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  1. Zunura'in Z, Almardhiyah AR, Gan SH, Arifin WN, Sirajudeen K, Bhavaraju V, et al.
    Asian Pac J Cancer Prev, 2016;17(9):4439-4444.
    PMID: 27797258
    The objective of this case-control study was to determine anthropometric and reproductive factors associated with the development of breast cancer among women. Fifty-six newly diagnosed breast cancer patients were recruited from the Oncology Clinic, Universiti Sains Malaysia (USM), and 56 healthy female hospital employees were recruited as controls. Socio-demographic and reproductive data were obtained using a standard questionnaire. Anthropometric factors (body weight, height, body fat percentage, visceral fat and waist and hip circumference) were assessed. A high waist circumference (adjusted OR= 1.04, [95% CI: 1.00, 1.09]) and being more than 30 years of age at rst full-term pregnancy (adjusted OR=3.77, [95% CI: 1.10, 12.90]) were predictors of breast cancer development. The results of this study indicate that weight and reproductive health management should be emphasized for breast cancer prevention in Malaysia.

    Study site: Oncology clinic, Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Hospitals, University
  2. Zulkifli MM, Kadir AA, Elias A, Bea KC, Sadagatullah AN
    Malays Orthop J, 2017 Jul;11(2):7-14.
    PMID: 29021872 MyJurnal DOI: 10.5704/MOJ.1707.003
    Introduction: This study aimed to cross-culturally adapt a Malay version of Knee Injury and Osteoarthritis Outcome Score (KOOS) and to evaluate its psychometric properties in patients with knee osteoarthritis (OA). Materials and Methods: The English version KOOS was translated into a Malay version using forward and backward translation process, followed by face validity and content validity. Two hundred and twenty-six knee OA patients attending the Outpatient and Orthopaedic Clinics, Universiti Sains Malaysia Hospital, completed the Malay version KOOS. Construct validity using confirmatory factor analysis and internal reliability assessment were performed. Results: The results showed that the original five-factor model with 42 items failed to achieve acceptable values of the goodness of fit indices, indicating poor model fit. A new five-factor model of 26 items demonstrated acceptable level of goodness of fit (comparative fit index= 0.929, incremental fit index= 0.930, Tucker Lewis fit index= 0.920, root mean square error of approximation= 0.073 and Chisquared/degree of freedom= 2.183) indices to signify a model fit. The Cronbach's alpha value for the new model ranged from 0.776 to 0.946. The composite reliability values of each construct ranged between 0.819 and 0.921, indicating satisfactory to high level of convergent validity. Conclusion: The five-factor model with 26 items in the Malay version of KOOS questionnaire demonstrated a good degree of goodness of fit and was found to be valid, reliable and simple as an assessment tool for symptoms, pain, activity of daily living, sports and recreational activity and quality of life for Malaysian adults suffering from knee osteoarthritis.

    Study site: Outpatient and orthopedic clinics, Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Hospitals, University
  3. Zueter A, Yean CY, Abumarzouq M, Rahman ZA, Deris ZZ, Harun A
    BMC Infect Dis, 2016;16:333.
    PMID: 27423906 DOI: 10.1186/s12879-016-1583-2
    Over the last two decades, many epidemiological studies were performed to describe risks and clinical presentations of melioidosis in endemic countries.

    Study site: Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Hospitals, University
  4. Zaris SNABSM, Ahmad MSB, Mohamed SZB, Shuid ANB, Mohamed INB, Mokhtar SAB
    Malaysia is a multi-ethnic country with an osteoporosis prevalence of 24.1% in 2005. Only few study reported on osteoporosis awareness. Aim of this study was to investigate the awareness and knowledge regarding osteoporosis among persons attending orthopaedic clinic at Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur. A total of 368 participants (male and female) aged 20 years old or older, was assessed using the Osteoporosis Questionnaire (OPQ). The mean total OPQ score was 1.7 (SD ± 3.08; range -5 to 9; maximum possible score 20). Subjects with family history of osteoporosis and high education level were found to have significantly higher OPQ scores (p<0.05). However, there was no significant difference (p>0.05) with respect to different age groups, gender, ethnicities, and menopausal status. The main source of osteoporosis knowledge was magazine/newspaper (45.9%). An overall low score indicates that new strategies to increase awareness of osteoporosis among the public is urgently required.
