Displaying publications 21 - 40 of 546 in total

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  1. A study of knowledge and attitudes of registered nurses towards pain management in an urban hospital
    Ho SE, Ho CC, Pang Yuen H, Lexshimi R, Choy YC, Jaafar MZ, et al.
    Clin Ter, 2013 May-Jun;164(3):215-9.
    PMID: 23868622 DOI: 10.7417/CT.2013.1551
    BACKGROUND AND AIMS: Nurses play a pivotal role in pain management. Unrelieved pain significantly interferes with patient's quality of life and is of great concern to nurses. The aim of this study was to determine the knowledge level and attitudes of nurses related to pain management.
    MATERIALS AND METHODS: This descriptive study was conducted in an urban hospital. A total of 84 registered nurses were recruited using a modified version of questionnaire of Knowledge and Attitudes Survey Regarding Pain.
    RESULTS: The findings showed that respondents possessed good knowledge (99.12±14.810) and attitude (66.00 ±10.415) towards pain management. Fifty five respondents (66%) responded as positive to cultural beliefs affecting their pain management and 65 respondents (77%) viewed that their personal experiences had influenced their practice in pain management. Another 45 respondents (54%) reported they have attended pain course. There was no significant difference in pain management between respondents' year of service, cultural belief and personal experiences (p=>0.05). In terms of knowledge towards to pain management, respondents' age groups of more than 40 years were noted to possess better knowledge (p=0.046), unmarried respondents (p=0.018), and attended pain course (p=0.001) were significant. Attitude towards to pain management was not significant (p≤0.05).
    CONCLUSION: Nurses' knowledge and attitudes scores were impressive but there is room for further improvement to pain management. Continuing education organized by the hospital had significant impact on the nurses. However, this education course has to be reinforced from time to time in order to improve patients' pain experiences.
  2. A study of the antioxidant effect of alpha lipoic acids on sperm quality
    Ibrahim SF, Osman K, Das S, Othman AM, Majid NA, Rahman MP
    Clinics (Sao Paulo), 2008 Aug;63(4):545-50.
    PMID: 18719769
    OBJECTIVE: Assisted reproductive techniques are useful in helping infertile couples achieve successful conception. Initial studies have shown that sperm cryopreservation, one step in assisted reproduction, causes a dramatic reduction in sperm quality. This has been attributed to, among other things, free radical activities. The aim of the present study was to minimize this oxidative attack by adding an antioxidant into the sperm microenvironment. Alpha lipoic acids were selected for this purpose for their efficient free radical scavenging properties and solubility in lipid and aqueous phases.

    METHODS: For this investigation, semen from six Boer bucks was pooled. Seminal analysis of the baseline prior to incubation of samples with different concentrations of Alpha lipoic acids (0.00625, 0.0125, 0.025, 0.05, 0.1 mmol/ml) was performed, and post-seminal analysis was conducted after a one-hour incubation. The comet assay was used to observe the effect of Alpha lipoic acids on sperm DNA integrity. Statistical analysis using an unpaired t-test with a significance level of p<0.05 was then performed.

    RESULTS: Our results indicate that the sperm motility rate was improved after incubation with Alpha lipoic acids at a concentration of 0.02 mmol/ml. This concentration was also capable of reducing DNA damage.

    CONCLUSION: In conclusion, Alpha lipoic acids renders cryoprotection to sperm, thereby improving sperm quality.

  3. Fulltext A study on measuring the 222Rn in the Buriganga River and tap water of the megacity Dhaka
    Alam MS, Siraz MMM, A M J, Das SC, Bradley DA, Khandaker MU, et al.
    PLoS One, 2023;18(5):e0286267.
