Displaying publications 141 - 160 of 23935 in total

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  1. Sumeet Kaur, Syaril Ezuan
    MyJurnal
    Objective: Suicide pacts are rare subsets of suicides amounting to less than 1% of suicides globally. Usually, there is one dominant participant to persuade the other by their shared experiences to agree to the suicide pact. There is also the perceived loss of a partner (which is a contributing factor in about 20% of cases) with the impending death of one member acting as a trigger.

    Methods: We report a 46-year-old Burmese lady who presented with deliberate self- poisoning immediately after the death of her husband to honour a suicide pact they made. She had no previous history of psychiatric illnesses. The pact, initiated by her husband, was well planned six months prior to his death.

    Result: She was discharged well after a thorough medical evaluation and supportive therapy. Input of family members knowledgeable in Buddhism helped allay her obligation to the pact citing religious reasons.

    Conclusion: The case highlights a suicide pact that was initially unrecognised in the ward. In a multicultural country, psychiatrists need to be more sensitive and aware of erroneous beliefs that may lead to a suicide pact.
    Matched MeSH terms: Female
  2. Ngah, U.K., Aziz, S.A., Aziz, M.E., Murad, M., Mahdi, N.M.N., Shakaff, A.Y.M., et al.
    ASM Science Journal, 2008;2(1):1-11.
    MyJurnal
    The incidences of breast cancer have been rising at an alarming rate. Mass breast screening programmes involving mammography and ultrasound in certain parts of the world have also proven their benefits in early detection. However, radiologists may be confronted with increased workload. An attempt has been made in this paper to rectify part of the problems faced in this area. Expert systems based on the interpretation of mammographic and ultrasound images for classifying patient cases could be utilized by doctors (expert and non-expert) in screening. These softwares consist of MAMMEX (for mammogram) and SOUNDEX (for breast ultrasound) could be used to deduce cases according to Breast Imaging Recording and Data System (BI-RADS), based on patients’ history, physical and clinical assessment, mammograms and breast ultrasound images. A total of 179 retrospective cases from the Radiology Department, hospital of the University of Science Malaysia, Kubang Kerian, Kelantan were used in this study. A receiver operating characteristic (ROC) curve analysis was implemented, based on the usage of a two-class forced choice of classifying suspicious and malignant findings as positive with normal, benign and probably benign classified as negative. Results yielded an area under the curve (AUC) of 0.997 with the least standard error value of 0.003 for MAMMEX while an AUC of 0.996 with the least standard error of 0.004 was accomplished for SOUNDEX. A system which very closely simulated radiologists was also successfully developed in this study. The ROC curve analysis indicated that the expert systems developed were of high performance and reliability.
    Matched MeSH terms: Female
  3. Abd-Aziz, N.A.A., Chatterjee, A., Chatterjee, R., Durairajanayagam, D.
    ASM Science Journal, 2014;8(2):117-124.
    MyJurnal
    Elevated glucocorticoid levels during stressed conditions have been demonstrated to impair reproductive function in rats. In our previous study investigating the dose-related effects of corticosterone (CORT) on the fertilising capacity of epididymal sperm in surgically-manipulated rats, we found that 25 mg/kg/day of CORT given subcutaneously for seven consecutive days significantly decreased the number of implantation sites and increased intrauterine embryonic loss compared to controls. Based on these findings, the current study aims to elucidate the possible mechanisms of action of CORT-induced stress on impaired sperm fertility in rats. Results of the present study showed that compared to controls, 25 mg/kg/day of CORT given subcutaneously for 7 consecutive days significantly increased the level of plasma malondialdehyde (MDA) with corresponding attenuated levels of superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) activities. Plasma adrenocorticotropin (ACTH) and testosterone levels were also found to be decreased in CORTtreated rats. These findings suggest that CORT-induced oxidative stress and exert an inhibitory effect at the hypothalamic-pituitary-gonadal (HPG) axis, as evidenced by increased lipid peroxidation, reduced enzymatic antioxidant activities, and decreased testosterone production. These subsequently result in decreased fertilising capacity of epididymal sperm leading to poor pregnancy outcomes.
    Matched MeSH terms: Female