    Matched MeSH terms: Hospitals, University
  5. Zarina AL, Norazlin KN, Hamidah A, Aziz DA, Zulkifli SZ, Jamal R
    Med J Malaysia, 2010 Dec;65(4):283-5.
    PMID: 21901946
    Splenectomised thalassaemia patients are at risk of developing sepsis. As the infection may be life-threatening, treatment should be sought and given promptly. A retrospective study was performed amongst our thalassaemia major patients who were splenectomised. The vaccination status of each patient and the types of infections seen were reviewed to obtain a local perspective. In our cohort of 49 splenectomised patients, 25 patients required hospitalization for the treatment of infection. There were a total of 40 febrile episodes within this hospitalised group of which 27.5% were microbiologically documented infection with bacteraemia. The predominant causative organisms were gram negative rods and three patients succumbed to overwhelming septicaemic shock as a result of delayed presentation. Sixty percent of the febrile episodes were clinically documented infection and comprised mainly upper respiratory tract infections. Based on the spectrum of infections seen, there is a need to improve the patients' awareness level so that early treatment is sought. There is also a need to re-address the approach towards vaccination in this immunocompromised group of patients by administering a booster pneumococcal and influenza vaccination in an attempt to reduce morbidity.
    Matched MeSH terms: Hospitals, University
  6. Zamri Z, Razman J
    Clin Ter, 2012 Nov;163(6):467-71.
    PMID: 23306739
    Acute pancreatitis is one of the common reasons for surgical admission. It is a potentially lethal disease that is increasing in its incidence. The most common causes of acute pancreatitis is from gallstones and alcohol. Other causes of acute pancreatitis include hypertriglyceridaemia, hyperparathyroidism, pancreatic malignancy, Endoscopic retrograde cholangiopancreatography (ERCP), trauma, infectious agents, drugs, autoimmunity, and hereditary. The treatment of acute pancreatitis is mainly supportive. The complication of ERCP in acute pancreatitis can be divided into local complication (pancreatic abscess, pseudocyst), systemic complications (renal failure, respiratory failure, cardiogenic shock) and biliary sepsis (acute cholangitis and acute cholecystitis). However, early ERCP and possible sphincterotomy should be kept in mind for patients with severe disease and biliary obstruction who are not improving with medical therapy. This study is done to compare the complication rate of ERCP and conservative management in acute pancreatitis for past 6 years in Pusat Perubatan UKM.
    Matched MeSH terms: Hospitals, University
  7. Zairul-Nizam ZF, Hyzan MY, Gobinder S, Razak MA
    Med J Malaysia, 2000 Dec;55(4):433-8.
    PMID: 11221154
    We attempted to compare the accuracy of our clinical examination and the usage of magnetic resonance imaging (MRI) in evaluating patients suspected of having internal derangement of the knee who were seen in our Orthopaedic clinic. This was done using the findings of arthroscopy as the 'gold standard'. The accuracy of MRI in detecting cruciate ligament tears was between 80-96% against 82-93% for clinical examination. MRI accuracy for meniscus injuries was 80-84% compared to 48-65% for clinical examination. We thus propose that MRI examination is an effective first-line investigation for patients with suspected internal knee derangement, especially menisci injuries; allowing arthroscopy to be reserved for patients in whom surgery is truly indicated.

    Study site: Orthopedic clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Hospitals, University
  8. Zainul Rashid MR, Lim JF, Nawawi NH, Luqman M, Zolkeplai MF, Rangkuty HS, et al.
    Gynecol Endocrinol, 2014 Mar;30(3):217-20.
    PMID: 24552449 DOI: 10.3109/09513590.2013.860960
    Gestational hypertension (GH) remains one of the main causes of high maternal and perinatal morbidity and mortality worldwide with the highest incidence among primigravidae of about 10%-15%. However, it was noted that the incidence of GH in primigravidae who conceived following assisted reproductive technique (ART) or intrauterine insemination (IUI) supplemented with dydrogesterone during the first trimester was low.

    Study site: Obstetrics and Gynecology
    Department, Pusat Perubatan Universiti Kebangsaan Malaysia PPUKM
    Matched MeSH terms: Hospitals, University
  9. Zainuddin J, Arokiasamy JT, Poi PJ
    Asia Pac J Public Health, 2003;15(2):88-93.
