Displaying publications 1 - 20 of 159 in total

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  1. Hassan H, Das S, Se H, Damika K, Letchimi S, Mat S, et al.
    Clin Ter, 2009;160(6):477-9.
    PMID: 20198291
    Medication error is defined as any preventable event that might cause or lead to an inappropriate use or harming of the patient. Such events could be due to compounding, dispensing, distribution, administration and monitoring. The aim of the present study was to determine the nurses' perception on medication error that were related directly or indirectly to the process of administration of drugs. MATERIALS AND METHODS. This was a descriptive cross sectional study conducted on 92 staff nurses working in the selected wards in one of the hospitals in East Malaysia. Data was obtained through structured questionnaires. RESULTS. Analysis of data was done through SPSS program for descriptive inferential statistics. Out of a total of 92 subjects, sixty-eight (73.9%) indicated medication error occurred because the nurses were tired and exhausted. Seventy nine subjects (85.9%) believed that any medication error should be reported to the doctors; another 74 (80.2%) knew that their colleagues committed medication error and 52 (56.5%) did not report the case. Forty eight (52.17%) subjects committed medication error at least once throughout their life. Of the 48 committed medication, 45 (93.75%) nurses believed that the error committed was not serious; while 39 (81.25%) believed the error occurred during the 1st 5 years of their working experience.
  2. Ho CC, Ngoo KS, Hamzaini AH, Rizal AM, Zulkifli MZ
    Clin Ter, 2014;165(2):75-81.
    PMID: 24770808 DOI: 10.7471/CT.2014.1680
    OBJECTIVE: To determine the clinical utility of urinary bladder and prostate characteristics measured by ultrasound scan in predicting acute urinary retention (AUR) for men with bladder outlet obstruction with an underlying benign prostate hyperplasia (BPH).
    MATERIALS AND METHODS: Consecutive men aged ≥50 years presenting with lower urinary tract symptoms (LUTS) or AUR were prospectively recruited in this cross-sectional study. International prostatic symptom score (IPSS) and serum prostate-specific antigen (PSA) were recorded. High-resolution ultrasound was used to measure bladder detrusor thickness (DT, mm), prostatic volume (PV, cm3), intravesical prostatic protrusion (IPP, mm), bladder wall thickness (BWT,mm), intravesical volume and bladder radius. The latter two parameters were used to estimate bladder weight (UEBW, g), assuming a spherical bladder.
    RESULTS: Among selected patients, thirty had AUR while 32 men presented with LUTS only. There were significant differences between those with and without AUR in their age (70.5 vs 66.0, p=0.017), IPSS (24.0 vs 18.5, p=0.009), serum PSA (6.18 vs 1.77, p=0.002), PV (56.7 vs 32.4, p=0.006), BWT (5.0 vs 4.4, p=0.034) and UEBW (39.1 vs 25.0, p=0.0003). Multivariate analysis revealed high IPSS and UEBW to be predictors for AUR. UEBW was the strongest predictor of AUR: area under ROC curve was 0.767, with sensitivity and specificity of 63.3% and 87.5%, respectively, at cut-off point of 35 g. The likelihood ratio for AUR was also best with UEBW≥35 g.
    CONCLUSIONS: Combined with IPSS, ultrasound determined bladder characteristic, particularly UEBW, is a useful tool in predicting AUR in men with BPH.
  3. Tan C C K Ho GH, Bahadzor B, Praveen S, Goh EH, Syahril AS, Zulkifli MZ
    Clin Ter, 2013;164(4):319-21.
    PMID: 24045515 DOI: 10.7417/CT.2013.1580
    Gas-forming infection of the kidneys can affect either the parenchyma or the collecting system. They are known as emphysematous pyelonephritis (EPN) and emphysematous pyelitis (EP) respectively. Bilateral EPN is a fairly established entity and numerous articles about this condition have been published. However, much less is known about bilateral EP. We report a rare case of bilateral EP and a literature review of this disease. A 66-year-old woman with long-standing bilateral staghorn calculi presented with bilateral EP and severe sepsis. She was treated with antibiotics and bilateral double-J stents to drain the upper urinary tracts. She recovered after 1 month of intensive care and medical therapy. Percutaneous nephrolithotomy (PCNL) had been scheduled to treat her staghorn calculi. A literature search on MEDLINE and Google Scholar with the terms "bilateral emphysematous pyelitis" only found 1 case report in English and another 2 reports in the Korean language that discussed bilateral EP. The collective experience of these few cases, including the present case, suggests that bilateral EP runs a more benign course than bilateral EPN. It should be diagnosed as soon as possible with computed tomography (CT) scans of the renal system. Current evidence shows that can be treated successfully with timely antibiotics. Drainage of the collecting system either percutaneously or with placement of double-J stents might facilitate recovery.
