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  1. Fulltext Outbreak management during the worst flood disaster of 2006–2007 in Johore, Malaysia
    Arbaiah, O., Badrul, H.A.S., Marzukhi, M.I., Mohd Yusof, Badaruddin, M., Mohd Adam
    Malaysian Journal of Community Health, 2009;15(3):111-118.
    MyJurnal
    Outbreak management in disaster has to be planned and implemented prior to, during and after the disaster is over. The risk of outbreaks following disaster is related to the size, health status and living conditions of the displaced population. The risk is increased due standing water in floods for vector borne diseases, overcrowding, inadequate water and sanitation and poor access to health care. The 2006-2007 flood in Johore resulted in 2 episodes of food poisoning and an outbreak of coxsackie A24 acute haemorrhagic conjunctivitis. Only 19,667 (12.5%) of the 157,018 displaced persons suffered from communicable diseases which comprised of acute respiratory disease 7361(28%), skin infection 4241(19%), acute gastroenteritis 1872(8%) and conjunctivitis 589 (2%). The routine disease surveillance and environmental control were enhanced to cover the relief centers and flood areas. Risk assessment of communicable disease carried out resulted in prompt control measures and good coverage of preventive activities. In conclusion the Johore State Health Department has successfully manage the outbreaks during the major flood.
    Matched MeSH terms: Disease Outbreaks
  2. Fulltext Public health preparedness and response to flood disaster in Johore, Malaysia : challenges and lessons learned
    Arbaiah, O., Daud, A.R., Surinah, A., Noorhaida, U., Shaharom, N.A.M.C.D., Rahim, A.
    Malaysian Journal of Community Health, 2009;15(3):126-131.
    MyJurnal
    Introduction : The 2006 -2007 flood in Johore which displaced more than 312,386 residents of the state was an extraordinary event and tested everyone preparedness. The disaster caused massive material, economic and environmental losses exceeded the state and local community capacity, forcing them seeks help from other states. Needs assessment, effectiveness of health services as well as leadership and nongovernment organization involvement were evaluated and constitute lessons learnt from the experiences.
    Methodology : This is a descriptive review of the Johore flood. The review was based on literature search using established data and published reports of previous disasters. Discussion will focus on the 4 S’s of the surge capacity that is Structure, Staffing, Supplies and System (policies & procedures). Result : Structure- although 49 or 14% of health facilities in the state were affected by the flood, health services continued to be given. Majority of the relief centers were schools with better facilities. Funding for repairs obtained early approval as estimation of damages was timely applied. Temporary isolation centers for the conjunctivitis outbreak was appropriate implemented. Staffing- Leadership was assumed by the Johore State Health Department, the strongest and most prepared health sector. Needs assessment resulted in additional staff being deployed from other states allowing local staff to have their break from work as well as personal stress. Local staff became multi-skilled players. Training in disaster preparedness has to be of utmost priority to support such needs. Supplies- Personnel protective and pest control equipment, and medical supplies were adequately supplied. The laboratory services were well prepared. Pamphlets, posters, buntings and banners were distributed including five new health promotion materials. System- Flood disaster plan of action was well in place resulting in efficient management of the operating rooms, data management, coordination of services and disease surveillance through early warning system.
    Conclusion : Public health preparedness is a matter of good governance and management based on evidence and experience. There is a need for a permanent and stable program for the Ministry of Health to prepare and coordinate the response to all disasters.
    Matched MeSH terms: Disease Outbreaks
  3. Fulltext Bioactivity analysis of lemongrass (Cymbopogan citratus) essential oil
    Mirghani, M.E.S., Liyana, Y., Parveen, J.
    International Food Research Journal, 2012;19(2):569-575.
