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George Town, Malaysia

Kurmanji J.M.,Universiti Sains Malaysia | Sulaiman S.A.S.,Universiti Sains Malaysia | Kah L.K.,Pulau Pinang Hospital | Chandrasekaran P.K.,Neurobehavioral Medicine
Asian Journal of Psychiatry | Year: 2010

Background: Depression is usually associated with changes in the endogenous hormonal system. The most important hormonal modifications are elevation of the serum cortisol level as well as the reduction of endogenous sex hormone levels. These changes have advanced side effects on a bone metabolism and bone remodelling process, which consequently, lead to the declining in bone mineral density and increase the risk of bone fractures, which is reported by current studies. Objective: To evaluate the association of low bone density with depression among Malaysian Chinese. Methods: 91 Chinese participants with depression were chosen from psychiatric clinics in Penang General Hospital and Penang Adventist Hospital, and 98 Chinese volunteers were employed from the community as controls of both genders, with their ages ranging from 25 to 65 years. Bone mineral density was detected by measuring the T-score and Z-score of the calcaneus bone at the heel; this was measured using the CM200 Furuno ultrasound bone densitometry. Results: The bone mineral density of the depressed group was observed to be significantly lower in terms of the T-score (P=0.020) and insignificantly lower in terms of Z-score as compared with the control group. Participants with depression had 1.5-fold relative risk (RR) of having T-score less than -1.0 (low bone density). Logistic regression was then used to adjust all confounding variables which showed a significant association between depression and low bone mineral density with an odds ratio of 2.28. Conclusion: Depression may be associated with low bone mineral density among the Malaysian Chinese. © 2010 Elsevier B.V.

Kurmanji J.M.,Universiti Sains Malaysia | Sulaiman S.A.S.,Universiti Sains Malaysia | Kah L.K.,Pulau Pinang Hospital | Chandrasekaran P.K.,Neurobehavioral Medicine
HealthMED | Year: 2010

Objective: In this study, we investigated the association of depressive illness with bone mineral density (BMD) represented by quantitative ultrasound derivatives in Malaysian males. Method: This study employed 107 Malaysian men that included 37 patients with depressive illness from 2 psychiatric centers and 70 apparently non depressed men from the community as control. We detected BMD by measuring the quantitative ultrasound derivatives T-score and Z-score of the calcaneus bone at the heel by using Ultrasound Bone Densitometer (UBD) for all subjects. Results: The mean ultrasound derivatives Tand Z-scores of the depressed group were significantly lower than the control group, after adjusting for age and body mass index (BMI), with P-values of < 0.001 and 0.003 respectively. Conclusion: Depressive illness thus, may be considered one of the unrecognized risk factors of low bone density in Malaysian males.

Najjar M.F.,Universiti Sains Malaysia | Aziz N.A.,Universiti Sains Malaysia | Hassan Y.,Universiti Sains Malaysia | Ghazali R.,Pulau Pinang Hospital | And 2 more authors.
HealthMED | Year: 2010

Geriatric population has grown rapidly in recent years. Geriatric inpatients' health care has become complicated due to the physiological and psychological changes increased by advancing age. Geriatric inpatients with polymorbidity often receive polypharmacy (PP) therapy. As a result, geriatric inpatients are at the high risk of adverse drug reactions (ADRs) and adverse health outcomes. The aim of this study was to estimate the incidence and significant predictors of PP leading to ADRs among geriatric inpatients. A prospective cohort design with convenient sampling was carried-out on 400 geriatric inpatients at Penang Hospital, Penang, Malaysia. The mean age for geriatric inpatients was 74.2 ± 6.5 years, more than half (53.5%) were females. The highest ethnic group was Chinese (58%) followed by Malays (25.8%). Only 7.5% of hospitalized geriatric inpatients admitted from nursing homes in Penang state. The mean number of prescribed medications was 5.45 ± 2.82. The incidence rates of PP and ADRs were 12.5% and 20.5% respectively. It was found that, ADRs was significantly increased with PP therapy. The main predictors of PP were; ADRs, hypertension, renal diseases, nursing homes residency, cardiovascular agents and elevated serum creatinine. Inpatient geriatric was at high risk of ADRs due to PP.

Ng E.K.,Serdang Hospital | Goh B.L.,Serdang Hospital | Chew S.E.,Serdang Hospital | Tan C.C.,Tuanku Ampuan Rahimah Hospital | And 3 more authors.
Seminars in Dialysis | Year: 2012

The demands for timely catheter insertion have spurred the growth of peritoneoscopic catheter insertion program by nephrologists in Malaysia. We performed a multicenter analysis to study its impact on the growth of peritoneal dialysis (PD) population. Data were collected retrospectively from five centers at the point of program initiation until December 2009. In Center 1, with this program, PD population continued to grow from 25 patients in 2006 to 120 in 2009. In center 2, the program began in 2005, but comprised only 28.6% of total insertions. From 2007 onwards, nephrologists had overtaken the surgeon, inserting from 85% to 97% of the total insertions. In center 3, with the program at its infancy, a modest growth in its PD population was shown. In center 4, nephrologists maintained an annual average of 41.8% of total catheter insertions, and thus maintaining a stable PD population. In center 5, surgeon-assisted PD catheter insertions helped to maintain the growth of its PD, seeing lesser impact from this program. Subanalysis showed that 1-year catheter survival in Center 1 was 85.4%. This study on PD catheter insertion program by nephrologists showed the greatest impact on new center and center experiencing suboptimal catheter insertions by traditional providers. © 2012 Wiley Periodicals, Inc.

Lim P.C.,Pulau Pinang Hospital | Lim K.,Pulau Pinang Hospital | Embee Z.C.,Pulau Pinang Hospital | Hassali M.A.,Universiti Sains Malaysia | And 2 more authors.
Pakistan Journal of Pharmaceutical Sciences | Year: 2016

Involvement of pharmacists in improving medication adherence among diabetic patients is recognized globally. In Malaysian healthcare system, pharmacists are also operating health services i.e. Diabetes Medication Therapy Adherence Clinic (DMTAC). This study aimed to assess the clinical outcomes of patients managed by pharmacists (DMTAC), in a Malaysian hospital setting. This was an open labelled randomised study. Type 2 diabetes patients with HbA1c ≥8% were recruited and arbitrarily divided into the intervention group (usual care plus DMTAC) and the non-intervention group (usual care only). Those enrolled in the intervention group were scheduled for follow-up for eight consecutive visits. Improvements in lab results were compared longitudinally (pre and post analysis) between the groups. Data analysis was done using PASW 18® version. A total of 76 patients were enrolled, with 39 patients in the intervention group and 37 patients in the non-intervention group. Mean HbA1c (-0.90% vs. -0.08%, p=0.011) and fasting blood glucose levels (-3.45mmol.l vs. +0.79mmol/l, p=0.002) reduced significantly between the intervention group vs. non-intervention group. Total cholesterol and low-density lipoprotein cholesterol (LDL-C) were also significantly reduced in the intervention group (TC -0.34mmol/l, p=0.018) (LDL -0.45mmol/l, p=0.001). In conclusion, pharmacists managed DMTAC significantly improved glycaemic control and lipid profile of diabetic patients.

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