  4. Ho CC, Khor TW, Singam P, Goh EH, Tan GH, Bahadzor B, et al.
    Clin Ter, 2012;163(3):211-4.
    PMID: 22964693
    OBJECTIVE: To evaluate power doppler ultrasonography (PDU)-directed prostate biopsy in patients with elevated serum prostate specific antigen (PSA) levels.
    MATERIALS AND METHODS: Men with serum total PSA levels of more than 4 ng/ml undergoing biopsy for the first time were included. Grey-scale transrectal ultrasound (TRUS) and PDU were performed. PDU signal on vascularity accumulation and perfusion characteristics were recorded and graded as normal or abnormal in the peripheral zone of the prostate. Abnormalities were defined on transverse image as radial or arc hypervascularities. A biopsy regime based on Vienna-normogram was performed in all patients.
    RESULTS: Overall, prostate adenocarcinoma detection rate was 21.4% and abnormal accumulation on PDU signal was identified in 96.7% of those patients (p = 0.01). PDU directed prostate biopsies were positive in 66.7% of the patients with prostate cancer. The sensitivity, specificity, positive predictive value and negative predictive value of PDU signal alone for prostate cancer detection was 96.7%, 24.5% and 96.4% respectively, and PDU guided biopsies were 66.7%, 24.5%, 19.4% and 73% respectively.
    CONCLUSIONS: The high sensitivity and negative predictive value of PDU makes it useful as an aid for TRUS biopsy in selected patient with previous negative biopsies at risk of harbouring prostate cancer.
  5. Tan GH, Ho CC, Bahadzor B, Praveen S, Goh EH, Afdzillah AR, et al.
    Clin Ter, 2013;164(1):35-7.
    PMID: 23455741 DOI: 10.7417/T.2013.1509
    Concurrent penetrating injury to the male external genitalia and the anterior urethra is uncommon. This case illustrates an unusual cause of such an injury, and its subsequent management and outcome. A 69-year-old man had his scrotum and anterior urethra pierced by a long thorn when he fell in his farm. He presented with urine leakage from the scrotal wound each time he micturated. Cystoscopic examination confirmed the cause and extent of the injury, and also facilitated the extraction of the thorn. The injury was allowed time to heal by urinary diversion with a urinary catheter. There were no stricture or fistula formations and the patient remained symptom-free at 3 months follow-up. Careful cystoscopic examination was both diagnostic and therapeutic in this case. A conservative approach is a feasible option in the management of selected cases of penetrating anterior urethral injury.
  6. Lee CY, Nurul Zaidah AS, Nur Amalina G, Muhammad Azree E, Das S, Zar CT
    Clin Ter, 2014;165(5):269-77.
    PMID: 25366948 DOI: 10.7417/CT.2014.1758
    Increase in prevalence of disease related oxidative stress disorders have been on the rise in the entire world since the past decades. Significant positive effects with few antioxidant properties in the modern drugs pave for the alternative medicines in managing the disease. Piper betel (P. betel), a herb, is known to possess high anti-oxidant, anti-diabetic, anti-atherosclerosis, anti-hyperlipidemic, anti-cancer and neuroprotective property. This review focused on the effect of P. betel on diabetes mellitus, atherosclerosis and chronic kidney disease, Alzheimer's disease and breast cancer. P. betel proved to show positive effects with specific outcomes towards these diseases. Moreover, the promising effect of P. betel in vitro studies was also highlighted in the present review. It is believed that the findings obtained in this review will draw the attention of the medical professionals and general public towards P. betel and it will open the door for further detailed research.
  7. Ng CG, Wong SK, Loh HS, Yee A
    Clin Ter, 2014;165(6):e384-90.
    PMID: 25524191 DOI: 10.7417/CT.2014.1778
    BACKGROUND AND AIMS: Escitalopram has widely been recognized as one of the most frequently used antidepressants, with superior tolerability and great efficacy in preventing major depressive disorder (MDD) relapse and recurrence. However, anhedonia, which is a core symptom of MDD, remains difficult to treat. This study investigates the hedonic levels of MDD patients treated with Escitalopram.

