Displaying publications 61 - 80 of 165 in total

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  1. Fulltext Dietary patterns and risk of colorectal cancer: a systematic review of cohort studies (2000-2011)
    Yusof AS, Isa ZM, Shah SA
    Asian Pac J Cancer Prev, 2012;13(9):4713-7.
    PMID: 23167408
    OBJECTIVES: This systematic review of cohort studies aimed to identify any association between specific dietary patterns and risk of colorectal cancer (CRC). Dietary patterns involve complex interactions of food and nutrients summarizing the total diet or key aspects of the diet for a population under study.

    METHODS AND MATERIALS: This review involves 6 cohort studies of dietary patterns and their association with colorectal cancer. An exploratory or a posteriori approach and a hypothesis-oriented or a priori approach were employed to identify dietary patterns.

    RESULTS: The dietary pattern identified to be protective against CRC was healthy, prudent, fruits and vegetables, fat reduced/diet foods, vegetables/fish/poultry, fruit/wholegrain/dairy, healthy eating index 2005, alternate healthy eating index, Mediterranean score and recommended food score. An elevated risk of CRC was associated with Western diet, pork processed meat, potatoes, traditional meat eating, and refined grain pattern.

    CONCLUSION: The Western dietary pattern which mainly consists of red and processed meat and refined grains is associated with an elevated risk of development of CRC. Protective factors against CRC include a healthy or prudent diet, consisting of vegetables, fruits, fish and poultry.
  2. Fulltext Malay Version of Nijmegen Cochlear Implant Questionnaire and Quality of Life of Patients with Post-lingual Deafness
    Paul M, Abdullah A, Hashim ND, Ismail NFM, Shah SA
    Medeni Med J, 2023 Jun 20;38(2):128-139.
    PMID: 37338914 DOI: 10.4274/MMJ.galenos.2023.60980
    OBJECTIVE: The Nijmegen Cochlear Implant questionnaire (NCIQ) was used to gauge the quality of life (QOL) improvement among cochlear implant (CI) users who suffered from post-lingual deafness. This study aimed to determine the consistency and reliability of the Malay version of the Nijmegen Cochlear Implant questionnaire (NCIQ-M) and to report the QOL of patients using NCIQ-M.

    METHODS: This study has two phases: Phase I involves the translation of the NCIQ from English to Malay, followed by internal consistency and test-retest reliability assessment of the final version of NCIQ-M. Phase II involves QOL assessment of post-lingual deafness using NCIQ-M.

    RESULTS: Twenty CI users and 20 non-CI users answered the NCIQ-M. Test-retest reliability analysis of the NCIQ-M was performed using an intraclass correlation coefficient, achieving scores of more than 0.85. Internal consistency was analysed with Cronbach α of more than 0.70 in all subdomains. Scores between the two groups of subjects were analyzed using an independent sample t-test. Good internal consistency, intraclass correlation, and test-retest reliability were obtained. Scores in all six subdomains of the NCIQ-M are significantly higher in the CI user group than in the non-CI user group.

    CONCLUSIONS: The NCIQ-M is a consistent and reliable subjective questionnaire to determine the QOL of CI users concerning physical, psychological, and social functioning.

  3. Factors Affecting Early and Late Cochlear Implantation
    Mansor WNW, Abdullah A, See GB, Umat C, Shah SA
    Int Tinnitus J, 2023 Dec 04;27(1):34-39.
    PMID: 38050882 DOI: 10.5935/0946-5448.20230006
    OBJECTIVES: This study aimed to describe the factors affecting early and late cochlear implantation.

    MATERIALS AND METHODS: A total of 159 patients from the Hospital Canselor Tuanku Muhriz (HCTM) Cochlear Implant Programme were recruited in this retrospective cross-sectional study. All paediatric Cochlear Implant (CI) recipients with pre-lingual deafness were included in this retrospective study. The study was conducted from January 2019 until December 2020. The pre-lingual cochlear implant recipients' data were analysed based on demographics and interval from diagnosis to hearing aid fitting and implantation. The association between the dependent variables with early and late cochlear implantation was compared.

