Displaying publications 361 - 380 of 440 in total

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  1. Norlaili M, Bakiah S, Zunaina E
    BMC Ophthalmol, 2011 Nov 23;11:36.
    PMID: 22111945 DOI: 10.1186/1471-2415-11-36
    BACKGROUND: Diabetic macular oedema is the leading causes of blindness. Laser photocoagulation reduces the risk of visual loss. However recurrences are common and despite laser treatment, patients with diabetic macular oedema experienced progressive loss of vision. Stabilization of the blood retinal barrier introduces a rationale for intravitreal triamcinolone treatment in diabetic macular oedema. This study is intended to compare the best corrected visual acuity (BCVA) and the macular oedema index (MEI) at 3 month of primary treatment for diabetic macular oedema between intravitreal triamcinolone acetonide (IVTA) and laser photocoagulation.

    METHODS: This comparative pilot study consists of 40 diabetic patients with diabetic macular oedema. The patients were randomized into two groups using envelope technique sampling procedure. Treatment for diabetic macular oedema was based on the printed envelope technique selected for every patient. Twenty patients were assigned for IVTA group (one injection of IVTA) and another 20 patients for LASER group (one laser session). Main outcome measures were mean BCVA and mean MEI at three months post treatment. The MEI was quantified using Heidelberg Retinal Tomography II.

    RESULTS: The mean difference for BCVA at baseline [IVTA: 0.935 (0.223), LASER: 0.795 (0.315)] and at three months post treatment [IVTA: 0.405 (0.224), LASER: 0.525 (0.289)] between IVTA and LASER group was not statistically significant (p = 0.113 and p = 0.151 respectively). The mean difference for MEI at baseline [IVTA: 2.539 (0.914), LASER: 2.139 (0.577)] and at three months post treatment [IVTA: 1.753 (0.614), LASER: 1.711 (0.472)] between IVTA and LASER group was also not statistically significant (p = 0.106 and p = 0.811 respectively).

    CONCLUSIONS: IVTA demonstrates good outcome comparable to laser photocoagulation as a primary treatment for diabetic macular oedema at three months post treatment.

    TRIAL REGISTRATION: ISRCTN05040192 (http://www.controlled-trial.com).

