Displaying publications 61 - 80 of 305 in total

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  1. Depression and coping in adults undergoing dialysis for end-stage renal disease
    Ibrahim N, Kong NCT, Desa A, Razali R
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:35-40.
    PMID: 23857835 DOI: 10.1111/appy.12042
    Introduction: Research on depression in local patients with end-stage renal disease (ESRD) is sparse. Thus, this study aims to examine the frequency and severity of depression among ESRD patients and relate depression with their coping skills.
    Methods: A cross-sectional study using universal sampling method was conducted at several dialysis centers in Kuala Lumpur, Selangor and Johor, Malaysia. The Beck Depression Inventory II (BDI-II) and the Brief COPE scale were used to measure depression and coping skill, respectively.
    Results: The study involved 274 ESRD patients, comprising of 183 hemodialysis and 91 continuous ambulatory peritoneal dialysis patients. The result showed that 21.1% of the patients experienced moderate to severe depression. Several components of coping skill were associated with depression. However, only two components in the Brief COPE (behavioral disengagement and self-blame) were identified as predictors.
    Discussion: This study showed that depression is common in ESRD patients and is related to the types of coping skills adopted by patients. Hence, this study provides some insight into ESRD patients with depression. Appropriate counseling should be given to these patients to empower them to cope with the illness so as to enhance their quality of life.
  2. Measurement of ²³⁸U,²³²Th and ⁴⁰K in boreholes at Gosa and Lugbe, Abuja, north central Nigeria
    Maxwell O, Wagiran H, Ibrahim N, Lee SK, Sabri S
    Radiat Prot Dosimetry, 2013 Dec;157(2):271-7.
    PMID: 23754832 DOI: 10.1093/rpd/nct140
    The purpose of this project is to evaluate the suitability of different sites as locations for obtaining underground water for consumption. The analysis of ²³⁸U, ²³²Th and ⁴⁰K from rock samples from each layer of borehole at a depth of ∼50 m at Site A borehole, S3L1-S3L6 in Gosa and 40 m at Site B borehole, S4L1-S4L5 in Lugbe, Abuja, north central Nigeria is presented. The gamma-ray spectrometry was carried out using a high-purity germanium detector coupled to a computer-based high-resolution multichannel analyzer. The activity concentrations at Site A borehole for ²³⁸U have a mean value of 26 ± 3, ranging from 23 ± 2 to 30 ± 3 Bq kg⁻¹, ²³²Th a mean value of 63 ± 5, ranging from 48 ± 4 to 76 ± 6 Bq kg⁻¹ and ⁴⁰K a mean value of 573 ± 72, ranging from 437 ± 56 to 821 ± 60 Bq kg⁻¹. The activity concentrations at Site B borehole for ²³⁸U have a mean value of 20 ± 2, ranging from 16 ± 2 to 23 ± 2 Bq kg⁻¹, ²³²Th a mean value of 46 ± 4, ranging from 43 ± 4 to 49 ± 4 Bq kg⁻¹, ⁴⁰K a mean value of 915 ± 116 and ranging from 817 ± 103 Bq kg⁻¹ to 1011 ± 128 Bq kg⁻¹. It is noted that the higher activity concentrations of ²³²Th and ²³⁸U are found in Site A at Gosa. Site B has lower radioactivity, and it is recommended that both sites are suitable for underground water consumption.
  3. Fulltext Stroke care in Pusat Perubatan UKM; the actual picture
    Sahathevan R, Wan Yahya WNN, Tan HJ, Mohd Ibrahim N
    Med J Malaysia, 2013 Apr;68(2):187-8.
    PMID: 23629577
  4. Fulltext Effectiveness of peer-led education on knowledge, attitude and risk behavior practices related to HIV among students at a Malaysian public university--a randomized controlled trial
    Ibrahim N, Rampal L, Jamil Z, Zain AM
    Prev Med, 2012 Nov;55(5):505-10.
    PMID: 22982947 DOI: 10.1016/j.ypmed.2012.09.003
    OBJECTIVE: Develop, implement and evaluate the effectiveness of a peer-led education program related to HIV/AIDS among university students.
    METHOD:
    DESIGN: randomized controlled trial with 276 university students at Faculty of Medicine and Health Sciences University Putra Malaysia (UPM), Serdang in 2011.
    INTERVENTION: A peer-led education program on HIV prevention by university students.
    OUTCOME: differences in knowledge, attitude and risk behavior practices related to HIV between baselines, immediate follow-up after intervention and after three months.
    RESULTS: Significant improvement in sound knowledge in the intervention group as compared to the control group (Odds ratio, 1.75; 95% CI 1.01, 3.00; p=0.04) and improvement in good attitude related to HIV (Odds ratio 2.22; 95% CI 1.37, 3.61; p=0.01). The odds of high substance risk behavior was significantly reduced in the intervention group as compared to the control group (Odds ratio 0.07; 95% CI 0.02, 0.34; p=0.01). The association between good knowledge and intervention was modified by the different time points (baseline, immediately after intervention and 3 months after intervention), ethnicity and gender.
    CONCLUSION:
    Peer-led education program in HIV prevention improves knowledge, attitude and substance risk behavior. Changes in sexual risk behavior may require a longer follow-up.
  5. Uncommon radiological findings: a case report
    Tandjung YR, Hong CP, Nambiar P, Ibrahim N
    Int Dent J, 2007 Jun;57(3):173-6.
    PMID: 17695738
    A 50-year-old friendly and attractive Chinese lady was examined by the Primary Care Unit, Faculty of Dentistry, University of Malaya. Her requests for treatment included implants and crowns. Two periapical radiographs of teeth 16 and 48 were taken to aid diagnosis. Interestingly, pin-like radio-opaque objects were found over the crown of the impacted tooth 15 and also tooth 17. These objects were initially interpreted as silver points or radiographic artifacts but further investigation employing panoramic radiography revealed the distribution of more radio-opaque objects in the orofacial region. Based on a review of the literature and the opinion of experienced radiology and oral surgery lecturers, these foreign radio-opaque objects were diagnosed as susuks or charm needles.
  6. Fulltext The effects of targeted deliveries of lovastatin and tocotrienol on ossification-related gene expressions in fracture healing in an osteoporosis rat model
    Ibrahim N', Mohamed N, Soelaiman IN, Shuid AN
    Int J Environ Res Public Health, 2015 Oct;12(10):12958-76.
    PMID: 26501302 DOI: 10.3390/ijerph121012958
    Osteoporotic drugs are used to prevent fragility fractures, but their role in fracture healing still remains unknown. Thus, alternative agents with suitable mode of delivery are needed to promote fracture healing. This study was performed to investigate the effects of direct deliveries of lovastatin and tocotrienol to fracture sites on ossification-related gene expression in fracture healing in a postmenopausal osteoporosis model. Forty-eight Sprague Dawley female rats were divided into six groups. Group I comprised the sham-operated rats, while Groups II-VI were ovariectomized rats. After 8 weeks, the right tibiae of all rats were fractured and stabilized. Group I and Group II were given two single injections of lovastatin and tocotrienol carriers. Group III was given an estrogen preparation at 64.5 µg/kg daily via oral gavages. Group IV was injected with lovastatin particles (750 µg/kg), while Group V was injected with tocotrienol particles (60 mg/kg). Group VI received two single injections of 750 µg/kg lovastatin particles and 60 mg/kg tocotrienol particles. After 4 weeks, the gene expressions were measured. Group VI showed significantly higher gene expressions of osteocalcin, BMP-2, VEGF-α, and RUNX-2 compared to Group II. In conclusion, combined treatment of lovastatin and tocotrienol upregulated the expression of genes related to fracture healing.
  7. Patient-reported outcome and its association with attachment type and bone volume in mandibular implant overdenture
    Khalid T, Yunus N, Ibrahim N, Elkezza A, Masood M
    Clin Oral Implants Res, 2017 May;28(5):535-542.
    PMID: 26989853 DOI: 10.1111/clr.12831
    OBJECTIVE: To determine oral health-related quality of life (OHRQoL) and denture satisfaction (DS) in patients provided with mandibular implant-supported overdentures (ISOD) retained by two different attachment types, and the association of mandibular bone volume with the change in patient-reported outcome, before and after implant treatment.

