Medical Journal of Malaysia最新文献

{"title":"The intersection of dermatology and immunology: Cutaneous manifestations, autoantibodies and quality of life in connective tissue diseases.","authors":"S W Lai, L Selvarajah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Connective tissue diseases (CTDs) are autoimmune diseases with multiorgan involvement. CTDs present with a heterogeneous clinical manifestation, especially in the cutaneous system. This study aimed to describe the common cutaneous manifestations of CTDs, to determine the association with antinuclear antibody (ANA) and other associated antibodies, and to assess the impact of CTDs on patient's quality of life (QOL).</p><p><strong>Material and methods: </strong>This was a cross-sectional study conducted among patients 18 years and above, with a confirmed diagnosis of systemic lupus erythematosus (SLE), systemic sclerosis, dermatomyositis, mixed connective tissue disease (MCTD) or overlap syndrome, who attended the rheumatology clinic at Hospital Sultan Ismail Johor Bahru between March 2023 to June 2023. The assessment instrument used was the Dermatology Quality Life Index (DLQI).</p><p><strong>Results: </strong>Among 79 patients recruited, the majority were females with a mean age of 39 ± 14.5 years. Malay was the predominant ethnic group. SLE was the most common CTD (64 patients, 81%), followed by systemic sclerosis (six patients, 7.6%), overlap syndrome (four patients, 5.1%), dermatomyositis (four patients, 5.1%) and MCTD (one patient, 1.3%). All patients had cutaneous involvement with photodermatitis being the commonest cutaneous manifestation (65 patients, 82.3%). ANA and anti-double stranded DNA (dsDNA) positivity were significantly associated with SLE while anti-scl70 and anti-centromere antibodies (ACA) were strongly associated with systemic sclerosis (p < 0.05). The presence of anti-dsDNA and antiscl70 were significantly associated with renal involvement and interstitial lung disease (ILD) respectively (p < 0.05). CTD had a moderate effect on patient's QOL.</p><p><strong>Conclusion: </strong>Photosensitivity was the commonest cutaneous manifestation among CTD patients. ANA was positive in the majority of SLE patients. The presence of anti-dsDNA was significantly associated with lupus nephritis, while anti-scl70 and ACA were strongly associated with systemic sclerosis and ILD. CTD had a moderate effect on patient's QOL.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The benefits of early pulmonary rehabilitation with incentive spirometer among chronic obstructive pulmonary disease patients with exacerbation of chronic obstructive pulmonary disease.","authors":"Y L Andrea Ban, A S Siti Istiana, N A Nik Nuratiqah, B H Ng, O Rose Azzlinda, J Hasni, S Z Syed Zulkifli","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Inspiratory muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD). This study aimed to compare the benefits of adding volume incentive spirometry (VIS) to active-cycle-breathing technique (ACBT) and ground-based walking (GBW) training in patients hospitalised for COPD exacerbations. The objectives were to evaluate the impact of early initiation of VIS on respiratory muscle strength, measured by maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and the 6-minute walk test (6-MWT), as well as on symptoms, as assessed by the COPD assessment test (CAT) score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This randomised, prospective study was conducted among COPD subjects admitted with exacerbation between June 2021 and August 2022. Subjects were randomly assigned to either the VIS (interventional group) or the control group. Baseline assessments, including spirometry, MIP, CAT score, and the 6-minute walk test (6MWT), were performed. Both groups commenced active cycle of breathing techniques (ACBT) and groundbased walking (GBW) training within 72 hours of admission, with daily sessions involving three repetitions of each phase to complete one cycle, repeated three times daily. The intervention group received VIS. Upon discharge, subjects were provided with a diary and instructed to continue a home-based pulmonary exercise regimen, performed for at least 15 minutes per day, 3 days a week, with compliance monitored through weekly phone calls. At the 4-week followup, repeat assessments of spirometry, MIP, maximal expiratory pressure (MEP), CAT score and 6MWT were conducted to evaluate the outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 34 subjects with a median age of 68 years (interquartile range [IQR] 65-74.3 years). The cohort predominantly males (32 subjects, 94%). The distribution of disease severity was as follows: GOLD 2 in 15 subjects (44%) and GOLD 3 in 14 subjects (41%). Additionally, 17 subjects (50%) had experienced three or more exacerbations in the preceding year. The majority of patients (29 out of 34, 85%) had a length of stay of less than 7 days. In the interventional group, the median MIP improved from 50 cm H2O (IQR 40.5-70.5) to 59 cm H2O (IQR 39-76.5), though this was not statistically significant (p = 0.407). The control group saw an improvement from 58 cm H2O (IQR 36.5-85) to 60 cm H2O (IQR 33-88), also not statistically significant (p = 0.112). The 6MWT distance improved in the interventional group from 220 meters (IQR 118-275) to 260 meters (IQR 195-327) (p = 0.002) and in the control group from 250 meters (IQR 144-294) to 280 meters (IQR 213-359.5) (p = 0.001). The median CAT score decreased significantly in the interventional group from 22 (IQR 16-28) to 11 (IQR 7.5-13) (p &lt; 0.001) and in the