Displaying publications 1 - 20 of 92 in total

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  1. H Sumery, Hazwani ZA, Kalsum I, Norliza R, Habibah O, Noorliaza S, et al.
    MyJurnal
    The quality of pap smear determined by the specimen adequacy of cervical smears. It plays an important role to detect changes in the cervix particularly the transformation zone (TZ). This study aimed to determine factors associated with poor pap smear quality in Barat Daya District, Penang. This is a cross-sectional study of 276 randomly selected specimens of woman who underwent pap smear test in all government health clinics in Barat Daya District, Penang between January until June 2019. Study proforma was based on cytological report issued by Pathology Department, Penang Hospital and staff records in Nursing Unit, Barat Daya District Health Office. 30.1% has poor smear quality. Women who are menopause are twice the risk to have poor smear quality [Adjusted OR (95% CI): 2.34(1.14, 4.84), p
  2. Ang, Wen-Jeat, Embong Zunaina, Raja Omar Raja Norliza, Abdul Jalil Fadzillah
    MyJurnal
    We describe the first clinical case of contact lens related corneal ulcer caused by Elizabethkingia meningosepticaregistered in Southeast Asia. A 20-year-old female student who wasa regular soft contact lens wearer, presented with pain, photophobia and blurring of vision of the right eye for 3 days. On slit lamp examination, there was a small paracentral anterior stromal infiltrate with an overlying epithelial defect. Microbiological cultures from corneal scrapings, contact lens and its casing were positive for E.meningoseptica. Due to high likelihood of contact lens contamination causing keratitis, topical fortified gentamicin0.9% and ceftazidime 5% were administered empirically. Topical vancomycin 5% was later added tailoring to the culture and sensitivity of the organism. After 8 weeks of treatment, the keratitis subsided and corneal epithelial defect completely healed with residual corneal opacity. Even though uncommon, contact lens related E.meningosepticakeratitis can occur in healthy immunocompetent individuals with no ocular comorbidities.
  3. Loh, Ui Lyn, Nadras, Indira, Yeong, Choo Mee, Nadarajah, Gaayathri, Fazilawati Qamarruddin, Shelina Oli Mohamed, et al.
    MyJurnal
    Tuberculosis, an ancient disease, still thrives today as the leading infection caused by Mycobacterium tuberculosis. Diagnosis of ocular tuberculosis poses a great challenge due to the varied clinical presentations. We report 3 cases of primary ocular tuberculosis with varied presentations: conjunctival abscess, sclera-uveitis and occlusive vasculitis. There were no symptoms suggestive of pulmonary tuberculosis in all cases. All patients presented with acute, unilateral painful red eye. The first case had good visual acuity (VA) OD (6/9) with a swollen upper lid, localized perilimbal-hemorrhagic conjunctival swelling superiorly, keratic precipitates and mild anterior chamber reaction. The posterior segment was normal. The second case had a VA of 6/60 OD. There was presence of conjunctival injection, keratic precipitates, posterior synechiae and anterior chamber reaction of 1+. A few days later, there was a progression to vitritis OU and hyperemic optic disc OD with choroidal folds, cystoid macula edema and a positive T sign on B scan ultrasonography. The third case had VA of 6/6 OU, AC reaction of 2+ OD. There was multiple peripheral choroiditis with peripheral vasculitis seen in the posterior segment OU. Fundus fluorescein angiography (FFA) showed peripheral periphlebitis in all 4 quadrants OU. All 3 cases had positive Tuberculin Skin Test (Mantoux test) results which were more than 20mm. Anti-tuberculous treatment was promptly started and all patients showed significant clinical improvement. This case series highlights the diverse clinical presentations of ocular tuberculosis. A high clinical index of suspicion led to prompt initiation of anti-tuberculous therapy which resulted in good clinical outcomes for all cases.