    MATERIAL AND METHODS: Thirty-four patients (mean age 60.70  ±  8.7 years) received telescopic crown or locator attachments for ISOD and completed OHIP-14 (Malaysian version) and DS questionnaires, at baseline (T0 ) with new conventional complete dentures (CCD) and 3 months (T1 ) and 3 years (T2 ) after ISOD conversion. Mandibular bone volume was calculated from cone beam computed tomography (CBCT) datasets using Mimics software. Mean changes (MC) in OHIP-14 and DS at intervals were analyzed using the Wilcoxon signed-rank test and effect size (ES). The association of bone volume, implant attachment type, and other patient variables with the change in OHIP-14 and DS were determined using multivariate linear regression analysis.

    RESULTS: The MC in OHIP-14 and DS scores from T0 to T1 and T2 showed significant improvement with moderate and large ES, respectively. Regression analyses for the change in OHIP-14 score from T0 to T2 showed significant association with implant attachment type (P = 0.043), bone volume (P = 0.004), and baseline OHIP-14 (P = 0.001), while for DS, the association was only significant with baseline DS score (P = 0.001).

    CONCLUSION: Improvement in patients' OHRQoL and satisfaction with ISOD was associated with their baseline ratings. Mandibular bone volume had a stronger association for improvement in OHRQoL compared to type of attachment.

