METHODS: This was a parallel, open-label randomised controlled trial with participants recruited from psychiatric outpatient services of a teaching hospital in Kuala Lumpur and a secondary hospital in Melaka. Adults (≥18 years) diagnosed with major depressive disorder; capable of reading and understanding English or Bahasa Malaysia; prescribed with at least one antidepressant and owns a smart phone were subsequently randomly assigned (1:1) to receive treatment reminders (intervention) or standard treatment without reminders (control), using a computergenerated randomisation programme. The intervention group received two reminder categories: Outpatient appointment reminders (a day before appointment); and medication reminders (weekly basis). Participants were followed-up over two months. We utilised Montgomery- Asberg Depression Rating Scale (MADRS) to measure the severity of depression; and Brief Adherence Rating Scale (BARS) to assess medication adherence. Primary outcomes were outpatient attendance rates and medication adherence assessed at two months. Secondary outcomes included changes in depression severity within each group at two months; comparison of changes in depression severity between both groups; preferences of participants towards treatment reminders, and reasons for non-attendance among participants. This trial was registered with the National Medical Research Registry, NMRR-19-3466-52001.
RESULTS: Between February and April 2020, 183 participants were randomised to each group, of whom 179 reached study endpoint (91 [98.9%] of 92 in intervention group and 88 [96.7%] of 91 in control group). All recruited participants (n=183) were analysed using intention-to-treat approach. At two months, intervention group has significantly higher outpatient attendance rates (76.8%) than control group (56.4%) (p=0.002), and reported higher medical adherence percentage (mean difference 23.1, [95%CI 0.4, 35.8]; p<0.001). There was also significant difference in the MADRS score change between both groups (mean difference 3.4, [95%CI 0.4, 6.3]; p=0.025). Treatment reminders preferences among participants varied; forgetfulness was the most commonly reported reason (53%) for missing outpatient appointments.
CONCLUSION: Reminders through mobile messaging applications significantly improved outpatient attendance and medication adherence among patients with depression. Our findings support the use of messaging apps for treatment reminders in psychiatric outpatient settings. However, concerns regarding confidentiality require careful measures to be taken.
METHODS: A cross-sectional study was conducted involving patients aged ≥ 13 years with AD who fulfilled the Hanifin and Rajka diagnostic criteria. These patients were recruited from Hospital Queen Elizabeth, Kota Kinabalu and Hospital Kuala Lumpur between January 2020 to March 2021. Assessment instruments used were Scoring for Atopic Dermatitis (SCORAD), Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS).
RESULTS: Of the 217 participants, 75 (34.6%) had mild eczema, 116 (53.5%) moderate eczema and 26 (12.0%) severe eczema with a mean SCORAD score of 30.4 (standard deviation [SD] = 4.70). Twenty-six (12.0%) and 17 (7.8%) had anxiety and depression, respectively. Patients with moderate to severe disease reported higher HADS-A (HADS-anxiety component), HADS-D (HADS-depression component), POEM, DLQI, itch, sleep loss and skin pain scores (p < 0.001 for all). Severe sleep loss (adjusted odd ratio [AOR] 12.41, p < 0.001) and hospitalisation in the past year (AOR 6.44, p = 0.004) were significant predictors for anxiety whereas those aged 41 to 60 (AOR 10.83, p = 0.020), having severe skin pain (AOR 6.12, p = 0.028), DLQI ≥ 10 (AOR 5.27, p = 0.002) and history of hospitalisation in the past year (AOR 12.73, p = 0.002) had increased risk for depression.
CONCLUSION: The prevalence of anxiety was 12.0% while depression was 7.8% in our cohort. AD renders a significant burden on mental health and QOL with a higher impact on those with more severe disease. The use of screening tools such as HADS and DLQI for assessment of mental health and QOL should be considered to address the multidimensional burden of AD.
METHODS: The questionnaire was developed in two stages: item development and scale development. Two forms of validity evidence were applied, which were content validity index (CVI) and face validity index (FVI), to estimate the content validity, response process and internal structure of the tool. This cross-sectional study was conducted among premarital young adults in Kota Bharu, Kelantan. The questionnaire assessed perceptions and attitudes toward IPV on six related components, which were its forms, causes, impacts, supports, acceptance and willingness to disclose.
RESULTS: CVI values for both perceptions and attitudes domains were more than 0.83. Five of the components have few items with low agreement by experts, hence those items were dropped. FVI values for the six domains among premarital young adults were at least 0.83, thus all these items were retained. The final result of development of this questionnaire were 64 items for perceptions and 23 items for attitudes, with five-Likert scale response option.
