Displaying publications 1 - 20 of 106 in total

  1. Paranthaman V, Satnam K, Lim JL, Amar-Singh HS, Sararaks S, Nafiza MN, et al.
    Asian J Psychiatr, 2010 Dec;3(4):206-12.
    PMID: 23050889 DOI: 10.1016/j.ajp.2010.07.002
    Background: Psychoeducation has shown promising benefits in managing patients with schizophrenia. In Malaysia, the use of psychoeducation is rather limited and its impact indeterminate.
    Aims: To assess the effectiveness of a structured psychoeducation programme for the community in improving caregiver knowledge, decreasing caregivers’ burden, reducing patients’ readmission and defaulter follow up rates.
    Method: In a controlled interventional study, 109 caregivers were included, 54 and 55 in the intervention and control groups respectively. Caregivers were assessed at baseline, 3 and 6 months post-intervention for knowledge and burden. Patients were monitored for relapse and defaulting follow up in the clinic.
    Results: Caregivers in the intervention group showed significant improvement in knowledge, reduction in burden in assistance in daily living (severity) and a reduced defaulter rate was seen in the patients’ follow up.
    Conclusion: The findings shows that structured psychoeducation programme among caregivers has the potential to improve outcome of care for patients with schizophrenia.
    Keywords: Schizophrenia; Psychoeducation; Community; Caregiver Questionnaire: Family Burden Interview Schedule–Short Form (FBIS/SF)
    Matched MeSH terms: Clinical Trial
  2. Mastura I, Teng CL
    Med J Malaysia, 2008 Oct;63(4):315-8.
    PMID: 19385492
    The quality of physician prescribing is suboptimal. Patients are at risk of potentially adverse reaction because of inappropriate or writing error in the drug prescriptions. We assess the effect of "group academic detailing" to reduce writing drug name using brand name and short form in the drug prescriptions in a controlled study at two primary health care clinics in Negeri Sembilan. Five medical officers in Ampangan Health Clinic received an educational intervention consisting of group academic detailing from the resident Family Medicine Specialist, as well as a drug summary list using generic names. The academic detailing focused on appropriate prescribing habit and emphasized on using the full generic drug name when writing the drug prescription. Analyses were based on 3371 prescriptions that were taken from two clinics. The other health clinic was for comparison. The prescribing rates were assessed by reviewing the prescriptions (two months each for pre- and post-intervention phase). Statistically significant reduction in writing prescription using brand name and using short form were observed after the educational intervention. Writing prescription using brand name for pre- and postintervention phase were 33.9% and 19.0% (postintervention vs pre-intervention RR 0.56, 95% CI 0.48 to 0.66) in the intervention clinic. Prescription writing using any short form for pre- and post-intervention phase were 49.2% and 29.2% (post-intervention vs pre-intervention RR 0.59, 95% CI 0.53 to 0.67). This low cost educational intervention focusing on prescribing habit produced an important reduction in writing prescription using brand name and short form. Group detailing appears to be feasible in the public health care system in Malaysia and possibly can be used for other prescribing issues in primary care.
    Matched MeSH terms: Clinical Trial
  3. Mohd Yusof BN, Ruzita AT, Norimah AK, Kamaruddin NA
    Med J Malaysia, 2013;68(1):18-23.
    PMID: 23466761 MyJurnal
    AIM: This prospective, single-group, pre-post design trial was conducted to evaluate the effect of individualised Medical Nutrition Therapy intervention administered by a dietitian in individuals with type 2 diabetes mellitus on glycaemic control, metabolic parameters and dietary intake.
    METHODS: Subjects (n=104; age=56.4 ±9.9 years; 37% male; years of diagnosis = 6.3 ±4.9 years) treated with diet and on a stabile dose of oral anti-diabetic agents were given dietary advice by a dietitian for a 12 week period. Individualised dietary advice was based on Malaysian Medical Nutrition Therapy for adults with type 2 diabetes mellitus. The primary outcome measure was glycaemic control (fructosamine and HbA1c level) and the secondary outcome included measures of anthropometry, blood pressure, lipid profile, insulin levels dietary intake and knowledge on nutrition.