    PMID: 37220107 DOI: 10.1371/journal.pone.0286267
    Radon (222Rn), an inert gas, is considered a silent killer due to its carcinogenic characteristics. Dhaka city is situated on the banks of the Buriganga River, which is regarded as the lifeline of Dhaka city because it serves as a significant source of the city's water supply for domestic and industrial purposes. Thirty water samples (10 tap water from Dhaka city and 20 surface samples from the Buriganga River) were collected and analyzed using a RAD H2O accessory for 222Rn concentration. The average 222Rn concentration in tap and river water was 1.54 ± 0.38 Bq/L and 0.68 ± 0.29 Bq/L, respectively. All the values were found below the maximum contamination limit (MCL) of 11.1 Bq/L set by the USEPA, the WHO-recommended safe limit of 100 Bq/L, and the UNSCEAR suggested range of 4-40 Bq/L. The mean values of the total annual effective doses due to inhalation and ingestion were calculated to be 9.77 μSv/y and 4.29 μSv/y for tap water and river water, respectively. Although all these values were well below the permissible limit of 100 μSv/y proposed by WHO, they cannot be neglected because of the hazardous nature of 222Rn, especially considering their entry to the human body via inhalation and ingestion pathways. The obtained data may serve as a reference for future 222Rn-related works.
  4. A study on nurses' perception on the medication error at one of the hospitals in East Malaysia
    Hassan H, Das S, Se H, Damika K, Letchimi S, Mat S, et al.
    Clin Ter, 2009;160(6):477-9.
    PMID: 20198291
    Medication error is defined as any preventable event that might cause or lead to an inappropriate use or harming of the patient. Such events could be due to compounding, dispensing, distribution, administration and monitoring. The aim of the present study was to determine the nurses' perception on medication error that were related directly or indirectly to the process of administration of drugs. MATERIALS AND METHODS. This was a descriptive cross sectional study conducted on 92 staff nurses working in the selected wards in one of the hospitals in East Malaysia. Data was obtained through structured questionnaires. RESULTS. Analysis of data was done through SPSS program for descriptive inferential statistics. Out of a total of 92 subjects, sixty-eight (73.9%) indicated medication error occurred because the nurses were tired and exhausted. Seventy nine subjects (85.9%) believed that any medication error should be reported to the doctors; another 74 (80.2%) knew that their colleagues committed medication error and 52 (56.5%) did not report the case. Forty eight (52.17%) subjects committed medication error at least once throughout their life. Of the 48 committed medication, 45 (93.75%) nurses believed that the error committed was not serious; while 39 (81.25%) believed the error occurred during the 1st 5 years of their working experience.
  5. Absence of the isthmus of the thyroid gland: anatomical and clinical considerations
    Taty-Anna K, Farihah HS, Norzana AG, Farida H, Das S
    Clin Ter, 2012 Nov;163(6):503-4.
    PMID: 23306746
    The right and left lobes of the thyroid gland are connected by an isthmus. The isthmus lies at the level of the second and third tracheal rings. Occasionaly, the isthmus may be absent. We hereby, report the absence of isthmus in a 52-year-old male cadaver of unknown origin. Both the right and left lobes were normal but they were separated. Both the right and left lobes of the thyroid gland measured 4.3 cm vertically. The separation distance between right and left glands was noted at the upper, middle and lower parts. The upper end of medial border of both lobes were separated by a distance of 1 cm while the separation distance was 0.7 cm and 1.5 cm at the middle and lower parts, respectively. The anatomical and clinical significance of absence of isthmus is important for medical personnel and the surgeons operating on the thyroid gland. The present case report is a an attempt to highlight such.
  6. Absence of the peroneus tertius muscle: cadaveric study with clinical considerations
    Das S, Haji Suhaimi F, Abd Latiff A, Pa Pa Hlaing K, Abd Ghafar N, Othman F
    Rom J Morphol Embryol, 2009;50(3):509-11.
    PMID: 19690784
    Peroneus tertius (PT) is a muscle of the anterior compartment of the leg. The PT muscle originates from the anterior surface of the fibula and the interosseous membrane and inserts into the medial side of the dorsal region of the fifth metatarsal bone. During routine dissection, we observed the absence of PT on the left lower limb of a cadaver. Usually, the PT is involved in dorsiflexion and eversion of the foot. In many cases, the absence of PT maybe asymptomatic and it may be incidentally detected during cadaveric dissections or autopsies. The existence of PT may help in the swing phase of bipedal walking. The PT may be used for tendon graft surgeries. The pull of the PT may be responsible for causing stress on the fifth metacarpal and account for all stress fractures in any individual. The absence of the PT may puzzle any transplant and foot surgeons performing graft operations. We as anatomists discuss the clinical implications of the absence of PT.