    PMID: 15038681 DOI: 10.1177/101053950301500203
    This is a preliminary cross-sectional study of 51 caregivers of older persons attending the Geriatric Clinic at an urban hospital in Kuala Lumpur, Malaysia. A questionnaire helped determine how the duration of caregiving affects the outcome of caregiver burden. The short version of Zarit's Burden Interview (BI) allowed the burden level to be grouped as low or high burden. The duration of caregiving was also grouped into short (two or less years) or long (more than two years) durations. One third of the caregivers, 31% (16 out of 51) reported high burden and within this group 81%, (13 out of 16) are short duration caregivers. Majority of the longer duration caregivers, 88% (21 out of 24) reported low level of burden. This was a significant finding (p-value 0.008). The study also showed that a higher proportion of caregivers are employed, working in the private sector, and earn less than RM2,000 per month. However, these findings were not significantly associated with high burden. It is concluded that although this study showed low level of caregiver burden, shorter duration of caregiving is associated with higher level of burden and longer duration of caregiving is associated with lower level of burden.
    Study site: Geriatric clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  10. Zaini S, Manivanna Bharathy HA, Sulaiman AH, Singh Gill J, Ong Hui K, Zaman Huri H, et al.
    PMID: 29970848 DOI: 10.3390/ijerph15071402
    Shared decision-making (SDM) has been recognized as an important tool in the mental health field and considered as a crucial component of patient-centered care. Therefore, the purpose of this study was to develop a strategic tool towards the promotion and implementation of SDM in the use of antidepressants among patients with major depressive disorder. Nineteen doctors and 11 major depressive disorder patients who are involved in psychiatric outpatient clinic appointments were purposively selected and recruited to participate in one of six focus groups in a large teaching hospital in Malaysia. Focus groups were transcribed verbatim and analyzed using a thematic approach to identify current views on providing information needed for SDM practice towards its implementation in near future. Patients’ and doctors’ views were organized into six major themes, which are; summary of treatment options, correct ways of taking medication, potential side effects of treatments related to patients, sharing of case study related to the treatment options, cost of treatment options, and input from pharmacist. The information may be included in the SDM tool which can be useful to inform further research efforts and developments that contribute towards the successful implementation of SDM into clinical practice.

    Study site: University Malaya Medical Centre (UMMC)
    Matched MeSH terms: Hospitals, University
  11. Zaini Anuar, Asrar M, Ngan A
    Med J Malaysia, 1982 Mar;37(1):78-9.
    PMID: 7121353
    A young Chinese female presented with severe bilateral chemosis without any other systemic evidence ofoedema or systemic lupus erythematosus (SLE). Investigations confirmed the diagnosis of SLE with early diffuse proliferative glomerulonephritis. The condition improved with steroid therapy.
    Matched MeSH terms: Hospitals, University
  12. Zaini A, Khir A, Doi SA, Chan SP, Paramsothy M, Khoo BH
    J Int Med Res, 1992 Jun;20(3):279-88.
    PMID: 1397673
    To evaluate the effects of simple compensated fixed-dose iodine-131 therapy for thyrotoxicosis, the long-term results for 74 patients treated with a fixed dose of iodine-131 ranging from 5 to 12 mCi (185 to 444 MBq) were evaluated in the first 2 years of a trial. The dose selected was loosely based on the gross size of the thyroid gland. Routine antithyroid drug therapy was given for a minimum of 3 months after iodine-131 therapy. The mean (+/- SD) duration of follow-up was 74.5 +/- 42 months. The results indicated that roughly 25% of patients treated in this way will become hypothyroid after 5 years and that 85% are cured (need no further therapy during the follow-up period) using a single dose of iodine-131. Of those cured using a single iodine-131 dose, 81% were no longer receiving drugs after 6 months and 85% after 1 year. Such a regimen seems currently to be among the best available where prolonged periods of medication-free euthyroidism after therapy are sought.
    Matched MeSH terms: Hospitals, University
  13. Zainal D, Monniaty M, Nazmi N
    PMID: 9139394
    The pattern and outcome of patients with chronic renal failure (CRF) in Kelantan, the northeastern state of Malaysia was determined. A total of 60 patients with CRF managed at the Hospital Universiti Sains Malaysia between January 1991 and June 1993 were reviewed retrospectively. The prevalence of CRF was 24.8 patients per year. The ratio of male to female patients was 1.5 : 1.0. Their mean age at presentation was 51.4 +/- 13.7 years. The cause of CRF in majority of our patients was unknown. Their mean blood urea and serum creatinine were 38.9 +/- 9.8 mmol/l and 1,154.9 +/- 458.7 mumol/l respectively. Sixty-five percent of our patients were already in end-stage renal failure (ESRF) at the time of presentation and only 53.8% of them could afford a definitive renal replacement therapy. Their mortality rate was 21.7% and majority of the death occurred in patients who were not receiving definitive renal replacement therapy. This debilitating course will continue unless the cost of renal replacement therapy is subsidised or a renal transplantation program is activated. Hence public education to encourage organ donation in this part of Malysia is necessary.
