First trimester placenta accreta is a rare occurrence but potential life threatening and catastrophic. Most of these
cases ended up with emergency hysterectomy. We report a case of incidental finding of placental accreta during
evacuation of retained product of conception (ERPOC) for missed miscarriage. A 33-year-old, Gravida 4 Para 2 + 1
at 15 weeks’ gestation admitted for missed miscarriage, failed medical evacuation requiring ERPOC. There was
excessive bleeding during the procedure and required hysterectomy and bilateral internal iliac artery ligation.
Histopathological examination confirmed products of conception with evidence of placenta accreta. This case
highlighted the diagnostic dilemma and importance of early accurate diagnosis of placental accreta prior to any
surgical intervention for miscarriage.
Breast carcinoma to the colon and rectum is rare type of metastatic spread. We report a case of colonic metastasis
from a lobular carcinoma of the breast twelve years after the initial diagnosis. Accurate diagnosis and early treatment
of systemic therapy can be done if awareness is increased.
MeSH terms: Breast; Breast Neoplasms; Colon; Humans; Rectum; Carcinoma, Lobular
A 23-year-old lady presented with both eye progressive painless blurring of vision for two weeks in 2011. Prior to that she had malar rash, hair loss, photosensitivity and bilateral leg swelling. Ocular examination showed that visual acuity on the right was 6/60 and on the left was 6/24. Both optic disc were swollen with extensive peripapillary cotton wool spot (CWS), flame shape haemorrhages, dilated and tortuous vessels with macular oedema. Systemic examination revealed blood pressure of 176/111 mmHg, malar rash and alopecia. Diagnosis of grade 4 hypertensive retinopathy secondary to SLE was made. The diagnosis was confirmed by positive ANA/ dsDNA, low C3/ C4 and renal biopsy showed lupus nephritis. She was treated with oral prednisolone, hydroxychloroquine and cyclosporin A. Throughout the monitoring for hydroxychloroquine toxicity, vision over both eyes were 6/9, but serial visual fields showed non-progressive left superior and inferior scotoma while right eye showed inferior scotoma. The intraocular pressure was normal with pink optic disc and cup disc ratio of 0.3. Optical coherence tomography (OCT) showed temporal and nasal retinal nerve fiber layer thinning bilaterally. However, macula OCT, fundus fluorescein angiography and autofluorescence were normal. The visual field defect was concluded secondary to CWS indicating microinfarction of the retinal nerve fiber secondary to previous hypertensive retinopathy. Non-progressive visual field defects may occur after the appearance of CWS in hypertensive retinopathy and it should not be overlooked when diagnosing glaucoma or hydroxychloroquine toxicity.
Congenital peritoneal band is an extremely rare condition, but may induce small bowel obstruction (SBO) at any age, predominantly in childhood and rarely in adults. We report a case of extensive bowel ischaemia following caesarean section, due to trapping of an intestinal loop between a congenital peritoneal band and the mesentery. A 42-year-old, Gravida 2 Para 1, who has no history of prior abdominal surgery or trauma, presented in spontaneous labour and underwent an uncomplicated emergency lower segment caesarean section, for fetal distress. Postoperatively, she had worsening abdominal distension and pain, followed by vomiting. Computed Tomography Scan of the abdomen showed gross fluid retention with marked small bowel dilatation and fluid filled bowel loops. An emergency exploratory laparotomy was performed which revealed a congenital band, extending between the right fimbrial end and the small bowel mesentery, looping over the small bowel, causing extensive small bowel ischemia. Post-operative course was uneventful. In conclusion, congenital peritoneal band causing small bowel obstruction, although rare, should be considered in the differential, especially for patients with virgin abdomen.
