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Fulltext Comprehensive care of a patient with obesity of BMI >70 kg/m2

Kabir S, Hossain AT, Shimmi SC, Jie CS

BMJ Case Rep, 2020 Dec 28;13(12).
PMID: 33372011 DOI: 10.1136/bcr-2020-236197

A 31-year-old woman, with a body mass index of 70.31 kg/m2, presented with progressive worsening of dyspnoea for 3 days. She had multiple comorbidities, including obesity hypoventilation syndrome. The patient developed type II respiratory failure with respiratory acidosis along with multiorgan failure. She was intubated and put on a mechanical ventilator and treated with intravenous diuretics, subcutaneous low-molecular-weight heparin and other supportive measures. Later, she was on noninvasive, continuous positive airway pressure ventilation overnight. She was prescribed a very-low-calorie diet along with physiotherapy and exercise. The patient underwent bariatric surgery 2 months after resolution of acute illness. Ten months after surgery, her body weight reduced from 180 kg to 121 kg, and her general condition improved. Successful management before and after surgical intervention depends on multidisciplinary teamwork, which includes the dietician, physiotherapist, endocrinologist, pulmonologist, nursing care and other supportive care.
Fulltext Diagnostic challenges and Gene-Xpert utility in detecting Mycobacterium tuberculosis among suspected cases of Pulmonary tuberculosis

Kabir S, Parash MTH, Emran NA, Hossain ABMT, Shimmi SC

PLoS One, 2021;16(5):e0251858.
PMID: 34015016 DOI: 10.1371/journal.pone.0251858

The incidence of pulmonary tuberculosis (PTB) can be reduced by preventing transmission with rapid and precise case detection and early treatment. The Gene-Xpert MTB/RIF assay is a useful tool for detecting Mycobacterium tuberculosis (MTB) with rifampicin resistance within approximately two hours by using a nucleic acid amplification technique. This study was designed to reduce the underdiagnosis of smear-negative pulmonary TB and to assess the clinical and radiological characteristics of PTB patients. This cross-sectional study included 235 participants who went to the Luyang primary health care clinic from September 2016 to June 2017. The demographic data were analyzed to investigate the association of patient gender, age group, and ethnicity by chi-square test. To assess the efficacy of the diagnostic test, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. The area under the curve for sputum for both AFB and gene-Xpert was analyzed to compare their accuracy in diagnosing TB. In this study, TB was more common in males than in females. The majority (50.71%) of the cases belonged to the 25-44-year-old age group and the Bajau ethnicity (57.74%). Out of 50 pulmonary TB cases (smear-positive with AFB staining), 49 samples were positive according to the Gene-Xpert MTB/RIF assay and was confirmed by MTB culture. However, out of 185 smear-negative presumptive cases, 21 cases were positive by Gene-Xpert MTB/RIF assay in that a sample showed drug resistance, and these results were confirmed by MTB culture, showing resistance to isoniazid. In comparison to sputum for AFB, Gene-Xpert showed more sensitivity and specificity with almost complete accuracy. The additional 21 PTB cases detection from the presumptive cases by GeneXpert had significant impact compared to initial observation by the routine tests which overcame the diagnostic challenges and ambiguities.
Fulltext Ethno-medicine survey of medicinal plants used by villagers in Kudat, Sabah, Malaysia. [Abstract]

Shimmi SC, Kabir S, Parash MTH, Hossain ABMT, Khaing MS, Muhd Yunus R

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):65.
MyJurnal

ABSTRACTS FOR THE 1ST INTERNATIONAL BORNEO HEALTHCARE AND PUBLIC HEALTH CONFERENCE AND 4TH BORNEO TROPICAL MEDICINE
AND INFECTIOUS DISEASE CONGRESS. New Frontiers in Health: Expecting the Unexpected; Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; On 3rd-5th September 2019
Introduction: The use of medicinal plants as a remedy and prevention of diseases based on practical skills, knowledge and therapies was passed down from one generation to the next. It was reported by WHO that, approximately a quarter of the modern drugs were derivatives of plants or herbs, used as traditional medicines. It has contributed greatly in the health care management as the main source of medicine for many of the rural population in Sabah. This preliminary study was carried out to observe the use of medicinal plants in different villages of Kudat and to know about the knowledge of the villagers related to possible side effects of these plants.
Methods: It was a cross-sectional descriptive study which was carried out in different villages of Kudat, Sabah, Malaysia between August and September 2018. The data were obtained through interviewing the people in different villages by using semi-structured questionnaire. Descriptive statistics were used to present the data.
Results: Among the 87 participants, 37.9% were male and 62.1% were female. Their mean age was 45.87 (±14.03) and they were mostly from Kadazan-Dusun (50.6%) and Rungus (42.5%). The highest level of education among the participants was SPM (20.7%). Roots, stems, leaves, flowers and fruits of 49 plant species were reported in the treatment of more than 30 types of health conditions. Anaemia, hypertension, diabetes, joint pain, hypercholesterolaemia, fever, asthma, malaria, vomiting and few acute illnesses are mentionable. Majority (71%) of the participants did not have any knowledge about possible side effects of the orally ingested or tropically applied medicinal plants.
Conclusion: There should be thorough research on dosage, mechanism of action and possible side effects of the medicinal plants and the results of these researches should reach the users of these plants.
Examining students' intention to perform voluntary blood donation using a theory of planned behaviour: A structural equation modelling approach