    RESULTS: A total of 83 (52%) patients were female. Chinese race constituted most of the patients, which was 90/159 (57%). The majority were from middle-income families (M40); 89 (56%). The most common aetiology of Hearing Loss (HL) was idiopathic; 139 (87%), followed by intrauterine infections, which comprised of congenital CMV; 8 (5%) and congenital Rubella; 1 (1%) and nonspecific intrauterine infection 2 (1%). The relationship between the universal neonatal hearing screening and the interval between diagnosis to implantation was significant (p=0.033). Other variables were not significant.

    CONCLUSION: UNHS was a significant factor contributing to early and late implantation. The median age of diagnosis of hearing loss was 18 months (interquartile range; 15); the age of CI was 34 months (interquartile range; 24); the interval from diagnosis to hearing aid was 2 months (interquartile range; 5), and the interval from diagnosis to CI was 16 months (interquartile range; 14).

  4. Evaluation of the Efficacy of Probiotics (MCP® BCMC® Strains) Treating Constipation in Elderly Patients with Multiple Chronic Co-Morbidities: A Randomized Control Trial
    Ghafar MYA, Yaakup H, Ali RAR, Shah SA
    J Nutr Health Aging, 2020;24(10):1066-1072.
    PMID: 33244562 DOI: 10.1007/s12603-020-1494-1
    OBJECTIVES: To evaluate the impact of a microbial cell preparation (MCP®) (Hexbio®; comprising MCP® BCMC® strains) on stool frequency, consistency, and constipation-related symptoms in elderly patients with multiple chronic medical conditions.

    DESIGN: Randomised control trial.

    SETTING: Medical outpatient and medical/surgical in-patient unit in single tertiary center.

    PARTICIPANT: Patients aged ≥ 60 years who experience constipation and have multiple chronic medical conditions.

    METHODS: Participants with constipation were blindly randomized into either a treatment (MCP® BCMC® strains) or a placebo group. The treatment was administered twice daily.

    MEASUREMENT: Gastrointestinal symptoms and stool habits were assessed over a week during the intervention via the use of a questionnaire and stool diary.

    RESULTS: Stool frequency was seen to be higher and the improvement in stool consistency was more significant in the treatment group than in the placebo group (p =<0.001). A significant improvement in symptoms was demonstrated in patients who received MCP® BCMC® strains,specifically with respect to straining (p = < 0.001) and a sensation of incomplete evacuation (p = < 0.001). reduction in anorectal blockage symptoms and the need for manual stool evacuation was also demonstrated, but this finding was not statistically significant. Significant adverse events were not observed.

    CONCLUSIONS: An improvement in stool frequency and consistency was reported in elderly patients with chronic medical conditions following the administration of MCP® BCMC® strains.

  5. Fulltext The association between the attention deficit hyperactivity disorder(ADHD) symptoms and bully/victim problem among malaysian sixth-graders
    Wan Ismail WS, Nik Jaafar NR, Mohd Daud TI, Shah SA, Ismail A, Shafiee Z
    ASEAN Journal of Psychiatry, 2010;11(1):79-86.
    MyJurnal
    Objective: School bullying in Malaysia is on the rise. While efforts are put together to combat the problem, the psychiatric aspect has been neglected. This is a cross-sectional study aimed to determine the association between the symptoms of ADHD and bully/victim problems among Malaysian sixthgraders attending primary schools in Kuala Lumpur.
    Methods: A total of 410 sixth-graders from seven randomly selected schools were assessed with regards to bully/victim problems and ADHD symptoms using self-reported questionnaires. Malaysian Bullying Questionnaire was used to rate bully/victim problems while ADHD symptoms were assessed using ConnersWells’ Adolescent Self-report Scale (CASS). Teachers and parents also assessed students’ ADHD symptoms using Conner’s Teachers Rating Scale (CTRS) and Conner’s Parents Rating Scale (CPRS), respectively.
    Results: Self-reported questionnaires showed that 61.2% of the children were involved in bully/victim problems. The ADHD symptoms were found significant in relation to bully/victim problems as tested by multiple logistic regression. Only students and parents reported significant ADHD symptoms among the bully/victim groups. The ADHD symptoms reported by students were significant among bullies(OR=0.59,CI=0.42-0.83, p
  6. Sodium pentosan polysulfate efficacy as thromboprophylaxis agent in high-risk women following gynecological surgery
    Indirayani I, Kalok A, Nik Ismail NA, Shah SA, Lim PS, Mohamed Ismail NA, et al.
    J Obstet Gynaecol Res, 2018 Aug;44(8):1458-1465.
    PMID: 29845672 DOI: 10.1111/jog.13686
    AIM: Sodium pentosan polysulfate (Na-PPS) is a plant-based agent that has similar action with low-molecular-weight heparin. It inhibits factor Xa, preventing blood clot formation. To date, its use in clinical practice as thromboprophylaxis agent is still limited. In addition, the efficacy and safety profile of this agent was not robustly reported globally, especially for countries with major Muslim population. We hypothesized that Na-PPS was equally effective as the standard thromboprophylaxis. We aim to compare the efficacy and safety of Na-PPS against standard agent (fondaparinux or enoxaparin).