Schwannomas are benign tumours arising from neurilemmal cells which forms the myelin sheath of peripheral nerves. It usually occurs in the head, but may be found in the brachial plexus and sciatic nerve. Common peroneal nerve schwannoma are rare. We report a case of a middle age gentleman who presented with pain and swelling over the right popliteal fossa with associated right radicular pain of the anterolateral leg and weakness of ankle dorsiflexion. Examination revealed a 3x2 cm lump behind the posterolateral aspect of the right knee with positiveTinel’s sign upon tapping of the lump, sensory deficit over the anterolateral aspect of the leg and the ankle dorsiflexors had a muscle power of grade 3. Magnetic resonance imaging (MRI) of the right leg revealed a well circumscribed, oval lesion located along the pathway of the common peroneal nerve homogenously hypointense on T1-weighted images and heterogeneously hyperintense on T2 weighted images compared to the muscles. The lesion was not surpressed on fat suppression sequences. Intra-operatively, we noted that the schwannoma was in continuity with the common peroneal nerve. The patient underwent excision of the schwannoma. Post operatively, the pain reduced remarkably but patient suffers from numbness and right foot drop as a complication of the tumour. This case highlights the rarity of common peroneal nerve schwannoma which presents with neuropathic symptoms complicated with right foot drop.
Retinal detachment is one of the common complications of pathological myopia due to presence of retinal break.
However, retinal break commonly occurs in the peripheral retina. This case report illustrates the rare incidence of
retinal break adjacent to the optic disc, highlights the possible causes of poor visual outcome following surgical
repair as well as the possible measures to treat the complications.
Pneumatic retinopexy is known as one of the treatment options for a specific type of retinal detachment. It is done in
an office setting and may be the most cost-effective means of retinal reattachment surgery. Location and size of the
retinal break remain as the major criteria for a successful outcome. We describe a case that fulfilled all except one
major criteria for pneumatic retinopexy and underwent multiple procedures but failed. Fluctuation in the resolution
of the retinal detachment such as in this particular case suggested possibility of early treatment failure.
Hematospermia is a distressing disorder in sexually active men resulting in great concern to the patient. We report an unusual case of hematospermia with an atypical presentation, involving a 54-year-old man presented with acute urinary retention after sexual intercourse. Although the causes are widely known, arteriovenous malformation as the cause of this disorder has not much been reported in the literature. Transcatheter embolization of internal pudendal artery is a promising option for hematospermia caused by arterial fistula or bleeding.
Gastrointestinal stromal tumour (GIST) is extremely rare with reported incidence of 20 per million per year. It is the most common mesenchymal tumour of the gastrointestinal tract. When it occurs at the pelvis in a female patient, it can be misleading to a gynaecological diagnosis. Non gynaecological diagnosis such as GIST must be considered in patients with pelvic mass presenting with atypical symptoms.
Rapunzel syndrome, or generically known as trichobezoar, is a rare condition. It usually happens among teenage population. We are presenting a case report of Rapunzel syndrome that happened in a 4-year-old child. She was initially investigated for nephrotic syndrome, as she had high blood pressure and hypoalbuminaemia. However, it was later found out to be a trichobezoar, indirectly causing both hypertension and malnutrition. This condition demanded a combination of surgical and psychiatric discipline for diagnosis and its treatment.
It is significant for the reverts to have an existing helping organization. Therefore, this study aims to identify organizational issues that are directly and indirectly involved with counsellors at the Council of Islamic Religious Department in Malaysia. This study utilizes a qualitative approach by using the case study method. This study involved five (5) counsellors from Council of Islamic Religious Department in Malaysia. This study used the N'Vivo 10.0 for the data analysis to develop themes and sub-themes that related to this study. The findings showed that there are two (2) sub themes involved both government and non-government. There are six (6) sub-sub themes for the government which are Jabatan Agama Islam, Jabatan Mufti, Pusat Dakwah Islamiah, Pusat Kaunseling MAINS Negeri Sembilan, Jabatan Kehakiman and Baitulmal. While, non-government has ten (10) sub-sub themes; Lembaga Kaunselor Malaysia, Unit Saudara Baru, Unit Ukhuwah, Pusat Saudara Baru Darul Saadah, Darul Ukhuwah Yayasan Kasih Sayang, Volunteer Body, Malaysian Chinese Muslim Association (MACMA), Pertubuhan Kebajikan Islam Malaysia (PERKIM), PERKAMA and Skuad Mubaligh Seremban. In conclusion, this study could be used as a guide for counsellors to provide guidance and counselling services to revert clients.
