METHODS: This is a true experimental post-test-only group design study, using male Wistar rats (Ratus novergicus) with weight-drop-induced traumatic brain injury. The subjects in this study were divided into four groups: two Control groups (Groups A and B) and two Therapy groups (Groups C and D). Groups C and D differed in the dose of Kencur ethanolic extract administered (600 mg/kgBW/day and 1,200 mg/kgBW/day, respectively). The Therapy groups were then subdivided into those receiving therapy for 24 h (C-24 and D-24) and those receiving therapy for 48 h (C-48 and D-48). Caspase-3 expression in brain tissue was evaluated at the end of the therapy using immunohistochemistry. All groups were subjected to a Kruskal-Wallis comparison test and the investigation continued with a Mann-Whitney U test to compare the two groups.
RESULTS: In traumatic brain injury rat models treated with Kaempferia galanga L. ethanolic extract at doses of 1,200 mg/kgBW/day within 48 h of therapy (D-48) compared to those who were not treated, there was a significant change in the cerebral expression of caspase-3 (P = 0.016). There was also a significant difference between the two doses of intervention (C-24 at 600 mg/kgBW/day and D-48 at 1,200 mg/kgBW/day; P = 0.016).
CONCLUSION: With a minimum of 48 h of treatment split into two doses, Kencur (Kaempferia galanga L.) ethanolic extract can decrease caspase-3 expression in rats with traumatic brain injury.
METHODS: This cross-sectional study was conducted between 1 July and 31 December 2019 among patients in medical wards who had a blood glucose (BG) level of > 7.8 mmol/L and stayed in the wards for ≥ 24 h. We retrieved information on demographics, diabetes history and BG profiles. The definition of controlled glycaemic status is when ≥ 80% of BG readings were between 4.0 mmol/L and 10.0 mmol/L during the hospital stay.
RESULTS: The prevalence of inpatient hyperglycaemia was 55.2%. There were 841 patients who met the eligibility criteria; their mean age was 60 (13.8) years old. Most (79.4%) of the patients were Malay and 53.9% were male. There were 452 (53.7%) patients in the uncontrolled group. They were younger and admitted with more kidney complications compared to those in the controlled group. The median LOS for both groups was 3 (2) days. The uncontrolled group showed a higher percentage of readmission within 30 days (7.5% versus 4.6 %) and death during admission (3.3% versus 1.6 %) (P = 0.100 and P = 0.082).
CONCLUSION: The prevalence of inpatient hyperglycaemia was high. More than half of them had uncontrolled BG. Both groups had a similar average length of stay. The 30-day readmission rate and death during admission were higher in the uncontrolled group, although statistically not significant.
METHODS: This is a prospective cohort study from January 2021 to January 2022. The short-term outcomes of patients were evaluated upon ICU discharge and 1 month after ICU discharge using GOS. Favourable outcome was defined as GOS 4 and 5. Generalised Estimation Equation (GEE) was adopted to conduct bivariate GEE and subsequently multivariate GEE to evaluate the factors associated with favourable outcome at ICU discharge and 1 month after discharge.
RESULTS: A total of 92 patients with severe TBI with GOS of 8 and below admitted to ICU received CP management. Proportion of death is 17% at ICU discharge and 0% after 1 month of ICU discharge. Proportion of favourable outcome is 26.1% at ICU discharge and 61.1% after 1 month of ICU discharge. Among factors evaluated, age (odds ratio [OR] = 0.96; 95% CI: 0.94, 0.99; P = 0.004), duration of CP (OR = 0.41; 95% CI: 0.20, 0.84; P = 0.014) and hyperosmolar therapy (OR = 0.41; CI 95%: 0.21, 0.83; P = 0.013) had significant association.
CONCLUSION: CP in younger age, longer duration of CP and patient not receiving hyperosmolar therapy are associated with favourable outcomes. We recommend further clinical trial to assess long term outcome of CP.
METHODS: This prospective cohort study was conducted at a single academic institution. The inclusion criteria involved all adult patients with haematological malignancies who had newly inserted PICCs. The patients were observed for a minimum duration of 60 days to evaluate the incidence of PICC-related infections and thrombosis, as well as mechanical complications.
RESULTS: A total of 119 PICCs were implanted in 85 patients. Among them, more than half of the patients were diagnosed with lymphoma (55.0%). The median dwell time was 61 days (interquartile range: 98 days). The incidence of PICC-related complications was 58.0% (6.9 per 1,000 catheter-days). Specifically, 43 PICCs (36.1%, 4.3 per 1,000 catheter-days) experienced infective complications, 25 (21.1%, 2.5 per 1,000 catheter-days) encountered mechanical complications and 1 (0.8%, 0.1 per 1,000 catheter-days) exhibited thrombotic complications. Furthermore, an underlying diagnosis of acute leukaemia was significantly associated with a higher incidence of PICC-related infections.