  4. Nadia Yaacob, Adil Hussein
    MyJurnal
    Sino-nasal osteoma is a common benign tumour of paranasal
    sinuses and usually asymptomatic. Here, we presented a case of a huge sinonasal osteoma. Despite the large size of the tumour, the only presentation
    was epiphora. There were no headache, facial pain or diplopia. Nasal
    obstruction only occurred after involvement of the nasal cavity. In diagnosing
    aetiology of the epiphora, sino-nasal pathology needed to be ruled out after
    excluding ocular causes. Multidisciplinary approach between otolaryngology
    (ORL) team and ophthalmology team was essential in managing the case.
    The tumour was successfully removed surgically via endoscopic approach;
    and dacryocystorhinostomy (DCR) was performed to alleviate the epiphora.
  5. Michael Dau Bing Ngu, Tengku Norina Tuan Jaffar, Adil Hussein
    MyJurnal
    Cornea bee sting is a rare condition with mild to severe complications. We report a case series of three patients with cornea bee sting presented to a tertiary center. All patients sustained embedded stingers in the cornea stroma and presented within a few hours of injuries. All patients received topical antibiotics, topical steroids and removal of stingers. However, techniques of stinger removal and administration of the medications are among factors that contributed to different outcomes in these patients
  6. Siti Amirah Hassan, Rafidah MD Saleh, Norlaila Talib, Adil Hussein
    MyJurnal
    Orbital cellulitis is a clinical diagnosis. Once the diagnosis is made, an empirical antibiotic is started, and in most cases, the clinical improvement can be observed within 24-48 hours. We discuss treatment options in managing orbital cellulitis in a 34-year-old male in which no improvement was seen despite being started on empirical broad-spectrum antibiotic. Patient had a prior history of being bitten by an insect in the left upper eyelid while doing gardening about 5 days prior to admission. The patient developed left orbital cellulitis a few days following the insect bite. Patient was started empirical broad-spectrum antibiotic immediately, but no improvement observed. Culture and sensitivity taken from the upper eyelid grew methicillin-resistance Staphylococcus aureus (MRSA) which was sensitive to vancomycin. Patient was treated with intensive fourteen days of intravenous vancomycin. The infection resolved as evidenced by clinical improvement and reduction of white blood cells count.
  7. Nur Asma Sapiai,, SThadchaiani Saminathan,, Wan Aireene Wan Ahmed,, Ahmad Zuhdi Mamat,
    MyJurnal
    Oesophageal perforation is a rare clinical situation. However, it is associated with high morbidity and mortality rate. A 39-year-old lady with underlying epilepsy was admitted to hospital for alleged accidental ingestion of broken dentures while sleeping. She underwent emergency direct laryngoscopy, oesophagoscopy and oesophagogastroduodenoscopy. However, no foreign body was found. She was subsequently discharged home. Two days later, the patient presented again with dyspnoea, fever and chest discomfort. A chest radiograph showed bilateral pleural effusion, left pneumothorax and right mediastinal shift. A suspicion of oesophageal perforation was raised. Upper gastrointestinal study revealed an oesophageal perforation. Under conservative management, her condition was complicated with thoracic empyema. She subsequently underwent video assisted thoracoscopy and decortication. Fortunately, after one month of hospitalization, she regained full recovery. In conclusion, any chest symptoms which arise after oesophagogastroduodenoscopy should be dealt with extra caution. Patients outcome after oesophageal injury are time dependent, thus any delay in obtaining radiological assessment should be avoided.
  8. Nor Ezzati Nor Albashri, Noor Fadzilah Zulkifli, Asral Wirda Ahmad Asnawi, Zetty Nadia Mohd Zain, Rashidah Mohamed, Sathar, Jameela, et al.
    MyJurnal
    Thalassaemia is one of the most common autosomal recessive blood disorders in the world and its carrier status is prevalent in nearly 15% of Malaysian population. The global and economic burden for lifelong care of those affected increases every year. Currently, there is no policy on thalassaemia-carrier screening for couples prior to marriage besides HIV/AIDS screening in Malaysia. Other countries such as Iran, Iraq, Turkey, Bahrain and Saudi Arabia have established a policy for thalassaemia prevention by conducting premarital thalassaemia screening. Zero thalassaemia cases in new-born child in Cyprus have proven that thalassaemia can be prevented. This study aimed to investigate the willingness of premarital Malays on premarital thalassaemia screening.

