MyMedR

Displaying all 8 publications

Abstract:

Sort:

Fulltext Large fungating thyroid cancers: a unique surgical challenge

Harjit KD, Hisham AN

Asian J Surg, 2005 Jan;28(1):48-51.
PMID: 15691799

Large goitres are common in the developing world, particularly in Asia and Africa. Nonetheless, large fungating goitres are extremely rare and represent a unique challenge to surgeons. Surgery should always be considered, when the general condition of the patient permits, to provide a better quality of life as it offers the only hope of long-term survival. The potential gain with surgery is that it allows maximum benefit for more effective radioactive iodine ablation and radiotherapy treatment. We report two cases of large fungating thyroid cancers complicated by anaemia and foul-smelling discharge.
Cardiovascular responses to stress in Singapore and India

Kaur D, Bishop GD

Int J Psychophysiol, 2013 Feb;87(2):130-40.
PMID: 23206971 DOI: 10.1016/j.ijpsycho.2012.11.011

Epidemiological studies have shown significant ethnic differences in coronary heart disease death rates with South Asians showing significantly greater coronary heart disease mortality than other groups.
Impact of emotional intelligence and spiritual intelligence on the caring behavior of nurses: a dimension-level exploratory study among public hospitals in Malaysia

Kaur D, Sambasivan M, Kumar N

Appl Nurs Res, 2015 Nov;28(4):293-8.
PMID: 26608428 DOI: 10.1016/j.apnr.2015.01.006

PURPOSE: The purpose of this research is to study the impact of individual factors such as emotional intelligence (EI) and spiritual intelligence (SI) on the caring behavior of nurses.
METHODS: A cross-sectional survey using questionnaire was conducted by sampling 550 nurses working in seven major public hospitals in Malaysia. Data were analyzed using structural equation modeling (SEM).
RESULTS: The main findings are: (1) critical existential thinking and transcendental awareness dimensions of SI have significant impacts on assurance of human presence dimension of caring behavior; (2) personal meaning production and conscious state expansion dimensions of SI have significant impacts on perception of emotion and managing own emotions dimensions of EI; and (3) managing own emotions dimension of EI has significant impacts on respectful deference to other and assurance of human presence dimensions of caring behavior of nurses.
CONCLUSION: The results can be used to recruit and educate nurses.
KEYWORDS: Caring behavior; Emotional intelligence; Malaysia; Nurses; Spiritual intelligence
Effect of spiritual intelligence, emotional intelligence, psychological ownership and burnout on caring behaviour of nurses: a cross-sectional study

Kaur D, Sambasivan M, Kumar N

J Clin Nurs, 2013 Nov;22(21-22):3192-202.
PMID: 24118522 DOI: 10.1111/jocn.12386

AIMS AND OBJECTIVES: To propose a model of prediction of caring behaviour among nurses that includes spiritual intelligence, emotional intelligence, psychological ownership and burnout.
BACKGROUND: Caring behaviour of nurses contributes to the patients' satisfaction, well-being and subsequently to the performance of the healthcare organisations. This behaviour is influenced by physiological, psychological, sociocultural, developmental and spiritual factors.
DESIGN: A cross-sectional survey was used, and data were analysed using descriptive statistics and structural equation modelling.
METHODS: Data were collected between July-August 2011. A sample of 550 nurses in practice from seven public hospitals in and around Kuala Lumpur (Malaysia) completed the questionnaire that captured five constructs. Besides nurses, 348 patients from seven hospitals participated in the study and recorded their overall satisfaction with the hospital and the services provided by the nurses. Data were analysed using structural equation modelling (SEM).
RESULTS: The key findings are: (1) spiritual intelligence influences emotional intelligence and psychological ownership, (2) emotional intelligence influences psychological ownership, burnout and caring behaviour of nurses, (3) psychological ownership influences burnout and caring behaviour of nurses, (4) burnout influences caring behaviour of nurses, (5) psychological ownership mediates the relationship between spiritual intelligence and caring behaviour and between emotional intelligence and caring behaviour of nurses and (6) burnout mediates the relationship between spiritual intelligence and caring behaviour and between psychological ownership and caring behaviour of nurses.
CONCLUSIONS: Identifying the factors that affect caring behaviour of nurses is critical to improving the quality of patient care. Spiritual intelligence, emotional intelligence, psychological ownership and burnout of nurses play a significant role in effecting caring behaviour of nurses.
RELEVANCE TO CLINICAL PRACTICE: Healthcare providers must consider the relationships between these factors in their continuing care and incorporation of these in the nursing curricula and training.
Fulltext Provision of renal-specific nutrition knowledge for changing dietary practice in Bangladeshi hemodialysis patients

Rahman T, Ahmed S, Kabir MR, Akhtaruzzaman M, Mitali EJ, Rashid HU, et al.

