Authors: Wei Xiang Wong, Ting Xuan Wong, Shu Hwa Ong, Sangeetha Shyam, Seong Ting Chen, Winnie Siew Swee Chee

ABSTRACT

Background: Malnutrition is common among cancer patients, and it can impact the surgical outcomes of the patients undergoing elective surgery. Addressing malnutrition at the early stage of treatment will enhance the recovery process of the patients after anti-cancer treatments. Our study aimed to assess the nutritional status among breast and colorectal cancer patients who were scheduled for elective surgery and treatment.

Methods: A total of 89 patients, 46 breast cancer patients and 43 colorectal cancer patients participated in the study. Sociodemographic information and medical history were collected using a questionnaire. Body weight and height were measured using a weighing scale and stadiometer. Body composition data were collected using an 8-point bioimpedance analysis machine. Dietary intake was collected using a 7-day diet history. Handgrip strength was evaluated using a dynamometer. The prevalence of malnutrition was determined based on the AND/ASPEN malnutrition clinical characteristics. The differences between groups were analysed using independent sample t-test, Mann Whitney U test and chi-square test.

Results: Out of 89 patients, 51.7% were diagnosed as being malnourished based on the AND/ASPEN characteristics. The most common malnutrition characteristic observed among the breast and colorectal cancer patients was reduced handgrip strength (56.2%), followed by experience of muscle loss (43.8%) and reduced food intake (42.7%).

Conclusion: There was a high prevalence of patients at risk of malnutrition among breast and colon cancer patients undergoing surgery. Early detection of malnutrition in cancer patients allows healthcare professionals to provide prompt intervention and improve their prognosis.

Keywords: Malnutrition; nutrition assessment; hospital; breast cancer; colorectal cancer

Citations: IeJSME 2022 16 (1): 16-29

DOI: https://doi.org/10.56026/imu.16.1.16

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

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

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

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

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

Authors: Sambandam Elango, Ramesh C Jutti, Palayan Kandasami, Cheong Lieng Teng, Li Cher Loh, Tirathram Motilal.

ABSTRACT

Introduction: Health educators and accrediting bodies have defined objectives and competencies that medical students need to acquire to become a safe doctor. There is no report in Malaysia, about the ability of medical students to perform some of the basic surgical skills before entering the houseman ship. The aim of this study is to determine whether the teaching/ learning methods of practical skills in our undergraduate program have been effective in imparting the desired level of competencies in these skills.

Methods: A list of basic practical skills that students should be competent has been identified. These skills are taught in a structured way and assessed as part of the composite end-of-semester examination. Practical skills stations form part of an Objective structured practical examination (OSPE).

Results: The results of 244 students who participated in three ends of semester examinations were analyzed. The mean score for the practical skills stations were higher than the mean OSPE (of all 18 stations) and overall score (of the written, practical and clinical examination). However the failure rate in the practical skills stations is higher in most of the stations (7 out of 8 stations) compared to overall failure rates.

Conclusions: In spite of the formal skills training many students failed to demonstrate the desired level of competencies in these stations. Assessment of practical skills as part of overall composite examination may not be effective in ensuring that all students have achieved the required level of competency. Practical skills should be assessed through dedicated formative assessments to make sure that all the students acquire the required competencies.

Keywords: clinical competence, practical skills, assessment.

Citation: IeJSME 2007: 1 (1): 41-45

DOI: https://doi.org/10.56026/imu.1.1.41

Author: Jagmohni Kaur Sidhu

ABSTRACT

Introduction: Motivation in Malaysia is to a large extent influenced by the value system amongst all Malaysians. Being able to motivate employees is one of the important keys to the success of the organization. In this paper, an attempt was made to look into the needs of employees in organizations and in particular, the needs based on Maslow’s theory on motivation.

Subjects and Methods: Employees which consisted of both academic and administrative employees of the International Medical University (IMU) were surveyed using a standard questionnaire. The aim of this study was to compare which levels of Maslow’s hierarchy of needs theory had been fulfilled and which needs were yet to be fulfilled in the different ethnic groups at IMU.

Results: Amongst the males, the Chinese and Indian ethnic groups placed most emphasis on the esteem needs and on self-actualization needs. The Malay males gave importance to Safety needs. Amongst the female ethnic groups, all three groups placed most importance on the esteem needs and self-actualization needs. The Chinese females scored the lowest for the Basic needs compared to the Malay and Indian females. The Indian females scored the lowest for Social needs.

