Displaying all 16 publications

Abstract:
Sort:
  1. Zaharan NL, Williams D, Bennett K
    Ir J Med Sci, 2014 Jun;183(2):311-8.
    PMID: 24013870 DOI: 10.1007/s11845-013-1011-1
    BACKGROUND: Over the last decade there have been significant changes in the prescribing of antidiabetic therapies. It is of interest to know about these trends and variations in the Irish population so that future prescribing patterns can be estimated.

    AIMS: To examine the trends in prescribed antidiabetic treatments, including variations across age, gender, socioeconomic status and regions in the Irish population over the last 10 years.

    METHODS: The Irish national pharmacy claims database was used to identify patients ≥ 16 years dispensed antidiabetic agents (oral or insulin) from January 2003 to December 2012 through the two main community drug schemes for diabetes. The rate of prescribing per 1,000 population was calculated. Logistic regression was used to examine variations in prescribing in patients with diabetes.

    RESULTS: There was a significant increase in the prescribing of fast and long-acting insulin analogues with a rapid decline in the prescribing of human insulin (p < 0.0001). Increased prescribing of metformin, incretin modulators and fixed oral combination agents was observed (p < 0.0001). Females and older aged patients were more likely to be prescribed human insulin than other insulins. Metformin was less likely while sulphonylureas were more likely to be prescribed in older than younger aged patients. Socioeconomic differences were observed in increased prescribing of the newer and more expensive antidiabetic agents in the non-means tested scheme. Regional variations were observed in the prescribing of both insulin and oral antidiabetic agents.

    CONCLUSION: There has been an increase over time in the prescribing of both insulin and oral antidiabetic agents in the Irish population with increasing uptake of newer antidiabetic agents. This has implications for projecting future uptake and expenditure of these agents given the rising level of diabetes in the population.

  2. Boyle E, Healy D, Hill AD, O'Connell PR, Kerin M, McHugh S, et al.
    Ir J Med Sci, 2013 Sep;182(3):337-43.
    PMID: 23242574 DOI: 10.1007/s11845-012-0882-x
    INTRODUCTION: The national junior doctor recruitment crisis prompts an appraisal of medical student attitudes to different career pathways. The purpose of this study was to perform a national review of surgical career intentions of Irish final year medical students.

    METHODS: Ethical and institutional approval was obtained at each study location. A questionnaire was designed and distributed to final year students. Domains assessed included demographics, career plans and reasons associated. Anonymised responses were collated and evaluated. Categorical data were compared with Fisher's exact test.

    RESULTS: Responses were obtained from 342 students in four medical schools of whom 78.6% were undergraduates. Over half (53%) were Irish, with Malaysia, Canada and the USA the next most common countries of origin. Only 18% of students intended to pursue surgery, with 60% stating they did not plan to, and 22% undecided. Of those who plan not to pursue surgery, 28% were unsure about a speciality but the most common choices were medicine (39%), general practice (16%) and paediatrics (8%). Reasons for not picking a career in surgery included long hours and the unstructured career path. Suggestions to improve uptake included earlier and more practical exposure to surgery, improved teaching/training and reduction in working hours.

    CONCLUSIONS: In this study 18% of final year medical students identified surgery as their chosen career pathway. Although lifestyle factors are significant in many students' decision, perceived quality and duration of surgical training were also relevant and are modifiable factors which, if improved could increase interest in surgery as a career.

  3. Bakar SM, Shamim M, Salam A, Sultana SA
    Ir J Med Sci, 2016 Feb;185(1):249-57.
    PMID: 25894278 DOI: 10.1007/s11845-015-1287-4
    BACKGROUND: The anatomy of the vermiform appendix shows variations in its macroscopic dimensions and microscopic features, some of which have potentials of influencing the clinical aspects of the appendix.

    AIM: The aim of this study was to find out some microscopic features of appendix and evaluate the correlation between the microscopic features of the appendix and the age of the subjects and to determine whether these findings should influence the clinical implications of appendix.

