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Management of severe early childhood caries, Second Edition

Matched MeSH terms: Humans
Clinical Practice Guideline: Management of autism spectrum disorder in children and adolescents

Matched MeSH terms: Humans
Polymicrobial interactions of Candida albicans and its role in oral carcinogenesis

Arzmi MH, Dashper S, McCullough M

J Oral Pathol Med, 2019 Aug;48(7):546-551.
PMID: 31183906 DOI: 10.1111/jop.12905

The oral microbiome is composed of microorganisms residing in the oral cavity, which are critical components of health and disease. Disruption of the oral microbiome has been proven to influence the course of oral diseases, especially among immunocompromised patients. Oral microbiome is comprised of inter-kingdom microorganisms, including yeasts such as Candida albicans, bacteria, archaea and viruses. These microorganisms can interact synergistically, mutualistically and antagonistically, wherein the sum of these interactions dictates the composition of the oral microbiome. For instance, polymicrobial interactions can improve the ability of C albicans to form biofilm, which subsequently increases the colonisation of oral mucosa by the yeast. Polymicrobial interactions of C albicans with other members of the oral microbiome have been reported to enhance the malignant phenotype of oral cancer cells, such as the attachment to extracellular matrix molecules (ECM) and epithelial-mesenchymal transition (EMT). Polymicrobial interactions may also exacerbate an inflammatory response in oral epithelial cells, which may play a role in carcinogenesis. This review focuses on the role of polymicrobial interactions between C albicans and other oral microorganisms, including its role in promoting oral carcinogenesis.

Matched MeSH terms: Humans
An unexpected encounter with jejunal web after foreign bodies entrapment in a toddler

Yik YI, How AK

Med J Malaysia, 2019 Jun;74(3):231-233.
PMID: 31256180

We present a very rare case of jejunal web discovered after a toddler presented with foreign bodies entrapment, following incidental ingestion. This is perhaps the first case reported in the English publication. Expectant management with spontaneous passage of foreign bodies failed. Serial abdominal radiographs failed to determine the site of the foreign bodies accurately. Endoscopic removal was unsuccessful. Surgical removal was warranted with unexpected intra-operative finding of a jejunal web with foreign body entrapment. Although rare, a congenital intestinal web must be considered in a child presents with failure of expectant management following foreign body ingestion as surgical intervention is necessary.

Matched MeSH terms: Humans
Anticholinergic exacerbation of psychotic symptoms: a case report

Gill JS, Jambunathan ST, Muhsin M, Abdul Rashid R

JUMMEC, 2005;8:61-62.

A common practice in psychiatry when treating patients is the concurrent administration of anticholinergics along with antipsychotics, either to prevent or treat extrapyramidal syndrome reactions from occurring. However, most antipsychotics have inherent anticholinergic properties themselves. Therefore, this subtype of these patients have a higher than usual risk of developing anticholinergic side-effects, of which the central nervous manifestations can mimic psychosis, and may cloud judgement on patients’ progress towards their treatment.

Matched MeSH terms: Humans
A prospective audit of Desflurane anaesthesia in the University of Malaya Medical Centre Day Surgery Unit

Chiu CL, Mansor M, Wang CY

JUMMEC, 2005;8:45-49.

We evaluated the use of Desflurane anaesthesia in this prospective observational audit in the University of Malaya Medical Centre Day Surgery Unit. Fifty ASA I-II unpremedicated day surgery patients received fentanyl and propofol induction after preoxygenation. Desflurane was introduced initially at 2% and the concentration was increased gradually to 4%, then 6%, 8% and 10% in nitrous oxide and oxygen. Patients breathed spontaneously throughout the surgery. Desflurane was switched off at the end of surgery and patients breathed 100% oxygen. The haemodynamic effect, perioperative complications and recovery profiles were recorded. Systolic arterial pressure and heart rate decreased after induction of anaesthesia but returned to baseline value at discharge. Adverse airway event such as coughing and postoperative nausea and vomiting are two unwanted complications. KEYWORDS: Desflurane, day surgery, propofol induction

Matched MeSH terms: Humans
Sexual health of male migrant workers

Siti Norazah Z

JUMMEC, 2002;1:52-58.