    MyJurnal
    Diseases such as diabetes mellitus and gout are among the chronic diseases affecting worldwide population. Investigation is required to find the alternative approaches to treat these chronic diseases, such as plant based medicine. In this study, lemongrass (Cymbopogan citratus) was chosen and examined on the basis of their usage in traditional medicines throughout Southeast Asia. GCMS analysis revealed the major constituents of the lemongrass essential oil which compromise 67.769% and 67.328% of the total oil respectively. Total phenolic content of the essential oil was analyzed by Folin Ciocalteau method and the results indicated that highest amount of phenolic content was obtained from essential oil extracted from lemongrasses stalk, with phenolic concentration of 2100.769 mg/l GAE. Anti oxidant activity was examined by DPPH scavenging test and the highest inhibition was obtained by essential oil extracted from lemongrass stalk (89.5%). β-glucosidase inhibition assay was carried out using an in-vitro model for anti diabetic test and lemongrass stalk essential oil showed highest degree of inhibitory activity (89.63%). Anti gout test was examined by xanthine oxidase inhibition (XOI) assay with the maximum percentage of xanthine oxidase inhibition of 81.34% obtained from lemongrass stalk essential oil.
    Matched MeSH terms: Chronic Disease
  4. Fulltext Factors influencing consumer intentions to avoid broiler chicken meat and products in Malaysia
    Huang, L.C., Goh, Y.N., Mohaidin, Z.
    International Food Research Journal, 2014;21(1):181-188.
    MyJurnal
    Reports of bird flu outbreaks occur around the globe, posing a severe threat to the poultry
    industry and consumer health. Despite the number of bird flu scares, few studies have
    considered the impact on consumers’ chicken consumption intentions in a non-western context,
    such as in Malaysia. The aim of this study is to determine the factors that influence consumers’
    intentions to take precautions by avoiding the consumption of broiler chicken meat and
    products in Malaysia when a bird flu outbreak occurs. A total of 276 online questionnaires were
    disseminated using convenience sampling with 109 respondents completing the questionnaires, generating a response rate of 40.8 percent. The study results show that attitudes, subjective norms, perceived behavioral control, perceived credibility of information, and perceived risk have a significant relationship with consumer intentions to take precautions by avoiding the consumption of broiler chicken meat and products. One factor is the exception: attention towards bird flu news. These findings shed some light on understanding the extent of consumer response (i.e. consumption behavior) to future health crises (e.g. bird flu). Moreover, for policy makers, these findings may serve as a guide and a reference to food safety issues in the poultry industry, especially future bird flu scares.
    Matched MeSH terms: Disease Outbreaks
  5. Fulltext Reverse Transcriptase PCR detection of Hepatitis A virus (HAV) in cultured and wild shellfish from the Peninsular of Malaysia
    Wan Norhana, M. N., Masazurah A. R.
    International Food Research Journal, 2011;18(1):411-415.
    MyJurnal
    Hepatitis A is a liver infection caused by the hepatitis A virus (HAV). Outbreaks of hepatitis A have been linked to the consumption of both raw and cooked shellfish. These outbreaks could induce a public confidence problem over shellfish safety and may result in important economic losses for the seafood industry. The work presented in this study investigated the presence of HAV in shellfish from Peninsular Malaysia. A total of 365 of cultured and wild shellfish from 36 sampling locations located throughout Peninsular Malaysia were examined using a commercial nucleic acid extraction and reverse transcription -polymerase chain reaction (RT-PCR) kit. HAV was not detected in almost all of the shellfish samples xamined. Only one cockle sample from Changkat, Seberang Perai was positive for HAV. The results suggest the absence of HAV or very low amount of HAV viral particles in most of the shellfish examined.
    Matched MeSH terms: Disease Outbreaks
  6. Fulltext Pre-enrichment effect on PCR Detection of Salmonella Enteritidis in artificially-contaminated raw chicken meat
    Mohd Afendy, A.T., Son, R.
    International Food Research Journal, 2015;22(6):2571-2575.
