MyMedR

Displaying all 8 publications

Abstract:

Sort:

Fulltext Severe open fracture of the tibia associated with massive soft tissue loss: limb salvage revisited

Shamsuddin AA, Mujait K

Med J Malaysia, 2005 Jul;60 Suppl C:108-10.
PMID: 16381294

The choice between limb salvage and primary amputation in a severely injured limb is at time difficult. A case of severe Gustilo type-IIIB open fracture of the tibia with massive soft tissue loss is presented to highlight the immediate and definitive treatment undertaken to preserve the limb.
Fulltext Impact of a Supplementation Policy (STOP) on Prescribing Pattern and Cost in a Rural Referral Hospitals of Sabah

S. Raman, Rohani R. N., Shamsuddin A. L., Saharun M. R.

Borneo Journal of Medical Sciences, 2019;2(101):21-22.
MyJurnal

In Malaysia, there is an increase in both demand and prescribing of supplements. Such trend raises the likelihood of adverse events and treatment costs. Numerous prescribing policies have been suggested for better utilization of resources. However, the adherence and improvement from such policies are yet to be fully characterized.
Fulltext Gaining insight into patients’ experience of adherence to hypertensive treatment

Lee, K., Yunus, M., Loong, Y. Y., Shamsuddin, A., Zubaidah, J., Rosna, A. R.

Malaysian Journal of Medicine and Health Sciences, 2010;6(2):43-50.
MyJurnal

Hypertension is one of the major risk factors for coronary heart disease and the most important factor for cerebrovascular diseases. Adherence to treatment is a fundamental pre-requisite for therapeutic benefit in hypertensive patients. Adherence is a complex behavioural process that is strongly influenced by the way in which patients live, as well as the psychological and social support system.
Aim: To understand and conceptualize the experience of people on long-term antihypertensive treatment Method: Qualitative analysis using semi-structured interviews with ten hypertensive patients from the medical clinic of Kuala Lumpur General Hospital.
Results: Although the participants were aware of having high blood pressure they declined receiving any treatment at the early stage of the disease. Fear of death and disease complications are reinforcements for participants to adhere to medication. They perceived the label of “hypertension” will affect their self-identity and social role. Positive thinking regarding medication assists participants to adhere to treatment. Conversely, participants who perceived medication negatively also adhere to a medication regime, as adherence behaviour satisfies the family. Participants justified modifying their regimen or taking Complementary and Alternative Medicine (CAM) as they believe know the their body best. However, participants wished to obtain more information regarding hypertension and its treatment from the doctors.
Conclusion: In finding the fine balance between stepping in and holding back treatment and care, health professionals need to know their clients in context. This balance can only be achieved by establishing processes of negotiation within an ongoing therapeutic relationship.

Study site: medical clinic of Kuala Lumpur General Hospital.
Fulltext Association between single trough-based area under the curve estimation of vancomycin and treatment outcome among methicillin-resistant Staphylococcus aureus bacteremia patients

Makmor-Bakry M, Ahmat A, Shamsuddin A, Lau CL, Ramli R

Anaesthesiol Intensive Ther, 2019;51(3):218-223.
PMID: 31434472 DOI: 10.5114/ait.2019.87362

BACKGROUND: Failure of antibiotic treatment increases mortality of critically ill patients. This study investigated the association between the treatment resolution of methicillin-resistant Staphylococcus aureus (MRSA) bacteremia and vancomycin pharmacokinetic variables.
METHODS: A total of 28 critically ill patients were included in this study. All data were collected from medical, microbiology and pharmacokinetic records. The clinical response was evaluated on the basis of clinical and microbiological parameters. The 24-h area under the curve (AUC0-24) was estimated from a single trough level using established equations.
RESULTS: Out of the 28 patients, 46% were classified as responders to vancomycin treatment. The trough vancomycin concentration did not differ between the responders and non-responders (15.02 ± 6.16 and 14.83 ± 4.80 μg mL-1; P = 0.929). High vancomycin minimum inhibitory concentration (MIC) was observed among the non-responders (P = 0.007). The ratio between vancomycin trough concentration and vancomycin MIC was significantly lower in the non-responder group (8.76 ± 3.43 vs. 12.29 ± 4.85 μg mL-1; P = 0.034). The mean ratio of estimated AUC0-24 and vancomycin MIC was 313.78 ± 117.17 μg h mL-1 in the non-responder group and 464.44 ± 139.06 μg h mL-1 in the responder group (P = 0.004). AUC0-24/MIC of ≥ 400 μg h mL-1 was documented for 77% of the responders and 27% of the non-responders (c2 = 7.03; P = 0.008).
CONCLUSIONS: Ratio of trough concentration/MIC and AUC0-24/MIC of vancomycin are better predictors for MRSA treatment outcomes than trough vancomycin concentration or AUC0-24 alone. The single trough-based estimated AUC may be sufficient for the monitoring of treatment response with vancomycin.
Kimura's disease: a report of three cases with a brief review of literature

Madhavan M, Othman NH, Singh MS, Indudharan R, Sharma HS, Shamsuddin AR

Acta Otorhinolaryngol Ital, 2000 Aug;20(4):284-9.
PMID: 11234448

Kimura's disease (KD) is an uncommon chronic inflammatory condition of unknown aetiology involving subcutaneous tissue, presenting as a tumor like lesion with a predilection for the head and neck region. Clinically it is often confused with parotid tumor with lymph node metastasis. It is difficult to diagnose before tissue biopsy. Fine needle aspiration cytology has only limited value. Unless the pathologists are aware of this entity, it might be misdiagnosed. Surgery, radiotherapy and steroid therapy have been tried but none is proved best and recurrence is common. Three cases of KD seen in our hospital and the problems encountered in them are presented.
Fulltext Social media use in higher education: Building a structural equation model for student satisfaction and performance

