The use of methylphenidate for physical and psychological symptoms in cancer patients: a review

Background: One of the goals of cancer treatment is symptoms management especially at the end stage. The common symptoms in cancer include pain, fatigue, depression and cognitive dysfunction. The available treatment options for symptom management are limited. Methylphenidate, a psychostimulant, may be of benefit for these patients. In this report, we review the use of methylphenidate for symptoms control in cancer patients. Method: Electronic literature search on PubMed was conducted using the following keywords: methylphenidate, cancer, carcinoma, oncology, oncological and tumour. We identified forty two relevant studies and publications on the use of methylphenidate in cancer patients to be included in this review. Results: Methylphenidate was found to have some evidence in reducing opioid-induced sedation, improving cognitive symptoms and reduction of fatigue in cancer patients. Nevertheless, the results were inconsistent due to variations in the study populations, study design and outcome measures, among others. There was minimal evidence on its use in treating depression. Otherwise, methylphenidate was generally well-tolerated by patients. Conclusion: This review potentially supports the use of methylphenidate for opioid-induced sedation, cognitive decline and fatigue in cancer patients. Further placebo-controlled trials would help in strengthening the evidence for this treatment

Psychiatric disorders among young male adult prisoners: a cross sectional study in a Malaysian prison

Introduction: In recent years there has been an increase in the number of young people in prison. This study is the firstto look at the proportion of psychiatric disorders among young adultprisoners. Objective: The main objective is to determine the percentage of psychiatric disorders among young adult male prisoners. Method: A cross sectional study of young adult male prisoners, with ages ranged between 18 and 21 years old, was conducted between September and December, 2008 at the Kajang Prison. A total of 225 inmates participated in the study which used the Mini International Neuropsychiatric Interview (MINI) as its instrument. Results: The percentage of psychiatric disorders was 60.0%. Alcohol and substance related disorders had the highest prevalence at 50.2%, followed by Major Depressive Disorders and Dysthymia at 16.9%. About 39.6% were observed to have antisocial personality disordet Psychiatric disorders were found to have significant differences (p<O.05) in connection with parental marriage and recidivism. Conclusion: This study shows that the percentage of psychiatric disorders, especially substance related disorders, is high among young male adult prisoners. It highlights the urgent need for early intervention for this group of young people

Executive function and attention span in euthymic patients with bipolar 1 disorder.

This is a cross secti onal co mparison study to assess executive function and attention span in euthymic p atients with bipolar 1 disorder. It compares the performance of these two cogn itive domains in 40 patients with bipolar 1 disorder to that of 40 healthy normal subjects using Trail Maki ng (TMT), Digit Span (Forward and Backward) and Ver bal Fluency (VF) tests. The association between demographic, clinical characteristics and performance in all tests were examined. Patients wit h bipola r illness showed significant impairment with moderate to large e ffect siz es (VF= 0.67, TMT A= 0.52, TMT B = 0.81, Digit Forward= 0.97, Digit ba ckward= 1.10) in all tasks of executive and atte ntion functioning. These impairments a re observed in the absence of active mood symptoms while duration and severity of illness are not found to have an e ffect on both cognitive domains. Medications received by patients with bipolar disorder have significant association with performance on executive tasks. The results of this study add on to the existing global evidence of cognitive impair ment in bipolar illness despite its cross cultural differences. Its presenc e in the absence of mania, depression or mixed episode indicates that cognitive impairmen t is stable even af ter symptoms recovery

Clinical correlates of erectile dysfunction among male patients on methadone maintenance therapy (MMT) in Kuala Lumpur

Introduction: Sexual dysfunction is common but not often assessed in the routine clinical care among males on opiate substitute treatment. Objective: To determine the association between clinical variables and erectile dysfunction (ED) among men on methadone maintenance therapy (MMT). Methods: A cross-sectional study involving 108 participants who attended the Drug Clinic, Hospital Kuala Lumpur. The instruments used include the Structured Clinical Interview for DSM-IV Axis-I Disorder (SCID-I),Beck Depression Inventory (BDI) and International Index of Erectile Function-15 (IIEF-15). Results: Concurrent heroin abuse was significantly associated with presence of ED (p=0.024). Treatment factors including methadone dose and duration of methadone treatment were not significantly associated with ED. Conclusion: Education on sexual dysfunction as a potential adverse effect and its association with illicit heroin use should be considered in the doctor-patient consultation to encourage treatment adherence and abstinence from heroin