  4. Teoh, P.H., Kuah, M.K., Lim, P.S., Muhammand, T.S.T., Najimudin, N., Chien, A.S.C.
    ASM Science Journal, 2010;4(2):123-132.
    MyJurnal
    The receptor-interacting protein 140 (RIP 140) is a well known nuclear repressor and has been shown to be crucial for female reproduction and metabolism. However, the function of this repressor in developmental processes is still unknown. We conducted a study to investigate the expression patterns of RIP 140 in developing zebrafish embryos. Semi-quantitative RT-PCR analysis revealed that RIP140 was highly expressed in the eye, swim bladder, reproductive and metabolic organs of adult zebrafish. During embryogenesis, RIP 140 mRNA was continuously expressed throughout all the developmental stages with the highest expression at 24 hours of post-fertilization (hpf). Furthermore, in situ hybridization whole-mounts revealed that the expression of this gene was mainly localized in the eyes, mid-brain, pectoral fin buds and somites. Therefore, this present study has provided a starting point for future investigations to examine the role of RIP 140 in the development of these organs.
    Matched MeSH terms: Female
  5. Yahya, A., Sidek, O., Salleh, M.F.M.
    ASM Science Journal, 2010;4(1):48-54.
    MyJurnal
    Frequency hopping spread spectrum (FHSS) systems with partial band interference require appropriate compounding of spread spectrum modulation, error correcting code, diversity and decoding method to receive improved transmission signal. In this paper, a fast FHSS system with regular low-density parity-check codes was employed to cater some anti-jamming competence by using good waterfall and error floor performance. The performance evalution of the previously mentioned system was conducted in the presence of partial band noise jamming. The best possible design of the system was achieved with the combination of diversity level L=2 with a probability rate of at 0.7 dB which showed the robustness of the system.
    Matched MeSH terms: Female
  6. Begum, T., Reza, F., Abdullah, J.M.
    ASM Science Journal, 2011;5(2):115-121.
    MyJurnal
    Reflex epilepsy is usually induced by external stimulation, photosensitive epilepsy being the most common. Epilepsy induced by auditory stimulation is rarely studied. There are no currently published magnetoencephalographic (MEG) studies demonstrating the initiation of epileptic neuronal discharges by repeated auditory stimulations in temporal lobe epilepsy (TLE) patients. We retrospectively studied one TLE patient who underwent a MEG study to localize her epileptic focus. Auditory, somatosensory, visual and motor evoked potential studies were performed during the MEG recording. A single dipole method calculated equivalent current dipoles to localize the epileptic source. The least-squares minimization method was used to obtain the optimal solution with goodness-of-fit of greater than 80%. Periodic lateralized epileptiform discharges (PLEDs) were recorded in the temporal region when repeated auditory stimulations were done. We postulated that neuronal cortical suppression occurred during repeated stimulations which provoked epileptiform discharges (PLEDs) without any physical symptoms or aura. It was concluded that repeated stimulations could facilitate epileptiform discharges in focal area/areas in certain subjects.
    Matched MeSH terms: Female
  7. Fathinul Fikri AS, Dharmendran R, Vikneswaran P, Nordin AJ
    Abdom Imaging, 2015 Aug;40(6):1457-64.
    PMID: 25576048 DOI: 10.1007/s00261-014-0343-2
    A study was undertaken to investigate the value of pretreatment PET-CT in predicting survival in patients with oesophageal cancer (OC).
    Matched MeSH terms: Female
  8. Hauswald M, Ong G, Tandberg D, Omar Z
    Acad Emerg Med, 1998 Mar;5(3):214-9.
    PMID: 9523928
    OBJECTIVE: To examine the effect of emergency immobilization on neurologic outcome of patients who have blunt traumatic spinal injuries.

    METHODS: A 5-year retrospective chart review was carried out at 2 university hospitals. All patients with acute blunt traumatic spinal or spinal cord injuries transported directly from the injury site to the hospital were entered. None of the 120 patients seen at the University of Malaya had spinal immobilization during transport, whereas all 334 patients seen at the University of New Mexico did. The 2 hospitals were comparable in physician training and clinical resources. Neurologic injuries were assigned to 2 categories, disabling or not disabling, by 2 physicians acting independently and blinded to the hospital of origin. Data were analyzed using multivariate logistic regression, with hospital location, patient age, gender, anatomic level of injury, and injury mechanism serving as explanatory variables.

