Psychiatric manifestations in orthopedic patients on Celecoxib therapy

Introduction: The Cyclooxygenase-2 (COX-2) enzyme is responsible for the synthesis of prostaglandin which is responsible for inflammation and pain. Celecoxib a cyclooxygenase-2 inhibitor was first used as a non-steroidal anti-inflammatory drug in 1999. Celecoxib is as effective as NSAJDs but causes less ulceration of the gastrointestinal tract, hence it is commonly used. It has been widely used in patients with osteoarthritis and rheumatoid arthritis. We present 3 cases of temporary psychiatric disorders associated with consumption of celecoxib, two of the patients presented with auditory hallucinations while one was diagnosed to be having depression. None had pre-existing psychiatric disorders or consumed alcohol or substance of abuse. All 3 patients recovered from their temporary psychiatric disorders after stopping celecoxib. Discussion: It is important to be aware of the psychiatric side effects when prescribing the drug for prolonged periods

A pilot study of mental health intervention programme in primary health carein two districts of Kelantan

Attempted Suicide, by Casper Truong, is an experimental hand drawn 2D and rotoscope animation that tells the story of depression and how and artist copes with it. The video, also serves as a critique at violence in entertainment, especially in cartoons. Image 05: Still from Attempted Suicide, 2019, Hand-drawn 2D and rotoscope animation, 3 minuteshttps://cedar.wwu.edu/bfa_images_2019/1070/thumbnail.jp

Psychotheraphy for rural Malays - does it work?

Broadly defined, psychotherapy is a process of interaction between two or more individuals in which skills of one is used in the helping relationship for the emotional support and/ or maturation of the other. The history of formal psychotherapy starts in the mid-19th century. At that time Freud experimented with the use of hypnosis in the treatment of neurotic patients. Initially he used hypnosis to suppress symptoms but later used it to release the emotions associated with repressed ideas. In helping patients to recall suppressed events, he found it effective to get the patients to lie on the couch and talk freely about the past while the therapist kept out of sight. This was the origin of free association. He also built an elaborate theory of mental development and functioning to guide his practice. This eventually gave birth to psychoanalysis on which most modern forms of psychotherapy derived. Another well-known definition describes psychotherapy as "an interpersonal process designed to bring ",bout modifications of feelings, cognition, attitudes and behavior which have proved troublesome to the person seeking help from a trained professional." This definition draws attention to three characteristics of psychotherapy: the presence of a therapist-patient relationship; the interpersonal context of the psychotherapies; and, implied by the notion of training and professionalism, the sense that therapies are conducted according to a model that guides the therapist's actions. Psychotherapies are defined in part by their setting and in part by the presence of an explicit model of psychopathology, which in turn generates procedures for relieving distress. Based on this background, some thirteen years ago we embarked on a journey of experimental research to answer the question whether psychotherapy can work on Malay patients from a rural background. Most therapies insist on strict inclusion criteria for their therapies; the major criteria being well educated and psychologically minded patients. This seems to exclude most of the patients we were treating. To do therapy on these patients would mean to defy the criteria and face poor outcome or to create a new form of therapy with our own model and own criteria. We started with neurotic disorders and gradually worked on depression and finally even on psychosis, which has been said to be resistant to psychotherapy, with remarkable success. The work has been recognized and our model of psychopathology and therapy has been included as a form of therapy within the CBT group. Further work is now being geared towards patients with the more severe and chronic forms of anxiety group of disorders

Emotional intelligence and academic performance in first and final year medical students: a cross-sectional study

