Displaying publications 1 - 20 of 59 in total

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  1. Fulltext Role of immunopathology in clinical course of malaria: a review
    Wynn AA, Myint O
    Borneo Journal of Medical Sciences, 2018;12(3):3-10.
    MyJurnal
    Malaria is a major health problem in various parts of the world especially affecting the tropical countries. It affects the vital organs causing severe complicated malaria. Clinical syndromes like severe cerebral anaemia, coagulation abnormalities, respiratory distress and severe anaemia can increase the mortality of malaria infected cases. Variation in individual susceptibility and severity and type of clinical presentations of malaria raises the need for study of both the parasite and host immune reactions as well as the contribution of inflammatory cytokines in malaria pathogenesis. This study explored the immunopathological basis and advances of severe malaria and their importance in pathogenesis of malaria and its complications. Previous and ongoing studies indicate that changes in endothelium during the sequestration of parasites in organs causes disruption of endothelial barrier function leading to serious effects of malaria. Parasite and host factors contribute to disturbance of cytokine regulation and escape of parasites from the immune system of the host. Immunopathological changes and dysregulation of cytokine production play central role in pathogenesis and disease severity in malaria.
  2. Fulltext Functional outcome of hindfoot arthrodesis in Charcot Arthropathy
    Kuharajan R., Mohd Yazid, B., Ohnmar, H., Yuliawiratman, B.S.
    Medicine & Health, 2019;14(1):172-182.
    MyJurnal
    Charcot arthropathy is a devastating degenerative condition which affects one or more joints that is marked by joint instability, hypermobility resulted from peripheral nerve damage. This was a retrospective study performed on patients who were diagnosed with Charcot arthropathy and those underwent surgery for hindfoot arthrodesis at Universiti Kebangsaan Malaysia Medical Centre from January 2011 until June 2016. The objective of the study was to review the feasibility of an algorithm in managing Charcot arthropathy and to assess functional, clinical and radiographic outcomes of Charcot arthropathy joints treated with hindfoot arthrodesis, at least 6 months follow-up using standardized and internationally accepted scoring systems, which were the American Orthopaedic Foot and Ankle Surgery (AOFAS) score and SF36. A total of 16 patients were included in this study of which 4 (25%) were males and 12 (75%) were females. The mean age was 58.1 (20-71) years. There was equal distribution for side of fusion. We achieved union in 13 out of our 16 (81%) cases followed up. Out of the 3 patients with non-union, 2 were attributed to deep infections. The AOFAS scores for hindfoot and midfoot showed significant improvement post operatively with p-value
  3. Fulltext Apoptosis: Dual Role in Aetiology and Cure
    Wynn, Aye Aye, Myint, Ohnmar, Mya, Nang Khin
    Borneo Journal of Medical Sciences, 2019;13(3):5-10.
    MyJurnal
    Apoptosis is a programmed cell death which occurs following a variety of stimuli. Physiologically the process is important for morphogenesis of organs and homeostasis of different types of cells. Apoptotic cell death is responsible for a variety of pathologic states such as elimination of cell death in mutated cells, infected cells, tumour cells and transplant rejection well as the pathological atrophy. In this review, there is discussion about the control of apoptosis, detection methods of apoptosis, its association with infectious and non-communicable diseases. Intracellular microorganisms survive through inhibition of host cell apoptosis as well as they destroy the parenchymal cells causing impaired functions. It plays important role in tumourigenesis. There are possible therapeutic roles of drugs that modify apoptosis in human diseases.
  4. An interesting case of autonomic dysreflexia
    Ohnmar H, Das S, Naicker AS
    Clin Ter, 2009;160(5):371-3.