    Matched MeSH terms: Hospitals, University
  14. Zainal D, Loo CS
    Singapore Med J, 1995 Aug;36(4):379-82.
    PMID: 8919150
    Acute (stab) peritoneal dialysis is commonly practised in Malaysia. This study is designed to improve the management of peritoneal dialysis (PD) in Hospital University Science Malaysia (HUSM). Consecutive peritoneal dialysis (PD) on adult inpatients from May 1992 to September 1992 were reviewed prospectively. There were 40 episodes of peritoneal dialysis on 27 patients during this period given at the rate of 2 PD per week. The mean age of patients were 53 +/- 15 years. Uraemia was the main indication for dialysis, while hyperkalaemia and pulmonary oedema were indications for urgent dialysis. Complications occurred in 14 episodes of dialysis (35%). The most common complication was bleeding in the peritoneal cavity while peritonitis was the second most common complication. Dialysis episodes complicated by peritonitis were done by less experienced performers compared to uncomplicated dialysis episodes. Overall mean time spent on each dialysis and time per cycle were longer than recommended (59 +/- 24 hours and 77 +/- 14 minutes). In conclusion, acute PD performed on patients admitted in Hospital University Malaysia was safe and had complication rates comparable to other established centres. However, improvements are possible through closer supervision of new doctors and tighter nursing precautions.
    Matched MeSH terms: Hospitals, University/statistics & numerical data
  15. Zailinawati AH, Ng CJ, Nik-Sherina H
    Asia Pac J Public Health, 2006;18(1):10-5.
    PMID: 16629433 DOI: 10.1177/10105395060180010301
    Missed appointments affect patients' health in addition to reducing practice efficiency. This study explored the rate and reasons of non-attendance among patients with chronic illnesses. It was a cross-sectional descriptive study carried out in a family practice clinic over a one-month period in 2004. Those who failed turn up for scheduled appointments were interviewed by telephone based on a structured questionnaire. Out of 671 patients, the non-attendance rate was 16.7%. Sixty-seven percent of non-attenders were successfully interviewed. Males (p = 0.01), Indians (p = 0.015), patients with coronary artery disease (p = 0.017), multiple diseases (> 4) (p = 0.036) and shorter appointment intervals (p = 0.001) were more likely to default. The main reasons for non-attendance were: forgot the appointment dates (32.9%), not feeling well (12.3%), administrative errors (19.1%) and work or family commitments (8.2%). The majority would prefer a reminder through telephone (71.4%), followed by letters (41.3%). In conclusion, appropriate intervention could be taken based on the reasons identified in this study.

    Study site: Family Practice Clinic of the
    Department of Primary Care
    Medicine, University of Malaya
    Medical Centre, Malaysia
    Matched MeSH terms: Hospitals, University
  16. Zahiruddin Othman, Hasanah Che Ismail, Ruzita Jamaluddin, Muhammad Najib Mohamad Alwi
    MyJurnal
    Objective: The present study aims to assess verbal memory performance in patients with schizophrenia attending HUSM and determine the relationship between the patients’ verbal memory performance and their demographic/clinical factors. Methods: A cross sectional study of 114 patients with schizophrenia attending HUSM psychiatric services from December 2007 to May 2008 was conducted. The schizophrenia symptoms as well as verbal memory performance were assessed using the Brief Psychiatric Rating Scale, the Malay version of the Calgary Depression Scale (MVCDS), and the Malay version of the Auditory Verbal Learning Test (MVAVLT). The relationship between verbal memory performance and demographic/clinical symptoms was evaluated using Pearson Correlation. Results: Overall MVAVLT scores in all the trials were lowered in patients with schizophrenia compared to average healthy controls. There were significant relationships between occupational status and MVAVLT performance in Trial A1-A5 Total; between educational level and MVAVLT performance in Trial A1 and Trial A1-A5 Total and between severities of illness and MVAVLT performance in all indexes except Trial A1 after controlled for occupation and
    educational level. Conclusions: Patient with schizophrenia in HUSM performed significantly worse than healthy controls in verbal memory with or without interference. There were significant relationships between MVAVLT performance and patient’s occupational s tatus, educational level and severity of the illness but not depressive symptoms.

