METHODS: A clinic based, cross sectional study using the Short Form-36 (SF-36) questionnaire was conducted in two primary care health clinics in Hulu Langat, Selangor, Malaysia over a period of 8 months. The nurses and medical assistants were involved in recruiting the patients while the family physicians conducted the interview.
RESULTS: A total 151 respondents were recruited. The mean age was 65.6 +/- 10.8 years with females constituted 119 (78.8%) of the patients. The mean duration of knee pain was 4.07 +/- 2.96 years. Half of the patients were overweight and majority, 138 (91.4%), had at least one co-morbidity, the commonest being hypertension. The physical health status showed lower score as compared to mental health component. The domain concerning mental health components showed positive correlation with age. There was a significant negative correlation between age and physical functioning (p < 0.0005) which indicated the deterioration of this domain as patients became older. Male respondents had better scores in most of the QOL dimensions especially in the physical functioning domain (p = 0.03). There was no significant association between QOL with different education levels, employment status and marital status. Patients with higher body mass index (BMI) and existence co-morbidities scored lower in most of the QOL domains.
CONCLUSIONS: This study has shown that patients with knee OA attending primary care clinics have relatively poor quality of life pertaining to the physical health components but less impact was seen on the patients' mental health.
METHOD: A cross-sectional study involving 200 parents of children with neurodevelopmental disabilities aged 1-18 years was carried out. The Malay version of the Measure of Process of Care (MPOC-20) questionnaire was used to measure the perceptions of parents on the services. Descriptive statistical analysis was done to describe the mean score of each MPOC-20 scale. Univariate and bivariate analyses were used to examine the associations between the characteristics of parents and children as well as the sociodemographic and environmental factors with the MPOC-20 scales.
RESULTS: The mean score of the MPOC-20 scales ranged from 4.50 to 5.65 (SD 0.93-1.51). Amongst the MPOC-20 scales, parents ranked enabling, having good partnership and being comprehensive (EP) the highest, whereas the provision of specific information (PS) received the lowest score. Amongst all the MPOC-20 scales, significant differences were shown in parent's employment, between children's age groups and between ethnic groups.
CONCLUSIONS: The Malay MPOC-20 is a validated tool that can be used in evaluation of services among the Malay-speaking community, and therefore, it is recommended for our clinical use to improve family-centred practice in paediatric rehabilitation.
AIM: The aim of this study was to classify the primary outcomes used in Cochrane Systematic Reviews (CSRs) into the ICF domains of functioning; to describe the differences in primary outcomes in reviews related to rehabilitation intervention and non-rehabilitation intervention; and to describe the trend of outcome selections according year of publication.
DESIGN: Methodological paper.
POPULATION: Adult stroke population.
METHODS: We analyzed the primary outcomes used in the CSRs published by the Cochrane Stroke Review Group up to December 2017. The primary outcomes were extracted and classified into the ICF domains of functioning (body functions, body structures and activity and participation).
RESULTS: One hundred and seventy-four papers with 216 primary outcomes were included in this analysis. Less than half (102/216, 47.2%) of the outcomes could be classified into the ICF domains of functioning. For the outcomes that could be classified into the ICF domains, the majority (72/102, 70.5%) were in the activity and participation domain, followed by body functions (26/102, 25.5%) and body structures (4/102, 4.0%). Of the outcomes that could not be classified into the ICF domains (N.=114), death (81/114, 71.1%) and recurrent stroke (21/114,18.4%) formed the majority of the outcome. There were 75 CSRs on rehabilitation related interventions; the majority of the outcomes (75/97, 77.3%) used in rehabilitation related CSRs could be classified into the ICF framework with more than half (49/75, 65.3%) in the activity and participation domain.
CONCLUSIONS: The majority of the primary outcomes selected by the Cochrane Stroke Review Group in their CSRs could not be classified into the ICF domains of functioning. Death and recurrence of vascular events remains the major outcome of interest. In rehabilitation related interventions, activity and participation domain is the functioning domain most commonly used.
CLINICAL REHABILITATION IMPACT: The systematic use of patients-centered ICF-based outcomes in CSRs could help the application of evidence in clinical decision making.