    PMID: 19997683
    Autonomic dysreflexia (AD) is not an uncommon clinical condition and it is usually detected in patients with complete spinal injuries at or above thoracic 6th vertebral level (T 6). This condition is reported to occur in 48- 60% of cases of spinal cord injury at or above the level of T6. But AD due to injury below T6 is rare. The basic mechanism is thought to be due to excessive, uncontrolled activation of sympathetic system. In the present case, we discuss a persistent AD in 55-yr-old tetraplegic patient with C5 American Spinal Injury Association (ASIA) grade A lesion due to a fall from 10 metre height. MRI examination showed C5 and C6 bi-facets fracture and dislocation with canal compromise. Wiring and fusion was performed but recurrent mucous plugging and aspiration pneumonia and urinary tract infection happened during the hospital stay. Three months later, he was re-admitted with multiple pressure sores, pneumonia, sepsis and high blood pressure. He was administered with nifedepine but the blood pressure kept fluctuating. The present study highlights how the precipitating factors like concomitant urinary tract infection, decubitus ulcers, spasticity triggered the AD attack. The knowledge of the AD and its proper diagnosis and management may be beneficial to all clinicians and the present article attempts to highlight such.
  5. Massive heterotopic ossification in Guillain-Barré syndrome: a rare case report
    Ohnmar H, Roohi SA, Naicker AS
    Clin Ter, 2010;161(6):529-32.
    PMID: 21181081
    Heterotopic ossification (HO) is the abnormal development of bone within soft tissue and a rare complication in Guillain-Barré syndrome (GBS). Only a few cases had been reported so far. We present the case of a 39-year-old man who had been diagnosed to have GBS about 10 years ago, presenting with severe limitation of both active and passive range of motion in bilateral shoulder, elbow and hip joints and was found to have massive heterotopic ossification. In our patient, it could be a myriad of factors such as prolonged ICU stay with mechanical ventilation and hypoxia, long-standing immobilization and hypomobility with incomplete flaccid paralysis.
  6. Fulltext Congenital bilateral agenesis of the tibialis anterior muscles: a rare case report
    Htwe O, Swarhib M, Pei TS, Naicker AS, Das S
    Rom J Morphol Embryol, 2012;53(3):657-9.
    PMID: 22990563
    Congenital bilateral agenesis of the tibialis anterior muscles is a rare condition. We present a case of congenital absence of bilateral tibialis anterior muscles in a 6-year-old boy who presented with an abnormal gait. He was previously diagnosed to have bilateral congenital talipes equinovarus (CTEV) deformity for which he underwent corrective surgery two times. However, he still had a residual foot problem and claimed to have difficulty in walking. On examination, he walked with a high stepping gait and muscle power of both lower limbs was 5/5 on the medical research council scale (MRCS) except for both ankle dorsiflexors and long toe extensors. The sensation was intact. Magnetic Resonance Imaging (MRI) study of both legs revealed that tibialis anterior muscles were not visualized on both sides suggestive of agenesis of the tibialis anterior muscles. The rest of the muscles appeared mildly atrophied. The electrophysiological study showed normal motor and sensory conduction in both upper and lower limbs. Electromyographic (EMG) study of the vastus medialis was within normal limit and no response could be elicited for EMG of tibialis anterior muscles suggesting possible absence of tibialis anterior muscles, bilaterally. The patient underwent split tibialis posterior tendon transfer to achieve a balanced and functional foot and was well on discharge. The present case describes the normal anatomy and embryology of tibialis anterior muscles as well as possible causes of its agenesis along with its clinical implications.
  7. Fulltext Knowledge and utilization of laboratory services among employees of University Malaysia Sabah. [Abstract]
    Wynn AA, Myint O, Mya NK, Aung TS, Myint T
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):39.
    MyJurnal
    Abstracts For The 1st International Borneo Healthcare And Public Health Conference And 4th Borneo Tropical Medicine And Infectious Disease Congress. Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia On 3rd-5th September 2019
    Introduction: Laboratory screening tests are common elements of health care. Comprehensive care of patients is dependent on the results of laboratory investigations. Dissemination of knowledge and improving attitude of com-munity for utilization of laboratory services are utmost important in community health care. This study aimed to assess the knowledge and utilization of the laboratory services among the employees of University Malaysia Sabah, determine their expectations of employees on the medical laboratory services.