  8. Fulltext Arterial stiffness during acute and recovery phases of children with rheumatic fever
    Ibrahim NN, Jaafar H, Rasool AH, Wong AR
    Med J Malaysia, 2016 02;71(1):23-5.
    PMID: 27130739
    Acute rheumatic fever (ARF) is associated with systemic inflammation and arterial stiffness during the acute stage. It has not been reported if arterial stiffness remains after recovery. The aim of this study was to determine the arterial stiffness during acute stage and 6 months after recovery from ARF. Arterial stiffness was assessed by carotid femoral pulse wave velocity (PWV) in 23 ARF patients during the acute stage of ARF and 6 months later. Simultaneously, erythrocyte sedimentation rate (ESR) and other anthropometric measurements were taken during both stages. There was a significant reduction in PWV; 6.5 (6.0, 7.45) m/s to 5.9 (5.38, 6.48) m/s, p=0.003 6 months after the acute stage of ARF. Similarly, ESR was also significantly reduced from 92.0 (37.5, 110.50) mm/hr to 7.0 (5.0, 16.0) mm/hr, p=0.001. In conclusion, arterial stiffness improved 6 months after the acute stage with routine aspirin treatment; this correlates well with the reduction in systemic inflammation.
  9. Fulltext Relations of Bedtime Mobile Phone Use to Cognitive Functioning, Academic Performance, and Sleep Quality in Undergraduate Students
    Ragupathi D, Ibrahim N, Tan KA, Andrew BN
    Int J Environ Res Public Health, 2020 09 29;17(19).
    PMID: 33003445 DOI: 10.3390/ijerph17197131
    The present cross-sectional study examined the relations of bedtime mobile phone use to cognitive functioning, academic performance, and sleep quality in a sample of undergraduate students. Three hundred eighty-five undergraduate students completed a self-administered questionnaire containing sociodemographic variables, bedtime mobile phone use, the Pittsburgh Sleep Quality Index, and the Cambridge Neuropsychological Test Automated Battery (attention and verbal memory). At bivariate level, increased scores in bedtime mobile phone use were significantly correlated with decreased scores in academic performance and sleep quality. Our multivariate findings show that increased scores in bedtime mobile phone use uniquely predicted decreased scores in academic performance and sleep quality, while controlling for gender, age, and ethnicity. Further untangling the relations of bedtime mobile phone use to academic performance and sleep quality may prove complex. Future studies with longitudinal data are needed to examine the bidirectional effect that bedtime mobile phone use may have on academic performance and sleep quality.
  10. Fulltext Effectiveness of Online Mindfulness-Based Intervention (iMBI) on Inattention, Hyperactivity-Impulsivity, and Executive Functioning in College Emerging Adults with Attention-Deficit/Hyperactivity Disorder: A Study Protocol
    Pheh KS, Tan KA, Ibrahim N, Sidik SM
    Int J Environ Res Public Health, 2021 01 30;18(3).
    PMID: 33573341 DOI: 10.3390/ijerph18031257
    Attention-deficit/hyperactivity disorder (ADHD), a common neurodevelopmental disorder, often persists into adulthood. In Malaysia, the prevalence rate of hyperactivity symptoms is highest among Chinese Malaysians. There are limited evidence-based treatment options targeting the core symptoms of ADHD, as well as executive functioning. In addition, conventional psychotherapeutic approaches for adults with ADHD have been found to be highly labor-intensive. The present study will evaluate the effectiveness of an online mindfulness-based intervention to reduce inattention and hyperactivity-impulsivity and improve executive functioning among Chinese Malaysian college emerging adults with ADHD. Informed by established literature, we will design an 8-week online mindfulness-based intervention (i.e., iMBI). We will conduct a two-arm randomized controlled trial comparing an iMBI plus treatment-as-usual group (n = 54) and an enhanced treatment-as-usual control group (n = 54). Outcome measures of inattention, hyperactivity-impulsivity, and executive functioning will be collected at baseline, immediately post-intervention, and 1-month post-intervention. The findings of the present study will not only demonstrate the implementation of iMBI as a new treatment modality but also inform practitioners on the effectiveness of iMBI in reducing the burden of adults living with ADHD.
  11. Paradoxical worsening of chest radiographs secondary to immune reconstitution syndrome (IRIS) in a patient with advanced HIV infection and Rhodococcus pneumonia
    Koh KC, Ibrahim NM, Ong SCL
    Med J Malaysia, 2020 03;75(2):164-166.
    PMID: 32281599
    We present a rare case of post-antiretroviral therapy (ART) paradoxically worsening of radiological findings in a patient with advanced HIV-infection on treatment for Rhodococcus pneumonia who was misdiagnosed with pulmonary tuberculosis. Despite clinical improvement, serial chest radiographs showed deteriorations a month after starting ART. This was attributed to Immune Reconstitution Inflammatory Syndrome (IRIS) which spontaneously resolved without any treatment.