Methods: A survey was performed using questionnaires composed of two parts: a scenario-based questionnaire using scenarios of polyps, which were adopted from the European Society of Gastrointestinal Endoscopy guidelines, and an image-based questionnaire using provided endoscopic images of polyps.
Results: A total of 154 endoscopists participated in this survey. The most preferred resection techniques for diminutive (≤5 mm), small (6-9 mm), and benign-looking intermediate (10-19 mm) nonpedunculated polyps were cold forceps polypectomy, hot snare polypectomy, and endoscopic mucosal resection (EMR), respectively, in both the scenario- and image-based questionnaires. For benign-looking large (≥20 mm) nonpedunculated polyps, EMR and endoscopic submucosal dissection (ESD) were preferred in the scenario- and image-based surveys, respectively. In case of malignant nonpedunculated polyps, EMR and ESD were preferred for intermediate-sized and large lesions, respectively, according to the scenario-based survey. However, ESD was preferred in both intermediate-sized and large malignant nonpedunculated polyps according to the image-based survey. Trainee endoscopists, endoscopists working in referral centers, and endoscopists in the colorectal cancer-prevalent countries were independently associated with preference of cold snare polypectomy for removing small polyps.
Conclusions: The polypectomy practice patterns of Asian endoscopists vary, and cold snare polypectomy was not the most preferred resection method for polyps <10 mm in size, in contrast to recent guidelines.
Methods: A survey study was performed in seven Asian countries. An email invitation with a link to the survey was sent to participants who were asked to complete the questionnaire consisting of eight clinical scenarios.
Results: Of the 137 doctors invited, 123 (89.8%) provided valid responses. Approximately 50% of the participants adhered to the guidelines regardless of the risk of adenoma, except in the case of tubulovillous adenoma ≥10 mm combined with high-grade dysplasia, in which 35% of the participants adhered to the guidelines. The participants were stratified according to the number of colonoscopies performed: ≥20 colonoscopies per month (high volume group) and <20 colonoscopies per month (low volume group). Higher adherence to the postpolypectomy surveillance guidelines was evident in the high volume group (60%) than in the low volume group (25%). The reasons for nonadherence included concern of missed polyps (59%), the low cost of colonoscopy (26%), concern of incomplete resection (25%), and concern of medical liability (15%).
Conclusions: A discrepancy between clinical practice and surveillance guidelines among physicians in Asia was found. Physicians in the low volume group frequently did not adhere to the guidelines, suggesting a need for continuing education and appropriate control. Concerns regarding the quality of colonoscopy and complete polypectomy were the main reasons for nonadherence.
AIM OF THE STUDY: This study aimed to investigate the bioactivity and phytochemistry of Morus alba ethanolic leaf extract from Brunei Darussalam and its subacute toxic effects in the Institute of Cancer Research (ICR) female mice.
MATERIALS AND METHODS: The phenolic yield and antioxidant of the extract were analysed. Meanwhile, liquid chromatography-mass spectrometry and high-performance liquid chromatography were utilised to determine the phenolic compound of the MLE. In the subacute toxicity study, twenty-five female mice were randomly divided into five groups: the control group, which received oral gavage of 5% dimethyl sulfoxide solvent (DMSO), and the MLE treatment group, which received the extract at a dose of 125, 250, 500 and 1000 mg/kg. Physiology, haematology, biochemistry, and histology were evaluated during the study.
RESULTS: Morus alba leaf depicted total phenolic 10.93 mg gallic acid equivalents (GAE)/g dry weight (DW), flavonoid 256.67 mg quercetin equivalents (QE)/g DW, and antioxidant bioactivity content of 602.03 IC50 μg/mL and 13.21 mg Fe2+/g DW. Twenty compounds in the Morus alba ethanolic leaf extract were identified, with chlorogenic acid (305.60 mg/100 g DW) as the primary compound. As for subacute toxicity in this study, neither mortality nor haematological changes were observed. On the other hand, administration of 500 and 1000 mg/kg MLE resulted in mild hepatocellular injury, as indicated by a significant (p