Factor analysis study on sexual responses in women with Type 2 diabetes mellitus

Aims: This study compared the components of sexual responses between Malaysian women with Type 2 diabetes mellitus and those without the disease. Methods: This cross-sectional study measured sexual responses by using the validated Malay version of Female Sexual Function Index. A factor analysis with varimax rotation method was employed using principal component analysis to explore the correlation structure of the different domains of sexual responses between the two groups. Components of sexual responses were obtained using Kaiser's criteria and compared between those in the diabetic and non-diabetic groups. Results: A total of 353 women (178 with diabetes and 175 without diabetes) were recruited. Three components of sexual responses emerged from the analysis in the study and control groups. Sexual pain was found to form a component together with lubrication and orgasm domains among the women with diabetes, unlike those without diabetes, where pain stood on its own. Sexual desire and arousal formed one component and satisfaction formed another in both groups. Conclusions: The domains in the sexual responses of Malaysian women were highly overlapping. It is concluded that the presence of pain as part of lubrication and orgasm component in women with diabetes indicates the importance of intact genital sensation, even though an adverse type of sensation, for vaginal congestion and orgasm to occur in this group of women

The relationship between internet addiction, internet gaming and anxiety among medical students in a Malaysian public university during covid-19 pandemic

The internet has become an important medium for learning and communication during the COVID-19 pandemic, particularly for university students. Nevertheless, an increase in internet usage could predispose people to internet addiction (IA) and internet gaming (IG). Equally, there is concern that anxiety levels have increased during the pandemic. The aim of this study is to determine the prevalence of IA and IG, and their associations with anxiety among medical students during the pandemic. Data were collected during the second wave of the "Conditional Movement Control Order" (CMCO) in Malaysia between 12 November and 10 December 2020. A total of 237 students participated through proportionate stratified random sampling in this cross-sectional study. They completed a set of online questionnaires which consisted of a sociodemographic profile, the Malay version of the internet addiction test (MVIAT), the Malay version of the internet gaming disorder-short form (IGDS9-SF) and the Malay version of the depression, anxiety and stress scale (DASS-21). The prevalence of IA and internet gaming disorder (IGD) were 83.5% and 2.5%, respectively. A multiple logistic regression showed that those in pre-clinical years had a greater risk of anxiety than those in clinical years [(AOR) = 2.49, p-value 0.01, 95% CI = 1.22-5.07]. In contrast, those who scored high on IA were protected against anxiety [AOR = 0.100, p-value 0.03, 95% CI = 0.01-0.76)]. In conclusion, IA was highly prevalent during the COVID-19 pandemic and its high usage might serve as a protective factor against anxiety among the medical students in this study sample

Premature ejaculation in urban Malaysian population: the associations between erectile dysfunction (ED), anxiety and depression

Introduction: Both premature ejaculation(PE) and erectile dysfunction(ED) are prevalent sexual health disorders that have been inadequately investigated in Malaysia, a multiethnic and conservative nation.The objective of the study was to study the relationship between PE and ED, and other common mental health issues, i.e. anxiety and depression in Malaysian urban population. Methods: The diagnosis for PE was established by clinical diagnosis using DSM-5 and ISSM definition criteria for PE, whereas a diagnosis of ED was established by the International Index of Erectile Function (IIEF) questionnaire. Anxiety and depression levels were detected from the Hospital Anxiety and Depression Scale (HADS). Results: Based on DSM-V and ISSM clinical diagnosis for PE, the prevalence of PE was found to be 25%. Erectile dysfunction (p = 0.035, OR = 3.315, 95% CI 1.088, 10.103) and severe anxiety (p = 0.020, OR = 7.656, 95% CI 1.383, 42.396) significantly predicted presence of PE. Conclusion: There was a strong association between PE and ED and between PE and anxiety. Routine examination for PE in male patients should address the issue and the management of both ED and anxiety among PE patients, especially in an urban Malaysian clinical and medical care setting

Stigma and posttraumatic growth among COVID-19 survivors during the first wave of the COVID-19 pandemic in Malaysia: a multicenter cross-sectional study

