RESEARCH DIGEST
Research Digest is a selection of original research done by Malaysian authors. The selection is focused on topics that are felt to be of clinical relevance to primary care physicians. This Research Digest is abstracted by CL Teng
Half of the primary care attendees in Kuching use complementary and alternative medicine
Lee PY, Abang Bennett AT, Lin K, et al. Usage of complementary and alternative medicine among primary care clinic attendees, Kuching, Sarawak, Malaysia, January - April 2004. Asia Pacific Family Medicine. 2007;6(1). [Full text]
Primary author’s affiliation: Universiti Malaysia Sarawak, Sarawak.
This is a cross-sectional survey of 181 attendees (age >15) from three primary care clinics in Kuching, Sarawak for the utilisation of complementary and alternative medicine (CAM). About half of them (51.4%) used CAM. Among the CAM users, the common type of CAM used were massage (36.2%) and herbal medicine (25.1%). Over one-third (37.8%) of these CAM users combined the CAM with medication prescribed by their doctors.
Editor’s note: Many surveys on the utilisation of CAM among Malaysian patients have been done; below are some of them:
- Goh E, Tan LC, Chow SK, et al. Use of complementary medicine in systemic lupus erythematosus patients in Malaysia. APLAR Journal of Rheumatology. 2003; 6(1):21-5.
- Ismail IA, Chan SC. Knowledge and practice of complementary medicine amongst public primary care clinic doctors in Kinta district, Perak. Med J Malaysia. 2004; 59(1):4-10. [PubMed]
- Jamaiah I, Koh YH, Lubnah H, et al. A survey of patients seeking alternative medicine in outpatient clinics. Journal of the Malaysian Society of Health. 2000;18:11-20.
- Mahfudz AS, Chan SC. Use of complementary medicine amongst hypertensive patients in a public primary care clinic in Ipoh. Med J Malaysia. 2005;60(4):454-9. [PubMed]
- Mirnalini K, Lee LC. Dietary supplementation and alternative medicine use among Malaysian cancer survivors. Asia Pac J Clin Nutr. 2006;15(Suppl 2):S19.
- Mokhtar N, Chan SC. Use of complementary medicine amongst asthmatic patients in primary care. Med J Malaysia. 2006;61(1):125-7. [PubMed]
- Nik Hazlina NH, Norlina M, Che Hasanah CI, et al. A preliminary report of a study on the psychosocial impact and the use of alternative medicine practices (homeopathy and traditional) on the infertile female. Free Paper 06. 8th IAMANEH World Conference, 21-24 August 2003, Kuala Lumpur, Malaysia.
- Remli R, Chan SC. Use of complementary medicine amongst diabetic patients in a public primary care clinic in Ipoh. Med J Malaysia. 2003;58(5):688-93. [Pubmed]
- Taha AB, Lee PY, Lin K, et al. Anxiety and depression in the primary health care clinics and the use of complementary and alternative medicine. International Medical Journal (Tokyo). 2005;12(2):93-7.
The Edinburgh Claudication Question is specific but not sensitive for the detection of peripheral vascular disease diagnosed using the ankle brachial pressure index
Rabia K, Khoo EM. Is the Edinburgh Claudication Questionnaire a good screening tool for detection of peripheral arterial disease in diabetic patients? Asia Pacific Family Medicine. 2007;6(1). [Full text]
Primary author’s affiliation: University of Malaya Medical Centre, Kuala Lumpur
Two hundred diabetic patients (age >18) were evaluated using the Edinburgh Claudication Questionnaire (ECQ). Subsequently ankle brachial pressure index (ABPI) was assessed in all of them; ABPI <0.9 on either leg was diagnosed as having peripheral arterial disease (PAD). The overall prevalence of PAD was 16% (based on ABPI). The ECQ had low sensitivity (25%) but a high specificity (99.4%), with a positive predictive value of 88.9% and a negative predictive value of 88% for diagnosing PAD in patients with diabetes.
NS1 antigen-capture ELISA kit has high sensitivity and specificity for the detection of serologically confirmed acute dengue infection
Kumarasamy V, Wahab AH, Chua SK, et al. Evaluation of a commercial dengue NS1 antigen-capture ELISA for laboratory diagnosis of acute dengue virus infection. J Virol Methods. 2007;140(1-2):75-9. [PubMed]
Primary author’s affiliation:National Public Health Laboratory, Sg Buloh, Kuala Lumpur.
Platelia Dengue NS1 Ag is a commercially available ELISA kit that tests for the unique non-structural protein formed during dengue virus replication. When evaluated based on 224 sera of dengue patients (serologically confirmed), the dengue NS1 antigen-capture ELISA gave an overall sensitivity of 93.4% and a specificity of 100%. The sensitivity was significantly higher in acute primary dengue (97.3%) than in acute secondary dengue (70.0%).
Biogeneric erythropoietin is therapeutically equivalent to Eprex in haemodialysis patients
Goh BL, Ong LM, Sivanandam S, et al. Randomized trial on the therapeutic equivalence between Eprex and GerEPO in patients on haemodialysis. Nephrology (Carlton). 2007;12(5):431-6. [PubMed] [Full text]
Primary author’s affiliation: Serdang Hospital, Selangor.
Eprex, the human recombinant erythropoietin, is well established as a treatment for renal anaemia but is limited by its high cost. In a randomised open-label clinical trial conducted among 186 haemolysis patients in 26 centres in Malaysia, GerEPO (a biogeneric epoetin) was found to be therapeutically equivalent to Eprex at the end of 12 weeks. However, the study duration is too short for safety evaluation.
Esomeprazole is therapeutically equivalent to pantoprazole for the maintenance treatment of previously healed gastro-oesophageal reflux disease
Goh KL, Benamouzig R, Sander P, Schwan T. Efficacy of pantoprazole 20 mg daily compared with esomeprazole 20 mg daily in the maintenance of healed gastroesophageal reflux disease: a randomized, double-blind comparative trial - the EMANCIPATE study. Eur J Gastroenterol Hepatol. 2007; 19(3):205-211. [PubMed]
Primary author’s affiliation: University of Malaya Medical Centre, Kuala Lumpur