  12. Improving multicultural parenting program for children with emotional and behavioral problems: An integrated review
    Masiran R, Ibrahim N, Awang H, Lim PY
    Asian J Psychiatr, 2020 Jun;51:101851.
    PMID: 31711780 DOI: 10.1016/j.ajp.2019.101851
    Children with emotional and behavioral problems are often managed using medications or behavioral therapy, but in some countries, there is no structured parenting intervention to equip parents from different cultural backgrounds with adequate parenting skills to help these children. This paper aims to synthesize key findings from previous research on multicultural parenting programs and produce a comprehensive integrated view by looking into three separate themes: effective multicultural parenting programs, ethnocultural groups and cultural adaptation process. Literature search through Scopus and Google Scholar from 1999 to 2019 was conducted using the terms "effective parenting program", "effective parenting intervention", "effective multicultural parenting program", "effective multicultural parenting intervention", "multicultural parenting program", "multicultural parenting intervention", "parenting program and ethnic groups", "parenting intervention and ethnic groups", "adapted parenting program", "adapted parenting intervention", "cultural adaptation of parenting program'' and "cultural adaptation of parenting intervention". By applying the "Literature Review Synthesis Process", authors conducted cross-analysis, integrated possibilities, and prioritized the synthesized information gearing towards highly probable solutions for improving multicultural parenting programs to manage emotional and behavioral problems in children better. Development of a culturally fit parenting intervention and its implications on existing parenting programs are also discussed. The findings highlight the need 1) to engage with ethnocultural groups of parents during development of a new multicultural parenting program, and 2) to incorporate specific measures for engaging with parents during multicultural parenting program implementation. This paper contributes in acknowledging cultural components in future parenting intervention programs. Finally, recommendations are made for future directions of research.
  13. Fulltext Frequency of Cognitive Impairment Among Malaysian Elderly Patients Following First Ischaemic Stroke-A Case Control Study
    Mohamed Fuad Z, Mahadzir H, Syed Zakaria SZ, Mohamed Ibrahim N
    Front Public Health, 2020;8:577940.
    PMID: 33282811 DOI: 10.3389/fpubh.2020.577940
    Background: Stroke is highly prevalent globally and is an important cause of cognitive impairment and dementia. Aims: We determined the frequency of post-stroke cognitive impairment (PSCI) at 1, 3, and 6 months among patients with first clinical ischemic stroke compared to risk and age-matched controls. Methods: This study involved 32 cases and 32 controls, and was conducted over 6 months. Cases were inpatients aged >60 with first clinical ischemic stroke. Controls were age-matched subjects without prior stroke. Montreal Cognitive Assessment (MoCA) was performed in all patients at 1, 3, and 6 month post stroke. A MoCA score of <26 was used for mild PSCI and <22 for moderate PSCI (post stroke dementia). Results: Post-stroke dementia was detected in 12 patients (37.5%) at 1st month, in 13 (40.6%) at 3rd month and 15 (48.4%) at 6th months. Mild PSCI was present in 7 patients (21.6%) at 1 month, 16 patients (50%) at 3 months, and 15 patients (48%) at 6 months. The odds ratio (OR) for post-stroke dementia was 3.2 (95%CI 0.98-10.68; p = 0.05) at 1 month; 3.69(95% CI 1.13-12.11; p = 0.031) at 3 months, and 4.88 (95% CI 1.49-15.99; p = 0.009) at 6 months. Years of education was an independent predictor for dementia (OR 0.60; p = 0.046). The OR for post-stroke dementia at 6th month was 7.23 with education level adjusted (95%CI 1.46-35.86, p = 0.015). Conclusion: The frequency of PSCI was high as early as 1 month after stroke. Stroke alone conferred a 7.2 times risk for post-stroke dementia compared to controls.
  14. Cardiovascular risk factors of Alzheimer's disease and other neurocognitive disorders in Malaysia
    Ibrahim B, Suppiah S, Piersson AD, Razali RM, Mohamad M, Abu Hassan H, et al.
    Med J Malaysia, 2021 05;76(3):291-297.
    PMID: 34031325
    INTRODUCTION: Risk factors for cardiovascular disease (CVD) have been increasingly implicated in the development of dementia but little is known about the effects in a Malaysian population. We aimed to determine the interaction between sociodemographic and CVD risk factors among the dementia and mild cognitive impairment (MCI) patients in Malaysia.

