Introduction Pulmonary rehabilitation (PR) could improve health outcomes for the increasing numbe... more Introduction Pulmonary rehabilitation (PR) could improve health outcomes for the increasing number of people with chronic respiratory diseases (CRDs), but programmes need to be adapted to low-resource settings and, in the context of a pandemic, to home-based delivery. Aim To assess the feasibility of delivering a home-PR programme for patients with CRDs in Malaysia. Methods We recruited patients with CRDs from two hospitals in Klang Valley, Malaysia to a Home-PR programme. Following Centre-based assessment, patients performed the exercises at home (five sessions/week for 8 weeks (total 40 sessions)). We monitored the patients via weekly telephone calls and asked about adherence to the programme. We measured functional exercise capacity (6-Minutes walking test (6MWT)) and Health-Related Quality-of-Life (HRQOL: COPD Assessment Test (CAT)) at baseline and post- PR at 9 weeks. We conducted semi-structured interviews with 12 purposively sampled participants to explore views and feedback ...
Introduction Opioids are increasingly used for non-cancer pain control. Studies in cancer patient... more Introduction Opioids are increasingly used for non-cancer pain control. Studies in cancer patients have shown that chronic opioid use could lead to secondary hypocortisolism and hypogonadism of varying degree. We seek to determine this association in an Asian cohort of patients with non-cancer pain and also examine the effect of opioids on other pituitary hormones comparing them to patients who are on non-opioid analgesia. Methods This is a cross-sectional study of patients recruited from pain clinic. Inclusion criteria were patients aged between 18-75 with non-cancer pain on opioids (morphine/oxycodone/fentanyl/tramadol) for more than 3 months. Patients with active cancer or intracranial pathology, who were already on hormone replacement and on long term glucocorticoids or had intra-muscular or intra-articular steroids in the preceding 3 months were excluded. Controls were age and sex matched. All recruited patients had a renal profile, albumin, cortisol, ACTH, fT4, TSH, FSH, LH, I...
Introduction: Illness perceptions involve personal beliefs that patients have about their illness... more Introduction: Illness perceptions involve personal beliefs that patients have about their illness and may influence health behaviour considerably. This preliminary study evaluates the understanding of illness perception among cardiac patients’ and correlations of each of the items. Methods: A preliminary study was conducted using the on Brief Illness Perception Questionnaire (BIPQ) in a tertiary hospital among 40 cardiac patients. Ethical approval was obtained from the institution ethical committee. There are 9 items in the BIPQ with 0-10 response scale measuring causal factors and an open-ended item. Items 1 to 5 assesses on the cognitive illness perception which comprises of consequences, timeline, personal control, treatment control and identity. Item 6 and 8 are on emotional response and item 7 is on coherence. Results: The overall mean score of the 8 items of BIPQ was 7.04 (1.07) with the highest mean for item 4 on treatment control and item 6 on personal control at 8.02 (0.92)...
In this review, current studies on hospital readmission due to infection of COVID-19 were discuss... more In this review, current studies on hospital readmission due to infection of COVID-19 were discussed, compared, and further evaluated in order to understand the current trends and progress in mitigation of hospital readmissions due to COVID-19. Boolean expression of (“COVID-19” OR “covid19” OR “covid” OR “coronavirus” OR “Sars-CoV-2”) AND (“readmission” OR “re-admission” OR “rehospitalization” OR “rehospitalization”) were used in five databases, namely Web of Science, Medline, Science Direct, Google Scholar and Scopus. From the search, a total of 253 articles were screened down to 26 articles. In overall, most of the research focus on readmission rates than mortality rate. On the readmission rate, the lowest is 4.2% by Ramos-Martínez et al. from Spain, and the highest is 19.9% by Donnelly et al. from the United States. Most of the research (n = 13) uses an inferential statistical approach in their studies, while only one uses a machine learning approach. The data size ranges from 79 ...
