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  1. The effectiveness of epilepsy educational intervention using computer game-based epilepsy educational program (Epigame) among Malaysian children with epilepsy: A prospective cohort study
    Fong CY, Low P, Ng KH, Heng HS, Chong ASL, Ong LC, et al.
    Epilepsy Behav, 2023 Dec;149:109536.
    PMID: 38008017 DOI: 10.1016/j.yebeh.2023.109536
    BACKGROUND: A computer game-based epilepsy educational programme (Epigame) can potentially improve the awareness, knowledge and attitude (AKA) and quality of life (QOL) of children with epilepsy (CWE). Our study among Malaysian CWE aimed to assess the: i) baseline level of epilepsy AKA and potential characteristics associated with poor levels of AKA, ii) effectiveness of Epigame in improving AKA and QOL of CWE.

    METHOD: Prospective cohort study on CWE age 7-18 years old with no comorbidities. Epilepsy education was delivered using Epigame. CWE completed AKA questionnaire before (time point 1 [TP1]), immediately after (TP2), 3 months (TP3) after provision of Epigame. Child self-report Health-Related Quality of Life Measurement for Children with Epilepsy (CHEQOL-25) questionnaire was completed at TP1 and TP3.

    RESULTS: Total of 106 CWE participated in this study (mean age of 13.3 years). Baseline (TP1) AKA was rated "very low to moderate" for awareness domain in 95.3 %, "very low to moderate" for knowledge domain in 67 %, "negative to indifferent" for attitude domain in 54.7 %, and "very poor to moderate' for total AKA score domain in 84 %. "Positive to very positive" for child attitude domain was significantly associated with parents with "positive to very positive" for attitude domain (OR 10.6, 95 % CI 3.23-34.66). "Good to excellent" for total child AKA domain was significantly associated with parents with "Good to excellent" for total AKA domain (OR 5.2, 95 % CI 1.16-15.02) and with 

    Matched MeSH terms: Comorbidity
  2. Fulltext Current Updates on Idiopathic Normal Pressure Hydrocephalus
    Liew BS, Takagi K, Kato Y, Duvuru S, Thanapal S, Mangaleswaran B
    Asian J Neurosurg, 2019 9 10;14(3):648-656.
    PMID: 31497081 DOI: 10.4103/ajns.AJNS_14_19
    Idiopathic normal pressure hydrocephalus (iNPH) is one of the neurodegenerative diseases which can be treated surgically with favorable outcome. The gait disturbance, cognitive, and urinary symptoms are known as the clinical triad of iNPH. In this review, we have addressed the comorbidities, differential diagnoses, clinical presentations, and pathology of iNPH. We have also summarized the imaging studies and clinical procedures used for the diagnosis of iNPH. The treatment modality, outcomes, and prognosis were also discussed.
    Matched MeSH terms: Comorbidity
  3. Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease
    Younossi ZM, Alqahtani SA, Alswat K, Yilmaz Y, Keklikkiran C, Funuyet-Salas J, et al.
    J Hepatol, 2024 Mar;80(3):419-430.
    PMID: 37984709 DOI: 10.1016/j.jhep.2023.11.004
    BACKGROUND & AIMS: Patients with fatty liver disease may experience stigma from the disease or comorbidities. In this cross-sectional study, we aimed to understand stigma among patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and healthcare providers.

    METHODS: Members of the Global NASH Council created two surveys about experiences/attitudes toward NAFLD and related diagnostic terms: a 68-item patient and a 41-item provider survey.

