Gestational breast cancer (GBC) or pregnancy-associated breast cancer was defined as breast cancer diagnosed during pregnancy and within 1 year of delivery. Breast cancer is the second commonest cancer after cervical seen in pregnancy and lactation. Nevertheless, the incidence is low and accounts for approximately 1 in 3000 of pregnancies. A delay in diagnosis is common and 70% to 89% of patients with operable primary lesions already have positive axillary lymph nodes. Breast cancer identified during pregnancy can be extremely distressing for the mother despite it has similar course of disease and prognosis seen in non-pregnant women of the same age and stage of disease. Diagnostic and treatment options should be carefully decided to prevent further harm to the mother or any potential risk to the developing fetus.
Preferred body sizes appear to decrease markedly with increasing exposure to contemporäry notions of slimness and economic modernity, and reduce even further in industrial settings as socio-economic status increases. Recently a study examining physical attractiveness preferences in Britain and Malaysia, shows that preference for slim ideals varies according to socio-economic status. Malaysians in
Britain and Kuala Lumpur preferred slimmer female bodies than observers in semiurban Kota Kinabalu, who in turn preferred slimmer figures than rural observers in East Malaysia. This study has important implications for the study of body image and eating disorders in Malaysia.
Smaller family size and advancing parental age have increased the demand for prenatal diagnosis.
Prenatal cytogenetic diagnoses currently used, such as amniocentesis and chorionic villus
sampling, are usually not preferred by the expectant couples due to the risk imposed on the mother and child. High false positive rates (5%) of current non-invasive screening methods, such as serum analysts or ultrasound, cause a large number of unnecessary invasive practices to be performed, which apart from the associated risk, place considerable psychological distress on the couples
involved (Wald et al., 1999). (Copied from article).
We report a rare case of undifferentiated (embryonal) sarcoma of the liver in a six-year-old girl who at presentation, had fever, right hypochondrium pain and hepatomegaly. The diagnosis was clinched by fine needle aspiration cytology and was subsequently reconfirmed by histopathological examination of the resected tumour. Pre-operative chemotherapy was given because primary resection was deemed not possible. The patient underwent a successful extensive hepatectomy followed by continuation chemotherapy
Congenital varicella syndrome is a rare outcome of early primary maternal varicella zoster infection. The neuromuscular anomalies, skeletal defects and skin lesions of such a case are described in our case report. The diagnosis of congenital varicella syndrome, the prenatal risk and management of primary maternal varicella infection in pregnancy are also discussed.
The earliest report of a dengue epidemic in the Malaysian Peninsula was from Singapore in 1901 (More, 1904). S. Kae' in 1902 described the next epidemic in Penang. In March 1954, an outbreak of febrile illness was reported at the Methodist Girls' School, Kuala Lumpur, from which dengue viruses were first isolated in Malaysia and identified as dengue type 1.2 However, the first report of the sinister dengue fever with haemorrhagic manifestations was made only in 1962 from Penang Island (Rudnick et al, 1965).3Parameswaran4 in 1965 described the clinical features seen in 41 cases admitted into the children's ward in the Penang General Hospital. Several of the early isolates were of dengue type 2. (Copied from article).
Percutaneous epiphysiodesis for arresting growth is a useful method for equalising moderate lower limb-length discrepancy. This paper reviews the result of this procedure performed at the Royal Hospital for Sick Children in Glasgowfrom 1989 to 1993. There were 8 children (5 girls and 3 boys) ranging in age (chronological) from 10 years 3 months to 13 years 3 months. Limb-length discrepancies (LLD) at the time of surgery were between 2.5 cm to 5.5 cm. The predicted LLD at maturity was obtained using the Moseleys graph. This ranged from 3.9 cm to 8.3 cm. The cause of discrepancy were hemihypertrophy (5), neurofibromatosis (1), AV malformation (1) and neonatal osteomyelitis (1). Bone age in 3 patients corresponded to their chronological age. In 2 patients their bone age were less than their chronological age by 1 year. In the remaining 3 patients their bone were less than their chronological age by 1 to 3 years. All patients had percutaneous epiphysiodesis of both the distal femur and proximal tibia. All patients except one had afinal LLD of 1 cm or less. There were 2 unsatisfactory results: one girl had a valgus knee due to asymmetric physeal closure. Another boy had a final LLD of 3.3 cm as the procedure was done near skeletal maturity. This technique is useful even with LLD greater than 5 cm in children whose predicted height is above average. The difference between chronological age and bone age ranged from I to 3 years.
