The effect of a single dose of Lactobacillus paracasei strain Shirota on whole gut transit time among healthy young adults

Posted Posted in Original Article

Authors: Elaine Geok Ting Tee, Jia Huei Wong, Kisalini Devi d/o Potharajoo, Mark Win Shun Low, Jea En Teh, Kean Ghee Lim.

ABSTRACT

Introduction: Yakult contains Lactobacillus casei strain Shirota (LcS). It has several protective effects on our digestive system which include preventing diarrhoea and improving constipation. The objective of our study was to determine the effect of a single dose of Yakult on whole gut transit time (WGTT) among young adults.

Methods: A cross-sectional study of 73 students who did not have any gastrointestinal disorder was performed. Subjects were given 4 carbon pills as a visual indicator to measure their WGTT in the normal setting of their usual activities. They then repeated measurement while consuming one dose of commercially available Yakult and 4 carbon pills (visual indicator). In the 2 settings, subjects were instructed to consume carbon pills and carbon pills with Yakult within 1 hour after bowel motion.

Results: The WGTT decreased in 48 of the 73 subjects (65.8%) after consuming Yakult. The mean WGTT was reduced by 4.4±14.6 hours. There was no significant effect of Yakult on the form of stools.

Conclusion: Yakult which contains Lactobacillus casei strain Shirota (LcS) is well known for helping in digestion and preventing constipation. A single dose of Yakult produces a reduction in the WGTT.

Keywords: Lactobacillus casei strain Shirota (LcS), whole gut transit time (WGTT), bowel habit, constipation, factors affecting bowel habit.

Citation: IeJSME 2021 15 (3): 21-26

DOI: https://doi.org/10.56026/imu.15.3.21

Association between pre-injury and injury-related factors and cognitive impairment of post-traumatic brain injury patients in a Hospital Universiti Sains Malaysia cohort

Posted Posted in Original Article

Authors: Nurshazwin Mohd Roszeki, Mohd Nasir Che Mohd Yusoff, Sabarisah Hashim.

ABSTRACT

Introduction: Traumatic brain injury (TBI) is one of the major global issues as it causes a serious health threatening condition for the injured persons, increased mortality rates, increased physical and cognitive impairment, as well as affecting the health care systems.

Method: The aim of this study was to predict the association between the pre-injury socio-demographic, injury-related factors and cognitive impairments in post-TBI patients. Self-administered questionnaires were used for descriptive correlational study. Three instruments used included (1) pre-injury sociodemographic characteristics (age, gender, race, religion, education level, occupation) (2) injury-related factor characteristics (location of brain injury and GCS) and (3) Montreal Cognitive Assessment (MoCA) questionnaire to estimate cognitive impairment.

Result: In this study, forty patients were recruited through purposive sampling from surgical based wards and 60.0% of TBI patients had cognitive impairments. This study found an association between injury factors (severity of TBI from GCS result) with cognitive impairment post-TBI among patients. However, there is no association between socio-demographic characteristics (age, gender, race, religion, education level, occupation) and cognitive impairment.

Conclusions: The study provided a better understanding on the association between pre-injury socio-demographic characteristics, injury related characteristics of the severity of TBI and cognitive impairments in post-TBI patients during hospitalisation. The results of this study can potentially be used as baseline information to improve the care and treatment needs of patients with cognitive impairment post-TBI during hospitalisation in relation to enhanced quality of life.

Keywords: Traumatic brain injury, Pre-injury related factors, Injury related factors, Cognitive impairment post-TBI, Montreal Cognitive Assessment (MoCA).

Citation: IeJSME 2021 15 (3): 27-36

DOI: https://doi.org/10.56026/imu.15.3.27

24-hour observation of patients after intrathecal morphine for lower segment caesarean section – Is it overrated? A prospective observational study

Posted Posted in Original Article

Authors: Thiruselvi Subramaniam, Shu Ning Kong, Shi Ting Tee, Muhammad Faiz Bin Ismail, Joanne Sue James, Hamitra Gandhi.

ABSTRACT

Background: Side effects of intra-thecal (IT) morphine in lower caesarean section (LSCS) can be dangerous hence they are co-managed by the anesthesia pain team for a minimum of 24 hours. The aim of this study was to identify the side effects and consider the possibility of earlier discharge from the pain team to the parent team.

Methods: A prospective observational study was conducted on 323 patients who received IT morphine for LSCS. An interviewer-centered questionnaire was used to obtain data on the side effects.

