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Fulltext An assessment of pharmacy students’ empathy levels in Malaysia

Hasan SS, Babar MG, Kai K, Mitha S

Journal of Advanced Pharmacy Education & Research, 2013;3:531-40.

This study examined the validity and reliability of the student version of Jefferson Scale of Empathy-Health Profession (JSE-HPS) in a sample of pharmacy students and to subsequently use JSE-HPS to assess empathy levels in first to fourth (final) year pharmacy students in public and private universities in Malaysia. The JSE-HPS was administered to 719 first to fourth (final) year pharmacy students; 313 were enrolled at a public university and 406 at a private university in Malaysia. Both descriptive and inferential statistics were performed using SPSS® version 18. The JSE-HPS demonstrated good internal consistency (Cronbach’s α = 0.70). A three-factor solution emerged and included ‘perspective taking’, ‘compassionate care’ and ‘standing in patient’s shoes’ factors, accounting for 16.4%, 16%, and 7.6% of the variance, respectively. The total mean empathy score was 83.02±8.23, the actual score ranged between 46.05 and 113.25. Overall, males and students of Malay origin were more empathic than females and students of other ethnic origins. Junior students (year one and two) were more empathic than senior students (year three and four), and public university students had significantly higher mean empathy score compared to those enrolled at a private university (83.89 versus 82.34, p=0.012). This study confirms the construct validity and internal consistency of the JSE-HPS for measuring empathy in pharmacy students. Empathy scores among students vary depending on type of university and year of study.
Keywords: Empathy, pharmacy students, public, private, university, Malaysia
Study site: University Kebangsaan Malaysia (UKM), International Medical University (IMU), Malaysia

Matched MeSH terms: Humans
Fulltext Investigating the psychometric properties of the Jefferson Scale of Physician Empathy in a sample of Malaysian medical students

Spasenoska M, Costello S, Williams B

Adv Med Educ Pract, 2016;7:331-9.
PMID: 27350763 DOI: 10.2147/AMEP.S96591

OBJECTIVE: The purpose of this present study was to investigate the psychometric properties of the Jefferson Scale of Physician Empathy - student version (JSPE-S).
SUBJECTS AND METHODS: This study recruited 193 Malaysian medical students enrolled in year one and year two studies. A principal-component analysis with Varimax rotation was conducted. Procrustes rotation was used to confirm the item to model fit, which allows for a comparison of actual structure against an ideal hypothesized structure. Items were systematically removed based on low communalities of < 0.3 and poor loading of items onto components.
RESULTS: A two-component solution was found, comprised of "perspective taking" and "compassionate care". Following item removal, eleven items remained. A Procrustes analysis revealed that this eleven-item measure demonstrated an excellent model fit. A possible third component was identified, though is not recommended for use, due to construct underrepresentation.
CONCLUSION: This study found the Jefferson Scale of Physician Empathy fitted best to a two-component model using eleven items. Item, component, and overall congruence were very high, and scale reliabilities were adequate. The results of this study suggest that the eleven-item, two-component solution demonstrates excellent psychometric properties and structural validity in a Malaysian medical student population. Future research could consider using the short eleven-item measure in both student and health care profession samples to investigate the role of empathy in health care.
Study site:; Jeffry Cheah School of Medicine and Health Sciences, Monash University Malaysia.

Matched MeSH terms: Humans
Physical and Natural Crosslinking Approaches on Three-Dimensional Gelatin Microspheres for Cartilage Regeneration

Sulaiman S, Rani RA, Mohamad Yahaya NH, Tabata Y, Hiraoka Y, Seet WT, et al.

