AOR=3.67; 95% CI: 1.84-7.31) and 1000-1999 MYR (AOR=2.71; 95% CI: 1.23-5.94) were more likely to have depression compared with those who had received ≥3000 MYR. Ever smokers were more likely to be depressed than non-smokers (AOR=1.68; 95% CI: 1.23-2.29).

    CONCLUSIONS: Elderly Malaysians are indeed at risk of developing depression particularly if they had ever smoked. Public health awareness and campaigning are pertinent to disseminate these outcomes in order to spread the awareness associated with smoking-related depression.

  10. Harnett JE, Desselle SP, Fernandes MB, Yao D, Modun D, Hallit S, et al.
    Front Pharmacol, 2023;14:1215475.
    PMID: 37654614 DOI: 10.3389/fphar.2023.1215475
    Introduction: An estimated 80% of the world's population use traditional and complementary medicine (T&CM) products as part of their healthcare, with many accessed through pharmacy. This cross-cultural study posed a set of professional practice responsibilities and actions to pharmacists related to T&CM products, with a view toward developing consensus, safeguarding, and promoting the health of the public. Methods: Data were collected from 2,810 pharmacists across nine countries during 2022 via a cross-sectional online survey reported in accordance with the guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) and the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Of the 2,810 participants from nine countries, 2,341 completed all sections of the survey. Of these, most agreed (69%) that T&CM product use was common in the community they served, but most did not have adequate training to support consumer needs. Over 75% acknowledged that there were known and unknown safety risks associated with T&CM use. Of 18 professional responsibilities posed, 92% agreed that pharmacists should be able to inform consumers about potential risks, including T&CM side effects and drug-herb interactions. The provision of accurate scientific information on the effectiveness of T&CM products, skills to guide consumers in making informed decisions, and communication with other healthcare professionals to support appropriate and safe T&CM product use were all ranked with high levels of agreement. In order to effectively fulfill these responsibilities, pharmacists agreed that regulatory reforms, development of T&CM education and training, and access to quality products supported by high-quality evidence were needed. Conclusion: General agreement from across nine countries on eighteen professional responsibilities and several stakeholder actions serve as a foundation for the discussion and development of international T&CM guidelines for pharmacists.
  11. Patel B, Joshi S, Nagrani T, Girdhar GA, Patel H, Sinha S, et al.
    Cureus, 2023 Aug;15(8):e44394.
    PMID: 37654905 DOI: 10.7759/cureus.44394
    Introduction This study aims to differentiate the employment of demineralized bone matrix (DMBM; Osseograft, Advanced Biotech Products (P) Ltd, Chennai, India) and platelet-rich fibrin (PRF) alone to a composite graft consisting of both materials in the surgical actions toward the anomalies of the human periodontal furcation imperfection. Methods In a split-mouth study, 30 patients with mandibular molars affected by the furcation were allocated without conscious choice to test (PRF + DMBM, n = 30) or control (PRF, n = 30) categories. At the starting point, three months after surgery, and six months later, the following modifiable