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Fulltext The use of electroconvulsive therapy in the University Hospital, Kuala Lumpur--a study of 31 patients

Lai ALP, Ooi ST, Yong BH, Koh L

Med J Malaysia, 1983 Jun;38(2):145-9.
PMID: 6621445

Thirty-one (31) patients undergoing electroconvulsive therapy (ECT) over a three-week period in October 1982 in the Psychiatric Unit, University Hospital, Kuala Lumpur, were studied. The main indications for ECT in these patients were poor response to drug therapy, depression with suicidal ideation, and aggression, which together accounted for 87 percent of all patients started on ECT during this period. The majority of patients (86 percent) showed some improvement, and 73 percent improved by the third ECT. The most common side-effects experienced by patients were memory disturbance (45 percent) and post ECT headache (45 percent). No serious side-effects were encountered.
Fulltext Barriers to smoking cessation: a qualitative study from the perspective of primary care in Malaysia

Chean KY, Goh LG, Liew KW, Tan CC, Choi XL, Tan KC, et al.

BMJ Open, 2019 07 09;9(7):e025491.
PMID: 31289057 DOI: 10.1136/bmjopen-2018-025491

OBJECTIVES: This qualitative study aims to construct a model of the barriers to smoking cessation in the primary care setting.
DESIGN: Individual in-depth, semistructured interviews were audio-taped, then verbatim transcribed and translated when necessary. The data were first independently coded and then collectively discussed for emergent themes using the Straussian grounded theory method.
PARTICIPANTS AND SETTING: Fifty-seven current smokers were recruited from a previous smoking related study carried out in a primary care setting in Malaysia. Current smokers with at least one failed quit attempts were included.
RESULTS: A five-theme model emerged from this grounded theory method. (1) Personal and lifestyle factors: participants were unable to resist the temptation to smoke; (2) Nicotine addiction: withdrawal symptoms could not be overcome; (3) Social cultural norms: participants identified accepting cigarettes from friends as a token of friendship to be problematic; (4) Misconception: perception among smokers that ability to quit was solely based on one's ability to achieve mind control, and perception that stopping smoking will harm the body and (5) Failed assisted smoking cessation: smoking cessation services were not felt to be user-friendly and were poorly understood. The themes were organised into five concentric circles based on time frame: those actionable in the short term (themes 1 and 2) and the long term (themes 3, 4, 5).
CONCLUSIONS: Five themes of specific beliefs and practices prevented smokers from quitting. Clinicians need to work on these barriers, which can be guided by the recommended time frames to help patients to succeed in smoking cessation.
Fulltext Assessing airflow limitation among smokers in a primary care setting

Chean KY, Rahim FF, Chin JS, Choi XL, Liew KW, Tan CC, et al.

Malays J Med Sci, 2018 May;25(3):78-87.
PMID: 30899189 MyJurnal DOI: 10.21315/mjms2018.25.3.8

Background: Many smokers have undiagnosed chronic obstructive pulmonary disease (COPD), and yet screening for COPD is not recommended. Smokers who know that they have airflow limitation are more likely to quit smoking. This study aims to identify the prevalence and predictors of airflow limitation among smokers in primary care.
Methods: Current smokers ≥ 40 years old who were asymptomatic clinic attendees in a primary care setting were recruited consecutively for two months. We used a two-step strategy. Step 1: participants filled in a questionnaire. Step 2: Assessment of airflow limitation using a pocket spirometer. Multiple logistic regression was utilised to determine the best risk predictors for airflow limitation.
Results: Three hundred participants were recruited. Mean age was 58.35 (SD 10.30) years old and mean smoking history was 34.56 pack-years (SD 25.23). One in two smokers were found to have airflow limitation; the predictors were Indian ethnicity, prolonged smoking pack-year history and Lung Function Questionnaire score ≤ 18. Readiness to quit smoking and the awareness of COPD were low.
Conclusions: The high prevalence of airflow limitation and low readiness to quit smoking imply urgency with helping smokers to quit smoking. Identifying airflow limitation as an additional motivator for smoking cessation intervention may be considered. A two-step case-finding method is potentially feasible.
Study site: primary care clinic (outpatient clinic), Pulau Pinang, Malaysia
Impact of COVID-19 pandemic on carbapenem-resistant Enterobacterales incidence in the South-East Asia region: an observational study

Linn KZ, Sutjipto S, Ng OT, Teo J, Cherng BPZ, Tan TY, et al.

Antimicrob Steward Healthc Epidemiol, 2023;3(1):e208.
PMID: 38156208 DOI: 10.1017/ash.2023.477

The COVID-19 pandemic led to an initial increase in the incidence of carbapenem-resistant Enterobacterales (CRE) from clinical cultures in South-East Asia hospitals, which was unsustained as the pandemic progressed. Conversely, there was a decrease in CRE incidence from surveillance cultures and overall combined incidence. Further studies are needed for future pandemic preparedness.