    Methods: A total of 200 UMS staff participated. The data were collected using a cross-sectional self-administered questionnaires and descriptive data analysis was done.
    Results: 5% of the participants in this study agreed to have the health check and blood screening tests every year. Less than 10% of respondents agreed to do more frequent blood tests check if they are at high risk such as family history of cancer, hypertension and diabetes 181 out of 200 respondents do not agree that doing laboratory tests can help for early diagnosis of some diseases. The most used laboratory tests were plasma sugar (70.8%), blood grouping (60.4%), urine examination (50%) and serum lipid (46%).
    Conclusion: Based on the results, recommendations were made to improve the knowledge, attitude and utilization of the laboratory services and set up laboratory services easily accessible by the university community. This will lead to positive health benefits in people and improve associated health outcomes.
  8. Fulltext Female urinary retention in the young and elderly: a case report and review of literature
    Hakim, B., Saw, Ohnmar, Malhi, F.S., Syed Rahim, S.H., Noraziana, A.W., Suhaiza, A., et al.
    Asian Journal of Medicine and Health Sciences, 2018;1(1):0-0.
    MyJurnal
    Urinary retention rarely affects women. In obstructive retention the source must be determined and treated to allow the patient to void normally. A common anatomic cause of urinary retention is extrinsic compression due to a pelvic mass. In addition, obstruction can also be seen in women with pelvic organ prolapse. Haematocolpos and uterine fibroids have also been documented as causes of acute urinary retention.

    The following cases of female urinary retention highlight the need to consider haematocolpos in the adolescent girl who has not attained menarche and fibroids in the older female.
  9. Fulltext Occupational performance of the primary schoolchildren with special education needs in Malaysia: exploring the needs of school-based therapy service
    Khin, Nyein Yin, Fatimah Ahmedy, Dayang Maryama Ag. Daud, Helen Lasimbang, Voo, Siew Ching, Chin Suliong, et al.
    Borneo Journal of Medical Sciences, 2021;15(2):21-33.
    MyJurnal
    Children’s occupational performance are activities of daily living, play/ leisure, social participation, education, and work. In developed countries, school-based therapy services are being provided for schoolchildren with special needs. The importance of these services in Malaysia is timely to be explored. This exploratory cross-sectional study identified occupational performance levels of primary schoolchildren with special needs in integrated special education programmes in Malaysia; children with intellectual disability, autism, attention deficit hyperactive disorder, Down syndrome, speech impairment, visual impairment, hearing impairment, and specific learning disorder. Researchers conducted Motor-Free Visual Perceptual Test Third Edition (MVPT-3), Beery-Buktenica Developmental Test of Visual-Motor Integration Fifth Edition (Beery-VMI), Test of Gross Motor Development – 2 (TGMD-2), Test of Hand Writing Skills-Revised (THS-R), and School Function Assessment (SFA) for 121 students. Results showed that 69.5% of the students scored very low to low average in MVPT-3 (median standard score = 70.0, Std. IQR = 37); 69.4% were very low to below average in Beery-VMI (mean standard score = 78.8, Std. deviation = 20.5); 73% were below age level raw score in TGMD-2; 72.8% were below average in THS-R (median standard score = 74.0, Std. IQR = 27.0); and 81% were below the criterion cut-off in school function. The children with below-normal MVPT, VMI, TGMD2, and THS scores, compared to the children with normal scores for these tests had significantly lower scores (p < 0.001). All the students had impairment in occupation performance at least in one area. This study recommends school-based occupational therapy and other rehabilitation services in the school system in Malaysia.
  10. Second regional plasmapheresis conference and workshop for Southeast Asia (SEA) on the immunomodulatory role of plasma exchange in central and peripheral nervous system disorders, Kuala Lumpur, Malaysia, 9th December 2017
    Viswanathan S, Hung SKY, Goyal V, Apiwattanakul M, Thirugnanam UN, Abdullah S, et al.
