MyMedR

Fulltext A comparative study of anxiety and depression among healthcare workers and non-healthcare workers in Johor, Malaysia during the Covid-19 era

Wong JW, Tan JH, Abraham RE, Jauhar Ali SN, Kok SY, Tan HCL, et al.

Medicine (Baltimore), 2024 Mar 22;103(12):e37415.

PMID: 38518019 DOI: 10.1097/MD.0000000000037415

The outbreak of Coronavirus disease 2019 (Covid-19) has a significant impact on the mental health of the global population. Updates are needed regarding the mental health status among the local population since limited studies were done so far. This research compared the prevalence of anxiety and depression symptoms among HCWs and non-HCWs. We also evaluated the factors associated with anxiety and depression symptoms among these 2 groups. This was a cross-sectional study conducted between September to December 2022. Online questionnaire was distributed to HCWs from 2 tertiary government hospitals. Non-HCWs from various occupational fields were recruited randomly. Generalised Anxiety Disorder 7 (GAD-7) and Patient Health Questionnaire 9 (PHQ-9) were used to screen for anxiety and depression symptoms respectively. Data were analyzed using IBM SPSS version 28.0. 200 questionnaires were distributed to HCWs and non-HCWs respectively. The response rate was 74.5% from HCWs and 82.5% from non-HCWs (P = .07). A total of 236 individuals (105 HCWs and 131 non-HCWs) were included in the study. Majority were female, married, highly educated and worked more than 8 hours per day. There was no significant difference for the prevalence of anxiety (37.2% vs 44.3%, P = .34) and depression symptoms (37.3% vs 35.1%, P = .75) between HCWs and non-HCWs. Among HCWs, poor workplace support (P = .009) and low income (P = .04) were associated with anxiety symptoms. Younger age (P = .02), single status (P = .01) and poor workplace support (P = .006) were associated with depression symptoms. More non-HCWs with a higher educational level were having anxiety and depression symptoms. Single status (P = .03), working away from home (P = .02), poor family support (P = .03) and quarantine as Covid-19 close contact (P = .04) were also associated with depression symptoms among non-HCWs. There is no significant difference between HCWs and non-HCWs experiencing possible anxiety or depressive symptoms in this study. However, attention should be paid to address associated factors identified among each group to promote good mental health.

Fulltext Evaluating the clinical relevance of codon 594 (g>a) polymorphism of estrogen receptor alpha in knee osteoarthritis

Tawonsawatruk T, Mulpruek P, Hamilton D, Wajanavisit W, Tan S

Malays Orthop J, 2014 Mar;8(1):37-40.

PMID: 25347522 DOI: 10.5704/MOJ.1403.016

It has been reported that oestrogen receptor alpha (ER-α) polymorphisms are associated with knee osteoarthritis (OA). In this study, we assessed whether there was any association between the codon 594 (G>A) polymorphism in ER-α and radiographic features of OA or patient function. Radiographs, WOMAC score and patient reported time of symptom onset were assessed in 194 patients presenting for total knee replacement at Ramathibodi hospital over a one year period. ESR-1 genotyping was assessed. There were 107 (55.15%) patients with common homozygote (GG), 78 (40.20%) patients with heterozygote (GA) and nine (4.65%) patients with rare homozygote (AA). There was poor correlation (r = <0.2) between group difference in the radiographic parameters, time of onset of symptom , or in WOMAC scores. This polymorphism is not associated with the clinical features of knee osteoarthritis. The role of this polymorphism is unlikely then to be used as a biological marker predicting the progression of knee OA.

Does clinical experience help oncology nursing staff to deal with patient pain better than nurses from other displines? Knowledge and attitudes survey amongst nurses in a tertiary care in Malaysia

Yaakup H, Eng TC, Shah SA

Asian Pac J Cancer Prev, 2014;15(12):4885-91.

PMID: 24998558

BACKGROUND: Successful implementation of pain management procedures and guidelines in an institution depends very much on the acceptance of many levels of healthcare providers.

AIM: The main purpose of this study was to determine the level of knowledge and attitudes regarding pain among nurses working in tertiary care in a local setting and the factors that may be associated with this.

