Displaying publications 81 - 100 of 399 in total

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  1. Nurul Iman, P., Ramliza, R., Wan Fariza, W.J., Shamsul Azhar, S., Nor Azimah, I., S. Fadilah, A.W.
    Medicine & Health, 2019;14(2):60-76.
    MyJurnal
    Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aim of the present study was to analyse the prevalence, antibiotic resistance and clinical outcome of bacteraemia in HSCT recipients, within 100 days following transplantation. We retrospectively analysed the prevalence, antibiotic resistance pattern and mortality rate of early bacteraemia among HSCT recipients in a single centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients developed bacteraemia with 40 positive cultures resulting in prevalence of 47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS) were the commonest pathogens isolated. GNB showed a high resistance rate to ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50% was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and life-threatening early complication among HSCT recipients with MDR GNB being the commonest cause of mortality. The high rate of resistance to ciprofloxacin and failure of the first line empirical antibiotics to treat FN calls for a thorough evaluation of the current antibiotic prophylaxis and empirical treatment protocols. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens to treat FN.
  2. Munirah, M., Mohd Nazrul, A.A., Norsheila, M., Dian Nasriana, N., Hanita, O.
    Medicine & Health, 2019;14(2):77-86.
    MyJurnal
    Point-of-care testing (POCT) of cardiac troponin device is aimed for improvement in turn round time (TAT) and assist in acute management care of acute coronary syndrome (ACS). The present study was conducted to assess the analytical performance and correlation of HUBI-QUANPro troponin I with an existing laboratory instrument of high-sensitivity troponin I, Abbott Architect. The factors that were studied, included precision study by using manufacturer quality control (QC) material (2 levels) and correlation study of sample differences (whole blood, plasma and serum) and methodology (immunochromatographic assay and chemiluminescent immunoassay). A total of 30 QC was used for precision study and 42 sample serum and EDTA for the correlation study. An acceptable total imprecision of 10.9% and 6.7% were seen at level of 0.91 ng/mL and 2.66 ng/mL, respectively. Regression analysis of sample differences (plasma vs whole blood) in HUBI-QUANPro showed slope of 0.935, r=0.991 (p=
  3. Jaafar, M.H., Villiers-Tuthill, A., Mcgee, H.
    Medicine & Health, 2019;14(2):87-96.
    MyJurnal
    Heart failure is a physically debilitating and psychologically distressing chronic condition. Although depressive disorder is a strong predictor of short-term deterioration of heart failure symptoms and mortality, only few studies have focused on habit and daily routines. The present study aimed to investigate the relationship between depression and anxiety and heart failure patients’ self-care behaviour. Interviews were completed with 161 patients at hospital outpatient clinics in Belfast and Dublin. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). Self-care behaviour was assessed using the European Heart Failure Self-Care Behaviour Scale (EHFSCBS). ‘Probable’ clinical depression was indicated in 18%, and ‘probable’ caseness of anxiety disorder in 16% of patients. Self-care behaviour adherence varied considerably across behaviours and was higher for taking medication as prescribed (93.1%), and taking it easy if breathless (75.1%) and lower for daily self-weighing (13.6%), regular exercise (33.6%) and limiting fluid intake (38.5%). No significant relationship was found between overall reported self-care adherence and anxiety or depression. However, significant association with depression were found for five of the 12 self-care items, and also with anxiety for two of these. Our results demonstrated that mental well-being in patients with heart failure plays a significant role in the patients’ ability to adhere to self-care regimens.
  4. Leow, S.N., Tong, S.F.
    Medicine & Health, 2019;14(2):97-108.
