Premenstrual syndrome among female medical students of Univerisiti Malaysia Sabah

The premenstrual syndrome (PMS) is particularly common in the younger age groups, posing a significant public health problem among young girls. It was noted that, among the female students, PMS was a frequent reason for seeking care at the in-house health clinics of Universiti Malaysia Sabah (UMS). The Faculty of Medicine and Health Sciences (FPSK) took an initiative to explore this problem as the health and quality of life of students are the major concerns of UMS. A cross-sectional study was conducted with 211 female medical students of FPSK to determine the prevalence of premenstrual syndrome (PMS) and to investigate its associated factors. American College of Obstetrics and Gynaecology (ACOG) PMS-criteria-based questionnaires were used. The mean age of students under study was 20.94±0.92 and 51.65% responded to have experienced PMS. Among the somatic symptoms, 70.6% of the studied females complained of breast tenderness, 62. 4% of abdominal bloating, 39.4% of headache and 2.8% of swelling of extremities. Common behavioural symptoms were irritability (80.7%), angry outbursts (66.1%), depression (57.8%), anxiety (53.2%), social withdrawal (31.2%), and confusion (24.8%). Among the reported symptoms; headache, confusion, irritability, social withdrawal, anxiety and swelling of extremities were significantly associated with PMS. However, the relationships between PMS and disturbances in students’ daily physical and mental activities were not statistically significant. As the prevalence estimated by this study was quite high, in-depth studies on PMS of female UMS students need to be conducted

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

Olanzapine-induced pancytopenia: a rare but worrying complication

Unlike clozapine, and despite its structural similarities, olanzapine is not usually associated with haematological suppression. Nonetheless this case report highlights an incident of olanzapine-induced thrombocytopenia and neutropenia in a first-contact patient. We report on a 50-year-old male who presented with 7 years of delusions and hallucinations. A diagnosis of schizophrenia was made in the absence of any suggestive features of mood disorders, substance abuse or organicity, and olanzapine as second-line treatment. Within a week of starting treatment he developed biochemical neutropenia and thrombocytopenia without any clinical symptoms that resolved after cessation of the offending drug. An organic workup for infective, inflammatory, and neoplastic causes was unremarkable. Comparison with other case reports and 3 postulated mechanisms are discussed. Despite its comparative rarity, the addition of this case report to a growing corpus suggests that clinicians should maintain heightened surveillance of patients prescribed olanzapine, to identify any untoward iatrogenic haematological abnormalities or immunosuppression

Assessment of depression and anxiety in hematological cancer patients and their relationship with quality of life.

OBJECTIVES:To determine the relationship between major depressive disorder, anxiety disorders and the quality of life of haematological cancer patients. METHODS: This cross-sectional study was conducted at Ampang Hospital Kuala Lumpur, Malaysia, a tertiary referral centre hospital for haematological cancer. The Mini-International Neuropsychiatric Interview was used for the diagnosis of major depressive disorder and anxiety disorders. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire was utilised to measure patients' quality of life. RESULTS: A total of 105 haematological cancer patients were included in the study with response rate of 100%. Major depressive disorder correlated with almost all domains of the quality of life, except the pain scores. Logistic regression showed that insomnia and financial difficulties were related to major depressive disorder. Different anxiety disorders also correlated with quality of life in specific domains. The leading anxiety disorders that correlated mostly with quality-of-life scales were generalised anxiety disorder, followed by obsessive-compulsive disorder, social anxiety disorder, as well as post-traumatic stress disorder and panic disorder with agoraphobia (p<0.05). CONCLUSIONS: Psychological treatment along with medication and intervention should be implemented to improve the overall quality of life and psychiatric disorder symptoms among the haematological cancer patients

A pilot placebo-controlled, double-blind, and randomized study on the cognition-enhancing benefits of a proprietary chicken meat ingredient in healthy subjects