  7. Accessory renal vessels at the upper and lower pole of the kidney: a cadaveric study with clinical implications
    Hlaing KP, Das S, Sulaiman IM, Abd-Latiff A, Abd-Ghafar N, Suhaimi FH, et al.
    Bratisl Lek Listy, 2010;111(5):308-10.
    PMID: 20568426
    The renal artery is known to exhibit variations in its number and position. The present study was performed on 50 cadaveric kidneys to observe the topographical anatomy of the accessory renal arteries (ARA) entering the upper or lower poles of the kidney. Out of 50 kidney cadaveric specimens (irrespective of sex) studied, 2 kidneys (4%) showed the presence of ARA. The presence of ARA was observed on the left and right kidneys, respectively. In one left kidney, we observed in addition to the usual renal artery, an ARA near the lower pole of the kidney which divided into anterior and posterior branches. Another right kidney specimen exhibited the presence of single and double ARA at the upper and the lower poles, respectively. The presence of ARA, both at the upper and lower poles is a rare entity. No medical history of the cadavers was available to corroborate the clinical findings. Additional renal vessels may signify a developmental defect. Anatomical knowledge of the variations in the renal vascular supply may be important for abdominal imaging studies and surgical operations involving renal transplantations. The present study discusses in detail the anatomical features and clinical implications of ARA located at both the upper and lower poles of the kidney (Fig. 2, Ref. 15). Full Text (Free, PDF) www.bmj.sk.
  8. Accessory sulci of the liver. An anatomical study with clinical implications
    Othman FB, Latiff AA, Suhaimi FH, Das S
    Saudi Med J, 2008 Sep;29(9):1247-9.
    PMID: 18813405
    To study the presence of accessory sulcus (AS) in the embalmed cadaveric livers, and compare it with the normal liver.
  9. Acute myocardial infarction in an adolescent
    Muthupalaniappen L, Menon RK, Das S
    Saudi Med J, 2012 Feb;33(2):197-200.
    PMID: 22327763
    Myocardial infarction (MI) is known to be common in adults. Interestingly, we report a case of a 15-year-old boy who presented with typical chest pain secondary to myocardial infarct attributable to a combination of familial hyperlipidemia and possible episode of Kawasaki disease in the past. The patient failed treatment and follow-up care, and died 2 years later. Although rare, this case demonstrates that MI should be considered as a diagnosis in adolescents presenting with typical chest pain as early detection, and management is vital for survival.
  10. Adductor accessorius - an unusual supernumerary adductor muscle of thigh
    Goel S, Arora J, Mehta V, Sharma M, Suri RK, Rath G, et al.
    Clin Ter, 2015;166(3):114-7.
    PMID: 26152618 DOI: 10.7417/CT.2015.1840
    The knowledge of variant anatomy of medial compartment of thigh is extremely important in surgical procedures requiring obturator nerve block. The nerve block is also recommended for providing additional analgesia following major knee surgeries and for relieving painful adductor muscle spasm. The interfascial injection technique is commonly followed in ultrasound guided obturator nerve block. For this procedure it is imperative to identify the adductor muscles on sonography to inject the anesthetic solution in the intermuscular fascial planes. The presence of an additional muscle can prove useful in myocutaneous flap surgeries for reconstruction especially of perineum. We hereby report a case of such an anomalous supernumerary adductor muscle present between adductor brevis and proximal part of adductor magnus, in an adult Indian male cadaver, recorded during routine dissection in Department of Anatomy, Vardhman Mahavir Medical College and Safdarjung Hospital. The muscle was innervated by the posterior division of obturator nerve. The morphology, embryological basis and clinical aspects are also discussed.
  11. An 11-year-old girl presenting with chronic knee pain: a case report with diagnostic dilemma
    Maj MK, Ar AH, Faisal SA, Ahmad J, Das S
    Acta Medica (Hradec Kralove), 2010;53(4):247-9.