    MyJurnal
    Among diabetic patients, fasting is associated with increased risk of ketoacidosis, hypoglycaemia and dehydration. Previous randomised controlled trials and prospective studies have shown that intensive pre-Ramadan education on fasting is able to help patients fast successfully during Ramadan. At the same time, observational studies show that many diabetic patients are still able to fast successfully throughout Ramadan despite deficiencies in knowledge about fasting practices. We conducted a retrospective recall study in Klinik Kesihatan Jalan Perak, Penang to determine the factors associated with successful fasting. Patients were selected using convenience sampling. Successful fasting was defined as a patient fasted as intended, and not having to break-fast due to hypo/ hyperglycaemia symptoms or hospitalization due to diabetic complications. Multiple logistic regression was used to determine independent factors associated with successful fasting. 113 patients were enrolled. 70.9% (n=80) of patients were able to fast successfully. Knowing the name of their diabetic medications were significantly associated with successful fasting (AOR=8.56, 95%CI: 2.04;35.8, p=0.003). Knowledge and fasting practices were not associated with successful fasting. We may identify patients who might not fast successfully by evaluating their understanding of their diabetic medications. They can then be targeted for further pre-Ramadan counselling. Nonetheless, an intensive pre-Ramadan counselling is still optimal if resources are available.

  5. Norazlina, M., Siti Mariam, B., Mohamad-Sharif, M.A., Norain, M.M., Muhammad-Adam, A.C., Hazlinda, M., et al.
    Medicine & Health, 2019;14(2):109-120.
    MyJurnal
    Pharmacology teaching during preclinical years is important for medical students to make rational choices in choosing suitable treatment for patients in future. Therefore, the present study determined the adequacy and effectiveness of pharmacology teaching in the undergraduate medical program at the Universiti Kebangsaan Malaysia Medical Center (UKMMC). Suggestions for improvement of the curriculum were also identified. An online questionnaire on the perceptions of pharmacology teaching methodology was distributed to a total of 459 medical students in 4th and 5th year at UKMMC. The questionnaire covered demographics, perceptions about pharmacology teaching, the ideal teaching learning methodology for learning pharmacology, pharmacology topics which are useful for future clinical practice, the pharmacology topic which was most interesting and recommendations for improvement. The response rate was 46.4% and majority of the participants were females (65.7%). Most of the students agreed that interactive learning was more helpful than didactic lectures (88.0%). Seventy percent of the students reported that pharmacology lectures in the preclinical years were helpful during the clinical years. Percentage of students who agreed that pharmacology teaching in their preclinical was adequate for their clinical practice was 47.0%. There was no association between demographic variables (gender, race, year of study and medical family background) and interest in pharmacology (p>0.05). In conclusion, the pharmacology teaching during preclinical years was perceived to be effective and useful for students’ clinical practice. More pharmacology teaching sessions in clinical years was suggested which may improve adequacy of pharmacology teaching.
  6. Yap, K.B., Shereen, T.S.P., Yeoh, C.N., Liu, C.Y., Nadia, M.N., Joanna, O.S.M., et al.
    Medicine & Health, 2019;14(1):135-144.
    MyJurnal
    This prospective crossover study compared the incidence of posterior vessel wall puncture between two approaches during ultrasound-guided simulated central venous cannulation by anaesthesiology trainees. Each phantom model, simulating a central vein and artery, was cannulated by 37 anaesthesiology trainees under ultrasound-guidance using the in-plane approach (IPA) and out-of-plane approach (OPA). Total procedural time and the time taken from starting image scanning until commencing puncture, was recorded. The number of attempts required to achieve successful venous cannulation was noted. Finally, the models were examined for posterior venous wall and arterial puncture. Total procedural time was shorter with the OPA (26.5 vs 50.3 seconds, p=0.001). The time taken from starting image scanning until commencing puncture was shorter for the OPA (2.2 vs 12.3 seconds, p
  7. Mardziah, M., Salwati, S., Azlin, I., Hafiza, A., Azma, R.Z., Noor Farisah, A.R., et al.
    Medicine & Health, 2019;14(1):145-156.
    MyJurnal
    Chronic myeloid leukemia (CML) patients who have BCR-ABL T315I mutation, usually present in the advance phase of the disease with overall survival (OS) shorter than those without the mutation. This study aimed to determine the prevalence of T315I mutation amongst imatinib mesylate (IM) resistant CML patients and to compare the OS between T315I-mutated and non-T315I-mutated patients. Sixty consecutive CML patients who were treated with IM for at least 18 months and their treatment responses, were recorded. The mutation analysis was done using allele-specific oligonucleotide reverse transcriptase-polymerase chain reaction (RT-PCR) assay followed by direct sequencing technique. Forty-two patients (70%) were found to have IM-resistance. Five out of 42 patients had detectable T315I mutation. Median OS of IM-resistant T315I-mutated patients was 96 months (95% CI:54-138) compared to 84 months (95% CI:48-120) in non T315I-mutated patients, although this was found to be statistically insignificant (p = 0.43). The present study showed a higher prevalence of T315I mutation as compared to a few local studies. Median OS of T315I-mutated patients were observed to be longer than non-T315-mutated patients. Further studies encompassing larger cohort of patients are required to confirm this finding.