    Matched MeSH terms: Pilot Projects
  2. Aliyu AS, Ramli AT, Garba NN, Saleh MA, Gabdo HT, Liman MS
    Radiat Prot Dosimetry, 2015 Feb;163(2):238-50.
    PMID: 24827576 DOI: 10.1093/rpd/ncu158
    This study assesses the 'radio-ecological' impacts of Fukushima nuclear accident on non-human biota using the ERICA Tool, which adopts an internationally verified methodology. The paper estimates the impacts of the accident on terrestrial and marine biota based on the environmental data reported in literature for Japan, China, South Korea and the USA. Discernible impacts have been detected in the marine biota around Fukushima Daiichi nuclear power plant. This study confirms that the Fukushima accident had caused heavier damage to marine bionts compared with terrestrial flora and fauna, in Japan.
    Matched MeSH terms: Pilot Projects
  3. Yahya F, Jasmin R, Ng CT, Cheah TE, Sockalingam S
    Int J Rheum Dis, 2013 Dec;16(6):724-30.
    PMID: 24119227 DOI: 10.1111/1756-185X.12179
    Mycophenolate is an immunosuppressive agent which has been used in systemic lupus erythematosus (SLE) patients who have failed conventional therapy. However, the use of mycophenolate sodium in extra-renal SLE involvement has yet to be established. This study aimed to assess the efficacy of mycophenolate sodium in extra-renal SLE.
    Matched MeSH terms: Pilot Projects
  4. Azhar ZM, Zubaidah JO, Norjan KO, Zhuang CY, Tsang F
    Nutr J, 2013;12:121.
    PMID: 23945213 DOI: 10.1186/1475-2891-12-121
    It has long been postulated that the relative abundance of specific nutrients can affect cognitive processes and emotions. Newly described influences of dietary factors on neuronal function and synaptic plasticity have revealed some of the vital mechanisms that could be responsible for the action of diet on brain health and cognitive function. Here, through a double-blind, randomized, placebo-controlled trial, we asked if the newly discovered chicken meat ingredient-168 (CMI-168) could be beneficial to the cognitive function in healthy adults.
    Matched MeSH terms: Pilot Projects
  5. Loch A, Lwin T, Zakaria IM, Abidin IZ, Wan Ahmad WA, Hautmann O
    Postgrad Med J, 2013 Jun;89(1052):335-9.
    PMID: 23524989 DOI: 10.1136/postgradmedj-2012-131174
    INTRODUCTION: Achieving target door-needle times for ST elevation myocardial infarction remains challenging. Data on emergency department (ED) doctor-led thrombolysis in developing countries and factors causing delay are limited.
    OBJECTIVES: To assess the effect on door-needle times by transferring responsibility for thrombolysis to the ED doctors and to identify predictors of prolonged door-needle times.
    METHODOLOGY: Data on medical on-call team-led thrombolysis at a tertiary Asian hospital were prospectively collected from May 2007 to Aug 2008 (1st study period). In September 2008, ED doctors were empowered to perform thrombolysis. The practice change was accompanied by new guidelines, tick chart implementation, and training sessions. Data were then consecutively collected from September 2008 to May 2009 (2nd study period). Door-to-needle times for the 1st and 2nd study periods were compared. All cases were analysed for factors of delay by multiple logistic regression.
    RESULTS: 297 patients were thrombolysed, 169 by the medical on-call team during the 1st study period and 128 by the ED doctors during the 2nd study period. Median door-needle times were 54 and 48 min, respectively (p=0.76). Significant delays were predicted by 'incorrect initial ECG interpretation' (adjusted OR (aOR) 14.3), 'inappropriate triage' (aOR 10.4) and 'multiple referrals' (aOR 5.9). No cases of inappropriate thrombolysis were recorded.
    CONCLUSIONS: Transfer of responsibility for thrombolysis to the ED doctors did not improve door-needle times despite measures introduced to facilitate this change. Key causative factors for this failure were identified.
    KEYWORDS: Accident & Emergency Medicine; Quality improvement
    Study site: Emergency department, University Malaya Medical Centre, Kuala Lumpur
    Matched MeSH terms: Pilot Projects
  6. Brough L, Jin Y, Shukri NH, Wharemate ZR, Weber JL, Coad J
    Matern Child Nutr, 2015 Oct;11(4):646-55.
    PMID: 23782592 DOI: 10.1111/mcn.12055
    Iodine deficiency during pregnancy and lactation may adversely affect fetal and infant development. Two initiatives were introduced in New Zealand to prevent deficiency: (1) mandatory fortification of bread with iodised salt; and (2) provision of a subsidised iodine supplement (150 μg) for all pregnant and breastfeeding women. The aim of this study was to assess iodine intake and status among a self-selecting sample of pregnant and lactating women in Palmerston North, both before and after the two initiatives. Pregnant and breastfeeding women were recruited before (n = 25 and 32; 2009) and after (n = 34 and 36; 2011) the initiatives. Iodine concentration was determined in 24-h urine and breast milk samples using inductively-coupled plasma mass spectrometry. Use of supplements and salt, knowledge of iodine deficiency, and awareness of the initiatives were determined by questionnaire. Median urine iodine concentration (UIC) was higher in 2011 compared with 2009 for both pregnant (85 and 47 μg L(-1) ) and breastfeeding (74 and 34 μg L(-1) ) participants; median UIC were below the cut-offs for adequate iodine status. However, in 2011, the estimated daily iodine intake during pregnancy was 217 μg day(-1) ; 74% of women achieved the Estimated Average Requirement. Knowledge of the initiatives was low, only 28-56% were aware of the need for iodine supplements and only 15-22% were aware of the mandatory addition of iodised salt to bread. Despite initiatives, UIC of these women indicates iodine deficiency, however, dietary intakes appear adequate. Ongoing surveillance of supplement use and iodine status among pregnant and lactating women throughout New Zealand is needed to fully assess the efficacy of the initiatives. Alternative strategies may require evaluation to ensure all women have adequate iodine during pregnancy and breastfeeding.
    Matched MeSH terms: Pilot Projects
  7. Yunos NM, Bellomo R, Hegarty C, Story D, Ho L, Bailey M
    JAMA, 2012 Oct 17;308(15):1566-72.
    PMID: 23073953 DOI: 10.1001/jama.2012.13356
    Administration of traditional chloride-liberal intravenous fluids may precipitate acute kidney injury (AKI).
    Matched MeSH terms: Pilot Projects
  8. Asha'ari ZA, Yusof S, Ismail R, Che Hussin CM
    Ann Acad Med Singap, 2010 Aug;39(8):619-24.
    PMID: 20838703
    INTRODUCTION: Allergic rhinitis (AR) is a prevalent disease worldwide but is still underdiagnosed in many parts of Asia. We studied the clinical profiles of AR patients in our community based on the new ARIA classification and investigated the aetiological allergens using a skin prick test.