The classical procedures of comparing two groups, such as t-test are, usually restricted with the assumptions of normality and equal variances. When these assumptions are violated, the rates of the Type I errors of the independent samples t-test are affected, particularly when the sample sizes are small. In this situation, the bootstrap procedure has an advantage over the parametric t-test. In this study, the performances of the bootstrap procedure and the independent sample t-test were investigated. The investigation focused on the power of both the test procedures to compare the two groups under different design specifications for normal and chi-square distributions. The results showed that the bootstrap procedure has a slight edge over the conventional t-test in term of the rate of achieving the benchmark level for both the distributions. In fact, the bootstrap procedure consistently outperformed the conventional t-test across all the combinations of the test conditions.
A cross-sectional study was undertaken to compare patients’ level of recall on verbal and written information about orthodontic treatment. Participants were the patients and parents attending the orthodontic screening clinic, Universiti Kebangsaan Malaysia (UKM). Participation was voluntary. Participants were placed into two groups. One group was given only written information in the form of an information leaflet, while another group was given only verbal information. The information content comprising of 13 items was based on the Patient Information Leaflet published by the British Orthodontic Society. Both groups received similar content of information in their preferred languages. Self administered close-ended questionnaire forms were given to the subjects after 15 minutes to assess the level of recall. The answers from both groups were compared. Data collected was analyzed using SPSS version 15.0. Chi-square test (p=0.05) was conducted to determine the effect of the method of information on the percentage of recall. A total of 79 subjects volunteered to participate in the study. There were more females than males. The majority were found to have achieved secondary level formal education. Comparison of each question item showed no significant difference between those who were provided with verbal or written information. Both groups showed a high proportion of correct responses. In conclusion, there was no difference in the patients’ level of recall whether the orthodontic patient was given verbal or written information.
A 38-year-old female presented with foreign body sensation in the throat for one year. It was
increasing in severity. There was no other associated symptom. Examination of the oral cavity showed an abnormal looking uvula(Fig. 1). The rest part of the oral cavity, oropharynx and larynx were unremarkable. What is your diagnosis?(Copied from article).
A 28-year-old G3P1+1 at 6 weeks period of amenorrhea with a previous Caesarean section presented with per vaginal bleeding. A cervical ectopic pregnancy was confirmed by a transvaginal scan. An intramuscular methotrexate was given followed by intracervical route due to poor decline of the serum βHCG. However, due to persistent increment of serum βHCG, an additional four doses of intramuscular methotrexate with folinic acid rescue were administered and she responded well to the regime. Unfortunately, following the last dose, she developed an episode of excessive per vaginal bleeding which required suction and curettage of the cervical canal. A Foley‘s catheter balloon was placed intracervically as a tamponade and the bleeding was successfully arrested.
A cross sectional study to measure the prevalence of domestic violence and the factors associated with it among women who seek treatment at Hospital Pontian Out Patient Department was carried out in September 1998 until April 1999. The study sample was chosen through systematic random sampling. A total of 370 women between 15 to 49 years were selected and the response rate was 100%. The Results show the one year prevalence rate of domestic violence was 16.8% and life- long prevalence of domestic violence was 35.1%. Studies shows significant difference between the prevalence of domestic violence by age, marital and working status, age at marriage, knowledge, attitude and action to be taken toward domestic violence. Percent of victim is higher among women less than 20 year old, single, still schooling, negative attitude and action towards abuse and less knowledge of place for seeking help. Factor that contribute significantly toward domestic violence among single women is the lack of positive action in dealing with violence and among married women are early marriage(<25 year), lack of positive action in dealing with violence and lack of moral support from husband and family.
Key words: prevalence of domestic violence, mangsa keganasan, associated factors, contributing factors
Study site: Outpatient clinic, Hospital Pontian, Johor, Malaysia
Injury Hncluding home injury} is an important contributor to the nations’ statistics on mortality and morbidity. However, statistics on injury is still lacking in Malaysia. In 1996, the National Health and Morbidity Survey was conducted nationwide that includes injury as one ofthe scope studied at the community level. It was found that the prevalence of sefreported home injury in Malaysia was 2.5%. The prevalence was higher among the 0-4 years and more than 80 years groups. There was no dwzrence in the prevalence of injury by urban/rural location, ethnicity, citizenship, religion, marital status, level of education, income group or type of occupation. Females however reported a slightht higher figure than males (2. 7% i· 95% CI and 2.3% i 95% CD. Recommendations made include planning and designing of preventive intervention strategies and sreas for future studies.
Study name: National Health and Morbidity Survey (NHMS-1996)
In August 2000, the Disease Control Unit of T erengganu noted an increase in the number of serologically confirmed cases of hepatitis A virus (HAH in Kuala Terengganu Hospital. Preliminary investigation revealed that there were an outbreak of hepatitis A in districts of Kuala Terengganu and Marang. Eventually, a total of 334 associated cases were reported among Kuala Terengganu residents and 59 cases among residents of Marang. The age of the patients range j9·om 2 years to 71 years old (median 16 years). Males accounted for ( 69.5% of cases and had a higher sex specyic attack rate (96.35/100,000) than females (42. 70/100,000). The highest attack rate (128.3/100,000} occurred among patients aged 10 — 14 years. The health staff of Kuala Terengganu and Marang District Health Ojice had investigated a total of 229 case. Most cases (62.4%) occurred amongst school children. A case control study was carried out amongst 35 cases that were matched with 71 controls by age group, class and sex, to identyy the potential source of injection. The results indicated that eating fried noodle with shelh‘ish significantly increased the risk of being infected during the outbreak (OR 16.38[4.2l-74.53]).