    A set of questionnaire was distributed to 57 persons at premarital course sites and wedding fairs and expositions held in Kuala Lumpur and Selangor. Components in the questionnaire included: 1) demographic 2) knowledge about thalassaemia, signs and screening method 3) attitudes towards thalassaemia premarital screening 4) practices of premarital thalassaemia screening. Analysis for the questionnaire was performed using IBM SPSS Statistics 23.0.
  9. Shaban S. N, Mokhtar K.I,, Ichwan S. J. A, Al-Ahmad B. E. M
    MyJurnal
    Wounds are inevitable events that can occur daily due to many factors such as; physical, chemical and biological, which can cause tissue, cell and in some events bone damage. The process of wound healing is complicated as it involves many factors; therefore, an effective and safe agent is essential to ensure good healing process. Herbal medicine is considered safe and effective. Flaxseed (Linum usitatissimum) is an effective plant when it comes to wound healing and has been used for decades as a traditional healing agent. The bioactivities of flaxseed extract have been reported to demonstrate many beneficial effects such as antimicrobial, antioxidant and anti-inflammatory effects. It has been shown that flaxseed has positive effects on many types of wounds such as skin wound healing, burns and burn scar healing, bone healing and also has demonstrated positive results in the healing of oral ulceration besides exhibiting anti-bacterial effects in the oral cavity. This review describes the positive effects of flaxseed in multiple types of wound healing. Additionally, it is also aimed to introduce the potential applications of flaxseed in socket healing which involves series of complex changes to both soft and hard tissues in the oral cavity.
  10. Noorlaila B., Zunaina E., Raja Norliza R.O., Nor Fadzillah A.J., Alice, G.K.C.
    MyJurnal
    We report a case of dural carotid cavernous fistula (CCF) pose a diagnostic dilemma with initial symptoms of the arteriovenous shunt. A 56 year-old man presented with right eye diplopia, thensubsequently developed ptosis, congestion of conjunctiva, dilated episcleral vessels, and gradual rise in intraocular pressure. Initial diagnosis of pseudotumour was made based on negative finding of CCF by computed tomography angiography (CTA). In view of persistent clinical manifestations in spite of steroid therapy, and with the presence of new ocular signs; cock-screw conjunctival vessels, dilated retinal veins, and proptosis, digital subtraction angiography (DSA) was performed and confirmed the diagnosis of dural CCF.The ocular symptoms resolved completely post embolization of the fistula.
  11. Sa’adiah Shahabudin, Rohayu Hami, Lim, Lee-Sim, Amalina Salleh
    MyJurnal
    The aim of this study to assess the efficiency of flushing
    method of Dental Unit Waterline (DUWL) system in reducing the
    number of microorganism. Water samples were taken before and after
    two minutes of flushing from air-water syringes system in ten randomly
    selected dental units in a Dental Teaching Centre. These samples
    were immediately transferred to the microbiology laboratory in the cool
    box within 8 hours for the heterotrophic plate count (HPC) test. Paired
    t-test was used to analyse number of microbe before and after flushing.
    The numbers of colony forming unit (CFU) ranged from 13,000 to
    120,000CFU/ml in unflushed samples, and 3,000 to 15,000CFU/ml in
    flushed samples. The mean HPC post-flushing was lower than preflushing [8360.00 (4561.48) vs 63300.00 (44587.12) CFU/ml]. The
    mean HPC between pre- and post-flushing was significantly different
    (P=0.004, 95% CI 22039.52, 87840.48). The coliform count from the
    control was 140 CFU/ml. In conclusion, flushing method of DUWL
    system significantly reduces the number of microorganisms in the
    dental unit. However, the level of microorganisms still does not meet
    the standard guideline by Environmental Protection Agency for safe
    drinking water, which should be below 500 CFU/ml. In our opinion, the
    duration of flushing should be increased and additional chemical
    treatments of the dental units should be implemented to ensure the
    safety of patients and dental personnel.