Hossain Parash M, Suki NM, Shimmi SC, Hossain ABMT, Murthy KD

Transfus Clin Biol, 2020 Apr;27(2):70-77.
PMID: 32139133 DOI: 10.1016/j.tracli.2020.02.002

OBJECTIVE: This study aims to examine the behavioural intention of students to make voluntary blood donations. Moreover, it uses a theory of planned behaviour as its guiding principle and does so within the context of Malaysia, a developing nation.
METHODS: Data were collected via a self-administered questionnaire from a sample of 500 students at a public higher learning institution in Malaysia. Structural equation modelling approach (SEM) was performed to assess the strength of the hypothesized relationships of the proposed model simultaneously via the two-stage model-building process.
RESULTS: The SEM approach revealed that knowledge was the most influential predictor of students' intention to make a voluntary blood donation. With the knowledge that the more blood they donate, the more lives will be saved, the inclination to donate blood is intensifying among students. Moreover, all of the TPB constructs applied were also seen to significantly influence students' response to voluntary blood donation.
CONCLUSIONS: The nexus of attitude, subjective norm, perceived behavioural control, and knowledge about students' intention to perform voluntary blood donation are evidenced in a developing nation. The implications of the study and directions for future research are provided.
Fulltext Retrospective descriptive study of patients with dermatological problems, at UMS Polyclinic, Kingfisher, Kota Kinabalu, Sabah. [Abstract]

Khaing MS, Parash MTH, Shimmi SC, Kabir S, Chodanakar NC, Subramaniam P, et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):89-89.
MyJurnal

ABSTRACTS FOR THE 1ST INTERNATIONAL BORNEO HEALTHCARE AND PUBLIC HEALTH CONFERENCE AND 4TH BORNEO TROPICAL MEDICINE AND INFECTIOUS DISEASE CONGRESS. New Frontiers in Health: Expecting the Unexpected; Held at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia; On 3rd-5th September 2019
Introduction: Since January 2010, the UMS Polyclinic, situated at Riverside Plaza, Kingfisher Park, Kota Kinabalu, Sabah, provided general medical consultation as well as specialist consultations comprising of Internal Medicine, Endocrinology (Diabetes and related problems), Dermatology, Rheumatology, Cardiology including ECG and ECHO services, Orthopedic, Ophthalmology, ENT (Ear, Nose and Throat), Obstetrics and Gynecology, Pediatrics and Psychiatry. The purpose of this study was to look into the Dermatology consultations provided by the UMS Polyclinic in order to improve health care services, by reporting on the demographic characteristics of the patients with reference to the provisional diagnosis and management offered, as well as referrals to tertiary health care centers for further managements. Methods: It was a retrospective, descriptive study which included 76 patients who visited the Dermatology Specialist Clinic at UMS Polyclinic from January to December 2018.
Results: The 76 patients comprised of 50 males and 26 female patients with the age ranged from 2 years to 86 years, with 5 children (under the age of 12 years).The catchment population of the patients were mainly from Universiti Malaysia Sabah, Kingfisher, and also from wide areas of Kota Kinabalu with a few from Kudat,Tamparuli, Telipok, Keningau, Kinarut and Beaufort, etc. The consultations comprised of 19 varieties of dermatological problems to which were given appropraite management. The period of the year 2018 under study showed highest attendance in February with 21 patients (27.6%) followed by 13 patients (17.1%) in October with December showing 11 patients (14.5% ).
Conclusion: A total of 32 varieties of Dermatological problems were found among the 76 patients consulted. Acne Vulgaris was found to be the highest variant with 12 cases(15.7%) with Seborrhoeic Dermatitis seen as 5 cases (6.5%) followed by 4 cases (5.2%) each of Contact Dermatitis, Allergy/Hypersensitivity, Photosensitive Dermatitis, and Vitiligo. Certain patients had to be referred to Dermatology Department at Hospital Queen Elizabeth for further management, like for skin biopsy, and also for Electro-cautery machine, Phototherapy, and Laser, as we are still waiting for few equipments.