    RESULTS: Surveys were completed by 1,976 patients with NAFLD across 23 countries (51% Middle East/North Africa [MENA], 19% Europe, 17% USA, 8% Southeast Asia, 5% South Asia) and 825 healthcare providers (67% gastroenterologists/hepatologists) across 25 countries (39% MENA, 28% Southeast Asia, 22% USA, 6% South Asia, 3% Europe). Of all patients, 48% ever disclosed having NAFLD/NASH to family/friends; the most commonly used term was "fatty liver" (88% at least sometimes); "metabolic disease" or "MAFLD" were rarely used (never by >84%). Regarding various perceptions of diagnostic terms by patients, there were no substantial differences between "NAFLD", "fatty liver disease (FLD)", "NASH", or "MAFLD". The most popular response was being neither comfortable nor uncomfortable with either term (56%-71%), with slightly greater discomfort with "FLD" among the US and South Asian patients (47-52% uncomfortable). Although 26% of patients reported stigma related to overweight/obesity, only 8% reported a history of stigmatization or discrimination due to NAFLD. Among providers, 38% believed that the term "fatty" was stigmatizing, while 34% believed that "nonalcoholic" was stigmatizing, more commonly in MENA (43%); 42% providers (gastroenterologists/hepatologists 45% vs. 37% other specialties, p = 0.03) believed that the name change to metabolic dysfunction-associated steatotic liver disease (or MASLD) might reduce stigma. Regarding the new nomenclature, the percentage of providers reporting "steatotic liver disease" as stigmatizing was low (14%).

    CONCLUSIONS: The perception of NAFLD stigma varies among patients, providers, geographic locations and sub-specialties.

    IMPACT AND IMPLICATIONS: Over the past decades, efforts have been made to change the nomenclature of nonalcoholic fatty liver disease (NAFLD) to better align with its underlying pathogenetic pathways and remove any potential stigma associated with the name. Given the paucity of data related to stigma in NAFLD, we undertook this global comprehensive survey to assess stigma in NAFLD among patients and providers from around the world. We found there is a disconnect between physicians and patients related to stigma and related nomenclature. With this knowledge, educational programs can be developed to better target stigma in NAFLD among all stakeholders and to provide a better opportunity for the new nomenclature to address the issues of stigma.

    Matched MeSH terms: Comorbidity
  4. Author's reply to editorial comment to sex among Asian men and women: The global better sex survey in Asia
    Tan HM
    International Journal of Urology, 2009;16:515.
    DOI: 10.1111/j.1442-2042.2009.02295.x
    Matched MeSH terms: Comorbidity
  5. Depression, hormonal status and erectile dysfunction in the aging male: results from a community study in Malaysia
    Low WY, Khoo EM, Tan HM, Hew FL, Teoh SH
    Journal of Men's Health and Gender, 2006;3:263-270.
    DOI: 10.1016/j.jmhg.2006.02.007
    Background: Depression and erectile dysfunction (ED) are common in aging and the two conditions often co-exist. These conditions have been shown to be associated with hormonal changes in men. This paper examines the association between depression, ED, and hormonal status of men aged above 50 years in the Klang Valley, Malaysia.
    Methods: Five hundred men aged 50 years and above were randomly selected via the electoral roll and invited to participate in a community-based study on men's health: 351 men responded. Respondents were interviewed individually based on a self-developed questionnaire, which included information on socio-demographic data. Erectile function was measured using the International Index for Erectile Function-5 (IIEF-5) and depression was measured using the 15 item Geriatric Depression Scale (GDS-15).
    Results: Sixty-nine percent of the men were diagnosed with ED. Mean GDS score was 3.33 (SD = 3.29). Nineteen percent (n = 67) of the men had abnormal levels of testosterone (≤11 nmol/l) and this comprised 73% of men with ED (n = 49) and 27% of men without ED (n = 18). There was no significant association between testosterone level and ED (χ2 = 0.68, p = 0.41). Significant association was found between depression (GDS ≥ 5) and men with ED (χ2 = 6.07, p = 0.014). Sex hormone binding globulin and luteinising hormone were negatively correlated with erectile function. Results of the multiple linear regression showed that age and depression are predictors of erectile function.
    Conclusion: Depression and ED should be screened for when either exists in the male patient and treatment directed accordingly. © 2006 WPMH GmbH.
    Matched MeSH terms: Comorbidity
  6. Assessing quality of life using WHOQOL-BREF: A cross-sectional insight among patients on warfarin in Malaysia
    Iqbal MS, Kassab YW, Al-Saikhan FI, Almalki ZS, Haseeb A, Iqbal MZ, et al.
    Saudi Pharm J, 2020 Aug;28(8):936-942.
    PMID: 32792838 DOI: 10.1016/j.jsps.2020.06.014
    Background and aim: The effect of anticoagulation control on overall Health-Related Quality of Life (HRQoL) in patients taking warfarin in Malaysia has not been explored yet. Therefore, this study aimed to evaluate HRQoL among patients on warfarin in Malaysia.