    MyJurnal
    Salmonella remains to be a major foodborne pathogen for animals and humans and is the
    leading cause of foodborne infections and outbreaks in various countries. Salmonella Enteritidis
    is one of the most frequently isolated serotypes in poultry and poultry products from human
    food poisoning cases. It can cause mild to acute gastroenterititis as well as other common
    food poisoning symptoms when infection takes place in human. Nucleic acid amplification
    technologies such as Polymerase Chain Reaction (PCR) is a tool that is rapid and sensitive
    for detection of bacterial pathogen. We report the successful detection of S. Enteritidis by
    PCR in raw chicken meat artificially-contaminated with serial concentration of S. Enteritidis
    using crude DNA extracts as DNA template. PCR primers, ENT-F and ENT-R targeted on sdfI
    gene were used to amplify DNA region unique to S. Enteritidis with crude DNA extract of the
    samples, yielded product with the size of 303 bp. These primers were specific to S. Enteritidis
    when tested by in-silico simulation against genome database of targeted bacterial species and
    confirmed in PCR as amplification bands were observed with S. Typhimurium, S. Polarum and
    S. Gallinarum. The established PCR can detect as few as 9.4 X 101
    CFU/ml of inoculated S.
    Enteritidis concentration and proved that pre-enrichment effect have significant effect on PCR
    detection by increasing 1000-fold of the sensitivity limit compared to the non pre-enriched
    samples. The PCR technique indicated that it can be successfully coupled with pre-enrichment
    step to offer advantage in routine screening and surveillance of bacterial contamination in food
    samples.
    Matched MeSH terms: Disease Outbreaks
  7. Fulltext Quality of life among young adults in rural Selangor: a cross-sectional study
    Norfazilah, A., Azmawati, M.N, Madihah, M
    Malaysian Journal of Public Health Medicine, 2015;15(1):0-0.
    MyJurnal
    This study aimed at measuring the quality of life (QOL) among young adults in rural area of Selangor, and determined the factors that affect the QOL scores. A cross-sectional study was conducted among young adults aged 18 to 39 years in rural area of Hulu Langat district, Selangor with a total sample of 308 selected through simple random sampling. Validated Malay version of WHOQOL-BREF questionnaire was used to measure the QOL, which generated overall QOL score and four domains’ scores of physical health, psychological health, social relationship and environmental QOL. The results showed that the highest mean score was social relationship domain 67.07 (18.87), followed by overall QOL 65.10 (17.92), environmental QOL domain 64.88 (12.83), psychological health domain 60.67 (11.88) and physical health domain 58.23 (11.00). Variables such as unemployment, having chronic diseases and mental distress were found to lower the QOL score.
    Matched MeSH terms: Chronic Disease
  8. Fulltext Paper review of factors, surveillance and burden of food borne disease outbreak in Malaysia
    Sharifa Ezat, W.P., Netty, D., Sangaran, G.
    Malaysian Journal of Public Health Medicine, 2013;13(2):98-105.
    MyJurnal
    Food borne diseases like cholera, typhoid fever, hepatitis A, dysentery and food poisoning occur as the results of ingestion of foodstuffs contaminated with microorganisms or chemical. The true incidence of food borne disease in Malaysia is unknown, however the incidence is low ranging from 1.56 to 0.14 cases per 100,000 population and the food poisoning cases is on the rise as the evident by the incident rate of 62.47 cases per 100,000 population in 2008 and 36.17 in 2009. The rapid population growth and demographic shift toward ageing population, changing eating habit such as consumption of raw or lightly cooked food, long storage of such food, lack of education on basic rules of hygienic food preparation and food trading without appropriate microbiological safety procedure become contributing factors for food borne diseases. Food borne disease in Malaysia is in the rise and the direct and indirect cost management of FBD will become one of the most common issues to face by the government. The world is spending millions and millions in cost of treatment due to food borne diseases. The information on this paper was collected via findings of previous journals, data and statistics from the MOH of Malaysia and WHO websites. As a result, authors found that the prevention and management of the food borne disease outbreak needs to be addressed seriously.
    Matched MeSH terms: Disease Outbreaks
  9. Fulltext Septic arthritis of lumbar facet joint with co-existing spondylolisthesis - a case report
    Khoo C, Thevarayan S, Rengsen P, Deepak AS
    Malays Orthop J, 2010;4(2):48-50.
