Displaying publications 1 - 20 of 193 in total

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  1. Loh, Li Loong, Raffael B. Ismail, Goh, Kian Liang, Kamarul Ariffin Khalid
    MyJurnal
    Giant cell tumour (GCT) of the metacarpal bone is rare, and it behaves more aggressively with a higher recurrence rate as compared to other long bones. Modalities such as bone curettage with or without bone grafting, ray amputation, or wide resection and reconstruction have been described as surgical management for this condition. Wide resection (en block) is often preferred as it has a lower recurrence rate among the rests. Reconstruction techniques options available include vascularised or non-vascularised fibular graft, iliac crest strut graft with loss of metacarpophalangeal joint function or with metatarsal substitution resulting in a more preserved function of the hand. This case report is about a 15-year-old teenager girl with a giant cell tumor of her left second metacarpal bone, which was confirmed with a plain radiograph and magnetic resonance imaging. This case report focuses the operative technique of the metacarpal reconstruction using the third metatarsal bone. The aim was to preserve hand function and cosmesis while achieving good local control of the disease without compromising the lower limb function. The transfer of osteoarticular ligamentous complex of the third metatarsal bone for the reconstruction of the second metacarpal bone defects is a possible operative procedure that provides good cosmetic and excellent functional outcomes while not compromising the donor’s foot function.
  2. Hong, Eric Qiu Weng, Cheo, Seng Wee, Low, Qin Jian
    MyJurnal
    Dengue and malaria infections are common mosquito-borne infectious diseases in tropical and subtropical regions. The clinical manifestations of dengue and malaria often mimic each other, causing the predicament of early diagnosis without laboratory investigations. Concurrent dengue and malaria infection are often rare scenarios when both diseases occur in a particular patient at the same time. A high index of suspicion is therefore required to establish an early diagnosis to ensure complete success in its management. This case report is about concurrent dengue and malaria infection in a 54-year-old Pakistani man who presented with high-grade fever for three days before admission. On examination, he was febrile (38.8°C) with no other findings. His blood investigations were positive for NS1 antigen and IgM but negative for IgG. His peripheral blood film revealed the presence of Plasmodium vivax. He was treated for dengue fever with supportive management and started with oral Riamet (artemether and lumefantrine) along with oral primaquine 30 mg daily for two weeks’ duration. Following treatment, the patient demonstrated progressive clinical improvement and was subsequently discharged back to the community clinic for the continuation of care.
  3. Ng, Benjamin Han Sim, Prakash Supahiah, Goh, Siew Yuen
    MyJurnal
    Cerebral venous thrombosis (CVT) is a neurological condition occurring because of thrombosis involving the cerebral venous sinuses. This case report is an unusual clinical manifestation of cerebral venous thrombosis in a 76-year-old Chinese man who presented with restricted eye movement and double vision. Despite extensive investigation, there was no better explanation for his clinical symptom and sign apart from cerebral venous thrombosis which was confirmed by magnetic resonance venography (MRV) of the brain. Once cerebral venous thrombosis was diagnosed, he was initiated on anticoagulation and discharged with oral warfarin. This case emphasizes the need to consider cerebral venous thrombosis as one of the rare causes of complex ophthalmoplegia especially when typical cardiovascular risk factors are lacking in an individual.
  4. Abilash Kumar, Jeffrey Jayaraj, Jacob Abraham, Premchandran Menon, Manohar Arumugam
    MyJurnal
    Post-operative complications are well known to impair the functional outcomes of total knee arthroplasty (TKA). Patella subluxations post-TKA is a grim complication rendering patients disable post-surgery. Howbeit, medial patella subluxation is a rarely recorded incident altogether. This case report describes a patient post successful TKA two years ago, who was incidentally diagnosed with a medial patellofemoral subluxation during a recent routine yearly follow up. This gentleman, however, had no complaints and the only evident clinical sign was anterior knee skin puckering. A radiograph of the knee confirmed our clinical suspicion of medial patella subluxation. The patient’s symptoms, his expectations, radiological findings, what went wrong during surgery and management of this rare entity were analysed. This rarely reported entity requires a high degree of suspicion especially if the patient complains of instability and peculiar anterior knee pain. Diagnosis is customarily clinical and revision surgery is almost invariably necessary.