    MATERIALS AND METHODS: A total of 108 participants, 26 of whom with MDD on Escitalopram, were recruited in this cross sectional study. They were evaluated using the Snaith-Hamilton Pleasure Scale (SHAPS) and Beck Depression Inventory (BDI) questionnaires to assess their hedonic state, general mental health condition and level of depression.

    RESULTS: Our study shows that most items in the SHAPS scores are significantly different between MDD patients on Escitalopram and the controls.

    CONCLUSIONS: The hedonic capacity remains different between the two groups despite patients with MDD are put on Escitalopram treatment. Escitalopram fails to alleviate the hedonic state of MDD patients. Antidepressants that improve both depressive symptoms and hedonic states should be considered when treating MDD patients in clinical settings.
  8. Makpol S, Jam FA, Rahim NA, Khor SC, Ismail Z, Yusof YA, et al.
    Clin Ter, 2014;165(1):e39-45.
    PMID: 24589959
    Antioxidant has been recognized to inhibit UV-induced melanogenesis. This study aimed to elucidate the molecular mechanism of tyrostat, tocopherol and tocotrienol-rich fraction in inhibiting melanogenesis in human skin melanocytes.
  9. Leonard JH, Paungmali A, Sitilertpisan P, Pirunsan U, Uthaikhup S
    Clin Ter, 2015;166(5):e312-6.
    PMID: 26550815 DOI: 10.7417/T.2015.1884
    OBJECTIVE: Lumbo-pelvic core stabilization training (LPST) is one of the therapeutic exercises common in practice for rehabilitation of patients with chronic low back pain. This study was carried out to examine the therapeutic effects of LPST on the muscle thickness of transversus abdominis (TrA) at rest and during contraction among patients with chronic non-specific low back pain.
    MATERIALS AND METHODS: A total of 25 participants (7 males and 18 females) with chronic non-specific low back pain participated in a within-subject, repeated measures, double-blinded, placebo-controlled comparisons trial. The participants received three different types of experimental therapeutic training conditions which includes the lumbo-pelvic core stabilization training (LPST), the placebo treatment with passive cycling (PC) and a controlled intervention with rest (CI). The interventions were carried out by randomization with 48 hours between the sessions. The effectiveness of interventions was studied by measuring the changes in muscle thickness of TrA at rest and during contraction using a real time ultrasonography.
    RESULTS: Repeated measures ANOVA demonstrated that the LPST provided significant therapeutic benefits as measured by an increase in the muscle thickness of the TrA at rest (p<0.05) and during contraction (p<0.01). The percentage change of the muscle thickness observed during LPST was significantly higher (p<0.01) when compared to the other two experimental training conditions.
    CONCLUSIONS: The findings indicated that the LPST might provide therapeutic benefits by increasing the muscle thickness and function of TrA. Therefore, it is suggested that LPST technique should be considered as part of management program for treatment of low back pain.
    KEYWORDS: Back pain; Core stabilization; Lumbo-pelvic exercise; Rehabilitation; Transversus abdominis
  10. Thambiah SC, Abu-Bakar M, Bador KM, Das S, Umar NA
    Clin Ter, 2010;161(4):349-54.
    PMID: 20931159
    We report the case of a 37-year-old Chinese man who came with a history of bilateral adrenalectomy and was admitted for recurrent phaeochromocytoma. Further investigations of an incidental finding of persistently raised carcinoembryonic antigen (CEA), fi rst observed four years ago, revealed medullary thyroid carcinoma (MTC). As such, a provisional diagnosis of Multiple Endocrine Neoplasia 2A (MEN 2A) was made. In this case, it seemed like the long-standing elevation of CEA was ignored until it was noted in a post-clinical discussion among several physicians. The present case illustrates the significance of considering a single abnormal biochemical test in an asymptomatic patient and also discusses the importance of life-long follow-up of a patient with a history of phaeochromocytoma.
  11. Sukalingam K, Ganesan K, Das S, Thent ZC
    Clin Ter, 2015;166(3):131-9.
    PMID: 26152621 DOI: 10.7417/CT.2015.1843
    Soy protein (SP) is a protein derived from soybean meal. SP is obtained from the removal of the outer shell of soybean and the fatty acid. The dietary supplementation of SP was was reported to have positive effects on human health. Therefore, the attention towards SP is increasing among the consumers, industrialist and researchers. However, the side effects and toxicity related to SP was not summarized, to date. This review summarized the toxic effects such as hormonal disturbances, carcinogenic and organotoxicity of SP based on the clinical and experimental studies. The review mainly focused on the effect of soy isoflavone-genistein on various organs. The main aim of the present review is to increase the public awareness on the harmful effect of SP on the various health aspects and draw the attention of the health care personnel and researchers.
  12. Vu H, Khanh Tuong TT, Hoang Lan N, Quoc Thang T, Bilgin K, Hoa T, et al.
    Clin Ter, 2023;174(1):42-47.
    PMID: 36655643 DOI: 10.7417/CT.2023.5007
    BACKGROUND: Many non-invasive methods have been studied for assessing the severity of fatty liver disease and carotid intima-media thickness (CIMT). However, the correlation between hepatic steatosis and CIMT has not been fully studied, either globally or in Vietnam. This study investigated the association between nonalcoholic fatty liver disease (NAFLD) and CIMT.