CONCLUSION: Our study revealed higher incidence rates of PICC-related complications in adult patients with haematological malignancies compared to the finding of other studies. Notably, patients with underlying acute leukaemia displayed a higher incidence of PICC-related infections. These findings underscore the importance of implementing appropriate interventions and conducting thorough root cause analyses to effectively mitigate this complication and improve patient outcomes.
METHODS: A cross-sectional study was conducted between 1 September 2022 and 20 September 2022 using a web-based questionnaire. Undergraduate students from medical and non-medical colleges in Iraqi universities participated in this study. Descriptive and inferential statistics and logistic regression were performed to analyse the data.
RESULTS: A total of 655 students participated in this study. The knowledge level of more than one-half of the students (53%) was inadequate. Approximately three-quarters of the study sample used sunscreens products. Skin type was the main factor in choosing the appropriate sunscreen product. Media and advice from specialists were the main factors affecting participants' usage of sunscreens. Gender (females), college (medical), year(s) of study (sixth), residence (urban), daily sun exposure (1 h-3 h) and less-than-normal vitamin D levels were found to be significantly associated with better knowledge (P-value < 0.05). Age, gender, being a student in medical colleges and not knowing vitamin D levels were found to be significant predictors of participants' knowledge.
CONCLUSION: The low level of knowledge reported among the participants' calls for more attention from health authorities in educating the public about the harmful effects of sun exposure and the importance of adopting protective measures.
METHOD: An observational analytical method was used. D-dimer examination was performed using the fluorescent lateral flow immunoassay method. The study sample consisted of 26 participants aged between 18 years old and 22 years old who had no blood disorders. Whole blood and ethylenediaminetetraacetic acid (EDTA) plasma samples were used for the examination of D-dimer levels.
RESULTS: D-dimer levels in 26 participants using whole blood samples had a mean value of 0.23 mg/L (230 ng/mL), while plasma samples yielded a mean value of 0.14 mg/L (140 ng/mL). D-dimer levels obtained from whole blood samples were higher than plasma samples but remained within the normal range of 0 mg/L-0.5 mg/L (0 ng/mL-500 ng/mL).
CONCLUSION: The results showed that whole blood samples were more practical than plasma samples. Nevertheless, plasma samples gave results within the normal range of D-dimer values.
METHODS: In 2018, a retrospective cohort study stretching from January to April was conducted. This study involved a review of data obtained from the National AIDS Registry. A total of 1,073 AIDS cases diagnosed from 1 January 2010 to 31 December 2014 were selected, and follow-up procedures were conducted until 31 March 2015 (a 3-month follow-up). The Kaplan-Meier plot and Cox's proportional hazard regression were used for data analyses.
RESULTS: 564 (52.5%) patients died due to AIDS, while the remaining 509 (47.4%) were censored. The overall median survival time was 11 months. The probability of survival in 1-year, 2-year, 3-year, 4-year and 5-year periods were 49.1%, 47.8%, 47.3%, 47.0% and 46.7%, respectively. Multiple Cox regression revealed that the significant prognostic factors were age 30-49 years [adjusted hazard ratio (Adj. HR) 1.57; 95% CI: 1.14, 2.16; P = 0.006], male (Adj. HR 1.39; 95% CI: 1.07, 1.79; P = 0.012), unemployed (Adj. HR 1.40; 95% CI: 1.12, 1.75; P = 0.003) and HIV-TB co-infection (Adj. HR 1.78; 95% CI: 1.37, 2.31; P < 0.001).
CONCLUSION: The overall median survival time among AIDS patients in North-East Peninsular Malaysia was revealed to be short, in comparison to the other studies. The chances for survival can be improved with more emphasis on early detection (to ensure early treatment) and social support, particularly for HIV-TB co-infected patients, as well as for younger and unemployed patients.
METHODS: The Malay version of the Perceived Stress Scale with 10 items and the Brief COPE Scale were administered to a sample of 190 Malay caregivers of children with learning disabilities registered with community-based rehabilitation centres in Kelantan, a state in Peninsular Malaysia. Multiple linear regression analysis was applied to determine the predictors of perceived stress.
RESULTS: The mean total perceived stress score of caregivers was 16.96 (SD = 4.66). The most frequently used coping styles found among caregivers included religion, acceptance and positive reframing, while substance use and behavioural disengagement were least frequently used. Higher perceived stress was significantly predicted among caregivers with fewer children, frequent use of instrumental support and behavioural disengagement coping, and lack of emotional support and religious coping.
