MyMedR

Drug substitution therapy: a new approach in preventing the spread of HIV/AIDS in Malaysia

Razali SM

Trop Doct, 2008 Apr;38(2):109-10.

PMID: 18453507 DOI: 10.1258/td.2007.070001

The prevalence of HIV/AIDS among drug addicts in Malaysia is high, especially among intravenous drug users. The present treatment and rehabilitation of drug addiction is considered as a failure. The government finally decided to start on Drug Substitution Therapy in early 2005 as an effort to prevent the spread of HIV/AIDS in the country.

Conversion disorder: a case report of treatment with the Main Puteri, a Malay shamanastic healing ceremony

Razali SM

Eur. Psychiatry, 1999 Dec;14(8):470-2.

PMID: 10683634

We report on the case of a 38-year-old Malay housewife diagnosed with conversion disorder. It was believed that 'evil spirits' caused her symptoms. The patient was eventually treated by the Main Puteri, a Malay shamanistic healing ceremony, after previous treatments failed. The patient improved on the third day of the performance, which was attributed to the departure of the spirits from her body. This case documents the potential benefits of indigenous psychotherapy.

Complementary treatment of drug addicts in Malaysia

Razali SM

Trop Doct, 2000 Apr;30(2):105-6.

PMID: 10842562 DOI: 10.1177/004947550003000218

Medical school entrance and career plans of Malaysian medical students

Razali SM

Med Educ, 1996 Nov;30(6):418-23.

PMID: 9217903

This study investigates the reasons for entry to medicine and the career perspectives of phase III medical students of the Universiti Sains Malaysia (USM). The majority of the students were Malays from low socio-economic backgrounds who entered medical school after completing a 2-year matriculation course. An interest in medicine and helping people were the two main stated reasons for entry to medical school. A group of students wishing to work in private practice was identified. In comparison to the rest of the study body, students in the group were: not well prepared to enter medical school; dissatisfied with the course; and subject to family influences. A desire for monetary gain motivated their choice of medicine as a career. Overall, 13% of the students wished to change career because they were dissatisfied with their experience of medicine as undergraduates. The study did not find a significant difference in career intentions between female and male medical students. However, women were less likely to seek entrance into private practice or pursue formal postgraduate education. The choice of surgery as a career was confined to men. About 90% of the students had already decided on their future specialty. Four well-established specialties were their most popular choices. The gender of the students had no significant influences of the decision to continue into postgraduate education. The proportion of female students who wished to marry doctors was significantly higher than for male students.

Public stigma towards patients with schizophrenia of ethnic Malay: a comparison between the general public and patients' relatives

Razali SM, Ismail Z

J Ment Health, 2014 Aug;23(4):176-80.

PMID: 24784779 DOI: 10.3109/09638237.2014.910644

The stigma attached to mental disorders has been recognized as a major concern in healthcare services across societies.

Modified assertive community treatment: effectiveness on hospitalization and length of stay

Razali SM, Hashim MA

Community Ment Health J, 2015 Feb;51(2):171-4.

PMID: 25056686 DOI: 10.1007/s10597-014-9757-0

The objective is to assess the efficacy of a modified Assertive Community treatment (ACT). This is a retrospective cross-sectional study with a comparative group. The study group was patients with schizophrenia who had completed modified ACT, while the control group was those who did not receive modified ACT. The final sample comprises 44 patients in each group. There was no significant difference between both groups in number of admissions and average length of stay. However, in the modified ACT group there was a significant reduction in the number of admissions after the intervention. In conclusion readmission rate was significantly reduced following modified ACT intervention.

Complementary treatment of psychotic and epileptic patients in malaysia

Razali SM, Yassin AM

Transcult Psychiatry, 2008 Sep;45(3):455-69.

