1.The Effectiveness of Tocotrienol Rich Fraction and Αlpha Tocoferol with Combination of Vitamin C in The Management of Systemic Inflammatory Response Syndrome (SIRS)
Husam YE ; Raha AR ; Jaafar MZ ; Mohd Heikal MY
Journal of Surgical Academia 2017;7(2):4-12
The pathophysiology of systemic inflammatory response syndrome (SIRS) had been described to involve various
strong oxidative reactions affecting the status and progress of the patients. Antioxidant therapy had been suggested in
many studies involving SIRS management. The objective of this study was to compare the role of vitamin E
Tocotrienol and vitamin E Tocopherol combined with vitamin C as antioxidant therapy in the management of
critically ill patients diagnosed with SIRS, admitted to the intensive care unit and high dependency wards of
Universiti Kebangsaan Malaysia Medical Centre (UKMMC). It was a single blind randomized clinical trial with a
total of 72 patients in which 44.4% Malays, 34.7% Chinese, 19.4% Indians and 1.4% others with 59.7% males and
40.3% females were recruited. Patients in TRI E group received Tocotrienol with Vitamin C while TOCO group
received Tocopherol with Vitamin C and a control group did not receive any antioxidant. The clinical parameters
(heart rate, respiratory rate, systolic blood pressure) showed improvements with significant difference at the end of
study (post-intervention) as compared to admission (pre-intervention).Whereas, the sepsis (temperature, PCT, CRP
and WBC) and oxidative stress (8-OHdG/Creatinine) parameters showed improvements with significant difference at
the end of study (post-intervention) as compared to admission (pre-intervention). The TRI E group showed obvious
improvement in clinical, sepsis and oxidative stress parameters, as compared to TOCO and control groups. This
study showed that Vitamin E Tocotrienol and Vitamin E Tocopherol in combination with Vitamin C demonstrated
significant improvement in the clinical and laboratory parameters during the management of SIRS. Therefore,
Vitamin E in combination with Vitamin C had therapeutic benefits in the treatment of critically ill patients with
SIRS.
Tocotrienols
2.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
3.The Impact of a Patient Education Package on Outcomes of Pain Management Following Orthopaedic Surgery in a Tertiary Hospital in Malaysia
Ho SE ; Wan Ahmad L ; Christopher CK Ho ; Tan ZY ; NurSharifah MS ; Choy YC ; Jaafar MZ ; Sabarul AM ; Sharaf I
Medicine and Health 2015;10(1):58-65
Patient’s belief towards pain management may affect pain management outcomes
and quality of life. The main aim of the present study was to determine the impact
of a pre-operative pain education package towards pain belief among patients
undergoing orthopaedic surgery in a tertiary hospital. A one-group pre-test post-test
design study was conducted on orthopaedic surgery patients. Thirty respondents
were recruited and pre-operative pain education was administered individually
before surgery. Pre-operative and post-operative pain belief, management scores
and side effects were measured using the Barrier Questionnaire (BQ-13). The results
reported significant differences between pre-test scores (Mean = 41.87, Standard
Deviation = 11.467) and post-test scores (Mean=34.80, Standard Deviation=13.026)
of pain belief (t = 2.84, p = 0.004). There were also significant differences between
pre-test scores (Mean = 37.10, Standard Deviation = 10.610) and post-test scores
(Mean=30.80, Standard Deviation = 11.424) of pain management (t = 3.856, p
= 0.0005). Respondent’s gender (t = -2.403, p = 0.023) and ethnicity (F = 5.038,
p=0.014) reported significant differences with p value < 0.05, respectively. However,
there were no significant differences between educational level, ethnicity, prior
surgical history with pain belief (p> 0.05). There was positive impact of the pain
education package towards pain belief and painmanagement among respondents
who underwent orthopaedics surgery in a tertiary hospital. Reinforcement of pain
educational program is pivotal in order to achieve optimal post-operative pain
management.
Pain management