    MyJurnal
    We report a rare case of septic arthritis of the lumbar facet joint (SALFJ) with co-existing spondylolisthesis of the L5 on S1 vertebra and discuss possible differential diagnoses, diagnostic difficulties and management of this condition.
    Matched MeSH terms: Disease Management
  10. Fulltext An adult with thumb sign In the lateral neck radiograph
    Irfan Mohamad, Mohd Syafwan Mohd Soffian, Amran Mohamad
    Malaysian Journal of Medicine and Health Sciences, 2015;11(1):85-88.
    MyJurnal
    Acute epiglottitis though relatively common in pediatric patients as compared to adults, present with almost similar clinical presentations. They include voice change, difficulty or painful swallowing and sometimes with upper airway obstruction. Physical finding of swollen epiglottis is difficult to be obtained owing to the danger of introducing laryngeal mirror into the oropharynx as to avoid contact spasm. The diagnostic thumb sign appearance on lateral neck radiograph is considered pathognomonic of epiglottitis. We report a case of an adult with clinical features and radiological finding of an acute epiglottitis, which did not resolve with antibiotic treatment. Subsequent imaging confirmed the presence of an abscess in the epiglottic mucosa.
    Matched MeSH terms: Acute Disease
  11. Fulltext Reliability and validity of the Malay version chronic respiratory questionnaire for used among COPD patients
    Ayiesah Ramli, Teh, Zi Ying, Khatijahbe Mohd Ali, Roslina Abdul Manap
    Malaysian Journal of Medicine and Health Sciences, 2014;10(2):83-89.
    MyJurnal
    Chronic Respiratory Questionnaire (CRQ) is one of the disease-specific questionnaires to assess health related quality of life (HRQoL) among chronic obstructive pulmonary disease (COPD) patients. Objectives: This study investigate the validity and reliability of Malay version CRQ among COPD patients. Methods: The CRQ was administered twice to 46 patients with COPD (mean FEV1 44% predicted, FEV1/ IVC 37% predicted) from Medical Center of University Kebangsaan Malaysia (PPUKM).Test-retest reliability was assessed using intra-class correlation coefficients (ICC). Internal consistency was determined using Crohnbach’s alpha coefficients (α = 0.7). Spearman’s correlation coefficient was done among the scores of CRQ, St George Respiratory Questionnaire (SGRQ) and six- minute walking test (6MWT) to examine the concurrent validity of the CRQ (p 0.70) was observed for 3 domains of CRQ with exception of dyspnoea domain (α = -0.631). Test retest reliability demonstrated strong correlation (ICC >0.80). Concurrent validity of CRQ, showed significant correlations observed between domain of SGRQ’s symptom, impact and total scores of SGRQ with CRQ’s dyspnoea and emotional function (-0.3< r < -0.4; p
    Matched MeSH terms: Pulmonary Disease, Chronic Obstructive
  12. Fulltext Subclinical hypothyroidism among patients with depressive disorders
    Siti Yazmin Zahari Sham, Nor Aini Umar, Zarida Hambali, Rosdinom Razali, Mohd Rizal Abdul Manaf
    Malaysian Journal of Medicine and Health Sciences, 2014;10(2):71-78.
    MyJurnal
    Subclinical hypothyroidism (SHT) is a biochemical diagnosis, defined as an elevated Thyroid Stimulating Hormone (TSH) with normal free thyroxine (FT4). It affects 4-10% of the adult population and is more prevalent in elderly women. Its commonest cause is autoimmune thyroiditis, detected by anti- thyroid peroxidase antibody (TPO-Ab). About 2-5% of SHT patients progress to overt hypothyroidism annually. The SHT prevalence among depressed patients ranges between 3% and 17%. This study aimed to determine the prevalence of SHT and TPO-Ab positivity among patients diagnosed with depressive disorders. It was a cross-sectional study carried out in the Universiti Kebangsaan Malaysia Medical Centre over a 12 months period. Serum TSH, FT4 and TPO-Ab were measured. Results showed that 82% of depressed patients were euthyroid, 4% had SHT, 11% had subclinical hyperthyroidism and 2% had discordant thyroid function. TPO-Ab positivity among the subjects was 7%, one of whom had SHT. In conclusion, the prevalence of SHT and TPO-Ab positivity in the study population, at 4% and 7%, respectively, were comparable to previous findings.