    RESULTS: At week 12, 100 subjects completed the study with a dropout rate of 3.8%. The post-Medical Nutrition Therapy results showed a significant reduction of fructosamine (311.5 ±50 to 297 ±44 umol/L; P< 0.001) and HbA1c (7.6 ±1.2 to 7.2 +1.1%, p<0.001) with pronounced reduction for subjects who had very high HbA1c levels of >9.3% at baseline. Waist circumference (90.7 ±10.2 to 89.1 ±9.8 cm, p<0.05), HDL-cholesterol (1.1 ±0.3 to 1.2 ±0.3 mmol/L, p<0.05), dietary intake and nutrition knowledge score (42 ±19 vs. 75 ±17%; p< 0.001) were significantly improved from the baseline.
    CONCLUSIONS: Individualised Medical Nutrition Therapy administered by a dietitian resulted in favourable diabetes outcomes, which were more apparent for individuals with higher than optimal HbA1c levels at the start of the study.
    Matched MeSH terms: Clinical Trial
  4. Tan SS, Leong CL, Lee CK
    Med J Malaysia, 2015 Oct;70(5):281-7.
    PMID: 26556116
    BACKGROUND: Co-infection by human immunodeficiency and hepatitis C viruses (HIV/HCV) is common and results in significant morbidity and mortality despite effective antiretroviral therapies (ART).
    METHOD: A retrospective and prospective evaluation of the efficacy and safety of pegylated interferon alfa 2a/2b plus ribavirin (PEG-IFN/RBV) in consecutive HIV/HCV co-infected patients treated in real life clinical practice in Malaysia.
    RESULTS: Forty-five HIV/HCV co-infected patients with a median age (interquartile range, IQR) of 41 years (37; 47) were assessed for treatment with PEG-IFN/RBV. All except one are of male gender and the most common risk behaviour was injecting drug use. At baseline 75.5% was on ART and the median (IQR) CD4 count was 492 cells/μl (376; 621). The HCV genotypes (GT) were 73 % GT3 and 27% GT1. Liver biopsies in forty patients showed 10% had liver cirrhosis and another 50% had significant liver fibrosis. The treatment completion rate was 79.5% with 15.9% dropped out of treatment due to adverse effects (AE) or default and 4.6% due to lack of early virological response. The AE causing premature discontinuations were neuropsychiatric and haematological. The overall sustained virological response (SVR) was 63.6% with a trend towards higher SVR in GT3 compared with GT1 (71.9% vs. 41.7%; p=0.064). In patients with bridging fibrosis plus occasional nodules or cirrhosis on liver biopsy, the SVR was significantly lower at 20% (p=0.030) compared to those with milder fibrosis.
    CONCLUSION: HIV/HCV co-infected patients can be successfully and safely treated with PEG-IFN/RBV achieving high rates of SVR except in cirrhotic patients.

    Study site: co-infection clinics at Sungai Buloh Hospita
    Matched MeSH terms: Clinical Trial
  5. Kwok FY, Venugobal S
    Med J Malaysia, 2016 Aug;71(4):166-170.
    PMID: 27770114 MyJurnal
    Induction of anaesthesia with propofol is often associated with a significant decrease in arterial pressure, especially in the older population. The aim of this study is to determine the efficacy of phenylephrine in two different doses i.e. 100mcg and 200mcg, given during induction to counteract the anticipated hypotensive effect of propofol in older patients aged over 55 years.
    Matched MeSH terms: Clinical Trial
  6. Low WHH, Seet W, Ramli AS, Ng KK, Jamaiyah H, Dan SP, et al.
    Med J Malaysia, 2013 Apr;68(2):129-35.
    PMID: 23629558 MyJurnal
    BACKGROUND: Hypertension is the number one cardiovascular risk factor in Malaysia. This study aimed to evaluate the effectiveness of a Community-Based Cardiovascular Risk Factors Intervention Strategies (CORFIS) in the management of hypertension in primary care.
    METHODS: This is a pragmatic, non-randomized controlled trial. Seventy general practitioners (GPs) were selected to provide either CORFIS (44 GPs) or conventional care (26 GPs) for 6 months. A total of 486 hypertensive patients were recruited; 309 were in the intervention and 177 in the control groups. Primary outcome was the proportion of hypertensive patients who achieved target blood pressure (BP) of <140/90mmHg (for those without diabetes mellitus) and <130/80mmHg (with diabetes mellitus). Secondary outcomes include change in the mean/median BP at 6-month as compared to baseline.