MATERIALS AND METHODS: This cross-sectional research study used a modified version of the Nurses' Knowledge and Attitudes Survey (NKAS) regarding pain. Basic demographic data were obtained for further correlation with the level of pain knowledge.

RESULTS: A total of 566 nurses, 34 male and 532 female, volunteered to participate in this study. The response rate (RR) was 76%, with an overall mean percentage score of 42.7±10.9 (range: 5-92.5). The majority of participants were younger nurses below 40 years of age and more than 70% had worked for less than 10 years (6.6±4.45). Up to 92% had never had any formal education in pain management in general. The total mean score of correct answers was 58.6±9.58, with oncology nursing staff scoring a higher percentage when compared with nurses from other general and critical care wards (63.52±9.27, p<0.045). Only 2.5% out of all participants obtained a score of 80% or greater. The majority of the oncology nurses achieved the expected competency level (p<0.03).

CONCLUSIONS: The present findings give further support for the universal concern about poor knowledge and attitudes among nurses related to the optimal management of pain. The results indicated that neither number of years working nor age influenced the level of knowledge or attitudes of the practising nurses. Oncology nursing staff consistently scored better than the rest of the cohort. This reflects that clinical experience helps to improve attitudes and knowledge concerning better pain management.

Fulltext A feasibility study on bedside upper airway ultrasonography compared to waveform capnography for verifying endotracheal tube location after intubation

Adi O, Chuan TW, Rishya M

Crit Ultrasound J, 2013;5(1):7.

PMID: 23826756 DOI: 10.1186/2036-7902-5-7

In emergency settings, verification of endotracheal tube (ETT) location is important for critically ill patients. Ignorance of oesophageal intubation can be disastrous. Many methods are used for verification of the endotracheal tube location; none are ideal. Quantitative waveform capnography is considered the standard of care for this purpose but is not always available and is expensive. Therefore, this feasibility study is conducted to compare a cheaper alternative, bedside upper airway ultrasonography to waveform capnography, for verification of endotracheal tube location after intubation.

Fulltext Open total talus dislocation: a case report

Tan E, Chua H, Ooi C, Zulkiflee O

Malays Orthop J, 2012 Nov;6(3):60-2.

PMID: 25279062 MyJurnal DOI: 10.5704/MOJ.1207.009

Total talus dislocation is a rare injury and is commonly accompanied by associated fractures. Common worrisome sequelae are infection, avascular necrosis and post-traumatic arthritis. We report here on a patient who sustained an open total talus dislocation with an ipsilateral medial malleolus fracture. Following early debridement, reduction and a combination of internal and external fixations, early recovery was good with no evidence of avascular necrosis.

Fulltext Chronic osteomyelitis secondary to human bite: a case report

Tan W, Wazir N, Chiu C, Ko M

Malays Orthop J, 2012 Nov;6(3):40-1.

PMID: 25279055 MyJurnal DOI: 10.5704/MOJ.1207.003

We report a case of a human bite that was initially inadequately treated and progressed to chronic osteomyelitis, finally resulting in digital amputation. Human bites are seemingly innocuous, but if neglected, may lead to subsequent infection and morbidity. Persistence of symptoms should alert the practitioner to the possibility of infection extending to the soft tissue or bone. Bacteriological studies commonly yield mixed aerobic and anaerobic flora. Early debridement and antibiotic treatment may prevent development of severe soft tissue or bone infection.

Cognitive enhancement and neuroprotection by catechin-rich oil palm leaf extract supplement

Mohamed S, Lee Ming T, Jaffri JM

J Sci Food Agric, 2013 Mar 15;93(4):819-27.

PMID: 23001939 DOI: 10.1002/jsfa.5802

Catechin-rich oil palm (Elaeis guineensis) leaf extract (OPLE) has good cardiovascular and phytoestrogenic properties. The OPLE (0.5 g day(-1) ) was supplemented to young, healthy, adult human volunteers, and their cognitive learning abilities were compared to placebo-controlled groups (N = 15). Their short-term memories, spatial visualisations, processing speeds, and language skills, were assessed over 2 months by cognitive tests computer programs.

Fulltext Disseminated fusariosis and endogenous fungal endophthalmitis in acute lymphoblastic leukemia following platelet transfusion possibly due to transfusion-related immunomodulation

Kah TA, Yong KC, Rahman RA

BMC Ophthalmol, 2011;11:30.

