RESEARCH DIGEST

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Research Digest is a selection of original research done by Malaysian authors or conducted in Malaysia. Only articles felt to be of clinical relevance to primary care physicians are selected. This Research Digest is abstracted by CL Teng (tengcl@gmail.com)
Editor’s note: We wish to thank authors for providing full text reprint of their articles.

Domestic violence is uncommon in pregnancy

Jahanfar S, Ellizza K, Mohammad Alavi S, et al. The prevalence of domestic violence against pregnant women in Perak, Malaysia. Arch Iran Med. 2007;10(3):376-8 [PubMed] [Full text]
Primary author’s affiliation: Department of Obstetrics and Gynecology, Royal College of Medicine, Ipoh, Perak, Malaysia.

134 antenatal and postnatal women in Ipoh General Hospital in Perak, Malaysia, were interviewed using a modified version of Abuse Assessment Screen questionnaire. The prevalence of domestic violence was low (4.5%). Comparison between the two groups of subjects with or without domestic violence did not show any significant difference in terms of risk factors.
Source of funding: Not known

 

One in eight Malaysian adults has chronic insomnia

Zailinawati AH, Kamil MA, Nurjahan MI, Teng CL. Epidemiology of insomnia in Malaysian adults: a community-based survey in 4 urban areas. Asia Pac J Public Health. 2008;20(3):224-233 [Link]
Primary author’s affiliation: Department of Family Medicine, International Medical University, Seremban, Negeri Sembilan, Malaysia (part-time lecturer)

1611 community-dwelling adults from four Malaysian states were interviewed in 2004. The prevalence of insomnia symptom was 33.8%, and 12.2% of the subjects had chronic insomnia. Insomnia was more common among elderly; those who were separated, divorced, or widowed; and those who smoked at bedtime. About one-third of the population had insomnia associated with impaired daily function.
Source of funding: Not reported

 

Seven out of ten patients with chronic prostatitis/chronic pelvic pain syndrome have sexual dysfunction

Lee SW, Liong ML, Yuen KH, et al. Adverse impact of sexual dysfunction in chronic prostatitis/chronic pelvic pain syndrome. Urology. 2008;71(1):79-84 [PubMed]
Primary author’s affiliation: School of Pharmaceutical Sciences, University of Science Malaysia, Penang, Malaysia

296 subjects with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) completed the National Institutes of Health-Chronic Prostatitis Symptom Index, International Index of Erectile Function-5, and selected questions from the University of Washington Symptom Score. Sexual dysfunction was defined as self-reported erectile dysfunction (ED) or ejaculatory difficulty, or both. 72.3% of subjects reported sexual dysfunction. Of the 214 participants with sexual dysfunction, 54 (25.0%) complained of ED only, 71 (33.4%) complained of ejaculatory difficulties only, and 89 (41.6%) complained of both ED and ejaculatory difficulties.
Source of funding: Not reported

Having positive family history would encourage breast cancer patients to present earlier? Unfortunately, no.

Yip CH, Mohd Taib NA, Lau PC. Does a positive family history influence the presentation of breast cancer? Asian Pac J Cancer Prev. 2008;9(1):63-5 [PubMed] [Full text]
Primary author’s affiliation: Dept of Surgery, University of Malaya Medical Centre, Kuala Lumpur, Malaysia

For the period Jan 2001 to Dec 2006, 1553 women with breast cancer presented to University of Malaya Medical Centre, 252 (16.2%) of had a family history of breast cancer in their first or second degree relatives. Screen-detected cancers were more common in those with family history (10.7% vs 5.1%). However, there is no statistical significant difference in percentage of late stages (Stage 3 and 4), mean size of tumour, and presentation after one year of symptom. Having a family history of breast cancer does not appear to have much impact on the health-seeking behaviour of women.
Source of funding: Not known

Vertical transmission of dengue is rare

Tan PC, Rajasingam G, Devi S, Siti Zawiah O. Dengue infection in pregnancy: prevalence, vertical transmission, and pregnancy outcome. Obstet Gynecol. 2008;111(5):1111-7 [PubMed]
Primary author’s affiliation: Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Over a period of six month in 2006, paired maternal-umbilical cord blood samples (n= 2,531) were tested for dengue-specific IgM. Sixty-three out of 2,531 maternal samples were positive (2.5%), and only 1 out of 64 cord blood sample was positive (1.6%) for dengue IgM. Fifty-six of 63 (88.9%) of dengue IgM-positive women did not report a febrile illness in pregnancy. Rates of preterm birth, mode of delivery, postpartum haemorrhage, low birth weight, and neonatal outcomes were not different between mothers with and without positive dengue IgM.
Source of funding: Ministry of Higher Education of Malaysia (Grant no. PPF UM FP031/2005D).