Tissue Eng Part C Methods, 2022 10;28(10):557-569.
PMID: 35615885 DOI: 10.1089/ten.TEC.2022.0073

The use of gelatin microspheres (GMs) as a cell carrier has been extensively researched. One of its limitations is that it dissolves rapidly in aqueous settings, precluding its use for long-term cell propagation. This circumstance necessitates the use of crosslinking agents to circumvent the constraint. Thus, this study examines two different methods of crosslinking and their effect on the microsphere's physicochemical and cartilage tissue regeneration capacity. Crosslinking was accomplished by physical (dehydrothermal [DHT]) and natural (genipin) crosslinking of the three-dimensional (3D) GM. We begin by comparing the microstructures of the scaffolds and their long-term resistance to degradation under physiological conditions (in an isotonic solution, at 37°C, pH = 7.4). Infrared spectroscopy indicated that the gelatin structure was preserved after the crosslinking treatments. The crosslinked GM demonstrated good cell adhesion, viability, proliferation, and widespread 3D scaffold colonization when seeded with human bone marrow mesenchymal stem cells. In addition, the crosslinked microspheres enhanced chondrogenesis, as demonstrated by the data. It was discovered that crosslinked GM increased the expression of cartilage-related genes and the biosynthesis of a glycosaminoglycan-positive matrix as compared with non-crosslinked GM. In comparison, DHT-crosslinked results were significantly enhanced. To summarize, DHT treatment was found to be a superior approach for crosslinking the GM to promote better cartilage tissue regeneration.

Matched MeSH terms: Humans
Fulltext The Agony of the Mystical Practice of Susuk: A Case Report

Rusly MFR, Md Yasin M, Kamaruddin KN, Nasir NMNM, Mat Nor K

Am J Case Rep, 2022 Oct 24;23:e937633.
PMID: 36279262 DOI: 10.12659/AJCR.937633

BACKGROUND Charm needle, otherwise known as susuk, is a needle-shaped pin inserted subcutaneously into various body parts. It is most commonly inserted by shamans in the orofacial region to grant magical powers to the wearer, such as health, wealth, beauty, and other benefits. These talismans are prevalent among women in South-East Asia countries. CASE REPORT A 75-year-old woman presented with recurrent musculoskeletal symptoms over multiple sites, but physical assessment only revealed mild tenderness over the right hip joint. A plain pelvic radiograph showed incidental findings of susuk around the genital regions, with older skull and pelvic radiograph displaying similar findings. The patient had a susuk insertion more than 20 years ago for marriage stability and beauty. After this incidental discovery, the patient had repeated visits to the clinic to request more imaging to determine whether the susuk were still present after the shaman's attempted mystical removal. She also developed persistent preoccupation, worry, and guilt related to the susuk presence and was referred to psychiatry for further assessment. She was diagnosed with generalized anxiety disorder. She was then started on psychotherapy and pharmacological treatment, with simultaneous spiritual therapy. CONCLUSIONS This case report describes the link between susuk implantation and psychological illness. Even though there are no reports that specifically correlate susuk with generalized anxiety disorder, it has been established that guilt and shame have a strong relationship with anxiety.

Matched MeSH terms: Humans
Microplastics in Malaysian bottled water brands: Occurrence and potential human exposure

Praveena SM, Shamsul Ariffin NI, Nafisyah AL

Environ Pollut, 2022 Dec 15;315:120494.
PMID: 36279991 DOI: 10.1016/j.envpol.2022.120494

The World Health Organization noted that there is a growing need to determine the occurrence of microplastics in bottled water and its potential risks to human health. Thus, present study analyzes microplastics in eight major bottled water brands available in Malaysia and estimates the potential human exposure. Membrane filtration method followed by visual and polymer identifications were utilized to identify microplastics particles in these eight major bottled water brands. Microplastic concentrations in bottled water samples ranged from 8 to 22 particles/L, with an average of 11.7 ± 4.6 particles/L. Particle sizes ranging between 100 and 300 μm were dominant and accounted for approximately 31% in these bottled water brands. Fragments were the most identified microplastics in bottled water with transparent color being the most prevalent. The polyethylene terephthalate (PET) and polypropylene (PP) polymer types found in this study are consistent with prior results in that microplastics in bottled water are mainly derived from packaging materials and bottle caps. The Estimated Dietary Intake (EDI) for adults was between 0.068 and 0.19 particle/kg/day, while the EDI for children was between 0.089 and 0.25 particle/kg/day. Although consumption of bottled water was estimated to have low EDI values, the potential risks to human health should be heeded due to the presence of numerous plastic additives and residual monomers in these particles, which have the potential to increase inflammatory reactions and cytotoxicity in human body. Future studies should concentrate on understanding microplastics particles less than 1.5 μm and other associated factors (bottled material quality, consumption behaviour, bottled water storage conditions, and the frequency of bottle opening and closing) to further understand the effects of these microplastics particles on human toxicological aspects.