  8. D. Maryama, A.D., Melvina, M.C.
    Medicine & Health, 2019;14(1):157-171.
    MyJurnal
    Cardiopulmonary capacity should be evaluated accurately to determine exercise intolerance and training intensity of stroke survivors before an exercise rehabilitation programme is prescribed. However, no cardiopulmonary exercise test (CPET) is suitable because of the stroke victims’ physical impairment. The aim of this study was to develop and validate a new rowing-ramp protocol as a CPET for stroke survivors. Eleven stroke patients (6 male; 5 female; age, 45 + 16.01 years, performed two incremental exercise tests on a Concept II rowing ergometer to determine the peak oxygen consumption (VO2 peak). Test-retest reliability for VO2 peak, measured 1-week apart, resulted in an intra-class correlation of 0.97 and 0.95, respectively. A linear regression equation was developed to predict the VO2 peak from final stage stroke power. Validity and reliability of the prediction equation were established. The regression equation for predicted VO2 peak was VO2 peak=11.429±+ 0.232 (Final Stage Stroke Power) + 12.63 (F=25.326, p
  9. Kuharajan R., Mohd Yazid, B., Ohnmar, H., Yuliawiratman, B.S.
    Medicine & Health, 2019;14(1):172-182.
    MyJurnal
    Charcot arthropathy is a devastating degenerative condition which affects one or more joints that is marked by joint instability, hypermobility resulted from peripheral nerve damage. This was a retrospective study performed on patients who were diagnosed with Charcot arthropathy and those underwent surgery for hindfoot arthrodesis at Universiti Kebangsaan Malaysia Medical Centre from January 2011 until June 2016. The objective of the study was to review the feasibility of an algorithm in managing Charcot arthropathy and to assess functional, clinical and radiographic outcomes of Charcot arthropathy joints treated with hindfoot arthrodesis, at least 6 months follow-up using standardized and internationally accepted scoring systems, which were the American Orthopaedic Foot and Ankle Surgery (AOFAS) score and SF36. A total of 16 patients were included in this study of which 4 (25%) were males and 12 (75%) were females. The mean age was 58.1 (20-71) years. There was equal distribution for side of fusion. We achieved union in 13 out of our 16 (81%) cases followed up. Out of the 3 patients with non-union, 2 were attributed to deep infections. The AOFAS scores for hindfoot and midfoot showed significant improvement post operatively with p-value
  10. Ismail, A.K., Court, D.J., Anthonysamy C.
    Medicine & Health, 2019;14(1):183-190.
    MyJurnal
    Most spider species in Malaysia are considered harmless and spider bites are rarely reported. This is partly due to the mild effects from the bite and victims do not seek medical treatment in the hospital. To date, there are few well-documented cases of medically significant bites from indigenous spider species in Malaysia. Here, we report the presentation, clinical management and outcome of two patients following a bite by the yet to be described ‘Black & Gold’ Huntsman spider from the genus Thelcticopis in Malaysia. The first case involved a 42-year-old man who was bitten on the tip of the distal phalanx of his right middle finger and presented with severe pain and local swelling. He was treated symptomatically and was discharged well. The second case involved a 57-year-old woman, who was bitten on the proximal phalanx of her right little finger and presented with severe throbbing pain and progressive swelling. She was treated symptomatically and was discharged after 24 hours observation in the medical ward. However, she noted moderate neck and generalized joints pains especially affecting the hips and knees, one day prior to discharge. She was treated with oral analgesia and symptoms resolved within two days.
  11. Nurul Ain, K.B., Mahanem, M.N., Irfan, Y.
    Medicine & Health, 2018;13(2):20-35.