factors were evaluated: probing pocket depth (PPD), full-mouth plaque scores, full-mouth gingival scores, radiographic defect depth, relative vertical clinical attachment level (RVCAL), and relative horizontal clinical attachment level (RHCAL). Results Results at three and six months demonstrated substantial differences between baseline values for both treatment methods in clinical and X-ray imaging appraisal. Nonetheless, the PRF/DMBM group manifests statistically significantly soaring changes observed in comparison to the PRF group. Overall, the probing depth (PD) in the test site was significantly lower than that in the control site, showing a reduction of 68% (95% CI=41%, 95%, p<0.001). Conclusion Clinical indications significantly improved with PRF and DMBM combined instead of PRF alone. On radiographs, the test group also showed higher bone fill.
  12. Khor HD, Lott PW, Daman Huri SNR, Singh S, Iqbal T
    Cureus, 2023 Jul;15(7):e42722.
    PMID: 37654949 DOI: 10.7759/cureus.42722
    This study aims to report a case of neuro-ophthalmic manifestation in a coronavirus disease 2019 (COVID-19) patient and a literature review of neuro-ophthalmological manifestation in COVID-19 patients. A 57-year-old male presented with headache, giddiness, and sudden onset of diplopia over two days after having a flu-like illness. Clinical examination revealed bilateral bizarre extraocular movement with right lower motor neuron facial nerve palsy. A polymerase chain reaction test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive. Computed tomography (CT) and contrast-enhanced CT of the brain and CT venography were unremarkable. Magnetic resonance imaging (MRI) of the brain, magnetic resonance angiography of the circle of Willis, and MRI of the internal auditory meatus revealed a subacute pontine infarction with no leptomeningeal or cranial nerve enhancement and a normal circle of Willis. The patient received a course of oral prednisolone and clinical symptoms improved gradually. Articles published between December 2019 and June 2022 were included. A total of 23 cases, with 14 male and nine female patients, were summarized. The mean age at presentation was 46.95 years (range = 9-71 years), with the most affected age group ranging from 31 to 70 years (17 of 23 cases, 73.91%). Neuro-ophthalmological symptoms and signs can be isolated or associated with neurological syndromes. The manifestations include optic neuritis, isolated or multiple cranial nerve palsies, acute vision loss, Miller Fisher syndrome, myasthenia gravis, acute disseminated encephalomyelitis, Guillain-Barré syndrome, internuclear ophthalmoplegia, and cerebrovascular events. Diagnosing neuro-ophthalmic complications secondary to SARS-CoV-2 infection is challenging, as there are no pathognomonic symptoms to detect the disease. High clinical suspicion aids in early diagnosis and initiation of treatment may help in relieving the symptoms.
  13. Norazman TA, Yusoff S, Mohd Niza Nizal H, Taib F
    Malays J Med Sci, 2023 Aug;30(4):175-192.
    PMID: 37655138 DOI: 10.21315/mjms2023.30.4.15
    BACKGROUND: Domestic violence has a significant impact on growing children. However, existing evidence is limited and often under reported. Consequently, the Child Exposure to Domestic Violence (CEDV) scale has been developed for global use. This study aims to provide a cross-cultural translation, adaptation and validation of the CEDV based on Malay language.