    PMID: 21400986
    Discoid meniscus is the commonest anatomical aberration of the knee joint, among rare cases such as bilateral separated lateral meniscus, accessory lateral meniscus, partial deficiency of the lateral meniscus and double-layered lateral meniscus. An 11-year-old girl presented with history of chronic pain in her right knee for the last 6 months. The problem disturbed her involvement in the sport activities at school. Clinical examination revealed a clicking sensation on knee extension with lateral joint line tenderness. Magnetic resonance imaging (MRI) of her right knee showed torn posterior horn of lateral meniscus. Arthroscopy examination revealed a discoid meniscus with absence posterior horn. Posterior horn deficient discoid meniscus is a rare form of a congenital meniscus anomaly. We as clinicians believe that the abnormal shaped meniscus may pose a diagnostic challenge clinically and radiologically. Presentation of this case may be beneficial for orthopaedicians in their daily clinical practice.
  12. An anatomico-radiological study of the grooves for occipital sinus in the posterior cranial fossa
    Das S, Abd Latiff A, Suhaimi FH, Othman FB, Yahaya MF, Ahmad F, et al.
    Bratisl Lek Listy, 2008;109(11):520-4.
    PMID: 19205565
    The occipital sinus (OS) lies in the attached margin of the faix cerebelli in the internal occipital crest of the occipital bone. The OS extends from the foramen magnum to the confluence of sinuses. Standard textbooks and research reports do not describe in detail any variation in the groove for the occipital sinus.
  13. An atavastic belly of the flexor digitorum profundus with absence of tendon of flexor digitorum superficialis to the little finger: morphological and histological considerations
    Das S, Norzana AG, Azian AL, Farihah HS, Faizah O
    Clin Ter, 2011;162(6):555-7.
    PMID: 22262329
    In this case report, we report the absence of the fourth tendon of flexor digitorium superficialis (FDS) to the little finger with a concurrent anomalous muscular belly of flexor digitorum profundus (FDP) in the palm. The FDS originated from the medial epicondyle, divided into three tendons for the index, middle and ring fingers with the little finger devoid of any attachment. The FDP exhibited a muscular belly which passed deep to the flexor retinaculum (FR) and continued for another 4 cm thereby dividing into four slips for the index, middle, ring and little fingers. The presence of the muscular belly of the FDP lead us to think whether it was an adhesion between the tendons of the FDP, so we proceeded to histological analysis. The tissue was processed and stained with Hematoxylin and Eosin. Abundant longitudinal muscle fibers with peripherally situated nuclei confirmed it to be a skeletal muscle. Absence of the tendon of FDS to little finger may influence the flexion movement in the middle and proximal interphalangeal joints. Presence of anomalous muscle belly of FDP in the palm may mimic any soft tissue tumour, compress neurovascular structures or even pose difficulty while performing tendon transplant surgeries.
  14. An insight into industrial accidents involving the hand
    Abdullah S, Jaafar JM, Das S, Sapuan J
    Clin Ter, 2009;160(6):427-33.
    PMID: 20198282
    BACKGROUND: Industrial hand injuries are a common occurrence and contributes to a large segment of workers' morbidity. The main aim of this study was to look into the day pattern, types and location of upper limbs injures, identify the types of machines involved and highlight the treatment received.
    MATERIALS AND METHODS: The present study was performed on 57 industrial workers admitted and treated by the Orthopaedic team of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) for acute injuries sustained whilst working.
    RESULTS: The majority of the workers were male (93%). The commonest age group involved was between 25-35 years (48%). The right hand was injured more then the left with majority of injuries involving the fingers. Interestingly, we also observed that injuries occurred more on Saturdays. Laceration was the most common injury followed by fractures and crush injuries. Treatment depends on the type and severity of injuries. For most lacerated wounds, treatment was debridement, primary suturing and antibiotic therapy. Injuries on Saturdays indicated that workers needed a longer time break especially during weekends after a long hectic week.
    CONCLUSIONS: Injuries sustained by workers may be prevented by proper working techniques and conditions together with wearing of protective gadgets.

    Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
  15. An insight into the harmful effects of soy protein: A review
    Sukalingam K, Ganesan K, Das S, Thent ZC
    Clin Ter, 2015;166(3):131-9.