control group from 21 (IQR 14-24.5) to 10 (IQR 8-12.5) (p &lt; 0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Early initiation of pulmonary rehabilitation in pa","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring nasopharyngeal carcinoma genetics: Bioinformatics insights into pathways and gene associations.","authors":"C L Che Ismail, N Y Yusof, N Mat Lazim, S Sarina, Z B Alwi, B Abdullah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The pathogenesis of nasopharyngeal carcinoma (NPC) is intricate, influenced by a combination of factors including host genetics, viral infection and environmental elements, resulting in genetic and epigenetic modifications. Despite a positive prognosis for early-stage patients, most NPC cases are diagnosed at an advanced stage, highlighting the pressing need for enhanced accessibility to early diagnosis and treatment. The underlying molecular pathways driving NPC progression remain elusive. This study focuses on the use of bioinformatics techniques and databases in carrying out research to gain insights into gene relevance and potential applications in NPC.</p><p><strong>Materials and methods: </strong>Searches encompassed articles published in English from January 2017 to June 2024, utilising keywords such as 'nasopharyngeal carcinoma,' 'bioinformatics,' 'gene expression' and 'gene microarrays' across PubMed, MEDLINE and Scopus databases. The Gene Expression Omnibus (GEO) database was utilised to access NPC messenger RNA (mRNA) expression profiling studies.</p><p><strong>Results: </strong>Most studies utilised the GEO database to identify differentially expressed genes (DEGs) between normal and NPC tissues, followed by functional analysis using gene ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathways. Protein protein interaction (PPI) networks of DEGs were commonly constructed using STRING and visualised with Cytoscape software. The integration of GO and KEGG pathway analysis alongside PPI network construction provides valuable insights into the dysregulated pathways and molecular mechanisms underlying NPC pathogenesis. Microarray analysis, particularly datasets such as GSE12452, GSE64634 and GSE34573, has enabled the identification of DEGs associated with NPC. PPI network analysis identifies hub genes, such as DNALI1, DNAI2 and RSPH9, implicated in NPC pathogenesis. Validation of gene expression patterns through platforms like GEPIA and Oncomine validates the clinical relevance of identified biomarkers. Furthermore, studies employing RNA sequencing and bioinformatics approaches uncover novel genes involved in NPC radio resistance and prognosis, paving the way for personalised therapeutic strategies.</p><p><strong>Conclusion: </strong>Integration of bioinformatics analysis provides insights into the complexity of tumour biology and potential molecular pathways, enabling the development of enhanced strategies for early detection, outcome prediction, recurrence detection and therapeutic approaches for NPC.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contact sensitisation pattern of patients with eczema at the face and neck region: A retrospective study in Kuala Lumpur.","authors":"H G Teo, S R Syed Nong Chek, M M Tang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Allergic contact dermatitis (ACD) involving the face and neck region (FNR) is not uncommon. We aimed to determine the sensitisation pattern among patients with dermatitis involving FNR who underwent skin patch tests between 2016 and 2022.</p><p><strong>Materials and methods: </strong>This is a 7-year retrospective review on contact sensitisation patterns in patients with dermatitis over the FNR who underwent skin patch tests between 2016 and 2022 in the Department of Dermatology Hospital Kuala Lumpur.</p><p><strong>Results: </strong>There were 291 patients (female-to-male ratio of 7.8:1; mean age of 34.1 ± 14.0 years) with dermatitis at the FNR who underwent patch tests. The majority (n = 116,39.9%) were aged between 20 and 29 years. About 8% were below 19 years of age. Nearly 50% had dermatitis over the perioral region, 8.6% at the periorbital area and 50.6% at the other parts of the face and neck region. The clinical diagnoses included contact dermatitis (n = 145, 49.8%), cheilitis (n = 81, 27.8%), endogenous eczema (n = 28, 9.6%) and others. All were tested with European baseline series, with 91.4% and 77.0% tested with extended series, and own products, respectively. About 70.1% were sensitised to at least one allergen. The most common sensitizing allergen was nickel sulfate (34.0%), followed by cobalt chloride (11.7%), fragrance mix (10.7%), methylchloroisothiazolinone/ methylisothiazolinone (8.9%), and formaldehyde (8.9%). Clinical relevance was documented in 58.8% of them.</p><p><strong>Conclusion: </strong>Contact sensitisation was detected in about 70% of patients with dermatitis at the FNR who were patchtested. Nickel, cobalt chloride and fragrance mix were the most common sensitising allergens in these patients.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global trends in the utilisation of NOMS framework for spinal metastasis management: A systematic review.","authors":"J F L Tobing, E Kow, S D A L Tobing","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional risk stratification systems based on the clinicopathological criteria have limitations and may not accurately predict outcomes for all patients. The neurologic, oncologic, mechanical, and systemic (NOMS) framework aims to optimise treatment outcomes and improve patient care. Here, we aimed to provide a comprehensive overview of the NOMS framework within the context of spinal metastasis.