PMID: 22044440 DOI: 10.1186/1471-2415-11-30

To report a case of disseminated fusariosis with endogenous endophthalmitis in a patient with acute lymphoblastic leukemia. Transfusion-associated immune modulation secondary to platelet transfusion could play an important role in the pathophysiology of this case.

Detection of microsporidia in local HIV-positive population in Malaysia

Lono A, Kumar S, Chye TT

Trans R Soc Trop Med Hyg, 2011 Jul;105(7):409-13.

PMID: 21596411 DOI: 10.1016/j.trstmh.2011.03.006

The HIV-positive population, due to their immuno-compromised nature, is considered more susceptible to parasitic infections than other populations. However despite the reports of other opportunistic pathogens such as Cryptosporidium and tuberculosis reported in vulnerable communities, microsporidia have not been highlighted in the local HIV-positive population in Malaysia. This study aimed to provide preliminary information on the prevalence of microsporidia in the local HIV-population. Microsporidia were detected in 21/247 (8.5%) stool samples from the HIV-infected individuals, a significantly higher (P-value <0.05) prevalence than in the control group, in which 5/173 (2.9%) were positive. HIV patients were 3x more at risk for acquiring microspordium (OR: 3.12; 95% CI 1.15-8.44). Spores were ellipsoid in shape with outlines that stained dark pink with the interior a lighter shade. Approximately 21% of the positive specimens were from individuals in the 40-49 years age group. Ten individuals who were positive for microsporidia were also positive for other enteric parasites such as Blastocystis hominis and Giardia lamblia. We detected Encephalitozoon intestinalis DNA following nested PCR from three of 10 samples analysed, as demonstrated by an amplicon of 370bp. From the findings reported, it appears that microsporidial infection in humans may actually be more common than reported. We strongly advocate greater emphasis on personal hygiene through public education on personal hygiene and the consumption of boiled or filtered water.

Fulltext Antioxidant effects of Etlingera elatior flower extract against lead acetate - induced perturbations in free radical scavenging enzymes and lipid peroxidation in rats

Jackie T, Haleagrahara N, Chakravarthi S

BMC Res Notes, 2011;4:67.

PMID: 21414212 DOI: 10.1186/1756-0500-4-67

Etlingera elatior or 'pink torch ginger' (Zingiberaceae) are widely cultivated in tropical countries and used as spices and food flavoring. The purpose of this study was to evaluate the antioxidant effects of Etlingera elatior against lead - induced changes in serum free radical scavenging enzymes and lipid hydroperoxides in rats.

Incidence of microsporidia in cancer patients

Lono AR, Kumar S, Chye TT

J Gastrointest Cancer, 2008;39(1-4):124-9.

PMID: 19459072 DOI: 10.1007/s12029-009-9065-z

INTRODUCTION: Microsporidia are considered opportunistic pathogens as evidenced by the significant detection in immunocompromised HIV/AIDS population. Cancer patients receiving chemotherapy are considered to be immunosuppressed.

MATERIALS AND METHODS: Stool samples were collected from 311 cancer patients in the Klang Valley. Each sample underwent water-ether concentration and staining with modified trichrome stain.

RESULTS AND DISCUSSION: Sixty-eight samples were positive by oil immersion examination. Polymerase chain reaction amplification with specific primers on those samples amplified Encephalitozoon intestinalis from two of the samples and Encephalitozoon hellem from one sample.

Prevalence of microsporidia in an indigenous Orang Asli community in Pahang, Malaysia

Lono A, Kumar GS, Chye TT

Trans R Soc Trop Med Hyg, 2010 Mar;104(3):214-8.

PMID: 19716577 DOI: 10.1016/j.trstmh.2009.07.006

Microsporidia are ubiquitous parasites thought to be closely related to fungi. Their presence in the environment means that humans are frequently exposed to infection. Stool samples were collected from 151 indigenous villagers from the eastern state of Pahang in 2005. The samples were concentrated with water-ether sedimentation, stained with modified trichrome stain and examined under oil-immersion microscopy. Thirty-two specimens (21.2%) were positive for microsporidia. Microsporidia were observed as ovoid or rounded ovoid shapes measuring approximately 1mum, with a bright pink outline containing a central or posterior vacuole. PCR amplification with specific primers on microscopy-positive specimens amplified Encephalitozoon intestinalis DNA from five of the ten specimens used.