PMID: 18799643 DOI: 10.1177/1363461508094676

The objective of this article is to describe and compare the use of traditional/complementary medicine (T/CM) among psychotic (schizophrenia and schizophreniform disorder) and epileptic Malay patients in peninsular Malaysia. There were 60 patients in each group. T/CM consultation was uniformly spread across all levels of education and social status. We could not find a single over-riding factor that influenced the decision to seek T/CM treatment because the decision to seek such treatment was complex and the majority of decisions were made by others. Fifty-three patients (44.2%), consisting of 37 (61.7%) psychotic and 16 (26.7%) epileptic patients had consulted Malay traditional healers (bomoh) and/or homeopathic practitioners in addition to modern treatment; of these, only three had consulted bomoh and homeopathic practitioners at the same time. The use of T/CM was significantly higher in psychotic than in epileptic Malay patients.

Pain symptoms in Malay patients with major depression

Razali SM, Khalib AQ

Asian J Psychiatr, 2012 Dec;5(4):297-302.

PMID: 23174436 DOI: 10.1016/j.ajp.2012.02.015

There is a strong association between depression and pain, which is influenced by various biological and psychological mechanisms. The objectives of this study were to assess the prevalence and severity of pain symptoms among patients with major depression; and to determine the correlation between pain with clinical variables, neurotic pathology and severity of depression.

Cost-effectiveness of cyclic antidepressants in a developing country

Razali SM, Hasanah CI

Aust N Z J Psychiatry, 1999 Apr;33(2):283-4.

PMID: 10336231

Help-seeking pathways among Malay psychiatric patients

Razali SM, Najib MA

Int J Soc Psychiatry, 2000;46(4):281-9.

PMID: 11201349

The aim of this study is to explore the help-seeking behaviour of Malay psychiatric patients. A semi-structured interview based on a standard proforma was conducted to assess help seeking process and delays for Malay psychiatric patients attending the psychiatric clinic for the first time. Help-seeking process and delays were defined. Among 134 patients evaluated in the study, 69% had visited traditional healers (bomoh) for the present illness before consulting psychiatrists. The second popular choice of treatment was medical practitioner and only a small percentage of them had consulted homeopathic practitioners and herbalists. Patients who had consulted bomohs were significantly delayed in getting psychiatric treatment compared with those who had not consulted them. Consultation of bomohs was significantly higher among married patients, those with major psychiatric illnesses and in family who believed in supernatural causes of mental illness. However, there was no significant difference in age, gender, educational status and occupation between patients who had consulted and not consulted bomoh. We concluded that majority of the Malay psychiatric patients had sought the traditional treatment prior to psychiatric consultation. The strength of social support and the belief of the patients, friends, and/or relatives in supernatural causes of mental illness were strongly associated with the rate of traditional treatment. Deep-seated cultural beliefs were major barrier to psychiatric treatment.

Case vignette in a community-based study

Razali SM, Hamzah AM

Am J Psychiatry, 1999 Jan;156(1):158.

PMID: 9892319

Fulltext Medication adherence in schizophrenia: a comparison between outpatients and relapse cases

Razali SM, Yusoff MZ

East Asian Arch Psychiatry, 2014 Jun;24(2):68-74.

PMID: 24986201

Objective: Adherence to medication is essential for maximising the outcomes of patients with schizophrenia as the consequences of poor adherence are devastating. The study aimed to compare medication adherence between patients with relapse schizophrenia and those attending psychiatric follow-up clinics, and to determine the factors affecting adherence.
Methods: This was a cross-sectional study involving 70 patients with schizophrenia who were divided equally into 2 groups. Medication adherence was assessed with the Medication Adherence Rating Scale. Appropriate instruments were used to measure insight, social support, and psychopathology. Various socio-demographic and clinical variables were explored to find associations with medication adherence.
Results: Medication adherence among patients with schizophrenia was poor; 51% of the patients did not adhere to a medication regimen. Adherence was better in outpatients with schizophrenia (61%) than in relapse cases (39%), although the difference was not statistically significant (t = 1.70; p = 0.09). Besides, relapse patients had significant higher number of admission (X2 = 22.95; p < 0.05) and severe psychopathology (t = –29.96; p < 0.05), while perceived social support was significantly better in outpatients with schizophrenia (t = 2.90; p < 0.05). Frequency of admission (adjusted b = –0.55; 95% confidence interval [CI], -0.99 to -0.10; p < 0.05) and psychopathology (adjusted b = –0.12; 95% CI, -0.24 to -0.01; p < 0.05) were also significantly associated with medication adherence.
Conclusion: Medication adherence among both groups of patients with schizophrenia was poor. If adherence is addressed appropriately, the number of admissions and severity of psychopathology could be improved.
Key words: Patient compliance; Psychopathology; Schizophrenia; Social support
Study site: Psychiatric clinic, Hospital Universiti Sains Malaysia (HUSM)