</p><p><strong>Materials and methods: </strong>The study rigorously followed the guidelines set by PRISMA. We conducted an extensive search and be as transparent as possible across wellregarded databases such as PubMed and Euro PMC. The primary outcome measure focused on examining the feasibility of implementing the NOMS framework for patients with spinal metastasis in real-world clinical settings, and this measure was predefined and justified.</p><p><strong>Results: </strong>This systematic review included three studies involving 300 participants with spinal metastases at the cervicothoracic junction. The studies examined surgical interventions like decompression, fusion and corpectomy within the NOMS framework. Across the studies, the NOMS approach is consistently associated with adverse outcomes, including complication rates, surgical revisions, hardware complications, deformities, tumour recurrence and variable survival rates. It is also linked to hospital stays, ICU durations and specific discharge statuses. Another study focused on spinal metastasis patients undergoing endoscopic surgery, highlighting the NOMS framework's connection to recurrence rates, performance metrics, neurological status, pain management, functional recovery and quality of life. In addition, other studies explored navigated instrumentation, with a primary focus on screw placement accuracy. All three studies demonstrated methodological rigor by reporting adequate allocation concealment.</p><p><strong>Conclusion: </strong>NOMS framework consistently associates with adverse spinal metastasis surgery outcomes.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presentation skills teaching in anaesthesia.","authors":"S Shamsher, N N Alam, S Shamsher","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Presentation is a communication method to convey information within a specific time, involving judgment, decision-making and critical thinking. Incorporation of teaching- learning-assessment of presentation skills is essential in medical curriculum because medical education involves presentations such as case reports, seminar, and conferences. The presentation skills equip 'the future doctors' to be at par with the ever-advancing world of technology, artificial intelligence and globalisation. The presentations should involve effective constructive feedback to enhance the effectiveness of presentation skills in medical curriculum.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normocytic Anemia in Pregnant Women: A Scoping Review.","authors":"S A Sharief, R Minhajat, D S Riu, A Bukhari, H Amir","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The iron supplementation program for pregnant women is the main program for tackling anemia in various countries, especially in developing countries in which daily diets may lack sufficient iron intake. In Indonesia, it is recommended that expectant mothers ingest 90 iron tablets during their pregnancy; however, the World Health Organization reports that 37% of pregnant women in the country continue to experience anemia. Iron deficiency anemia consistently emerges as the primary etiology for diagnosing anemia; however, it is important to recognize that anemia can stem from various factors beyond just lack of iron. In addition to iron deficiency, chronic illnesses and infections significantly contribute to the prevalence of anemia worldwide. Consequently, this literature review endeavors to uncover the underlying factors responsible for normocytic anemia among pregnant women, focusing on developing countries.</p><p><strong>Materials and methods: </strong>Eight search engines, specifically Proquest, EbscoHost, Scopus, Cochrane Library, Science Direct, Wiley Online Library, PubMed, Google Scholar, and Garuda, were utilized to identify primary articles. Three independent reviewers assessed abstracts and full articles based on specific inclusion and exclusion criteria. The data collected encompassed information regarding the population under study, research methods employed, and primary findings pertinent to the review's objectives. Fifteen studies, published between 2014 and 2023, that met the eligibility criteria outlined in the PRISMA-ScR.</p><p><strong>Results: </strong>Among the 15 studies on normocytic anemia in pregnant women, malaria and HIV were the highest causes of normocytic anemia, followed by worm/intestinal parasite infections, chronic diseases, and bleeding.. In pregnant women, anemia of chronic disease and infection often coexists with iron deficiency anemia, both show decrease serum iron levels. Hence, other investigations need to be carried out to diagnose with certainty the cause of anemia in pregnant women.</p><p><strong>Conclusion: </strong>Anemia is not a standalone disease but rather a symptom of various underlying diseases. Therefore, diagnosing anemia requires identifying the basic disease that causes anemia, rather than simply labeling it as anemia.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eating disorders among physically disabled national athletes in Malaysia.","authors":"H S Arvinder-Singh, A S Shamsul, N Safian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Eating disorders are becoming a cause of concern amongst athletes in recent times. The objective of this study was to determine the prevalence of eating disorders amongst physically disabled athletes in Malaysia. Athletes were sampled and screened for eating disorders utilising the Eating Disorder Examination-Questionnaire 6.0 (EDE-Q-for females) and the Eating Disorder Assessment in Males (EDAM-for males).