Matched MeSH terms: Humans
Fulltext Clinical practice guidelines for the management of hyperemesis gravidarum: A systematic review and quality appraisal with AGREE II

Wong ZY, Ou KQ, Prasad A, Say WX, Nalliah S

Aust J Gen Pract, 2022 10;51(10):758-765.
PMID: 36184858 DOI: 10.31128/AJGP-01-22-6288

BACKGROUND AND OBJECTIVES: Nausea, vomiting and hyperemesis in early pregnancy are common in primary care, and hospital care is required in severe cases. The aim of this review is to appraise relevant clinical practice guidelines (CPGs) to manage hyperemesis gravidarum (HG) by using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) checklist.
METHOD: A systematic search was conducted employing PubMed, Cochrane and ScienceDirect from inception until May 2021. The quality of four CPGs were evaluated by two appraisers independently using the AGREE II checklist.
RESULTS: Four international CPGs that fulfilled the criteria were included in this review; all scored over 50% according to the AGREE II tool. Applying a modified categorisation standard, CPGs were considered as either 'recommended' or 'recommended with modifications'.
DISCUSSION: The synthesis of all four CPGs suggested similar management strategies for HG, with minor differences. Medical practitioners could use the guiding principles of management on the basis of the needs of individual patients.

Matched MeSH terms: Humans
Fulltext Iptacopan monotherapy in patients with paroxysmal nocturnal hemoglobinuria: a 2-cohort open-label proof-of-concept study

Jang JH, Wong L, Ko BS, Yoon SS, Li K, Baltcheva I, et al.

Blood Adv, 2022 08 09;6(15):4450-4460.
PMID: 35561315 DOI: 10.1182/bloodadvances.2022006960

Iptacopan (LNP023) is a novel, oral selective inhibitor of complement factor B under clinical development for paroxysmal nocturnal hemoglobinuria (PNH). In this ongoing open-label phase 2 study, PNH patients with active hemolysis were randomized to receive single-agent iptacopan twice daily at a dose of either 25 mg for 4 weeks followed by 100 mg for up to 2 years (cohort 1) or 50 mg for 4 weeks followed by 200 mg for up to 2 years (cohort 2). At the time of interim analysis, of 13 PNH patients enrolled, all 12 evaluable for efficacy achieved the primary endpoint of reduction in serum lactate dehydrogenase (LDH) levels by ≥60% by week 12 compared with baseline; mean LDH levels dropped rapidly and durably, namely by 77% and 85% at week 2 and by 86% and 86% at week 12 in cohorts 1 and 2, respectively. Most patients achieved a clinically meaningful improvement in hemoglobin (Hb) levels, and all but 1 patient remained transfusion-free up to week 12. Other markers of hemolysis, including bilirubin, reticulocytes, and haptoglobin, showed consistent improvements. No thromboembolic events were reported, and iptacopan was well tolerated, with no severe or serious adverse events reported until the data cutoff. In addition to the previously reported beneficial effect of iptacopan add-on therapy to eculizumab, this study showed that iptacopan monotherapy in treatment-naïve PNH patients resulted in normalization of hemolytic markers and rapid transfusion-free improvement of Hb levels in most patients. This trial was registered at www.clinicaltrials.gov as #NCT03896152.

Matched MeSH terms: Humans
Achilles in Ukraine: Concerns and priorities over the long-term implications of trauma

Matiashova L, Tsagkaris C, Essar MY, Romash IB, Vus VI

Int J Health Plann Manage, 2022 11;37(6):3369-3371.
PMID: 36030526 DOI: 10.1002/hpm.3562
Matched MeSH terms: Humans
Letter to the Editor: Research and consensus is required concerning integrity of randomized clinical trials

Khan KS, Chien PFW

Int J Gynaecol Obstet, 2022 11;159(2):613.
PMID: 36030408 DOI: 10.1002/ijgo.14394
Matched MeSH terms: Humans
Global variations in diagnostic guidelines for Barrett's esophagus

Kusano C, Singh R, Lee YY, Soh YSA, Sharma P, Ho KY, et al.