    METHODS: A cross-sectional study was performed on 125 patients at the Cardiology Department, the Emergency Interventional Cardiology Department, and the Internal Cardiology Clinic of Thong Nhat Hospital.

    RESULTS: Among the 125 patients in our study population, NAFLD was diagnosed in 56%, and the mean CIMT was 0.89 ± 0.48 mm. Normal CIMT was measured in 21% of patients, whereas 79% had an elevated CIMT. The NAFLD rates were significantly different between patients with normal and increased CIMT, at 26.9% and 69.6%, respectively (p = 0.001).

    CONCLUSIONS: Our study revealed a strong association between NAFLD and CIMT. NAFLD is currently considered a feature of metabolic syndrome, and an increase in the prevalence of NAFLD might result in an increase in the incidence of cardiovascular disease.

  13. Kurien M, Teo R, Zainuddin K, Azidin AM, Izaham A, Budiman M, et al.
    Clin Ter, 2021 Jul 05;172(4):278-283.
    PMID: 34247211 DOI: 10.7417/CT.2021.2332
    Objective: We compared sonoanatomy of the internal jugular vein (IJV) the high (HA), conventional (CA) and the medial oblique approach (MA) to identify the best approach and head position for IJV cannulation.

    Materials & Methods: Total of 45 volunteers aged 18-65 years were included in this study. The degree of overlap in percentage, depth of IJV from skin, antero-posterior (AP) and transverse diameters (TD) of IJV were measured in real time with ultrasound (US). Measurements were taken in the HA, CA and MA in neutral and 30° head rotation on both the right and left side of the neck.

    Results: The HA had lower percentage of overlap when compared to CA and MA in neutral and 30° head rotation (p= 0.002 to ≤0.001). The IJV was more shallow in the CA and MA. The AP and TD of the IJV were larger in the MA when compared to HA (p=<0.001) and CA (p =0.026 to < 0.001) and the right IJV has a larger AP and TD in all approaches.

    Discussion: The HA had the least percentage of overlap compared to CA and MA, therefore the risk of accidental ICA puncture can be reduced. The apparent overlap seen in MA may not reflect the actual scenario because of the way the US beam cuts the vessel. The AP and TD of IJV were significantly increased in the MA, which would ease CVC.

