MyMedR

Fulltext Text messaging: an innovative method of data collection in medical research

Kew S

BMC Res Notes, 2010 Dec 20;3:342.

PMID: 21172018 DOI: 10.1186/1756-0500-3-342

BACKGROUND: The ubiquitous use of mobile phones in sending and receiving text messages has become a norm for young people. Undeniably, text messaging has become a new and important communication medium not only in the social realm but in education as well. The aim of this study is to evaluate the effectiveness of using text messaging as a means to collect data for a medical research project.A cross sectional study was carried out during a double blind, randomized controlled trial to assess the efficacy and safety of a probiotic in the management of Irritable Bowel Syndrome (IBS). The study aim was to assess the response rate of weekly symptom reports via Short Message Service (SMS). The subjects were undergraduates in a private medical university in Malaysia. They were identified through a previous university wide study as suffering from IBS based on Rome III criteria. The subjects were randomly assigned to either the treatment arm receiving a daily probiotic, or the placebo arm. They were required to score their symptoms using eight-item-questionnaires at baseline, and thereafter weekly, for a total of 8 weeks. All subjects were given the choice to communicate their symptom scores by text messaging via mobile phones or by email. SMS text messages were sent to remind trial subjects to attend face-to-face visits and to complete a paper based 34-item-questionnaires on IBS quality of life assessment at baseline and at end of 8 weeks.

FINDINGS: The response rate of weekly symptom scores via Short Message Service (SMS) from a total of 38 subjects was 100%. Through the study, 342 reports were submitted: 33.3% of these were received on the due date without reminder, 60.0% one day after the deadline, after a single reminder, 6.1% 2-3 days after the deadline, after 2-3 reminders and 0.6% 5 days after the deadline, after SMS, phone reminder and face-to-face encounter. All SMS symptom reports, whether on time or late, were complete. With the help of SMS reminder, all trial subjects completed the paper based IBS quality of life assessment at baseline and at end of study.

CONCLUSIONS: This study found using text messaging via mobile phone an excellent instrument for collecting weekly symptom reports in response to trial medication, reminding trial subjects to attend face to face visits and completing more complex paper based evaluation. The 100% response rate of weekly symptom reports was facilitated by using simple number codes for SMS submission.

TRIAL REGISTRATION: Not appropriate.

Ice-cream stick injury resembling torus palatinus

Khajotia R, Kew ST

Ear Nose Throat J, 2013 Sep;92(9):E33.

PMID: 24057915

Fulltext Images in clinical medicine: Melanosis coli

Kew ST, Chakravarthi S

N Engl J Med, 2013 Jun 13;368(24):2303.

PMID: 23758235 DOI: 10.1056/NEJMicm1204882

Fulltext The eyes have it - A diagnostic challenge

Loh KY, Kew ST

Aust Fam Physician, 2010 Sep;39(9):647-8.

PMID: 20877768

Fulltext Endocannabinoid system and cardio-metabolic risk

Loh KY, Kew ST

Med J Malaysia, 2008 Oct;63(4):348-50; quiz 351.

PMID: 19385504 MyJurnal

Recent research in bio-medical science has shown an integral role of endocannabinoid system (ECS) in determining cardio-metabolic risk of human body. The mechanism is mediated through binding of endocannabinoids at the CB1 receptors. The stimulation of CB1 receptor in the brain is believed to control and mediate the effects on appetite. In normal physiology, CB1 receptors activation is responsible for energy homeostasis, govern emotions and behaviors such as anxiety, fear, appetite, food and water intake. CB1 receptors also found in peripheral tissues like liver, pancreas, skeletal muscles and adipose tissues, which play an important role in lipid and glucose metabolism. Over-activation of ECS is associated with various metabolic diseases such as dyslipidemia, insulin resistance, lipogenesis, excessive weight gain and increasing intra-abdominal obesity. All these events lead to increased cardiovascular risk. Use of selective CB1 receptor blocker such as rimonabant has shown to reduced waist circumference, better glycemic control, lower triglyceride levels, raise HDL cholesterol and over all reduction in total body fat. This drug has been recommended for patients with metabolic syndrome.

