3.Structured Education Programme on Patient Controlled Analgesia (PCA) for Orthopaedic Patients
Ho Se ; Christopher Ck HO ; Zainah M ; Indra ; Jaafar MZ ; Choy YC ; Ismail MS
Medicine and Health 2016;11(1):62-71
Patient-controlled analgesia (PCA) via an infusion pump enables patient to
administer their own analgesia. The aim of this study was to evaluate the effect
of an educational programme in managing post-operative pain and satisfaction
on PCA following orthopedic surgery. A pre-test and post-test interventional study
design with implementation of patient education programme on PCA was provided
to 54 respondents. The control group received conventional PCA briefing from
the Acute Pain Service protocol. Pain intensity was measured at 2 hrs, 6 hrs and
24 hrs following surgery and pre-test and post-test of the Revised American Pain
Society Patient Outcome Questionnaire (APS-POQ-R) was administered. There
was difference in respondents’ level of pain score among the study respondents’
medians for control group at 2 hrs, 6 hrs and 24 hrs following surgery and they were
7.00 (IQR=3.00), 5.00 (IQR=2.00) and 3.00 (IQR=2.00); intervention group at 2 hrs,
6 hrs and 24 hrs following surgery were 6.00 (IQR=2.00), 3.00 (IQR=1.00) and
1.00 (IQR=1.00) respectively. There were significant differences in median of pain
score between intervention and control group at 2 (U=142.0, p<0.05), 6 (U=150.50,
p<0.05) and 24 (U=120.00, p<0.05) hrs following surgery. There were statistically
significant differences (p<0.05) in the median of patient’s pain severity at all pain
levels i.e. least pain, worst pain, and severe pain between intervention and control
group (least pain, U=219.50, p<0.05; worst pain, U=117.0, p<0.05; severe pain,
U=49.0, p<0.05). In conclusion, patients who received pre-operative structured
education programme showed improvement in managing post-operative pain and
satisfaction on PCA after orthopedic surgery.
Analgesia, Patient-Controlled
4.First report of mermithid parasitism (Nematoda: Mermithidae) in mosquitoes (Diptera: Culicidae) from Lao PDR.
Indra Vythilingam ; Bonphone Sidavong ; Thim Chan Seng ; Tunkham Phonemixay ; Samlane Phompida ; M Krishnasamy
Tropical biomedicine 2005;22(1):77-9
Unidentified mermithid nematodes were found in the abdominal cavity of three species of Anopheles mosquitoes from LAO PDR. This is a first record of mermithid nematodes in adult mosquitoes from Lao PDR. Two worms were found in each adult host and the infection was more prevalent in the northern region compared to the south.
Culicidae
;
seconds
;
Parasitism
;
Mermithidae
;
First
5.Zika virus and its potential re-emergence in Malaysia
Jamal I-Ching Sam ; Yoke Fun Chan ; Indra Vythilingam ; Wan Yusoff Wan Sulaiman
The Medical Journal of Malaysia 2016;71(2):66-68
Zika virus (ZIKV) has re-emerged to cause explosive
epidemics in the Pacific and Latin America, and appears to
be associated with severe neurological complications
including microcephaly in babies. ZIKV is transmitted to
humans by Aedes mosquitoes, principally Ae. aegypti, and
there is historical evidence of ZIKV circulation in Southeast
Asia. It is therefore clear that Malaysia is at risk of similar
outbreaks. Local and international guidelines are available
for surveillance, diagnostics, and management of exposed
and infected individuals. ZIKV is the latest arbovirus to have
spread globally beyond its initial restricted niche, and is
unlikely to be the last. Innovative new methods for
surveillance and control of vectors are needed to target
mosquito-borne diseases as a whole.
