Psychiatric Manifestations in Orthopedic Patients on Celecoxib Therapy

Introduction: The Cyclooxygenase-2 (COX-2) enzyme is responsible for the synthesis of prostaglandin which is responsible for inflammation and pain. Celecoxib a cyclooxygenase-2 inhibitor was first used as a non-steroidal anti-inflammatory drug in 1999. Celecoxib is as effective as NSAIDs but causes less ulceration of the gastrointestinal tract, hence it is commonly used. It has been widely used in patients with osteoarthritis and rheumatoid arthritis. We present 3 cases of temporary psychiatric disorders associated with consumption of celecoxib,two of the patients presented with auditory hallucinations while one was diagnosed to be having depression. None had pre-existing psychiatric disorders or consumed alcohol or substance of abuse. All 3 patients recovered from their temporary psychiatric disorders after stopping celecoxib.Discussion: It is important to be aware of the psychiatric side effects when prescribing the drug for prolonged periods

Computer Aided Learning Knowledge among Medical Students in the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

Computer proficiency has become necessary in many areas of medicine, administration, clinical practices, research, as well as education. The need for greater competence in information and communication technologies (IST) by doctors and medical students is increasingly recognised. Objectives: This study was undertaken to determine the knowledge, attitude and practices on ICT in the medical students of a local university. Methods: A cross-sectional descriptive study was conducted among medical students (Years 1-5) from December 2005 to May 2006 in Universiti Putra Malaysia. A self-administered questionnaire was used to collect data. Descriptive statistics were used to obtain frequencies for allvariables studied. Results: There were 343 respondents aged 18-29 years old. The results showed 82.2% of the respondents (82.2%) were comfortable using computers after enteringmedical school and 89.2% believed that ICT and computers skills are important for doctors. About 81.3% of the respondents were aware of the role of ICT and computers in learning medicine, 90.4% had used presentation packages, and 83.4% used word processing and search engines as software tools. Conclusion: The findings of this study show that medical students are knowledgeable and do have skills in information technology (IT) and computers. They are also aware of the role of information technology (IT) and computers in medicine

A National Study on the Prevalence and Factors Associated with Smoking Amongst Malaysians Aged 18 Years and Above

Objective: A cross-sectional study was conducted in Malaysia with the objectives of determining the prevalence of smoking in Malaysia, reasons for starting to smoke, age first started to smoke, duration of smoking and to determine the relationship between smoking and age, sex,race, education level, peer influence and parental smoking status. Methods:All residents aged 18 years and above from selected households were included in this study. A standardised pre-tested structured questionnaire was used in this study. Results: The results showed that the overall mean age of the 17.246 respondents was 38.8 (95% CI=38.5-39.2) years with a range of 18-100 years. The majority were Malays (55.5%) followed by Chinese (21.2%) and Indians (11.2%). The age , sex and ethnicity adjusted prevalence of ever and current smokers were 32.0% and 24.9% respectively. The prevalence of ever and current smokers for males was 59.3% and 47.2% respectively. For the females,the prevalence of ever and current smokers was 4.8% and 2.7% respectively. The highest ethnicity adjusted prevalence of current smokers was in Malays (28.9%) followed by the Chinese (18.7%). The lowest prevalence was amongst the Indians (16.8%). The highest prevalence of current smokers was found in Kelantan (30.2%), Terengganu (29.7%), Pahang (28.7%) and Kedah (26.9%); the lowest prevalence was in Kuala Lumpur, Federal Territory (20.4%). The overall mean initiation age of current smokers was 19.2 years (95% CI=19.1. 19.4 years). The mean initiation age of male current smokers was significantly lower (18.9 years) compared to female current smokers(24.1 years). The mean duartion of smoking amongst the current smokers was 18.6 years .Males smoked significantly more cigarettes than the females (p<0.001). Discussion: Multivirate logistic regression analysis showed that smoking was significantly associated with age, sex, ethnicity, educational level and peer and family influence.

Effectiveness of Different SSRI Antidepressants in Combination with CBT for Short-term Management of Panic Disorder

Objective: This paper reports the result of an analysis of data of brief therapy for out-patients with panic disorder reffered by physicians in a busy specialist hospital in Kuala Lumpur. Methods: The patients were randomly assigned into different groups of SSRI (Specific Serotonin Reuptake Inhibitor) antidepressants i.e. escitalopram, setraline, or fluoxetine. All patients received cognitive behaviour therapy (CBT). The therapy was aimed for a maximum of twelve sessions. There were 33 patients in the escitalopram group, 31 patients in the setraline group, and 31 patients in the fluoxetine group. Results: the result shows that all the groups were similar in the severity and scores for pre-treatment but for post-treatment, there were significant differences among them. Conclusion: All groups showed significant improvements in all modalities of measurements. However, the escitalopram and setraline groups showed faster overall improvement compared to the fluoxetine group.