    MATERIALS AND METHODS: A cross-sectional study was conducted in the memory clinic at Hospital Kuala Lumpur (HKL). Medical records data from 2014 to 2019 were extracted. Mini Mental State Examination (MMSE) test was used to assess the neurocognitive function of patients.

    RESULTS: A total of 298 patients (30 MCI, and 268 dementia) were evaluated, with dementia patients consisting of 78 Alzheimer's disease (AD), 93 Vascular dementia (VaD), 94 Mixed dementia, 2 early-onset Alzheimer's disease (EOAD) and 1 Logopenic Progressive Aphasia type of AD (LPA). MCI and dementia were significantly associated with a history of CVD, particularly stroke (p=0.023).

    CONCLUSION: Given that stroke significantly predicted the risk of developing vascular dementia among the patients in a central Malaysian population, lifestyle modifications are recommended to alleviate these risk factors of CVD.

  15. Fulltext The integron prevalence of extended-spectrum beta-lactamase producing enterobacterial isolates in a Malaysian teaching hospital
    Ibrahim N, Wajidi MF, Yusof MY, Tay ST
    Trop Biomed, 2011 Dec;28(3):668-71.
    PMID: 22433898 MyJurnal
    The increased frequency of antibiotic resistance is known to be associated with the dissemination of integrons in the Enterobacteriaceae. This study determined the prevalence and type of integrons amongst 160 extended-spectrum beta-lactamase producing enterobacterial isolates kept in our culture collection. Integrons were detected in 98(61.3%) isolates, including 28(62.2%) Escherichia coli, 34(64.2%) Klebsiella spp., 27(61.4%), Enterobacter spp. and 9(50.0%) Citrobacter spp. investigated in this study. Restriction analysis of the integron gene fragments revealed that class I integron was the principal integron detected in 92(57.5%) of our isolates. Class II integron was detected in 6(3.8%) of our isolates, while no class III integron was detected in this study. The high rates of integron prevalence particularly of the class I integron in the E. coli and Klebsiella spp. concur with previous studies in other geographical regions. The higher (≥50%) integron prevalence of Citrobacter and Enterobacter isolates comparing to previous studies suggests the potential of these isolates as sources for dissemination of resistance determinants. The finding in this study serves as a basis for further study on the antibiotic resistance mechanisms of enterobacterial species in this teaching hospital.
  16. Fulltext Health System Governance for the Integration of Mental Health Services into Primary Health Care in the Sub-Saharan Africa and South Asia Region: A Systematic Review
    Abd Rahim A, Abdul Manaf R, Juni MH, Ibrahim N
    Inquiry, 2021 7 20;58:469580211028579.
    PMID: 34275346 DOI: 10.1177/00469580211028579
    Governance has been highlighted as an important building block underpinning the process of mental health integration into primary healthcare. This qualitative systematic review aims to identify the governance issues faced by countries in the Sub-Saharan Africa and South Asia Region in the implementation of integrated primary mental healthcare. PRISMA guideline was used to conduct a systematic search of relevant studies from 4 online databases that were filtered according to inclusion and exclusion criteria. Using the Critical Appraisal Skills Program (CASP) Qualitative Checklist, a quality appraisal of the selected articles was performed. By drawing upon institutional theory, data was extracted based on a pre-constructed matrix. The CERQual approach synthesized evidence and rank confidence level as low, moderate or high for 5 key findings. From 567 references identified, a total of 8 studies were included. Respondents were policymakers or implementers involved in integrated primary mental healthcare from the national, state, and district level. Overall, the main governance issues identified were a lack of leadership and mental health prioritization; inadequate financing and human resource capacity; and negative mental health perceptions/attitudes. The implication of the findings is that such issues must be addressed for long-term health system performance. This can also improve policymaking for better integration of primary mental health services into the health systems of countries in the Sub-Saharan and South Asia region.
  17. Predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge
    Johari N, Manaf ZA, Ibrahim N, Shahar S, Mustafa N
    Clin Interv Aging, 2016;11:1455-1461.
    PMID: 27799751
    PURPOSE: Diabetes mellitus is prevalent among older adults, and affects their quality of life. Furthermore, the number is growing as the elderly population increases. Thus, this study aims to explore the predictors of quality of life among hospitalized geriatric patients with diabetes mellitus upon discharge in Malaysia.