Zika Virus
6.Comparison of microscopy and PCR for the detection of human Plasmodium species and Plasmodium knowlesi in southern Myanmar
Han Zar Thu ; Han Thwe Kay ; Aye Hla Kyin ; Hlaing Thaung ; Thant Zin Kyaw ; Vythilingam Indra
Asian Pacific Journal of Tropical Biomedicine 2017;7(8):680-685
Objectives: To determine the distribution of Plasmodium (P) species including Plas-modium knowlesi and to compare the specificity and sensitivity of microscopy with nested PCR in malaria diagnosis. Methods: The study was conducted in Kawthaung, southern Myanmar. Ninety clinically suspected malaria patients were screened for malaria by Giemsa stained microscopy and confirmed by nested PCR. Results: Among the participants, 57 (63.3%) were positive and 33 (36.7%) were negative by microscopy. Of positive samples, 39 (68.4%) were Plasmodium falciparum, 17 (29.8%) Plasmodium vivax and 1 (1.8%) Plasmodium malariae, whereas 59-amplified by PCR were 40 (67.8%), 18 (30.5%) and 1 (1.7%) respectively. PCR amplified 2 mi-croscopy negative samples. Two samples of P. falciparum detected by microscopy were amplified as P. vivax and vice versa. All samples were negative for Plasmodium ovale, P. knowlesi and mixed infections. Microscopy had a very good measure of agreement (k= 0.95) compared to nested PCR. Sensitivity and specificity of microscopy for diag-nosis of P. falciparum were 92.5%(95%CI:79.6–98.4) and 96.0%(95%CI:86.3–99.5) respectively, whereas for P. vivax were 83.3%(95%CI:58.6–96.4) and 97.2%(95%CI:90.3–99.7). Conclusions: P. knowlesi was not detected by both microscopy and PCR. Giemsa stained microscopy can still be applied as primary method for malaria diagnosis and is considered as gold standard. As to the lower sensitivity of microscopy for vivax malaria, those with previous history of malaria and relapse cases should be diagnosed by RDT or PCR combined with microscopy. Inaccuracy of species diagnosis highlighted the requirement of training and refresher courses for microscopists.
7.Serum neuron specific enolase is increased in pediatric acute encephalitis syndrome.
Dian PRATAMASTUTI ; Prastiya INDRA GUNAWAN ; Darto SAHARSO
Korean Journal of Pediatrics 2017;60(9):302-306
PURPOSE: This study aimed to investigate whether serum neuron-specific enolase (NSE) was expressed in acute encephalitis syndrome (AES) that causes neuronal damage in children. METHODS: This prospective observational study was conducted in the pediatric neurology ward of Soetomo Hospital. Cases of AES with ages ranging from 1 month to 12 years were included. Cases that were categorized as simple and complex febrile seizures constituted the non-AES group. Blood was collected for the measurement of NSE within 24 hours of hemodynamic stabilization. The median NSE values of both groups were compared by using the Mann-Whitney U test. All statistical analyses were performed with SPSS version 12 for Windows. RESULTS: In the study period, 30 patients were enrolled. Glasgow Coma Scale mostly decreased in the AES group by about 40% in the level ≤8. All patients in the AES group suffered from status epilepticus and 46.67% of them had body temperature >40℃. Most of the cases in the AES group had longer duration of stay in the hospital. The median serum NSE level in the AES group was 157.86 ng/mL, and this value was significantly higher than that of the non-AES group (10.96 ng/mL; P<0.05). CONCLUSION: AES cases showed higher levels of serum NSE. These results indicate that serum NSE is a good indicator of neuronal brain injury.