Sexual health is defined as part of reproductive health and includes healthy sexual development; equitable and responsible relationships and sexual fulfillment; and freedom from illness, disease, disability, violence and other harmful practices related to sexuality. For this project on Health Problems of Migrant Workers, a section on sexual health was incorporated based on a special concern over sexually transmitted diseases (STDs), and high-risk behaviours. Access to healthcare is recognised to be a problem with minority or marginalised groups, including adolescents and migrant populations, especially undocumented migrants. This exacerbates the issue of control and management of STDs. The Sexual Health section covered experience with sexual interourse, and a limited number of questions related to sex partners and condom use among those who are sexually experienced.

Matched MeSH terms: Humans
Fulltext Landslide factors and susceptibility mapping on natural and artificial slopes in Kundasang, Sabah

Sharir K, Roslee R, Lee KE, Simon N

Sains Malaysiana, 2017;46:1521-1540.

This study was carried out on the hilly topographic area in Kundasang, Sabah. This area is known to be extremely prone to landslides that occurred either naturally or by human interference to natural slopes. Aerial photographs interpretation was conducted in order to identify landslide distributions across three assessment years (2012, 2009 and 1984). These datasets were classified into two landslides groups based on their occurrences; natural and artificial. A total of 362 naturally occurring landslides were identified and another 133 are artificial slope landslides. Physical parameters which include lithology, slope angle, slope aspect and soil series were analyzed with each landslide group to examine the different influence of these parameters on each of the group. From the analysis, the landslide density for the natural landslide group shows that more than 35° slope angle and slope aspect facing east and southwest are prone to landslides. In terms of geological materials, high landslide density is recorded in the phyllite, shale, siltstone and sandstone lithologies group and the Pinosuk, Kepayan and Trusmadi soil series. In contrast, for the artificial
slope landslide, high landslide density is observed in the 25°-35° slope angle and similar density in every slope aspect classes. The geological materials however have similar landslide density across their factors’ classes. The landslide density technique was also used to generate the landslide susceptibility maps for both landslide conditions. Validation of the maps shows acceptable accuracy of 71% and 74%, respectively, for both natural and artificial slope landslide susceptibility maps and this shows that these maps can be used for future land use planning.

Matched MeSH terms: Humans
Fulltext Relationship between patient factors and specific learning needs of women on breast cancer

Raja Lexshimi R, Siti Mariam B, Rohaizak M, Subahan M, Nabishah M

Malaysian Journal of Public Health Medicine, 2017;17(1):14-23.

The type of specific learning needs of women with breast cancer using the Information Needs Questionnaire (INQ) had been identified prior to developing a breast cancer education package. It is also important to determine the types of patient factors such as demographic and clinical factors that influence women’s specific learning needs on breast cancer. This study thus reports the findings on what type of patient factors influence women’s specific learning needs related to the types of INQ. A total of 140 women with breast cancer who sought treatment at Universiti Kebangsaan Malaysia Medical Centre participated in this cross sectional study. Age showed a significant relationship with specific learning needs on sexual attractiveness (p=0.001) and self-care (p=0.048). Duration of illness was related to information on spread of breast cancer (p=0.040) and self-care (p=0.047). Education level showed a significant relationship with cure (p=0.001), sexual attractiveness (p=0.007) and spread of breast cancer (p=0.003). Occupation showed a significant relationship with specific learning needs on sexual attractiveness (p=0.005), chemotherapy (p=0.043), radiotherapy (p=0.039) and hormonal therapy (p=0.043). On treatment received, a significant relationship was noted with sexual attractiveness (p=0.009), radiotherapy (p=0.029), hormonal therapy (p=0.038) and targeted therapy (p=0.047). Ethnicity and Marital status showed no significant relationship with all the specific learning needs. Findings of this study concluded that certain patient factors had significant relationship with certain specific learning needs. All the patient factors studied and their influence on the specific learning needs were taken into consideration prior to developing the breast cancer education package.

Matched MeSH terms: Humans
Fulltext Careful selection of predictor variables of AKI for robust regression model in Intensive Care Unit

Mallhi TH, Khan AH, Sarriff A, Adnan AS, Khan YH

J Bras Nefrol, 2016 12;38(4):483-484.
PMID: 28001178 DOI: 10.5935/0101-2800.20160078
Matched MeSH terms: Humans
Fulltext Dengue Infection Complicated by Hemophagocytic Lymphohistiocytosis: Experiences From 180 Patients With Severe Dengue

Kan FK, Tan CC, Von Bahr Greenwood T, Khalid KE, Supramaniam P, Hed Myrberg I, et al.