    Conclusion: We conclude and recommend the medial oblique probe position with 30° head rotation provides optimal real time sonographic parameters for US guided IJV cannulation.

  14. Tee CK, Suzaily W
    Clin Ter, 2015;166(2):72-3.
    PMID: 25945434 DOI: 10.7417/CT.2015.1819
    Olfactory reference syndrome (ORS) is a person's fear of exuding an offensive body odour which is not perceived by others. The objective of this case report is to highlight the challenges in diagnosing olfactory reference syndrome due to the lack of diagnostic criteria as well as its similarities to other psychiatric illnesses. We report a case of a young Chinese gentleman who was preoccupied with the belief that he had an offensive body odour which was not noticeable by others since the age of 10. As a result of this, he developed compulsive behaviour, social anxiety and avoidance, as well as depression. The patient had an array of psychiatric symptoms. He had symptoms which fulfilled criteria for obsessive compulsive disorder (OCD), delusional disorder somatic type, and social anxiety disorder. ORS remains a diagnostic challenge. Further studies are needed in this area for a better understanding of the disorder.
  15. Yuen GK, Clements JB, Ramalingam V, Sundar V
    Clin Ter, 2021 Mar 15;172(2):163-167.
    PMID: 33763681 DOI: 10.7417/CT.2021.2305
    Conclusion: The obtained results conclude piano players are highly prone to the risk of developing PRMSD in the upper body.

    Results: The findings showed piano players have a higher NDI, lower CVA, and RSP when compared with the non-piano players at a statistically significant level of p-value <0.05.

    Objective: Playing-related musculoskeletal disorders (PRMSD) are a common problem for the pianist. The poor upper body ergonomics influences the natural positioning of the neck and shoulders, which involves forward head posture (FHP) and rounded shoulder posture (RSP). This misaligned position could produce a sensation of pain over the upper body, which affects the piano player and computer users with similar ergonomic posture. Recently, photogrammetry methods are commonly applied in a clinical setting to assess posture. The goal of this research is to compare the upper body playing-related muscu-loskeletal disorders between the piano and the non-piano players by applying photogrammetry.

    Materials and Methods: This causal-comparative study includes 70 participants with 35 piano and 35 non-piano players. The participant's FHP was assessed using a digitized photo to record the Craniovertebral angle (CVA) with the support of Kinovea software. Besides, digital Vernier Calliper used to assess the scapular index on the RSP and Neck disability indices (NDI) used to measure neck pain and functional disability of the participants.