The pathway followed by psychotic patients to a tertiary health center in a developing country: a comparison with patients with epilepsy

Razali SM, Mohd Yasin MA

Epilepsy Behav, 2008 Aug;13(2):343-9.

PMID: 18514034 DOI: 10.1016/j.yebeh.2008.04.009

The objective of this study was to describe and compare the pathways followed by Malay patients with psychoses (schizophrenia and schizophreniform disorder) and Malay patients with epilepsy to a tertiary health center in the northeastern area of peninsular Malaysia. There were 60 patients in each group. The most popular pathway for both groups was first contact with traditional or alternative healers. Consultation with Malay traditional healers (bomohs) and/or homeopathic practitioners (44.2%) was significantly higher for psychotic patients (61.7%) than for patients with epilepsy (26.7%) (chi(2)(2)=15.609, P<0.001). Direct access (24.2%) was the second most popular pathway and almost equally followed by both groups of patients. The third and last pathway was initial contact with private general practitioners and government doctors, respectively. Patients with epilepsy dominated the last two pathways. The treatment delay (TD) was significantly longer in epileptic than psychotic patients regardless of their visit to a bomoh and/or homeopathic practitioner (P<0001) or not (p<0.01). The socioeconomic status of psychotic patients also was significantly better than people with epilepsy (chi(2)=9.957, chi(2)(4), p=0.041).

Study site: Psychiatric clinic, Hospital Universiti Sains Malaysia HUSM

Religious--sociocultural psychotherapy in patients with anxiety and depression

Razali SM, Hasanah CI, Aminah K, Subramaniam M

Aust N Z J Psychiatry, 1998 Dec;32(6):867-72.

PMID: 10084352

To show the effectiveness of incorporating religious-sociocultural components in the management of patients with generalised anxiety disorders and major depression who have strong religious and cultural backgrounds as compared with a normal psychotherapeutic approach.

Belief in supernatural causes of mental illness among Malay patients: impact on treatment

Razali SM, Khan UA, Hasanah CI

Acta Psychiatr Scand, 1996 Oct;94(4):229-33.

PMID: 8911557

The concept of aetiology of mental illness in 134 Malay patients was investigated by means of a 20-item checklist. About 53% of the patients attributed their illnesses to supernatural agents. Witchcraft and possession by evil spirits were regarded as common causes of illness. The number of patients who believed in supernatural causes of their mental illness was significantly higher among those who had consulted bomohs (Malay traditional healers) than among those who had not consulted them. The belief that mental illness is caused by supernatural agents is firmly held by bomohs, who reinforce this notion in those who seek their advice. Belief in supernatural causes of mental illness was not significantly associated with age, gender, level of education or occupation of the patients. Patients who believed in supernatural causes of mental illness were also found to show poor drug compliance, and the number of such patients at 6 months follow-up was significantly lower than the corresponding figure for those who did not believe in supernatural causes. The importance of understanding the patients' cultural background when treating psychiatric patients is highlighted.

Influence of DRD2 polymorphisms on the clinical outcomes of patients with schizophrenia

Zahari Z, Teh LK, Ismail R, Razali SM

Psychiatr Genet, 2011 Aug;21(4):183-9.

PMID: 21206399 DOI: 10.1097/YPG.0b013e3283437250

Variations in the gene for dopamine D2 receptor (DRD2) might have an influence on the outcome of antipsychotic treatment in schizophrenia. The objective of this study was to investigate the influence of DRD2 polymorphisms on treatment outcomes in patients with schizophrenia.

Does the success of a school-based HPV vaccine programme depend on teachers' knowledge and religion? -- A survey in a multicultural society

Ling WY, Razali SM, Ren CK, Omar SZ

Asian Pac J Cancer Prev, 2012;13(9):4651-4.