    METHODS: CEDV scale was translated from the original English version to Malay. Content and face validity were examined before field-testing. The study comprised a cross sectional study using the Malay version of the CEDV (CEDV-M) scale conducted at a secondary school in Perlis, Malaysia and investigated 235 children aged 13 years old-16 years old using an online platform. The construct validity, internal consistency and stability of the tool were assessed.

    RESULTS: The CEDV-M scale's content and face validity both yielded a value exceeding 0.80. Furthermore, the tool demonstrated has good stability reliability, using the intra-class correlation value for all items ranging from 0.659 to 1.00. The exploratory factor analysis of the 36 items of the CEDV scale revealed possibilities of five or six factor domains. However, the five factor domains were most conceptually equivalent. Consequently, this study found that the CEDV-M scale is reliable with a total Cronbach's alpha of 0.87.

    CONCLUSION: CEDV-M scale is a valid and reliable tool for measuring a child's experience of domestic violence. Future studies recommend confirmatory factor analysis and standard settings for scoring systems.

  14. Sabirin AA
    Malays J Med Sci, 2023 Aug;30(4):1-7.
    PMID: 37655139 DOI: 10.21315/mjms2023.30.4.1
    With the world recovering from a public health disaster in the form of the COVID-19 pandemic and with political and social upheaval in the forms of wars such as in Ukraine and Sudan, localised fighting in various hotspots, the medical field faces huge challenges in addressing the needs of the various stakeholders. Still, these disasters represent opportunities to advance the new discoveries without compromising on the safety of the patients or general population. The COVID-19 vaccines were pushed through with great urgency driving on new discoveries of the genomic research, i.e. RNA based vaccines. This is complemented by the use of big data to monitor the disbursement of the vaccine to the general public. Unmistakably these new developments in tackling serious health disasters will lead to improvements on how the world tackle future crisis. Recent advances in artificial intelligence (AI), genomics discoveries and cell biology are driving research and fueling hope for the future. Amid this scenario of great upheavals and significant advances in technologies or emerging technologies for the health sector, SIRIM Berhad is increasing its preparedness in terms of development of new facilities and new competencies as well as building the platform for the communication of conventional health or medical technologies with other technologies particularly digital technologies to unlock the potential of emerging technologies in both medical and digital to develop novel solutions to future problems or challenges.
  15. Sa'uadi MI, Lee KP, Abd Halim S, Abdullah JM
    Malays J Med Sci, 2023 Aug;30(4):207-212.
    PMID: 37655140 DOI: 10.21315/mjms2023.30.4.17
    Taste disorders are uncommon and frequently unrecognised during neurological and even oral examinations. Nevertheless, understanding taste pathway, its disorders, as well as assessment of taste are crucial as it can reveal various oral, systemic and neurological pathologies that manifest as an alteration of taste. Multiple taste examination techniques have been described in the literature; however, certain techniques are complicated and may not be feasible. This paper describes the adoption of a relatively simple technique for taste assessment that can be performed at the bedside. The bedside detection of taste disorders will allow examiners to assign the patient for more detailed and invasive taste assessments.
  16. Aldawsari M, Soh KL, Abdul Raman R, Mohd Taib N, Aboshaiqah A
    Malays J Med Sci, 2023 Aug;30(4):116-131.
    PMID: 37655141 DOI: 10.21315/mjms2023.30.4.11
    BACKGROUND: Hands are the most common vehicle of pathogen transmission in a healthcare setting. Therefore, hand hygiene is the leading method of reducing healthcare-associated infections. This study aimed to determine the knowledge, attitude and practice (KAP) of hand hygiene and predictors for poor hand hygiene practice among healthcare workers who care for children with leukaemia in the paediatric oncology ward of King Saud Medical City (KSMC) in Saudi Arabia.

    METHODS: One hundred and ninety medical doctors and nurses, who were registered with the Saudi Commission for Health Specialities, were selected to participate in this cross-sectional study using a simple sampling technique. Their KAP of hand hygiene was assessed using a self-structured questionnaire and the collected data was analysed using IBM® SPSS® version 26.0.

    RESULTS: Of the 190 healthcare workers, 74.7% were nurses and 25.3% were medical doctors. Among the participants, 53.7% (102) had good knowledge of hand hygiene, 51.6% (98) had positive attitudes towards hand hygiene and 55.8% (106) practised satisfactory hand hygiene. Bachelor education level (adjusted OR = 2.736; 95% CI = 1.101, 6.799; P = 0.030), postgraduate education level (adjusted OR = 6.256; 95% CI = 2.171, 18.028; P = 0.001), poor knowledge (adjusted OR =2.575; 95% CI = 1.263, 5.246; P = 0.009) and negative attitude (adjusted OR = 4.702; 95% CI = 1.263, 5.246; P < 0.001) were the significant predictor variables of unsatisfactory hand hygiene practice among healthcare workers.

    CONCLUSION: The performance of hand hygiene among healthcare workers is still far less than optimal, particularly in settings like oncology units. Effective programmes are needed to increase their awareness of hand hygiene KAP, while strict guidelines are needed to reduce nosocomial infections.

  17. Mohd Yosli HN, Hong W, Kazura K, Abdul Salim NH, Md Pauzi AL, Mat Din H, et al.
    Malays J Med Sci, 2023 Aug;30(4):157-174.
    PMID: 37655142 DOI: 10.21315/mjms2023.30.4.14
    INTRODUCTION: Despite the high prevalence of post-stroke delirium in Malaysia, there are no studies on good practices related to its management. This study aimed to analyse the knowledge, attitude, perception, and factors associated with current practices related to delirium in acute stroke patients among health personnel at Hospital Sultan Abdul Aziz Shah (HSAAS) (formerly known as Hospital Pengajar Universiti Putra Malaysia).

    METHODS: This cross-sectional study was conducted from 26 April 2021 to 9 May 2021 (17 weeks). All health personnel from various departments managing patients with acute stroke in our centre were invited to participate. An online questionnaire was disseminated to assess their knowledge, attitude, perception, and current practices concerning delirium. Multiple logistic regression was used to examine the association between the independent and dependent variables. The level of significance was set at P < 0.05.