Background: It has long been postulated that the relative abundance of specific nutrients can affect cognitive processes and emotions. Newly described influences of dietary factors on neuronal function and synaptic plasticity have revealed some of the vital mechanisms that could be responsible for the action of diet on brain health and cognitive function. Here, through a double-blind, randomized, placebo-controlled trial, we asked if the newly discovered chicken meat ingredient-168 (CMI-168) could be beneficial to the cognitive function in healthy adults. Methods: Normal, healthy subjects were supplemented with either placebo or CMI-168 for 6 weeks. The subjects were given a series of cognitive tests to examine their levels of cognitive functioning at the beginning and end of supplementation, as well as two weeks after termination of supplementation. The combination of these tests, namely Digit Span Backwards, Letter-Number Sequencing, and the Rey Auditory Verbal Learning Test (RAVLT), was used to assess the subjects' attention and working memory. For all comparisons, the probability level of p < 0.05 was taken as statistically significant using repeated measure 2-way ANOVA followed by Bonferroni post-hoc test. Results: Overall, subjects supplemented with CMI-168 showed significantly (p < 0.01) better performance in all cognitive tests after 6 weeks' supplementation compared to control and such superior performance was maintained even 2 weeks after termination of supplementation. Conclusions: The present study reveals the cognition-enhancing properties of a recently developed chicken meat ingredient, likely arising from the promotion of attention and prefrontal cortex functions

Depression and quality of life among patients with hematological cancer in a Malaysian hospital

Objective: To determine the prevalence of major depressive disorder (MDD) in hematological cancer patients and to investigate MDD with quality of life. Methods: The research, which uses a cross sectional design, has been carried out at Ampang Hospital, Kuala Lumpur. The hospital is a tertiary referral center for cancer cases that include non-Hodgkin lymphoma, acute myelogenous leukemia, acute lymphoblastic leukemia, Hodgkin lymphoma and other hematological cancers. In total, 105 patients with hematological malignancies were included in the study. This study employed the MINI International Neuropsychiatric Interview for diagnosis of MDD, the Patient Health Questionnaire (PHQ-9) for symptom severity of depression and the European Organisation for Research and Treatment of Cancer Quality Of Life questionnaire (EORTC QLQ-C30) to assess the quality of life of the respondents. Result: The response rate was 83.3%. The prevalence of MDD was 24.8% (n=26) with the majority of cases classified as moderately severe depression (38.5%). About 92.3% (n=24) of depressed hematological cancer patients were diagnosed with a current episode of MDD. The depressed patients also had significantly reduced quality of life in physical, role, emotional, cognitive and social domains (p<0.05). They also had significantly more symptoms of fatigue, nausea and vomiting, dyspnea, insomnia, appetite loss, constipation and diarrhea in addition to having financial difficulties and poor global health statuses (p<0.05). Conclusion: The prevalence of depression among the hematological cancer patients was high and the depressed patients had reduced qualities of life. Special attention in psychotherapy would help to improve both depression level and the quality of life in these patients

The socio-demographic and clinical factors associated with quality of life among patients with haematological cancer in a large government hospital in Malaysia.

Background: The paper examined the quality of life of haematological cancer patients according to their socio-demographic profiles and clinical diagnoses. Methods: This cross-sectional study was conducted at the tertiary referral centre of Ampang Hospital, Kuala Lumpur, involving 105 patients. The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) questionnaire was used to measure their quality of life. Results: The study involved patients diagnosed with all types of haematological cancer, including non-Hodgkin lymphoma (NHL), acute myelogenous leukaemia (AML), acute lymphoblastic leukaemia (ALL), Hodgkin lymphoma (HL), and multiple myeloma (MM), with a response rate of 83.3%. The patients with ALL, HL, without NHL, and without MM were younger than other patients. There were significant differences in quality of life scores in different socio-demographic groups and types of cancer diagnosis. The global quality of life of the female patients was much better than that of the male patients. Patients who were 40 years old or younger had a better global quality of life and physical functioning, as well as fewer symptoms of constipation, nausea, and vomiting. Employed patients were in less pain but showed greater impairments of cognitive function than did unemployed patients. Patients who earned a monthly wage of RM1000 or less had reduced physical function, more symptoms of pain, and more financial difficulties compared with patients who earned more. Patients with AML tended to have better physical functioning than did patients with MM, whose physical functioning was impaired. Comparatively, more symptoms of dyspnoea were found in ALL and HL patients than in other types of lymphoma. Compared with other patients, those with ALL had a greater loss of appetite, and other lymphoma patients had fewer symptoms of pain. Patients with NHL had impaired role functioning and more constipation compared with other patients. The results were all statistically significant (P < 0.05). Conclusion: The quality of life of haematological cancer patients is affected by sociodemographic factors and clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients

The socio-demographic and clinical factors associated with quality of life among patients with brain pathology in a tertiary referral hospital in Malaysia