    Matched MeSH terms: Hashimoto Disease
  13. Fulltext Depression In Parkinson Disease: Clinical Features And Aetiology
    Chan, Y.F., Zainal, N.Z.
    Malaysian Journal of Psychiatry, 2010;19(1):1-11.
    MyJurnal
    Parkinson Disease (PD) is a neurodegenerative disorder of the central nervous system that often impairs the patient’s motor skills, speech and other functions. The four cardinal signs of parkinsonism are resting tremor, bradykinesia, cogwheel rigidity and postural instability. The prevalence of depression in PD ranges from 4% to 75%. However depression in PD is often mistakenly as the presentation of the disease itself. Therefore this paper reviewed the clinical feature of depression in PD and explored the aetiology of depression in PD.
    Matched MeSH terms: Parkinson Disease
  14. Fulltext Rejuvenating chronic disease management in Malaysian private general practice - a global perspective
    Anis Safura R, Wijesinha S, Piterman L
    Malays Fam Physician, 2010;5(1):49-52.
    MyJurnal
    Rapid epidemiological transition globally has witnessed a rising prevalence of major chronic diseases such as hypertension, diabetes, hyperlipidaemia, obesity, chronic respiratory diseases and cancers over the past 30 years. In Malaysia, these conditions are commonly managed in primary care and published evidence has consistently shown suboptimal management and poor disease control. This in turn, has led to the massive burden of treating complications in secondary care, burden to the patients and their families with regards to morbidity and premature death, and burden to the country with regards to premature loss of human capital. The crushing burden and escalating health care costs in managing chronic diseases pose a daunting challenge to our primary care system, as we remain traditionally oriented to care for acute, episodic illnesses. This paper re-examines the current evidence supporting the implementation of Wagner Chronic Care Model in primary care globally; analyses the barriers of implementation of this model in the Malaysian private general practice through SWOT (strengths, weaknesses, opportunities and threats) analysis; and discusses fundamental solutions needed to bridge the gap to achieve better outcomes.
    Matched MeSH terms: Chronic Disease
  15. Fulltext Holistic management of chronic obstructive pulmonary disease in primary care
    Tengku Saifudin TI, Wan Haniza WM
    Malays Fam Physician, 2010;5(3):119-125.
    MyJurnal
    Chronic obstructive pulmonary disease (COPD) is a major respiratory illness in Malaysia that is mainly preventable and treatable but unfortunately remains largely undiagnosed. Primary care providers play a vital role in screening the population at risk, making an early diagnosis and initiating prompt and appropriate therapy including smoking cessation to improve symptoms and quality of life of the COPD patient. Measures to prevent and treat exacerbations are also important to prevent further rapid decline in lung function and to reduce morbidity and mortality associated with the disease.
    Matched MeSH terms: Pulmonary Disease, Chronic Obstructive
  16. Fulltext An adolescent with anorexia nervosa - a case report
    Khairani O, Majmin SH, Saharuddin A, Loh SF, Noor Azimah M, Hizlinda T
    Malays Fam Physician, 2011;6(2):79-81.
    PMID: 25606230 MyJurnal
    This case report illustrates an adolescent with clinical presentation of moderate anorexia nervosa with no significant co-morbidities. It highlights the management of anorexia nervosa in the outpatient setting by a multi-disciplinary health care team which includes a family physician, a dietician, a psychologist and a child psychiatrist.
    Matched MeSH terms: Disease Management
  17. Fulltext The effects of hospital based respiratory physiotherapy an intervention study among COPD patient in Al-Zawia city, Libya
    Zafar Ahmed, Sharifa Ezat Wan Puteh, Aisha Abdussalam, Mahmud Hanesh, Suriati Sukeri, Joseph, Leonard
    Int J Public Health Res, 2012;2(1):65-74.