</p><p><strong>Materials and methods: </strong>Athletes were approached individually, and they responded via an online questionnaire. A total of 271 athletes responded (sample needed 269) from the total of 700 athletes (38.7%).</p><p><strong>Results: </strong>From the total, 14.4% (n = 39, 95% CI = 10.56-19.28) of the athletes had eating disorders (14.4% of the male athletes and 14.5% of female athletes). The final model of a binary logistic regression was conducted and found that the higher the body weight (AOR: 1.02, 95% CI: 1.00-1.04, p = 0.03), the higher the income (AOR: 0.992, 95% CI: 0.990- 0.994, p = 0.02), the more athlete suffered from coaches intimidating behaviours(AOR: 1.17, 95% CI: 1.03-1.33, p = 0.02), a perception of having stress (AOR: 7.61, 95% CI: 1.69-34.39, p = 0.01) and having stress (AOR: 3.70, 95% CI: 1.02-9.68, p = 0.04) were common factors seen in athletes with eating disorders.</p><p><strong>Conclusion: </strong>About two in every 10 disabled athletes suffered from eating disorders.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence, risk factors and coping strategies of low back pain among nurses in public hospitals in Kota Kinabalu, Sabah: A cross-sectional study.","authors":"A S Perumal, K Awang Lukman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare workers are recognised to have a high prevalence of musculoskeletal disorders and nursing profession are well known with high prevalence of low back pain (LBP). There is a widespread consensus that low back discomfort is a major contributor to both inabilities to work and illness. Absenteeism is frequently employed as a proxy for the presence of a handicap.</p><p><strong>Aim: </strong>The purpose of this study was to determine the prevalence of LBP among nurses in six different wards in three general hospitals in Kota Kinabalu, Sabah as well as the associated workplace risk factors and coping strategies implemented by nurses in ward.</p><p><strong>Materials and methods: </strong>A cross-sectional study involved 420 nurses from three public hospitals in Kota Kinabalu, Sabah, was carried out. The respondents were carefully selected by proportionate stratified random sampling method. Nurses sociodemographic and occupational details, occupational health in nursing practice, seventeen work risk variables and nine coping techniques were collected via a selfadministered questionnaire.</p><p><strong>Results: </strong>Among the 420 participants, 57 did not report any discomfort. In the previous 12 months, 44.5% (95.0% CI: 39.74,49.25) of nurses experienced low back discomfort lasting longer than three days. The results of a simple logistic regression analysis revealed that gender and years of working experience were significantly associated with LBP. The department of intensive care unit nurses had the highest OR value of 2.4 (p = 0.03). There were no statistically significant association with age, marital status and body mass index (p > 0.05). Adjusting plinth or bed height (68.4%) was the top coping mechanism cited by respondents in the clinical context to reduce the risk of LBP, and working with perplexed or agitated patients posed the greatest occupational risk.</p><p><strong>Conclusion: </strong>LBP is still a major work-related issue among nurses, with a high prevalence rate. To mitigate these impacts, multidisciplinary efforts are required. The outcomes of this study may help policy makers to allocate resources to reduce LBP among nurses.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of dexmedetomidine in postoperative nausea and vomiting in laparoscopic bariatric surgery: A systematic review and meta-analysis of randomised clinical trials.","authors":"T Subramaniam, H Y Tan, J H Tan, J W Pung, H Htet","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative nausea and vomiting (PONV) is a common side effect of all types of surgeries, especially so in bariatric surgery. Dexmedetomidine (DX) is an α2-agonist that may be useful as an adjunct prophylactic medication for PONV. This meta-analysis aims to evaluate the efficacy of DX in reducing the incidence and severity of PONV in laparoscopic bariatric surgeries.</p><p><strong>Materials and methods: </strong>Databases were searched for articles with the determined MESH terms and keywords before February 2022. Identified articles were screened and 13 randomised clinical trials (RCTs) were included in this meta-analysis based on the inclusion criteria. Data were extracted from the articles and statistical analysis was performed using Review Manager.</p><p><strong>Results: </strong>Administration of DX significantly reduced the incidence of PONV and Numerical Rating Scale (NRS) scores for PONV. The outcome was probably due to the intrinsic sympatholytic effect of the medication, reduction of postoperative pain and total postoperative opioid usage. DX showed better efficacy as PONV prophylaxis if the duration of surgery was < 120 minutes. Delivery of DX as a continuous infusion without a loading dose before infusion was found to be effective in reducing PONV compared to infusion after a loading dose.</p><p><strong>Conclusion: </strong>Administration of DX can reduce the incidence of PONV in patients undergoing laparoscopic bariatric surgery. However, further studies are required to investigate the optimal dose of DX as an antiemetic, considering its side effects to increase the applicability of our results in future guidelines for laparoscopic bariatric surgery.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}