Background Research on emotional intelligence (EI) suggests that it is associated with more pro-social behavior, better academic performance and improved empathy towards patients. In medical education and clinical practice, EI has been related to higher academic achievement and improved doctor-patient relationships. This study examined the effect of EI on academic performance in first- and final-year medical students in Malaysia. Methods This was a cross-sectional study using an objectively-scored measure of EI, the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). Academic performance of medical school students was measured using continuous assessment (CA) and final examination (FE) results. The first- and final-year students were invited to participate during their second semester. Students answered a paper-based demographic questionnaire and completed the online MSCEIT on their own. Relationships between the total MSCEIT score to academic performance were examined using multivariate analyses. Results A total of 163 (84 year one and 79 year five) medical students participated (response rate of 66.0%). The gender and ethnic distribution were representative of the student population. The total EI score was a predictor of good overall CA (OR 1.01), a negative predictor of poor result in overall CA (OR 0.97), a predictor of the good overall FE result (OR 1.07) and was significantly related to the final-year FE marks (adjusted R2 = 0.43). Conclusions Medical students who were more emotionally intelligent performed better in both the continuous assessments and the final professional examination. Therefore, it is possible that emotional skill development may enhance medical students’ academic performance

Psychiatric morbidity in the first degree relatives of mood disorder patients

The well known advances in molecular genetics have lent new importance to the evidence that the disorders are genetically transmitted, raising the hope that vulnerable individuals, rational and definitive treatments may be identified, based on the discovery of specific deficits.At the same time, epidemiological evidence points to a secular increase in mood disorders in recent decades that interacts with familial vulnerability, but also must include major non genetic causative factors.Twin and adoption studies show that vulnerability to a disorder has a genetic component.Family studies indicate in a particular population the degree to which a disorder is familial, which diagnostic entities or other characteristics share familial transmission with a particular disorder and perhaps most importantly, allow the testing of hypothesis regarding the mode of genetic transmission

Effect of taking chicken essence on cognitive functioning of normal stressed human volunteers

Objective: This study evaluates the effect of a commercial brand of chicken essence (BEC) on the various parameters related to stress and cognition of human volunteers. BEC is produced by a hot-water extraction process from chicken meat under high pressure conditions. It contains concentrated amounts of proteins, amino acids and peptides such as carnosine compared to homemade traditional chicken soup. Due to the unique extraction process, it has been postulated that readily absorbed amino acids and bioactive peptides are present in BEC. Methods: In this study, we evaluated the effect BEC in comparison with a placebo on a group of distressed medical students. Students were randomly divided into two groups and given either BEC or a placebo drink daily for two weeks.Before and after the two weeks, the students were given a series of tests to asses their level of cognitive functioning and perceived stress level while being monitored for EEG recording. The combination of these tests, namely Digit span, Arithmetic and Letter-number sequencing, generally assessed the student's attention and working memory. Results: The working memory performance of student's who ingested essence of chicken was found to be significantly better than those who consumed placebo when data comparing baseline and after two weeks consumption were compared. Conclusion: This study seems to suggest that essence of chicken has positive effects on the subjects' cognitive functions

Screening for depression with a brief questionnaire in a primary care setting : validation of the two questions with help question.

Objective: To determine the diagnostic accuracy of the two questions with help question (TQWHQ) in the Malay language. The two questions are case-finding questions on depression, and a question on whether help is needed was added to increase the specificity of the two questions. Method: This cross sectional validation study was conducted in a government funded primary care clinic in Malaysia. The participants included 146 consecutive women patients receiving no psychotropic drugs and who were Malay speakers. The main outcome measures were sensitivity, specificity, and likelihood ratios of the two questions, the help question, and combination of the two questions and help question. Results: The two questions showed a sensitivity of 99% (95% confidence interval 88% to 99.9%) and a specificity of 70% (62% to 78%), respectively. The likelihood ratio for a positive test was 3.3 (2.5 to 4.5) and the likelihood ratio for a negative test was 0.01 (0.00 to 0.57). The addition of the help question to the two questions increased the specificity to 95% (89% to 98%). Conclusion: The two questions on depression detected most cases of depression in this study. The questions have the advantage of brevity. The addition of the help question increased the specificity of the two questions. Based on these findings, the TQWHQ can be strongly recommended for detection of depression in government primary care clinics in Malaysia. Translation did not appear to affect the validity of the TQWHQ

Prevalence, awareness, treatment and control of hypertension in Malaysia: A national study of 16,440 subjects.