Clin Infect Dis, 2020 05 23;70(11):2247-2255.
PMID: 31188423 DOI: 10.1093/cid/ciz499

BACKGROUND: Globally, ~500 000 people with severe dengue (SD) require hospitalization yearly; ~12 500 (2.5%) die. Secondary hemophagocytic lymphohistiocytosis (sHLH) is a potentially fatal hyperinflammatory condition for which HLH-directed therapy (as etoposide and dexamethasone) can be life-saving. Prompted by the high mortality in SD and the increasing awareness that patients with SD may develop sHLH, our objectives were to (1) determine the frequency of dengue-HLH in SD, (2) describe clinical features of dengue-HLH, (3) assess mortality rate in SD and dengue-HLH, and (4) identify mortality-associated risk factors in SD.
METHODS: A 5-year retrospective single-center study in all adult patients with SD admitted to a tertiary intensive care unit in Malaysia.
RESULTS: Thirty-nine of 180 (22%) patients with SD died. Twenty-one of 180 (12%) had HLH defined as an HLH probability ≥70% according to histo score (HScore); 9 (43%) died. Similarly, 12 of 31 (39%) fulfilling ≥4 and 7 of 9 (78%) fulfilling ≥5 HLH-2004 diagnostic criteria died. Peak values of aspartate aminotransferase (AST), alanine aminotransferase, lactate dehydrogenase, and creatinine correlated to fatality (odds ratios [ORs], 2.9, 3.4, 5.8, and 31.9; all P < .0001), as did peak ferritin (OR, 2.5; P = .0028), nadir platelets (OR, 1.9; P = .00068), hepatomegaly (OR, 2.9; P = .012), and increasing age (OR, 1.2; P = .0043). Multivariable logistic regression revealed peak AST (OR, 2.8; P = .0019), peak creatinine (OR, 7.3; P = .0065), and SOFA (Sequential Organ Failure Assessment) score (OR, 1.4; P = .0051) as independent risk factors of death.
CONCLUSIONS: Be observant of dengue-HLH due to its high mortality. A prospective study is suggested on prompt HLH-directed therapy in SD patients with hyperinflammation and evolving multiorgan failure at risk of developing dengue-HLH.

Matched MeSH terms: Humans
Fulltext Hidden Choroidal Melanoma Presented with Bullous Non-rhegmatogenous Retinal Detachment in a Myopic Asian Lady: A Rare Manifestation

Ibrahim N, Sakinah Z, Abdul Ghani Z, Ibrahim M

Cureus, 2019 Mar 27;11(3):e4335.
PMID: 31187000 DOI: 10.7759/cureus.4335

Choroidal melanoma is an uncommon malignant melanoma among non-Caucasians. We report here a case of a high myope patient who presented with symptoms of acute retinal detachment, which had been diagnosed as possible rhegmatogenous retinal detachment from the initial assessment. A detailed vitreoretinal evaluation revealed a glimpse of an obscured intraocular mass underneath the detached retina, which later proved to be a choroidal melanoma. This is an unexpected cause of retinal detachment in a myopic eye. Furthermore, the rare nature of choroidal melanoma in this particular region of the world makes this an ignored diagnosis at presentation.

Matched MeSH terms: Humans
Pre-employment screening & monitoring of the health of foreign workers

Khairul Anuar A, Nooriah MS

JUMMEC, 2002;7:82-84.

Matched MeSH terms: Humans
Small forms of Blastocystis hominis

Rajah S, Suresh K, Vennila GD, Khairul Anuar A, Saminathan R

JUMMEC, 2002;7:77-79.

Matched MeSH terms: Humans
Reply to Deprescribing in Nursing Homes

Kua CH, Mak VSL, Lee SWH

J Am Med Dir Assoc, 2019 09;20(9):1178-1179.
PMID: 31272858 DOI: 10.1016/j.jamda.2019.05.008
Matched MeSH terms: Humans
Doing gender better: can the UN step up?