CONCLUSION: The newly developed tool, named as MYPAIPVQ, is valid based on content validity and face validity to assess perceptions and attitudes toward intimate partner violence among premarital young adults. Before it can be used, further validation studies should be conducted to determine its psychometric properties.
METHODS: An observational controlled study comparing neonatal respiratory morbidities before and after the single dose 12mg dexamethasone was implemented in our obstetrics and gynaecology centre for term elective caesarean section deliveries. We included singleton pregnancies from 37+0 to 38+6 weeks undergoing elective caesarean section into our study. A total of 674 patients fulfilled the inclusion criteria and were recruited. We compared the rates and duration of admission to neonatal intensive care unit, the need for mechanical ventilation and the rate of transient tachypnoea of the newborn in the first half of 2019 without IM dexamethasone injections against the second half of the year when a single dose IM dexamethasone was given.
RESULTS: IM dexamethasone injection did not show any significant benefit with regards to reducing the admission to neonatal care (OR 0.97, p- value 0.69), admission to neonatal intensive care unit (OR 0.91, p- value 0.80), the need for mechanical ventilation (OR 0.98, p- value 0.95), and the incidence of transient tachypnoea of the newborn (OR1.01, p- value 0.96). There was also no significant difference for the duration of admission in the neonatal intensive care unit for both groups (p- value 0.17).
CONCLUSIONS: This study showed that there was no significant benefit gained from the lower dose antenatal corticosteroids for term elective caesarean section deliveries and considering that there have been long term harmful consequences demonstrated from the higher dose of antenatal corticosteroids at term, this practice should therefore be discontinued until a larger study is done to refute these findings. The use of such dexamethasone should only be a viable option in a research setting.
METHODS: This study involved forward and back translation method. The translated questionnaire was then pretested and piloted among 10 parents and 50 participants, respectively. The procedure was repeated using the same questionnaire to evaluate the test-retest reliability.
RESULTS: The ERC-Malay (ERC-M) has excellent qualitative and quantitative measurements in both item-level content validation index (I-CVI) and scale-level content validation index (S-CVI). In addition, the ERC-M demonstrated good internal consistency from Cronbach's alpha and test-retest reliability based on the Intraclass Correlation Coefficient (ICC) in all domains.
CONCLUSION: ERC-M can potentially be used as a tool to evaluate emotion for the population with emotional dysregulation issue, such as autism spectrum disorder.
METHODS: The preliminary version of IPM3P that is used to investigate the perception of Muslim adults with hearing impairment towards Islamic understanding and practice has been tested in this study. The preliminary version of IPM3P consists of three domains (obligation, practice, and difficulty) with 59 items in total. Four phases of validity and reliability testing involved were: i) Content validation, ii) Pretesting, face validity and proofreading, iii) Pilot study, and iv) Psychometric evaluation.
RESULTS: The final version of IPM3P consists of 36 items. The findings from the present study suggest that the final version of IPM3P has excellent psychometric properties manifested by: i) good content validity, ii) excellently pretested, iii) good face validity, iv) good construct validity shown by principal component analysis and convergent validity, and v) good discriminant validity showed by divergent validity.
CONCLUSION: IPM3P shows good potential to be used as a tool in investigating perception of Muslim adults towards Islamic understanding and practice.
METHODS: DLBCL patients at HPP who underwent 18F-FDG PET/CT and BMB were recruited between November 2016 to February 2018. Two reviewers, blinded to the BMB results, evaluated the 18F-FDG PET/CT scans to identify and characterize BMI. The diagnostic performance of 18F-FDG PET/CT was calculated using the BMB histopathological evaluation as the reference standard.
RESULTS: A total of 21 DLBCL patients were enrolled. Seven patients demonstrated BMI on PET/CT (3 with multifocal uptake were concordant with BMB). Fourteen scans were negative for BMI and concordant with BMB. The sensitivity and specificity of 18F-FDG PET/CT scans for detecting BMI is 100% and 77.8%, respectively.
CONCLUSION: 18F-FDG PET/CT is excellent for ruling-out the presence of BMI. A negative 18F-FDG PET/CT scan for BMI can preclude the need for BMB in certain cases. Although 18F-FDG PET/CT can accurately detect BMI in multifocal pattern of infiltration, it cannot fully replace BMB, which is still considered as the gold standard for evaluating BMI in DLBCL.