ABSTRACT
@#Introduction: Treatment adherence with antiretroviral therapy (ART) and its related factors have hitherto been the subject of clinical concern. However, research focusing on the relationships between ART adherence and the presence of psychological distress and selected personality traits have yet to be concluded. Therefore, our study aimed to remedy this. Methods: A multicentre hospital-based cross-sectional study was conducted in northwest Peninsular Malaysia on HIV outpatients given ART from July 1st, 2018, till April 31st, 2020. Participants were recruited via purposive sampling. Data were collected through an interviewer-guided questionnaires: Hospital Anxiety and Depression Scale (HADS) and Zuckerman-Kuhlman personality test (ZKPQ-M-40-CC), and interviewer-guided Timeline Follow-back (TLFB) for the assessment of adherence to ART. Results: A total of 229 patients completed the study. Majority (n=220, 96.1%) were considered adherent to ART. Among those who were non-adherent, two (22.2%) had anxiety disorder and five (55.6%) had depressive disorder. There was no significant association between treatment adherence and the presence of anxiety nor depression. However, sociodemographic factors determined that age group (p=0.033) and marital status (p=0.044) were significantly associated with treatment adherence. Multivariate analysis determined that ‘Active’ personality trait increases the likelihood to better treatment adherence by 1.14 times (95% CI: 1.02, 1.28, p=0.018). Conclusion: We did not find any association between treatment adherence and the presence of anxiety or depression. However, higher scores in ‘Active’ personality trait increases the likelihood of better treatment adherence among adult HIV on ART.
ABSTRACT
@#Introduction: Methadone maintenance therapy (MMT) requires a client to take a daily dose of methadone to reduce cravings for opioid and suppress withdrawal syndrome. Non-retention in the MMT will seriously expose more risk rather than the benefits of the program. Hence, determining the factors associated with non-retention to the MMT is essential. Thus, the present study was conducted to determine the proportion of non-retention and its associated factors among clients receiving MMT in Kelantan, Malaysia. Methods: By using a retrospective record review analysis, the required information of the clients was obtained from fourteen MMT clinics in Kelantan, Malaysia. A total of 155 clients were selected in this study using systematic random sampling. Multiple logistic regression analysis was performed to determine the factors associated with non-retention among clients receiving MMT. Results: It was found that the proportion of non-retention to the MMT in Kelantan, Malaysia was 21.9%. Clients with advanced age, taking daily direct observed therapy, and no underlying HIV were the predictors of non-retention among clients receiving MMT in Kelantan, Malaysia. Conclusion: The findings highlight a relatively high proportion of non-retention among the MMT clients. There is a need for an integrated, culturally relevant approach towards tackling the factors associated with non-retention in the future to keep this program sustainable and effective.
ABSTRACT
Poor sleep quality was frequently reported by opioid dependence patients during methadone maintenance therapy [MMT]. The study investigated a sample of patients on MMT to investigate the severity and prevalence of sleep problems in MMT patients. We evaluated sleep quality and disturbances of 119 Malay male patients from MMT clinics in Kelantan, Malaysia between March and July 2013 using the Pittsburgh Sleep Quality Index [PSQI]-Malay version. Patients' demographic, clinical data, past drug history and methadone treatment variables were recorded. Patients averaged 37.5 years of age [SD 6.79] and their mean age of first time illicit drug use was 19.3 years [SD 4.48]. Their mean age of entering MMT was 34.7 years [SD 6.92] and the mean duration in MMT was 2.8 years [SD 2.13]. The mean current daily dosage of methadone was 77.8 mg [SD 39.47] and ranged from 20 to 360 mg. The mean global PSQI score was 5.6 [SD 2.79] and 43.7% patients were identified as 'poor sleepers' [global PSQI scores >5]. This study confirms the poor overall sleep quality among patients on MMT. The prevalence and severity of sleep problems in MMT patients should not be underestimated
ABSTRACT
We report a case 35-year-old lady who developed acute psychosis following administration of cefuroxime and metronidazole. Earliest mood changes occurred on the second day of antibiotics therapy. She developed hallucinations, delusions and bizarre behavior 1 day after the completion of the antibiotic therapy. All the relevant investigations including CT brain were normal. The psychosis resolved completely within 5 days of antipsychotic treatment.