    MATERIALS AND METHODS: In 2008, 142 newly diagnosed patients with AR were seen and underwent skin prick testing with 90 patients completing the study.

    RESULTS: Intermittent mild and moderate/severe AR were evident in 10% and 21.1% of the patients, while persistent mild and moderate/severe were seen in 20% and 48.9%, respectively. Rhinitis and asthma co-morbidity occurred in 28.8% with asthma incidence significantly higher in persistent AR (P = 0.002). There was no significant association between AR severity, city living and asthma co-morbidity. Nasal itchiness and sneezing were the main presenting complaints and were more common in intermittent AR (P <0.05). Sleep disturbance was associated with moderate-severe AR (P <0.05). Polypoidal mucosa was associated with asthma co-morbidity (P <0.05). Monosensitivity reaction occurred in 12.2% of patients and was associated with fungi sensitivity (P <0.05). Majority of patients were oligosensitive (52.8%) and polysensitive (34.4%) and were significantly associated with moderate-severe persistent AR (P <0.01). The highest positive skin prick reaction and the largest average wheal diameter were for the house dust mites and cat allergen (P <0.05).

    CONCLUSION: Our results reflected the AR profiles in our country, which was comparable with typical profiles of the neighbouring country and other Mediterranean countries with a similar temperate climate.