Allotey P, Remme M, Lo S

Lancet, 2019 06 15;393(10189):2371-2373.
PMID: 31155269 DOI: 10.1016/S0140-6736(19)30988-2
Matched MeSH terms: Humans
Fulltext A systematic review of the health-financing mechanisms in the Association of Southeast Asian Nations countries and the People's Republic of China: Lessons for the move towards universal health coverage

Myint CY, Pavlova M, Thein KN, Groot W

PLoS One, 2019;14(6):e0217278.
PMID: 31199815 DOI: 10.1371/journal.pone.0217278

We systematically review the health-financing mechanisms, revenue rising, pooling, purchasing, and benefits, in the Association of Southeast Asian Nations (ASEAN) and the People's Republic of China, and their impact on universal health coverage (UHC) goals in terms of universal financial protection, utilization/equity and quality. Two kinds of sources are reviewed: 1) academic articles, and 2) countries' health system reports. We synthesize the findings from ASEAN countries and China reporting on studies that are in the scope of our objective, and studies that focus on the system (macro level) rather than treatment/technology specific studies (micro level).The results of our review suggest that the main sources of revenues are direct/indirect taxes and out of pocket payments in all ASEAN countries and China except for Brunei where natural resource revenues are the main source of revenue collection. Brunei, Indonesia, Philippines, Malaysia, and Viet Nam have a single pool for revenue collection constituting a national health insurance. Cambodia, China, Lao, Singapore, and Thailand have implemented multiple pooling systems while Myanmar has no formal arrangement. Capitation, Fee-for-Service, DRGs, Fee schedules, Salary, and Global budget are the methods of purchasing in the studied countries. Each country has its own definition of the basic benefit package which includes the services that are perceived as essential for the population health. Although many studies provide evidence of an increase in financial protection after reforming the health-financing mechanisms in the studied countries, inequity in financial protection continue to exist. Overall, the utilization of health care among the poor has increased as a consequence of the implementation of government subsidized health insurance schemes which target the poor in most of the studied countries. Inappropriate policies and provider payment mechanisms impact on the quality of health care provision. We conclude that the most important factors to attain UHC are to prioritize and include vulnerable groups into the health insurance scheme. Government subsidization for this kind of groups is found to be an effective method to achieve this goal. The higher the percentage of government expenditure on health, the greater the financial protection is. At the same time, there is a need to weigh the financial stability of the health-financing system. A unified health insurance system providing the same benefit package for all, is the most efficient way to attain equitable access to health care. Capacity building for both administrative and health service providers is crucial for sustainable and good quality health care.

Matched MeSH terms: Humans
Fulltext Trust in Nurse Scale Developed on the Basis of the Standardized Trust in Physician Scale by Anderson and Dedrick

Krajewska-Kułak E, Kułak W, Cybulski M, Kowalczuk K, Guzowski A, Łukaszuk C, et al.

Mater Sociomed, 2019 Mar;31(1):57-61.
PMID: 31213958 DOI: 10.5455/msm.2019.31.57-61

Introduction: Nursing care is one of the most important areas of health services, taking place in direct contact with the patient, constituting a subsystem deciding about the general level of services.
Aim: The aim of the study was to construct the Trust in Nurse Scale on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick.
Methods: The study included a group of 1,200 people selected at random, 600 each from surgical and medical treatment wards. Patients did not report any problems with understanding the statements on the scale.
Results: The internal accuracy scores were excellent, all Cronbach's a values were well above 0.70. The Spearman's rank correlation coefficient values were highly statistically significant (p <0.001), and correlation strength was very high (for most items rs > 0.90).
Conclusion: We suggest that The Trust in Nurse Scale, developed on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick, can be used in studies on patient satisfaction with nursing care.

Matched MeSH terms: Humans
Fulltext A systematic review and meta-analysis of the impact of collaborative practice between community pharmacist and general practitioner on asthma management