  16. Muthupalaniappen L, Rosdinom R, Suguna M
    Clin Ter, 2012;163(1):31-2.
    PMID: 22362231
    Pisa syndrome or pleurothotonus is the persistent flexion of the body and head to one side giving the appearance of the leaning tower of Pisa. It is most commonly caused by typical and atypical antipsychotic drugs. We report a case of Pisa Syndrome caused by prolonged use of high dose cholinesterase inhibitor, rivastigmine. Symptoms subsided when rivastigmine was withdrawn and did not reappear when a different cholinesterase inhibitor, donepezil was introduced. Physicians should be aware of Pisa syndrome and should alert patient of this possibility when starting and stepping up medications. The purpose of reporting this case is to create awareness among general practitioners as it is a reversible condition which responds to removal of the offending drug.
  17. Yazid Bajuri M, Tan BC, Das S, Hassan S, Subanesh S
    Clin Ter, 2011;162(6):549-52.
    PMID: 22262327
    There are various causes of the common peroneal nerve palsy. However, common peroneal nerve palsy caused by ganglia are uncommon. We hereby present a case of a 55-year-old man with a 1 week history of foot drop and swelling in the region of the right leg. Physical examination and nerve conduction study studies confirmed a diagnosis of common peroneal nerve palsy. Magnetic resonance imaging (MRI) revealed a lobulated, elongated cystic-appearing mass anterior to the head of fibula. Surgical decompression of the nerve with removal of the mass was performed. Surgical pathology reports confirmed the diagnosis of a ganglion cyst. Findings on physical examination, nerve conduction study and MRI results of this interesting case are being discussed. We wish to highlight that even a tumour which is benign and within the nerve sheath can cause compression.
  18. Anitha H, Lam YF, Sutton PA, Kosai NR, Srijit D
    Clin Ter, 2014;165(4):203-5.
    PMID: 25203334 DOI: 10.7417/CT.2014.1734
    Refeeding syndrome is a potentially fatal clinical condition characterized by severe electrolyte and fluid shifts associated with metabolic abnormalities in severely malnourished or starved patients undergoing oral, enteral or parenteral refeeding. We here present a case of a 50-year-old Indian male with a background of depression and alcoholic liver disease presented with alleged ingestion of a detergent. He subsequently developed an oesophageal stricture resulting in severe malnutrition. He developed refeeding syndrome following commencement of TPN associated with clear biochemical alteration. This was immediately identified and rectified. This case report highlights the prevalence of refeeding syndrome in a typical hospital setting that can easily be overlooked and stresses the importance of early recognition as this is a preventable disorder.
  19. Rosdinom R, Fazli A, Ruzyanei NJ, Azlin B, Srijit D
    Clin Ter, 2011;162(1):23-9.
    PMID: 21448542
    BACKGROUND AND AIMS: Parkinson disease (PD) is the second most prevalent neurodegenerative disorder after Alzheimer disease. Besides motor presentations, cognitive impairment is among the other likely complications as the illness progresses. This study aimed to determine the prevalence of cognitive impairment in PD and the factors associated with the cognitive impairment.
    MATERIALS AND METHODS: A cross-sectional, descriptive study was conducted on all PD patients at different stages of their illness, in two major tertiary hospitals in Malaysia with their caregivers, over a three month period in 2002. Patients' cognitive functions were tested using the Mini Mental State Examination (MMSE). Important sociodemographic data and relevant clinical information of the patients as well as caregivers' information on income, duration of care-giving, relationship with the patient, and other relevant variables were gathered. Patients' level of functioning was assessed using the Activities of Daily Living (ADL) index. Staging of illness was done based on the Hoehn and Yahr Scale.
    RESULTS: Out of 115 eligible patients, 35% were in the 60-69 age group with 57% in stage 2 of illness, A total of 29% of patients experienced various degrees of cognitive impairment , with almost half (47%) in the stage 3 and 4 exhibiting MMSE scores <24. Factors which were significantly associated with impaired cognitions were race, educational level and stage of illness.
    CONCLUSION: Cognitive impairment was fairly common in PD and the severity of impairment in cognition and physical functioning increased with the advancement of the illness.
  20. Amro MS, Teoh SL, Norzana AG, Srijit D
    Clin Ter, 2018 2 16;169(1):e23-e33.
    PMID: 29446788 DOI: 10.7417/T.2018.2050
    Parkinson's disease (PD) is a multifactorial disorder of the nervous system in which there is a progressive loss of dopaminergic neurons. There is a disturbance in the movement in PD and these include resting tremors, rigidity, bradykinesia or akinesia, disturbance, posture and freezing (motor block). The substantia nigra and other parts of the brain are commonly affected. The disorder could be related to oxidative stress and there is an important role of reactive oxygen species (ROS). A number of herbal products contain active components which are known to possess antioxidant action. Hence, the potential role of herbal products in treating PD cannot be undermined. In the present narrative review, the main aim is to discuss the pathogenesis of PD, define the role of different potential herbal extracts on its pathogenesis which may form the basis of treatment. We also discuss in detail the active chemical compounds present each herb which are effective in the treatment of PD. These herbs include Baicalei, Erythrina velutin, Resveratrol, Peganum Harmal, Curcuma longa (Zingiberaceae), Carthamus tinctorius L. (Safflower), Pueraria lobate, Juglandis Semen (Walnut), Tianma Gouteng Yin (TGY), Lycium barbarum L fruit, Mucuna pruriens (Velvet bean), Chunghyuldan (CHD), Paeoniae Alba Radix. The present review may be beneficial for designing future drugs for effective treatment of PD.
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