    METHODS: This was a randomized control, open-label trial. Women underwent major gynecological surgery were randomized to receive either subcutaneous 50 mg of Na-PPS twice daily or subcutaneous enoxaparin 40 mg once daily. Fondaparinux 2.5 mg once daily was given to Muslim women as an alternative to enoxaparin. The treatment was started 6 h postoperatively, for at least 3 days. All the patients received thromboembolic deterrent stockings. The primary efficacy outcome was venous thromboembolism up to 3 days postsurgery. The main safety outcomes were minor and major bleeding.

    RESULTS: Among 109 participants, there was no incidence of venous thromboembolism. None of the women developed major bleeding. Minor bleeding was observed in 28.3% (15/53) and 5.4% (3/56) of Na-PPS and standard thromboprophylaxis group, respectively (P = 0.001).

    CONCLUSION: Na-PPS was associated with increased risk of minor bleeding. There was insufficient data to conclude its efficacy as thromboprophylaxis. Further research is needed to evaluate Na-PPS safety as a standard thromboprophylactic agent.

  7. Fulltext Novel Bi-heterocycles as Potent Inhibitors of Urease and Less Cytotoxic Agents: 3-({5-((2-Amino-1,3-thiazol-4-yl)methyl)-1,3,4-oxadiazol-2-yl}sulfanyl)-N-(un/substituted-phenyl)propanamides
    Abbasi MA, Ramzan MS, Ur-Rehman A, Siddiqui SZ, Hassan M, Ali Shah SA, et al.
    Iran J Pharm Res, 2020;19(1):487-506.
    PMID: 32922502 DOI: 10.22037/ijpr.2019.13084.11362
    The synthesis of a novel series of bi-heterocyclic propanamides, 7a-l, was accomplished by S-substitution of 5-[(2-amino-1,3-thiazol-4-yl)methyl]-1,3,4-oxadiazol-2-thiol (3). The synthesis was initiated from ethyl 2-(2-amino-1,3-thiazol-4-yl)acetate (1) which was converted to corresponding hydrazide, 2, by hydrazine hydrate in methanol. The refluxing of hydrazide, 2, with carbon disulfide in basic medium, resulted in 5-[(2-amino-1,3-thiazol-4-yl)methyl]-1,3,4-oxadiazol-2-thiol (3). A series of electrophiles, 6a-l, was synthesized by stirring un/substituted anilines (4a-l) with 3-bromopropanoyl chloride (5) in a basic aqueous medium. Finally, the targeted compounds, 7a-l, were acquired by stirring 3 with newly synthesized electrophiles, 6a-l, in DMF using LiH as a base and an activator. The structures of these bi-heterocyclic propanamides were confirmed through spectroscopic techniques, such as IR, 1H-NMR, 13C-NMR, and EI-MS. These molecules were tested for their urease inhibitory potential, whereby, the whole series exhibited very promising activity against this enzyme. Their cytotoxic behavior was ascertained through hemolysis and it was observed that all these were less cytotoxic agents. The in-silico molecular docking analysis of these molecules was also in full agreement with their in-vitro enzyme inhibition data.
  8. A pilot study to determine whether progestogen supplementation using dydrogesterone during the first trimester will reduce the incidence of gestational hypertension in primigravidae
    Zainul Rashid MR, Lim JF, Nawawi NH, Luqman M, Zolkeplai MF, Rangkuty HS, et al.
    Gynecol Endocrinol, 2014 Mar;30(3):217-20.
    PMID: 24552449 DOI: 10.3109/09513590.2013.860960
    Gestational hypertension (GH) remains one of the main causes of high maternal and perinatal morbidity and mortality worldwide with the highest incidence among primigravidae of about 10%-15%. However, it was noted that the incidence of GH in primigravidae who conceived following assisted reproductive technique (ART) or intrauterine insemination (IUI) supplemented with dydrogesterone during the first trimester was low.