    J Clin Apher, 2018 Oct;33(5):559-568.
    PMID: 29626354 DOI: 10.1002/jca.21630
    In December 2017, 79 delegates attended the 2nd regional plasmapheresis conference and workshop for Southeast Asia (SEA) on the immunomodulatory role of plasma exchange in central and peripheral nervous system disorders in Kuala Lumpur, Malaysia. This meeting featured 6 plenary lectures, interactive sessions dedicated for experience sharing, case presentations, and a practical session for paramedics. Clinical experts and researchers from 7 SEA countries and India shared experience and challenges in treating autoimmune neurological disorders. While the spectrum of diseases and neurology practice remained largely similar, there was great disparities in accessibility of therapeutic plasma exchange (TPE) within SEA countries and between urban or rural settings. Costs, human resources, and healthcare policies are common challenges in providing sustainable TPE services. Novel techniques and innovative ideas in performing TPE were explored. A working consortium comprising of key opinion leaders was proposed to improve standards of TPE and enhance future research.
  11. Fulltext Association between HLA-B* 15:02 and carbamazepine induced severe cutaneous adverse drug reactions in Myanmar
    Amy Hui-Ping Khor, Lim, Kheng-Seang, Tan, Chong-Tin, Seinn Mya Mya Aye, Yan Lynn Aung, Yin Minn Aye, et al.
    Neurology Asia, 2017;22(3):283-285.
    MyJurnal
    Genetic predisposition to carbamazepine (CBZ)-induced Stevens-Johnson syndrome (SJS) and toxic
    epidermal necrolysis (TEN) had been reported in several Southeast Asian populations, but not in
    Myanmar. Previous studies had so far reported more than 70% of CBZ-induced SJS/TEN cases
    positive for HLA-B*15:02 allele.1-4 Myanmar, as the second largest country in Southeast Asia with a
    population of 54.5 million, has high HLA-B*15:02 carrier frequency in its general population (27.3-
    49.1%).5,6 We investigated the association of HLA-B alleles and CBZ-induced SJS/TEN in Myanmar
    population. HLA-B*15:02 was detected in 3/3 (100%) of cases and 6/53 (11.3%) of tolerant controls,
    and HLA-B*15:02 is significantly associated with CBZ-SJS/TEN in Myanmar population (OR 51.2,
    95% CI 2.36-1106.95, p=0.003). (Copied from article)
  12. Affordability of newer antiseizure medications in Asian resource-limited countries
    Fong SL, Thuy Le MA, Lim KS, Khosama H, Ohnmar O, Savath S, et al.
    Epilepsia, 2023 Aug;64(8):2116-2125.
    PMID: 37243851 DOI: 10.1111/epi.17668
    OBJECTIVE: One of the objectives of the Intersectoral Global Action Plan on epilepsy and other neurological disorders for 2022 to 2031 is to ensure at least 80% of people with epilepsy (PWE) will have access to appropriate, affordable, and safe antiseizure medications (ASMs) by 2031. However, ASM affordability is a significant issue in low- and middle-income countries, preventing PWE from accessing optimal treatment. This study aimed to determine the affordability of the newer (second and third generation) ASMs in resource-limited countries in Asia.

    METHODS: We conducted a cross-sectional survey by contacting country representatives in lower-middle-income countries (LMICs) in Asia, including Indonesia, Lao People's Democratic Republic (PDR), Myanmar, Philippines, Vietnam, India, Bangladesh, and Pakistan, and the upper-middle-income country Malaysia, from March 2022 to April 2022. The affordability of each ASM was calculated by dividing the 30-day ASM cost by the daily wage of the lowest paid unskilled laborers. Treatment costing 1 day's wage or less for a 30-day supply of chronic disease is considered affordable.