Conclusion: Organisations should play an important role in the motivation of employees. Human resource development is an integral part in the development of its employees.

Keywords: Maslow, motivation, ethnic, medical, university.

Citation: IeJSME 2007: 1 (1): 46-51

DOI: https://doi.org/10.56026/imu.1.1.46

Authors: Chiew Eng Wooi, Susan Lim Lee Hong, Stephen Ambu.

ABSTRACT

Introduction: Kelantan, an east coast state of Peninsular Malaysia is rich in culture and supports a population that is dependent on agriculture. The crops cultivated are mainly paddy and rubber but in recent years tobacco is beginning to gain importance over paddy. We centered our study around Bachok District which is about 25 kilometers east of Kota Bharu, the state capital.

Methods: Based on case reports we focused our study on cercarial dermatitis and also recorded the socioeconomic status of the people in the four study villages.

Result: The ducks and cows were the common livestock kept by the farmers and these were found to be significantly associated (P=0.05) with the occurrence of dermatitis. Cercariae shedding by snails were found in waters used for irrigation.

Conclusion: The results indicate that cercarial dermatitis is occupation specific, and its debilitating effect was having an influence on the socioeconomic status and general wellbeing of the population in these villages. The dermatitis occurred only during the field preparation and transplanting stages of paddy and was found to be significantly associated (P=<0.05) with the source of water used for irrigation. The water sources for irrigation was mainly from the river and irrigation canal and the snail Indoplanorbis exustus infected with schistosome cercariae was found to be abundant in both these sources during these stages. The ducks and cows were the common livestock kept by the farmers and these were also found to be significantly associated (P=0.05) with the occurrence of dermatitis. Therefore we concluded that the dermatitis among paddy farmers in Bachok District was due to an animal schistosome.

Keywords: Environment, Occupational health, Disease vectors, Zoonoses.

Citation: IeJSME 2007: 1 (2): 69-73

DOI: https://doi.org/10.56026/imu.1.2.69

Authors: Yow-Wen Chin, Li-Cher Loh, Thim-Fatt Wong, Abdul Razak Muttalif.

ABSTRACT

Introduction: To review the sputum bacteriology and its in-vitro antibiotic susceptibility in patients hospitalized with community-acquired pneumonia (CAP) in a state tertiary-referral Hospital (Penang hospital, Malaysia) in order to determine the most appropriate empiric antibiotics.

Methods: From September 2006 to May 2007, 68 immunocompetent adult patients [mean age: 52 years (range 16-89); 69% male] admitted to respiratory wards for CAP with positive sputum isolates within 48 hours of admission were retrospectively identified and reviewed.

Results: 62 isolates were Gram(-) bacilli (91%) & 6 were Gram(+) cocci (9%). The two commonest pathogens isolated were Pseudomonas aeruginosa (n=20) and Klebsiella pneumoniae (n=19) together constituted 57% of all positive isolates. Among the Pseudomonas isolates, 84.2% were fully sensitive to cefoperazone and cefoperazon/sulbactam; 95% to ceftazidime, cefepime, piperacillin/tazobactam, ciprofloxacin and amikacin, and 100% to gentamycin, netilmycin, imipenem and meropenem. Among the Klebsiella isolates, 5.3% were fully sensitive to ampicillin; 84.2% to amoxicillin, ampicllin/sulbactam, cefuroxime and ceftriazone; 89.5% to piperacillin/tazobactam; 93.3% to cefoperazon/sulbactam and 100% sensitive to ceftazidime, cefepime, ciprofloxacin, all aminoglycosides and carbopenems.

Conclusion: In view of the high prevalence of respiratory Pseudomonas aeruginosa, ampicillin/sulbactam, currently the most prescribed antibiotic to treat CAP in our respiratory wards, may not be the most appropriate empiric choice. Higher generation cephalosporins with or without beta-lactamase inhibitors, ciprofloxacin or carbapenem may be the more appropriate choices. The lack of information on patients’ premorbidities such as recent hospitalization and prior antibiotic exposure, limits the interpretation of our findings and may have biased our results towards higher rates of Gram negative organisms.

Keywords: Antibiotic sensitivity, Community-acquired pneumonia, Penang hospital, Sputum bacteriology.

Citation: IeJSME 2007: 1 (2): 74-79

DOI: https://doi.org/10.56026/imu.1.2.74