Background Despite its proven benefits, participation in cardiac rehabilitation (CR) still remain... more Background Despite its proven benefits, participation in cardiac rehabilitation (CR) still remains low globally. The predictors of participation in this programme have been widely studied abroad however, in Malaysia, the data in this field is scarce as the programme is relatively new. Objective The aim of this study is to investigate the relationship between status of participation with sociodemographic, logistic and clinical health status. Methods A cross-sectional study was done in University Malaya Medical Centre, Malaysia. A total of 45 respondents of outpatient Phase II CR were selected through convenient sampling. The respondents completed sociodemographic and logistic survey through face-to-face and telephone-based interview. The clinical health status data were obtained from medical records. Data received were analyse using SPSS version 24.0. The percentage of each variable was calculated and the differences were tested using t-test and chi-square test where applicable. Multiple logistic regression was performed. Statistical significance was set at p <0.05. Results 51% of respondents were participants while 49% were non-participants. Univariate analysis revealed significant difference of more non-participants had medical comorbidities while more participants perceived already exercise (p<0.05). However, multiple logistic regression of the status of participation with sociodemographic, logistic and clinical health status shows no statistical significant predictors in the final model. Discussion Presence of medical comorbidities and exercise status were associated with participation status in CR. Patients education and awareness on CR should be emphasized by health care practitioners. Further studies involving multiple centres with larger cohort of patients should be done to identify predictors for CR participation which can assist the policy maker in structuring the programme to encourage more participation in CR programme
The Journal of Sports Medicine and Physical Fitness, 2022
BACKGROUND Primary knee osteoarthritis is the leading cause of chronic disability and pain among ... more BACKGROUND Primary knee osteoarthritis is the leading cause of chronic disability and pain among adults worldwide. Retro-walking has been shown to reduce patellofemoral pain, increases functional capability while strengthening the lower limbs and improving proprioception and balance. We aim to examine the effects of retro-walking on symptoms, pain, and perceived ability to perform daily activities in comparison to forward-walking in subjects with primary knee osteoarthritis. METHODS This was a single-blinded, randomised control trial involving 34 subjects between the age of 45-70 years (58.41 ± 5.93) comparing retro-walking (RW) to forward-walking (FW). Subjects were randomly allocated to receive either RW with structured resistance training (SRT) or FW with SRT; 3 times a week for 12 weeks. The symptoms, pain, and function of daily living sub scores of the Knee Injury and Osteoarthritis Outcome Score (KOOS) along with Timed up and go (TUG) and Chair stand test (CST) were assessed at baseline and after 12 weeks. The outcomes were analysed with two-way repeated measure analysis of variance. RESULTS Significant improvements for all outcomes were observed intra-group (p-value < 0.05) after 12 weeks. The KOOS sub scores, TUG and CST times was not statistically significant between study groups (pvalue >0.05). However, the partial eta squared scores for all outcomes were better in the RW group compared to FW except for CST. CONCLUSIONS It can be concluded that RW is a feasible and non-inferior option to FW in the rehabilitation of subjects with bilateral knee OA.
Bariatric Surgery - From the Non-surgical Approach to the Post-surgery Individual Care [Working Title], 2020
The bariatric population presents at a greater risk for functional decline with increasing weight... more The bariatric population presents at a greater risk for functional decline with increasing weight and advancing age. This can be prevented at various time points through multidisciplinary rehabilitation interventions in a multitude of different settings to accommodate the severity of an individuals’ disability and to target different functional goals. Bariatric rehabilitation is a multipronged approach that addresses the ongoing functional impairment, medical comorbidities, hospital-related deconditioning and prevents future cardiovascular and musculoskeletal complications from progressing. The emerging concept of utilising rehabilitation interventions and goal-centric approach as means to reduce post-operative complications and enhance surgical outcomes is also discussed. Pragmatic approaches to post-surgical bariatric rehabilitation are discussed highlighting the multi-faceted rehabilitation concerns to achieve optimal functionality in the face of a chronic medical condition.
Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology, 2020
OBJECTIVE The purpose of this study was to assess the validity and reliability of a Turkish versi... more OBJECTIVE The purpose of this study was to assess the validity and reliability of a Turkish version of the Seattle Angina Questionnaire (SAQ) in patients with coronary heart disease (CHD) and angina. METHODS The SAQ was translated from English to Turkish using the back-translation method. It contains 19 questions scored from 1 to either 5 or 6 in 5 domains (physical limitation, angina stability, angina frequency, disease perception, and treatment satisfaction). Cronbach's alpha coefficient was used to evaluate internal consistency. Spearman's rank correlation coefficient was calculated to assess the construct validity. Convergent validity was examined using correlations between the SAQ and the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) and the Nottingham Health Profile. Divergent validity was evaluated using correlations between the SAQ and age, body mass index (BMI), gender, and the marital status of patients. A value of p<0.05 was considered statistically significant. RESULTS Sixty-seven patients were enrolled in the study. The mean age of the study patients was 58.7 years (SD: 10.2). Cronbach's alpha scores of the SAQ, ranging in value from 0.715 to 0.910, demonstrated that this scale is reliable. All of the SAQ scales had a significant correlation with all of the MacNew scales, which indicated that the scale has convergent validity. Insignificant correlations with age, BMI, gender, and marital status illustrated the good divergent validity of the scale. CONCLUSION The Turkish version of the SAQ is a valid and reliable instrument. It is a useful and practical tool to evaluate patients with angina and CHD.