    METHODS: A total of 110 hospitalized geriatric patients aged 60 years and older were selected using convenience sampling method in a cross-sectional study. Sociodemographic data and medical history were obtained from the medical records. Questionnaires were used during the in-person semistructured interviews, which were conducted in the wards. Linear regression analyses were used to determine the predictors of each domain of quality of life.

    RESULTS: Multiple regression analysis showed that activities of daily living, depression, and appetite were the determinants of physical health domain of quality of life (R(2)=0.633, F(3, 67)=38.462; P<0.001), whereas depression and instrumental activities of daily living contributed to 55.8% of the variability in psychological domain (R(2)=0.558, F(2, 68)=42.953; P<0.001). Social support and cognitive status were the determinants of social relationship (R(2)=0.539, F(2, 68)=39.763; P<0.001) and also for the environmental domain of the quality of life (R(2)=0.496, F(2, 68)=33.403; P<0.001).

    CONCLUSION: The findings indicated different predictors for each domain in the quality of life among hospitalized geriatric patients with diabetes mellitus. Nutritional, functional, and psychological aspects should be incorporated into rehabilitation support programs prior to discharge in order to improve patients' quality of life.

  18. Fulltext Cross-Cultural Adaptation and Validation of the Attitudes Toward Suicide Questionnaire Among Healthcare personnel in Malaysia
    Siau CS, Wee LH, Ibrahim N, Visvalingam U, Wahab S
    Inquiry, 2017 01 01;54:46958017707295.
    PMID: 28486042 DOI: 10.1177/0046958017707295
    Understanding attitudes toward suicide, especially among healthcare personnel, is an important step in both suicide prevention and treatment. We document the adaptation process and establish the validity and reliability of the Attitudes Toward Suicide (ATTS) questionnaire among 262 healthcare personnel in 2 major public hospitals in the Klang Valley, Malaysia. The findings indicate that healthcare personnel in Malaysia have unique constructs on suicide attitude, compared with the original study on a Western European sample. The adapted Malay ATTS questionnaire demonstrates adequate reliability and validity for use among healthcare personnel in Malaysia.
  19. Fulltext Optimizing the multidimensional aspects of the patient-physician relationship in the management of inflammatory bowel disease
    Chew D, Zhiqin W, Ibrahim N, Ali RAR
    Intest Res, 2018 10;16(4):509-521.
    PMID: 30369231 DOI: 10.5217/ir.2018.00074
    The patient-physician relationship has a pivotal impact on the inflammatory bowel disease (IBD) outcomes. However, there are many challenges in the patient-physician relationship; lag time in diagnosis which results in frustration and an anchoring bias against the treating gastroenterologist, the widespread availability of medical information on the internet has resulted in patients having their own ideas of treatment, which may be incongruent from the treating physicians' goals resulting in patient physician discordance. Because IBD is an incurable disease, the goal of treatment is to sustain remission. To achieve this, patients may have to go through several lines of treatment. The period of receiving stepping up, top down or even accelerated stepping up medications may result in a lot of frustration and anxiety for the patient and may compromise the patient-physician relationship. IBD patients are also prone to psychological distress that further compromises the patient-physician relationship. Despite numerous published data regarding the medical and surgical treatment options available for IBD, there is a lack of data regarding methods to improve the therapeutic patient-physician relationship. In this review article, we aim to encapsulate the challenges faced in the patient-physician relationship and ways to overcome in for an improved outcome in IBD.
  20. Earlier onset of motor complications in Parkinson's patients with comorbid diabetes mellitus
    Mohamed Ibrahim N, Ramli R, Koya Kutty S, Shah SA
    Mov Disord, 2018 12;33(12):1967-1968.
    PMID: 30427552 DOI: 10.1002/mds.27526
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