    Methods: HRQoL among patients on warfarin was measured using WHOQOL-BREF (World Health Organization Quality of life Assessment: Brief Version). Descriptive and inferential statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 22.

    Results: Out of 319 patients, more female patients were observed than the males (n = 221, 69.3%, and n = 98, 30.7% respectively). Mean scores for the physical (61.14 ± 15.96), psychological (68.58 ± 16.11), social (63.55 ± 27.06) and environmental domains (62.78 ± 17.58) were observed. Statistically, a significant association was found between the comorbidities other than CVDs with health satisfaction (p = 0.002), physical (p = 0.001), psychological (p 

    Matched MeSH terms: Comorbidity
  7. Fulltext Glomus tympanicum
    Appannan, V.R., Md Daud, M.K.
    Malaysian Family Physician, 2018;13(1):45-48.
    MyJurnal
    Glomus tympanicum is a tumour classified under the group glomus tumours, and is also known
    as paragangliomas. It is thought to commonly occur in women in the fifth to sixth decades of life.
    Here, we report a case of a 77-year-old lady with multiple co-morbids and a diagnosis of glomus
    tympanicum presenting to us. Her symptoms included pulsatile tinnitus, and reduced hearing,
    and the management of the case was done with consideration for her underlying multiple comorbidities. This paper also describes the best modality of treatment for this patient with regard
    to her background history. The treatment goal was to improve her quality of life and control the
    disease.
    Matched MeSH terms: Comorbidity
  8. Fulltext Epilepsy and comorbidities: towards unravelling the common underlying mechanisms
    Paudel, Yam Nath, Lisgaras, Christos Panagiotis, Lim, Kheng Seang, Shaikh, Mohd. Farooq
    Neuroscience Research Notes, 2018;1(3):1-4.
    MyJurnal
    Epilepsy is a chronic neurological disorder characterized by the rapid occurrence of epileptic seizures affecting approximately 70 million people worldwide[1,2]. The quality of life of people with epilepsy (PWE) is challenged by a series of comorbidities that might include neurologic and neuropsychiatric disorders (cognitive decline, depression, anxiety, schizophrenia, and autism) as well as metabolic, cardiovascular and respiratory diseases[3]. Neurobehavioral and other comorbidities might share a reciprocal and complex relationship with epileptogenesis and ictogenesis thus biomarkers of the former might be useful for the prediction of the latter and vice versa[4].
    Matched MeSH terms: Comorbidity
  9. Fulltext Risk Factors Associated With Medication Errors Among Patients Suffering From Chronic Disorders
    Rasool MF, Rehman AU, Imran I, Abbas S, Shah S, Abbas G, et al.
    Front Public Health, 2020;8:531038.
    PMID: 33330300 DOI: 10.3389/fpubh.2020.531038
    Introduction: Medication error is unintentional and can be reduced by reducing the risk factors. Patients suffering from chronic diseases are at an increased risk of medication errors. Objective: This work aims to assess the risk factors associated with medication errors among patients suffering from chronic disorders in hospitals of South Punjab, Pakistan. Methodology: Multiple logistic regression analysis was used to assess the impact of different risk factors on the prevalence of medication errors in patients suffering from chronic diseases. Results: A greater risk for the occurrence of medication errors was associated with age ≥60 years (odds ratio, OR = 1.9; 95% CI = 1.3-3.1; p = 0.001), overburdened healthcare system (OR = 2.2; 95% CI = 1.64-3.56; p < 0.000), number of prescribed drugs ≥5 (OR = 1.74; 95% CI = 1.02-2.64; p < 0.000), comorbidities (OR = 2.6; 95% CI = 1.72-3.6; p = 0.003), Charlson comorbidity index (OR = 1.31; 95% CI = 0.49-1.84; p = 0.004), and multiple prescribers to one patient (OR = 1.12; 95% CI = 0.64-1.76; p = 0.001). Conclusion: Older age, overburdened healthcare system, number of prescribed drugs, comorbidities, Charlson comorbidity index, and multiple prescribers to one patient are significant risk factors for the occurrence of medication errors.
    Matched MeSH terms: Comorbidity
  10. Fulltext Thirty-Day Morbidity and Mortality after Simultaneous Bilateral Total Knee Arthroplasty
    Tai, C.C., Tan, S.H., Misnan, N.A., Nam, H.Y., Choon, S.K.
    Malays Orthop J, 2008;2(1):38-43.
    MyJurnal
