OBJECTIVES: This study was conducted to gain an insight into the experiences and views of poststroke patients and their urut Melayu practitioners.
METHODS: A qualitative study design was adopted. A total of 17 semistructured in-depth interviews were carried out with poststroke patients who were undergoing urut Melayu treatment at one of the three integrated hospitals. Information was solicited from their accompanying caregivers whenever necessary. The 2 urut Melayu practitioners at the hospital were also interviewed. All the interviews were carried out in Malay by the authors, at the Traditional and Complementary Medicine unit of the relevant hospital. The interviews were audiotaped, transcribed, and coded into categories through a constant-comparison method of data analysis. Illustrative quotations were identified to supplement the narrative descriptions of the themes.
RESULTS: It was found that urut Melayu was sought by patients who had experienced stroke brought about by hypertension and postdelivery complications. They reported the unique characteristics of urut Melayu and their positive experiences with it.
CONCLUSIONS: Urut Melayu has potential as a complementary therapy for poststroke patients. It is recommended that the number of practitioners at the Traditional and Complementary Medicine unit be increased to provide the optimum care for poststroke patients.
Materials and Methods: The compilation of data was based on signalment, case history, duration of clinical signs, anatomical location of the pain, method of diagnosis, type of EBD, treatment, and outcome. The diagnosis of EBD was based on a history of poor performance, clinical examination findings, radiography, and, where applicable, necropsy.
Results: A total of 181 diagnosed cases of EBDs were identified. The age of horses ranged from 5 to 22 years. The EBD cases were more prevalent in male than female horses and predominantly in geldings (60.77%). Thoroughbred, Arab, Polo pony, and Warmblood also recorded the most EBD cases among breeds. The discipline of horses tended to influence the development of EBDs, with patrolling horses recording the highest frequency. Most EBD cases were of the primary type (92.27%), with the main causes being soft-tissue lesions (57.48%), vertebral lesions (18.56%), tack-associated problems (16.77%), and neurological lesions (7.19%). The common treatments employed were administration of nonsteroidal anti-inflammatory agents, 1 to 3-month rest, warm and cold compression therapy, massage therapy, exercise adjustment, as well as correction of ill-saddle fit.
Conclusion: Most EBDs in this study were associated with soft-tissue lesions. Among vertebral lesions, kissing spines were the most common cause of EBDs in horses in Malaysia.
METHODS AND ANALYSIS: This randomised controlled trial will involve an intervention group receiving BRM and standard labour care, and a control group receiving only standard labour care. Primigravidae of 26-34 weeks of gestation without chronic diseases or pregnancy-related complications will be recruited from antenatal clinics. Eligible and consenting patients will be randomly allocated to the intervention or the control group stratified by intramuscular pethidine use. The BRM intervention will be delivered by a trained massage therapist. The primary outcomes of labour pain and anxiety will be measured during and after uterine contractions at baseline (cervical dilatation 6 cm) and post BRM hourly for 2 hours. The secondary outcomes include maternal stress hormone (adrenocorticotropic hormone, cortisol and oxytocin) levels, maternal vital signs (V/S), fetal heart rate, labour duration, Apgar scores and maternal satisfaction. The sample size is estimated based on the between-group difference of 0.6 in anxiety scores, 95% power and 5% α error, which yields a required sample size of 154 (77 in each group) accounting for a 20% attrition rate. The between-group and within-group outcome measures will be examined with mixed-effect regression models, time series analyses and paired t-test or equivalent non-parametric tests, respectively.
ETHICS AND DISSEMINATION: Ethical approval was obtained from the Ethical Committee for Research Involving Human Subjects of the Ministry of Health in the Saudi Arabia (H-02-K-076-0319-109) on 14 April 2019, and from the Ethics Committee for Research Involving Human Subjects (JKEUPM) Universiti Putra Malaysia on 23 October 2019, reference number: JKEUPM-2019-169. Written informed consent will be obtained from all participants. Results from this trial will be presented at regional, national and international conferences and published in indexed journals.
TRIAL REGISTRATION NUMBER: ISRCTN87414969, registered 3 May 2019.