PEC Innov, 2022 Dec;1:100028.
PMID: 37213733 DOI: 10.1016/j.pecinn.2022.100028

OBJECTIVE: Studies show that provision of nutrition knowledge help renal patients make informed food choices. This study aimed to evaluate the impact of nutrition knowledge for changing dietary practice among Bangladeshi dialysis patients.
METHODS: Following development of a renal-specific nutrition booklet, a pilot study was conducted among 50 hemodialysis patients from a single dialysis setting. Demographic, anthropometric, clinical, biochemical, dietary data, and a 10-item MCQ on renal-specific nutrition information were collected before and 3 months after the provision of the booklet.
RESULTS: 52% of the participants were male, 54% had twice weekly dialysis, age 53 ± 12 years, and dialysis vintage was 46 ± 25 months. Serum potassium and phosphorous, dietary potassium, phosphorous, and phosphorous to protein ratio were significantly reduced after the provision of the booklet. Additionally, patients consuming >3 meals/day increased to 66% while adherence to renal-specific cooking method and vegetable preference were significantly increased to 70% and 62%, respectively.
CONCLUSION: Provision of knowledge via renal-specific nutrition booklet was able to improve patients' dietary practice and enhance their dietary adherence to renal specific recommendations.
INNOVATION: The booklet was developed using locally available food items in local language and was found beneficial in low-resource settings where overall health care facilities, including nutrition support are limited.
Fulltext Dietary Patterns and Health Outcomes among African American Maintenance Hemodialysis Patients

Tallman DA, Latifi E, Kaur D, Sulaheen A, Ikizler TA, Chinna K, et al.

Nutrients, 2020 Mar 18;12(3).
PMID: 32197373 DOI: 10.3390/nu12030797

The association between dietary patterns and health outcomes, such as quality of life (QOL), in maintenance hemodialysis (MHD) patients with certain racial backgrounds has not been studied in detail. QOL is a powerful outcome measure in which dietary patterns could be a modifying factor. This study is a secondary analysis examining the association between dietary patterns and health outcomes in 101 African American (AA) maintenance hemodialysis (MHD) patients participating in the Palm Tocotrienols in Chronic Hemodialysis (PATCH) study. Quality of life (QOL) was assessed using the Kidney Disease Quality of Life 36-item survey (KDQOL-36™). Blood samples were analyzed for lipids, lipoprotein subfractions, and inflammatory markers. Food intake was measured using six non-consecutive 24-h dietary recalls over 15 months. Implausible energy intake reports were screened out by comparing reported energy intake (rEI) with predicted total energy expenditure (pTEE). Cluster analysis, using the k-means algorithm, identified two distinct dietary patterns in the study population: a high "sugar sweetened beverage" pattern (hiSSB) and a low "sugar sweetened beverage pattern" (loSSB). In the hiSSB group, consumption of SSB accounted for ~28% of energy intake, while SSB represented only 9% of energy intake in the loSSB group. The hiSSB group was characterized by a higher intake of total calories, sugar and percentage of kilocalories from carbohydrates, whereas the percentage of kilocalories from protein and fat was lower. While additional micronutrient intakes differed between groups (vitamin C, zinc, chromium), these were significantly lower than recommended values in the entire cohort. Patients in the hiSSB group presented with lower high-density lipoprotein cholesterol (HDL-C), lower large HDL particles and smaller low density lipoprotein (LDL) particle diameters. Antidepressant usage was significantly higher in the hiSSB group. Patients in the hiSSB group scored lower across all five KDQOL domains and scored significantly lower in the mental composite domain. MHD patients following a hiSSB dietary pattern had smaller dense LDL particles, lower HDL-C, and a lower QOL. Suboptimal intakes of fruits, vegetables, and grains as well as key micronutrients were evident in both patterns.
Identifying Challenges and Potential Solutions for Sustainable Kidney Nutrition Care Delivery in Selected Asian Countries

Karupaiah T, Mat Daud ZA, Khosla P, Khor BH, Sahathevan S, Kaur D, et al.