  5. Sobani Din, Fadzilah Ismail, Teh, Carren Sui Lin, Raudha Ezaty Ruslan, Shiraz Qamil Muhammad Abdul Kadar, Azuin Izzati Arshad
    MyJurnal
    The current COVID-19 pandemic has forced many clinical disciplines to evolve to function safely and still provide the necessary care. Otorhinolaryngology (ORL) is a field that has been greatly affected by this highly transmissible viral pathogen. Aerosolizing procedures, proximity examination and other common procedures must be revamped to suit current time. The usual norm ORL procedures need also be altered to incorporate safeguards to protect both patient and healthcare workers. This recommendation for current practices aims to give a practical approach to modify current practices to maintain safety during the pandemic. These recommendations are the consensus amongst ORL practitioners in Hospital Sungai Buloh which is the designated COVID-19 centre for Malaysia’s central region and is currently being practised.
  6. Daisuke, Mori, Wahida Khanam, Kamruddin Ahmed
    MyJurnal
    Although mumps virus (MuVi) is an important agent of encephalitis, however, mumps vaccine has not yet been included in the national immunization programme of Bangladesh. Furthermore, the genotype distribution of this virus in Bangladesh is unknown. Cerebrospinal fluid samples collected from 97 children with encephalitis from April 2009 to March 2010 were subjected to polymerase chain reaction (PCR) test to determine the causative agents. MuVi was detected in two samples, these samples were further subjected to conventional PCR using specific primers, then amplicons were sequenced, and genotype was determined as genotype G. Phylogenetic analysis showed that these strains were clustered with strains from Nepal, India, the UK, Thailand, and the USA. By Bayesian inference, we also determined that the ancestor of Bangladeshi and Indian MuVi were same and segregated only about two decades back. These results will help future surveillance and the detection of invading MuVi strains from other countries.
  7. Muhammad Wafiuddin, Ahmad Faizal Roslan, Ahmad Hafiz Zulkifly
    MyJurnal
    Tuberculosis (TB) is an ancient disease dated back from ancient Greece time. Once rare in developed countries, now it has re-emerged due to immigration and secondary immunodeficiency. A 27-year-old lady had left knee pain for the past 4 years, went for knee diagnostic arthroscopy procedure, and diagnosed as pigmented villonodular synovitis (PVNS) of the left knee. Despite regular analgesics and physiotherapy, patient symptoms worsen. Two years after the initial treatment, the patient went for a further workout and diagnosed as knee tuberculosis, commenced on anti-TB treatment, the patient still left complicated with a stiff knee and fixed flexion deformity. Identification of knee tuberculosis during the initial phase is crucial as late diagnosis and treatment will leave the patient with debilitating complications.
  8. Amelia Inbam Neelagandan, Esther Tuin, Tay, Chia Yi, Rajesh Kumar Muniandy
    MyJurnal
    Swallowing involves 55 muscles, five cranial nerves and two cervical nerve roots. When the coordination of this reflex is disturbed, dysphagia occurs. Dysphagia refers either to the difficulty someone may have with the initial phases of a swallow or to the sensation that the foods or the liquids are being obstructed in their passage from the mouth to the stomach. The objective of the study was to identify the diagnosis of patients attending Speech Therapy clinic, in Queen Elizabeth Hospital, Kota Kinabalu, Sabah, and to identify the demography of dysphagic patients. From the 406 patients that came during the study period, 139 patients (34.2%) were diagnosed with dysphagia, followed by developmental language disorders (33.3%). Of the 139 patients diagnosed with dysphagia, most of them are within the 41 to 60 (43.2%) and above 60 (42.2%) age groups. The majority were males (66.2%). A total of 81 (58.3%) patients with dysphagia had a history of cerebrovascular accident. Dysphagia is a common disorder among patients attending Speech Therapy Clinics at Queen Elizabeth Hospital, Kota Kinabalu. Training of Speech Therapists and early dysphagia intervention leads to a better outcome.
  9. Alamgir Chowdhury, M., Farid Hossain Chowdhury, Khaled Bin Shahabuddin, Tofazzal Hossain, A.B.M., Shaila Kabir
    MyJurnal
    Complete or partial restriction of the vocal cords usually occurs due to cancer, neurologic causes or mechanical causes like huge neck mass, trauma to the neck, viral infection, and sometimes iatrogenic during surgery. Bilateral vocal cord palsy is a severe condition that can lead to significant problems in breathing, speaking, and swallowing. If any patient presents with stridor, it requires urgent surgical airway management followed by specific treatment. A case of viral bilateral abductor vocal cord palsy in a 41-year-old female is reported here. The patient presented with stridor, and immediate tracheostomy was done. The stridor developed first 3 months earlier followed by cold and fever for a week. The stridor worsened gradually and leads to a state of commencing immediate tracheostomy. There was no history of trauma to the neck or any neck surgery. All basic laboratory blood test was within the normal limit. The laryngoscopic examination showed both vocal cords were immobile and almost median position with a small gap at the posterior commissure. Chest and neck plain X-ray along with computed tomography scan of neck was normal which ruled out the other causes of bilateral vocal cord palsy. The patient subsequently underwent successful left posterior cordectomy by laser, and decannulation of tracheostomy was done, known as Kashima operation.