    METHODS: In this cross-sectional observational study, thirty adult males' (age from 18 to 67 years) postmortem appendices and adnexa from Bangladeshi victims of road traffic accidents were sectioned at the base, midzone and tip stained with H+E stain and examined under microscope. Measurements were taken at the base, at the midzone and at the tip of the appendix, and the mean of the three measurements was considered as the overall value.

    RESULTS: The overall number of mucosal glands in a section ranged from 42.33 to 130.00 and the number of the germinal centres varied between 2.33 and 10.00. The overall luminal diameter ranged between 1764.58 and 3208.33 µm. The overall luminal diameter in more than 52 % of cases was between 2700.00 and 3299.99 µm with a median value of 2750 µm.

    CONCLUSION: The overall number of mucosal glands showed a tendency towards a positive correlation with age. The overall luminal diameter and the overall number of germinal centres showed a tendency towards a negative correlation with the age. However, none of the tendencies of correlation reached statistically any significant level.

  4. Hor ESL, Russell V, Vasudevan U, O' Brien F
    Ir J Med Sci, 2020 Feb;189(1):253-259.
    PMID: 31338691 DOI: 10.1007/s11845-019-02064-x
    BACKGROUND: Studies have suggested that the undergraduate clinical clerkship improves medical students' attitudes to psychiatry and career interest in the specialty, but few studies have explored the sustainability of these changes.

    AIMS: To explore changes in students' attitudes to psychiatry and career preference for psychiatry during the course of their senior clinical years at RCSI & UCD Malaysia Campus (RUMC).

    METHODS: All year 3 students (n = 111) at RUMC were invited to complete the Attitudes towards Psychiatry questionnaire (ATP-30) and a separate questionnaire seeking opinions on career preferences. The questionnaires were administered at 3 points in time: in year 3 before the 8-week psychiatry posting, following completion of the posting in year 4, and at the end of year 5. Quantitative data analysis was performed using SPSS version 18, and free-text responses were thematically analysed.

    RESULTS: One hundred completed questionnaires (90.1%) were returned. There was a significant improvement in students' ATP scores after their psychiatry rotation and this was sustained into year 5. Psychiatry as a career choice had highest preference levels following completion of the clerkship but declined in year 5 to below pre-clerkship preference levels. Qualitative analysis of factors influencing a career in psychiatry revealed themes of job satisfaction, lifestyle factors, perceived image of psychiatry, and self-appraisal.

    CONCLUSIONS: Our findings suggest that an enriched undergraduate clinical clerkship experience can help to sustain improved attitudes to psychiatry into the final medical year. However, declining interest in the specialty a career choice prior to graduation presents an enduring challenge.

  5. Khan A, Khan AH, Adnan AS, Sulaiman SAS, Ahmad N, Gan SH
    Ir J Med Sci, 2019 Feb;188(1):311-319.
    PMID: 29680929 DOI: 10.1007/s11845-018-1813-2
    BACKGROUND: Achieving and maintaining dry weight appears to be an effective strategy for controlling and maintaining normotension among hypertensive patients on hemodialysis (HD).

    OBJECTIVE: The present study aimed to determine the time at which the majority of patients achieve postdialysis dry weight using bioimpedance spectroscopy (BIS).

    METHODS: A total of 220 HD patients were prospectively assessed for fluid overload using the Fresenius body composition monitor (BCM). BCM readings were taken at 30 and 45 min postdialysis.

    RESULTS: Among the 220 patients included in this study, 120 (54.5%) achieved a euvolemic state at 30 min, and 25 (11.4%) achieved it at 45 min according to the BCM. In the multivariate analysis, vascular access other than arteriovenous fistula (AVF) (OR = 0.286, p value = 0.049) and cardiovascular disease (OR = 0.384, p value = 0.026) had a statistically significant negative association and receiving HD at Hospital Universiti Sains Malaysia (HUSM) (OR = 2.705, p value = 0.008) had a statistically significant positive association with achieving a euvolemic state at 30 min.

