We report a case of rhinocerebral mucormycosis in a 31 year old immunocompetent female presenting initially like acute rhinosinusitis with nasal stuffiness, severe headache, vomiting who soon developed isolated right lateral rectus palsy. Computed tomography (CT) scan of the Post-Nasal Spaces(PNS) showed an ill defined expansile heterogenous density mass in the sphenoid with extension into the ethmoids, nasal cavity, optic canal, superior orbital fissure, clivus and right temporal lobe with signal void in Magnetic Resonance Imaging (MRI). The debris and polypoid mucosa obtained on nasal endoscopy revealed mucormycosis on histopathologic examination. The patient was managed with urgent surgical debridement and medical management.
Synovial sarcoma is a rare soft tissue sarcoma that commonly involves the lower extremities and occurs predominantly in young adults. It very rarely occurs in the head and neck region and carries a poor prognosis. The tumor demonstrates both a loco-regional and a systemic pattern of spread that makes management challenging. Combined modality therapy of this aggressive tumor yields better results. Herein, we described a 58 years old lady presented with left parapharyngeal synovial sarcoma. This is to demonstrate the aggressiveness of the disease despite complete surgical excision followed by post operative radiotherapy. Local regional control was difficult and recurrence of disease was seen in this particular patient.
Suspension laryngoscopy is a common laryngeal procedure in Endolaryngeal microsurgery (ELMS). Oral mucosa and dental injuries are the known complications of the procedure. Nerve injury however is an infrequent encounter. We report a rare complication of lingual nerve injury which manifested as tongue numbness and altered taste following Endolaryngeal microsurgery procedure. The condition improved completely after few months of conservative management.
Globally, rotaviruses are the single most important etiologic agents of severe childhood dehydrating diarrhea that accounts for more than 125 million of cases, 25-55% of all hospital admissions for diarrhea and ≈600,000 deaths every year. In Bangladesh, while overall diarrhea related deaths are declining, the proportion of diarrhea deaths due to rotavirus is increasing. This study was aimed at estimating the burden of rotavirus diarrhea and isolating the genotypes of rotavirus in a children hospital of Bangladesh; thereby endorsing a logical search for an appropriate rotavirus vaccine. This cross sectional study was carried out in the Institute of Child and Mother Health, Matuail, Dhaka, Bangladesh during 2006-2007. Children aged between one month and five years suffering form diarrhea were enrolled in the study. Stool samples were analyzed by ELISA for rotavirus antigen. The rotavirus-positive samples were further analyzed for genotype determination. Among 656 stool samples, 39.5% samples were positive for rotavirus antigen. The mean age of the children studied was 12±9.9 months; the peak being in the second half of infancy. G2 was identified as the most dominant genotype (45.5%) followed by G1 (24.8%), G12 (9.6%), G9 (8.5%) and G4 (2.1%) genotypes. Since G2 were found to be the predominant circulating rotavirus strain in this study and some other studies in Bangladesh, the recommended vaccine for prevention of rotavirus infection in Bangladesh should cover this strain to have maximum effectiveness.
BACKGROUND: Acne is considered a cosmetic nuisance in Malaysia since no insurance coverage is provided for its treatment. Its psychological impact is unknown.
OBJECTIVE: The aim of this study is to determine the impact of acne on quality of life and its relationship with severity.
METHODS: A cross-sectional study using the Cardiff acne disability index (CADI) and Global Acne Grading System for acne severity grading was done in three government-run dermatology clinics in Sarawak, Malaysia.
RESULTS: The study cohort of 200 patients had a mean CADI score of 5.1. Most of the patients (59.5%) had mild CADI impairment, with the domain of feelings most affected. Patients with a family income <1,000 United States Dollor/month had a higher mean CADI (mean 5.5 vs. 4.4; p=0.04). Females, indigenous groups, and patients with tertiary education tended to have more severe CADI impairment (p>0.05). The correlation between CADI and mild acne severity was low (Pearson correlation coefficient=0.35; p<0.001) but became insignificant for moderate and severe acne.
CONCLUSION:
Acne impairment in Sarawak was moderate and must be addressed. It should be viewed as a psychologically disabling disease requiring optimal management and resource allocation.
KEYWORDS: Acne vulgaris; Disability; Quality of life
Study site: Dermatology Departments of Sarawak General Hospital
Previous studies indicated that a tropical freshwater eel Anguilla bicolor bicolor occurs in Africa, India, Sri Lanka, Bangladesh, Myanmar, Indonesia and Australia, but an intensive survey has indicated an extended distribution range for the species into Peninsular Malaysia. Thus, A. b. bicolor is a native subspecies of Malaysia.