    RESULTS: There was less neurologic disability in the unimmobilized Malaysian patients (OR 2.03; 95% CI 1.03-3.99; p = 0.04). This corresponds to a <2% chance that immobilization has any beneficial effect. Results were similar when the analysis was limited to patients with cervical injuries (OR 1.52; 95% CI 0.64-3.62; p = 0.34).

    CONCLUSION: Out-of-hospital immobilization has little or no effect on neurologic outcome in patients with blunt spinal injuries.

    Matched MeSH terms: Female
  9. Kelly AM, Keijzers G, Klim S, Graham CA, Craig S, Kuan WS, et al.
    Acad Emerg Med, 2017 Mar;24(3):328-336.
    PMID: 27743490 DOI: 10.1111/acem.13118
    OBJECTIVES: The objective was to describe the epidemiology of dyspnea presenting to emergency departments (EDs) in the Asia-Pacific region, to understand how it is investigated and treated and its outcome.

    METHODS: Prospective interrupted time series cohort study conducted at three time points in EDs in Australia, New Zealand, Singapore, Hong Kong, and Malaysia of adult patients presenting to the ED with dyspnea as a main symptom. Data were collected over three 72-hour periods and included demographics, comorbidities, mode of arrival, usual medications, prehospital treatment, initial assessment, ED investigations, treatment in the ED, ED diagnosis, disposition from ED, in-hospital outcome, and final hospital diagnosis. The primary outcomes of interest are the epidemiology, investigation, treatment, and outcome of patients presenting to ED with dyspnea.

    RESULTS: A total of 3,044 patients were studied. Patients with dyspnea made up 5.2% (3,105/60,059, 95% confidence interval [CI] = 5.0% to 5.4%) of ED presentations, 11.4% of ward admissions (1,956/17,184, 95% CI = 10.9% to 11.9%), and 19.9% of intensive care unit (ICU) admissions (104/523, 95% CI = 16.7% to 23.5%). The most common diagnoses were lower respiratory tract infection (20.2%), heart failure (14.9%), chronic obstructive pulmonary disease (13.6%), and asthma (12.7%). Hospital ward admission was required for 64% of patients (95% CI = 62% to 66%) with 3.3% (95% CI = 2.8% to 4.1%) requiring ICU admission. In-hospital mortality was 6% (95% CI = 5.0% to 7.2%).

    CONCLUSION: Dyspnea is a common symptom in ED patients contributing substantially to ED, hospital, and ICU workload. It is also associated with significant mortality. There are a wide variety of causes however chronic disease accounts for a large proportion.

    Matched MeSH terms: Female
  10. Chur-Hansen A, Vernon-Roberts J
    Acad Med, 1999 Jul;74(7):829-34.
    PMID: 10429593
    PURPOSE: To explore the use of standardized patients for evaluating medical student's proficiency in speaking English.

    METHOD: In 1995, using a language rating scale constructed by the authors, six standardized patients evaluated the English-language proficiencies of 127 second-year medical student undergraduates enrolled at the University of Adelaide, Australia, many of whom were from a non-English speaking background.

    RESULTS: An earlier standardized test (Screening Test for Adolescent Language) had identified approximately one third of the students as potentially experiencing difficulties in using English in their training. Students so identified were rated lower than were their peers by the standardized patients.

    CONCLUSION: The study proved useful both in identifying aspects of speech that can be reasonably rated by standardized patients and also in identifying students who might benefit from language interventions. Replication studies with the new instrument are required to further establish its reliability, validity, and generalizability across different student cohorts.

    Matched MeSH terms: Female
  11. Zaharias G, Piterman L, Liddell M
    Acad Med, 2004 Feb;79(2):148-55.
    PMID: 14744716
    BACKGROUND: Much research on gender differences in medicine has centered on women as better communicators, more egalitarian, more patient-centered, and more involved with psychosocial problems, preventive care, and female-specific problems. Hardly any research has examined the interaction between the doctor's gender and the patient's gender. The authors examined students' perceptions and comfort levels regarding patients' gender during consultation.