Fulltext Respiratory clinics: left-sided hydropneumothorax in a young male: importance of clinical and radiological markers in arriving at an aetiological diagnosis

Khajotia R, Kew S, Cham Y

Malays Fam Physician, 2009;4(1):41-3.

PMID: 25606160

Fulltext Understanding non ulcer dyspepsia

Loh KY, Kew ST

Med J Malaysia, 2008 Jun;63(2):174-6; quiz 177.

PMID: 18942314 MyJurnal

Non ulcer dyspepsia is one of the most common problems encountered in primary care practice. The underlying pathophysiology of non ulcer dyspepsia is not fully understood, but it is known that this condition is associated with H. pylori infection and motility disorder. The presenting abdominal symptoms are non specific: they include bloating, belching, flatulence, excessive fullness after eating and nausea. Psychological condition such as anxiety, depression and stress do play a role in the recurrence of symptoms. Upper GI endoscopy is necessary in patients who presents with alarm symptoms suggestive of possible underlying organic condition before one makes the diagnosis of non ulcer dyspepsia. Pharmacological therapy using H2 receptor antagonist and proton pump inhibitors are effective for symptom relief. Patient's education and supportive care should be part of the management strategy in recurrent chronic dyspepsia.

Fulltext A man with contracted fingers

Loh KY, Kew ST

Aust Fam Physician, 2008 Mar;37(3):150.

PMID: 18345365

An Indian man from Malaysia presented with contracture of his hands. He is 55 years of age and has a history of chronic alcohol consumption. Examination revealed bilateral thickened structure at the palms.

Fulltext A painful gum

Loh KY, Kew ST

Aust Fam Physician, 2007 Sep;36(9):755.

PMID: 17885711

This middle aged Malaysian man presented complaining of painful gums for a few months. He is known to have had epilepsy since childhood.
Keywords: quiz; gum hypertrophy

Fulltext A man with an acute abdomen

Loh KY, Kew ST

Malays Fam Physician, 2008;3(2):109-10.

PMID: 25606131

Fulltext Educational Quiz. A painful gum

Loh KY, Kew ST

Aust Fam Physician, 2007 Nov;36(11):941.

PMID: 18050541

Fulltext Interpreting hepatitis B serology

Loh KY, Kew ST

Malays Fam Physician, 2007;2(1):31-2.

PMID: 25606076

Fulltext Glibenclamide induced chronic cholestasis simulating primary biliary cirrhosis: a case report

Ramanathan M, Wahinuddin S, Kew ST

Med J Malaysia, 1996 Mar;51(1):140-3.

PMID: 10967995

A 43-year-old lady with long standing non-insulin dependent diabetes mellitus on glibenclamide presented with cholestatic liver disease. Initially she was thought to have developed primary biliary cirrhosis (PBC). When she made a spontaneous recovery following the withdrawal of glibenclamide, it became obvious that the patient had been suffering from drug-induced chronic cholestasis (DICC). The subtle differences between PBC and DICC are highlighted.

Fulltext Cardiac arrhythmias and echocardiographic features in Wolff-Parkinson-White syndrome

Ng WH, Kew ST

Med J Malaysia, 1980 Sep;35(1):41-5.

PMID: 7253998

Electrocardiographic features of the Woljf-Parkinson-White syndrome may be seen in normal individuals and in those with congenital or acquired heart disease. Predisposition to tachyarrhythmias and its misinterpretation are common. In this report a case of Wolff-Parkinson-White syndrome in a 25 year old Malay male who presented with cardiac arrhythmias is described. Echocardiographic findings and the role of echocardiography are discussed.

Fulltext Hepatitis B infection: what the primary care doctors should know

Kew ST, Loh KY

Malays Fam Physician, 2006;1(1):8-10.

MyJurnal

Hepatitis B virus infection is a global public health problem. The prevalence of hepatitis B infection is higher in Asia. The rate of HBsAg carriage in the general population ranges from 2-20%. The WHO has recommended that by the end of 21st century hepatitis B vaccination should be incorporated into routine childhood immunisation programmes for all nations. Vaccination against hepatitis B remains the most important aspect of preventive care. Most importantly hepatitis B vaccination can protect individual from fulminant hepatitis, liver cirrhosis and hepatocellular carcinoma. Primary care physicians must be familiar with the pathology, epidemiological and clinical presentations of this disease and be able to refer patients for appropriate treatment at the tertiary centre.