Results: Side effects were experienced by 80% (n=259) of the patients, and none developed respiratory depression. Side effects occurred in first 6 hours in 94% (n=244) of the patients, 5% (n=13) within 6 to 12 hours and 1% (n=2) within 12 to 24 hours. Pruritus was the most common side effect (88%; n=227) and 93% (n=210) experienced it within the first 6 hours. Nausea and vomiting occurred in 54% (n=139) of the patients with side effects and 70% (n=97) of them experienced them within the first 6 hours. Kruskal-Wallis H test showed that Malays experienced more side effects, χ2(2) = 3.363, p = 0.004. No difference in pain scores was noted between races at 0-6 hours and 12-24 hours. However, Indians had higher scores at 6-12 hours (χ2(1) =4.31, p = 0.031).

Conclusion: The most common side effect was pruritus, then nausea and vomiting with no respiratory depression. Most occurred in the first 12 hours suggesting possibility of earlier discharge by the pain team to the parent team. However, further research is needed as guidelines suggest 24 hours, fearing respiratory depression. Side effects in Malays and increased pain perception among Indians need exploration.

Keywords: Caesarean Sections, Drug side effects, Intrathecal morphine, Race, Respiratory depression.

Citation: IeJSME 2021 15 (3): 37-45

DOI: https://doi.org/10.56026/imu.15.3.37

Cross-cultural adaptation of the General Functioning Scale of the family into the Malay language

Posted Posted in Original Article

Authors: Muneer Gohar Babar, Sobia Bilal, Zamros Yuzadi Mohd Yusof, Karuthan Chinna, Jennifer Geraldine Doss, Allan Pau.

ABSTRACT

Introduction: The McMaster Family Assessment Device (FAD) has been used to measure family functioning in several cultures. The FAD’s 12-item General Functioning Subscale (GF12) provides a general assessment of family functioning. This study aims to assess the cross-cultural adaptation of the FADGF12 scale in the Malaysian population.

Methods: The translation and adaptation procedure of the Malay GF12 was based on the dual-panel methodology. This involved a bilingual panel (providing the initial translation into the Malay language) followed by a lay panel (where items are assessed for comprehension and acceptability). A mixed-methods approach with exploratory sequential study design was employed. This study used a mixed-methods approach, combining a quantitative survey of the Malay version of GF12 and a qualitative focus group analysis of dual-panel members.

Results: Two hundred and fifty-one parents who have children attending Tadikas (pre-school) responded to the Malay GF12. In the reliability analysis, the internal consistency value was good; in the test-retest analysis, the intra-class correlation values were more than 0.7. In the exploratory factor analysis, two factors were extracted. In the confirmatory factor analysis, a single factor 12-item model did not fit well. Alternatively, a 2-factor-6-item model showed sufficient fit. The two constructs are comprised of Positive and Negative Items.

Conclusion: The Malay version of GF12 has adequate psychometric properties to measure family functioning in the Malay speaking population.

Keywords: family functioning, Family Assessment Device, confirmatory factor analysis, reliability, construct validity, Malay.

Citation: IeJSME 2021 15 (3): 46-56

DOI: https://doi.org/10.56026/imu.15.3.46

Postural improvement in young deaf and mute boy in post 2 weeks pineal gland tumour removal after 3 balance rehabilitation: A Case Study

Posted Posted in Case Study & Report

Authors: Zuraida Zainun, Zamzuri Idris, Muhammad Munzir Zuber Ahmad, Nur Syakirah Bt Che Mat Amin.

ABSTRACT

Pineal region tumours are primary central nervous system (CNS) tumours. Pineal region tumours may cause increased pressure inside the skull due to the production of too much CSF or blockage of its normal flow known as hydrocephalus. Imbalance is one of the features in this case. Vestibular Rehabilitation (VRT) is a specific form of physical therapy designed to habituate symptoms and promote adaptation to and substitution for various aspects of deficits related to a wide variety of balance disorders. Bal Ex is a home-based module of VRT with specific modules that are available in three forms; manual book, poster and DVD. This module was developed with a combination of customized Cawthorned Cookseey Exercise and prayer movements. The patient is a 14-year-old boy, disabled (mute and deaf), known case of pineal gland tumour since 2016, then post tumour removal 2 weeks ago. The patient experienced balance problem 8 years ago before he was diagnosed with pineal tumour. He did not complain of any dizziness and vertigo according to his mother. The patient then underwent intensive BAL Ex therapy inward for 3 sessions starting with Level 1, once per day, 40 minutes each session, and without taking any medicine during the treatment. He underwent one-to-one sessions with the trainer and also followed the balance exercise video in every session. After 1 week of balance exercise only in level 1, the patient showed a small difference and 10% improvement.