    MyJurnal
    Population explosion is one of the global issues of concern. The increasing number of individuals could result in negative impact on social and economy. To overcome this problem, convenient and safe modern contraception was introduced. However, recently many researchers have conducted studies on the effectiveness of medicinal plants as contraceptive agents on human and animal models. Therefore, the studies of herbal and modern contraceptives were summarized in this review article. A total of 66 relevant articles were documented having information regarding the modern and herbal contraceptives. All contraceptives are highly effective provided they are used consistently and in the proper way. Contraception is important as it could prevent diseases and infections caused by sexual intercourse and prevent unintended pregnancy. Therefore, this review is an attempt to summarize the potential of medicinal plants as contraceptive agents and the modern contraceptive methods used as birth control in males and females.
  12. Marina, M.B., Mohd Tahir, J., Mawaddah, A., Asma, A., Mohd Razif, M.Y., Jemaima, C.H.
    Medicine & Health, 2018;13(2):36-47.
    MyJurnal
    Obstructive Sleep Apnoea (OSA) affects 2-5% of the middle-aged population and is a potentially life-threatening condition. Previous studies on OSA and glaucoma have reported mixed findings. This was a cross-sectional comparative study with a study duration of one year to compare the incidence of high intraocular pressure among OSA subjects and non-OSA subjects. This study took place in a tertiary hospital where a total of 50 subjects with OSA and 50 non-OSA subjects were recruited. The average age was 37 years (19,65) in a multiethnic study population (76% (Malay), 18% (Chinese) and 6% (Indian)). All patients underwent a full night computer-assisted polysomnogram (SOMNOCheck Effort Weinmann, Hamburg, Germany), Epworth Sleepiness Scale (ESS), Mullers manouevre (MM) to assess the level of obstruction and tonometry. The incidence of high Intra Ocular Pressure (IOP) among OSA subject was 52% with a significant difference between non-OSA and OSA subjects. Correlation between ESS and IOP were significant (p
  13. Nurul Azmawati, M., Hariz, M.S., Mohd Dzulkhairi, M.R., Shalinawati, R., Ilina, I.
    Medicine & Health, 2018;13(2):48-57.
    MyJurnal
    Ebola virus disease (EVD), Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), rabies and Nipah infections were examples of diseases that were related to bats and shook the world with a series of outbreak and epidemic. Through the understanding of bats as potential public health risk, awareness had become vital to prevent another outbreak. This pilot study was done to evaluate the appropriateness of the questionnaires and to determine preliminary data on knowledge, attitude and practices of bats-related infections. Residents of a village were recruited by randomly choosing houses from a list obtained from the local head village. Knowledge, attitude and practice were assessed using a 56-items questionnaire. The study recruited 100 respondents. The questionnaire’s Cronbach Alpha score was 0.817. Majority of the respondents were found to have good knowledge (71%), attitude (99%) and practice (64%) relating to bat-related infection. There was a weak positive correlation between knowledge and practice towards bat-related infections among residents of the study population. Majority (80%) of respondents did not aware that bats can cause rabies, and 84% did not know about rabies vaccination. The result of this pilot study provides a limited but valuable insight into bat-related infection. Overall, respondents had good knowledge, attitude and practice scores towards bats-related infection. However, more awareness is needed to key areas lacking such as in educating awareness about rabies in bats.
  14. Gunawan, E., Deo, P., Hidayat, T., Pandia, V., Iskandar, S., Yuni, P.S., et al.
    Medicine & Health, 2018;13(2):95-102.
    MyJurnal
    Lecturers are expected to cope with stress in their workplace in order to continue to be productive. The demand to fulfill targets will increase the incidence of occupational stress. The aim of the study was to determine the factors associated with occupational stress among state university lecturers in Bandung, Indonesia. The study was carried out on 354 state university lecturers in Bandung, who came to the research location during May 2017. It was conducted by means of a diagnostic survey with the use of the Self Reporting Questionnaire (SRQ), Spiritual Wellness Inventory-R (SWI-R), Social Readjustment Rating Scale (SRRS), Miller Smith lifestyle assessment inventory, and Occupational Stress Scale (OSC). A total of 330 respondents became our study subjects with response rate of 92.94%. A correlation bivariate was applied to analyse the correlation of external and internal factors with occupational stress. The statistical analysis was conducted by means of SPSS Statistics 18.0 with p≤0.05. From 330 lecturers, there were 153 (46.4%) males and 177 (53.6%) females. The marital status included 257 (77.9%) married, 27 (8.2%) single, while 46 (13.9%) did not answer. The results proved the existence of a correlation between life, stress event, life style, mental emotional disorders, with occupational stress. The spirituality factors contributed to occupational stress were selfworth, control, and connectedness. Lecturer had to cope with occupational stress. There are some factors, which could influence occupational stress among lecturers.