    CONCLUSION: This suggests that assessing the hydration status at 45 min postdialysis in all patients or in those with identified risk factors for not achieving a euvolemic state at 30 min will provide a relatively accurate assessment for most patients.

  6. Koh LL, O'Rourke S, Brennan M, Clooney L, Cafferkey M, McCallion N, et al.
    Ir J Med Sci, 2018 May;187(2):423-427.
    PMID: 28689228 DOI: 10.1007/s11845-017-1649-1
    BACKGROUND: Both Staphylococcus aureus and coagulase negative Staphylococci are common causes of late-onset neonatal sepsis in the neonatal intensive care unit (NICU), usually relating to intravascular access device infections.

    AIMS: This project aimed to review the impact on antimicrobial treatment and clinical outcome in the NICU setting, of the introduction of the Xpert MRSA/SA BC test (Cepheid, USA) for the identification of staphylococci in blood cultures.

    METHODS: A retrospective audit was carried out of the pre- and post-intervention periods; the intervention was the introduction of the Xpert MRSA/SA BC test.

    RESULTS: In total, 88 neonates had positive blood cultures with Staphylococcus spp., comprising 42 neonates in the pre-intervention and 46 in the post-intervention groups. The pre-intervention group had a higher birth weight (1.541 kg vs. 1.219 kg, p = 0.05) and higher platelet count (288 vs. 224 × 109/L, p = 0.05). There was a trend towards a shorter duration of antimicrobial therapy in term infants and in the length of admission; however, this was not statistically significant (p = 0.2). All of the nine infants post-intervention with significant bacteraemia (S. aureus =3, CoNS =6) were changed to the optimal antimicrobial at the time the result was available.

    CONCLUSIONS: This study shows that the introduction of the Xpert MRSA/SA BC test can lead to a reduction in the length of admission and duration of antimicrobials in term infants; however, the difference was not statistically significant. All nine infants with clinically significant bacteraemia were treated with the appropriate antimicrobial when the Xpert MRSA/SA BC test result was available.

  7. Alanazi HO, Abdullah AH, Qureshi KN, Ismail AS
    Ir J Med Sci, 2018 May;187(2):501-513.
    PMID: 28756541 DOI: 10.1007/s11845-017-1655-3
    INTRODUCTION: Information and communication technologies (ICTs) have changed the trend into new integrated operations and methods in all fields of life. The health sector has also adopted new technologies to improve the systems and provide better services to customers. Predictive models in health care are also influenced from new technologies to predict the different disease outcomes. However, still, existing predictive models have suffered from some limitations in terms of predictive outcomes performance.

    AIMS AND OBJECTIVES: In order to improve predictive model performance, this paper proposed a predictive model by classifying the disease predictions into different categories. To achieve this model performance, this paper uses traumatic brain injury (TBI) datasets. TBI is one of the serious diseases worldwide and needs more attention due to its seriousness and serious impacts on human life.

    CONCLUSION: The proposed predictive model improves the predictive performance of TBI. The TBI data set is developed and approved by neurologists to set its features. The experiment results show that the proposed model has achieved significant results including accuracy, sensitivity, and specificity.

