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Fulltext Ruptured Testicular Abscess: A Rare Complication of Epididymo-Orchitis

Lee CY, Abu Syazwan, Syed Omar, Syahril Anuar, Hamid Ghazali, Mohd Nazli, et al.

IIUM Medical Journal Malaysia, 2019;18(101):8-0.
MyJurnal

Epididymo-orchitis is a medical condition characterised by inflammation of epididymis and testis which is a common urological diagnosis encountered by healthcare professionals. Misdiagnosis and under treatment can lead to poor outcome such as infarction and abscess formation.We presented a33-year-old man, with no known medical illness, presented with one-week history of left testicular pain, swelling and fever. He was commenced on Amoxicillin by his general practitioner. Physical examination showed left swollen and tender testis and normal right testis. Investigations showed an elevated white cell count (WCC) 41.3x103 /L and colour doppler ultrasound (USG) testes showed left epididymo-orhitis.He was admitted and treated with IV Unasyn®(Ampicillin+Sulbactam) for 5 days. His symptoms improved, and he discharged home well with one week oral Unasyn®. He represented 2 weeks later with worsening left scrotal swelling and pain. Clinical examination found a swollen, tender and erythematous scrotum with 1x1cm defect in the left scrotum with purulent discharge.He underwent operation incision and drainage of left scrotum and left orchidectomy. Post-operatively he recovered well. Histopathology reported as epididimo-orchitis with abscess, necrosis and perforation.As a conclusion, testicular rupture and abscess formation secondary to epididymo-orchitis is an uncommon reported complication. Immediate recognition and treatment is crucial as a delayed diagnosis can lead to sepsis and infertility.
Fulltext Management of Traumatic Perineal DeglovingInjury: A Case Series

Lee CY, Abu Syazwan, Syed Omar, Syahril Anuar, Hamid Ghazali, Islah Munjih, et al.

IIUM Medical Journal Malaysia, 2019;18(101):9-0.
MyJurnal

Degloving injury is severe and commonly results from a huge rotational force which avulses the skin and subcutaneous tissue from its underlying fascia. This injury is associated with high morbidity and mortality if mismanaged. Perineal degloving injury commonly associated with urethral injury which can be further classified into anterior and posterior urethral injury. This study retrospectively evaluated management of traumatic perineal degloving injury compared to standard approach.A total of 3 cases of open perineal degloving injuries been identified and was managed at our centre at the year 2017. 2 cases of degloving wound of scrotum and one case of crush perineal injury with transected posterior urethral were included. We reviewed methods of management and clinical outcomes of these patients. All patients promptly underwent wound debridement and surgical repair after immediate diagnosis and resuscitation. Suprapubic insertion of catheter is crucial in managing the urethral injury. The case of crush perineal injury with transected urethral treated with operation primary urethral anastomosis, de-functioning of stoma and external fixation of pelvis. Unfortunately, this case was complicated with rupture at anastomotic urethral site after a traumatic CBD insertion during his hospitalization and he was treated conservatively with CBD. All patients did well clinically with their wounds healed well.We showed a multidisciplinary team approach consisting of colorectal surgeon, urologist, orthopaedics surgeon and plastic surgeon, together with prompt diagnosis provides the best outcome were for the treatment of open perineal degloving injury.
Fulltext Knowledge, awareness and dietary practice on urolithiasis among general population in Kuantan, Pahang, Malaysia: Preliminary findings

Sowtali SN, Ariffin SRM, Nazli NS, Shukri NABM, Khattak MMAK, Ab Rashid IM, et al.

J Public Health Res, 2021 Apr 14;10(2).
PMID: 33855421 DOI: 10.4081/jphr.2021.2238

BACKGROUND: To date, no studies have been published at evaluating the level of knowledge, awareness and practice of dietary, particularly regarding to urolithiasis in patients or the general population. This study aims to provide basic information on the level of knowledge, awareness and dietary practice among general population in Kuantan, Pahang.
DESIGN AND METHODS: The respondents (n=30) were conveniently recruited within 10 kilometres radius of Kuantan city. The data were obtained using semi-guided administered questionnaires, which consists of four parts: socio-demographic data, lifestyle and clinical history (Part A); attitude and awareness on dietary practice regarding urolithiasis (Part B); food frequency questionnaire on urolithiasis (Part C) and level of knowledge on urolithiasis (Part D).
RESULTS: Majority of the respondents were women (70%), Malay (83.3%), mean age of 33.97 (±9.27), married (63.3%), completed higher education level (60%), working with government sector (33.3%) and have fixed monthly income (53.3%). Some of them had hypertension (n=4), diabetes (n=1), gout (n=1) and intestinal problem (n=1). Majority (80%) claimed having no family history of urolithiasis, consumed alcohol (10%), exercise with average frequency 2-3 times/week (46.7%) and heard about urolithiasis from healthcare worker (46.7%). The respondents' awareness about urolithiasis is considered to be good [81.23 (±9.98)] but having poor knowledge score [2.70 (±1.149)]. Majority preferred wholemeal bread, white rice, chicken meat, mackerel fish, chicken egg, apple, carrot, mustard leave and fresh milk in daily intake. Lesser plain water intake than standard requirement was noticed among respondents. Seasoning powder was commonly used for seasoning.
CONCLUSIONS: Generally, the general population of Kuantan, Pahang was aware of urolithiasis disease but needed more information on dietary aspect in terms of knowledge and food choice.
Stone diet and dietary change: understanding determinants for dietary change behaviour in patients following urinary stones

Muhamad S, Sowtali SN, Arifin SRM, Islah MAR, Mohd Shukri NA

J Hum Nutr Diet, 2023 Oct;36(5):2060-2072.
PMID: 37515409 DOI: 10.1111/jhn.13215

BACKGROUND: Dietary habit is one of the most important methods to prevent and treat urinary stones. However, only limited evidence of the experiences of dietary management among urinary stone patients in Malaysia is available. This study aimed to explore participants' current dietary practices after the diagnosis of urinary stones and to identify the factors that facilitate their dietary changes.
METHODS: A qualitative study with purposive sampling was conducted using face-to-face semistructured interviews. A total of 20 participants from a tertiary general hospital in Kuantan, Malaysia, were recruited in this study. Data were analysed using framework analysis.
RESULTS: Two themes emerged from the analysis. The first theme explained the changes in the dietary practice of the participants postdiagnosis. The second theme revealed that the participants' dietary changes were greatly influenced by personal factors and external support from professionals, family and peers.
CONCLUSIONS: Urinary stone patients highlighted the fear of complications, self-determination and knowledge of nutrition as the main drivers of their dietary change postdiagnosis. Emphasising proper nutritional care by assessing and evaluating dietary self-management among patients can facilitate effective self-care in stone prevention management.