This study aims to determine the mediating effects of coping strategies on the relationships between organizational support (supervisor and coworker support) and work-family conflict. A questionnaire survey approach was conducted with the purposive sampling. This study was contributed to 342 married employees from different organizations in the Luangprabang province, Laos. The gathered data was analyzed by employing the Structural Equation Modeling using SPSS Amos 21.0 software. The findings showed that organizational support (supervisor support and coworker support) was not significantly related to work-family conflict. Problemfocused coping was not significantly related to work-family conflict, whereas emotion-focused coping was significantly related to work-family conflict. This is one of the first studies to provide empirical evidence in terms of the mediating effects regarding coping strategies among married employees in Laos. The organizations should consider the coping strategies and the support from supervisors and colleagues in formulating strategies to minimize work-family conflict. Additionally, problem-focused coping is a more meaningful predictor of work-family conflict than emotion-focused coping. Providing the training of the comprehensive coping program to the employees could help them to be sensitive in coping work-family conflict. This study could serve as an important guideline to develop planning strategies in managing work and family role and promoting work-life balance among the employees.
MeSH terms: Adaptation, Psychological; Emotions; Family Relations; Laos; Marriage; Surveys and Questionnaires; Software; Family Conflict; Work-Life Balance
This research was aimed to study the relationship between attachment style and relationship quality among young couples. A correlational research design was adopted to answer the objectives of this study. A total of 257 students of Universiti Malaysia Sarawak (UNIMAS), Sarawak participated in this study. Two types of questionnaire were used in this study; the Experience in Close Relationship (ECR) to measure the attachment styles, and Couples Satisfaction Index (CSI) to measure the relationship satisfaction of the couples. The results showed that there was a significant relationship between attachment style and relationship quality among the young couples in UNIMAS. Attachment avoidance and attachment anxiety had a significant effect on the relationship quality of the young couples. It is suggested for future studies to consider selecting the samples by using simple random sampling as the targeted population would be able to represent the whole population and the result would be more accurate.
MeSH terms: Anxiety; Anxiety Disorders; Malaysia; Personal Satisfaction; Surveys and Questionnaires; Students
Parental involvement during early childhood development is important especially when the child has learning disabilities. This research aims to study the effectiveness of parental-based speech training programs for preschoolers with Speech Language Impairments (SLI) in a localized setting. The method used was qualitative and data was collected from selected preschoolers (N = 5) with different types of SLI symptoms. Each participant was assessed using a standardized assessment protocol to measure his/her language scale. The participants were given the intervention program by their own parents using the Hanen’s It Takes Two to Talk program. The progress of each subject and observations from these sessions were documented. The participants were assessed again once the intervention had been implemented. Substantial results were achieved when all subjects showed improvements in language comprehension and production skills. These results highlight the importance of parental involvement as first teachers in the early intervention of children with SLI.
Web 2.0 has given opportunities in letting students learn through active collaboration
with and from their peers. The purpose of this study is to explore interactions that
happens between learners, types of contributions made and learners’ experience when
collaborating in a Web-based context. The finding shows that the learners contribute
in terms of adding, editing and deleting content and structure of their report. The learners’
pattern of interaction shows that the learners with higher level of English proficiency
are more dominant towards learners with lower level of proficiency. Students
feedback shows that they are accepting the idea of writing collaboratively. Overall,
the learners gave positive response towards the use of Google Docs in collaboratively
completing their report writing project.
Dyslexia is a language disorder that leads to difficulty with words and it is the most common type of learning disability. This article presents a systematic review on the current state of assistive technologies used in improving the learning process of learn-ers with dyslexia. A total of 25 journals articles and international conference papers published between 2000 and 2014 were included in the review. The research articles were collected from 12 databases and analyzed based on the qualitative cyclical pro-cess. A majority of the studies focused on children and adolescents. Four main themes on the types of technologies used in aiding the learning process of learners with dys-lexia are derived and discussed. These include text-to-speech, eye-tracking, virtual learning environments, and games. The text-to-speech technology is the most common type of technology used by learners with dyslexia. In terms of the roles played by the assistive technologies, another four emerging themes are identified, which cover the roles of aiding reading, writing, memory, and mathematics. The review also discovers that a majority of these studies focus on the use of technologies for improving the reading ability of learners with dyslexia.