  8. Haziman AA, Ravinderan S, Thangavelu T, Thomas W
    Ir J Med Sci, 2019 May;188(2):389-395.
    PMID: 30014247 DOI: 10.1007/s11845-018-1867-1
    Colorectal cancer (CRC) is a malignancy whose incidence is increasing globally, and there is a gender difference in the increasing risk. Evidence from hormone replacement therapy studies points to a role for circulating estrogens in suppressing the development of CRC. Estrogen receptor-β has been identified as a tumor suppressor, but other actions of estrogen may also contribute to the difference in CRC incidence between men and women. The KCNQ1/KCNE3 potassium channel is regulated by estrogen in order to modulate chloride secretion during the menstrual cycle; the effect of estrogen on the colon is to promote fluid conservation during the implantation window. KCNQ1 is also a tumor suppressor in CRC, and its sustained expression has been linked to suppression of the Wnt/β-catenin signaling pathway that contributes to CRC tumor progression. KCNQ1 regulation may represent a link between the normal physiological actions of estrogen in the colon and the hormone's apparent tumor-suppressive effects in CRC development.
  9. Mahmood S, Shah KU, Khan TM, Nawaz S, Rashid H, Baqar SWA, et al.
    Ir J Med Sci, 2019 May;188(2):437-452.
    PMID: 30136222 DOI: 10.1007/s11845-018-1889-8
    Hypertension is a major risk factor for a number of cardiovascular diseases. Proper management of hypertension may require both pharmacological and non-pharmacological interventions. Non-pharmacological interventions help reduce the daily dose of antihypertensive medication and delay the progression from prehypertension to hypertension stage. Non-pharmacological interventions include lifestyle modifications like dietary modifications, exercise, avoiding stress, and minimizing alcohol consumption. Nutritional requirements of hypertensive individuals can be addressed through adopting either the DASH diet or through traditional Mediterranean diet. These dietary guidelines promote the consumption of fruits, vegetables, grains, dairy products, and food rich in K+, Mg+2, Ca+2, and phosphorus. Restriction of Na+ intake has the greatest role in lowering the blood pressure. The DASH diet alone has the effect equal to that of a single drug therapy. After dietary modifications, exercise and weight loss are the second major intervention for hypertension management. Avoiding stressful lifestyle, depression, and anxiety also help to reduce elevated blood pressure. Minimizing alcohol intake also favors the blood pressure reduction. However, lifestyle modification is a dynamic process and requires continuous adherence. It is a multi-factorial approach targeting more than one intervention. However, 6-12-month lifestyle modifications can be attempted in stage-1 hypertensive patients without any cardiovascular complication, in the hope that they may be sufficiently effective to make it unnecessary to use medicines.
  10. Ching SM, Singh R, Azmi FSB, Chong KL, Ong CRS, Ayob NAB, et al.
    Ir J Med Sci, 2024 Feb;193(1):375-382.
    PMID: 37204559 DOI: 10.1007/s11845-023-03397-4
    PURPOSE: Obstructive sleep apnea (OSA) has been increasingly recognized as an important factor contributing to medical morbidity and mortality. It was reported that more than half of the population with hypertension had OSA. Limited studies have been done on assessing OSA in hypertensive patients. This study aimed to determine the prevalence, socio-demographic characteristics, and factors associated with probable OSA in hypertensive patients in primary care clinics in Sarawak.

    METHODS: A cross-sectional study was carried out using a systematic random sampling method in hypertensive patients who attended two government primary care clinics in Sarawak. The STOP-Bang questionnaire was used to screen for OSA, and social-demographic data was captured with a questionnaire. Multiple logistic regressions were used to examine the determinants of the OSA.

    RESULTS: A total of 410 patients were enrolled in this study. The mean age of study population patients was 56.4 years, with more than half being female. The mean blood pressure was 136/82. The prevalence of probable OSA among patients with hypertension was 54.4%. According to multiple logistic regression analyses, smoking (odds ratio [OR] 14.37, 95% confidence interval [CI] 3.335-61.947), retirees (OR 3.20, 95% CI 1.675-6.113), and being Chinese (OR 2.21, 95% CI 1.262-3.863) had a significant positive association with probable OSA.

    CONCLUSIONS: Because of the high prevalence of probable OSA among patients with hypertension, primary care physicians should be more vigilant in identifying hypertensive patients with OSA risk. Early detection and intervention would reduce disease complications and healthcare costs.