    RESULTS: The proportion of hypertensive patients who achieved target BP at 6-month was significantly higher in the CORFIS arm (69.6%) as compared to the control arm (57.6%), P=0.008. Amongst those who had uncontrolled BP at baseline, the proportion who achieved target BP at 6-month was also significantly higher in the CORFIS arm (56.6%) as compared to the control arm (34.1%), p<0.001. There was no difference in the patients who had already achieved BP control at baseline. There were significant reductions in SBP in the CORFIS arm (median -9.0mmHg; -60 to 50) versus control (median -2mmHg; -50 to 48), p=0.003; as well as in DBP (CORFIS arm: median -6.0mmHg; ranged from -53 to 30 versus control arm: median 0.0mmHg; ranged from -42 to 30), p<0.001.
    CONCLUSIONS: Patients who received CORFIS care demonstrated significant improvements in achieving target BP.
    Matched MeSH terms: Clinical Trial*
  7. Muhammad R, Johann KF, Saladina JJ, Mohd Latar NH, Niza ASS
    Med J Malaysia, 2013 Jun;68(3):204-7.
    PMID: 23749007 MyJurnal
    Treatment for breast cancer has improved dramatically over the decades. Nevertheless, modified radical mastectomy with axillary dissection remains the standard treatment for most patients, especially those with big tumours. The conventional technology is to use diathermy to cut and coagulate blood vessels. The Ultracision dissector has been widely used in laparoscopic surgery and is documented to be safe and fast for cutting and coagulating tissue. The aim of this study is to compare ultracision to electrocautery, looking in terms of amount of post operative drainage, duration of drain days, seroma formation and other complications.
    Matched MeSH terms: Clinical Trial
  8. Zainab K, Adlina S
    Med J Malaysia, 2004 Aug;59(3):395-401.
    PMID: 15727387 MyJurnal
    A comparative pilot study was conducted to determine the difference in the reduction of total serum bilirubin in a group of infants who had phototherapy at home compared to an in-patient group on hospital phototherapy. Eighteen infants with unconjugated hyperbilirubinaemia who fitted the selection criteria were put under the mobile home unit (Bluelite Portable Light) placed in the home. A control group of 18 infants with the same matching characteristics had intense phototherapy in the hospital using a unit with top and bottom light sources. The infants were matched for race, starting total serum bilirubin level, birth weight (up to 250 grams) and age of baby at initiation of phototherapy (up to one-day difference). It was observed that the mean daily decrease in serum bilirubin concentration was significantly more in the home group as compared to the hospital group (t=2.95, df=17, P<0.05). The mean duration of treatment was significantly less for the home group as compared to the hospital group (t=2.84, df=17, P<0.05). None of the infants who had home phototherapy were re-hospitalized. Phototherapy related complications were mild and comparable in both groups. The result suggests that home phototherapy is safe and effective in bringing down the concentration of serum bilirubin for term babies with uncomplicated hyperbilirubinaemia.
    Matched MeSH terms: Clinical Trial
  9. Huam SH, Lim JM, Raman S
    Med J Malaysia, 1997 Mar;52(1):3-7.
    PMID: 10968046
    This prospective, randomised, controlled trial was performed to evaluate the effectiveness of single-dose antibiotic prophylaxis in decreasing the infectious morbidity following elective caesarean section. Two hundred women undergoing elective caesarean section were randomly assigned to receive either 1.2 g of Augmentin intravenously, or no treatment, just before the start of their caesarean section. The two groups of women were comparable in terms of patient characteristics and operation variables. The overall postoperative morbidity rate was 19% in the Augmentin treated group versus 38% in the group that received no prophylaxis (p < 0.01). The incidence of wound sepsis was 3% in the Augmentin group versus 13% in the control group (p < 0.01). The incidence of febrile morbidity with no identifiable cause was 8% in the Augmentin group versus 18% in the control group (p < 0.05). The duration of hospital stay was significantly shorter in the Augmentin group (p < 0.05). A single-dose of prophylactic Augmentin significantly reduced the postoperative morbidity and duration of hospital stay in women who underwent elective caesarean sections.
    Matched MeSH terms: Clinical Trial
  10. Yao SC, Chai MC, Singh A
    Med J Malaysia, 1990 Mar;45(1):29-36.