    The safety of simultaneous bilateral total knee arthroplasty (TKA) remains controversial. The objective of the current study was to investigate perioperative morbidity and mortality rates within 30 days of simultaneous bilateral TKA. A detailed analysis of medical, surgical and anaesthesia records of 183 consecutive patients who underwent total knee arthroplasty between 2002 and 2006 was performed. The mean age of the patients was 67.6 years old. More than 80% had one or more co-morbidities, but none of them had ASA score greater than class 2. The mean hospital stay was 10 days, and the mean surgical time 156 minutes. Less than half of the patients (42.6%) required blood transfusion. The rate of perimorbidity was 15.3 % and there was no mortality in this series. We believe that simultaneous bilateral total knee arthroplasty is a safe and cost effective option for our patients, provided that patients are selected and informed appropriately.
    Matched MeSH terms: Comorbidity
  11. Fulltext When males become victims – a case report
    Ek Zakuan Kalil, Tan, Susan M.K., Loh, Sit Fong, Norazlin Kamal Nor, Suzaily Wahab
    ASEAN Journal of Psychiatry, 2010;11(2):216-219.
    MyJurnal
    Objective: This case report highlights males as victims of sexual abuse, ascertain the factors that are associated with male sexual abuse and outline problems in management of sexual abuse with the presence of co morbidities. Methods: We report a case of sexual abuse in a 14 year old boy who has borderline mental retardation and ADHD. Results: The victim was
    traumatized due to the abuse. The perpetrator was not charged due to lack of evidence of the abuse and stigma. Conclusion: Sexual abuse that occurs in males can be influenced by multiple factors such as the presence of comorbidities. Strong awareness must be present in caregivers to prevent abuse in this population and to take appropriate and early action to effect the necessary intervention.
    Matched MeSH terms: Comorbidity
  12. Fulltext Co-morbid physical illness among long-stay patients in a psychiatric institution
    Mohamad Isa, M.F., Tan, C.L., Gill, J.S.
    Malaysian Journal of Psychiatry, 2010;19(2):1-7.
    MyJurnal
    About 60% of people with mental illness developed co-morbid medical and physical illness that invariably worsens their lives. However, most of the studies regarding this issue were done either in the out-patient or community settings, ignoring long stay inpatients. Locally, no data exists among long stay patients in psychiatric institutions. The aim of this retrospective study was to look at the prevalence of physical illness among long-stay patients and to compare the occurrence of physical illness before and after admission to the psychiatric institution. We found that 85 (63.4%) out of 134 subjects there was suffering with co-morbid physical and medical illnesses. There were 33 (24.6%) subjects with hyperlipidaemia, 22 (16.4%) subjects with hypertension and 17 (12.7%) subjects with diabetes. Approximately 75 (55.9%) subjects developed medical illness after admission. In conclusion, long-stay psychiatric patients are at a high risk of developing medical problems that tends to begin after admission to the psychiatric institution.
    Study site: Hospital Bahagia, Ulu Kinta, Perak, Malaysia
    Matched MeSH terms: Comorbidity
  13. Fulltext Interactions Between Psychiatric Disorder And Physical Illness
    Nor Zuraida, Z.
    Malaysian Journal of Psychiatry, 2009;18(2):1-2.
    MyJurnal
    The vital importance of the mental health of a nation for the overall well being of the population and socioeconomic development is increasingly recognized. In Malaysia, psychiatric disorders were responsible for 8.6% of the total Disability Adjusted Life Years and were ranked fourth as the leading cause of burden of disease by disease categories. More and more evidence shows that physical illnesses are strongly associated with psychiatric disorders. Those with physical illnesses have much higher risk of developing psychiatric disorders compared to that without. The mechanisms of co-morbidity of psychiatric and physical illness are complex. It is a two-way interaction and there are five different possible ways to describe this.
    Matched MeSH terms: Comorbidity
  14. Fulltext Should parental decision override best interest of a handicapped child? A case illustration in a Malaysian child with Down Syndrome