    Study site: Hospital Universiti Sains Malaysia (HUSM)
    Matched MeSH terms: Hospitals, University
  17. Zahedi FD, Husain S, Gendeh BS
    Indian J Otolaryngol Head Neck Surg, 2016 Jun;68(2):218-23.
    PMID: 27340641 DOI: 10.1007/s12070-015-0899-3
    A prospective single blinded interventional study was held in Otorhinolaryngology Clinic, Universiti Kebangsaan Malaysia Medical Centre in August 2010 until November 2012 to evaluate the functional outcome of septorhinoplasty objectively and subjectively. Objective assessment was done using rhinomanometry and subjective assessment using Nasal Obstruction Symptoms Evaluation (NOSE) scale and Health-Related Quality of Life Questionnaires (HRQOL) in Rhino Surgery. All measurements were taken preoperatively and 3 months postoperatively. A total of 29 patients were enrolled and completed the study. Septorhinoplasty was commonly performed in Malays and Indians and rare amongst Chinese, with age ranged from 18 to 54 years. Majority had no history of trauma. Twisted nose was the most common external nose abnormality followed by crooked and saddle nose. All patients had internal valve insufficiency. There were significant improvement of the total and of all the parameters in the NOSE scale post septorhinoplasty (p  0.05). Significant correlations were noted in the improvement between the two subjective assessments (NOSE scale and HRQOL score). However, there was no significant correlation in the improvement between the subjective (NOSE scale and HRQOL score) with objective (rhinomanometry score) assessments. Septorhinoplasty improves the nasal airflow and quality of life of patients with nasal obstruction.
    Study site: Otorhinolaryngology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Hospitals, University
  18. Zahari Z, Lee CS, Ibrahim MA, Musa N, Mohd Yasin MA, Lee YY, et al.
    Am J Drug Alcohol Abuse, 2016 09;42(5):587-596.
    PMID: 27284701 DOI: 10.3109/00952990.2016.1172078
    BACKGROUND: Methadone is a substrate of the permeability glycoprotein (P-gp) efflux transporter, which is encoded by the ABCB1 (MDR1) gene. Large interindividual variability in serum methadone levels for therapeutic response has been reported. Genetic variations in ABCB1 gene may be responsible for the variability in observed methadone concentrations.
    OBJECTIVE: This study investigated the associations of ABCB1 polymorphisms and serum methadone concentration over the 24-hour dosing interval in opioid-dependent patients on methadone maintenance therapy (MMT).
    METHODS: One hundred and forty-eight male opioid-dependent patients receiving MMT were recruited. Genomic deoxyribonucleic acid (DNA) was extracted from whole blood and genotyped for ABCB1 polymorphisms [i.e. 1236C>T (dbSNP rs1128503), 2677G>T/A (dbSNP rs2032582), and 3435C>T (dbSNP rs1045642)] using the allelic discrimination real-time polymerase chain reaction (PCR). Blood samples were collected at 0, 0.5, 1, 2, 4, 8, 12, and 24 hours after the dose. Serum methadone concentrations were measured using the Methadone ELISA Kit.
    RESULTS: Our results revealed an association of CGC/TTT diplotype (1236C>T, 2677G>T/A, and 3435C>T) with dose-adjusted serum methadone concentration over the 24-hour dosing interval. Patients with CGC/TTT diplotype had 32.9% higher dose-adjusted serum methadone concentration over the 24-hour dosing interval when compared with those without the diplotype [mean (SD) = 8.12 (0.84) and 6.11 (0.41) ng ml-1mg-1, respectively; p = 0.033].
    CONCLUSION: There was an association between the CGC/TTT diplotype of ABCB1 polymorphisms and serum methadone concentration over the 24-hour dosing interval among patients on MMT. Genotyping of ABCB1 among opioid-dependent patients on MMT may help individualize and optimize methadone substitution treatment.
    Study site: Psychiatric Clinic, Hospital Universiti Sains Malaysia (HUSM), and other MMT clinics in Kelantan,
    Malaysia
    Matched MeSH terms: Hospitals, University
  19. Zahari Z, Lee CS, Tan SC, Mohamad N, Lee YY, Ismail R
    PeerJ, 2015;3:e839.