    PMID: 2152066
    Existing criteria for admission of newborns to the special care nursery, Sarawak General Hospital, resulted in the admission of many neonates with certain risk factors ("at risk" neonates). To test whether such babies could be safely and better cared for in postnatal wards, 392 of these babies were randomly allocated into two groups. One group of 196 was admitted to the special care nursery and the other group of 196 was cared for with their mothers in the postnatal wards. The two groups were compared for mortality, morbidity and breastfeeding. There was no significant difference in mortality and morbidity between the two groups. While in hospital a larger proportion of babies cared for in postnatal wards were breastfed, compared to babies admitted to the special care nursery. In addition, they initiated their breastfeeding earlier. Babies with these risk factors should therefore be cared for with their mothers in the postnatal wards.
    Matched MeSH terms: Clinical Trial
  11. Chuan OK, Ping WW, Fook CW
    Med J Malaysia, 1976 Jun;30(4):296-8.
    PMID: 790111
    Matched MeSH terms: Clinical Trials as Topic; Clinical Trial
  12. Lua PL, Wong SY
    Objective: This interventional study was aimed to investigate the effects of dark chocolate
    consumption on anxiety, depression, and stress (ADS) among trainee nurses. Methods: A
    parallel and open-label experimental study was conducted. Of the 128 nurses enrolled, only 47 participated in the intervention study (mean age = 20.32 years; ranging from 19 to 22 years old). They were randomly assigned to an intervention group (IG, n = 25) or a control group (CG, n = 22). The IG consumed dark chocolate and CG ingested mineral water for 3 consecutive days. The validated Malay Hospital Anxiety and Depression Scale (HADS) and Depression, Anxiety and Stress Scale (DASS-21) were utilised for measuring ADS levels. Data were analysed descriptively and score comparisons were conducted using non-parametric tests. Results: No significant differences between IG and CG in ADS scores were detected at baseline (all p > 0.05). At post-consumption, ADS score were significantly reduced in IG (all p < 0.01) compared with CG (all p < 0.05). Larger effect sizes among these respondents had also revealed that there were mood-elevating effects of dark chocolate consumption. Conclusion: This study has discovered that 3-day consumption of dark chocolate may alleviate ADS status among trainee nurses suggesting that dark chocolate may have a more prominent role in improving emotional and mood generally. Further investigations are however warranted to confirm this finding.
    Matched MeSH terms: Clinical Trial
  13. Zulkifli A, Chelvam P, Weng Hwa N, Dharmalingam SK
    Med J Malaysia, 1979 Jun;33(4):346-8.
    PMID: 392273
    Matched MeSH terms: Clinical Trial
  14. Pazooki S, Solhi H, Vishteh HR, Shadnia S, Beigi MJ
    Med J Malaysia, 2011 Oct;66(4):342-5.
    PMID: 22299554
    With the establishment of the inadequate efficiency of atropines and oximes in reducing morbidity and mortality of patients poisoned by organophosphates, more attention is given to using other methods such as Fresh Frozen Plasma (FFP) as a bioscavenger to mop up organophosphate toxins. This randomized clinical trial was conducted on 56 organophosphate poisoned patients who were randomly assigned to the FFP and control groups in order of admission. The routine treatment in both groups included atropine and, in moderate to severe cases of poisoning, pralidoxime. The FFP group received four packs of FFP as stat dose at the beginning of treatment. No significant difference was seen between the two groups on the atropine and pralidoxime dosage, hospitalization length and mortality. The present study showed that using four packs of FFP as stat dose at the onset of treatment had no significant effect on the clinical course of organophosphate poisoned patients.
    Matched MeSH terms: Clinical Trial
  15. Suzanna AB, Liu CY, Rozaidi SW, Ooi JS
    Med J Malaysia, 2011 Oct;66(4):304-7.
    PMID: 22299547
    The LMA-Classic laryngeal mask airway (Classic LMA) is an autoclavable and reusable laryngeal mask airway with strong evidence supporting its efficacy and safety. Due to the concern of infection risk particularly of prion disease, various single-use laryngeal mask devices were developed. The Ambu AuraOnce LMA (Ambu LMA) is a single use disposable laryngeal mask airway with special design that conforms better to the anatomy of the airway.
    Matched MeSH terms: Clinical Trial
  16. Esa K, Azarinah I, Muhammad M, Helmi MA, Jaafar MZ
    Med J Malaysia, 2011 Aug;66(3):182-6.
