1.The prevalence and associated factors of neuropathic pain symptoms in a cohort of multi-ethnic Malaysian patients with diabetes mellitus
Li-Ying GOH ; Ezmeer Emiral SHAHROM ; Clarita Clarence GANESAN ; Shireene Ratna VETHAKKAN ; Khean-Jin GOH
Neurology Asia 2017;22(4):325-331
Objective: To determine prevalence and factors associated with neuropathic pain symptoms in a multiethniccohort of Malaysian adult diabetic patients. Methods: This was aprospective cross-sectionalobservational study of hospital-based diabetic outpatients in Malaysia. Subjects were interviewedfor their demographic data and medical history. The painDETECT questionnaire was used to screenfor neuropathic pain symptoms and pain intensity was assessed using the numeric pain rating scale(NPRS). Neuropathy symptoms and signs were assessed using the Neuropathy Symptom Score(NSS) and Neuropathy Disability Score (NDS). Results:Of 242 patients,140 (58%) were women,with a mean age of 61 + 11.4 years (range 21 to 81). Ninety nine(40.9%) were Malay, 64 (26.4%)Chinese, 76 (31.4%) Indian and three (1.2%) were Eurasian. Mean duration of diabetes was 15.9+ 9.8years (range 1 to 53) and 232 (95.9%) patients had Type II diabetes. Peripheral neuropathy,based onNSS and NDS criteria, was found in 83 (34.3%). Thirteen (5.4%) patients were found to likely haveneuropathic pain symptoms and this was independently associated with peripheral neuropathy ((OR)= 3.40, 95% confidence interval (CI): 1.04, 11.14) and Indian ethnicity (OR = 5.44, 95% CI: 1.50,19.57)). Patients with neuropathic pain had higher average pain intensity scores.Conclusions: The prevalence of neuropathic pain symptoms in a Malaysian DM patient cohort waslow and was associated with the severity of neuropathy symptoms and Indian ethnicity. The causesfor ethnic differences are unknown and could be due socio-cultural or physiological differences inneuropathic pain perception.
2.Clinical efficacy and long-term immunogenicity of an early triple dose regimen of SARS-CoV-2 mRNA vaccination in cancer patients.
Matilda Xinwei LEE ; Siyu PENG ; Ainsley Ryan Yan Bin LEE ; Shi Yin WONG ; Ryan Yong Kiat TAY ; Jiaqi LI ; Areeba TARIQ ; Claire Xin Yi GOH ; Ying Kiat TAN ; Benjamin Kye Jyn TAN ; Chong Boon TEO ; Esther CHAN ; Melissa OOI ; Wee Joo CHNG ; Cheng Ean CHEE ; Carol L F HO ; Robert John WALSH ; Maggie WONG ; Yan SU ; Lezhava ALEXANDER ; Sunil Kumar SETHI ; Shaun Shi Yan TAN ; Yiong Huak CHAN ; Kelvin Bryan TAN ; Soo Chin LEE ; Louis Yi Ann CHAI ; Raghav SUNDAR
Annals of the Academy of Medicine, Singapore 2023;52(1):8-16
INTRODUCTION:
Three doses of SARS-CoV-2 mRNA vaccines have been recommended for cancer patients to reduce the risk of severe disease. Anti-neoplastic treatment, such as chemotherapy, may affect long-term vaccine immunogenicity.
METHOD:
Patients with solid or haematological cancer were recruited from 2 hospitals between July 2021 and March 2022. Humoral response was evaluated using GenScript cPASS surrogate virus neutralisation assays. Clinical outcomes were obtained from medical records and national mandatory-reporting databases.
RESULTS:
A total of 273 patients were recruited, with 40 having haematological malignancies and the rest solid tumours. Among the participants, 204 (74.7%) were receiving active cancer therapy, including 98 (35.9%) undergoing systemic chemotherapy and the rest targeted therapy or immunotherapy. All patients were seronegative at baseline. Seroconversion rates after receiving 1, 2 and 3 doses of SARS-CoV-2 mRNA vaccination were 35.2%, 79.4% and 92.4%, respectively. After 3 doses, patients on active treatment for haematological malignancies had lower antibodies (57.3%±46.2) when compared to patients on immunotherapy (94.1%±9.56, P<0.05) and chemotherapy (92.8%±18.1, P<0.05). SARS-CoV-2 infection was reported in 77 (28.2%) patients, of which 18 were severe. No patient receiving a third dose within 90 days of the second dose experienced severe infection.
CONCLUSION
This study demonstrates the benefit of early administration of the third dose among cancer patients.