  15. Syaziah, I., Azura, S.S., Tzar, M.N.
    Medicine & Health, 2018;13(2):103-113.
    MyJurnal
    The AIDS epidemic in Southeast Asia has led to a marked rise in the incidence of talaromycosis (penicilliosis) marneffei. The aim of this cross-sectional study was to determine the clinico-epidemiological features and outcome predictors of talaromycosis in Malaysia. We identified Talaromycosis marneffei cases from cultures of sterile specimens from 191 human immunodeficiency virus (HIV)- infected patients. Talaromycosis increased from 20-25 (2010-2011) to 45-50 cases per year (2012-2014). Talaromycosis was the HIV-presenting illness in 117 (61.3%) patients. The incidence of talaromycosis as HIV-presenting illness showed an increasing trend from 10.7 (2010) to 26.4 (2014) cases per 1000 new HIV patients. The patients were between 19 and 74 of age (mean 37.2+9.4 years) and the male to female ratio was 7.7:1. Malay (73, 38.2%) and Chinese (70, 36.3%) were the most prevalent ethnic groups. Common clinical manifestations included loss of weight (85.9%), fever (84.8%) and cough (67%), while skin lesions were only present in 42.9% cases. Common concurrent infections were oral candidiasis (79.6%), tuberculosis (36.1%) and hepatitis C infection (20.9%). Most patients (93.7%) were anaemic with mean haemoglobin level of 9.9+2.3 g/dL, 39% had impaired liver function, and 18.8% were neutropaenic. Median CD4 cell count was 16 cells/L. Most patients (70.4%) received intravenous amphotericin B followed by itraconazole. At 8-month follow up, 148 (81.8%) patients were alive while 33 (18.2%) had died. Intravenous drug abuse, concurrent toxoplasma encephalitis and concurrent Pneumocystis jiroveci pneumonia independently predicted death outcome in both univariate and multivariate logistic regression analyses.
  16. Amiratul Athirah, S., Aryati, A., Wan Rohani, W.T.
    Medicine & Health, 2018;13(2):58-71.
    MyJurnal
    Leptin is a hormone that regulates the energy intake and expenditure which is encoded by leptin gene. Leptin gene variants were studied comprehensively in relation with body weight status, but the evidences were indecisive. This study was to determine the association between leptin gene variants, G2548A, H1328080 and A19G with obesity and its attributes in Terengganu, Malaysian population. This study involved a total of 249 Malay subjects (101 healthy adults with normal BMI as the control group and 148 overweight and obese subjects). The anthropometrics data were obtained, blood samples were collected for genetic markers and lipid profile analyses. PCR-RFLP technique was performed to determine the genotype and allele distribution of leptin gene variants. The genotypic and allelic frequencies of leptin gene variants presented no significant difference between groups, G2548A (P = 0.93 and 0.74); H1328080 (P = 0.58 and 0.56); and A19G (P = 0.72 and 0.38) correspondingly. However, there was statistical significant difference between triglyceride level and genotypes of G2548A variant (P = 0.016); between total cholesterol level and H1328080 genotypes (P = 0.027). In addition, multivariate logistic regression projected the male gender (adjusted OR= 26.27; CI= 1.06-1.25; P = 0.009), waist circumference (adjusted OR = 1.15; CI = 1.06-1.25; P = 0.001) and body fat percentage (adjusted OR = 1.43; CI = 1.20-1.70; P
  17. Sherina, Q., Rosiah, M., Mushawiahti, M.
    Medicine & Health, 2019;14(2):271-277.