Introduction Pulmonary rehabilitation (PR) could improve health outcomes for the increasing numbe... more Introduction Pulmonary rehabilitation (PR) could improve health outcomes for the increasing number of people with chronic respiratory diseases (CRDs), but programmes need to be adapted to low-resource settings and, in the context of a pandemic, to home-based delivery. Aim To assess the feasibility of delivering a home-PR programme for patients with CRDs in Malaysia. Methods We recruited patients with CRDs from two hospitals in Klang Valley, Malaysia to a Home-PR programme. Following Centre-based assessment, patients performed the exercises at home (five sessions/week for 8 weeks (total 40 sessions)). We monitored the patients via weekly telephone calls and asked about adherence to the programme. We measured functional exercise capacity (6-Minutes walking test (6MWT)) and Health-Related Quality-of-Life (HRQOL: COPD Assessment Test (CAT)) at baseline and post- PR at 9 weeks. We conducted semi-structured interviews with 12 purposively sampled participants to explore views and feedback ...
Introduction Opioids are increasingly used for non-cancer pain control. Studies in cancer patient... more Introduction Opioids are increasingly used for non-cancer pain control. Studies in cancer patients have shown that chronic opioid use could lead to secondary hypocortisolism and hypogonadism of varying degree. We seek to determine this association in an Asian cohort of patients with non-cancer pain and also examine the effect of opioids on other pituitary hormones comparing them to patients who are on non-opioid analgesia. Methods This is a cross-sectional study of patients recruited from pain clinic. Inclusion criteria were patients aged between 18-75 with non-cancer pain on opioids (morphine/oxycodone/fentanyl/tramadol) for more than 3 months. Patients with active cancer or intracranial pathology, who were already on hormone replacement and on long term glucocorticoids or had intra-muscular or intra-articular steroids in the preceding 3 months were excluded. Controls were age and sex matched. All recruited patients had a renal profile, albumin, cortisol, ACTH, fT4, TSH, FSH, LH, I...
Introduction: Illness perceptions involve personal beliefs that patients have about their illness... more Introduction: Illness perceptions involve personal beliefs that patients have about their illness and may influence health behaviour considerably. This preliminary study evaluates the understanding of illness perception among cardiac patients’ and correlations of each of the items. Methods: A preliminary study was conducted using the on Brief Illness Perception Questionnaire (BIPQ) in a tertiary hospital among 40 cardiac patients. Ethical approval was obtained from the institution ethical committee. There are 9 items in the BIPQ with 0-10 response scale measuring causal factors and an open-ended item. Items 1 to 5 assesses on the cognitive illness perception which comprises of consequences, timeline, personal control, treatment control and identity. Item 6 and 8 are on emotional response and item 7 is on coherence. Results: The overall mean score of the 8 items of BIPQ was 7.04 (1.07) with the highest mean for item 4 on treatment control and item 6 on personal control at 8.02 (0.92)...
In this review, current studies on hospital readmission due to infection of COVID-19 were discuss... more In this review, current studies on hospital readmission due to infection of COVID-19 were discussed, compared, and further evaluated in order to understand the current trends and progress in mitigation of hospital readmissions due to COVID-19. Boolean expression of (“COVID-19” OR “covid19” OR “covid” OR “coronavirus” OR “Sars-CoV-2”) AND (“readmission” OR “re-admission” OR “rehospitalization” OR “rehospitalization”) were used in five databases, namely Web of Science, Medline, Science Direct, Google Scholar and Scopus. From the search, a total of 253 articles were screened down to 26 articles. In overall, most of the research focus on readmission rates than mortality rate. On the readmission rate, the lowest is 4.2% by Ramos-Martínez et al. from Spain, and the highest is 19.9% by Donnelly et al. from the United States. Most of the research (n = 13) uses an inferential statistical approach in their studies, while only one uses a machine learning approach. The data size ranges from 79 ...