PMID: 23167396

Organized introduction of prophylactic human papillomavirus (HPV) vaccination can reduce the burden of cervical cancer in developing countries. One of the most effective ways is through a national school-based program. Information on teachers is therefore important since this group may have a disproportionate influence in the success of any implementation.

OBJECTIVE: To assess teachers' knowledge and perception of HPV, cervical cancer and HPV vaccine prior to commencing a school-based HPV vaccination program in a multiethnic, predominantly Muslim country. Factors associated with acceptability of the vaccine were identified.

METHOD: A bilingual questionnaire was applied to 1,500 secondary school teachers from 20 urban schools in Malaysia. Data collected were analyzed using SPSS version 17.

RESULTS: 1,166 questionnaires were returned. From this group, 46.1% had never heard of HPV while 50.9% had never had a pap smear. However, 73.8% have heard of the HPV vaccine with 75% agreeing to have it. 96% considered themselves religious with 79.8% agreeing to have the vaccine.

CONCLUSIONS: A national school-based HPV immunization program can be implemented effectively in a multiethnic, cultural and religious country despite limited knowledge of HPV-related pathology among teachers. In addition, the perception that religion has a negative influence on such a program is unwarranted.

Screening for schizophrenia in initial prodromal phase: Detecting the sub-threshold psychosis

Razali SM, Abidin ZZ, Othman Z, Yassin MA

Asian J Psychiatr, 2015 Aug;16:26-31.

PMID: 26182843 DOI: 10.1016/j.ajp.2015.06.011

The aim of the study is to screen and evaluate the efficacy of the screening tools in detecting subjects with sub-threshold psychosis among asymptomatic individuals at genetic risk, as compared with persons in the general public.

Reduced red-cell folate in mania

Hasanah CI, Khan UA, Musalmah M, Razali SM

J Affect Disord, 1997 Nov;46(2):95-9.

PMID: 9479613

Forty-five hospitalised patients with DSM-III-R diagnosis of mania, were found to have a mean red-cell folate level of 193 nmol/l, as compared to 896 nmol/l in the control group (P < 0.00001). Assessment of serum folate in both groups showed no significant differences in the levels. Furthermore the manic patients and the controls were matched by the socio-economic status. This indicated that the reduced red-cell folate in mania is associated with the illness and not due to reduced absorption or dietary deficiency of folate. Considering previous studies that showed reduced red-cell folate in depression, our findings suggest that reduced red-cell folate occurred in both phases of bipolar disorders.

Fulltext Capability of integrated MODIS imagery and ALOS for oil palm, rubber and forest areas mapping in tropical forest regions

Razali SM, Marin A, Nuruddin AA, Shafri HZ, Hamid HA

Sensors (Basel), 2014 May 07;14(5):8259-82.

PMID: 24811079 DOI: 10.3390/s140508259

Various classification methods have been applied for low resolution of the entire Earth's surface from recorded satellite images, but insufficient study has determined which method, for which satellite data, is economically viable for tropical forest land use mapping. This study employed Iterative Self Organizing Data Analysis Techniques (ISODATA) and K-Means classification techniques to classified Moderate Resolution Imaging Spectroradiometer (MODIS) Surface Reflectance satellite image into forests, oil palm groves, rubber plantations, mixed horticulture, mixed oil palm and rubber and mixed forest and rubber. Even though frequent cloud cover has been a challenge for mapping tropical forests, our MODIS land use classification map found that 2008 ISODATA-1 performed well with overall accuracy of 94%, with the highest Producer's Accuracy of Forest with 86%, and were consistent with MODIS Land Cover 2008 (MOD12Q1), respectively. The MODIS land use classification was able to distinguish young oil palm groves from open areas, rubber and mature oil palm plantations, on the Advanced Land Observing Satellite (ALOS) map, whereas rubber was more easily distinguished from an open area than from mixed rubber and forest. This study provides insight on the potential for integrating regional databases and temporal MODIS data, in order to map land use in tropical forest regions.

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