    RESULTS: Eight LMICs and one upper-middle-income country were included in this study. Lao PDR had no newer ASM, and Vietnam had only three newer ASMs. The most frequently available ASMs were levetiracetam, topiramate, and lamotrigine, and the least frequently available was lacosamide. The majority of the newer ASMs were unaffordable, with the median number of days' wages for a 30-day supply ranging from 5.6 to 14.8 days.

    SIGNIFICANCE: All new generation ASMs, whether original or generic brands, were unaffordable in most Asian LMICs.

  13. Fulltext Evaluation of limb load asymmetry using two new mathematical models
    Kumar SN, Omar B, Joseph LH, Htwe O, Jagannathan K, Hamdan NM, et al.
    Glob J Health Sci, 2015;7(2):1-7.
    PMID: 25716372 DOI: 10.5539/gjhs.v7n2p1
    Quantitative measurement of limb loading is important in orthopedic and neurological rehabilitation. In current practice, mathematical models such as Symmetry index (SI), Symmetry ratio (SR), and Symmetry angle (SA) are used to quantify limb loading asymmetry. Literatures have identified certain limitations with the above mathematical models. Hence this study presents two new mathematical models Modified symmetry index (MSI) and Limb loading error (LLE) that would address these limitations. Furthermore, the current mathematical models were compared against the new model with the goal of achieving a better model. This study uses hypothetical data to simulate an algorithmic preliminary computational measure to perform with all numerical possibilities of even and uneven limb loading that can occur in human legs. Descriptive statistics are used to interpret the limb loading patterns: symmetry, asymmetry and maximum asymmetry. The five mathematical models were similar in analyzing symmetry between limbs. However, for asymmetry and maximum asymmetry data, the SA and SR values do not give any meaningful interpretation, and SI gives an inflated value. The MSI and LLE are direct, easy to interpret and identify the loading patterns with the side of asymmetry. The new models are notable as they quantify the amount and side of asymmetry under different loading patterns.
  14. Fulltext Expression distribution of cancer stem cells, epithelial to mesenchymal transition, and telomerase activity in breast cancer and their association with clinicopathologic characteristics
    Makki J, Myint O, Wynn AA, Samsudin AT, John DV
    Clin Med Insights Pathol, 2015;8:1-16.
    PMID: 25624778 DOI: 10.4137/CPath.S19615
    A total of 167 surgically resected primary invasive breast carcinomas and 63 metastatic lymph node lesions were analyzed for immunohistochemical (IHC) localization of the CD44(+)CD24(-low) breast cancer stem cell (CSC) markers, epithelial to mesenchymal transition (EMT) markers, and telomerase activity by double-staining IHC technique, in formalin-fixed, paraffin-embedded tissue, the results were validated by double-staining immunofluorescent and flow cytometry techniques. The results showed that CSCs with CD44(+)CD24(-low) phenotype were significantly increased in node-positive tumors, high-grade tumors, and ductal carcinoma in situ (DCIS). There was a high incidence of telomerase expression in metastatic lymph node lesion. There were considerably high number of tumor cells with EMT expression in metastatic lymph node lesion, and triple-negative tumor. The occurrence of EMT phenomena was usually accompanied by the co-existence of CSCs of CD44(+)CD24(-low) phenotype. There was no association between the existence of CSCs and detection of telomerase activity in tumor cells. Increased numbers of both CSCs of CD44(+)CD24(-low) phenotype and cells underwent EMT in DCIS lesion might be an initial step in the stromal invasion and propagation of breast cancer, and occurrence of EMT in the breast tumor associated with high prevalence of CSCs, promoting tumor invasiveness and metastasis.
  15. Fulltext Reliability, agreement, and validity of digital weighing scale with MatScan in limb load measurement
    Kumar SN, Omar B, Htwe O, Joseph LH, Krishnan J, Jafarzedah Esfehani A, et al.
    J Rehabil Res Dev, 2014;51(4):591-8.