    Matched MeSH terms: Pilot Projects
  9. Nuryastuti T, Henny C, Henk JB, Roel K, Abu TA, Bastiaan PK
    Med J Malaysia, 2008 Jul;63 Suppl A:97.
    PMID: 19025002
    Phenotypic variation in biofilm formation is common in clinical isolates of S. epidermidis. In the current study, nearly 5% of all clinical isolates analysed showed phenotypic variation in biofilm forming ability and electrophoretic mobility (EM). This is the first report of S. epidermidis strains irreversibly switching from biofilm-positive to biofilm-negative phenotype by spontaneous deletion of icaADBC genes which represents a new, possibly common mechanism of phenotypic variation.
    Matched MeSH terms: Pilot Projects
  10. Ponnusamy K, Mohan M, Nagaraja HS
    Med J Malaysia, 2008 Jul;63 Suppl A:102.
    PMID: 19025005
    Lead (Pb) is a neurotoxic heavy metal and children in the developmental stage are particularly susceptible to toxic effects of lead exposure. The brain is the key organ involved in interpreting and responding to potential stressors. Epidemiological investigations have established the relationship between chronic lead exposure and cognitive impairments in young children. Excessive production of radical species plays an important role in neuronal pathology resulting from excitotoxic insults, therefore one plausible neuroprotective mechanism of bioflavonoids is partly relevant to their metal chelating and antioxidant properties. Centella asiatica (CA) is a tropical medicinal plant enriched with bioflavonoids and triterpenes and selenium, reported to rejuvenate the cells and promote physical and mental health. Bioflavonoids are claimed to be exert antimutagenic, neurotrophic and xenobiotics ameliorating and membrane molecular stabilizing effects. The objective of the present work is to study the protective antioxidant effect of pretreatment of CA extract (CAE) on lead acetate induced changes in oxidative biomarkers in the central nervous system (CNS) of mice.
    Matched MeSH terms: Pilot Projects
  11. Francis K, Chapman Y, Doolan G, Sellick K, Barnett T
    Aust J Rural Health, 2008 Jun;16(3):164-9.
    PMID: 18471187 DOI: 10.1111/j.1440-1584.2008.00967.x
    OBJECTIVE:This study sought to identify and evaluate approaches used to attract internationally trained nurses from traditional and non-traditional countries and incentives employed to retain them in small rural hospitals in Gippsland, Victoria.
    DESIGN: An exploratory descriptive design.
    SETTING: Small rural hospitals in Gippsland, Victoria.
    PARTICIPANTS: Hospital staff responsible for recruitment of nurses and overseas trained nurses from traditional and non-traditional sources (e.g. England, Scotland, India, Zimbabwe, Holland, Singapore, Malaysia).
    RESULTS AND CONCLUSION: Recruitment of married overseas trained nurses is more sustainable than that of single registered nurses, however, the process of recruitment for the hospital and potential employees is costly. Rural hospitality diffuses some of these expenses by the employing hospitals providing emergency accommodation and necessary furnishings. Cultural differences and dissonance regarding practice create barriers for some of the overseas trained nurses to move towards a more sanguine position. On the positive side, single overseas registered nurses use the opportunity to work in rural Australian hospitals as an effective working holiday that promotes employment in larger, more specialized hospitals. Overall both the registered nurses and the employees believe the experience to be beneficial rather than detrimental.
    Matched MeSH terms: Pilot Projects
  12. Devi Beena CR, Tang TS, Gerard LC
    Med J Malaysia, 2008 Sep;63 Suppl C:63-5.
    PMID: 19230250
    Carcinoma of the cervix is the most common malignancy in many developing countries. The purpose of this pilot study on cervical cancer patients treated at selected sites in Malaysia is to examine the achievability of collecting information on patients. The data was collected from the medical records of the patients using case report form. The results reveal that more than 90% of the forms had completed data from all sites. The pilot study has demonstrated that it is feasible to register and collect information on cervical cancer patients using the case report forms. Treatment outcome obtained from this data will form the baseline to establish existing clinical practice and will be useful for treating physicians to monitor the treatment outcome and the late complications and with longer followup to measure the disease free and overall survival. In addition, it is an useful tool as the national indicator.
    Matched MeSH terms: Pilot Projects