Background: This paper investigates the quality of life of brain pathology patients in relation to their socio-demographic profiles and clinical factors. Methods: This is a cross-sectional study done at a tertiary referral hospital in Kuala Lumpur. A total of 100 patients were recruited in the study after excluding 22 patients who did not met the exclusion criteria. The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) self-administered questionnaire was utilized in the study. The Global health status/QoL, Physical functioning, Role functioning, Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Pain, Dyspnoea, Insomnia, Appetite loss, Constipation, Diarrhoea, and Financial difficulties were assessed in this study. Results: The most severe impairment in functioning was with lowest score of cognitive functioning (mean score=61) and the most severe symptom was fatigue (mean score=45). There were significant differences in quality of life scores in different socio-demographic groupsand types of brain pathology patients. Patients aged below 40 years old or less had better physical functioning, less symptoms of fatigue and insomnia compared to patients who were more than 40 years old. Male patients faced more financial difficulties compared with female patients. Patients who were married had increased insomnia compared to the single patients. Employed patients had better physical functioning and less financial difficulties compared with patients who were unemployed. Patients who earned >RM 2500.00 monthly had better physical functioning, less symptoms of pain and less financial difficulties than patients who earned ≤RM 2500.00. Patients with qualifications lower than SPM tended to face more financial difficulties compared to patients with qualifications of SPM or higher. Meningioma patients had better social functioning compared with others, whereas Carvenoma patients had better physical functioning. Meningioma patients had more symptoms of insomnia compared with other patients. All the findings were with p value less than 0.05. Conclusion: The quality of life of patients with brain pathology is affected by socio-demographic factors and clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients

Anxiety and depressive symptoms and coping strategies in Nasopharyngeal carcinoma patients in Hospital Kuala Lumpur

Introduction: Nasopharyngeal Carcinoma (NPC) is the second most common cancer among men in Malaysia. Establishing local data will help to improve the treatment strategies and lower the anxiety and depression level among NPC patients. Our aim was to compare the level of symptoms of anxiety and depression and the coping strategies employed between NPC and cancer-free patients. Methods: A comparative cross-sectional study with universal sampling was conducted on 22 NPC patients and 30 cancer-free patients from the Oncology and Radiotherapy Department and Ear, Nose and Throat clinic of Hospital Kuala Lumpur (HKL) between 12 to 29 May 2008. In this study, the symptoms of depression and anxiety were obtained by using the Hospital Anxiety and Depression Scale (HADS) while Brief COPE questionnaire was used to understand patients’ coping strategies. Results: The prevalence of NPC was higher in the Chinese, men, aged between 40 and 59 years, and those from the lower income group. The levels of anxiety and depression symptoms were found to be higher in the NPC group as compared to the cancer-free group. However, only the level of depression was found significantly related to the NPC group (p=0.002). This study also found that the two comparison groups were using different types of coping strategies. The NPC patients mainly used ‘acceptance’ as their coping strategy while the comparative group most often used ‘religion’. Among the types of coping strategies reported by the patients, ‘use of instrumental support’ type was found to be associated with a lower level of anxiety (p = 0.035) and ‘humour’ type was associated with lower depressive symptoms (p = 0.269). On the contrary, ‘selfblame’ type was associated with both anxiety (p =0.0001) and depression (p = 0.001) symptoms. In addition, patients with different gender, ethnicity, educational levels, and monthly income were also found to have significant differences in their levels of anxiety and depression as well as type of coping strategies. Conclusions: NPC patients had higher anxiety and depression levels as compared to the comparative group. Different socio-demographic backgrounds and different types of coping strategies had an influence on patients resulting in different levels of anxiety and depression

A comparative study of sertraline dosages, plasma concentrations, efficacy and adverse reactions in Chinese versus Caucasian patients

This prospective 6-week study examined the differences in dosage and steady state plasma concentrations of sertraline in Chinese versus Caucasian depressed patients. Two groups of Chinese patients from different geographical sites and a group of Caucasian patients were evaluated with clinical measures during an initial dose of 50 mg/day, with subsequent doses adjusted clinically. The results of 17 Australian Chinese (ACHI), 13 Malaysian Chinese (MCHI) and 15 Australian Caucasians (AC) were analysed. Despite controlling for weight, the AC subjects received a significantly higher dose than both the ACHI (P=0.002) and the MCHI groups (P=0.012). However, the mean sertraline concentration to dose ratios at weeks 1 and 6 were not significantly different between the three groups. Sertraline was effective and well tolerated in both ethnic groups with few adverse events. Although there was a lack of difference between groups in the pharmacokinetic results, Chinese depressed patients appeared to require lower dosages with consequently lower plasma concentrations of sertraline compared to Caucasian patients to achieve clinical efficacy. Further studies of the dosages, kinetics and adverse effects of selective serotonin reuptake inhibitors linked with genotyping are necessary