Anaemia is a global health problem including Malaysia. In adults, anaemia may affect work productivity. Iron deficiency anaemia and thalassaemia are common causes of anaemia in Malaysia. However, there is scarcity of data on national prevalence of iron deficiency anaemia and thalassaemia, especially in young adults. This cross sectional study was performed to determine the prevalence of iron deficiency anaemia and thalassaemia among medical students of Universiti Kebangsaan Malaysia Medical Centre (UKMMC).
Acral melanoma involve the non-pigmented palmoplantar and subungual areas and are commonly seen among Asians. Patients commonly display advanced stage of disease at presentation. It may appear unnoticed and mimic benign lesions.
Dapsone syndrome is a potentially fatal hypersensitivity reaction to sulphone. We report a 12-year-old girl who developed high grade fever associated with intense jaundice, exfoliative skin rash and hepatomegaly after five weeks of starting the multidrug regimen for the treatment of Hansen's disease. Laboratory investigations revealed presence of leucocytosis with eosinophilia, deranged liver enzymes and an abnormal coagulation profile. Immediate cessation of the offending drug and administration of steroid proved successful. A high level of clinical awareness is fundamental for early diagnosis of dapsone syndrome as initiation of a prompt treatment may lead to rapid recovery.
The purpose to do this research was to find out the habits of contact lens wearers towards lens care in this country, and to evaluate the compliance of contact lens wearers.
METHODS: All respondents underwent an interview regarding questionnaire which was carried out at the Klang Valley and Sabah, Malaysia by trained bilingual optometrists. The questionnaire was obtained from a study by Yvonne Wu et al., 2010. The questionnaire included information about respondents' demographics, contact lens hygiene behaviors and attitudes toward lens care. Comparison between groups and certain factors of lens care were analyzed.
RESULTS: Within the 100 respondents, 74% were female. The majority used monthly disposable lens (53%, 53/100), 35% (35/100) wore daily lens, 3% (3/100) wore biweekly disposable lens, 8% (8/100) wore quarter-yearly (3 months) lens, and only a participant (1%) used conventional lenses. The major non-compliance aspect that found out from this research were poor lens case (46%), inadequate cleaning of lens before storing (38%) and wearers not remembering how often they were advised to return for an aftercare (24%).
CONCLUSION: The poor lens care hygiene, inadequate cleaning of lens before storing may due to lack of proper advice to the contact lens wearers during examination or lack of awareness of aftercare visit.
Oral leiomyomas are rare benign tumour of smooth muscle. The first case of oral leiomyoma was reported by Blanc in 1884 and since then more cases has been published following advancement in immunohistochemical study. This tumour has an excellent prognosis and recurrences are extremely rare. We report a case of a recurrent glossal leiomyoma in a patient with HIV infection and the lesion recurred one year after the first excision.
Stroke is a leading cause of death in Asia; however, many estimates of stroke mortality are based on epidemiological models rather than empirical data. Since 2005, initiatives have been undertaken in a number of Asian countries to strengthen and analyse vital registration data. This has increased the availability of empirical data on stroke mortality.
To assess the validity and reproducibility of a new computer-based physical activity questionnaire (cPAQ) to estimate the habitual physical activity levels in Malaysian adolescents.
PURPOSE: This study aims to investigate the relationships between workplace spirituality, organizational citizenship behavior (OCB), and affective organizational commitment among nurses, and whether affective commitment mediates the relationship between workplace spirituality and OCB.
METHODS: In the present correlational study, a cross-sectional design was employed, and data were collected using a questionnaire-based survey. Based on the random sampling, 305 nurses were chosen and questionnaires were distributed among respondents in four public and general hospitals located in Kerman, Iran. To analyze the data descriptive statistics, Pearson coefficient, simple and multiple regression, and path analyses were also conducted.
FINDINGS: Workplace spirituality has a positive influence on nurses' OCB and affective commitment. Workplace spirituality explained 16% of the variation in OCB, while it explained 35% of the variation in affective commitment among nurses. Moreover, affective organizational commitment mediated the impact of workplace spirituality on OCB.
CONCLUSIONS: Workplace spirituality predicts nurses' OCB and affective organizational commitment. It emphasizes benefits from the new perspective of workplace spirituality, particularly among nurses who need to be motivated in their work.