Keywords: Bal Ex, Postural improvement, Bal Ex Module, imbalance

Citation: IeJSME 2021 15 (3): 57-60

DOI: https://doi.org/10.56026/imu.15.3.57

Assessing Students – Clinical Competence Versus Performance

Posted Posted in Review Articles

Author: John Ruedy

ABSTRACT

The recent elaboration of the range of physician competencies upon which the quality of health care is dependent has fostered the development of a variety of methods of assessing medical student competencies and performance. Such assessments are essential in providing feedback to students to guide their learning and to faculty on the success of the curriculum in achieving competency outcomes. In addition they provide evidence that students have achieved minimum requirements for progressing. Well-designed Observed Structured Clinical Examinations (OSCEs), Mini-Clinical Examinations (Mini-CEXs) and some forms of Multi-Source Feedback (MSF) can meet acceptable standards of validity and reliability and are feasible. Competency assessments are limited in predicting how a student will actually act in the work situation particularly in humanistic skills. More emphasis needs to be placed on student performance, in such competencies as communication and professionalism, in a variety of settings by a number of observers.

Keywords: assessment, evaluation, clinical competence, performance, multi-source feedback.

Citation: IeJSME 2007: 1 (1): 15-21

DOI: https://doi.org/10.56026/imu.1.1.15

The Changing Roles Of Pharmacists In Society

Posted Posted in Review Articles

Authors: Stephen Arthur Hudson, John Jackson Mc Anaw, Barbara Julienne Johnson.

ABSTRACT

A clinical role for pharmacists has developed in response to the societal need to improve the use of medicines. Clinical role development has been led by initiatives in the hospital sector which have enabled Schools of Pharmacy to make shifts in the pre-graduate education of pharmacists. The increasing complexity in the management of drug therapy has given pharmacists clear roles that integrate within the healthcare team. The history is one in which the development of changing roles of pharmacists is an example of progress in healthcare delivery creating the need for revision of the curriculum for a whole profession.

Milestones in the changing roles and in the preparation of pharmacists for those roles have been; Establishment of clinical pharmacy in the US hospitals and the doctorate (PharmD) as the professional entry qualification; postgraduate clinical pharmacy education in UK and elsewhere, notably Asia and Australasia; hospital pharmacist specialisation across the wide range of medical specialties; the clinical teaching of pharmacists; the concept of ‘pharmaceutical care’ as a factor in public health; changes in Schools of Pharmacy – with professors of pharmacy practice and a shift to patient-centred teaching.

Future evolution of pharmacist roles will follow the wider use of quality systems to address errors in prescribing and drug administration; the automation of systems of drug prescribing and administration and improved documentation of care; widening of prescribing roles; increased patient education and higher patient expectations; patient-centred research in Schools of pharmacy; development of primary care and improved accessibility to pharmaceutical advice; integration of pharmacists’ public health roles in strategies to address prevention and management of disease.

Keywords: clinical pharmacy, pharmacy education, pharmaceutical care, chronic disease management, drug therapy problems, public health.

Citation: IeJSME 2007: 1 (1): 22-34

DOI: https://doi.org/10.56026/imu.1.1.22

Quality Of Life And Disability In Alcohol And Drug Dependent Patients Undergoing Treatment At Depaul House

Posted Posted in Original Article

Authors: George Philip, Whelan Greg, Nicolle Ait Khelifa.

ABSTRACT

Quality of life and disability are important indices that may help change the perception, treatment and care of those with alcohol or drug dependence problem. A cross-sectional survey was done among 25 drug and 25 alcohol dependents consecutively admitted to a community based residential withdrawal service in Melbourne, Australia to assess their quality of life and disabilities using the World Health Organisation Quality of Life (WHOQoL)-Bref and the World Health Organisation Disability Assessment Scale (WHODAS) questionnaires. The quality of life of the sample population was found to be significantly poorer than the general population. The scores on quality of life and disability measurements in the group of patients with alcohol dependence were similar to the other drug dependent group.

Keywords: quality of life, disability, drug, alcohol dependents.

Citation: IeJSME 2007: 1 (1): 35-40

DOI: https://doi.org/10.56026/imu.1.1.35