Dig Endosc, 2022 Nov;34(7):1320-1328.
PMID: 35475586 DOI: 10.1111/den.14342

Endoscopic diagnosis of gastroesophageal junction and Barrett's esophagus is essential for surveillance and early detection of esophageal adenocarcinoma and esophagogastric junction cancer. Despite its small size, the gastroesophageal junction has many inherent problems, including marked differences in diagnostic methods for Barrett's esophagus in international guidelines. To define Barrett's esophagus, gastroesophageal junction location should be clarified. Although gastric folds and palisade vessels are landmarks for identifying this junction, they are sometimes difficult to observe due to air entry or reflux esophagitis. The possibility of diagnosing a malignancy associated with Barrett's esophagus <1 cm, identified using palisade vessels, should be re-examined. Nontargeted biopsies of Barrett's esophagus are commonly used to detect intestinal metaplasia, dysplasia, and cancer as described in the Seattle protocol. Barrett's esophagus with intestinal metaplasia has a high risk of becoming cancerous. Furthermore, the frequency of cancer in patients with Barrett's esophagus without intestinal metaplasia is high, and the guidelines differ on whether to include the presence of intestinal metaplasia in the diagnosis of Barrett's esophagus. Use of advanced imaging technologies, including narrow-band imaging with magnifying endoscopy and linked color imaging, is reportedly valid for diagnosing Barrett's esophagus. Furthermore, artificial intelligence has facilitated the diagnosis of Barrett's esophagus through its deep learning and image recognition capabilities. However, it is necessary to first use the endoscopic definition of the gastroesophageal junction, which is common in all countries, and then elucidate the characteristics of Barrett's esophagus in each region, for example, length differences in the risk of carcinogenesis with and without intestinal metaplasia.

Matched MeSH terms: Humans
Fulltext Plasmodium vivax malaria serological exposure markers: Assessing the degree and implications of cross-reactivity with P. knowlesi

Longley RJ, Grigg MJ, Schoffer K, Obadia T, Hyslop S, Piera KA, et al.

Cell Rep Med, 2022 06 21;3(6):100662.
PMID: 35732155 DOI: 10.1016/j.xcrm.2022.100662

Serological markers are a promising tool for surveillance and targeted interventions for Plasmodium vivax malaria. P. vivax is closely related to the zoonotic parasite P. knowlesi, which also infects humans. P. vivax and P. knowlesi are co-endemic across much of South East Asia, making it important to design serological markers that minimize cross-reactivity in this region. To determine the degree of IgG cross-reactivity against a panel of P. vivax serological markers, we assayed samples from human patients with P. knowlesi malaria. IgG antibody reactivity is high against P. vivax proteins with high sequence identity with their P. knowlesi ortholog. IgG reactivity peaks at 7 days post-P. knowlesi infection and is short-lived, with minimal responses 1 year post-infection. We designed a panel of eight P. vivax proteins with low levels of cross-reactivity with P. knowlesi. This panel can accurately classify recent P. vivax infections while reducing misclassification of recent P. knowlesi infections.

Matched MeSH terms: Humans
Children growing up in conflict zones in Ukraine and beyond need urgent mental health support

Matiashova L, Tsagkaris C, Essar MY, Danilchenko V, Isayeva G

Lancet, 2022 04 30;399(10336):1689-1690.
PMID: 35397235 DOI: 10.1016/S0140-6736(22)00579-7
Matched MeSH terms: Humans
A dermatoglyphic study of the Malays and Chinese of Malaysia

Ganeson D, Chattopadhyay PK, Sunderland E, Woolley V

Ann Hum Biol, 1982 May-Jun;9(3):283-5.
PMID: 7103408
Matched MeSH terms: Humans
Fulltext ClicO FS: an interactive web-based service of Circos

Cheong WH, Tan YC, Yap SJ, Ng KP

Bioinformatics, 2015 Nov 15;31(22):3685-7.
PMID: 26227146 DOI: 10.1093/bioinformatics/btv433

: We present ClicO Free Service, an online web-service based on Circos, which provides a user-friendly, interactive web-based interface with configurable features to generate Circos circular plots.