    Fashiham Taib, Nur Arzuar Abdul Rahim, Mohd Rizal Mohd Zain, Mohamad Ikram Ilias, Nik Mohd Rizal Mohd Fakri, Zabidi Azhar Hussin
    Education in Medicine Journal, 2015;7(1):67-71.
    MyJurnal
    The paper discusses on the complexity of the issues surrounding a patient with subluxation of cervical spine in a Down syndrome child. Several relevant issues are discussed including consent in a minor, conflicting decision making between parents and doctors, end-of-life issues, supporting handicapped child with minimal co-morbidities, community ethics, neglect of care by the caregiver and decision making after allowing zonal of parental discretion. Despite the difficulties surrounding parental actions, there are still ethical priorities which have to be considered individually to alleviate the suffering of the patients and the family members. Dealing with patients with chronic illnesses is a challenge for any medical doctors. The case warrants sensitive approach to allow appropriate respect for parental decision despite in disagreement with the clinical team. The term ‘zone of parental discretion’ refers to a controversial area of decision making; and has still many potential conflicts on day to day clinical cases, especially among the conservative society in the East Coast of Peninsular Malaysia.
    Matched MeSH terms: Comorbidity
  15. Fulltext Modified assertive community treatment (ACT) in the management of comorbid mental and physical illnesses: a case report
    Lai, M.H., Marhani, M.
    Malaysian Journal of Psychiatry, 2013;22(1):1-4.
    MyJurnal
    The holistic approach of assertive community treatment (ACT) may provide better care and lead to better outcomes in populations with difficult-to-treat comorbid mental and physical illnesses. This paper describes the complex issues in managing a person with multiple chronic medical illnesses who also
    had comorbid treatment-resistant depression and poor social support. The patient achieved improvement after the implementation of the therapeutic ingredients of ACT.
    Matched MeSH terms: Comorbidity
  16. Association between temporomandibular disorders and pubertal development: A systematic review
    Song YL, Yap AU, Türp JC
    J Oral Rehabil, 2018 Dec;45(12):1007-1015.
    PMID: 30125394 DOI: 10.1111/joor.12704
    The aim of this systematic review (SR) was to determine the association between temporomandibular disorders (TMDs) and pubertal development. Due to the inadequacy of the conventional PICO (Population, Interventions, Comparisons and Outcome) format used for intervention-based SRs, the Joanna Briggs Institute's guidelines for synthesising evidence related to associations with a focus on aetiology were adopted. A search of the PubMed and LIVIVO databases covering the period from January 1980 to May 2018 yielded four publications, which fulfilled the inclusion criteria. Analysis of articles based on the Pubertal Development Scale showed that TMD prevalence increases with pubertal development. Although no sex difference in TMD prevalence and diagnosis was observed, more females reported TMD anamnestic variables, including accounts of temporomandibular pain during pubertal maturity. The higher prevalence of depression and somatisation during pubertal development may contribute to more TMD symptom reporting in females. More prospective studies incorporating standardised methods for diagnosing TMDs and detecting comorbid psychosocial and somatic problems are desired to further elucidate the relationship between TMDs and pubertal development.
    Matched MeSH terms: Comorbidity
  17. Fulltext Gastro Oesophageal Reflux Disease Shadowing Anxiety Disorder Causing Prolonged Exposure to Proton Pump Inhibitor
    Tahir NSM, Zakaria R, Draman N
    Korean J Fam Med, 2019 Sep;40(5):348-350.
    PMID: 30477049 DOI: 10.4082/kjfm.18.0001
    Anxiety disorders are the most prevalent psychiatric disorders in the general population. The relationship between dyspepsia and particularly gastroesophageal reflux disease (GERD) and psychiatric comorbidity such as anxiety is poorly defined. However, GERD was noted to be strongly associated and often coincident in onset with generalized anxiety disorder in the community. In this paper, we report the case of an adult man who presented with severe weight loss and underlying GERD, and was later found to have an anxiety disorder as the cause of both.
    Matched MeSH terms: Comorbidity