CONCLUSION: Findings indicate that the perceived stress levels among caregivers were significantly predicted by different coping styles. It is vital to help the caregivers improve their good coping styles in order to reduce their stress levels.
METHODS: This was a retrospective study of patients who underwent isolated CABG in Hospital Universiti Sains Malaysia, Kelantan, Malaysia, from 1 January 2013 until 31 December 2017. Data were collected from medical records, and comparisons were made between patients who received perioperative RBC transfusions and those who did not have adverse outcomes after CABG.
RESULTS: A total of 108 patients who underwent isolated CABG were included in our study, and 78 patients received perioperative RBC transfusions. Patients who received perioperative RBC transfusions compared to those who did not were significantly more likely to develop prolonged ventilatory support (21.8% versus 0%, P = 0.003), cardiac morbidity (14.1% versus 0%, P = 0.032), renal morbidity (28.2% versus 3.3%, P = 0.005) and serious infection (20.5% versus 3.3%, P = 0.037). With each unit of packed RBC transfusions, there was a significantly increased risk of prolonged ventilatory support (adjusted odds ratio [AOR] = 1.45; 95% confidence interval [CI] = 1.20-1.77; P < 0.001), cardiac morbidity (AOR =1.40; 95%CI = 1.01-1.79; P = 0.007), renal morbidity (AOR = 1.23; 95%CI = 1.03-1.45; P = 0.019) and serious infection (AOR = 1.31; 95%CI = 1.07-1.60; P = 0.009).
CONCLUSION: Perioperative RBC transfusion in isolated CABG patients is associated with increased risks of developing adverse events such as prolonged ventilatory support, cardiac morbidity, renal morbidity and serious infection.
OBJECTIVES: This pilot study compared the motor evoked potential (MEP) changes using different settings of rTMS in the post-ischemic stroke patient. The goal of the study is to identify effect sizes for a further trial and evaluate safety aspects.
METHODS: Eight post-stroke patients with upper limb hemiparesis for at least six months duration were studied in a tertiary hospital in Northeast Malaysia. Quasi experimental design was applied and the participants were randomised into two groups using software generated random numbers. One of the two settings: i) inhibitory setting, or ii) facilitatory setting have been applied randomly during the first meeting. The motor evoked potential (MEP) were recorded before and after application of the rTMS setting. A week later, a similar procedure will be repeated but using different setting than the first intervention. Each patient will serve as their own control. Repeated measures ANOVA test was applied to determine the effect sizes for both intervention through the options of partial eta-squared (η2 p).
RESULT: The study observed large effect sizes (η2 p > 0.14) for both rTMS settings in the lesion and non-lesion sides. For safety aspects, no minor or major side effects associated with the rTMS was reported by the participants.
CONCLUSIONS: The partial eta square of MEP value for both rTMS settings (fascilitatory and inhibitory) in both lesion and non-lesion sides represents large effect sizes. We recommend further trial to increase number of sample in order to study the effectiveness of both settings in ischemic stroke patient. Our preliminary data showed both settings may improve the MEP of the upper extremity in the ischemic stroke patient. No significant improvement noted when comparing both settings.
METHODS: In the present descriptive cross-sectional study, 300 nurses in SUMS were selected based on systematic random sampling. To this aim, demographic information, and Nordic musculoskeletal disorder questionnaires were used for data collection. The data were analysed by descriptive and analytical tests (mean, standard deviation, independent t-test, and ANOVA) by SPSS/21 software.
RESULTS: Based on the findings of WMSDs, low back disorders (88.33%) were more prevalent. In addition, a significant relationship was observed between WMSDs in different areas of the body with age, sex, and work experience and hours (P < 0.05).
CONCLUSION: Regarding the high prevalence of WMSDs among nurses, it is recommended to adopt interventional program for preventing WMSDs by reducing working hours and physical pressure control.
METHODS: Twenty-four male Wistar rats were randomly allocated into four experimental groups to receive NAC, saline, noise, or both noise and NAC. Noise exposure continued for ten days. Saline and NAC were injected daily during the noise exposure, and 2 days before and after the noise exposure. Evaluation of cochlear histopathology and the density of spiral ganglion cells was performed 21 days after exposure.
RESULTS: In the animals exposed to noise, a reduction in the density of spiral ganglion cells was evident in both the basal and middle turns of the cochlea. This improved on receiving NAC treatment (P = 0.046). In the histopathology evaluation, some histological changes, such as disorganised architecture of the outer hair and supporting cells and a slightly thickened basilar membrane, were found in the basal turns in the noise group.