  10. Malay Kanti Mridha
    MyJurnal
    Since December 2019, COVID-19 is impacting the health, economy, education, and well-being of every country in the world. The total number of reported COVID-19 cases will soon surpass 100 million and the death toll will be more than 20 million. At this moment, the top 10 countries with the most reported number of cases currently are the USA, India, Brazil. Russia, UK, France, Turkey, Italy, Spain, and Germany. These countries altogether represent 31.7% of the world’s population. However, they reported 65.5% of the total COVID-19 cases and 58.9% of total deaths. For containing the spread of SARS-CoV-2, the virus that causes COVID-19, Malaysia was one of the most successful countries in the world. However, since September 2020, the situation in Malaysia started changing, and at this moment Malaysia is reporting more than 2,500 new cases per day. During the past year, all the countries in the world acted fast and took different initiatives to reduce transmission of SARS-CoV-2, find effective drugs that can improve the clinical outcomes of COVID-19, and invent vaccines that can give immune protection. The first vaccine that was approved was invented by Pfizer/BioNTech and in December 2020, within one year of the beginning of the pandemic, the UK was the first country to start mass vaccination. As reported by the World Health Organization (WHO) in January 2021, more than 50 COVID-19 vaccines were in different phases of clinical trial and five vaccines received certain national regulatory approval for mass vaccination. However, given all these developments the COVID-19 pandemic is still making a devastating impact on the whole world and the pandemic is not going to over soon. Therefore, we need to discuss what we can do now to deal with the pandemic and ensure the health and wellbeing of the citizens of the world.
  11. Md. Shamsur Rahman, David Matanjun, Urban John Arnold D’souza, Wan Salman Wan Saudi, Fairrul Kadir, Tan, Teck Song, et al.
    MyJurnal
    Irrational use of drugs could be detrimental issues in the practices of healthcare communities. This problem arises either because of the wrong prescription or inappropriate self-medication. Faulty prescribing practices and incorrect self-medication will lead to an ineffective treatment regime. Still, they can also be unsafe as these may exacerbate or prolong the illness and distress the patients. In turn, these will incur unnecessary treatment costs. The most typical issues in the irrational use of drugs are the patient’s lack of information about the medicine and inadequate proper consultation from physicians. Lack of regulation in the appropriate use and supply of drugs by the relevant enforcement agencies could also be the problem in the irrational use of drugs. Ulceration and inflammation due to the irrational use of NSAIDs, antibiotics, and unhealthy lifestyle may contribute to the novel therapeutic strategy challenges. The ability to purchase the drugs without a doctor’s prescription of nonsteroidal anti-inflammatory drugs (NSAIDs) was also the landmark event that became the most widely used medications for the anti-inflammatory, analgesic, and antipyretic effects. Inadequate knowledge from both drug providers and patients may contribute to the most recognized influential factors in the irrational use of drugs in various countries. The recommendation should introduce an appropriate educational intervention that can be designed to promote rational prescribing. Proper regulation on prescription practices by policymakers and physicians could be the way to ensure the standard of rational usage of drugs have compliant with the healthcare communities.
  12. Chieng, Jin Yu, Yasotha Sugumaran, Pan Yan
    MyJurnal
    Hepatitis B is a well-recognized occupational risk for healthcare workers. This self-administered questionnaire study was designed to assess awareness and knowledge towards hepatitis B virus infection among 140 nurses at Serdang Hospital, Selangor, Malaysia from the period of 1st April to 30th September 2017. The response rate was 97.2% (n = 140/144). A total of 71.4% of participants showed adequate awareness of hepatitis B. Most participants had heard hepatitis B with the predominant sources receiving from friends, media and education. Majority of them did serology blood test of hepatitis B before. A total of 84.3% of participants were aware of vaccine available for hepatitis B, although 78.6% got vaccinated in the past. Antiviral treatment of hepatitis B was not well noticed by most of them. Education qualification determines the awareness of hepatitis B. Regarding the knowledge, 73.6% of participants showed poor knowledge of hepatitis B. Most participants understood that hepatitis B was caused by a virus infection and the organ most affected was the liver. Surprisingly, 77.9% of them failed to recognize that cancer could be caused by hepatitis B. Majority of participants were aware that transmission of hepatitis B could be mediated via sexual intercourse, as well as childbirth. Nevertheless, 14.3% of them believed that hepatitis B was able to spread by cough and sneeze. Older age, Chinese ethnicity, and having high educational qualification were factors leading to adequate knowledge of hepatitis B. Additional attention should be emphasized to strengthen knowledge towards hepatitis B among nurses and perhaps other healthcare workers in Malaysia.