The global drop in oil and natural gas industry have had a significant impact on the
Malaysian market and have potentially redirected Malaysia under a negative global
spotlight. The layoff rate in oil and natural gas organizations have risen dramatically,
this situation may affect the satisfaction level among employees and their loyalty in
the respective oil and natural gas industry. The present study is aimed to determine the
relationship between employee satisfaction and employee loyalty in Oil and Natural
Gas Industry. Using simple random sampling technique 100 employees working in Oil
and Natural Gas Industry were selected as respondents. Questionnaire was used for
data collection. Results obtained showed that there is positive correlation between different
components of employee satisfaction and employee loyalty. A notable variable
that emerged in the analysis was compensation and benefits, while career development
was least important that predisposed loyalty.
MeSH terms: Oil and Gas Industry; Industry; Malaysia; Personal Satisfaction; Surveys and Questionnaires; Natural Gas
Visual Simultaneous Localization and Mapping (vSLAM) system is widely used by autonomous mobile robots. Most vSLAM systems use cameras to analyze surrounding environment and to build maps for autonomous navigation. For a robot to perform intelligent tasks, the built map should be accurate. Landmark features are crucial elements for mapping and path planning. In the vSLAM literature, loop closure detection is a very important process for enhancing the robustness of the vSLAM algorithms. The most widely used algorithms for loop closure detection use a single descriptor. However, the performance of the single descriptors appears to worsen as the map keeps growing. One possible solution to this problem is to use multiple descriptors and combine them as in Naive and linear combinations. These approaches, however, have weaknesses in recognizing the correct locations due to overfitting and highbias, which hinder the generalization performance. This paper proposes the usage of ensemble learning to combine the predictions of multiple Bayesian filter models which make more accurate prediction than individual models. The proposed approach is validated on three public datasets; namely, Lip6 Indoor, Lip6 Outdoor and City Centre. The results show that the proposed ensemble algorithm significantly outperforms the single approaches with a recall of 80%, 97% and 87%, with 100% precision on the three datasets, and outperforms the Naive approach and the existing loop closure detection algorithms.
Blood cancer is an umbrella term for cancers that affect the blood, bone marrow and lymphatic system. There are three main groups of blood cancer: leukemia, lymphoma and myeloma. Some types are more common than others. In this paper, a new image transform based on geometric mean properties of integral values in both horizontal and vertical image directions is proposed for leukemia cancer cell classification. Available classification methods using the classical feature extraction methods which are sensitive to rotation and deformation of the blood cells. The new transform is based on geometric mean projection, which —unlike other image transforms, such as Radon transform— is not considered all signals in an image with the same signal acquisition rate. Instead, it is general and thus applicable to all capturing signal functions to achieve sufficient invariant features. The geometric mean projection transforms (GMPT) guarantees that the detector only extracts the highly informative information from the object to achieve an invariant feature vector for an accurate classification process. This method has been used as cancer cell identification using microscopic Imagery analysis in this study. Dissimilarity metric calculation and shape analysis by using image transform has been used to extract the feature vectors of the imagery. Then, the accumulated feature vectors have been classified to different classes by using artificial neural network (ANN). The proposed technique has been evaluated in the standard images sourced from USIM, Malaysia. The evaluation results indicate the robustness of the technique in different types of images available in the dataset.
K-Means is an unsupervised method partitions the input space into clusters. K-Means algorithm has a weakness of detecting outliers, which have it available in many variations research fields. A decade ago, Rough Sets Theory (RST) has been used to solve the problem of clustering partition. Specifically, Rough K-Means (RKM) is a one of the powerful hybrid algorithm, which has it, has various extension versions. However, with respect of the ideas of existing rough clustering algorithms, a suitable method to detect outliers is much needed now. In this paper, we propose an effective method to detect local outliers in rough clustering. The Local Outlier Factor (LOF) method in rough clustering improves the quality of the cluster partition. The improved algorithm increased the level of clusters quality. An existing algorithm version, the π Rough K-Means (π RKM) tested in the study. Finally, the effectiveness of the algorithm performance is demonstrated based on synthetic and real datasets.