    MyJurnal
    Acute retinal necrosis (ARN) is a rare, blinding disease that typically affects adults. However, in this case report, we highlight the diagnosis, management and outcome of herpes simplex acute retinal necrosis in a 13-year-old healthy girl, who presented with painful right eye, redness and blurring of vision for one week. Examination of the right eye showed features of granulomatous panuveitis. Optic disc was swollen and retina appeared pale. There were multiple patches of retinitis and haemorrhages at mid-periphery of the fundus with inferior serous detachment observed. Rapidly progressive inflammation in just four days along with secondary cataract that obscured fundus view, imposed greater challenge to the diagnosis and management. Intravenous acyclovir 300mg, 3 times a day was initiated promptly while vitreous fluid was sent for polymerase chain reaction, which identified Herpes Simplex Virus-1. Inflammation improved, but she developed vitreous haemorrhage secondary to proliferative retinopathy, which required panretinal photocoagulation. ARN is therefore, principally a clinical diagnosis and high index of suspicion is crucial particularly, in children for prompt diagnosis and treatment. Complications should also be addressed timely to improve the chances of preserving vision.

  18. Manali Haniti, M.Z., Norazrina, A., Chan, K.M.
    Medicine & Health, 2018;13(2):3-19.
    MyJurnal
    Neurodegenerative diseases commonly affect elderly population and are characterised by progressive neuronal loss. Oxidative stress is highly associated with neurodegeneration. The targeted herbal plant in this review, Ocimum basilicum (O. basilicum), is typically used in Indochina and Italian cuisine. Pharmacological studies on O. basilicum have demonstrated potent antioxidant activities with some reports of neuroprotective actions. This brief review highlights the potential neuroprotective roles of O. basilicum by discussing previously documented antioxidative actions of the plant extract, essential oils and its phytochemical compounds on the nervous system based on in vitro and in vivo studies. Accumulating evidence on the neuroprotective action of O. basilicum points to a notion that neuroprotection is made possible by way of its antioxidant properties and largely due to the presence of polyphenol compounds such as rosmarinic acid which has been identified as the major constituent. Although the mechanisms of O. basilicum antioxidant action have been proposed, further studies are required for better understanding of its antioxidant action leading to neuroprotective roles. It is also possible that the antioxidant actions of O. basilicum are mediated through synergism of a mixture of various naturally-occurring bioactive compounds in the plant, as is with many other plant-based food supplements, to produce the putative effects instead of a single bioactive compound from the plant. Therefore, specific targeting of neuroprotection by means of antioxidant actions warrants further preclinical and clinical studies investigating the therapeutic potentials of O. basilicum particularly in view of the prevention of neurodegenerative processes.
  19. Nurulaini, A., Syahnaz, M.H., Shamsul, A.S., Teh Rohaila, J.
    Medicine & Health, 2018;13(2):133-144.
    MyJurnal
    Gait and balance disorder are among the most common causes of falls in elderly and often lead to injury, disability and loss of independence. However, there might be a discrepancy between elderly’s perception of their own walking ability, balance, risk of fall with doctor’s evaluation. The aim of this study was to compare perception of the elderly’s walking ability, balance and risk of fall with clinical assessment. This cross sectional study was done in a Primary Care Clinic which involved elderly > 60 years using systematic random sampling. Participants completed a self-administered questionnaire comprising of sociodemographic data and question assessing their perception of ability of walking, balance and risk of fall. Actual clinical assessment was done using Tinetti Performance Oriented Mobility Assessment. Most of the participants perceived they had good walking (84.4%) and balance ability (77%). A small proportion (11.5%) agreed that they are at risk of fall. There was a good agreement in walking ability (k: 0.702, p:
  20. Ng, V.H., Ahmad Khaldun, I., Siti Sarah, M.Z., Ida Zarina, Z.
    Medicine & Health, 2018;13(2):114-121.
    MyJurnal
    Pain is one of commonest presentations at Emergency Department (ED). Previous studies showed inadequate pain control in ED. However, few have addressed specific, practical methods of improving the timeliness and frequency of pain control in emergency setting. This study was a randomized controlled trial in a simulated environment of an actual functioning ED using a timer device to remind care personnel to assess pain and provide analgesia at set intervals versus a “standard therapy” group without visual/audio aids. The mean documentation performance scores between timer and control groups were 94.45% + 5.85 vs 72.22% + 17.57 (p
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