Matched MeSH terms: Humans
Fulltext The effectiveness of laser vitreolysis for vitreous floaters in posterior vitreous detachment

Goh WN, Mustapha M, Zakaria SZS, Bastion MC

Indian J Ophthalmol, 2022 08;70(8):3026-3032.
PMID: 35918966 DOI: 10.4103/ijo.IJO_3198_21

Purpose: To determine the effectiveness of laser vitreolysis in terms of contrast sensitivity function (CSF) and vision-related quality of life (VRQol) for symptomatic floaters due to posterior vitreous detachment (PVD).
Materials: This is an interventional study that involved 57 eyes of 45 patients with symptomatic floaters for more than 3 months. Patients underwent one to three sessions of vitreolysis via Neodymiun-doped Yttrium Aluminum Garnet (Nd:YAG) laser. We examined the CSF using the computer programs Freiburg Acuity and Contrast Test (FrACT) and VRQoL survey using the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) before, and 1 month after, vitreolysis.
Results: Twelve patients had both eyes lasered and 33 patients had one eye lasered. The mean CSF improved from 3.20 ± 0.85%W to 2.64 ± 0.63%W 1 month after vitreolysis. Each use of the laser showed a significant mean difference in CSF (%W) as analyzed by paired t-test before and after the first laser (0.29 ± 0.49%W [P ≤ 0.001]); after the first and second laser (0.35 ± 0.53%W [P = 0.01]); and after second and third laser (0.21 ± 0.31%W [P = 0.02]). There was improvement in the median of four subscales in NEI VFQ-25 scores post treatment: general vision (z = -3.30, P = 0.001), near activity (z = 3.396, P = 0.001, distance activity (z = -2.788, P = 0.005), and mental health (z = -2.219, P = 0.026). The mean scores increased to 79.55 ± 9.45 from the baseline 75.06 ± 9.69 (P ≤ 0.001). No adverse events were recorded 1 month after the laser treatments.
Conclusion: Vitreolysis by Nd:YAG laser improved the CFS and VRQoL in symptomatic PVD patients.

Matched MeSH terms: Humans
Economic Evaluation of Type 2 Diabetes Mellitus Interventions in Low- and Middle-Income Countries: A Systematic Review of the Literature

Lum KY, Oppong R, Kigozi J

Asia Pac J Public Health, 2022 Nov;34(8):752-760.
PMID: 36039503 DOI: 10.1177/10105395221122643

The primary aim of this study is to assess the evidence on the cost-effectiveness of type 2 diabetes mellitus (T2DM) interventions with a focus on diabetes education, lifestyle modifications, surgical intervention, and pharmacological therapy in low- and middle-income countries (LMICs). A systematic review was conducted to identify economic evaluations of T2DM interventions published in LMICs for the period 2009-2019. A total of 25 studies were identified, with more than half of the studies being decision analytic models. Critical appraisal of the identified studies showed they were of good quality. Overall, the reported interventions in this review were very heterogeneous, which made them difficult to compare. However, there was strong evidence suggesting that diabetes education was a very cost-effective strategy in LMICs. Further evidence on affordability and budget impact of bariatric surgery is required before adopting the intervention. Metformin-based therapy showed promising evidence on cost-effectiveness and thus should be offered to T2DM patients in LMICs. On the contrary, the cost-effectiveness of lifestyle modifications remains understudied in LMICs. The findings in this review can inform policy guidance toward the inclusion of T2DM interventions in the benefit packages for Universal Health Coverage in LMICs.

Matched MeSH terms: Humans
Structured Imaging Approach for Viral Encephalitis

Ramli NM, Bae YJ

Neuroimaging Clin N Am, 2023 Feb;33(1):43-56.
PMID: 36404046 DOI: 10.1016/j.nic.2022.07.002

MR imaging is essential in diagnosing viral encephalitis. Clinical features, cerebrospinal fluid analysis and pathogen confirmation by polymerase chain reaction can be supported by assessing imaging features. MR imaging patterns with typical locations can identify pathogens such as temporal lobe for herpes simplex virus type 1; bilateral thalami for Japanese encephalitis and influenza virus ; and brainstem for enterovirus and rabies. In this article, we have reviewed representative viral encephalitis and its MR imaging patterns. In addition, we also presented acute viral encephalitis without typical MR imaging patterns, such as dengue and varicella-zoster virus encephalitis.