Humans
;
SARS-CoV-2
;
COVID-19/prevention & control*
;
Treatment Outcome
;
Neoplasms/drug therapy*
;
Hematologic Neoplasms
;
Vaccination
;
RNA, Messenger
;
Antibodies, Viral
;
Immunogenicity, Vaccine
3.Burnout Among Critical Care Personnel In Intensive Care Unit During COVID-19 Pandemic In A Malaysian Tertiary Hospital
E-Li LEONG ; Chii-Chii CHEW ; Ju-Ying ANG ; Ce-Cin GOH ; Audrey Hee-Mun LEOW ; Keren Seok-Luan LIM ; Muhammad-Khaidir MOHD SHAFFIE ; Kit-Weng FOONG
Malaysian Journal of Medicine and Health Sciences 2023;19(No.2):104-111
Introduction: During the early phase of Coronavirus disease (COVID-19), there were various uncertainties, which had a detrimental impact on the prevalence of burnout among critical care personnel worldwide. This study aims to investigate the prevalence of burnout and its associated factors in critical care personnel involved in the COVID-19
pandemic.
Methods: This is a single-center, cross-sectional study with 81 critical care personnel for a survey using Copenhagen Burnout Inventory. Binary logistic regression analysis was conducted to identify factors associated with personal burnout.
Results: More than half of the respondents were female (60.5%) over the age of 30 (61.7%), and 54.3% were medical doctors. A large number (72.8%) of the respondents experienced personal burnout, with twothirds of them experiencing work-related (65.4%) and client-related burnout (59.3%). Personal burnout was found to be associated with those who had children [OR: 11.31 (1.90, 67.37), p = 0.008], stayed with family, relatives, or friends [OR: 9.40 (1.27, 69.46), p = 0.028], were medical doctors [OR: 26.52 (2.79, 252.22), p = 0.004], worked more than 45 hours per week [OR: 8.68 (1.45, 58.09), p = 0.018], and previously never had COVID-19 viral test
[OR: 6.93 (1.17, 40.89), p = 0.033].
Conclusion: Overall, more than half of the critical care personnel experienced burnout. There were possible associations between personal burnout with social characteristics such as having children and living with family, relatives, or friends, and occupational characteristics such as being a medical doctor, long working hours, and previously never had COVID-19 viral test.
4.Safety attitudes, burnout and well-being among healthcare workers during the COVID-19 pandemic: an Indo-Pacific regional cross-sectional study.
Abhiram KANNEGANTI ; Benjamin Yong Qiang TAN ; Nik Hisamuddin NIK AB RAHMAN ; Aloysius Sheng-Ting LEOW ; Max DENNING ; Ee Teng GOH ; Lucas Jun HAO LIM ; Ching-Hui SIA ; Ying Xian CHUA ; James KINROSS ; Melanie TAN ; Li Feng TAN ; Yi Min WAN ; Arvind SHARMA ; Rivan DANUAJI ; R N KOMAL KUMAR ; Chew Keng SHENG ; Cheah Phee KHENG ; Sarah Shaikh ABDUL KARIM ; Mohd Najib ABDUL GHANI ; Suhaimi MAHMUD ; Yiong Huak CHAN ; Vijay Kumar SHARMA ; Kang SIM ; Shirley Beng SUAT OOI
Singapore medical journal 2023;64(11):667-676
INTRODUCTION:
The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact in Asia and has placed significant burden on already stretched healthcare systems. We examined the impact of COVID-19 on the safety attitudes among healthcare workers (HCWs), as well as their associated demographic and occupational factors, and measures of burnout, depression and anxiety.
METHODS:
A cross-sectional survey study utilising snowball sampling was performed involving doctors, nurses and allied health professions from 23 hospitals in Singapore, Malaysia, India and Indonesia between 29 May 2020 and 13 July 2020. This survey collated demographic data and workplace conditions and included three validated questionnaires: the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory and Hospital Anxiety and Depression Scale. We performed multivariate mixed-model regression to assess independent associations with the SAQ total percentage agree rate (PAR).
RESULTS:
We obtained 3,163 responses. The SAQ total PARs were found to be 35.7%, 15.0%, 51.0% and 3.3% among the respondents from Singapore, Malaysia, India and Indonesia, respectively. Burnout scores were highest among respondents from Indonesia and lowest among respondents from India (70.9%-85.4% vs. 56.3%-63.6%, respectively). Multivariate analyses revealed that meeting burnout and depression thresholds and shifts lasting ≥12 h were significantly associated with lower SAQ total PAR.
CONCLUSION
Addressing the factors contributing to high burnout and depression and placing strict limits on work hours per shift may contribute significantly towards improving safety culture among HCWs and should remain priorities during the pandemic.
Humans
;
Cross-Sectional Studies
;
Pandemics
;
COVID-19/epidemiology*
;
Burnout, Psychological
;
Health Personnel