MyMedR

Fulltext Huge Chest Wall Tumour Resection and Reconstruction using Titanium Mesh

Adli Azam MR, Raja Amin RM

Malays J Med Sci, 2015 Jan-Feb;22(1):70-3.

Malignant chest wall tumour is rare. The presentation is usually aggressive that requires extensive resection to prevent recurrence. However, the extensive resection is to the expense of causing defect on the chest wall and hence, respiratory mechanics. Two cases of chest wall tumour are discussed including the surgical approach of radical tumour resection which was combined with placement of titanium mesh and Tranverse Rectus Abdominis Myocutaneus (TRAM) flap to cover the defect and preserve respiratory mechanical functions. The morbidity of using titanium mesh demonstrated in the case series were infection and injury to surrounding tissue due to its rigidity and large size which required its removal. However the formation of 'pseudopleura' made the thoracic cage return back as closed cavity even after the removal of the titanium mesh and allow normal respiratory functions.

Fulltext Profile of clients attending a methadone clinic

Jacob SA, Mohammed F, Hassali MA

Malays J Med Sci, 2015 Jan-Feb;22(1):58-69.

PMID: 25892951 MyJurnal

BACKGROUND: Client characteristics provide useful information for designing programs that target individuals with risk factors for substance use and for determining client retention. Therefore, this study examined the profiles of clients attending a methadone clinic.
METHODS: A cross-sectional analysis of clients of a methadone clinic was conducted through a survey to obtain a profile of methadone clients.
RESULTS: Of the 51 patients who responded (response rate: 66.2%), the mean (SD) age at which they started substance use was 19.8 (5.1) years. Friends were cited as the most regular source of drugs (82.4%), and heroin was the most commonly used drug (98%). Daily substance use was reported by 72.5% of the respondents; 23.5% admitted to having stolen money to purchase drugs; 92.2% tried quitting substance use on their own and 98% stated that the main reason for registering at the clinic was that they wanted to stop their drug dependence. Approximately 60% of clients were receiving methadone doses of less than 60 mg/day.
CONCLUSION: Heroin is still the most popular drug of abuse and most clients still receive methadone doses below the recommended level, despite evidence of poor patient retention rates associated with these low doses.
KEYWORDS: Malaysia; methadone; patient appointments; profile; substance use
Study site: Methadone clinic, hospital, Malaysia.

Fulltext The Effect of Second-Hand Smoke Exposure during Pregnancy on the Newborn Weight in Malaysia

Norsa'adah B, Salinah O

Malays J Med Sci, 2014 Mar;21(2):44-53.

PMID: 24876807 MyJurnal

There was strong evidence from studies conducted in developed countries that second-hand smoke (SHS) exposure is detrimental to the birth weight of newborn. This study was conducted to determine the effect of exposure to SHS smoke during pregnancy on the weight of newborns.

Fulltext Influence of Age, Weight, and Pirani Score on the Number of Castings in the Early Phase of Clubfoot Treatment using Ponseti Method

Awang M, Sulaiman AR, Munajat I, Fazliq ME

Malays J Med Sci, 2014 Mar;21(2):40-3.

PMID: 24876806 MyJurnal

The objectives of this study were to investigate whether severity of clubfoot, age, and weight of the patients at initial manipulation and casting influence the total number of castings required.

Medics and Marine Mammals - An Unlikely but Important Connection for Humanity's Survival

Ponnampalam LS

Malays J Med Sci, 2014 Mar;21(2):1-3.

PMID: 24876801

Marine mammals, as top predators in the marine food web, are sentinels of changes in the oceans and public health. Pollution in the sea and overfishing of seafood resources affects these organisms just as much as it affects human beings. Medics, especially doctors, have an influential reach to patients, and are in an ideal position to get better acquainted with ongoing marine environmental issues and subsequently disseminating such information to them. While seemingly an out-of-the-box approach, it is one that can help with environmental conservation and preservation for the future of humanity.

Necrotizing Fasciitis on the Right Side of the Neck with Internal Jugular Vein Thrombophlebitis and Septic Emboli: A Case of Lemierre's-Like Syndrome

Nguyen D, Yaacob Y, Hamid H, Muda S

Malays J Med Sci, 2013 Oct;20(5):70-8.

PMID: 24643401

Lemierre's syndrome (LS) is a rare life-threatening infective condition typically starting with an oropharyngeal infection causing thrombophlebitis and metastatic abscesses. The most common aetiology of LS is Fusobacterium necrophorum; however, it can also occur after infection with other organisms. LS mainly affects young healthy adults. The initial infection site can be in the head and neck or in the abdomen. The morbidity rate of this disease is high despite aggressive treatments. In this article, we report a 63-year-old male patient with uncontrolled diabetes mellitus, presenting with Klebsiella pneumoniae infection-induced necrotizing fasciitis on the right side of the neck, leading to LS.