    PMID: 22111436
    This was a prospective randomized study comparing the ease of insertion, haemodynamic changes, quality of airway seal, oxygenation and ventilation parameters and complications between Laryngeal Tube Suction II (LTS II) with Proseal Laryngeal Mask Airway (PLMA), both are supraglottic airway incorporated with gastric passage. Fifty-four ASA I and II patients were randomly allocated to receive either LTS II or PLMA. Both devices provided a secure airway even under conditions of elevated intra-abdominal pressure up to 17 mmHg. In this study, there were no differences concerning ease of insertion, haemodynamic changes, quality of airway seal, oxygenation and ventilation parameters and complications between LTS II and PLMA.
    Matched MeSH terms: Clinical Trial
  17. Muzlifah KB, Choy YC
    Med J Malaysia, 2009 Jun;64(2):114-7.
    PMID: 20058569 MyJurnal
    This prospective, randomized, study was designed to compare the effect of two different preloading volumes of Ringer's lactate for prevention of maternal hypotension induced by spinal anaesthesia for Caesarean section. Eighty ASA I or II obstetric patients were randomized to two groups. Group 1 (n = 40) received 20 ml/kg of Ringer's lactate and Group 2 (n = 40) 10 ml/kg of Ringer's lactate over 20 minutes before spinal anaesthesia. The lowest mean arterial pressure (MAP) for both groups were recorded at 15 minutes after giving spinal anaesthesia, This difference in the drop of MAP from base-line at 15 minutes (mean decrease of 12.5 mmHg from baseline), between preloading with 10 ml/kg and 20 ml/kg of Ringer's was statistically significant. Twelve patients from Group 1 required bolus doses of ephedrine and 15% of these needed additional crystalloid whereas two patients from Group 2 needed ephedrine boluses and 22% of these required additional crystalloid. The difference in frequency of requirement for treatment of hypotension was not statistically significant. There were five patients in Group 1 and six patients in Group 2 who experienced nausea and vomiting, the frequency of occurrence did not show any statistically significant difference between the two groups. In conclusion, for prevention of hypotension during spinal anaesthesia for Caesarean section, infusing 20 ml/kg or 10 ml/kg of Ringer's Lactate gave similar results and we do not recommend the use of a larger volume of crystalloid for preloading before spinal anaesthesia.
    Matched MeSH terms: Clinical Trial
  18. Shukrimi A, Sulaiman AR, Halim AY, Azril A
    Med J Malaysia, 2008 Mar;63(1):44-6.
    PMID: 18935732 MyJurnal
    Honey dressing has been used to promote wound healing for years but scanty scientific studies did not provide enough evidences to justify it benefits in the treatment of diabetic foot ulcers. We conducted a prospective study to compare the effect of honey dressing for Wagner's grade-II diabetic foot ulcers with controlled dressing group (povidone iodine followed by normal saline). Surgical debridement and appropriate antibiotics were prescribed in all patients. There were 30 patients age between 31 to 65-years-old (mean of 52.1 years). The mean healing time in the standard dressing group was 15.4 days (range 9-36 days) compared to 14.4 days (range 7-26 days) in the honey group (p < 0.005). In conclusion, ulcer healing was not significantly different in both study groups. Honey dressing is a safe alternative dressing for Wagner grade-II diabetic foot ulcers.
    Matched MeSH terms: Clinical Trial
  19. Harvinder S, Rosalind S, Philip R, Mallina S, Gurdeep S
    Med J Malaysia, 2008 Aug;63(3):237-8.
    PMID: 19248697 MyJurnal
    Dacrycystorhinostomy (DCR) is a procedure performed to drain the lacrimal sac in cases of nasolacrimal duct obstruction or in chronic dacryocystitis. It can be performed externally or endoscopically. This is a prospective, nonrandomized study involving twenty-two consecutive patients (16 Females and 6 Males; mean age 45.54 y; range 18-74 y) who presented to the DCR clinic with epiphora secondary to nasolacrimal duct obstruction and recurrent infection. All patients underwent primary powered endoscopic DCR. A total of 24 procedures were performed using a standardized surgical technique. Post-operatively, symptom evaluation and endoscopic assessment of the newly created lacrimal ostium were done. Twenty-two of the 24 DCR's were patent after a mean follow-up of 21.5 months, yielding a success rate of 91.66%. Patency was assessed by symptomatic evaluation and endoscopic visualization at each post-operative visit. Two patients had complications, one orbital fat exposure and the other secondary haemmorhage. The two failures were due to synechiae formation. Therefore, powered endoscopic DCR with mucosal flaps without stenting has a success rate comparable to that achieved with stents and external DCR.
    Matched MeSH terms: Clinical Trial
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