Synovial Sarcoma is a rare malignancy. It presents in adolescents and young adults. It occurs in soft tissue
of extremities usually near to the large joints, heart, lung, mediastinum, head and neck. A 23-year-old
female presented with a big hard fixed swelling in right supraclavicular region for 15 years. X-Ray chest
posterior-anterior view presented Homogenous opacity in upper lobe of right lung. USG of neck showed
large heterogeneous lobulated almost avascular solid mass in right side of root of neck and anterior upper
mediastinum may be associated with Schwannoma/ paraganglioma/soft tissue sarcoma. Spindle cell
lesion was reported by FNAC. MRI showed large slightly lobulated mass along right side of root of neck
and right side of superior mediastinum. A large soft tissue density mass along right side of neck and
superior mediastinum was found in CT scan. Surgical excision was done successfully. Histopathological
examination revealed spindle cell tumor favoring synovial sarcoma in the neck tissue and metastatic
spindle cell tumor in the lung lesion.
It is important to prepare the nursing students to be confident and able to interact with the patients,
colleagues, doctors and other staff because the nature of nursing work included a high degree of personal
and group interaction. Continuous communication and interaction in nursing work are some of the
important factors for self-esteem among nurses. Self-esteem affects the relationship between job roles and
job satisfaction as well as the link between work performance and work roles conflict. The objective of this
study is to examine the effects of low self-esteem on clinical performance among first year nursing students
at private nursing college in Kota Kinabalu, Sabah. A descriptive qualitative study was conducted among
10 first year nursing students in one of the private nursing college. Data was collected through one to one
interviews using semi-structured questions. The interview question was structured based on observation
and literature review. The design is ideal because it facilitate the collection of data from a small number of
participants through personal interview. The collected data was transcribed into verbatim and analysed by
identifying the themes via coding and categorization. The results showed there are two main themes
emerged from the study: Defensive behavior and poor communication as the effects of low self-esteem on
the students’ clinical performance. As conclusion from this study, defensive behavior and poor
communication and are the obvious effects of low self-esteem among the first year nursing students in a
private nursing college. This study revealed the needs to equip the students with more conducive learning
environment facilitate suitable motivational and mentoring approaches and practice good communication
skills. Future research suggested, extends the study to the public nursing college for outcomes comparison
and evaluation.
An Objective Structured Clinical Examination (OSCE) is now a well-recognized modern type of
examination often used in faculties of medicine and health sciences all over the world. Though the
assessment tool has been designed to assess different types of clinical skill but this is evident that student
performance are not the same in different types of stations. The aim of this study was to evaluate the
performances in different types of OSCE stations among undergraduate medical students. Three types of
stations were set in this cross-sectional study. They were clinical reasoning, history taking and procedure
performing. On the examination day all the students had attended 3 stations for procedure, 4 stations for
clinical reasoning and 3 stations for history taking. The scores were collected and transferred to excel
spreadsheet. Mean score of each types of modules were calculated. Statistical difference between all three
means were measured by one-way ANOVA F-test. F was 7.2 and p-value was 0.001304. The result was
significant at p
Out of bacteria which cause food –borne infections, enterohemorrhagic Escherichia coli (EHEC) is
well known to be pathogen causing serious outbreaks. The first outbreak of EHEC infection occurred
in 1982 was due to ingestion of hamburger at restaurant. A rare Escherichia coli serotype, 0157:H7
was isolated at that time and the following outbreaks were mostly due to this serotype. However, O26,
O111 and O104 were also responsible for EHEC outbreaks. Enterohemorrhagic E. coli is an important
food and water-borne pathogen. Verotoxins (VTs) produced by this pathogen causes painful
hemorrhagic colitis along with major complications of hemolytic uremic syndrome (HUS). The
morbidity and significantly high mortality and enormous economic loss are problematic to the health
care administrators and EHEC infection is a serious public health issue. Another factor which makes
it high transmissibility is the low infectious dose. The German O104:H4 epidemic was caused by the
pathogen carrying a combination of virulence genes derived from two well-known pathogens, EHEC
and enteroaggregative E. coli (EAEC). There is a possibility that two mobile DNA elements can occur
again in this versatile pathogen. In this article, some aspects of EHEC infections which were
established but not well known to the medical personals were explained to get understanding of why
this infection should not be overlooked and should be under surveillance.