    METHOD: This cross-sectional study used a questionnaire to survey final-year medical students at one school in 1999. It tested students' patient-centeredness, "patient-care" values, and degree of comfort in performing certain intimate physical examinations.

    RESULTS: Women students were more patient-centered than were men students. Both genders were more attuned to the concerns of patients of their own gender, were more comfortable with personal rather than sexual issues, and were more uncomfortable with performing more intimate examinations upon the opposite gender. Using comparable case studies, it was also shown that the female student-female patient dyad had significantly greater "patient-care" values than did the male student-male patient dyad.

    CONCLUSION: Medical students did not behave in a gender-neutral way in the consultation. There is a powerful interaction between a student's gender and a patient's gender. This warrants further investigation in the real clinical situation because it has implications on the outcomes of the consultation.

    Matched MeSH terms: Female
  12. Coombs CM, Shields RY, Hunt EA, Lum YW, Sosnay PR, Perretta JS, et al.
    Acad Med, 2017 04;92(4):494-500.
    PMID: 27680320 DOI: 10.1097/ACM.0000000000001387
    PROBLEM: Because reported use of simulation in preclinical basic science courses is limited, the authors describe the design, implementation, and preliminary evaluation of a simulation-based clinical correlation curriculum in an anatomy course for first-year medical students at Perdana University Graduate School of Medicine (in collaboration with Johns Hopkins University School of Medicine).

    APPROACH: The simulation curriculum, with five weekly modules, was a component of a noncadaveric human anatomy course for three classes (n = 81 students) from September 2011 to November 2013. The modules were designed around major anatomical regions (thorax; abdomen and pelvis; lower extremities and back; upper extremities; and head and neck) and used various types of simulation (standardized patients, high-fidelity simulators, and task trainers). Several methods were used to evaluate the curriculum's efficacy, including comparing pre- versus posttest scores and comparing posttest scores against the score on 15 clinical correlation final exam questions.

    OUTCOMES: A total of 81 students (response rate: 100%) completed all pre- and posttests and consented to participate. Posttest scores suggest significant knowledge acquisition and better consistency of performance after participation in the curriculum. The comparison of performance on the posttests and final exam suggests that using simulation as an adjunctive pedagogy can lead to excellent short-term knowledge retention.

    NEXT STEPS: Simulation-based medical education may prove useful in preclinical basic science curricula. Next steps should be to validate the use of this approach, demonstrate cost-efficacy or the "return on investment" for educational and institutional leadership, and examine longer-term knowledge retention.

    Matched MeSH terms: Female
  13. Goh ZNL, Khoo EJ
    Acad Pediatr, 2018 07;18(5):481-482.
    PMID: 29331344 DOI: 10.1016/j.acap.2018.01.001
    Matched MeSH terms: Female
  14. Fernandez A, Tan KA, Knaak S, Chew BH, Ghazali SS
    Acad Psychiatry, 2016 Dec;40(6):905-911.
    PMID: 27527730
    OBJECTIVE:
    If presented with serious mental illness (SMI), individuals' low help-seeking behaviors and poor adherence to treatment are associated with negative stereotypes and attitudes of healthcare providers. In this study, we examined the effects of a brief psychoeducational program on reducing stigma in pre-clinical medical students.