BackgroundContracting COVID-19 can cause negative and distressing psychological sequelae, but traumatic stressors may also facilitate the development of positive psychological change beyond an individual’s previous level of adaptation, known as posttraumatic growth (PTG). As a result, studies have investigated the negative effects of COVID-19 on mental health, but data on PTG among patients who have recovered from COVID-19 remains limited. This study aims to evaluate the level of PTG and its associations with stigma, psychological complications, and sociodemographic factors among COVID-19 patients 6 months post-hospitalization.MethodA cross-sectional online survey of 152 COVID-19 patients was conducted after 6 months of being discharged from Hospital Canselor Tuanku Muhriz, MAEPS Quarantine Center, or Hospital Sungai Buloh, Malaysia. Patients completed a set of questionnaires on sociodemographic and clinical data. The Posttraumatic Growth Inventory (PTGI-SF) was used to assess the level of PTG, the Kessler Psychological Distress (K6) was used to measure the degree of psychological distress, the General Anxiety Disorder-7 (GAD-7) was used to evaluate the severity of anxiety symptoms, the Patient Health Questionnaire (PHQ-9) was used to assess the severity of depression symptoms, and the Explanatory Model Interview Catalog Stigma Scale (EMIC-SS) was used to record the degree of perceived stigma toward COVID-19.ResultsThe median PTGI SF score of the respondents was 40.0 (Interquartile range 16.0). Multivariable general linear model with bootstrapping (2,000 replications) revealed factors that significantly predicted PTG, which were at the higher level of the perceived stigma score, at 37 (B = 0.367, 95% CI = 0.041 to 0.691, p = 0.026), among the Malay ethnicity (B = 12.767, 95% CI 38 = 7.541 to 17.993, p &lt; 0.001), retirees (B = −12.060, 95% CI = −21.310 to −2.811, p = 0.011), and those with a history of medical illness (B = 4.971, 95% CI = 0.096 to 9.845, p = 0.046).ConclusionExperiencing stigma contributed to patients’ PTG in addition to psychosocial factors such as ethnicity, history of medical illness, and retirement

Reducing the isolation: A malaysian family in need

ABSTRACT Introduction: Many challenges are faced in the optimum management of a family caring for children with developmental disorders (FCCDD). Case Report: This case report highlights an isolated Malaysian family as victims of discrimination against special children, illustrates the factors and challenges that are associated with it. We report our experience, as part of a multiprofessional team in managing an isolated FCCDD. Our role of service providers, became that of the sole lifeline the family depended upon. We helped the family return from the brink of death; they helped us understand that no family should be an island and every family has a right to optimum care. Conclusion: Isolation that occurs in FCCDD is real and can be influenced by multiple factors such as low education and income. To help an FCCDD is to help Malaysian society overcome its prejudices. Getting FCCDD to participate in decisions regarding treatment and in other biopsychosocial needs is crucial i

VALIDATION OF THE MALAY VERSION OF THE EXPLANATORY MODEL INTERVIEW CATALOGUE STIGMA SCALE AMONG COVID-19 SURVIVORS IN MALAYSIA

Abstract The Coronavirus disease (COVID-19) imparted unprecedented negative impact worldwide since it was declared as a global pandemic in 2020 due to its high infectivity and mortality rate. Consequently, those who have been infected with COVID-19 experienced significant amount of social stigma which resulting in deterioration of mental well being. Hence, this study aimed to translate the Explanatory Model Interview Catalogue Stigma Scale (EMIC-SS) into Malay and investigate the reliability and validity of the Malay version (EMIC-SS-M) among COVID-19 survivors in Malaysia. Initially, concurrent translation and back translation of the EMIC-SS was conducted followed by the assessment of its face and content validity. Then, the EMIC-SS-M was administered to 219 COVID-19 survivors recruited from three targeted centers for assessment of its reliability (internal consistency) and validity (convergent and discriminant validity, exploratory factor analysis [EFA] and confirmatory factor analysis [CFA]). The EMIC-SS-M reported an acceptable internal consistency with Cronbach’s α of 0.727, while its domains reported acceptable Cronbach’s α ranged from 0.708 to 0.795. EFA and CFA confirmed that the EMIC-SS-M consisted of 15 items in 4 domains. The EMIC-SS-M exhibited good psychometric properties and ready for use to assess stigma among COVID 19 survivors in Malaysia. It can be adapted for use to assess stigma in other disease conditions among the Malaysian population in future studies