Prevalence of visual impairment among students is increasing in trends especially in rural area. A cross sectional study was conducted among secondary school students in Taman PKNS Beranang, Selangor in March 2008 with the objective of determining the prevalence of visual acuity impairment and its influencing factors. A total of 77 secondary school students were interviewed using guided questionnaire. The prevalence of visual acuity impairment among the respondents was 25.0% and study found that being female and have been watching television at a distance of less than two meters were significantly associated with visual acuity impairment. In conclusion, the problem occurred maybe due to the students sit nearer to the television (
Introduction: This study aimed to explore the associated factors related to causes of stress and coping strategies among university students. Materials and Methods: As a focus group discussion, it was universal sampling, conducted among 39 of Medical Science and Biomedicine students on their second semester from Management and Science University (MSU), Shah Alam, Malaysia. Three issues were discussed: firstly, how they define the stress; secondly, what the most important causes of stress in their life are; and thirdly, how they cope with stress. Verbal consent was obtained from all participants. Due to the small sample size, the data was analyzed manually. Results: Total of participants were 39 students, their age ranged from 21 to 26 years. Seventeen (43.6%) of the students were 21 years old and the majority were female 31 (79.5%). The
most important causes of stress reported by the students were financial, lack of sleep, and family problems. In terms of coping with stress, the students were able to describe a variety of strategies to cope with their stressful situations. These included counseling services, doing meditation, sharing of problems, getting adequate sleep, and going out with friends. Conclusion: Most of the students defined stress as “a mental condition”. Lack of sleep, financial, and family problems were the most causes of stress among students. The students were able to identify some strategies to cope with stress.
Background: Historically, more men enrolled in medical schools than women. However, during the last few decades, there has been an increase in the number of women attending medical schools worldwide. Although a similar trend is seen, there is no documentation found in Malaysia. In this present study, we investigated if such gender enrolment differences occurred at our medical school. Methods: Information was obtained from Kulliyyah of Medicine student statistic for 2006/2007 section and graduates from 2001/2002 (1st batch) to 2006/2007. Results: Our study showed that more than half (60%)of our students are female and all students who received distinction in final year exam from 2002 till now are females although the number of males who needed to sit for the supplementary examination outnumbered the females during that period. Discussion: The feminization of medicine in International Islamic University Malaysia (IIUM) was similar to other studies worldwide. Further research should be aimed on comparison of the academic performance of male and female medical students and also choice of specialty chosen by men and women in our university.
Monoamniotic twin pregnancy is a rare type of twin pregnancy which poses risk of cord entanglement and
sudden death of either one or both fetuses. The role of antenatal surveillance by Ultrasound Doppler for
umbilical cord and ultrasonic evidence of cord entanglement or knotting may predict the pregnancy outcome
but yet unavoidable. The discussion will include antenatal surveillance in this rare type of pregnancy.
The aim of the study was to compare the body fat percentages between Malaysian national women basketball players and netball players. Both basketball and netball players were elite players who represented Malaysia in the 1997 Southeast Asia Games in Jakarta, Indonesia and the 1998 Commonwealth Games in Kuala Lumpur. The percentage of body fat was determined by means of skinfold measurement at seven different locations. Results of the findings showed that overall, the basketball players had higher percentages of body fat than netball players. The average percentages of body fat of basketball and netball players were 19.68 ± 4.93% and 18.93 ± 4.41%, respectively. Both Malaysian national basketball and netball players' average percentage of body fat were found to be higher than the ideal average percentage of body fat range between 10-16% for female athletes in elite team sports. The players in the defence position in basketball were found to have the highest percentage of body fat (23.00%), followed by centre position players (21.62%) and attack position players (15.10%). These results differed from netball players' in similar playing positions. Among the netball players, the defence position players had the highest percentage of body fat (21.00%), followed by attack position players (18.63%), and centre position players (16.57%).
We report a 21-year old female patient who presented with an 18-month history of a swelling in the distal phalanx of her right little finger. Although the history, clinical features and MRI were suggestive of a benign tumour or a tuberculous lesion, the histo-pathological examination of the swelling was reported as a conventional osteosarcoma. Osteosarcoma of the hand is very rare. This article highlights the possibility of a seemingly benign lesion seen in a routine clinic could well turn out to be malignant, and the need to maintain a high index of suspicion.