    METHODS: One hundred and two pre-clinical medical students (20-23 years old) were randomly assigned to face-to-face contact + educational lecture (n = 51) condition or video-based contact + educational lecture (n = 51) condition. Measures of pre-clinical medical students' mental illness-related stigma using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) were administered at pre-, post-treatment, and 1-month follow-up.
    RESULTS: A 2 (condition: face-to-face contact + educational lecture, video-based contact + educational lecture) by 3 (time: pre-treatment, post-treatment, and 1-month follow-up) mixed model MANOVA was conducted on the Attitudes, Disclosure and Help-Seeking, and Social Distance OMS-HC subscales. Participants' scores on all subscales changed significantly across time, regardless of conditions. To determine how participants' scores changed significantly over time on each subscale, Bonferroni follow-up comparisons were performed to access pairwise differences for the main effect of time. Specifically, pairwise comparisons produced a significant reduction in Social Distance subscale between pre-treatment and post-treatment and between pre-treatment and 1-month follow-up, and a significant increase between post-treatment and 1-month follow-up, regardless of conditions. With respect to the Attitudes and Disclosure and Help-Seeking subscales, pairwise comparisons produced a significant reduction in scores between pre-treatment and post-treatment and a significant increase between post-treatment and 1-month follow-up.
    CONCLUSIONS: Our findings provide additional evidence that educational lecture on mental illness, coupled with either face-to-face contact or video-based contact, is predictive of positive outcomes in anti-stigma programs targeting future healthcare providers.
    KEYWORDS: Face-to-face contact; Stigma; Video-based contact
    Matched MeSH terms: Female
  15. Russell V, Clarke M, Loo CE, Bharathy A, Vasudevan U, Byrne E, et al.
    Acad Psychiatry, 2019 Apr;43(2):157-166.
    PMID: 30069698 DOI: 10.1007/s40596-018-0960-0
    OBJECTIVE: The study's objective was to determine the educational value of participation in a consultation/liaison psychiatry service to primary care clinics, from the perspective of Malaysian medical undergraduates.

    METHODS: A mixed method design was used. Fourth-year medical students participated in a consultation/liaison psychiatry service to two government-operated primary care clinics. Each student attended two half-day consultations to the clinics during the psychiatry clinical clerkship. Students joined in discussions with primary care clinicians, performed supervised clinical assessments, and administered a depression screening instrument. The learning experience was evaluated through four focus groups, each with 9-10 participants, held throughout the academic year. An end-of-year, anonymous, online questionnaire survey was administered to the entire class. Thematic analysis of focus group transcripts was performed and quantitative statistics were calculated (Stata version 13).

    RESULTS: Focus group themes included the following: (a) active learning opportunities in primary care psychiatry consultation had perceived added educational value, (b) students benefited from contact with patients with previously undiagnosed common mental disorders, and (c) students' primary care experience raised their awareness of societal and professional responsibilities. Of the class of 113 students, 93 (82%) responded to the questionnaire. The survey responses reflected the qualitative themes, with 79 respondents (85%) stating that the learning experience met or exceeded their expectations.

    CONCLUSIONS: Academic psychiatry has been criticized for its overreliance on secondary care settings in undergraduate clinical teaching. Our findings suggest that supervised clinical placements in primary care are feasible and provide added educational value as a routine component of the undergraduate psychiatry clinical clerkship.

    Matched MeSH terms: Female
  16. Siau CS, Wee LH, Yacob S, Yeoh SH, Binti Adnan TH, Haniff J, et al.
    Acad Psychiatry, 2017 Aug;41(4):503-509.
    PMID: 28168406 DOI: 10.1007/s40596-017-0661-0
    OBJECTIVES: This research is aimed to examine the attitude of health-care workers toward suicidal patients in Malaysian hospitals, comparing responses from psychiatric and non-psychiatric workers, and to identify specific needs in suicide prevention and management training.

    METHOD: This is a multi-site cross-sectional study. The authors conducted a survey based on a translated self-administered questionnaire to participants from seven core hospital departments.

    RESULTS: While most health-care workers regardless of department and specialty took their duty to prevent suicide seriously, a large majority of them expressed negative attitudes such as finding suicidal behavior irritating, and more than half believed suicidal attempts were a way of making others sorry. However, psychiatric workers were less likely to have judgmental attitudes that included believing suicide attempters as being selfish or trying to get sympathy from others.

    CONCLUSIONS: As there were more similarities than differences in health-care workers' attitudes toward suicide, recommendations on basic and continuous suicide prevention and management training among hospital workers were made. The interventions focused on improving knowledge, affective, and skill-based areas that were aimed to correct the wrongful understanding of and to minimize the negative attitudes toward suicidal individuals indicated by the study results.