  13. Shu, Ann Hon, Lian, Thai Lee, Qin, Jian Low
    MyJurnal
    Silicosis is a fibronodular lung disease secondary to the inhalation of crystalline silica dust. It had continued to cause significant morbidity and mortality worldwide. Here is a case of a 63-year-old woman, a lifelong non-smoker who complained of intermittent wheezing since retired 8 years ago. She had worked in the clay and piping industry for more than a decade. She wore only a simple 3-ply face mask at work without other protective devices. She had multiple hospital admissions for acute exacerbation of chronic lung disease for the past several years. Respiratory examinations revealed bilateral fine crepitations and occasional rhonchi on auscultation. Chest radiograph revealed ground glass changes. Pulmonary function testing showed an irreversible severe obstruction picture with an FEV1 of 45%. High resolution computed tomography thorax demonstrated hyperinflated lungs with emphysematous changes and multiple nodules over subpleural region, conglomerate mass with calcifications over bilateral lungs. Her imaging findings combined with a significant occupational history were suggestive of progressive massive fibrosis (PMF) due to silicosis. She is currently being treated with several inhalers and does not require home oxygen therapy. She is suffering from accelerated silicosis which may potentially progress to radiological deterioration, altered respiratory function and premature death. Therefore, it is essential to avoid any potential hazards that may predispose to silicosis.
  14. Kwong, Hui Wong, Hui, Wei Ho
    MyJurnal
    Rapid rural appraisal (RRA) is a systematic but semi-structured study used to gain new insight into rural life in a quick manner. The current article describes the RRA conducted in a remote village in Lahad Datu, Sabah. The RRA aimed to address the background of the rural community and identify public health issues. Collection of secondary data, key informants’ interview, field observation and a structured interview with the villagers selected via convenience sampling were applied to obtain necessary data. Findings from informal approaches were summarised. Descriptive analysis was carried out for data collected from structured interview. Water sanitation, sanitation facility, food safety, air pollution, zoonosis and non-communicable diseases were among the potential public health issues identified within the village. A total of 188 villagers participated in the structured interview. The median age was 28.0 (IQR 30.8). The percentage for manual workers were 21.3% while 13.8% were white collars. The illiteracy rate was 12.2% and the poverty rate at 48.9%. A total of 22.3% of respondents reported overcrowded households. The household environment and take-up rate of basic amenities were suboptimal. The highest self-reported chronic disease was hypertension, recording 13 cases. The foremost priority is to fill up the flaws in the public health needs of the villagers. Those challenges require participation from relevant authorities as well as individual empowerment
  15. Seng, Wee Cheo, Tee, Tat Khoo, Qin, Jian Low, Yuen, Kang Chia
    MyJurnal
    Rapid Stroke is a common clinical problem. Stroke can be broadly divided into ischaemic and haemorrhagic stroke. Ischaemic stroke can be further classified by TOAST classification into large-artery atherosclerosis, cardioembolism, small vessel occlusion, the stroke of other determined aetiology and stroke of undetermined aetiology. Importantly, we need to be wary of important stroke mimics such as brain tumour, demyelination, intoxication as they can lead to changes in clinical management. Here, we would like to illustrate a case of meningioma which clinically mimics a stroke. This patient is a 78-year-old lady who initially presented with sudden onset right-sided body weakness associated with slurred speech and facial asymmetry. An urgent plain computed tomography (CT) of the brain showed hypodensities at the left middle cerebral artery territory. However, re-evaluation noted her to have a normal Glasgow Coma Scale without any cortical signs, cerebellar sign or dysphasia. In view of these, stroke mimics was suspected. A contrasted CT brain was done which confirmed the diagnosis of meningioma. She was offered surgical intervention for meningioma but she was not keen on it. In conclusion, this case highlighted the importance of clinical evaluation in recognising stroke mimics
  16. Kow, Ren Yi, Zaharul Azri Mustapha Zakaria, Ruben Jaya Kumar, Low ,Chooi Leng, Khairul Nizam Siron Baharom
    MyJurnal
    Multiple carpometacarpal joint (CMCJ) dislocations are rare and are easily missed. The anatomical configuration renders stability to the joints. As a result, a high-velocity impact is required to dislocate the joint. We present two cases of multiple carpometacarpal joint dislocations with different mechanisms of injury and their subsequent management at our centre. In case 1, a 29-year-old gentleman presented with acute dislocations of the CMCJs involving the right middle, ring, and little fingers. An open reduction and fixation with Kirschner wires were done to stabilize the dislocated CMCJs and he subsequently recovered. In case 2, a 25-year-old gentleman had the CMCJ dislocations detected late due to other more profound injuries. Partial arthrodesis was performed to address the instability of the CMCJs of the right index, middle and ring fingers. He subsequently recovered and returned to work 6-months postoperatively. The diagnosis of carpometacarpal joint dislocation can be easily missed especially when there is a concurrent distracting injury. It is crucial to maintain a high index of suspicion as early diagnosis and prompt treatment is paramount to yield a better outcome
  17. Tan, Jia Yi, Teoh, Xie Jing
    MyJurnal
    Since the COVID-19 pandemic, Taiwan reported a total of 776 cases of COVID-19 (Dong et al., 2020) in comparison with its neighbouring countries, Japan and the Philippines which reported 210,769 and 465,724 cases of COVID-19 respectively, until 24 December 2020. Looking at the curve of the COVID-19 pandemic among various countries, Taiwan had indeed distinguished herself and stood out considering her well-contained COVID-19 infection despite it being a widespread infection in other countries.