    PMID: 25144172 DOI: 10.1682/JRRD.2013.07.0166
    Limb loading measurements serve as an objective evaluation of asymmetrical weight bearing in the lower limb. Digital weighing scales (DWSs) could be used in clinical settings for measurement of static limb loading. However, ambiguity exists whether limb loading measurements of DWSs are comparable with a standard tool such as MatScan. A cross-sectional study composed of 33 nondisabled participants was conducted to investigate the reliability, agreement, and validity of DWSs with MatScan in static standing. Amounts of weight distribution and plantar pressure on the individual lower limb were measured using two DWSs (A, B) and MatScan during eyes open (EO) and eyes closed (EC) conditions. The results showed that intra- and interrater reliability (3, 1) were excellent (0.94-0.97) within and between DWS A and B. Bland-Altman plot revealed good agreement between DWS and MatScan in EO and EC conditions. The area under the receiver operating characteristic curve was significant and identified as 0.68 (p = 0.01). The measurements obtained with DWSs are valid and in agreement with MatScan measurements. Hence, DWSs could be used interchangeably with MatScan and could provide clinicians an objective measurement of limb loading suitable for clinical settings.
  16. Fulltext Accuracy of a digital weight scale relative to the nintendo wii in measuring limb load asymmetry
    Kumar NS, Omar B, Joseph LH, Hamdan N, Htwe O, Hamidun N
    J Phys Ther Sci, 2014 Aug;26(8):1205-7.
    PMID: 25202181 DOI: 10.1589/jpts.26.1205
    [Purpose] The aim of the present study was to investigate the accuracy of a digital weight scale relative to the Wii in limb loading measurement during static standing. [Methods] This was a cross-sectional study conducted at a public university teaching hospital. The sample consisted of 24 participants (12 with osteoarthritis and 12 healthy) recruited through convenient sampling. Limb loading measurements were obtained using a digital weight scale and the Nintendo Wii in static standing with three trials under an eyes-open condition. The limb load asymmetry was computed as the symmetry index. [Results] The accuracy of measurement with the digital weight scale relative to the Nintendo Wii was analyzed using the receiver operating characteristic (ROC) curve and Kolmogorov-Smirnov test (K-S test). The area under the ROC curve was found to be 0.67. Logistic regression confirmed the validity of digital weight scale relative to the Nintendo Wii. The D statistics value from the K-S test was found to be 0.16, which confirmed that there was no significant difference in measurement between the equipment. [Conclusion] The digital weight scale is an accurate tool for measuring limb load asymmetry. The low price, easy availability, and maneuverability make it a good potential tool in clinical settings for measuring limb load asymmetry.
  17. Clinical evaluation of the anterior translation of glenohumeral joint using ultrasonography: an intra- and inter-rater reliability study
    Joseph LH, Hussain RI, Pirunsan U, Naicker AS, Htwe O, Paungmali A
    Acta Orthop Traumatol Turc, 2014;48(2):169-74.
    PMID: 24747625 DOI: 10.3944/AOTT.2014.3184
    The aim of this study was to investigate the intra- and inter-rater reliability of ultrasonography (US) to measure anterior translation of the humeral head (ATHH) among healthy subjects and patients with sacroiliac joint dysfunction.
  18. Fulltext Assessment of depression and anxiety in haematological cancer patients and their relationship with quality of life
    Priscilla D, Hamidin A, Azhar MZ, Noorjan KO, Salmiah MS, Bahariah K
    East Asian Arch Psychiatry, 2011 Sep;21(3):108-14.
    PMID: 21921304
    Objectives: To determine the relationship between major depressive disorder, anxiety disorders and the quality of life of haematological cancer patients.
    Methods: This cross-sectional study was conducted at Ampang Hospital Kuala Lumpur, Malaysia, a tertiary referral centre hospital for haematological cancer. The Mini-International Neuropsychiatric Interview was used for the diagnosis of major depressive disorder and anxiety disorders. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was utilised to measure patients’ quality of life.
