1.The temerloh hospital cataract complications study:factors associated with, types and outcomes of cataract surgery complications
Thevi THANIGASALAM ; Sagili Chandrasekhara REDDY ; Karuthan CHINNA
International Eye Science 2014;(8):1367-1372
AIM: To study the prevalence of complications of cataract surgery and any association between the occurrence of complications and experience of surgeon, type of surgery, type of anaesthesia and visual outcome.METHODS: This was a retrospective study of patients who underwent cataract surgery over a period of two years in a district hospital in Malaysia. The demographic details of patients, type of surgery done, as well as type of anaesthesia used and experience of the surgeon were noted. The types of intraoperative and postoperative complications were recorded. The final best corrected visual outcome was recorded.
RESULTS:Complications occurred in 11. 1% of the total 1007 patients operated. Posterior capsule rupture (3. 6%) was the most common complication. The experience of the surgeon and the type of anaesthesia used did not affect complications during surgery. Intracapsular cataract extraction ( ICCE ) and phacoemulsification converted to extracapsular cataract extraction ( ECCE ) were significantly associated with more complications ( P < 0. 001 ). The visual outcome was significantly poor in patients with complications (P<0. 001).
CONCLUSION: The occurrence of complications during cataract surgery significantly affected the visual outcome. The type of surgery done was associated by the occurrence of complications. However, the experience of the surgeon and the type of anaesthesia used did not affect the occurrence of complications. We recommend that particular attention be given to ICCE and phacoemulsification converted to ECCE to minimise the complications and thereby reducing the chances of poor vision postoperatively.
2.Psychometric Properties of the Malay Version of the Dutch Eating Behaviour Questionnaire (DEBQ) in a Sample of Malaysian Adults Attending a Health Care Facility
Kavitha Subramaniam ; Wah Yun Low ; Karuthan Chinna ; Kin Fah Chin ; Saroja Krishnaswamy
Malaysian Journal of Medical Sciences 2017;24(4):64-73
Objective: This study aims to investigate the psychometric properties of the Malay version of the Dutch Eating Behaviour Questionnaire (DEBQ) among Malaysian adults. Method: The Malay version of the DEBQ instrument was administered to 398 outpatients (269 women and 129 men) at the University of Malaya Medical Centre (UMMC). Confirmatory Factor Analysis (CFA) was conducted to study the construct validity of the instrument. Composite reliability coefficient, Raykov's rho, was used to determine the internal consistency. Results: The proposed three-factor structure for the DEBQ instrument was appropriate, although three items (Items 21, 14 and 27) showed problematic loadings with inappropriate model fit and were removed. The modified version had an appropriate model fit χ2/df = 2.129, TLI = 0.908, CFI = 0.918, RMSEA = 0.053 (90%CI = 0.048–0.058), close-fit P-value = 0.136 and satisfactory internal consistency of 0.914 for emotional eating scale, 0.819 for external eating scale and 0.856 for restrained eating scale. Discussion: The Malay version of the DEBQ is a valid instrument to study eating behaviour traits among Malaysian adults. Further research is warranted to determine if Items 14 and 27 are appropriate for the Malaysian population.
3.Preliminary study of an exercise programme for reducing fatigue and improving sleep among long-term haemodialysis patients.
Radha MANIAM ; Pathmawathi SUBRAMANIAN ; Surindar Kaur Surat SINGH ; Soo Kun LIM ; Karuthan CHINNA ; Roshaslina ROSLI
Singapore medical journal 2014;55(9):476-482
INTRODUCTIONFatigue and quality of sleep are the main factors that contribute to a poor quality of life among patients on long-term haemodialysis. Studies have also emphasised the importance of exercise for improving the wellbeing of dialysis patients. This study aimed to determine the effectiveness of a predialysis low-to-moderate-intensity exercise programme for reducing fatigue and improving sleep disorders among long-term haemodialysis patients.
METHODSIn this quasi-experimental study, an exercise programme was conducted three times a week for 12 weeks before long-term haemodialysis patients underwent dialysis at two centres. The patients were categorised into either the exercise group (n = 28) or control group (n = 27). The latter was asked to maintain their current lifestyles. Assessments of fatigue and sleep disorder levels were performed for both groups using self-reported questionnaires at baseline and after intervention. The patients' perception of the exercise programme was also determined using self-reported questionnaires.
RESULTSPaired sample t-test indicated improvements in fatigue level in the exercise group (mean fatigue score: post-treatment 40.5 ± 7.9 vs. pre-treatment 30.0 ± 10.9). Improvements in sleep disorders were also observed in the exercise group (mean score: post-treatment 7.6 ± 3.3 vs. pre-treatment 10.1 ± 3.8). However, sleep quality deteriorated in the control group (mean score: post-treatment 10.7 ± 2.9 vs. pre-treatment 9.3 ± 2.9).
CONCLUSIONSimple low-to-moderate-intensity exercise is effective for improving fatigue, sleep disorders and the overall quality of life among haemodialysis patients.