  12. Nasibah Mohamad,, Khairil Amir Sayuti, Ganeshwara Lingam,, Anis Shafina Mahfudz,
    MyJurnal
    Haemoptysis is the clinical features of pulmonary tuberculosis (PTB) (32.5%) in Malaysia, in which if massive and left untreated it carries out a mortality risk of more than 50%. In the majority of cases, the main bleeder arises from the bronchial artery, with the pulmonary arterial circulation as a rare cause of bleeding, accounting for less than 10% of cases. Rasmussen aneurysm is a rare phenomenon following the weakening of the pulmonary artery wall resulting from adjacent cavitary tuberculosis. The sequelae which follow include pseudoaneurysm formation and subsequent rupture.
  13. Adam, M., Irfan, M., Muhammad Nasri AB, Arfahiza S.
    MyJurnal
    Laryngopharyngeal tuberculosis (TB) is a rare disease and usually associated with pulmonary tuberculosis. Mostly, it occurs in adults without BCG vaccination or in immuno-compromised patients (such as AIDS patients). A 34-year-old gentleman with odynophagia and poor oral intake was referred to us to rule out malignancy. Direct laryngoscopy examination revealed ulcerative lesion involving right tonsillar fossa extending downward till right pyriform sinus. Panendoscopy and biopsy was performed. Laryngopharyngeal TB was diagnosed based on the histopathological examination and Ziehl-Neelsen staining.
  14. Norhayaty S., Sangeetha, T, Tai, Evelyn L.M., Wan Hazabbah W.H., Zaidah A.R., Azhany Y.
    MyJurnal
    nfectious endophthalmitis is a devastating and potentially sight-threatening condition.The objective is toanalyse the microbiological profile and visual outcome of culture positive endophthalmitis seen in Hospital Universiti Sains Malaysia. All patients with endophthalmitis admitted to Hospital Universiti Sains Malaysia over a 7-year period from January 2007 until December 2013 were recruited into this study. Retrospective review of medical and microbiology records was conducted among patients clinically diagnosed with endophthalmitis in Hospital Universiti Sains Malaysia from January 2007 until December 2013. Sixteen patients were admitted with endophthalmitis during this study period. Seven (43%) were culture-positive, in which five (71%) cases were from vitreous culture and two (29%) from blood specimens. The mean age for culture positive patients of presentation was44 years. The most common bacterial isolate was Pseudomonas spp., while the most common fungus was Candida spp. Other organisms isolated were Fusariumsp., Aspergillus sp., Staphylococcus sp.and Enterococcus sp. The risk factors for culture-positive cases were ocular trauma, corneal keratitis, ocular chemical injury, severe urinary tract infection and retropharyngeal abscess. Only three of the affected eyes could be salvaged. The final visual acuity waspoor in all the culture-positive eyes. Two cases underwent evisceration while one case underwent enucleation. As a conclusion,Culture-positive endophthalmitis in this study were mainly attributed to Pseudomonas spp. and Candida spp. The visual outcome of culture-positive endophthalmitis was poor.
  15. Norhayaty S., Nurul Dalila M.S., Tai, Evelyn L.M., Liza Sharmini A.T., Zunaina E., Azhany Y.
    MyJurnal
    Tunnel vision is a classic sign among patients with advanced glaucoma. However, other conditions such as retinitis pigmentosa, optic neuritis and rod-cone dystrophy may be characterized by similar visual field defects. A 52-year-old lady with a family history of glaucoma presented with bilateral gradual loss of peripheral vision for two years. She claimed to have poor night vision about 20 years prior to this presentation. Her visual acuity was 6/7.5 in both eyes. The anterior chamber depth was moderate bilaterally, with Schaffer grading on gonioscopy of grade I to II. The intraocular pressure was 14 mmHg in both eyes. The optic discs appeared normal. Fundus examination showed scattered hypopigmented changes sparing the fovea. Humphrey visual field test revealed bilateral constricted visual fields. She was diagnosed with retinitis punctata albescens (RPA) based on her symptom of poor night vision, supported by the diffuse hypopigmented changes in her fundi. The management of this condition involves careful counselling regarding the genetic nature of the disease and its progressive course. We discuss this case to illustrate the importance of a thorough history taking and careful fundus examination in the workup of patients presenting with tunnel vision.