    Matched MeSH terms: Female
  17. Hani AF, Kumar D, Malik AS, Walter N, Razak R, Kiflie A
    Acad Radiol, 2015 Jan;22(1):93-104.
    PMID: 25481518 DOI: 10.1016/j.acra.2014.08.008
    Quantitative assessment of knee articular cartilage (AC) morphology using magnetic resonance (MR) imaging requires an accurate segmentation and 3D reconstruction. However, automatic AC segmentation and 3D reconstruction from hydrogen-based MR images alone is challenging because of inhomogeneous intensities, shape irregularity, and low contrast existing in the cartilage region. Thus, the objective of this research was to provide an insight into morphologic assessment of AC using multilevel data processing of multinuclear ((23)Na and (1)H) MR knee images.
    Matched MeSH terms: Female
  18. Wong SC, Nawawi O, Ramli N, Abd Kadir KA
    Acad Radiol, 2012 Jun;19(6):701-7.
    PMID: 22578227 DOI: 10.1016/j.acra.2012.02.012
    The aim of this study was to compare conventional two-dimensional (2D) digital subtraction angiography (DSA) with three-dimensional (3D) rotational DSA in the investigation of intracranial aneurysm in terms of detection, size measurement, neck diameter, neck delineation, and relationship with surrounding vessels. A further aim was to compare radiation dose, contrast volume, and procedural time between the two protocols.
    Matched MeSH terms: Female
  19. Veeramuthu V, Seow P, Narayanan V, Wong JHD, Tan LK, Hernowo AT, et al.
    Acad Radiol, 2018 09;25(9):1167-1177.
    PMID: 29449141 DOI: 10.1016/j.acra.2018.01.005
    RATIONALE AND OBJECTIVES: Magnetic resonance spectroscopy is a noninvasive imaging technique that allows for reliable assessment of microscopic changes in brain cytoarchitecture, neuronal injuries, and neurochemical changes resultant from traumatic insults. We aimed to evaluate the acute alteration of neurometabolites in complicated and uncomplicated mild traumatic brain injury (mTBI) patients in comparison to control subjects using proton magnetic resonance spectroscopy (1H magnetic resonance spectroscopy).

    MATERIAL AND METHODS: Forty-eight subjects (23 complicated mTBI [cmTBI] patients, 12 uncomplicated mTBI [umTBI] patients, and 13 controls) underwent magnetic resonance imaging scan with additional single voxel spectroscopy sequence. Magnetic resonance imaging scans for patients were done at an average of 10 hours (standard deviation 4.26) post injury. The single voxel spectroscopy adjacent to side of injury and noninjury regions were analysed to obtain absolute concentrations and ratio relative to creatine of the neurometabolites. One-way analysis of variance was performed to compare neurometabolite concentrations of the three groups, and a correlation study was done between the neurometabolite concentration and Glasgow Coma Scale.

    RESULTS: Significant difference was found in ratio of N-acetylaspartate to creatine (NAA/Cr + PCr) (χ2(2) = 0.22, P 

    Matched MeSH terms: Female
  20. Tey LS, Zhu S, Ferreira L, Wallis G
    Accid Anal Prev, 2014 Oct;71:177-82.
    PMID: 24929822 DOI: 10.1016/j.aap.2014.05.014
    Level crossings are amongst the most complex of road safety issues, due to the addition of rail infrastructure, trains and train operations. The differences in the operational characteristics of different warning devices together with varying crossing, traffic or/and train characteristics, cause different driver behaviour at crossings. This paper compares driver behaviour towards two novel warning devices (rumble strips and in-vehicle audio warning) with two conventional warning devices (flashing light and stop sign) at railway level crossings using microsimulation modelling. Two safety performance indicators directly related to collision risks, violation and time-to-collision, were adopted. Results indicated the active systems were more effective at reducing likely collisions compared to passive devices. With the combined application of driving simulation and traffic microsimulation modelling, traffic safety performance indicators for a level crossing can be estimated. From these, relative safety comparisons for the different traffic devices are derived, or even for absolute safety evaluation with proper calibration from field investigations.
    Matched MeSH terms: Female
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