    Study site: Obstetrics and Gynecology
    Department, Pusat Perubatan Universiti Kebangsaan Malaysia PPUKM
  9. Synthesis of 2-Furyl[(4-aralkyl)-1-piperazinyl]methanone derivatives as suitable antibacterial agents with mild cytotoxicity
    Abbasi MA, Nazeer MM, Rehman A, Siddiqui SZ, Hussain G, Shah SA, et al.
    Pak J Pharm Sci, 2018 Nov;31(6):2477-2485.
    PMID: 30473521
    The aim of the present research work was synthesis of some 2-furyl[(4-aralkyl)-1-piperazinyl]methanone derivatives and to ascertain their antibacterial potential. The cytotoxicity of these molecules was also checked to find out their utility as possible therapeutic agents. The synthesis was initiated by reacting furyl(-1-piperazinyl)methanone (1) in N,N-dimethylformamide (DMF) and lithium hydride with different aralkyl halides (2a-j) to afford 2-furyl[(4-aralkyl)-1-piperazinyl]methanone derivatives (3a-j). The structural confirmation of all the synthesized compounds was done by IR, EI-MS, 1H-NMR and 13C-NMR spectral techniques and through elemental analysis. The results of in vitro antibacterial activity of all the synthesized compounds were screened against Gram-negative (S. typhi, E. coli, P. aeruginosa) and Gram-positive (B. subtilis, S. aureus) bacteria and were found to be decent inhibitors. Amongst the synthesized molecules, 3e showed lowest minimum inhibitory concentration MIC = 7.52±0.μg/mL against S. Typhi, credibly due to the presence of 2-bromobenzyl group, relative to the reference standard, ciprofloxacin, having MIC = 7.45±0.58μg/mL.
  10. Fulltext Knowledge of colorectal cancer among patients presenting with rectal bleeding and its association with delay in seeking medical advice
    Mohd Hashim S, Tong SF, Omar K, Abdul Rashid MR, Shah SA, Sagap I
    Asian Pac J Cancer Prev, 2011;12(8):2007-11.
    PMID: 22292642
    BACKGROUND: Knowledge is believed to be a driving factor for patients' early presentation for healthcare. This study was conducted to assess knowledge of colorectal cancer among subjects presenting with rectal bleeding and to determine its association with late presentation.

    METHODS: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The research instruments used in this study was a self-administered questionnaire including data on duration of rectal bleeding, first medical consultation and knowledge of colorectal cancer.

    RESULTS: Sixty percent of subjects with rectal bleeding delayed seeking medical advice. Subjects were more aware of symptoms of non-colorectal cancers compared to symptoms of colorectal cancer. The majority of subjects (63.8%) correctly identified rectal bleeding as a symptom but were not aware of the best screening method to detect colorectal cancer. Half of the subjects knew increasing age and genetic background to be risk factors for colorectal carcinoma. However, knowledge of colorectal cancer was not found to be significantly associated with delay in seeking help.