Cigarette smoking is considered as the symbol of adulthood and as a friend during stress and loneliness. The developing countries in South Asia where the largest segment of the population is comprised of adolescents are more susceptible to smoking epidemic and its consequences. A cross sectional survey among 304 randomly selected medical students was carried out to determine their smoking habit of a selected medical college in Dhaka, from 1st October to 31st December 2014. The respondents were from 16 to 20 years of age, with mean (±SD) of 16.8 (±1.9) years. Among them (including 28 girl students), 96(31.5%) were non-smokers. The remaining 208(68.4%) were smokers, among them 43(20.6%) were regular smokers, and 165(79.3%) were occasional smokers. All 28 female students were non-smokers. Regarding duration of smoking, 42(20.2%) respondents smoked for less than 6 months, 64(30.8%) for 6 months to 1 year, 88(42.3%) for 1 to 4 years, 11(5.3%) for 5 to 10 years and a least 3(1.4%) smoked for more than 10 years. Thirty six percent of current smokers smoked more than 10 sticks per day compared
with thirty percent who smoked 6 to 10 a day. Significantly more users knew that it causes tuberculosis, heart attack, cancer and development of hypertension. Overall, students’ major sources of information were doctors (69.7%), medias (47.7%), parents (9.2%) and friends (3.3%). As the prevalence of smoking among medical students was found very high hence, the multi-pronged intervention strategy is needed to tackle the problem. Anti-tobacco education and awareness should be adopted in the curriculum of schools and colleges. All forms of tobacco advertising and promotional activities should be banned, and parents should be encouraged to adopt more responsible attitudes toward smoking in the home.
Ocular trauma is a significant health problem in paediatric age group. This study is to evaluate the
demographics, etiology, management and visual outcome of paediatric ocular trauma in Sabah.
This is a retrospective review of all ocular trauma occurring in the paediatric age group from age
12 years old and below from January to December 2014 at Hospital Wanita Dan Kanak-Kanak,
Sabah. Medical records were reviewed and the data was examined based on Birmingham Eye
Trauma Terminology (BETT) system. Incomplete case notes were excluded from the study. A total
of 37 cases were accumulated during the study period. All the paediatric ocular trauma cases were
admitted and accounted for 13.4% of the total paediatric eye ward admission. However, 4 cases
were excluded from the study as the medical records were incomplete. There were 26(78.8%) males
while 7(21.2%) female children with a ratio male: female of 3.7: 1. There were 31(93.9%) unilateral
ocular injury cases while only 2(6.1%) bilateral injury caused by chemical injury. The most
common type of ocular trauma was closed globe injury totaling 24 (72.7%) cases. Trauma caused
by blunt object contributed to the highest mode of injury 15 (45.5%) of cases. Open globe injuries
which had poor visual outcome accounted for 9 (27.3%) cases. Most of patients required surgical
treatment 21(63.6%) while 12(36.4%) cases treated non-surgically. In conclusion, ocular trauma
was more common in male and pre-school age group. The main aetiology was blunt injury. Most
of the cases treated surgically. Poorer visual outcome was observed in open globe injury.
Gurayat General Hospital is a 350 bed secondary referral hospital of Kingdom of Saudi Arabia. This is one of the busiest hospitals in Al-Jouf region. Trauma is very common in this city and the ER department is mostly overwhelmed by Neurosurgical emergency patients. The aim the study was to evaluate the age sex,
types of injuries and causes of injuries of the neurosurgical emergency patients. This was a cross-sectional descriptive observational study. Ethical approval was achieved from proper authority. Good Clinical Practice (GCP) ICH E6 protocol was followed in order to ensure safety and efficacy. Data was collected from the log book of the ER department. Data were transferred to a spreadsheet to make a master sheet. Valuables of individual columns were analyzed and tabulated. Comparison was performed between the result of this study and other international studies. About 7.3% of all ER admissions were for the Neurosurgical cases. Among the Neurosurgical cases (n=3588) there was clear predominance of male
gender (81%). Majority (45%) of the Neurosurgical patients were from children and teen age group. Nearly 50% of the patients reported to ER with the history of Road Traffic Accident (RTA). Head injury was the commonest (61%) type of injury. Approximately 45% patients were admitted in to general ward whereas 42% patients were discharged from ER after providing primary treatment. When the results of this study were compared to the results of the other international studies fair similarities were observed.
Diversity of forensically important insects were documented from two experiments using a monkey
(long-tailed macaque, Macacafascicularis Raffles) and a pig (Susscrofa L.) carcasses. The experiments
were conducted in shrub area of Universiti Malaysia Sabah (UMS), Kota Kinabalu and in rural area of
Menggatal district, Kota Kinabalu, Sabah respectively. Records were made daily on insects visiting the
carcasses, the environmental temperatures and relative humidity.Blowflies, Chysomyamegacephala
(Fabricius), Chrysomyarufifacies (Macquart) and Sarcophagabrevicornis(Ho) were the earliest species
to be recorded in both studies. Other species of flies recorded from both
carcasesincludeLuciliacuprina(Wiedemann),Hydroteaspinigera(Stein), Muscadomestica(Linnaeus)
and Fannia spp. Additional species observed on pig carcasswere Hypopygiopsisviolacea(Macquart),
Stomorhina sp.(Rondani) and beetles,Diamesusosculans(Vigors) (Coleptera: Silphidae). Information
from this study provides important base data on the local carrion fauna which help to improve the post
mortem interval determination in local forensic cases.