The role of wrist anthropometric measurement in idiopathic carpal tunnel syndrome

Lim PG, Tan S, Ahmad TS

J Hand Surg Eur Vol, 2008 Oct;33(5):645-7.

PMID: 18662961 DOI: 10.1177/1753193408093326

Anthropometric wrist measurement ratios were examined for an association with idiopathic carpal tunnel syndrome (CTS). Wrist measurements were recorded in 67 patients with CTS and in a matched control group of 67 healthy volunteers. The Wrist Ratio (WR) (wrist anterior to posterior dimension/wrist medial-lateral dimension) and the Wrist Palm Ratio (wrist anterior to posterior dimension/palm length) were calculated for each case. We found that a WR of > or =0.70 and a Wrist Palm Ratio of >0.342 were significantly associated with idiopathic CTS.

The state of lipid control in patients with diabetes in a public health care centre

Wong JS, Tan F, Lee PY

Asia Pac J Public Health, 2007;19(3):16-21.

PMID: 18330400 DOI: 10.1177/101053950701900304

Achieving treatment targets has been difficult in treating diabetic patients. This cross-sectional study describes the lipid profiles of patients with diabetes mellitus at a public primary health care centre in Sarawak, Malaysia. The targets for lipid control were based on the International Diabetes Federation recommendation (2002). 1031 patients (98% Type 2 Diabetes) were studied. Fasting lipid profiles were available in 990 (96%) patients. The mean total cholesterol was 5.3 +/- 1.0 mmol/L, Triglycerides 1.90 +/- 1.26 mmol/L, HDL-C 1.28 +/- 0.33 mmol/L and LDL-C 3.2 +/- 0.9 mmol/L. Overall, 22% of patients achieved the treatment target for LDL-C level < 2.6mmol/L. 67% of patients had HDL-C > 1.1 mmol/L and 42% of patients had a target TG level below 1.5 mmol/L. Of the 40% of patients who received lipid-lowering drug, 17% achieved LDL-C target, 50% had LDL-C 2.6-4.4 mmol/ L and 33% have LDL-C > 4.0 mmol/L. For the remaining 60% not receiving any lipid lowering therapy, 68% had LDL-C between 2.6-4.0 mmol/L and 7% had LDL-C level > 4 mmol/L. Dyslipidemia is still under-treated despite the availability of effective pharmacological agents and the greatly increased risk of cardiovascular diseases in diabetic patients.

Liver isolation in abdominal MRI

Rajasvaran L, Haw TW, Sarker SZ

J Med Syst, 2008 Aug;32(4):259-68.

PMID: 18619090

This work presents a method for liver isolation in magnetic resonance imaging (MRI) abdomen images. It is based on a priori statistical information about the shape of the liver obtained from a training set using the segmentation approach. Morphological watershed algorithm is used as a key technique as it is a simple and intuitive method, producing a complete division of the image in separated regions even if the contrast is poor, and it is fast, with possibility for parallel implementation. To overcome the over-segmentation problem of the watershed process, image preprocessing and postprocessing are applied. Morphological smoothing, Gaussian smoothing, intensity thresholding, gradient computation and gradient thresholding are proposed for preprocessing with morphological and graph based region adjacent list constructed for region merging. A new integrated region similarity function is also defined for region merging control. The proposed method produces good isolation of liver in axial MRI images of the abdomen, as is shown in this paper.

Determination of the herbicide fluroxypyr in oil matrices

Muhamad HB, Ai TY, Sahid IB

J Environ Sci Health B, 2008 Feb;43(2):134-40.