Fulltext A profile of acute myocardial infarction in urban Malays

Bakar R, Ng WH, Kew ST, Mohan A

Med J Malaysia, 1982 Mar;37(1):62-5.

PMID: 7121349

This is a retrospectioe study of epidemiological and riskfactors ofischaemic heart disease in Malay patients admitted into the Coronary Care Unit, General Hospital, Kuala Lumpur between October 1977 and December 1979 unth. proven myocardial infarction. Ofthe 116patients (M/F sex ratio 9.5 : 1), the incidence of various risk factors were smoking 82 percent, hypertension 42 percent, hypercholesterolemia 23 percent, diabetes mellitus 20 percent and family history 9 percent. Anterior infarctions were more common than inferior. Hyperuricemia was detected in 19 percent and 96 percent had at least one major riskfactor. In terms ofoccupation, a majorproportion ofthose afflicted were pensioners, security personnel and businessmen.

RSV and bronchiolitis

Van Rostenberghe HL, Kew ST, Hanifah MJ

Arch. Dis. Child. Fetal Neonatal Ed., 2006 Mar;91(2):F154.

PMID: 16492958

Fulltext Management of Helicobacter pylori infection--a Working Party Report of the Malaysian Society of Gastroenterology and Hepatology

Goh KL, Mahendra Raj S, Parasakthi N, Kew ST, Kandasami P, Mazlam Z

Med J Malaysia, 1998 Sep;53(3):302-10.

PMID: 10968173

The Working Party Report on the Management of Helicobacter pylori serves as a clinical practice guideline for Malaysian doctors. H. pylori is not uncommon in the Malaysian population. Marked racial differences and the consistently low prevalence rates amongst Malays are noted. The working party recommends that if endoscopy is to be performed, a rapid urease test should be used for diagnosis. Where suspicion of the infection is strong and the urease test is negative, histology should be performed on gastric biopsies. Culture should be used to monitor resistance patterns to antibiotics and regional laboratories should assume this responsibility. The urea breath tests are highly accurate tests for diagnosis of H. pylori but is as yet not widely available in Malaysia. The working party strongly recommends that all peptic ulcer patients infected with H. pylori whether active, in remission and complicated ulcers should be treated for the infection. Patients with low-grade gastric mucosal lymphoid tissue lymphoma should also be treated for H. pylori infection. It is considered advisable that patients on long term nonsteroidal antinflammatory drug (NSAID) treatment with a history of peptic ulcers or dyspepsia and patients following resection of early gastric cancer or those with a family history of gastric cancer should also be tested and treated for H. pylori. The working party recommends, as first line treatment a 7-day combination therapy of a proton pump inhibitor, clarithromycin and metronidazole or amoxicillin. High metronidazole resistance rates locally may adversely affect regimens containing the antibiotic. It should also be noted that regimens that yield lower eradication rates may result in higher long term expenditure.

Fulltext Training programme in medical gastroenterology and hepatology: recommendations of the Malaysian Society of Gastroenterology and Hepatology

Kew ST, Goh KL, Zawawi M, Tan SS, Mohd R, Raj SM

Med J Malaysia, 1999 Sep;54(3):406-7.

PMID: 11045074

Fulltext Distribution of blood glucose in a national sample of Malaysian adults

Lim TO, Ding LM, Zaki M, Suleiman AB, Kew ST, Maimunah AH, et al.

Med J Malaysia, 2000 Mar;55(1):65-77.

PMID: 11072493 MyJurnal

We describe the distribution of capillary blood glucose (BG) by age, sex and ethnicity in Malaysian adults. A national sample of 20,041 individuals aged 30 or older had usable data. They were selected by stratified 2-stage cluster sampling. BG was measured using reflectance photometer. Percentile tables and curves by age, sex and ethnicity are presented. The BG distribution was right skewed and showed the expected increase with age. Except in Indian, women had higher BG than men. There were also marked ethnic differences. Indian had the highest BG concentration, followed by Chinese, Malay and other indigenous ethnic group.
Study name: National Health and Morbidity Survey (NHMS-1996)

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