  11. Kow CS, Ramachandram DS, Hasan SS
    Ir J Med Sci, 2023 Dec;192(6):2897-2904.
    PMID: 36754948 DOI: 10.1007/s11845-022-03266-6
    We summarized through systematic review and meta-analysis of observational studies the risk of mortality as well as severe illness of COVID-19 caused by omicron variant relative to delta variant of SARS-CoV-2. A total of twelve studies were included. Our results showed significantly reduced odds of mortality (pooled OR = 0.33; 95% CI: 0.16-0.67) and significantly reduced odds of severe illness (pooled OR = 0.24; 95% CI: 0.21-0.28) in patients infected with the omicron variant of SARS-CoV-2 relative to their counterparts infected with the delta variant. Findings of lower disease severity following infection with the omicron variant of SARS-CoV-2 than the delta variant are encouraging during the ongoing transition from the pandemic phase into the endemic phase of COVID-19.
  12. Chaubal TV, Ywen BS, Ying Ying T, Bapat R
    Ir J Med Sci, 2024 Feb 20.
    PMID: 38376640 DOI: 10.1007/s11845-024-03635-3
    BACKGROUND: The main aim of periodontal therapy is to halt the progression of periodontitis. Curcumin, one of the main components of Curcumin longa, has been well known to possess antimicrobial, anti-inflammatory, and even anticarcinogenic properties. This systematic review assessed the impact of local application of curcumin in the pocket on the clinical and microbiologic parameters as an adjunct to scaling and root planing in periodontitis patients.

    METHODS: The electronic literature search retrieved 61 studies from PubMed, MEDLINE, and ScienceDirect. After screening titles, abstracts, and keywords and reading through these articles, we identified 9 articles meeting all inclusion criteria, which were included for systematic review.

    RESULTS: There was a significant difference in both clinical parameters in a short duration of a month after curcumin chips were placed as an adjunct to scaling and root planing as compared to the control. Local application of curcumin also results in slight to significant reduction in the red complex microorganisms.

    CONCLUSION: This review suggested that local application of curcumin can be considered as a viable adjunct to mechanical debridement in periodontitis. However, further studies need to be conducted to establish its optimum dose, delivery method, and frequency in achieving the best clinical outcomes.

  13. Ching SM, Cheong AT, Yee A, Thurasamy R, Lim PY, Zarina II, et al.
    Ir J Med Sci, 2024 Apr;193(2):851-863.
    PMID: 37556104 DOI: 10.1007/s11845-023-03483-7
    BACKGROUND: This study aimed to assess the determinants of burnout among healthcare providers in the primary care setting.

    METHODS: A web-based cross-sectional study was conducted among 1280 healthcare providers aged 18 years and older from 30 primary care clinics in Selangor, Malaysia. In this study, the Copenhagen Burnout Inventory was used to assess burnout. The results were analyzed using multiple logistic regression.

    RESULTS: The prevalence of personal burnout was 41.7%, followed by work-related burnout (32.2%) and client-related burnout (14.5%). The determinants for personal burnout in this study were younger age, being a doctor, higher COVID-19 exposure risk, do not know where to seek help, inability to handle stress, poorer sleep quality score, higher total COVID-19 fear score, higher total stress score, and lower total BRS score. The determinants of work-related burnout were younger age, being a doctor, longer years of working, higher COVID-19 exposure risk, do not know where to seek help, lower altruistic score, poorer sleep quality score, higher total stress score, and lower total brief resilience score (BRS) score. The determinants of client-related burnout were doctor, single/divorced, more than one attachment site, and higher satisfaction toward the infection control, inability to handle stress, higher total depression score, and lower total BRS score.

    CONCLUSION: Every fourth out of ten suffered from personal burnout, one-third from work-related burnout, and one-seventh from client-related burnout among healthcare providers during the COVID-19 pandemic. Healthcare systems must take care of healthcare workers' physical and emotional depletion, reducing the risk of burnout.

Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links