  18. Shaila Kabir, A B M Tofazzal Hossain, Liew, Constance Sat Lin, M. Tanveer Hossain Parash, Chandrika Murugaiah, A. H. M. Delwar, et al.
    MyJurnal
    Besides the common respiratory symptoms or viral pneumonia, COVID-19 is also presented with different neurological symptoms. Olfactory dysfunction (OD) or impairment of the sense of smell is one of the common neurological symptoms being reported in infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The severity varies from anosmia to microsmia or hyposmia. OD could have a potential early screening and diagnostic value besides other neurological and common respiratory symptoms. In our descriptive concise review, we aimed to elicit the manifestation of olfactory dysfunction as an early predictor of SARS-CoV-2 infection. We are also aiming to establish, OD as a quick and reliable assessment tool of COVID-19 risk, among the healthcare workers and contact tracers, which can justify self-quarantine of the person as well as recommendation for testing on a priority basis. We have also focused on, any effect to produce this symptom by the drug used for treatment in COVID-19, and if the old age of the patient showing any extra influence to develop OD in COVID-19.
  19. Khin, Nyein Yin, Fatimah Ahmedy, Dayang Maryama Ag. Daud, Helen Lasimbang, Voo, Siew Ching, Chin Suliong, et al.
    MyJurnal
    Children’s occupational performance are activities of daily living, play/ leisure, social participation, education, and work. In developed countries, school-based therapy services are being provided for schoolchildren with special needs. The importance of these services in Malaysia is timely to be explored. This exploratory cross-sectional study identified occupational performance levels of primary schoolchildren with special needs in integrated special education programmes in Malaysia; children with intellectual disability, autism, attention deficit hyperactive disorder, Down syndrome, speech impairment, visual impairment, hearing impairment, and specific learning disorder. Researchers conducted Motor-Free Visual Perceptual Test Third Edition (MVPT-3), Beery-Buktenica Developmental Test of Visual-Motor Integration Fifth Edition (Beery-VMI), Test of Gross Motor Development – 2 (TGMD-2), Test of Hand Writing Skills-Revised (THS-R), and School Function Assessment (SFA) for 121 students. Results showed that 69.5% of the students scored very low to low average in MVPT-3 (median standard score = 70.0, Std. IQR = 37); 69.4% were very low to below average in Beery-VMI (mean standard score = 78.8, Std. deviation = 20.5); 73% were below age level raw score in TGMD-2; 72.8% were below average in THS-R (median standard score = 74.0, Std. IQR = 27.0); and 81% were below the criterion cut-off in school function. The children with below-normal MVPT, VMI, TGMD2, and THS scores, compared to the children with normal scores for these tests had significantly lower scores (p < 0.001). All the students had impairment in occupation performance at least in one area. This study recommends school-based occupational therapy and other rehabilitation services in the school system in Malaysia.
  20. Francis Paul, Kent Kong Kian Keong, Jennifer Tan, Anna Lee En Moi, Alen Lim Chung Chieh
    MyJurnal
    Introduction: Maternal death is a sensitive health indicator being monitored closely by the Ministry of Health. Obstetric emergency (OE) protocol is introduced to manage OE and to improve maternal outcome. However, there is no national OE guideline available and the OE protocol varies among different institutions. The current audit aims to evaluate the service quality during OE in Duchess of Kent Hospital (DOKH) in accordance with OE protocol DOKH revision-2017.
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