PMID: 18246505 DOI: 10.1080/03601230701795072

The purpose of this study was to develop a method for the determination of fluroxypyr (4-amino-3,5-dichloro-6-fluro2-pyridyloxyacetic acid) residue in palm oil namely crude palm oil (CPO) and crude palm kernel oil (CPKO). The method involves the extraction of the herbicide from the oil matrix followed by low temperature precipitation and finally quantification of the residues using the high performance liquid chromatography (HPLC). The extraction efficiency of the method was evaluated by conducting recovery studies. The recovery of fluroxypyr from the fortified CPO samples ranged from 78%-111% with the relative values for the coefficient of variation ranging from 1.4 to 8.6%. Furthermore, the recovery of fluroxypyr from the spiked CPKO samples ranged from 91-107% with the relative values for the coefficient of variation ranging from 0.6 to 4.5%. The minimum detection limit of fluroxypyr in CPO and CPKO was 0.05 microg/g. The method was used to determine fluroxypyr residues from the field-treated samples of CPO and CPKO. When fluroxypyr was used for weed control in oil palm plantations no residue was detected in CPO and CPKO irrespective of the sampling interval and the dosage applied at the recommended or double the manufacturer's recommended dosage.

Aspiration of breast abscess under ultrasound guidance: outcome obtained and factors affecting success

Elagili F, Abdullah N, Fong L, Pei T

Asian J Surg, 2007 Jan;30(1):40-4.

PMID: 17337370

To assess ultrasonographically (US) guided needle aspiration of breast abscesses as an alternative to surgical incision and drainage.

Reporting of adverse drug reactions: predictors of under-reporting in Malaysia

Aziz Z, Siang TC, Badarudin NS

Pharmacoepidemiol Drug Saf, 2007 Feb;16(2):223-8.

PMID: 16947117

Malaysia like many other countries worldwide uses spontaneous reporting systems as a mean of collecting data on suspected adverse drug reaction (ADR). However, compared to other countries, which use the system, the reporting rate in Malaysia is very low. Why some physicians do not report ADRs is not well understood.

Morphological and biochemical changes of andrographolide-induced cell death in human prostatic adenocarcinoma PC-3 cells

Kim TG, Hwi KK, Hung CS

In Vivo, 2005 May-Jun;19(3):551-7.

PMID: 15875775

Andrographolide was extracted and purified from Andrographis panicula using hexane and water partitioning followed by ethyl acetate extraction and chromatography. It showed selective cytotoxicity to prostate cancer PC-3 cells in vitro. The morphological and biochemical changes induced by the extract in carcinoma PC-3 cell death were studied. In andrographolide-treated cells, evidence of apoptosis such as cell shrinkage and surface microvilli loss after 4-hour treatment and chromatin condensation and fragmentation in H&E-stained cells between 4 to 8 hours after treatment were observed. Under electron microscopy, membrane blebbing and apoptotic bodies formation were seen after 8-hour treatment. Using immunocytochemistry staining and cellular caspase-3 activity assay, andrographolide-treated cells showed considerable caspase-3 activation and caspase-8 in PC-3 cells at 4 and 2 hours after treatment, respectively. This suggests andrographolide-induced cell death was achieved through the apoptotic pathway, via the activation of an extrinsic caspase cascade.

Fulltext An epidemiological investigation of an outbreak of leptospirosis associated with swimming, Beaufort, Sabah

Koay TK, Nirmal S, Noitie L, Tan E

Med J Malaysia, 2004 Oct;59(4):455-9.

PMID: 15779577

From October 13 to October 21, 1999, a total of 46 males, aged 8 to 19 years, were admitted to Beaufort Hospital after swimming in the creek near an oil palm plantation in Kampung (Kg) Kebatu, Beaufort. Thirty (30) presented with symptoms including fever, vomiting, bodyache, giddiness, headache, chest pain and cough, while 16 others, were asymptomatic. One, a 15 year old boy, died from haemorrhagic shock secondary to pulmonary haemorrhage. The onset of the illness was from 11 October to 19 October 1999. A case-control study found that the outbreak was associated with swimming in the creek (p<0.0001). A total of 44 paired sera samples were sent for microscopic agglutination test (MAT), 5 pairs showed sero-conversion, 3 pairs had 4 fold rise in titre and 18 pairs were positive at >320. The findings indicated that Leptospirosis was the cause of the outbreak of this illness and the contaminated creek water was the source of the infection. The occurrence of flooding and stagnation in the creek following the heavy rainfall during the first week of October 1999 could have contributed to the timing of the outbreak.

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