Mubarak N, Hatah E, Khan TM, Zin CS

J Asthma Allergy, 2019;12:109-153.
PMID: 31213852 DOI: 10.2147/JAA.S202183

Objective: This systematic review aims to investigate the impact of collaborative practice between community pharmacist (CP) and general practitioner (GP) in asthma management. Methods: A systematic search was performed across 10 databases (PubMed, Medline/Ovid, CINAHL, Scopus, Web of Science, Cochrane central register of controlled trials, PsycARTICLES®, Science Direct, Education Resource Information Centre, PRO-Quest), and grey literature using selected MeSH and key words, such as "community pharmacist", "general practitioner", and "medicine use review". The risk of bias of the included studies was assessed by Cochrane risk of bias tool. All studies reporting any of the clinical, humanistic, and economical outcomes using collaborative practice between CPs and GPs in management of asthma, such as CPs conducting medications reviews, patient referrals or providing education and counseling, were included. Results: A total of 23 studies (six RCTs, four C-RCT, three controlled interventions, seven pre-post, and three case control) were included. In total, 11/14 outcomes were concluded in favor of CP-GP collaborative interventions with different magnitude of effect size. Outcomes, such as asthma severity, asthma control, asthma symptoms, PEFR, SABA usage, hospital visit, adherence, and quality of life (QoL) (Asthma Quality-of-Life Questionnaire [AQLQ]; Living with Asthma Questionnaire [LWAQ]) demonstrated a small effect size (d≥0.2), while inhalation technique, ED visit, and asthma knowledge witnessed medium effect sizes (ES) (d≥0.5). In addition to that, inhalation technique yielded large ES (d≥0.8) in RCTs subgroup analysis. However, three outcomes, FEV, corticosteroids usage, and preventer-to-reliever ratio, did not hold significant ES (d<0.2) and, thus, remain inconclusive. The collaboration was shown to be value for money in the economic studies in narrative synthesis, however, the limited number of studies hinder pooling of data in meta-analysis. Conclusion: The findings from this review established a comprehensive evidence base in support of the positive impact of collaborative practice between CP and GP in the management of asthma.

Matched MeSH terms: Humans
Methodology

Atiya AS, Anuar Zaini MZ, Khairul Anuar A

JUMMEC, 2002;7:8-13.

A pilot study on 250 foreign workers was undertaken during a 7 month period beginning December 1996. The study subjects were mainly males (88.8%). They were selected using non-probability sampling from two sources, that is, from University of Malaya Medical Centre (72.8%) and the PEREMBA group (27.2%). The study was clinic-based. Face-to-face interviews (using a structured questionnaires) were carried out to obtain socio-demographic, environmental, health and morbidity data. Physical examinations were also performed on the same day of the interview. Subjects were also required to give their stools, venous blood and urine specimens for microbiological, parasitological and clinical laboratory investigations. Chest X-Ray was done on all subjects. The other investigators had already reported findings on the various specific areas of their study. In this part of the report attempt was made to relate the infectious diseases to some of the socio-demographic and environmental variables on the 112 Indonesians and 133 Bangladeshi workers. Some aspects of health seeking behaviour of these foreign workers were also presented. Most of the Indonesian workers (84%) were from East Java, Jambi in the Sumatra, while majority of the Bangladeshis were from two neighboring administrative districts of Dhaka and Chittagong. The majority of the Indonesians (50.0%) were working in the service industry, while 53.5% Bangladeshis were in the manufacturing. One-fifth of the workers lived in squatter areas and nearly half of them were working in the service industry. About 70% of the workers had at least one infection. The proportion was slightly higher among the Indonesians (72.3%) compared to the Bangladeshis (67.7%). It is of interest to point out that 40% had multiple infections. Thirteen had five or more infections (details for the two of the thirteen cases are presented as case studies). However, the findings did not indicate any association between sanitation and infections. The Indonesian workers carried a higher risk of transmitting the diseases (33.9%) compared to 19.5% among the Bangladeshi workers. Those working in the construction industry were at a higher risk of transmitting the diseases compared to other industries. Slightly more than half of the workers experienced some form of minor illness or injury during the two week period preceding the interview. Majority sought private care (43.1%), while 42.3% either self-medicate or doing nothing at all. Nearly two-thirds paid out of their own pocket. Among the employers, those in the construction sector made negligible contribution (2.9%) to the payment. It is interesting to find that 41.0% of the workers took some form of health supplements, and the majority (48.4%) got it from the pharmacy or traditional sources. Nearly all (88.5%) paid on their own for their health supplements. The findings from this pilot project need to be interpreted with some caution. However, it appears that the foreign workers do have a considerable amount of health problems. If these are not addressed quickly it may endanger the health of the nation, while we readily acknowledge their contribution towards our national development.

Matched MeSH terms: Humans

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