CLINICAL RELEVANCE: This study illustrates that there are potential benefits owing to the positive influence of workplace spirituality on OCB and affective commitment among nurses. Managers of nursing services should consider workplace spirituality and its positive influence on nurses' outcomes in order to improve their performance and, subsequently, the healthcare system.
The burden of non-communicable diseases is increasing in Malaysia. Insufficient Physical Activity, which is an important risk factor for non-communicable diseases, is less researched in Malaysia. We aimed to assess the level of physical activity and identify its correlates. An online survey was carried out during October, 2011 in the University Tunku Abdul Rahman by the opinion poll research committee. Young adults answered the Short International Physical Activity Questionnaire and a questionnaire about factors according to a socio-ecological model which was adapted from published studies. Metabolic equivalent (MET)-hours and MET-minutes were calculated. Physical activity was classified as sufficient when MET-minutes were > 840. The mean age of the 474 participants was 22.4 years (S.D. = 4.7), and 253 (53.4%) were females. Their mean and median of MET-hours of PA done during the previous seven days were 31.36 (S.D., 52.19) and 14.7 (IQR, 5.77-32.07), respectively. Physical activity done was sufficient among 242 (51.1%) participants. Using univariate analysis, being male, good self-rated health, positive intention, self-efficacy, perceived benefits, social support, and availability of facilities were associated with sufficient physical activity. Using multivariate analysis sufficient physical activity was associated with participants' intention (OR 0.75, 95% CIs 0.64, 0.88), self-efficacy (OR 0.91, 95% CIs 0.85, 0.97) and facility availability (OR 0.81, 95% CIs 0.73, 0.91). The proportion of participants with sufficient physical activity was low. Positive intention and self-efficacy associated with sufficient physical activity should be supported by availability of facilities and a safely-built environment. A nationwide survey about physical and associated socialecological factors is needed to design rational health promotion strategies.
Pseudoaneurysm of the internal iliac artery is a rare occurrence. Our patient presented with pain over the lower abdomen which also radiated to the back. An Angiogram of the aorta and the iliac arteries showed a pseudoaneurysm of the right internal iliac artery which measured about 8 x 8 cm with a proximal branch of the internal iliac artery distended. Initial efforts of trying to embolize the pseudoaneurysm revealed that there was a connection between the pseudoaneurysm and the interanal iliac vein where foam was getting dislodged into the venous system. Subsequently, we decided to use a vascular plug which has just been recently being introduced. Post procedure there was no more flow into the right internal iliac artery pseudoaneurysm.
Thalassaemia is a common disorder in Malaysia. It is estimated that 4.5% of the population are carriers for beta- or alpha- thalassaemias. We set out to screen Form 4 students aged between 15 and 16 years old in a national school, for thalassaemia in March 2008. Written consent was obtained from 310 students. The carrier rate for the common thalassaemia syndromes was 6.8% (2.9% for beta-thalassaemia, 2.6% for HbE and 1.3% for two-gene deletion for alpha-thalassaemia). Carriers for beta-thalassaemia and two-gene deletion for alpha-thalassaemia were more common in the Chinese (4.3% and 1.4% respectively) while heterozygous HbE was more common in the Malays (3.8%). The laboratory cost of screening one student was RM 45 and the total number of man-hours spent in this screening activity was 600. This screening exercise showed that thalassaemia carriers are common among the Chinese and Malays and it is feasible to carry out a screening programme for secondary school students.
The aim of the study was to document the prevalence of learning disability among the children attending the Paediatric Clinic in Hospital Tuanku Ja'afar Seremban. The demographic distribution of these patients; the age of detection of the problem; the associated medical conditions and types of intervention received by these patients were documented. Patients who were between the ages of five to twelve years were included in the study. Learning disability was divided into three categories: speech and articulation problems, academic skills disorder and other categories which included developmental delay. Children with cerebral palsy were excluded from the study. Out of 1320 patients screened, 355 were found to have learning disorders. Majority were Malays, with the male to female ratio of 1.9:1. Most of the patients stayed in Seremban. The learning problem was most commonly detected at the age of 4 years and below. The commonest type of learning disorder was developmental delay, followed by academic skills disorder, speech and academic skills problems and speech disorders. Problems that were detected early were speech problems and developmental delay. Majority of the children had associated medical conditions. Most of the patients received some form of intervention but 11.3% did not attend any intervention program at all. A strategy should be formulated and implemented to help this group of children.
Study site: Paediatric Clinic in Hospital Tuanku Ja'afar Seremban