Cancers of the ovary and corpus uteri afflict 5% and 3.6% Malaysian women respectively. Ovarian cancer (OC) remained the deadliest gynaecological malignancy in perimenopausal women mainly due to the lack of symptoms until the disease had spread. Ultrasonography could provide a preliminary screening allowing the clinician to tailor subsequent management and counselling for these women. To support the basis for selective screening, a study on 517 urban disease free women aged 45 years and above, uterus-intact, non-users of HRT was undertaken. This study presented normograms of ovary, uterus and endometrium derived from entry ultrasound assessment. The sample comprised of 58.0% premenopaused and 42.0% postmenopaused women with an average age of 51.27±5.35 years old. Over two thirds were Chinese followed by Malays and Indians. The findings indicated that the average uterine size and endometrial thickness (ET) was 7.21±1.67x4.36±1.30cm and 6.36±3.73mm respectively. Premenopausal women had larger uterus compared to those postmenopaused (p
Tissue-integrated oral implants have opened-up a new perspective in oral rehabilitation of tumour patients who had undergone surgery. The present case demonstrated a simple approach to rehabilitate a patient who had subtotal maxillectomy using dental implant. The use of an implant in combination with a natural abutment tooth was shown to improve the retention and stability of the obturator. Magnetic attachment and telescopic restoration were the retainers of choice and they provided good aesthetic result.
The role of smoking as a contributory factor in the progression of the periodontal disease process has long been suspected and recently a large number of studies have been published in the dental literature regarding this possible role. Much of the literature has also indicated that smokers affected with periodontitis respond less favorably to periodontal treatment be it non-surgical, surgical and regenerative. This paper will review the current literature regarding the effects of smoking on various aspects of the periodontal disease process and present an explanation for the possible association between smoking and the progression of periodontitis.
Temporary obturator is necessary for maxillectomy procedures to minimise functional disabilities of speech and the swallowing of food and fluid following surgery.l.2 It also provides a base to hold surgical packing and/ or tissue conditioners in place. This packing helps to restore function and counter act contraction during healing of the ,tissues at the operated site. Dental clinicians are often faced with the problem of surgical staffs requesting an obturator for their patients at short notice.This article describes a fast technique of constructing an immediate surgical obturator.
Frequency hopping spread spectrum (FHSS) systems with partial band interference require appropriate compounding of spread spectrum modulation, error correcting code, diversity and decoding method to receive improved transmission signal. In this paper, a fast FHSS system with regular low-density parity-check codes was employed to cater some anti-jamming competence by using good waterfall and error floor performance. The performance evalution of the previously mentioned system was conducted in the presence of partial band noise jamming. The best possible design of the system was achieved with the combination of diversity level L=2 with a probability rate of at 0.7 dB which showed the robustness of the system.
Solid papillary breast carcinoma is a rare type of breast carcinoma. We present four cases which highlight the radiological and histological findings of solid papillary carcinoma. Mammogram supplemented with ultrasound played an important role in detecting solid papillary carcinomas which usually presents as intraductal lesions or intracystic mass with Doppler signal. Excision biopsy is a better option than core biopsy as the latter modality may not be representative and the diagnosis of solid papillary breast carcinoma may be missed.
Interlocked intramedullary nailing is accepted as the gold standard for femoral shaft fractures. However for Winquist type I and II femoral fractures at the isthmus region, unlocked intramedullary nailing (Küntscher nailing) is still a good option. We performed a retrospective study on 86 patients with a total of 88 femoral shaft fractures around the isthmus that presented at our institution between 1 January 1988 and 31 August 2003. All patients (84.1% Winquist type I and 15.9% Winquist Type II fractures) were treated with unlocked intramedullary nail. The average time to union was 16 weeks with 97.7% rate of union. There were two cases (2.3%) of infection and non-union each. Overall results were comparable to standard interlocking intramedullary nailing. We conclude that unlocked intramedullary nailing is a good treatment option for Winquist Type I and II femoral fracture around the isthmus with its good union rate and minimal complications.
Forty children treated non-operatively for fractures of the femoral shaft were reviewed with regard to differences in limb length after treatment. Follow up duration ranged from two to seven years. The average femoral overgrowth was 0.85cm (range 0 - 2.5cm) and was influenced by age at the time of fracture. We were not able to find any association between the quantity of overgrowth and race, gender, level or configuration of the fracture.
We conducted a retrospective review on eleven patients who were treated for Type A and C distal femoral fractures (based on AO classification) between January 2004 and December 2004. All fractures were fixed with titanium distal femoral locking compression plate. The patient’s ages ranged from 15 to 85 with a mean of 44. Clinical assessment was conducted at least 6 months post-operatively using the Schatzker scoring system. Results showed that four patients had excellent results, four good, two fair and one failure.
In recent years, the internet has become an increasingly popular tool for people to obtain information due to the overwhelming availability of material. As internet access becomes more readily available, the newer generation of patients, medical students and doctors are starting to prefer the internet as a source of reference to acquire medical knowledge. The main objectives of this study were to determine the accuracy of using Google search in establishing a clinical diagnosis based on information provided from the New England Journal of Medicine (NEJM) and to determine the concordance rate of Google diagnosis with the actual diagnosis from NEJM.
Most countries around the world have experienced a shortage in organs needed for transplantation. Organ donation performance is widely attributed to two important factors: the legislation and the role of the family. Thus, this literature review aims to examine the willingness of people for organ donation while highlighting the importance of having a presumed consent system.
In ancient times, before Hippocrates, disease and illness were attributed as a sign of divine dismay, and the Gods needed to be appeased to achieve a cure. Hippocrates and his followers showed courage in breaking away from this paradigm. They moved away from the divine and supernatural, to focus on the biology of the body. In the process they put the patient at the centre of their focus. They collected detailed case histories, dismissed religious and supernatural explanations and developed remedies in the form of diets, exercise and mixed minerals and herbs based on their understanding of ill health.
Community-acquired pneumonia (CAP) is one of the most common infectious diseases and the world’s leading cause of mortality and morbidity, especially in patients aged 65 years and above.1,2 It is the 6th cause of mortality and the most important cause of hospitalisation in Malaysia. According to the British Thoracic Society, the gold standard in diagnosing CAP is based on radiological findings and it is defined into 2 different settings – community and hospital.3
Forty thousand children die each day in developing countries; which is approximately 28 dead children every minute. In many of these countries 25% of their children do not even live long enough to celebrate their fifth birthday. These mortality statistics represents a human tragedy affecting our very youngest. The United Nations Children's Fund (UNICEF) has identified seven simple, practical and cost-effective activities to help save the lives of our children. The acronym GOBI FFF - Child Survival Strategy describes these 7 measures. The B in the acronym represents beastfeeding which is a pivotal and fundamental component of this child survival strategy.
Objective: This paper aims to discuss the answers to Review Paper Exam for the Malaysian Master of Medicine (Psychiatry) May 2012 theory examination. The paper studied the psychotropic prescription practice in cancer patients using a health care registration database. Methods: One of the papers presented during the journal club presentation was picked-up for evaluation of student's critical appraisal. Results: Model answers were provided at the end of the Critical Review Paper. Conclusion: This review paper evaluates students' understanding and critical thinking on the topic of Psychotropic Drugs in cancer patients. This paper may serve as a guideline to teach students how to critically appraise topic related to psychiatry. ASEAN Journal of Psychiatry, Vol. 14 (1): January - June 2013: XX XX.