    MyJurnal
    OBJECTIVE. Chronic obstructive pulmonary disease (COPD) is a one of the major cause of death and disability worldwide. This study aimed to compare the quality of life (QOL), Activity of Daily Living (ADL), Pulmonary Function Test (PFT) and general health symptoms pre and after hospital-based respiratory physiotherapy program among COPD patients. METHODS. Pre and post intervention study was conducted between January and July 2010. A total of 54 subjects aged between 30 to 40 years old were recruited for this study using universal sampling method from Alzawia Teaching Hospital, Libya. Data collected were socio-demographic data, QOL (before and after the intervention) using the Short Form-36 (SF-36) questionnaire, ADL using the Barthel Index and the General Health Symptoms.
    RESULTS.. The mean SF-36 score for QOL is 30.13 (SD = 8.06) and 63.46 (SD = 13.53) before and after the physiotherapy respectively (with the p <0.0001). Patients’ Activity of Daily Living mean scores are 70.18, (SD = 16.50) and mean = 88.89 (SD = 13.28) before and after program (p< 0.0001). The general medical condition mean score after respiratory physiotherapy is 3.72 as compared to 4.96 before the respiratory physiotherapy (p< 0.0001). Pulmonary Function Test shows improvement in actual/predicted FEV1 ratio in all 54 cases with mean improvement from 55.85 before to 81.67 after the pulmonary physiotherapy (with the p <0.0001).
    CONCLUSION. Hospital based respiratory physiotherapy program had significantly improved QOL, pulmonary function and activities of daily living among the subjects.
    Matched MeSH terms: Pulmonary Disease, Chronic Obstructive
  18. Concomitant measurements of serum annexin A5 levels and hematological indices as markers in recent and old myocardial infarction with low ejection fraction: A preliminary study
    Alhusseiny AH, Al-Nimer MS, Mohammad FI, Ali Jadoo SA
    Int J Cardiol, 2016 Nov 15;223:514-518.
    PMID: 27552568 DOI: 10.1016/j.ijcard.2016.08.244
    Serum annexin A5 (anxA5) level is significantly increased in patients with acute coronary syndrome. Hematological indices are significantly increased in patients with ischemic heart disease. This study aimed to demonstrate the changes in the distribution of blood cells and the levels of anxA5 in patients presented with significant low ejection fraction ST-elevation acute myocardial infarction (STEMI) in comparison with corresponding patients with ischemic heart disease.
    Matched MeSH terms: Coronary Artery Disease
  19. Fulltext Milk derived bioactive peptides and their impact on human health - A review
    Mohanty DP, Mohapatra S, Misra S, Sahu PS
    Saudi J Biol Sci, 2016 Sep;23(5):577-83.
    PMID: 27579006 DOI: 10.1016/j.sjbs.2015.06.005
    Milk-derived bioactive peptides have been identified as potential ingredients of health-promoting functional foods. These bioactive peptides are targeted at diet-related chronic diseases especially the non-communicable diseases viz., obesity, cardiovascular diseases and diabetes. Peptides derived from the milk of cow, goat, sheep, buffalo and camel exert multifunctional properties, including anti-microbial, immune modulatory, anti-oxidant, inhibitory effect on enzymes, anti-thrombotic, and antagonistic activities against various toxic agents. Majority of those regulate immunological, gastrointestinal, hormonal and neurological responses, thereby playing a vital role in the prevention of cancer, osteoporosis, hypertension and other disorders as discussed in this review. For the commercial production of such novel bioactive peptides large scale technologies based on membrane separation and ion exchange chromatography methods have been developed. Separation and identification of those peptides and their pharmacodynamic parameters are necessary to transfer their potent functional properties into food applications. The present review summarizes the preliminary classes of bioactive milk-derived peptides along with their physiological functions, general characteristics and potential applications in health-care.
    Matched MeSH terms: Chronic Disease
  20. Fulltext Transcutaneous electrical stimulation (TES) for treatment of constipation in children
    Ng RT, Lee WS, Ang HL, Teo KM, Yik YI, Lai NM
    Cochrane Database Syst Rev, 2016 Jul 05;7:CD010873.