  16. Nor Hazliana Harun, Mydin, Rabiatul Basria S.M.N., Sreekantan, Srimala, Khairul Arifah Saharudin, Norfatehah Basiron, Fakrul Radhi, et al.
    MyJurnal
    Zinc oxide (ZnO) nanoparticles (NPs) has become as promising candidate for antibacterial agents against Escherichia coli (E.coli), commensal hospital- acquired infections (HAIs). This study investigates the antibacterial action of ZnO NPs in three difference shapes; nanorod, nanoflakes and nanospheres against E.coli ATCC 25922. The antibacterial activity of ZnO NPs was determine through two standard protocols known as Clinical Laboratory Standards Institute (CLSI) MO2-A11 under light conditions of 5.70 w/m2 and American standard test method (ASTM) E-2149. Preliminary screening shows ZnO NPs did not inhibit the growth of E.coli. Further analysis using ASTM E-2149 in dynamic conditions revealed antibacterial activity after 3 hours with 100% reduction for ZnO NPs nanoflakes and 6 hours with 94.63% reduction for ZnO nanospheres, respectively. It demonstrated the ZnO NPs in nanoflakes and nanospheres exerted higher antibacterial activity possibly through release of ios, free radicals, ROS generation and electrostatic collision which contribute to bacterial death. Further analysis is needed to investigate biocompatibility of these samples for future biomedical applications.
  17. Yuen CW,, Halim MA,, Najimudin N,, Azzam G,
    MyJurnal
    Alzheimer’s disease (AD) is a brain disease attributed to the accumulation of extracellular senile plaques comprising β-amyloid peptide (Aβ). In this study, a transgenic Caenorhabditis elegans (C. elegans) containing the human beta amyloid Aβ42 gene which exhibited paralysis when expressed, was used to study the anti-paralysis effect of salvianolic acid A. Various concentrations ranging from 1 μg/ml to 100 μg/ml of salvianolic acid A were tested which exhibited the highest effect on the worm at the concentration of 100 μg/ml. For anti-aggregation effect, 14 μg/ml of salvianolic acid A (within 4 mg/ml of Danshen) showed a significant level of inhibition of the formation of Aβ fibrils. An amount of 100 μg/ml of salvianolic acid A had the potential in reducing the reactive oxygen species (ROS) but did not totally obliterate the ROS production in the worms. Salvianolic acid A was found to delay the paralysis of the transgenic C. elegans, decrease Aβ42 aggregation and decrease Aβ-induced oxidative stress.
  18. Tan, Kok-Leong, Fhun, Lai-Chan, Ahmad Tajudin Liza Sharmini, Maizan Yaakub, Chong, Mei-Fong
    MyJurnal
    Glaucoma is a chronic disease that could affect the quality of life and is a potential stressor for patients. Visual field assessment is important in monitoring disease progression among glaucoma patients. Stress could influence the performance of patients in visual field test that may affect the reliability of the test. Our objective in this study was to determine the association between stress score using Depression, Anxiety and Stress Scale (DASS) questionnaire and reliability indices of Humphrey visual field analysis (HFA). A total of 155 primary and secondary glaucoma patients were recruited in the study. Face to face interview using stress component of DASS questionnaire was conducted after automated HFA test. Reliability indices; i.e. fixation loss, false positive, and false negative error, were used to determine the accuracy of HFA result. Only 12 patients (7.7%) were found to have elevated stress score. No significant correlation was found between DASS stress score and the reliability indices of HFA. There was 0.2 folds (95% confidence interval (CI) [-2.35, -0.06], p = 0.039) reduction of fixation loss for every number of HFA done. For every one year increase in age, there was 0.2 folds (95% CI [-0.38, -0.07], p = 0.006) reduction in false positive error in HFA.
    Minimal stress may not affect the reliability of HFA assessment. Minimising stress among glaucoma patients is important not only for assessment of visual field but also for improvement of quality of life.