Fulltext "VisionTouch Phone" for the Blind

Yong R

Malays J Med Sci, 2013 Oct;20(5):1-4.

PMID: 24643391

Our objective is to enable the blind to use smartphones with touchscreens to make calls and to send text messages (sms) with ease, speed, and accuracy. We believe that with our proposed platform, which enables the blind to locate the position of the keypads, new games and education, and safety applications will be increasingly developed for the blind. This innovative idea can also be implemented on tablets for the blind, allowing them to use information websites such as Wikipedia and newspaper portals.

Functional magnetic resonance imaging (FMRI) neurofeedback: implementations and applications

Dewiputri WI, Auer T

Malays J Med Sci, 2013 Oct;20(5):5-15.

PMID: 24643368

Neurofeedback (NFB) allows subjects to learn how to volitionally influence the neuronal activation in the brain by employing real-time neural activity as feedback. NFB has already been performed with electroencephalography (EEG) since the 1970s. Functional MRI (fMRI), offering a higher spatial resolution, has further increased the spatial specificity. In this paper, we briefly outline the general principles behind NFB, the implementation of fMRI-NFB studies, the feasibility of fMRI-NFB, and the application of NFB as a supplementary therapy tool.

Fulltext Assessment of nutrient intake in cleft lip and palate children after surgical correction

Gopinath VK

Malays J Med Sci, 2013 Oct;20(5):61-6.

PMID: 24643339 MyJurnal

This research aimed to compare the nutrient intake of children with cleft lip and palate (CLP) with that of normal children (without CLP) in the same age groups. The study was conducted at the School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia. A total of 139 children, of both sexes, from two to six years of age, either with CLP (40 children) or without CLP (99 children), were selected. The CLP and non-CLP children were grouped according to age, which is a key determinant of nutrient intake. Children in subgroup I were between the ages of 2 and 4 years, the group comprising 48 normal children of mean age 39.85 months (SD 7.1), and 20 CLP children of mean age 37.05 months (SD 5.9). Children in subgroup II were those over 4 years and up to 6 years old, and the group comprised 51 normal children, of mean age 64.16 months (SD 7.9), and 20 CLP children of mean age 56.75 months (SD 9.9). A comparative cross-sectional study was conducted to evaluate nutrient intake in subgroups I and II, using a 24 hours diet recall method. The nutrient intake of CLP children was shown to have no significant differences from that of normal children. A comparison of intake per day with Recommended Dietary Allowances (RDA) for Malaysian children showed that the consumption of nutrients was inadequate in both the normal and CLP children, in both age sub-groups.

Fulltext Incidental Follicular Thyroid Carcinoma Detected on F-18 FDG PET CT Imaging for Breast Cancer Staging: A Case Report

Cheen Hoe AK, Hamzah F, Abdul Khader MA

Malays J Med Sci, 2014 Sep-Oct;21(5):75-7.

PMID: 25977638 MyJurnal

The detection rate of thyroid incidentalomas is increasing; in fact, as many as 2.3% of patients undergoing FDG PET-CT for other indications have been found to have thyroid incidentalomas. The risk of malignancy in these thyroid incidentalomas can be as high as 47%. The increased uptake and the focal uptake pattern of F-18 fluorodeoxyglucose (FDG) in the thyroid during positron emission tomography (PET)-computed tomography (CT), and the calcification of the thyroid incidentaloma, are associated with even higher risk of malignancy. We report a case of a lady undergoing FDG PET-CT for breast cancer staging but noted to have a calcified thyroid incidentaloma, which was proven to be follicular thyroid carcinoma.

Fulltext Validation of the Malay version of the Parental Bonding Instrument among Malaysian youths using exploratory factor analysis

Muhammad NA, Shamsuddin K, Omar K, Shah SA, Mohd Amin R

Malays J Med Sci, 2014 Sep-Oct;21(5):51-9.

PMID: 25977634 MyJurnal

Parenting behaviour is culturally sensitive. The aims of this study were (1) to translate the Parental Bonding Instrument into Malay (PBI-M) and (2) to determine its factorial structure and validity among the Malaysian population.

Fulltext Relationship between intracellular magnesium level, lung function, and level of asthma control in children with chronic bronchial asthma

Sein HH, Whye Lian C, Juan Loong K, Sl Ng J, Rahardjai A, Sultan MA

Malays J Med Sci, 2014 Sep-Oct;21(5):30-6.