Study design: A cross-sectional study was conducted in all states of Malaysia to determine the prevalence, awareness, treatment and control of hypertension. A stratified two-stage cluster sampling design with proportional allocation was used. Methods: Trained nurses obtained two blood pressure measurements from each subject. Hypertension was defined as mean systolic blood pressure 4140 mmHg, diastolic blood pressure490 mmHg, or a self-reported diagnosis of hypertension and taking antihypertensive medication. All data were analysed using Stata 9.2 software and took the complex survey design into account. A two-sided P-value of o0.05 was considered to be statistically significant. Results: The overall prevalence of hypertension for subjects aged X15 years was 27.8% (95% confidence interval (CI) 26.9–28.8). The prevalence of hypertension was significantly higher in males (29.6%, 95% CI 28.3–31.0) compared with females (26.0%, 95% CI 25.0–27.1). Multivariate logistic regression showed that the odds of having hypertension increased with increasing age, in males, in subjects with a family history of hypertension, with increasing body mass index, in non-smokers and with decreasing levels of education. Only 34.6% of the subjects with hypertension were aware of their hypertensive status, and 32.4 were taking antihypertensive medication. Amongst the latter group, only 26.8% had their blood pressure under control. The prevalence of hypertension amongst those aged X30 years has increased from 32.9% in 1996 to 40.5% in 2004. Conclusion: In Malaysia, the prevalence of hypertension is high, but levels of awareness, treatment and control are low. There is an urgent need for a comprehensive integrated population-based intervention programme to ameliorate the growing problem of hypertension in Malaysians

Needle stick and sharps injuries and factors associated among health care workers in a Malaysian hospital.

Introduction: Needle stick and sharps injuries (NSSIs) have been recognized as one of the occupational hazards among health care workers (HCWs). They increase risk of spread of diseases like HIV, Hepatitis B and Hepatitis C. The objective of this study was to determine the prevalence and factors associated with needle stick and sharps injuries. Methods: This cross sectional study was conducted in Serdang Hospital Malaysia using a self-administered validated questionnaire. The respondents consisted of 345 HCWs namely medical assistant officer, staff nurses, medical laboratory technician and community nurse. Data was analysed using SPSS version 17. Results: Results showed that the overall mean age of the 345 respondents was 29.7years and it ranged from 22 years to 45 years with a median of 29 years. The mean age for the males (28.9 years) did not differ significantly from the females (29.9 years). The overall prevalence of needle stick or sharps injuries was 23.5%. Staff nurses had the highest prevalence (27.9%). The causes of NSSI in 58% of cases were hypodermic needle and 27.2% cases were recapping. Medical ward reported the highest NSSIs (51.9%). Knowledge on body fluid transmitted by HIV/AIDS and blood products was high (99.1%). Majority stated that they throw needles or sharps immediately after use in sharp bins (92.7%), do not separate needles from syringes prior to disposal (98.0%) and do not dissemble needles or sharps with hand (98.5%) and do not recap needles after use (94.3%). Majority also stated that they were aware about universal precaution guideline (96.5%) and needle stick and sharps injury needs to be reported (99.1%). However, out of those health care workers (23.5%) who had NSSI, only 30.9% had reported the incident of needlestick and sharps injuries indicating that there were gaps between knowledge and practice among the HCWs. There was a statistically significant association between NSSIs and age (p=0.01) of respondent, working experience (p=0.001) and job categories (p=0.03). Conclusions: The prevalence of NSSI was 23.5%. Although the knowledge on Universal Precautions is good, the prevalence of NSSIs is still high and there are gaps between knowledge and practice related to HIV prevention. NSSIs continue to pose a serious occupational problem