    CONCLUSION: Findings indicate poor awareness of colorectal cancer among the subjects. Although public education of colorectal cancer is important for early presentation on rectal bleeding, further studies are advocated to evaluate other factors influencing patients' help seeking behavior other than knowledge.
  11. Fulltext Factors influencing late consultation among patients with rectal bleeding in University Kebangsaan Malaysia Medical Centre
    Hashim SM, Omar K, Fah TS, Rashid RA, Daud TI, Shah SA, et al.
    Asian Pac J Cancer Prev, 2010;11(5):1335-9.
    PMID: 21198288
    BACKGROUND: Patients' delay in the presentation with rectal bleeding had been identified as a factor for late diagnosis of colorectal cancer. This study was conducted to determine the prevalence of delay in consulting a medical practitioner and identifying associated factors.

    MATERIALS AND METHODS: A cross-sectional study of 80 patients with rectal bleeding, aged 40 and above, was conducted between December 2008 and June 2009 in the endoscopy unit, University Kebangsaan Malaysia Medical Centre. The self-administered questionnaire included data on sociodemographic, concern of rectal bleeding, whether patients sought initial advice, any self treatment prior to medical consultation and patients' opinion on causes of their own rectal bleeding.

    RESULTS: The prevalence of delay in the presentation of rectal bleeding was 60%. Patients who were less worried (OR 9.6; 95% CI 3.3-27.5), who did not seek anyoneandapos;s advice (OR 11.8; 95% CI 3.8-36.8) and took some treatment before seeking medical consultation (OR 5.0; 95% CI 1.0-24.1) were significantly more likely to delay. Multiple logistic regression revealed that less worry of rectal bleeding and not seeking anyoneandapos;s advice were important predictors (p<0.05). The majority of patients attributed their bleeding to benign causes.

    CONCLUSION: A high proportion of patients with rectal bleeding in the high risk group delayed in seeking medical advice. Public education needs to focus on interventions to reduce the delay in presenting and diagnosis of colorectal carcinoma.
  12. Fulltext Colorectal cancer patients in a tertiary referral centre in Malaysia: a five year follow-up review
    Rashid MR, Aziz AF, Ahmad S, Shah SA, Sagap I
    Asian Pac J Cancer Prev, 2009;10(6):1163-6.
    PMID: 20192604
    BACKGROUND: Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC is fast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental and genetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC.

    MATERIALS AND METHODS: Retrospective case review study done on CRC patients at University Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia. Patientsandapos; socio-demographic characteristics, modalities of treatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records.

    RESULTS: A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%). Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms including per rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was 13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presented with Dukes C stage (40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%. Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lower recurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinese patients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment (22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45).

    CONCLUSION: Socio-demographic profile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatment gives rise to poor overall survival and local recurrence rates.
  13. Cancer Screening Perception Scale: development and construct validation
    Mahmood MI, Shah SA, Ahmad N, Rosli NM
    J Cancer Educ, 2018 04;33(2):269-277.
    PMID: 27448613 DOI: 10.1007/s13187-016-1081-7
    The aim of this study was to demonstrate the construct validity of a newly developed cancer screening perception scale as a measure of the perception of cancer screening in general among high-risk but healthy asymptomatic groups.The cancer screening perception scale (CSPS) was developed based on extensive literature reviews guided by The Health Belief Model. Fifty-five written items were initially pooled, reviewed by experts for face validity, pretested by 25 healthcare workers and translated into Malay using simple back translation. The scale was then distributed to 300 respondents from two health clinics for construct validation purposes. The obtained data were analyzed using the varimax rotation method for exploratory factor analysis (EFA). The data was submitted for further confirmatory factor analysis using AMOS software.Based on EFA, the results produced five constructs as predicted: perceived severity, perceived susceptibility, perceived benefits, perceived barriers, and cues for action. Two items with low factor loading and unrelated to the recovered domains were removed. Perceived barriers and cues for action had three and two sub-domains respectively which were further confirmed to fit the measurement and structural models. CFA demonstrated the scale fitted GFI = 0.936, CFI = 0.935, RMSEA = 0.076, NORMEDCHISQ = 2.162. The scale discriminated between the domains. Cronbach's alpha for perceived severity, perceived susceptibility, perceived benefits, perceived barrier, and cues for action were 0.907, 0.877, 0.940, 0.864 and 0.938, respectively.The cancer screening perception scale with its promising psychometric properties is now available to measure risks to high-risk but healthy, asymptomatic groups aged 18 and above and can also be used for larger scale study purposes.
  14. Fulltext Unmet Healthcare Needs Among Elderly Malaysians
    Shah SA, Safian N, Ahmad S, Nurumal SR, Mohammad Z, Mansor J, et al.
    J Multidiscip Healthc, 2021;14:2931-2940.
    PMID: 34703245 DOI: 10.2147/JMDH.S326209
    Purpose: Older people often have chronic diseases which require a continuity of care over the long term. Countries undergoing population aging need to ensure that older people are receiving the care they need. This study assesses the prevalence of, reasons for, and factors associated with unmet healthcare needs among older people individuals in Malaysia.