    Results: A total of 105 haematological cancer patients were included in the study with response rate of 100%. Major depressive disorder correlated with almost all domains of the quality of life, except the pain scores. Logistic regression showed that insomnia and financial difficulties were related to major depressive disorder. Different anxiety disorders also correlated with quality of life in specific domains. The leading anxiety disorders that correlated mostly with quality of life scales were generalised anxiety disorder, followed by obsessive-compulsive disorder, social anxiety disorder, as well as post-traumatic stress disorder and panic disorder with agoraphobia (p < 0.05).
    Conclusions: Psychological treatment along with medication and intervention should be implemented to
    improve the overall quality of life and psychiatric disorder symptoms among the haematological cancer
    patients.
    Key words: Anxiety; Depression; Hematologic neoplasms; Quality of life
  19. A comparative study of sertraline dosages, plasma concentrations, efficacy and adverse reactions in Chinese versus Caucasian patients
    Hong Ng C, Norman TR, Naing KO, Schweitzer I, Kong Wai Ho B, Fan A, et al.
    Int Clin Psychopharmacol, 2006 Mar;21(2):87-92.
    PMID: 16421459
    This prospective 6-week study examined the differences in dosage and steady state plasma concentrations of sertraline in Chinese versus Caucasian depressed patients. Two groups of Chinese patients from different geographical sites and a group of Caucasian patients were evaluated with clinical measures during an initial dose of 50 mg/day, with subsequent doses adjusted clinically. The results of 17 Australian Chinese (ACHI), 13 Malaysian Chinese (MCHI) and 15 Australian Caucasians (AC) were analysed. Despite controlling for weight, the AC subjects received a significantly higher dose than both the ACHI (P = 0.002) and the MCHI groups (P = 0.012). However, the mean sertraline concentration to dose ratios at weeks 1 and 6 were not significantly different between the three groups. Sertraline was effective and well tolerated in both ethnic groups with few adverse events. Although there was a lack of difference between groups in the pharmacokinetic results, Chinese depressed patients appeared to require lower dosages with consequently lower plasma concentrations of sertraline compared to Caucasian patients to achieve clinical efficacy. Further studies of the dosages, kinetics and adverse effects of selective serotonin reuptake inhibitors linked with genotyping are necessary.
  20. Assessment of documentation of DSM-IV-TR Criteria A for diagnosis of schizophrenia in psychiatric unit, tertiary hospital, Malaysia
    Maung K, Ohnmar H, Than W, Ramli M, Najwa Hanim MR, Ali Sabri R, et al.
    Clin Ter, 2015;166(2):87-90.
    PMID: 25945438 DOI: 10.7417/CT.2015.1823
    OBJECTIVE: The purposes of this study were to investigate the documentation of the DSM-IV-TR- Criteria A in diagnoses of schizophrenia and to identify the symptoms associated with over diagnosis of schizophrenia.

    METHOD: This study involved a retrospective review and analysis of data from case notes.

    RESULTS: Data of 107 newly diagnosed patients with schizophrenia were keyed in and analyzed using SPSS v 19. The cases were then evaluated for the use of the DSM-IV-TR- Criteria A. Over diagnosis was noted in 37.39% of the patients. Disorganised behaviour (12.5%), affective flattening (12.5%), hallucination (16%) and non-bizarre delusion (18.3%) significantly contributed to the over-diagnosis of schizophrenia. Symptoms such as non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia and were statistically significant with p ≤0.05.

    CONCLUSIONS: There was a significant lack of DSM-IV-TR Criteria A among the data documented to diagnose schizophrenia and non-bizarre delusion and hallucination were the most commonly used in over-diagnosing schizophrenia. This key problem needs to be addressed. The reliability of a diagnosis is indispensable and achievable with the proper clinical application of DSM-IV-TR Criteria A. The DSM-IV-TR Criteria have been perceived to be useful and reliable and is most widely used throughout the world.
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