Al-Rahmi AM, Shamsuddin A, Wahab E, Al-Rahmi WM, Alyoussef IY, Crawford J

Front Public Health, 2022;10:1003007.
PMID: 36203665 DOI: 10.3389/fpubh.2022.1003007

Social media utilization at the student-level has become more prevalent contemporary higher education. Hence, this study is aimed at developing a specific model, along with the behavioral intention to use, to explore educational quality, actual social media use, and task-technology fit that affects student satisfaction and performance impact through examining the synergies of constructivism, user acceptance and usage of information technology, and technology acceptance. To test, a survey was administered to 430 students across five Malaysian universities. Through structural equation modeling, findings indicate that to improve student satisfaction and student performance through embedded social media, students need to have opportunities to collaborate on learning, have easy access to social media, perceive such use to be easy, and have aligned expectation on performance and effort. Interestingly, the actual social media use, was the only variable in the model that did not predict student satisfaction, despite its role in predicting student performance. The study highlights that constructivist learning, as well as task-technology fit over social media, enhances the students' learning experience and enables knowledge sharing and dissemination. The effect of using social media on student satisfaction and academic performance highlights that all students think that it is adequate for their instructors to improve their usage of social media tools. Therefore, we advocate learners and students employing social media for academic purposes with the help of lecturers at higher teaching organizations and institutions.
Fulltext Nucleotide variations of 9-cis-epoxycarotenoid dioxygenase 2 (NCED2) and pericarp coloration genes (Rc and Rd) from upland rice varieties

Amer Hamzah M, Mohd Kasim NA, Shamsuddin A, Mustafa N, Mohamad Rusli NI, Teh CY, et al.

3 Biotech, 2020 Mar;10(3):105.
PMID: 32099746 DOI: 10.1007/s13205-020-2092-y

In this study, we analyzed the Rc and Rd genes that are responsible for the coloration of rice pericarps from six upland rice varieties. We also examined the association of pericarp coloration to the single nucleotide polymorphism in 9-cis-epoxycarotenoid dioxygenase 2 (NCED2), a key gene involved in abscisic acid (ABA) biosynthesis. Our findings demonstrated that all the upland rice varieties analyzed have a Rd gene which encodes a complete dihydroflavonol-4-reductase without early translational termination codon irrespective of their pericarp colors. However, the upland rice varieties with white pericarps were found to have a defective Rc gene with a 14-base deletion at exon 7 which could disrupt the function of a positive regulator of proanthocyanidin biosynthesis. In addition, the NCED2 genes from the upland rice varieties with white pericarps in this study have a C-allele while the NCED2 genes from Pandasan Red, Tomou and Taragang varieties that bear red pericarps were found to have a T-allele which was reported to be associated with a higher ABA level in upland rice. A better understanding of the gene sequences of upland rice varieties with red pericarp may provide important information for rice breeding programs.
Appendectomy and asthma: a search for an association in older subjects

Koay KL, Mohd Zim MA, Botross NP, Thong YK, Nordin N, Ramachandran A, et al.

Med J Malaysia, 2024 Jan;79(1):47-51.
PMID: 38287757

INTRODUCTION: Several risk factors found to be associated with postoperative complications and cancer surgery, which carry a significant morbidity risk to cancer patients. Therefore, prehabilitation is necessary to improve the functional capability and nutritional status of a patient prior to surgery, so that the patient can withstand any postoperative activity and associated deterioration. Thus, this study aims to assess the effectiveness of prehabilitation interventions on the functional status of patients with gastric and oesophageal cancer who underwent esophagectomy and gastrectomy.
MATERIAL AND METHODS: An interventional study was carried out among oesophageal and gastric cancer patients who had undergone surgery at the National Cancer Institute of Malaysia. The prehabilitation process took a maximum of two weeks, depending on the patient's optimisation before surgery. The prehabilitation is based on functional capacity (ECOG performance status), muscle function (handgrip strength), cardio-respiratory function (peak flow meter) and nutritional status (calorie and protein). Postoperative outcomes are measured based on the length of hospital stay, complications, and Clavien-Dindo Classification.
RESULTS: Thirty-one patients were recruited to undergo a prehabilitation intervention prior to gastrectomy (n=21) and esophagectomy (n=10). Demographically, most of the cancer patients were males (67.7%) with an ideal mean of BMI (23.5±6.0). Physically, the majority of them had physical class (ASA grade) Grade 2 (67.7%), ECOG performance status of 1 (61.3%) and SGA grade B (51.6%). The functional capacity and nutritional status showed a significant improvement after one week of prehabilitation interventions: peak expiratory flow meter (p<0.001), handgrip (p<0.001), ECOG performance (p<0.001), walking distance (p<0.001), incentive spirometry (p<0.001), total body calorie (p<0.001) and total body protein (p=0.004). However, those patients who required two weeks of prehabilitation for optimization showed only significant improvement in peak expiratory flow meter (p<0.001), handgrip (p<0.001), and incentive spirometry (p<0.001). Prehabilitation is significantly associated postoperatively with the length of hospital stay (p=0.028), complications (p=0.011) and Clavien-Dindo Classification (p=0.029).
CONCLUSION: Prehabilitation interventions significantly increase the functional capacity and nutritional status of cancer patients preoperatively; concurrently reducing hospital stays and complications postoperatively. However, certain cancer patients might require over two weeks of prehabilitation to improve the patient's functional capacity and reduce complications postoperatively.