Background Despite its proven benefits, participation in cardiac rehabilitation (CR) still remain... more Background Despite its proven benefits, participation in cardiac rehabilitation (CR) still remains low globally. The predictors of participation in this programme have been widely studied abroad however, in Malaysia, the data in this field is scarce as the programme is relatively new. Objective The aim of this study is to investigate the relationship between status of participation with sociodemographic, logistic and clinical health status. Methods A cross-sectional study was done in University Malaya Medical Centre, Malaysia. A total of 45 respondents of outpatient Phase II CR were selected through convenient sampling. The respondents completed sociodemographic and logistic survey through face-to-face and telephone-based interview. The clinical health status data were obtained from medical records. Data received were analyse using SPSS version 24.0. The percentage of each variable was calculated and the differences were tested using t-test and chi-square test where applicable. Multiple logistic regression was performed. Statistical significance was set at p <0.05. Results 51% of respondents were participants while 49% were non-participants. Univariate analysis revealed significant difference of more non-participants had medical comorbidities while more participants perceived already exercise (p<0.05). However, multiple logistic regression of the status of participation with sociodemographic, logistic and clinical health status shows no statistical significant predictors in the final model. Discussion Presence of medical comorbidities and exercise status were associated with participation status in CR. Patients education and awareness on CR should be emphasized by health care practitioners. Further studies involving multiple centres with larger cohort of patients should be done to identify predictors for CR participation which can assist the policy maker in structuring the programme to encourage more participation in CR programme
The Journal of Sports Medicine and Physical Fitness, 2022
BACKGROUND Primary knee osteoarthritis is the leading cause of chronic disability and pain among ... more BACKGROUND Primary knee osteoarthritis is the leading cause of chronic disability and pain among adults worldwide. Retro-walking has been shown to reduce patellofemoral pain, increases functional capability while strengthening the lower limbs and improving proprioception and balance. We aim to examine the effects of retro-walking on symptoms, pain, and perceived ability to perform daily activities in comparison to forward-walking in subjects with primary knee osteoarthritis. METHODS This was a single-blinded, randomised control trial involving 34 subjects between the age of 45-70 years (58.41 ± 5.93) comparing retro-walking (RW) to forward-walking (FW). Subjects were randomly allocated to receive either RW with structured resistance training (SRT) or FW with SRT; 3 times a week for 12 weeks. The symptoms, pain, and function of daily living sub scores of the Knee Injury and Osteoarthritis Outcome Score (KOOS) along with Timed up and go (TUG) and Chair stand test (CST) were assessed at baseline and after 12 weeks. The outcomes were analysed with two-way repeated measure analysis of variance. RESULTS Significant improvements for all outcomes were observed intra-group (p-value < 0.05) after 12 weeks. The KOOS sub scores, TUG and CST times was not statistically significant between study groups (pvalue >0.05). However, the partial eta squared scores for all outcomes were better in the RW group compared to FW except for CST. CONCLUSIONS It can be concluded that RW is a feasible and non-inferior option to FW in the rehabilitation of subjects with bilateral knee OA.
Bariatric Surgery - From the Non-surgical Approach to the Post-surgery Individual Care [Working Title], 2020
The bariatric population presents at a greater risk for functional decline with increasing weight... more The bariatric population presents at a greater risk for functional decline with increasing weight and advancing age. This can be prevented at various time points through multidisciplinary rehabilitation interventions in a multitude of different settings to accommodate the severity of an individuals’ disability and to target different functional goals. Bariatric rehabilitation is a multipronged approach that addresses the ongoing functional impairment, medical comorbidities, hospital-related deconditioning and prevents future cardiovascular and musculoskeletal complications from progressing. The emerging concept of utilising rehabilitation interventions and goal-centric approach as means to reduce post-operative complications and enhance surgical outcomes is also discussed. Pragmatic approaches to post-surgical bariatric rehabilitation are discussed highlighting the multi-faceted rehabilitation concerns to achieve optimal functionality in the face of a chronic medical condition.
Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology, 2020
OBJECTIVE The purpose of this study was to assess the validity and reliability of a Turkish versi... more OBJECTIVE The purpose of this study was to assess the validity and reliability of a Turkish version of the Seattle Angina Questionnaire (SAQ) in patients with coronary heart disease (CHD) and angina. METHODS The SAQ was translated from English to Turkish using the back-translation method. It contains 19 questions scored from 1 to either 5 or 6 in 5 domains (physical limitation, angina stability, angina frequency, disease perception, and treatment satisfaction). Cronbach's alpha coefficient was used to evaluate internal consistency. Spearman's rank correlation coefficient was calculated to assess the construct validity. Convergent validity was examined using correlations between the SAQ and the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) and the Nottingham Health Profile. Divergent validity was evaluated using correlations between the SAQ and age, body mass index (BMI), gender, and the marital status of patients. A value of p<0.05 was considered statistically significant. RESULTS Sixty-seven patients were enrolled in the study. The mean age of the study patients was 58.7 years (SD: 10.2). Cronbach's alpha scores of the SAQ, ranging in value from 0.715 to 0.910, demonstrated that this scale is reliable. All of the SAQ scales had a significant correlation with all of the MacNew scales, which indicated that the scale has convergent validity. Insignificant correlations with age, BMI, gender, and marital status illustrated the good divergent validity of the scale. CONCLUSION The Turkish version of the SAQ is a valid and reliable instrument. It is a useful and practical tool to evaluate patients with angina and CHD.
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Papers by Anwar Suhaimi