    Patients and Methods: This cross-sectional study used data collected during 2018-2020 from 1204 older adults aged 60 and older selected from Selangor state, Malaysia. A comprehensive face-to-face interview based on the Bahasa Malaysia version of the Japan Gerontological Evaluation Study (JAGES-BM) questionnaire was administered to gain information on unmet healthcare needs, socioeconomic factors, health-related factors, and measures of function (activities of daily living, depression, visual impairment, hearing impairment, memory impairment, and walking impairment). Multivariate logistic regression was used to analyze factors associated with their unmet healthcare needs.

    Results: Overall, the percentage of older people respondents with unmet healthcare needs is 6.6%. The most reported reasons for forgoing or delaying healthcare were lack of knowledge about healthcare and financial barriers to care. The inability to travel alone (adjusted odds ratio [aOR] 2.51), being overweight (aOR 1.88), and having self-reported depression (aOR 2.23) were each associated with a higher likelihood of having unmet healthcare needs in their daily life.

    Conclusion: The prevalence of unmet healthcare needs among older people in this part of Malaysia is lower than that reported in some other countries. However, it is possible to further reduce unmet healthcare needs by improving people's knowledge and attitudes about appropriate healthcare utilization, strengthening financial protection measures and providing support to people at high risk of having unmet healthcare needs.

  15. Chitosan based thermosensitive injectable hydrogels for controlled delivery of loxoprofen: development, characterization and in-vivo evaluation
    Ahmad U, Sohail M, Ahmad M, Minhas MU, Khan S, Hussain Z, et al.
    Int J Biol Macromol, 2019 May 15;129:233-245.
    PMID: 30738157 DOI: 10.1016/j.ijbiomac.2019.02.031
    Oral drug delivery is natural, most acceptable and desirable route for nearly all drugs, but many drugs like NSAIDs when delivered by this route cause gastrointestinal irritation, gastric bleeding, ulcers, and many undesirable effects which limits their usage by oral delivery. Moreover, it is almost impossible to control the release of a drug in a targeted location in body. We developed thermo-responsive chitosan-co-poly(N-isopropyl-acrylamide) injectable hydrogel as an alternative for the gastro-protective and controlled delivery of loxoprofen sodium as a model drug. A free radical polymerization technique was used to synthesize thermo-responsive hydrogel by cross-linking chitosan HCl with NIPAAM using glutaraldehyde as cross-linker. Confirmation of crosslinked hydrogel structure was done by Fourier transform infrared spectra (FTIR). The thermal stability of hydrogel was confirmed through thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC). The scanning electron microscopy (SEM) was performed to evaluate the structural morphology of cross-linked hydrogel. To evaluate the rheological behavior of hydrogel with increasing temperature, rheological study was performed. Swelling and in vitro drug release studies were carried out under various temperature and pH conditions. The swelling study revealed that maximum swelling was observed at low pH (pH 1.2) and low temperature (25 °C) compared to the high range of pH and temperature and it resulted in quick release of the drug. The high range of pH (7.4) and temperature (37 °C) however caused controlled release of the drug. The in vivo evaluation of the developed hydrogel in rabbits demonstrated the controlled release behavior of fabricated system.
  16. Preferences of Malaysian cancer patients in communication of bad news
    Eng TC, Yaakup H, Shah SA, Jaffar A, Omar K
    Asian Pac J Cancer Prev, 2012;13(6):2749-52.
    PMID: 22938453
    BACKGROUND: Breaking bad news to cancer patients is a delicate and challenging task for most doctors. Better understanding of patients' preferences in breaking bad news can guide doctors in performing this task.