Dengue is one of the commonest viral diseases of Africa and tropical Asia. This disease is characterized by headache, fever, generalized body pain, severe malaise and back pain. The uncomplicated Dengue which is also named the classical dengue fever usually begins 3-8 days after biting of an infected mosquito. This is a cross sectional study on clinical presentation of Dengue in a general hospital in Bangladesh. The total number of patients was 198. The study period was 6 months (July 2004 to December 2004). All the patients who were admitted in the ‘Dengue ward’ and diagnosed as Dengue by serological test were included in this study. The aim of this study was to evaluate the common clinical presentations of Dengue in a General hospital in Bangladesh. The aim and objective was to compare the clinical presentations of Dengue in Bangladesh patients with those of other international studies. Most of the patients were male (3.7 :1) in sex and young adult(s) in age (80.3%). Fever and severe backache were the commonest clinical features. Nearly two-third (74%) patients presented with hemorrhagic features. Gum bleeding (20.2%) was the commonest bleeding feature. The result of this study showed a similarity with that of other international studies.
Normally endometrial carcinoma presents with post-menopausal bleeding in the majority of cases. It
rarely presents with haematometra. If it does, it rarely reaches the term pregnant uterus size. This case
report is a rare presentation of endometrial carcinoma which was at first diagnosed as a huge ovarian
mass later found out to be haematometra intraoperatively. There was a discordant finding between the
endometrial invasions with distant metastasis (Local invasion of stage 1A with lung metastasis which
should be stage 4B). It is an uncommon combined occurrence but at least we learnt there can be possible
different presentation for endometrial cancer. It further proved that almost all of haematometra can turn
out to be associated with endometrial carcinoma.
Toxigenic strains of Vibrio cholerae serogroup O1 and O139 are causative agents of deadly
diarrheal disease named cholera. Vibrio cholerae O1 is traditionally divided into two
biotypes, classical and El Tor, which are different in phenotypic as well as genotypic traits.
Since 1961, classical strains of Vibrio cholerae O1 serogroup has become obsolete as the
cause of epidemic and pandemic cholera and replaced by El Tor strains. Since 2002, atypical
O1 El Tor strains possessing the traits of classical strains have been increasingly recognized
as the cause of cholera in many countries across the world. This article focuses on the genetic
traits of O1 classical and El Tor strains. Furthermore, an overview of emergence of atypical
O1 El Tor strains and their genetic traits is presented.
Slum children are at risk for serious mental health problems because of their economic and social
environments. Little is known about their mental health. This cross sectional study was carried out to
know the extent of mental health problems among slum-dweller children in Dhaka city, Bangladesh. One
hundred and twenty students of four different primary schools were selected. In the first stage of the study,
socio-demographic data as well as information about mental health problems were collected through
socio-demographic questionnaire and validated Bengali version of Rutter B2 scale respectively, from the
teachers of the schools. In the second stage, all the students were assessed again personally by the both
authors with the help of Diagnostic and Statistical Manual of Mental Disorders- fourth edition (DSMIV).
High prevalence of mental health problems was found among slum children (70.8%). Emotional,
conduct and undifferentiated disorders were detected in 14.17%, 45.83% and 10.83%, respectively.
Conduct disorder was 3.23 times more prevalent in the children than was emotional disorder. It was more
prevalent in boys than in girls (57.90% vs 34.90%). Significant relationships were found among gender
and emotional disorder (p < 0.030), father’s employment status and undifferentiated disorder (p < 0.010),
substance abuse by father and child’s emotional disorder(p
Parasitic worm infections, particularly by soil-transmitted helminths (STHs), are considered a public
health concern affecting millions of children in developing countries around the world. In Malaysia,
various prevalence studies have been carried out since 1970s among children from diverse population
ranging from the remote aboriginal communities in the Peninsular Malaysia to the rural interior tribes of
Sarawak. However, the number of worm infection studies in Malaysia is still limited particularly in East
Malaysia but overall, more studies should be conducted presently compared to 20 years ago. Focusing
mainly on STHs, we reviewed the prevalence and intensity of worm infection among children between
East Malaysia and West Malaysia, particularly from rural and urban settings.