Matched MeSH terms: Humans
Management of Bimaxillary Protrusion

Rajandram RK, Ponnuthurai L, Mugunam K, Chan YS

Oral Maxillofac Surg Clin North Am, 2023 Feb;35(1):23-35.
PMID: 36336600 DOI: 10.1016/j.coms.2022.06.006

Bimaxillary protrusion is a unique dentofacial deformity trait that can exist in an individual as an isolated problem or in combination with other skeletal and dental-related issues. Orthodontist and oral and maxillofacial surgeons are often the main primary team involved in the management of bimaxillary protrusion. Clinical dilemma often exists as cases can either be treated orthodontically or may require a combination of orthodontic and skeletal segmental orthognathic surgery. This article aims to help clinicians improve their approach to management of bimaxillary protrusion by creating a classification based on the severity that can guide treatment selection.

Matched MeSH terms: Humans
CircRNA-miRNA interactions in atherogenesis

Tong KL, Tan KE, Lim YY, Tien XY, Wong PF

Mol Cell Biochem, 2022 Dec;477(12):2703-2733.
PMID: 35604519 DOI: 10.1007/s11010-022-04455-8

Atherosclerosis is the major cause of coronary artery disease (CAD) which includes unstable angina, myocardial infarction, and heart failure. The onset of atherogenesis, a process of atherosclerotic lesion formation in the intima of arteries, is driven by lipid accumulation, a vicious cycle of reactive oxygen species (ROS)-induced oxidative stress and inflammatory reactions leading to endothelial cell (EC) dysfunction, vascular smooth muscle cell (VSMC) activation, and foam cell formation which further fuel plaque formation and destabilization. In recent years, there is a surge in the number of publications reporting the involvement of circular RNAs (circRNAs) in the pathogenesis of cardiovascular diseases, cancers, and metabolic syndromes. These studies have advanced our understanding on the biological functions of circRNAs. One of the most common mechanism of action of circRNAs reported is the sponging of microRNAs (miRNAs) by binding to the miRNAs response element (MRE), thereby indirectly increases the transcription of their target messenger RNAs (mRNAs). Individual networks of circRNA-miRNA-mRNA associated with atherogenesis have been extensively reported, however, there is a need to connect these findings for a complete overview. This review aims to provide an update on atherogenesis-related circRNAs and analyze the circRNA-miRNA-mRNA interactions in atherogenesis. The atherogenic mechanisms and clinical relevance of each atherogenesis-related circRNA were systematically discussed for better understanding of the knowledge gap in this area.

Matched MeSH terms: Humans
Mathematical Modelling of Dengue Transmission with Intervention Strategies Using Fractional Derivatives

Hamdan N', Kilicman A

Bull Math Biol, 2022 Oct 26;84(12):138.
PMID: 36287255 DOI: 10.1007/s11538-022-01096-2

This paper deals with a deterministic mathematical model of dengue based on a system of fractional-order differential equations (FODEs). In this study, we consider dengue control strategies that are relevant to the current situation in Malaysia. They are the use of adulticides, larvicides, destruction of the breeding sites, and individual protection. The global stability of the disease-free equilibrium and the endemic equilibrium is constructed using the Lyapunov function theory. The relations between the order of the operator and control parameters are briefly analysed. Numerical simulations are performed to verify theoretical results and examine the significance of each intervention strategy in controlling the spread of dengue in the community. The model shows that vector control tools are the most efficient method to combat the spread of the dengue virus, and when combined with individual protection, make it more effective. In fact, the massive use of personal protection alone can significantly reduce the number of dengue cases. Inversely, mechanical control alone cannot suppress the excessive number of infections in the population, although it can reduce the Aedes mosquito population. The result of the real-data fitting revealed that the FODE model slightly outperformed the integer-order model. Thus, we suggest that the FODE approach is worth to be considered in modelling an infectious disease like dengue.

Matched MeSH terms: Humans

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