    OBJECTIVES: This study aimed to describe the preferences of Malaysian cancer patients regarding the communication of bad news.

    METHODOLOGY: This was a cross-sectional study conducted in the Oncology clinic of a tertiary teaching hospital. Two hundred adult cancer patients were recruited via purposive quota sampling. They were required to complete the Malay language version of the Measure of Patients' Preferences (MPP-BM) with minimal researcher assistance. Their responses were analysed using descriptive statistics. Association between demographic characteristics and domain scores were tested using non-parametric statistical tests.

    RESULTS: Nine items were rated by the patients as essential: "Doctor is honest about the severity of my condition", "Doctor describing my treatment options in detail", "Doctor telling me best treatment options", Doctor letting me know all of the different treatment options", "Doctor being up to date on research on my type of cancer", "Doctor telling me news directly", "Being given detailed info about results of medical tests", "Being told in person", and "Having doctor offer hope about my condition". All these items had median scores of 5/5 (IQR:4-5). The median scores for the three domains were: "Content and Facilitation" 74/85, "Emotional Support" 23/30 and "Structural and Informational Support" 31/40. Ethnicity was found to be significantly associated with scores for "Content and Facilitation" and "Emotional Support". Educational status was significantly associated with scores for "Structural and Informational Support".

    CONCLUSION: Malaysian cancer patients appreciate the ability of the doctor to provide adequate information using good communication skills during the process of breaking bad news. Provision of emotional support, structural support and informational support were also highly appreciated.