Adult ; Aged ; Exercise ; Exercise Therapy ; methods ; Fatigue ; therapy ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Renal Dialysis ; Renal Insufficiency ; psychology ; therapy ; Sleep ; physiology ; Sleep Wake Disorders ; psychology ; therapy ; Surveys and Questionnaires ; Treatment Outcome
4.Calcium Intake, Vitamin D and Bone Health Status of Post-menopausal Chinese Women in Kuala Lumpur
Chee WSS ; Chong PN ; Chuah KA ; T Karupaiah ; Norlaila Mustafa ; Seri Suniza S ; Karuthan Chinna ; Horcajada MN ; Ameye L ; Offord-Cavin E
Malaysian Journal of Nutrition 2010;16(2):233-242
Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using
whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide ß cross
link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine
and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high
levels of CTX- ß. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as <50 nmol/l). Mean
total calcium intake of the subjects was 497 + 233 mg, of which only 14% met the RNI for calcium with the additional intake of calcium supplements. Body fat was also significantly correlated (r=0.181, p<0.05) with BMD at the spine but not BMD at the femoral neck. Lean body mass was positively correlated with BMD at the spine (r=0.289, p<0.001) and femoral neck (r=0.295, p<0.001). CTX-β was
negatively correlated with BMD at the spine (r= -0.235, p<0.001), whereas P1NP (r=-0.215, p<0.001) and osteocalcin (r=-0.265, p<0.001) were both negatively
correlated with BMD at the femoral neck. Generally, the study found that women with osteopenia had higher levels of bone turnover markers, less lean body mass and lower calcium intake than women with normal BMD. In conclusion,
this study demonstrated that the majority of free living Chinese post-menopausal women in Kuala Lumpur have low calcium intake, low 25-OH vitamin D status
and low bone mass and elevated biochemical markers of bone turnover.
5.Barcelona Clinic Liver Cancer and Hong Kong Liver Cancer staging systems for prediction of survival among Hepatocellular Carcinoma patients
Sumitra Ropini Karuthan ; Peng Soon Koh ; Karuthan Chinna ; Wah Kheong Chan
The Medical Journal of Malaysia 2021;76(2):199-204
Introduction: We aimed to compare the Barcelona Clinic
Liver Cancer (BCLC) and Hong Kong Liver Cancer (HKLC)
staging systems.
Materials and Methods: This is a retrospective study on
patients with newly diagnosed hepatocellular carcinoma
(HCC) at the University Malaya Medical Centre between 2011
and 2014. Survival times were analysed using the KaplanMeier procedure and comparison between groups was done
using the log rank test.
Results: The data of 190 patients was analysed. Chronic
hepatitis B was the most common aetiology for HCC (43.7%),
but a large proportion was cryptogenic or non-alcoholic
steatohepatitis-related (41.6%). Only 11.1% were diagnosed
early (BCLC Stage 0-A) while majority were diagnosed at an
intermediate stage (BCLC Stage B, 53.7%). The median
survival rate was significantly different between the different
groups when either of the staging systems was used (p<0.05
for all comparisons). However, the two staging systems
lacked agreement (weighted kappa 0.519, 95%CI: 0.449,
0.589) with significant difference in median survival rates
between BCLC Stage A and HKLC Stage 2, and between
BCLC Stage C and HKLC Stage 4.
Conclusion: Both staging systems were able to stratify
patients according to survival, but they only had moderate
agreement with significant differences observed in two
groups of the staging systems.
6.Characteristics of dietary intakes including NOVA foods among pre-adolescents living in urban Kuala Lumpur – Findings from the PREBONE-Kids study
Wai Yew Yang ; Soon Yee Wong ; Shu Hwa Ong ; Kanimolli Arasu ; Chung Yuan Chang ; Megan Hueh Zan Chong ; Meenal Mavinkurve ; Erwin Jiayuan Khoo ; Karuthan Chinna ; Connie M. Weaver ; Winnie Siew Swee Chee
Malaysian Journal of Nutrition 2023;29(No.3):401-414
Introduction: Evidence showed considerable variability of health risk factors within different socioeconomic groups. This study aimed to characterise dietary intakes by total household income among a sample of Malaysian pre-adolescents in urban Kuala Lumpur. Methods: Baseline data of 243 healthy, pre-adolescent children between 9 and 11 years old including socio-demographic background (gender, ethnicity, and total household monthly income), anthropometry (body weight and height), and
7-day diet histories were collected. Secondary analysis was performed on dietary intakes to quantify food groups based on the Malaysian Dietary Guidelines and NOVA classification systems besides nutrients. Differences and associations between total monthly household income categories with anthropometry and dietary intakes were tested using independent t-test/Mann-Whitney U (depending on normality) and chi-square tests, respectively. Results: Most children in this study population
had dietary intakes below the recommended serving sizes for five food groups, except meat/poultry (195.2±107.2%) and fish (110.1±106.3%) and consumed about 32% of energy from ultra-processed foods (NOVA food group 4). While there was no difference in dietary intake between the bottom 40% with the middle 40% and high 20% household income groups, the percentage of energy contributed by NOVA food group 4 (processed fats/oils, condiments, and sauces) was higher in the bottom 40% households (p=0.024). Conclusion: Most pre-adolescent children in this study, regardless of household income, did not meet dietary recommendations and ate diets comprised of less nutritious foods. Comprehensive approaches that aim to improve dietary patterns and reduce the risk of diet-related chronic diseases are warranted.