    PMID: 27378432 DOI: 10.1002/14651858.CD010873.pub2
    BACKGROUND: Childhood constipation is a common problem with substantial health, economic and emotional burdens. Existing therapeutic options, mainly pharmacological, are not consistently effective, and some are associated with adverse effects after prolonged use. Transcutaneous electrical stimulation (TES), a non-pharmacological approach, is postulated to facilitate bowel movement by modulating the nerves of the large bowel via the application of electrical current transmitted through the abdominal wall.

    OBJECTIVES: Our main objective was to evaluate the effectiveness and safety of TES when employed to improve bowel function and constipation-related symptoms in children with constipation.

    SEARCH METHODS: We searched MEDLINE (PubMed) (1950 to July 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 7, 2015), EMBASE (1980 to July 2015), the Cochrane IBD Group Specialized Register, trial registries and conference proceedings to identify applicable studies .

    SELECTION CRITERIA: Randomized controlled trials that assessed any type of TES, administered at home or in a clinical setting, compared to no treatment, a sham TES, other forms of nerve stimulation or any other pharmaceutical or non-pharmaceutical measures used to treat constipation in children were considered for inclusion.

    DATA COLLECTION AND ANALYSIS: Two authors independently assessed studies for inclusion, extracted data and assessed risk of bias of the included studies. We calculated the risk ratio (RR) and corresponding 95% confidence interval (CI) for categorical outcomes data and the mean difference (MD) and corresponding 95% CI for continuous outcomes.

    MAIN RESULTS: One study from Australia including 46 children aged 8 to 18 years was eligible for inclusion. There were multiple reports identified, including one unpublished report, that focused on different outcomes of the same study. The study had unclear risk of selection bias, high risks of performance, detection and attrition biases, and low risks of reporting biases.There were no significant differences between TES and the sham control group for the following outcomes: i).number of children with > 3 complete spontaneous bowel movements (CSBM) per week (RR 1.07, 95% CI 0.74 to 1.53, one study, 42 participants) (

    QUALITY OF EVIDENCE: very low, due to high risk of bias and serious imprecision ), ii). number of children with improved colonic transit assessed radiologically (RR 5.00, 95% CI 0.79 to 31.63; one study, 21 participants) (

    QUALITY OF EVIDENCE: very low, due to high risk of bias, serious imprecision and indirectness of the outcome). However, mean colonic transit rate, measured as the position of the geometric centre of the radioactive substance ingested along the intestinal tract, was significantly higher in children who received TES compared to sham (MD 1.05, 95% CI 0.36 to 1.74; one study, 30 participants) (

    QUALITY OF EVIDENCE: very low, due to high risk of bias , serious imprecision and indirectness of the outcome). There was no significant difference between the two groups in the number of children with improved soiling-related symptoms (RR 2.08, 95% CI 0.86 to 5.00; one study, 25 participants) (

    QUALITY OF EVIDENCE: very low, due to high risk of bias and serious imprecision). There was no significant difference in the number of children with improved quality of life (QoL) (RR 4.00, 95% CI 0.56 to 28.40; one study, 16 participants) (

    QUALITY OF EVIDENCE: very low, due to high risk of bias issues and serious imprecision ). There were also no significant differences in in self-perceived (MD 5.00, 95% CI -1.21 to 11.21) or parent-perceived QoL (MD -0.20, 95% CI -7.57 to 7.17, one study, 33 participants for both outcomes) (QUALITY OF EVIDENCE for both outcomes: very low, due to high risk of bias and serious imprecision). No adverse effects were reported in the included study.

    AUTHORS' CONCLUSIONS: The very low quality evidence gathered in this review does not suggest that TES provides a benefit for children with chronic constipation. Further randomized controlled trials assessing TES for the management of childhood constipation should be conducted. Future trials should include clear documentation of methodologies, especially measures to evaluate the effectiveness of blinding, and incorporate patient-important outcomes such as the number of patients with improved CSBM, improved clinical symptoms and quality of life.

    Matched MeSH terms: Chronic Disease
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