J Ren Nutr, 2023 Nov;33(6S):S73-S79.
PMID: 37597574 DOI: 10.1053/j.jrn.2023.08.003

BACKGROUND: Recent surveys highlight gross workforce shortage of dietitians in global kidney health and significant gaps in renal nutrition care, with disparities greater in low/low-middle income countries.
OBJECTIVE: This paper narrates ground experiences gained through the Palm Tocotrienols in Chronic Hemodialysis (PaTCH) project on kidney nutrition care scenarios and some Asian low-to-middle-income countries namely Bangladesh, India, and Malaysia.
METHOD: Core PaTCH investigators from 3 universities (USA and Malaysia) were supported by their postgraduate students (n = 17) with capacity skills in kidney nutrition care methodology and processes. This core team, in turn, built capacity for partnering hospitals as countries differed in their ability to deliver dietitian-related activities for dialysis patients.
RESULTS: We performed a structural component analyses of PaTCH affiliated and nonaffiliated (Myanmar and Indonesia) countries to identify challenges to kidney nutrition care. Deficits in patient-centered care, empowerment processes and moderating factors to nutrition care optimization characterized country comparisons. Underscoring these factors were some countries lacked trained dietitians whilst for others generalist dietitians or nonclinical nutritionists were providing patient care. Resolution of some challenges in low-to-middle-income countries through coalition networking to facilitate interprofessional collaboration and task sharing is described.
CONCLUSIONS: We perceive interprofessional collaboration is the way forward to fill gaps in essential dietitian services and regional-based institutional coalitions will facilitate culture-sensitive capacity in building skills. For the long-term an advanced renal nutrition course such as the Global Renal Internet Course for Dietitians is vital to facilitate sustainable kidney nutrition care.
Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh

Rahman T, Khor BH, Sahathevan S, Kaur D, Latifi E, Afroz M, et al.

Nutrients, 2022 Apr 01;14(7).
PMID: 35406082 DOI: 10.3390/nu14071469

Malnutrition is associated with high rates of mortality among patients with end stage kidney disease (ESKD). There is a paucity of data from Bangladesh, where around 35,000−40,000 people reach ESKD annually. We assessed protein-energy wasting (PEW) amongst 133 patients at a single hemodialysis setting in Dhaka. Patients were 49% male, age 50 ± 13 years, 62% were on twice-weekly hemodialysis. Anthropometric, biochemical, and laboratory evaluations revealed: BMI 24.1 ± 5.2 kg/m2, mid-arm muscle circumference (MAMC) 21.6 ± 3.6 cm, and serum albumin 3.7 ± 0.6 g/dL. Based on published criteria, 18% patients had PEW and for these patients, BMI (19.8 ± 2.4 vs. 25.2 ± 5.2 kg/m2), MAMC (19.4 ± 2.4 vs. 22.2 ± 3.8 cm), serum albumin (3.5 ± 0.7 vs. 3.8 ± 0.5 g/dL), and total cholesterol (135 ± 34 vs. 159 ± 40 mg/dL), were significantly lower as compared to non-PEW patients, while hand grip strength was similar (19.5 ± 7.6 vs. 19.7 ± 7.3 kg). Inflammatory C-reactive protein levels tended to be higher in the PEW group (20.0 ± 34.8 vs. 10.0 ± 13.9 p = 0.065). Lipoprotein analyses revealed PEW patients had significantly lower low density lipoprotein cholesterol (71 ± 29 vs. 88 ± 31 mg/dL, p < 0.05) and plasma triglyceride (132 ± 51 vs. 189 ± 103 mg/dL, p < 0.05), while high density lipoprotein cholesterol was similar. Nutritional assessments using a single 24 h recall were possible from 115 of the patients, but only 66 of these were acceptable reporters. Amongst these, while no major differences were noted between PEW and non-PEW patients, the majority of patients did not meet dietary recommendations for energy, protein, fiber, and several micronutrients (in some cases intakes were 60−90% below recommendations). Malnutrition Inflammation Scores were significantly higher in PEW patients (7.6 ± 3.1 vs. 5.3 ± 2.7 p < 0.004). No discernible differences were apparent in measured parameters between patients on twice- vs. thrice-weekly dialysis. Data from a larger cohort are needed prior to establishing patient-management guidelines for PEW in this population.