PMID: 25977631 MyJurnal

BACKGROUND: This study aimed to determine the intracellular (red blood cell (RBC)) magnesium levels in children with chronic bronchial asthma and to determine the relationship between the magnesium level and peak expiratory flow rate (PEFR), type of asthma treatment, and level of asthma control.
METHODS: A cross-sectional study was conducted at the Paediatric Clinic, Sarawak General Hospital. A total of 100 children, aged 6-12 years with chronic bronchial asthma, were recruited according to the study criteria. Venous blood samples were obtained to measure the intracellular (RBC) magnesium level using the GBC Avanta Flame Atomic Absorption Spectrophotometer.
RESULTS: Mean age was 8.57 (SD 1.18) years, and 63% of the participants were male. Mean duration of asthma was 62.2 (SD 32.3) months. A normal intracellular magnesium level was found in 95% of the participants, with a mean of 2.27 (SD 0.33) mmol/L. Two-thirds of the participants had a normal peak flow expiratory rate (> 80% of predicted value). About 85% were using both reliever and controller. Almost half of the participants (49%) had chronic asthma that was well-controlled. No significant relationship was found between magnesium level and age (r = -0.089, P = 0.379), gender (t = 0.64, P = 0.52), duration of asthma (r = -0.03, P = 0.74), PEFR (t = 0.41, P = 0.68), current level of asthma control (t = 0.02, P = 0.97), and current treatment (t = 0.414, P = 0.680).
CONCLUSION: There was no significant intracellular magnesium deficiency in children with chronic bronchial asthma. There was no significant relationship between therapeutic medications used for treatment of children with chronic asthma and intracellular magnesium levels.
KEYWORDS: asthma; intracellular; magnesium
Study site: Paediatric Clinic, Sarawak General Hospital, Sarawak, Malaysia

Fulltext Neural Commitment of Embryonic Stem Cells through the Formation of Embryoid Bodies (EBs)

Liyang G, Abdullah S, Rosli R, Nordin N

Malays J Med Sci, 2014 Sep-Oct;21(5):8-16.

PMID: 25977628 MyJurnal

An embryonic stem cell (ESC) is a good tool to generate neurons in vitro and can be used to mimic neural development in vivo. It has been widely used in research to examine the role of cell signalling during neuronal development, test the effects of drugs on neurons, and generate a large population of functional neurons. So far, a number of protocols have been established to promote the differentiation of ESCs, such as direct and indirect differentiation. One of the widely used protocols to generate neurons is through the spontaneous formation of multicellular aggregates known as embryonic bodies (EBs). However, for some, it is not clear why EB protocol could be the protocol of choice. EB also is known to mimic an early embryo; hence, knowing the similarities between EB and an early embryo is essential, particularly the information on the players that promote the formation of EBs or the aggregation of ESCs. This review paper focuses on these issues and discusses further the generation of neural cells from EBs using a well-known protocol, the 4-/4+ protocol.

Fulltext Second-trimester uterine rupture: lessons learnt

F Abdulwahab D, Ismail H, Nusee Z

Malays J Med Sci, 2014 Jul;21(4):61-5.

PMID: 25977625 MyJurnal

Uterine rupture is a rare life-threatening complication. It mainly occurs in the third trimester of pregnancy and is rarely seen during the first or second trimesters. Our centre experienced three important cases of uterine rupture.

Fulltext Posterior capsule rupture during phacoemulsification among patients with pseudoexfoliation - Is there a correlation?

Thanigasalam T, Sahoo S, Kyaw Soe HH

Malays J Med Sci, 2014 Jul;21(4):51-3.

PMID: 25977622

This study was done to correlate the occurrence of posterior capsule rupture among patients with pseudoexfoliation during phacoemulsification. This was a retrospective audit of patients who underwent phacoemulsification type cataract surgery from January 2011 to December 2012 in a tertiary hospital in Malaysia. Data was obtained from the National Eye Database (NED) of Malaysia. The data was analysed using SPSS version 21.0. By using logistic regression analysis, it was found that there was no significant increase in the occurrence of posterior capsule rupture among patients with pseudoexfoliation. Hence, we concluded that there was no correlation between the occurrence of posterior capsule rupture and the presence of pesudoexfoliation among patients who underwent phacoemulsification.

A Psychometric Properties of the Malay-version Police Stress Questionnaire

Irniza R, Emilia ZA, Muhammad Saliluddin S, Nizam Isha AS

Malays J Med Sci, 2014 Jul;21(4):42-50.