Etoricoxib relieves pain better and has less side effect than mefenamic acid

Nor Azlin MI, Maryasalwati I, Norzilawati MN, et al. The efficacy of etoricoxib vs mefenamic acid in the treatment of primary dysmenorrhoea: a randomised comparative trial. J Obstet Gynaecol. 2008;28(4):424-6 [PubMed]
Primary author’s affiliation: Department of Obstetrics and Gynaecology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

This was a randomised cross-over trial of the efficacy of etoricoxib compared with mefenamic acid in treating primary dysmenorrhoea among twenty single, sexually inactive women (mean age 22 years). Pain was measured using visual analogue scale. The pre-treatment pain score was 8.2 (±1.3), post-treatment were 3.8 (±1.6) and 5.3 (±2.9) for etoricoxib and mefenamic acid groups, respectively (the difference was statistically significant, p=0.048). Some 80% had significantly better pain relief with etoricoxib, compared with only 20% in the mefenamic acid group. Etoricoxib has significantly fewer side-effects compared with mefenamic acid with significantly reduced menstrual blood loss.
Source of funding: Not known

 

Buprenorphine is more effective than naltrexone in preventing heroin relapse

Schottenfeld RS, Chawarski MC, Mazlan M. Maintenance treatment with buprenorphine and naltrexone for heroin dependence in Malaysia: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;371(9631):2192-200 [PubMed]
Primary author’s affiliation: Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, United States

126 detoxified heroin-dependent patients, from an outpatient research clinic and detoxification programme in Malaysia, were randomly assigned to 24 weeks of manual-guided drug counselling and maintenance with naltrexone (n=43), buprenorphine (n=44), or placebo (n=39). Medications were administered on a double-blind and double-dummy basis. Buprenorphine was associated with greater time to first heroin use than were naltrexone (hazard ratio 1.87 [95% CI 1.21-2.88]) or placebo (2.02 [1.29-3.16]). The study findings lend support to the widespread dissemination of maintenance treatment with buprenorphine as an effective public-health approach to reduce problems associated with heroin dependence.
Funding support: US National Institute on Drug Abuse.

 

Symptomatic dengue has major effects on patients' quality of life

Lum LCS, Suaya JA, Tan LH, et al. Quality of life of dengue patients. Am J Trop Med Hyg. 2008;78(6):862-7 [PubMed]
Primary author’s affiliation: Department of Pediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia

Quality of life of 207 dengue patients (adults and children) from the University Malaya Medical Centre was evaluated using the EuroQol visual analogue scale (English and Malay version). Of eight health domains, 6.2 and 5.0 domains were affected in the hospitalized and ambulatory cohorts, respectively (P < 0.001), with cognition and interpersonal activities affected most. All patients experienced a drastic decrease in their QoL from the onset of symptoms. The QoL deteriorated to the lowest point  between the 3rd and 7th days of illness. The duration of impaired QoL (9 days for ambulatory or 13 days for hospitalized patients) was longer than the duration of fever (5 and 7 days, respectively).
Funding support: Pediatric Dengue Vaccine Initiative to University Malaya and Brandeis University

 

Durian has lower glycaemic index than pineapple

Robert SD, Ismail AA, Winn T, Wolever TM. Glycemic index of common Malaysian fruits. Asia Pac J Clin Nutr. 2008; 17(1):35-9 [PubMed]
Primary author’s affiliation: Program in Dietetics, School of Health Sciences, Health Campus, Universiti Sains Malaysia,
Kelantan, Malaysia

The glycaemic index of durian, papaya, pineapple and water-melon grown in Malaysia is evaluated. Ten healthy volunteers  consumed 50 g of available carbohydrate portions of glucose (reference food) and four test foods (durian, papaya, pineapple and watermelon) in random order after an overnight fast. Postprandial plasma glucose was measured at intervals for two hours after intake of the test foods. Incremental areas under the curve were calculated, and the glycaemic index was determined by expressing the area under the curve after the test foods as a percentage of the mean area under the curve after glucose. The glycaemic index of pineapple, 82+/-4, was significantly greater than those of papaya, 58+/-6, watermelon, 55+/-3, and durian, 49+/-5 (p<0.05). The differences in area under the curve and glycaemic index among papaya, watermelon and durian were not statistically significant. The validity of these results depends on the accuracy of the data in the food tables upon which the portion sizes tested were based.
Funding support: Universiti Sains Malaysia

 

GPs in Perak achieved 3 out of 10 cardiovascular disease audit standards

Chan SC, Lee TW, Teoh LC, et al. Audit on cardiovascular disease preventive care in general practice. Singapore Med J. 2008;49(4):311-5 [PubMed] [Full text]
Primary author’s affiliation: Department of Primary Care, Universiti Kuala Lumpur Royal College of Medicine Perak, Ipoh, Perak, Malaysia

Nine GPs in Perak did a retrospective audit on the records of patients, aged 45 years and above, who attended the clinics in June 2005. The adequacy of cardiovascular disease preventive care was assessed using 10 criteria and standards. Targets were achieved in three out of ten indicators of cardiovascular preventive care. Standards achieved included blood pressure recording (92.4 percent), blood sugar screening (72.7 percent) and attaining the latest blood pressure of equal or less than 140/90 mmHg in hypertensive patients (71.3 percent). Standards were not achieved for maintenance of hypertension and diabetic registries, recording of smoking status, height and weight, screening of lipid profile and attaining target blood sugar levels in diabetics.

Funding support: Not reported