CONCLUSION: NAC offered partial protection against noise exposure by improving the density of spiral ganglion cells and reducing morphological changes.
METHODS: In this qualitative study, structured interviews by focus groups were conducted. Dietitians from different governmental and private sectors were invited to participate in the study. Focus groups were stratified based on the participants' gender and years of experience to promote self-disclosure. Abridged transcript of relevant and useful points was performed. The transcripts were coded and cross-validated by two researchers.
RESULTS: A total of four focus groups were conducted. Two focus groups comprise 9 male participants and the other two comprise 10 females. The age of participants ranged 25-40 years old. Participants were employees in Riyadh city with experience that ranged 3-10 years old. Nine themes of the necessary knowledge and skills were identified.
CONCLUSION: It is recommended for the Saudi government to create standards specialised for clinical nutrition and dietetics undergraduate and graduate programmes.
METHODS: Between December 2016 and October of 2017, a total of 158 eligible individuals were classified as 50 healthy subjects and 108 diabetic patients who were subdivided into six groups according to the type of anti-diabetic treatments.
RESULTS: Overall, the results elucidated that hemoglobin concentration was markedly diminished, while red cell distribution width (RDW) value was significantly (P < 0.001) elevated in all diabetic groups as compared to control. Moreover, in all diabetic groups, malondialdehyde (MDA) concentration was elevated noticeably (P < 0.001), while reduced glutathione (GSH) revealed a lower concentration (P < 0.001) than that of control.
CONCLUSION: The present study exhibited the amelioration effect of metformin administration on oxidative stress and glycemic status which reflected on some RBCs indices. However, hemoglobin concentration showed a noticeable diminution in all metformin-treated groups in spite of the improvement in glycemic and oxidative stress status which indicated that the metformin-induced anemia is independently from diabetic complications.
METHODS: The icv-STZ (3 mg/kg, 10 μL, twice) induced neuronal loss in the hippocampus of adult male rats. Animals were divided into naive control, sham-operated, STZ+saline (1 μL, icv), STZ+NAD-299 (5 μg/μL, icv), STZ+TCB-2 (5 μg/μL, icv), and STZ+NAD-299+TCB-2 (5 μg/μL of any agent, icv) groups. Following the 35 days' treatment period, neuronal apoptosis was detected using the Tunnel. Cells with morphological features of apoptotic cell were contended by microscopy.
RESULTS: TCB-2 and NAD-299 administration decreased number of apoptotic neurons in the treatment group compared with the STZ group. Combined treatment of STZ rat with NAD+TCB more decreased number of apoptotic cells in compare to TCB-2 or NAD-299 treated STZ groups.
CONCLUSION: Treatment with 5-HT1A receptor antagonist or 5-HT2A receptor agonist diminished apoptosis. The beneficial effect of 5HT1A receptor inhibition was potentiated with activation of 5-HT2A receptor in prevention of apoptosis in hippocampus.
METHODS: Clinical data of 143 adult patients diagnosed with TBM over a 6-year period in two tertiary hospitals in Malaysia were retrospectively reviewed. Relevant clinical and radiological data were studied. Patients with TBMH were further analysed based on their clinical grade and rendered treatment to identify associated factors and outcome of this subgroup of patients. The functional outcome of patients was assessed at 12 months from treatment.
RESULTS: The mean age of patients was 35.6 (12.4) years old, with a male gender predominance of 67.1%. Forty-four percent had TBMH, of which 42.9% had surgical intervention. In the good modified Vellore grade, 76.5% was managed medically with concurrent anti-tuberculosis treatment (ATT), steroids and osmotic agents. Four patients had surgery early in the disease as they did not respond to medical therapy and reported a good outcome subsequently. Poor outcome (65.2%) was seen in the poor modified Vellore grade despite medical and surgical intervention. Multivariate model multiple Cox regression showed significant results for seizure (adjusted hazard ratio [aHR]: 15.05; 95% CI: 3.73, 60.78), Glasgow coma scale (GCS) (aHR: 0.79; 95% CI: 0.70, 0.89) and cerebrospinal fluid (CSF) cell count (aHR: 1.11; 95% CI: 1.05, 1.17).
CONCLUSION: Hydrocephalus was seen in 44% of patients in this study. GCS score, seizure and high CSF cell count were factors associated with a poor prognosis in TBM. Patients with TBMH treated medically (TBMHM) had better survival function compared to TBMH patients undergoing surgical intervention (TBMHS) (P-value < 0.001). This retrospective study emphasises that TBMH is still a serious illness as 47.6% of the patients had poor outcome despite adequate treatment.