PMID: 25977621 MyJurnal

BACKGROUND: Police Stress Questionnaire (PSQ) was developed to measure police-specific stressors. The present study was the first to have translated the PSQ to Malay. This study aims to test the reliability, construct validity, and component structure of the Malay-version PSQ.

METHODS: A set of survey consisted of the Malay-version PSQ, General Health Questionnaire (GHQ-12), Job Content Questionnaire (JCQ), Global Stress Questionnaire (GSQ) and General Self-rated Health (GSRH) were distributed to 300 traffic police officers in Kuala Lumpur and all traffic police officers in a few districts of Pahang and Negeri Sembilan.

RESULTS: The response rate was 65.5% (N = 262). The reported Cronbach's alpha coefficient was 0.93 for Operational PSQ (PSQ-Op) and 0.94 for Organisational PSQ (PSQ-Org). Findings indicated that the PSQ had positive construct validity with the GSRH, GSQ, and GHQ. After excluding four factors related to lifestyles, all police-specific stressors were highly loaded (0.50) in one component.

CONCLUSION: It is confirmed that the Malay-version PSQ, excluding the four factors related to lifestyle, was uni-dimensional, reliable, and a valid questionnaire. This study proffers a potentially better instrument for assessing the stressors among Malaysian police.

Fulltext An outcome of Surgically Treated Head and Neck Cancer in one of the tertiary Referral Center in the East Coast of Malaysia: A 6-year Retrospective Analysis

Abdullah K, Raja Lope Ahmad RA, Asha'ari ZA, Razali MS, Leman WI

Malays J Med Sci, 2014 Jul;21(4):28-36.

PMID: 25977619 MyJurnal

Surgical management of head and neck cancer is undoubtedly challenging, and we would like to see the outcome of managing such cases at one of the tertiary referral center in the East Coast of Malaysia.

Fulltext Searching for the Origin through Central Nervous System: A Review and Thought which Related to Microgravity, Evolution, Big Bang Theory and Universes, Soul and Brainwaves, Greater Limbic System and Seat of the Soul

Idris Z

Malays J Med Sci, 2014 Jul;21(4):4-11.

PMID: 25977615 MyJurnal

Cerebrospinal fluid (CSF) serves buoyancy. The buoyancy thought to play crucial role in many aspects of the central nervous system (CNS). Weightlessness is produced mainly by the CSF. This manuscript is purposely made to discuss its significance which thought contributing towards an ideal environment for the CNS to develop and function normally. The idea of microgravity environment for the CNS is supported not only by the weightlessness concept of the brain, but also the noted anatomical position of the CNS. The CNS is positioned in bowing position (at main cephalic flexure) which is nearly similar to an astronaut in a microgravity chamber, fetus in the amniotic fluid at early gestation, and animals and plants in the ocean or on the land. Therefore, this microgravity position can bring us closer to the concept of origin. The hypothesis on 'the origin' based on the microgravity were explored and their similarities were identified including the brainwaves and soul. Subsequently a review on soul was made. Interestingly, an idea from Leonardo da Vinci seems in agreement with the notion of seat of the soul at the greater limbic system which has a distinctive feature of "from God back to God".

The Eight Stages of Trust and "Amanah" in Medicine and the Dunning-Kruger effect

Abdullah JM

Malays J Med Sci, 2014 Jul;21(4):1-3.

PMID: 25977614

The Dunning-Kruger effect is a cognitive bias in which unskilled people make poor decisions and reach erroneous conclusions, but their incompetence denies them the metacognitive ability to recognise their mistakes. These unskilled people therefore suffer from illusory superiority, rating their ability as above average, much higher than it actually is, while the highly skilled underrate their own abilities, suffering from illusory inferiority.

Fulltext The brain in pain

Ahmad AH, Abdul Aziz CB

Malays J Med Sci, 2014 Dec;21(Spec Issue):46-54.

PMID: 25941463 MyJurnal

Pain, while salient, is highly subjective. A sensation perceived as painful by one person may be perceived as uncomfortable, not painful or even pleasant to others. Within the same person, pain may also be modulated according to its threat value and the context in which it is presented. Imaging techniques, such as functional magnetic resonance imaging and positron emission tomography, have identified a distributed network in the brain, the pain-relevant brain regions, that encode the sensory-discriminative aspect of pain, as well as its cognitive and affective/emotional factors. Current knowledge also implicates the prefrontal cortex as the modulatory area for pain, with its subdivisions forming the cortico-cortical pathway, an alternative pain modulatory pathway distinct from the descending modulatory pathway of pain. These findings from neuroimaging in human subjects have paved the way for the molecular mechanisms of pain modulation to be explored in animal studies.

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