  13. Inatomi T, Nakamura T, Koizumi N, Sotozono C, Kinoshita S
    Med J Malaysia, 2008 Jul;63 Suppl A:42.
    PMID: 19024975
    The cultivated epithelial transplantation is a new surgical modality for treating a variety of severe ocular surface disorders. This type of tissue-engineered epithelial sheet provides a rapid epithelial coverage on the corneal surface that reduces inflammation and postoperative complications. Although cultivated corneal epithelial transplantation is an effective surgical strategy, autologous transplantation is limited to unilateral cases. Autologous cultivated oral mucosal epithelial transplantation (COMET) enables surgeons to reconstruct the ocular surface using autologous, non-ocular surface cells, and has opened a new pathway for treating severe, bilateral ocular surface disorders.
    Matched MeSH terms: Pilot Projects
  14. See HS, Yap YY, Yip WK, Seow HF
    World J Surg Oncol, 2008;6:18.
    PMID: 18275617 DOI: 10.1186/1477-7819-6-18
    Nasopharyngeal carcinoma (NPC) is a human epithelial tumour with high prevalence amongst Chinese in Southern China and South East Asia and is associated with the Epstein-Barr virus (EBV). The viral genome harbours an oncogene, namely, the latent membrane protein 1 (LMP1) gene and known variants such as the 30-bp deletion and loss of XhoI restriction site have been found. Less is known about the relationship between these variants and the population characteristics and histological type.
    Matched MeSH terms: Pilot Projects
  15. Henderson-Smart DJ, Lumbiganon P, Festin MR, Ho JJ, Mohammad H, McDonald SJ, et al.
    PMID: 17892586
    Disorders related to pregnancy and childbirth are a major health issue in South East Asia. They represent one of the biggest health risk differentials between the developed and developing world. Our broad research question is: Can the health of mothers and babies in Thailand, Indonesia, the Philippines and Malaysia be improved by increasing the local capacity for the synthesis of research, implementation of effective interventions, and identification of gaps in knowledge needing further research?
    Matched MeSH terms: Pilot Projects
  16. Aziz NA, Norzila MZ, Hamid MZ, Noorlaili MT
    Med J Malaysia, 2006 Dec;61(5):534-9.
    PMID: 17623952 MyJurnal
    The increasing prevalence of childhood asthma has become a concern among health practitioners. Effective management emphasizes long-term management and inhaled therapy has become the mainstay home management for children. However, proper utilization of medication is pertinent in improving control. Proper asthma education is mandatory in improving skills and confidence amongst parents. To assess the skills of using the metered-dose inhaler (MDI) with a spacer among asthmatic children before and after educational intervention and to analyse any difficulties which may occur amongst the participants in executing the assessment steps. A cross-sectional clinic based study involving 85 parents and children with asthma. A standardized metered-dose inhaler-spacer checklist of eight steps of medication usage and five steps of cleaning the spacer were used as the assessment tools for pre and post intervention. The performance on using the inhaler-spacer and spacer cleaning knowledge pre and two months post intervention was evaluated. One point was given for each correct step and zero points for incorrect answers/steps. The mean score for skills of inhaler technique improved significantly after educational intervention (3.51 to 6.01, p < 0.0001) as did the mean score for parental knowledge of spacer cleaning technique (1.35 to 3.16, p 0.001). Analysis showed only a limited improvement even after an educational session in three steps of inhalation technique: step 5 (23.5%/69.4%), step 6 (28.2%/68.2%) and step 7 (25.9%/61.2%). Parents with asthmatic children had poor skills in utilizing their children's medication. A short-term educational intervention was able to improve overall knowledge and skill but certain skills need more emphasizing and training.
    Study site: Klink HUKM Taman Jaya, Cheras, Kuala Lumpur, Malaysia (primary care clinic for Hospital University Kebangsaan Malaysia)
    Matched MeSH terms: Pilot Projects
  17. Devi BC, Tang TS, Corbex M
    Ann. Oncol., 2007 Jul;18(7):1172-6.
    PMID: 17434897 DOI: 10.1093/annonc/mdm105
    BACKGROUND:
    The registry of the Oncology Departmental in Sarawak General Hospital showed that 79% of nasopharyngeal, 77% of breast and 70% of cervix cancer patients were diagnosed at an advanced stage (stages III and IV) for year 1993. Hence, a low cost Early Cancer Surveillance Program was started in 1994, with the intent of downstaging these three most common cancers in Sarawak.

