MyMedR

Displaying all 4 publications

Abstract:

Sort:

Fulltext Depression, distress and self-efficacy: The impact on diabetes self-care practices

Devarajooh C, Chinna K

PLoS One, 2017;12(3):e0175096.
PMID: 28362861 DOI: 10.1371/journal.pone.0175096

The prevalence of type 2 diabetes is increasing in Malaysia, and people with diabetes have been reported to suffer from depression and diabetes distress which influences their self-efficacy in performing diabetes self-care practices. This interviewer administered, cross sectional study, conducted in the district of Hulu Selangor, Malaysia, involving 371 randomly selected patients with type 2 diabetes, recruited from 6 health clinics, aimed to examine a conceptual model regarding the association between depression, diabetes distress and self-efficacy with diabetes self-care practices using the partial least square approach of structural equation modeling. In this study, diabetes self-care practices were similar regardless of sex, age group, ethnicity, education level, diabetes complications or type of diabetes medication. This study found that self-efficacy had a direct effect on diabetes self-care practice (path coefficient = 0.438, p<0.001). Self-care was not directly affected by depression and diabetes distress, but indirectly by depression (path coefficient = -0.115, p<0.01) and diabetes distress (path coefficient = -0.122, p<0.001) via self-efficacy. In conclusion, to improve self-care practices, effort must be focused on enhancing self-efficacy levels, while not forgetting to deal with depression and diabetes distress, especially among those with poorer levels of self-efficacy.
Study site: 6 primary health clinics (Klinik Kesihatan), Hulu Selangor. Selangor. Malaysia
Fulltext Microgrids: A Model for Basic Microsurgery Skills Training

Gunasagaran J, Rasid RJ, Mappiare S, Devarajooh C, Ahmad TS

Malays Orthop J, 2018 Jul;12(2):37-41.
PMID: 30112127 MyJurnal DOI: 10.5704/MOJ.1807.007

Introduction: Microsurgery is a subspecialised field which requires high technical skill. Laboratory training offers good opportunity for novice surgeons to learn and repetitively practise their skills prior to hands-on clinical practice. Commonly, the training programme consists of models in a stepwise increase in fidelity: from latex sheet to anaesthetised rat. We introduce microgrids model as a daily warm up procedure in a 5-day basic microsurgery course. The purpose of this study is to evaluate the correlation between microgrids colouring under magnification with microsuturing proficiency among novice surgeons. Materials and Methods: Participants were required to fill in microgrids under magnification everyday during their 5-day training as a starter test. The number of completely filled in microgrids in 20 seconds was recorded. A simulated cut on latex sheet was sutured and the time taken to apply five sutures was recorded. The sutures were evaluated with modified Global Rating Scale (GRS). Data was analysed with SPSS. Results: There was a statistically significant correlation between the number of microgrids coloured and the time taken to apply five sutures (p<0.01). An increase in number of microgrids coloured was significantly associated with the increase in quality of the suturing technique (p< 0.01). During the 5-day basic microsurgery skills training for novice surgeons, microsuturing skill improvement correlated with microgrid colouring. Conclusion: Microgrids colouring reflected microsuturing proficiency. It is an inexpensive, readily available, and simple model of 'warm up' for hand dexterity. The microgrids model can function as a starter test for initial training and a quick screening measure to assess microsurgical skill.
Upper limb infections: A comparison between diabetic and non-diabetic patients

Lim SH, Tunku Ahmad TS, Devarajooh C, Gunasagaran J

J Orthop Surg (Hong Kong), 2022 2 2;30(1):23094990221075376.
PMID: 35103531 DOI: 10.1177/23094990221075376

BACKGROUND: Upper limb infections are common among patients with diabetes mellitus and their sequelae can be debilitating. They tend to present with severe infections but minimal symptoms probably due to neuropathy and vasculopathy among diabetics. The study aims to compare the demographic characteristics, clinical presentations and outcomes of upper limb infections between diabetic and non-diabetic patients.
METHODS: All patients with upper limb infections who were admitted in a tertiary hospital from June 2017 to December 2020 were included in this study. Demographic data, clinical presentations, investigations and outcomes were obtained retrospectively from electronic medical record. There were 117 patients with diabetes mellitus and 127 with no diabetes mellitus. Comparisons were made between these two groups, and statistical analysis was done with SPSS.
RESULTS: There were 244 patients included; 117 were diabetic and 127 were non-diabetic. Diabetic patients were more likely to present with emergent scenarios, especially necrotizing fasciitis and infective tenosynovitis (p < .05) with higher erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) readings (p < .05). Their microbiological cultures were less likely to be negative (p < .05). Diabetic patients also had poorer clinical outcomes with higher risk of amputation, re-operation and longer duration of hospital stay (p < .05).
CONCLUSION: Upper limb infections among diabetic patients should be treated aggressively. Early diagnosis and surgical intervention might decrease the morbidity and mortality in this group. Prevention of infections should be emphasized.
Fulltext Flexor tendon degeneration affects short-term outcomes of open trigger digit release

Abdul Nasir M, Ahmad TS, Low TH, Devarajooh C, Gunasagaran J

PLoS One, 2023;18(5):e0286301.
PMID: 37252923 DOI: 10.1371/journal.pone.0286301

We aimed to investigate the association between flexor tendon degeneration and outcome of open trigger digit release. We recruited 162 trigger digits (136 patients) who had open trigger digit release from February 2017 to March 2019. Intraoperatively, six features of tendon degenerations were identified: irregular tendon surface, tendon fraying, intertendinous tear, synovial thickening, hyperaemia of sheath and tendon dryness. Longer duration of preoperative symptoms was associated with worsening tendon surface irregularity and fraying; increased number of steroid injections was associated with worsening tendon surface irregularity and dryness; higher DASH score was associated with severe tendon fraying, dryness and intertendinous tear; limited proximal interphalangeal joint (PIPJ) motion was associated with severe tendon dryness. At 1-month post-surgery, DASH score remained high in severe intertendinous tear group while PIPJ motion remained limited in severe tendon dryness group. In conclusion, the severity of various flexor tendon degenerations influenced the outcome of open trigger digit release at 1-month but did not affect the outcome at 3- and 6-months post-surgery.