  18. An Overview of the Psychodynamics of Addiction
    Alfonso CA
    Psychodyn Psychiatry, 2021;49(3):363-369.
    PMID: 34478324 DOI: 10.1521/pdps.2021.49.3.363
    The author provides an overview of the psychodynamics of addiction, diverging from outdated conceptualizations such as orality and regression, and emphasizing the clinical relevance of the self-medication hypothesis. Rado and Bion paved the way for Khantzian's self-medication hypothesis by describing the drug user's need to escape unpleasure and seek self- containment. The author reviews research corroborating the relevance of the self-medication hypothesis and other relevant constructs such as self-deceptive attempts at adaptation, inability to prioritize self-care or delay gratification, excessive hedonism and novelty seeking, and impulsivity. Adverse childhood experiences, abuse and neglect are known to cause epigenetic changes altering gene expression, which may endure throughout life and be transmitted intergenerationally. Effective psychotherapeutic interventions have the potential to reverse DNA methylation and other epigenetic changes triggered by trauma and co-morbid psychopathology. Lastly, this editorial also introduces the psychodynamically informed clinical recommendations of Baurer and Gottdiener, further described in separate articles in this issue of Psychodynamic Psychiatry.
    Matched MeSH terms: Comorbidity
  19. Quantifying Regional and Health Care Variations to Identify Ways to Improve Hemodialysis Service Quality and Survival Outcomes
    Jamal A, Babazono A, Li Y, Yoshida S, Fujita T, Kim SA
    Am J Med Qual, 2021 5 20;36(5):345-354.
    PMID: 34010165 DOI: 10.1097/01.JMQ.0000735484.44163.ce
    The authors examined variations in hemodialysis care and quantified the effect of these variations on all-cause mortality. Insurance claims data from April 1, 2017 to March 30, 2018 were reviewed. In total, 2895 hospital patients were identified, among whom 398 died from various causes. Controlling effects of the facility and secondary medical care areas, all-cause mortality was associated with older age, heart failure, malignancy, cerebral stroke, severe comorbidity, and the first and ninth centile of physician density. Multilevel analyses indicated a significant variation at facility level (σ22 0.27, 95% confidence interval: 0.09-0.49). Inclusion of all covariates in the final model significantly reduced facility-level variance. Physician density emerged as an important factor affecting survival outcome; thus, a review of workforce and resource allocation policies is needed. Better clinical management and standardized work processes are necessary to attenuate differences in hospital practice patterns.
    Matched MeSH terms: Comorbidity
  20. Fulltext Health-related quality of life of Kuwaiti adults living with diabetes
    Alowayesh MS, Aljunid SM, Aladsani A, Alessa T, Alattar A, Alroudhan D
    Front Public Health, 2023;11:1085928.
    PMID: 37033039 DOI: 10.3389/fpubh.2023.1085928
    Diabetes is known to compromise patients' health-related quality of life (HRQoL). It is important to understand the HRQoL of Kuwaiti nationals living with diabetes and identify factors that negatively affect it. This study included 1,182 Kuwaiti nationals with diabetes, aged 18-80 years. Patients' demographic and HRQoL information was collected using the EuroQol EQ-5D-5L instrument. Mean values for each EQ-5D subscale were worst for mobility (1.9) and pain/discomfort (1.8). Most patients reported having no problems in self-care (84.4%). Older adults were most likely to report severe problems with mobility (p < 0.001). Females were more likely to report severe problems with anxiety and depression than males (p < 0.006). The EQ visual analog scale (EQ VAS), which reports perceived overall health on a 0-100 scale, showed a mean of 74.7 (±19.6). Patients with comorbidities and/or complications perceived their health to be worse, with VAS scores significantly lower (p < 0.001). Other factors that negatively affected VAS scores were being female, obesity, insulin usage, and lower levels of education. In conclusion, patients with diabetes who have comorbidities and/or complications perceived their health to be worse. Further research is required to evaluate if current diabetes management interventions help improve patients' HRQoL.
    Matched MeSH terms: Comorbidity
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