    RESULTS: The response rate was 22.49% (47 of 209 participants). More than half (61.7%, n = 29) had good current practices towards delirium in acute stroke patients. A significant association was found between knowledge and current practices related to delirium (P = 0.024). However, there was no significant association between current practices and sociodemographic factors (age, ethnicity, gender and job position), attitude, perceptions, screening barriers, or health service organisation.

    CONCLUSION: Most respondents had good current practices and knowledge in managing post-stroke delirium. Therefore, upskilling health personnel for managing this illness is essential to ensure good post-stroke care and improve prognosis related to delirium.

  18. Md Khairi LNH, Gnanasan S
    Malays J Med Sci, 2023 Aug;30(4):33-47.
    PMID: 37655143 DOI: 10.21315/mjms2023.30.4.4
    The arrival of COVID-19 pandemic in March 2020 adversely affected every aspect of human life, including the management of asthma. The pandemic has forced clinicians to revisit the application of high-risk aerosol-generating procedures in asthma management, including spirometry and nebuliser therapy. The use of commercial spacers with pressurised metered-dose inhalers to replace nebulisation is limited by the high cost and pandemic-induced stock unavailability of these inhalers. The need for social distancing, healthcare reserves reallocation, and scarce personal protective equipment has promote increased telemedicine uptake for patients' asthma control and monitoring. Malaysian pharmacists have been providing long-term care of asthma through the introduction of the respiratory Medication Therapy Adherence Clinic (MTAC) to empower patients' general health literacy, train and regularly evaluate their inhalation technique, and reinforce the importance of medication compliance. To minimise the use of unplanned healthcare resources and avoidable COVID-19 infection exposure, Malaysian pharmacists need to better support asthma self-management via increased uptake of written Asthma Action Plans (AAPs). Pharmacist-led asthma treatment step-down to attain the lowest effective dose of inhaled corticosteroids (ICS) has become increasingly relevant during the pandemic, as its prolonged use carries risk of numerous side effects and possible hospitalisation. Telepharmacy offers a promising model for exploration and an alternative to the traditional service delivery of asthma education. Despite not being authorised as vaccinators, Malaysian pharmacists hold strong positions in COVID-19 immunisation programmes for pharmacovigilance and advocacy. The pandemic demands an increased role for pharmacists within medication management to prevent patients from the stockpiling that can cause adverse effects on pharmaceutical supply chain. This review intends to summarise the impact of COVID-19 on asthma management, with a focus on the transitional roles of Malaysian pharmacists before and after the pandemic era.
  19. Boulesnam SL, Hamaidi-Chergui F, Benamara M, Azrou S
    Malays J Med Sci, 2023 Aug;30(4):85-93.
    PMID: 37655144 DOI: 10.21315/mjms2023.30.4.8
    BACKGROUND: Acinetobacter baumannii (A. baumannii) causes a variety of nosocomial infections that mainly affect critically ill patients in intensive care units (ICUs). The objective of this study was to assess the prevalence of A. baumannii in the ICU environment and evaluate the antibiotic resistance and biofilm formation ability of the environmental isolates compared to those isolated from ICU patients simultaneously.

    METHODS: A total of 166 non-duplicate ICU samples (80 environmental and 86 clinical) were collected between January 2019 and January 2020. Antimicrobial susceptibility detection was determined using the disc diffusion method, and the strains were evaluated for the minimum inhibitory concentration (MIC) of imipenem (IMP) using broth microdilution or metallo-β-lactamase (MBL) detection according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The isolates' capacity to produce biofilms was evaluated using the tube method and the crystal violet microtitre plate-based method.

    RESULTS: A. baumannii was identified in 25 (31.25%) environmental and 30 (34.88%) clinical samples, and beds were the most infected (60%). Both types of isolate demonstrated a rate surpassing 80% resistance to the tested antibiotics. Phenotypically, the environmental and clinical strains were found to be MBL producers. Fourteen environmental (56%) and 15 clinical (50%) strains were found to be moderate biofilm producers, indicating that each isolate has a high biofilm-forming capacity.

    CONCLUSION: These results show that the spread of multidrug-resistant (MDR) A. baumannii in an ICU setting emphasises the necessity of disinfecting and cleaning medical devices and surfaces to prevent and restrict cross-transmission. Intensive surveillance and infection control methods are also of paramount importance.

External Links