  17. Fulltext Restless legs syndrome and its associated risk factors in Parkinson's disease
    Azmin S, Khairul Anuar AM, Nafisah WY, Tan HJ, Raymond AA, Hanita O, et al.
    Parkinsons Dis, 2013;2013:535613.
    PMID: 24455416 DOI: 10.1155/2013/535613
    Introduction. Restless legs syndrome has been shown to negatively impact the quality of life of patients. Studies have shown an association between restless legs syndrome and Parkinson's disease. We attempted to investigate the prevalence of restless legs syndrome in Parkinson's disease patients and to identify associated risk factors. Method. This was a cross-sectional study among patients with idiopathic Parkinson's disease. Exclusion criterion was a Mini Mental State Examination score of less than 21/30. The International Restless Legs Syndrome Study Group criterion was used to identify patients with restless legs syndrome. Results. A total of 113 patients were recruited. The prevalence rate of restless legs syndrome in our cohort was 9.7% and was significantly associated with a younger onset of Parkinson's disease (P = 0.023), male gender (P = 0.045), higher Mini Mental State Examination score (P = 0.004), and less advanced Hoehn & Yahr stage (P = 0.014). Conclusion. The prevalence rate of restless legs syndrome in our Parkinson's disease population is in keeping with other studies published worldwide. The significance of the association between a younger onset of Parkinson's disease and restless legs syndrome needs to be further investigated.
  18. Fulltext Nonmotor symptoms in a malaysian Parkinson's disease population
    Azmin S, Khairul Anuar AM, Tan HJ, Nafisah WY, Raymond AA, Hanita O, et al.
    Parkinsons Dis, 2014;2014:472157.
    PMID: 24800102 DOI: 10.1155/2014/472157
    Background. The nonmotor symptoms are important determinants of health and quality of life in Parkinson's disease but are not well recognized and addressed in clinical practice. This study was conducted to determine the prevalence of nonmotor symptoms and their impact on quality of life in patients with Parkinson's disease. Methods. This was a cross-sectional study among patients with idiopathic Parkinson's disease. Exclusion criteria were a Mini Mental State Examination score of <21/30. Prevalence of nonmotor symptoms was determined using the NMSQuest. The severity of nonmotor symptoms and the quality of life were assessed using validated disease-specific questionnaires (PDQ-39 and NMSS). Results. A total of 113 patients consisting of 60 males and 53 females were recruited. The median duration of illness was 5.0 (2.0-8.0) years. The prevalence rate of nonmotor symptoms in our cohort was 97.3%. The most common reported nonmotor symptom in our cohort was gastrointestinal (76.1%). We found that the severity of the nonmotor symptoms was associated with poorer quality of life scores (r s : 0.727, P < 0.001). Conclusions. Nonmotor symptoms were highly prevalent in our patients with Parkinson's disease and adversely affected the quality of life of our patients. In contrast to western studies, the most common nonmotor symptom is gastrointestinal. The possibility of an Asian diet playing a role in this observation requires further study.
  19. Intravenous calcitriol versus paricalcitol in haemodialysis patients with severe secondary hyperparathyroidism
    Abdul Gafor AH, Saidin R, Loo CY, Mohd R, Zainudin S, Shah SA, et al.
    Nephrology (Carlton), 2009 Aug;14(5):488-92.
    PMID: 19298641 DOI: 10.1111/j.1440-1797.2008.01058.x
    Secondary hyperparathyroidism (SHPT) is common among haemodialysis patients. Intensive treatment with calcitriol is often complicated by hypercalcaemia, hyperphosphataemia and elevated calcium phosphorus (Ca X PO(4)) product. Paricalcitol is a vitamin D analogue developed to overcome some of the limitations of calcitriol therapy. The study objectives were to compare the response of intact parathyroid hormone (iPTH) and the incidence of hypercalcaemia, hyperphosphataemia and elevated Ca X PO(4) product in patients with severe SHPT treated with either i.v. calcitriol or i.v. paricalcitol.
  20. Fulltext Depression and Suicidal Ideation in a Sample of Malaysian Healthcare Workers: A Preliminary Study During the COVID-19 Pandemic
    Sahimi HMS, Mohd Daud TI, Chan LF, Shah SA, Rahman FHA, Nik Jaafar NR
    Front Psychiatry, 2021;12:658174.
    PMID: 34025479 DOI: 10.3389/fpsyt.2021.658174
    Objective: The burden of suicidal behavior is anticipated to increase as a sequela of the COVID-19 pandemic. However, there is limited evidence on suicidal behavior among healthcare workers, an at-risk population. Our study aimed to investigate suicidal ideation in terms of the rate and associated factors in a sample of Malaysian healthcare workers during the early-phase of the COVID-19 pandemic. Methods: A subpopulation analysis (N = 171) was conducted within a larger, nation-wide cross-sectional study of Malaysian healthcare worker psychological distress from March 18-21, 2020. Current suicidal ideation was measured with item 9 of the Patient Health Questionnaire-9 (PHQ-9). The following independent variables were assessed: socio-demographic profile, occupation and service-related factors, health-anxiety (Health Anxiety Inventory, HAI), lifetime anxiety disorder and severity of depression (PHQ-9). Results: The proportion of healthcare workers with current suicidal ideation (19/171) and clinical depression (17/171) were 11.1 and 9.9%, respectively. Multivariable analysis showed that clinical depression was the most significant factor associated with current suicidal ideation (p < 0.001, OR = 55.983, 95% CI = 9.015-347.671) followed by mild (subthreshold) depression (p = 0.001, OR = 115.984, 95% CI = 2.977-85.804). Service duration of more than 10 years was associated with significantly less suicidal ideation (p = 0.049, OR = 0.072, 95% CI = 0.005-0.993). Conclusions: Depression (subthreshold and especially within the clinical range) and early-career status (<10 years in service) may be target areas of early intervention for reduction of suicidal ideation amongst healthcare workers who have served during the COVID-19 pandemic. Further research is warranted to elucidate specific occupational stressors related to COVID-19 work conditions to tailor appropriate suicide preventive strategies in this population.
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