  19. Ghani Siti-Ilyana, Ang, Wen-Jeat, Wan-Hazabbah Wan-Hitam, Embong Zunaina
    MyJurnal
    Pre-eclampsia may have an impact on women’s health beyond their
    pregnancies and has been associated with increased risks for future hypertension
    and cardiovascular disease. We report a case of a patient with history of preeclampsia and emergency caesarean section at 31 weeks of gestation due to
    impending eclampsia who defaulted follow up and presented with malignant
    hypertension and acute loss of vision 10 years later. A 34-year-old Malay female,
    presented with generalized painless reduced vision of 5 days duration which was
    preceded by an intermittent headache for 1 months duration. She had a history of
    pre-eclampsia during her last childbirth 10 years ago and was not started on any
    antihypertensive medication as her blood pressure normalized 2 weeks post-delivery.
    Subsequently, she defaulted on her follow up. Visual acuity was counting finger at 1
    meter in both eyes with no relative afferent pupillary defect. Funduscopy revealed
    bilateral grade IV hypertensive retinopathy with the presence of optic disc swelling
    and macular star. Optical coherence tomography showed bilateral sub-retinal fluid at
    the macula. Her blood pressure was 255/168 mmHg with other systemic
    examinations being normal. Ultrasonography of the kidneys showed the presence of
    bilateral renal parenchymal disease with elevation of serum urea and creatinine
    levels. Her blood pressure was controlled with triple oral antihypertensive agents. Her
    vision improved to 6/36 and 6/6 with a pinhole in both eyes and resolution of
    papilloedema and sub-retinal fluid at three months follow-up. Patients with a history
    of pre-eclampsia must be closely monitored during the postpartum period. Even
    though her blood pressure was normalized, careful monitoring and long-term medical
    follow up plan must be clearly explained to the patient as she might develop chronic
    or essential hypertension afterward. Our patient most likely had essential
    hypertension superimposed with pre-eclampsia during her last pregnancy and
    currently presented with malignant hypertension due to undiagnosed chronic
    hypertension as she defaulted her medical follow up.
  20. Ghani Siti-Ilyana, Koh, Yi-Ni, Embong Zunaina
    MyJurnal
    Toxoplasmic optic neuropathy is rare and usually occurs monoocularly. This case report demonstrates a rare presentation of bilateral
    juxtapapillary retinochoroiditis (Jensen disease) due to toxoplasma infection in
    a young healthy patient. A 20-year-old lady presented with bilateral painless
    blurring of central vision for 5 days duration. It was preceded by fever, upper
    respiratory tract symptoms and headache. There was no history of contact or
    being scratched by a cat. Visual acuity was counting fingers for the right eye
    and 6/45 for the left eye. There was presence of relative afferent pupillary
    defect in the right eye. Optic nerve functions were impaired bilaterally which
    was severe in the right eye. Both eyes showed the presence of mild anterior
    segment inflammation and vitritis. Fundus examination revealed juxtapapillary
    retinochoroiditis bilaterally with swollen optic disc. Optical coherence
    tomography (OCT) showed presence of intra-retinal and sub-retinal fluid at
    macular area bilaterally. Serology for anti-toxoplasma Immunoglobulin G (IgG)
    was positive with titre of 1450 IU/ml. Computed tomography scan (CT scan) of
    brain and orbit was normal. A diagnosis of bilateral juxtapapillary
    retinochoroiditis or Jensen disease was made. Oral azithromycin 500 mg daily
    and guttae prednisolone 4 hourly for 6 weeks was commenced. Oral
    prednisolone 50 mg daily (1 mg/kg/day) was added after completion of 1 week
    of antibiotic and was tapered down within 5 weeks. There was improvement of
    vision as early as 3 weeks post initiation of the treatment. Upon 6 weeks
    completing the treatment, her vision has improved to 6/7.5 on both eyes with
    resolution of optic disc swelling and sub-retinal fluid. Early recognition and
    initiation of treatment in toxoplasma infection associated with juxtapapillary
    retinochoroiditis usually result in good visual prognosis.
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