Body Temperature
;
Brain Injuries
;
Child
;
Encephalitis*
;
Glasgow Coma Scale
;
Hemodynamics
;
Humans
;
Neurology
;
Neurons*
;
Observational Study
;
Phosphopyruvate Hydratase*
;
Prospective Studies
;
Seizures, Febrile
;
Status Epilepticus
8.The Effect of Trigonella foenum-graceum L. (Fenugreek) Towards Collagen Type I Alpha 1 (COL1A1) and Collagen Type III Alpha 1 (COL3A1) on Postmenopausal Woman's Fibroblast
Shannaz Nadia YUSHARYAHYA ; Kusmarinah BRAMONO ; Natalia Rania SUTANTO ; Indra KUSUMA
Natural Product Sciences 2019;25(3):208-214
Trigonella foenum-graceum L. (fenugreek) is a phytoestrogen, a nonsteroidal organic chemical compound from plants which has similar mechanism of action to sex hormone estradiol-17β. This study aims to assess the effectivity of fenugreek seeds extract on collagen type I alpha 1 (COL1A1) and collagen type III alpha 1 (COL3A1) which are both decreased in aging skin and become worsen after menopause. This in vitro experimental study used old human dermal fibroblast from leftover tissue of blepharoplasty on a postmenopausal woman (old HDF). As a control of the fenugreek's ability to trigger collagen production, we used fibroblast from preputium (young HDF). Subsequent to fibroblast isolation and culture, toxicity test was conducted on both old and young HDF by measuring cell viability on fenugreek extract with the concentration of 5 mg/mL to 1.2 µg/mL which will be tested on both HDF to examine COL1A1 and COL3A1 using ELISA, compared to no treatment and 5 nM estradiol. Old HDF showed a 4 times slower proliferation compared to young HDF (p<0.05). Toxicity test revealed fenugreek concentration of 0.5 – 2 µg/mL was non-toxic to both old and young HDF. The most significant fenugreek concentration to increase COL1A1 and COL3A1 secretion was 2 µg/mL (p<0.05).
Aging
;
Blepharoplasty
;
Cell Survival
;
Collagen Type I
;
Collagen Type III
;
Collagen
;
Enzyme-Linked Immunosorbent Assay
;
Estradiol
;
Female
;
Fibroblasts
;
Humans
;
In Vitro Techniques
;
Menopause
;
Phytoestrogens
;
Skin
;
Toxicity Tests
;
Trigonella
9.Sequential Sacral Insufficiency Fracture After Unilateral Pubic Fractures: A Case Report.
Kyung Soon PARK ; Dong Hyun LEE ; Indra PENI ; Taek Rim YOON
Korean Journal of Bone Metabolism 2012;19(1):47-51
Osteoporotic fractures of the pelvic ring are not uncommon and among them sacral insufficiency fractures (SIFs) are often overlooked in patients with buttock or low back pain following no or minimal trauma, which results in diagnostic delays. SIFs are often bilateral and are commonly associated with other fractures - most frequently with a pubic ramus fracture. However, it remains unclear which fracture (sacral or pubic ramus) occurs first, and the only report on the subject found that the fracture sequence is initiated by a sacral fracture. The authors describe a case of sequential bilateral SIFs in a 74-year old woman following superior and inferior pubic rami fractures on one side. In conclusion we suggested that SIFs can occur after pelvic ring injury in any side because biomechanical disruption of the pelvic ring can induce the sacral fracture in patients with severe osteoporosis.
Buttocks
;
Female
;
Fractures, Stress
;
Humans
;
Low Back Pain
;
Osteoporosis
;
Osteoporotic Fractures
10.Sequential Sacral Insufficiency Fracture After Unilateral Pubic Fractures: A Case Report.
Kyung Soon PARK ; Dong Hyun LEE ; Indra PENI ; Taek Rim YOON
Korean Journal of Bone Metabolism 2012;19(1):47-51
Osteoporotic fractures of the pelvic ring are not uncommon and among them sacral insufficiency fractures (SIFs) are often overlooked in patients with buttock or low back pain following no or minimal trauma, which results in diagnostic delays. SIFs are often bilateral and are commonly associated with other fractures - most frequently with a pubic ramus fracture. However, it remains unclear which fracture (sacral or pubic ramus) occurs first, and the only report on the subject found that the fracture sequence is initiated by a sacral fracture. The authors describe a case of sequential bilateral SIFs in a 74-year old woman following superior and inferior pubic rami fractures on one side. In conclusion we suggested that SIFs can occur after pelvic ring injury in any side because biomechanical disruption of the pelvic ring can induce the sacral fracture in patients with severe osteoporosis.
Buttocks
;
Female
;
Fractures, Stress
;
Humans
;
Low Back Pain
;
Osteoporosis
;
Osteoporotic Fractures