    PMID: 25870765 DOI: 10.7717/peerj.839
    Aim. Poor sleep quality due to pain has been reported among opioid-dependent male patients on methadone maintenance therapy (MMT) but objective pain data are lacking. This study aimed to investigate the rate of pain-sensitivity using cold pressor test (CPT) and the relationship between pain-sensitivity and sleep quality in this population.
    Methods. A total of 168 male participants were included into the study. Objective pain-tolerance was evaluated at 0 h and at 24 h after the first CPT. Malay version of the Pittsburgh Sleep Quality Index (PSQI) and the subjective opiate withdrawal scale (SOWS) questionnaires were administered to evaluate the quality of sleep and withdrawal symptoms, respectively.
    Results. The mean age of study participants was 37.22 (SD 6.20) years old. Mean daily methadone dose was 76.64 (SD 37.63) mg/day, mean global PSQI score was 5.47 (SD 2.74) and mean averaged SOWS score was 5.43 (SD 6.91). The averaged pain-tolerance time ranged from 7 to 300 s with a mean time of 32.16 (SE 2.72) s, slightly below the cut-off score of 37.53 s. More specifically, 78.6% (n = 132) of participants were identified as pain-sensitive (averaged pain-tolerance time ≤37.53 s), and 36 (21.4%) participants were pain-tolerant (averaged pain-tolerance time >37.53 s). The pain-sensitive group reported poorer sleep quality with mean (SD) PSQI of 5.78 (2.80) compared with the pain-tolerant group with mean (SD) PSQI of 4.31 (2.18) (p = 0.005). With analysis of covariance, pain-sensitive group was found to have higher global PSQI scores (adjusted mean 5.76, 95% CI 5.29; 6.22) than pain-tolerant participants (adjusted mean 4.42, 95% CI 3.52; 5.32) (p = 0.010).
    Conclusions. Majority of opioid-dependent male patients on methadone treatment are pain-sensitive with CPT. Poor sleep quality is associated with cold pressor pain-sensitivity. Pain and sleep complaints in this male population should not be overlooked.
    Study site: Hospital Universiti Sains Malaysia (HUSM) and other MMT clinics (Kota Bharu, Pasir Mas, Pasir Puteh and Bachok), Kelantan, Malaysia
    Matched MeSH terms: Hospitals, University
  20. Zahari Z, Lee CS, Ibrahim MA, Musa N, Mohd Yasin MA, Lee YY, et al.
    Iran J Pharm Res, 2018;17(Suppl):8-16.
    PMID: 29796025
    Hyperalgesia is a common clinical phenomenon among opioid dependent patients on methadone maintenance therapy (MMT) and it may be associated with undertreated pain and/or therapeutic failure. This study aimed to investigate association between serum methadone concentration (SMC) and cold pressor pain responses. Cold pressor pain responses in 147 opioid dependent patients on MMT were assessed using cold pressor test (CPT) at 0 h and at 2, 4, 8, 12, and 24 h after the dose intake. Blood samples were collected at 24 h after the dose. Serum methadone concentrations were measured using the Methadone ELISA kit and classified into two categories: < 400 ng/mL and ≥ 400 ng/mL. Eighty-eight patients (59.9%) had trough concentrations of < 400 ng/mL and 40.1% had trough concentrations of ≥ 400 ng/mL. There were significant effects of SMC on the cold pressor pain threshold (p = 0.019). Patients with concentrations < 400 ng/mL had significantly higher (almost 60% higher) cold pressor pain threshold (adjusted mean (95% CI) = 30.15 (24.29, 36.01) s) compared to those with concentrations of ≥ 400 ng/mL (18.93 (11.77, 26.08) seconds). There was also a 20% difference in pain tolerance, and 6% difference in cold pressor pain intensity score, neither of which were significant statistically (p > 0.05). Our results suggest an association of trough methadone concentration with the cold pressor pain threshold among opioid dependent patients on MMT. It would be useful to study the mechanisms underlying this association to help managing pain in such a population.
    Study site: Psychiatric Clinic, Hospital Universiti Sains Malaysia (HUSM); Psychiatric Clinic, Hospital Raja Perempuan Zainab II; and eight other government MMT clinics in Kelantan, Malaysia
    Matched MeSH terms: Hospitals, University
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