    MATERIALS AND METHODS:
    The program consisted of (i) training health staff in hospital and rural clinics to improve their skills in early cancer detection, (ii) raising public awareness through pamphlets, posters and sensitization by health staff.

    RESULTS:
    Data analysis revealed that the program achieved downstaging in two of the cancers. Breast cancer in stage III and IV was reduced from 60% (1994) to 35% (1998) (P < 0.0001) and cervical cancer in stage III and IV from 60% (1994) to 26% (1998) (P < 0.0001). No reduction was observed for nasopharyngeal cancer at 88% (1994) to 91% (1998).

    CONCLUSIONS:
    The overall cost of this program was
    Matched MeSH terms: Pilot Projects
  18. Chawarski MC, Mazlan M, Schottenfeld RS
    Drug Alcohol Depend, 2008 Apr 1;94(1-3):281-4.
    PMID: 18164145 DOI: 10.1016/j.drugalcdep.2007.11.008
    This pilot randomized clinical trial evaluated whether the efficacy of office-based buprenorphine maintenance treatment (BMT), provided with limited counseling or oversight of medication adherence is improved by the addition of individual drug counseling and abstinence-contingent take-home doses of buprenorphine. After a 2-week buprenorphine and stabilization period, heroin dependent individuals (n=24) in Muar, Malaysia were randomly assigned to Standard Services BMT (physician administered advice and support, and weekly, non-contingent medication pick-up) or Enhanced Services (nurse-delivered manual-guided behavioral drug and HIV risk reduction counseling (BDRC) and abstinence-contingent take-home buprenorphine (ACB), 7 day supply maximum). Outcomes included retention, proportion of opioid-negative urine tests, self-reported drug use, and self-reported HIV risk behaviors. 12/12 (100%) of Enhanced Services and 11/12 (92%) of Standard Services participants completed the entire protocol. The proportion of opioid-negative urine tests increased significantly over time for both groups (p<0.001), and the reductions were significantly greater in the Enhanced Services group (p<0.05); Enhanced Services group achieved higher overall proportions of opiate negative urine toxicology tests (87% vs. 69%, p=0.04) and longer periods of consecutive abstinence from opiates (10.3 weeks vs. 7.8 weeks, p=0.154). Both groups significantly reduced HIV risk behaviors during treatment (p<0.05), but the difference between Enhanced and Standard Services (26% vs. 17% reductions from the baseline levels, respectively) was not statistically significant (p=0.9). Manual-guided behavioral drug and HIV risk reduction counseling and abstinence-contingent take-home buprenorphine appear promising for adding to the efficacy of office-based BMT provided with limited drug counseling and medication oversight.
    Matched MeSH terms: Pilot Projects
  19. Nathan AM, Zaki R, Rozario R, Dhania N, Mohd Hamirudin SN, Eg KP, et al.
    PMID: 26338016 DOI: 10.1186/s12955-015-0336-z
    The Canadian Acute Respiratory Illness and Flu Scale (CARIFS) is a parent-proxy questionnaire that assesses severity of acute respiratory infections in children. The aim was to (a) perform a cross-cultural adaptation and (b) prove that the Malay CARIFS is a reliable tool.
    Matched MeSH terms: Pilot Projects
  20. Khoo JJ, Ng CS, Sabaratnam S, Arulanantham S
    Asian Pac J Cancer Prev, 2016;17(3):1149-55.
    PMID: 27039740
    BACKGROUND: Examination of sentinel lymph node (SLN) biopsies provides accurate nodal staging for breast cancer and plays a key role in patient management. Procurement of SLNs and the methods used to process specimens are equally important. Increasing the level of detail in histopathological examination of SLNs increases detection of metastatic tumours but will also increase the burden of busy laboratories and thus may not be carried out routinely. Recommendation of a reasonable standard in SLN examination is required to ensure high sensitivity of results while maintaining a manageable practice workload.

    MATERIALS AND METHODS: Twenty-four patients with clinically node-negative breast cancer were recruited. Combined radiotracer and blue dye methods were used for identification of SLNs. The nodes were thinly sliced and embedded. Serial sectioning and immunohistochemical (IHC) staining against AE1/AE3 were performed if initial HandE sections of the blocks were negative.

    RESULTS: SLNs were successfully identified in all patients. Ten cases had nodal metastases with 7 detected in SLNs and 3 detected only in axillary nodes (false negative rate, FNR=30%). Some 5 out of 7 metastatic lesions in the SLNs (71.4%) were detected in initial sections of the thinly sliced tissue. Serial sectioning detected the remaining two cases with either micrometastases or isolated tumour cells (ITC).

    CONCLUSIONS: Thin slicing of tissue to 3-5mm thickness and serial sectioning improved the detection of micro and macro-metastases but the additional burden of serial sectioning gave low yield of micrometastases or ITC and may not be cost effective. IHC validation did not further increase sensitivity of detection. Therefore its use should only be limited to confirmation of suspicious lesions. False negative cases where SLNs were not involved could be due to skipped metastases to non-sentinel nodes or poor technique during procurement, resulting in missed detection of actual SLNs.

    Matched MeSH terms: Pilot Projects
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