    PMID: 26152621 DOI: 10.7417/CT.2015.1843
    Soy protein (SP) is a protein derived from soybean meal. SP is obtained from the removal of the outer shell of soybean and the fatty acid. The dietary supplementation of SP was was reported to have positive effects on human health. Therefore, the attention towards SP is increasing among the consumers, industrialist and researchers. However, the side effects and toxicity related to SP was not summarized, to date. This review summarized the toxic effects such as hormonal disturbances, carcinogenic and organotoxicity of SP based on the clinical and experimental studies. The review mainly focused on the effect of soy isoflavone-genistein on various organs. The main aim of the present review is to increase the public awareness on the harmful effect of SP on the various health aspects and draw the attention of the health care personnel and researchers.
  16. An interesting case of Multiple Endocrine Neoplasia Type 2A
    Thambiah SC, Abu-Bakar M, Bador KM, Das S, Umar NA
    Clin Ter, 2010;161(4):349-54.
    PMID: 20931159
    We report the case of a 37-year-old Chinese man who came with a history of bilateral adrenalectomy and was admitted for recurrent phaeochromocytoma. Further investigations of an incidental finding of persistently raised carcinoembryonic antigen (CEA), fi rst observed four years ago, revealed medullary thyroid carcinoma (MTC). As such, a provisional diagnosis of Multiple Endocrine Neoplasia 2A (MEN 2A) was made. In this case, it seemed like the long-standing elevation of CEA was ignored until it was noted in a post-clinical discussion among several physicians. The present case illustrates the significance of considering a single abnormal biochemical test in an asymptomatic patient and also discusses the importance of life-long follow-up of a patient with a history of phaeochromocytoma.
  17. An interesting case of autonomic dysreflexia
    Ohnmar H, Das S, Naicker AS
    Clin Ter, 2009;160(5):371-3.
    PMID: 19997683
    Autonomic dysreflexia (AD) is not an uncommon clinical condition and it is usually detected in patients with complete spinal injuries at or above thoracic 6th vertebral level (T 6). This condition is reported to occur in 48- 60% of cases of spinal cord injury at or above the level of T6. But AD due to injury below T6 is rare. The basic mechanism is thought to be due to excessive, uncontrolled activation of sympathetic system. In the present case, we discuss a persistent AD in 55-yr-old tetraplegic patient with C5 American Spinal Injury Association (ASIA) grade A lesion due to a fall from 10 metre height. MRI examination showed C5 and C6 bi-facets fracture and dislocation with canal compromise. Wiring and fusion was performed but recurrent mucous plugging and aspiration pneumonia and urinary tract infection happened during the hospital stay. Three months later, he was re-admitted with multiple pressure sores, pneumonia, sepsis and high blood pressure. He was administered with nifedepine but the blood pressure kept fluctuating. The present study highlights how the precipitating factors like concomitant urinary tract infection, decubitus ulcers, spasticity triggered the AD attack. The knowledge of the AD and its proper diagnosis and management may be beneficial to all clinicians and the present article attempts to highlight such.
  18. An interesting case of isolated pancreatic teratoma: lessons to learn
    Razman J, Azlanudin A, Eyad AJ, Zahiah M, Das S
    Clin Ter, 2012 Nov;163(6):495-7.
    PMID: 23306744
    Mature cystic teratomas of the pancreas are extremely rare tumours encountered in day-to-day clinical practice. Only few cases have been reported to date involving all age groups. The management, diagnosis and evaluation of this tumor are questionable, with definitive diagnosis taking place intra-operatively. We hereby report the case in a 30 year-old-male who presented with newly diagnosed diabetes mellitus and during the follow up he was noted to have elevated liver enzymes clinically, he was asymptomatic. The computerized tomography revealed a retropancreatic mass and pushing the mesenteric veins anteriorly. The mass was hypodense in nature and there was presence of calcification. Although the patient was asymptomatic, the decision for resecting the mass was made in view of the size and possibility of malignancy. In conclusion, considering the size and approximity of the mass to the pancreas, Whipple procedure's is the most appropriate approach although the histological diagnosis has not been established preoperatively.
  19. Fulltext An interesting case of systemic lupus erythematosus presenting with hypercalcemia: A diagnostic dilemma
    Abdul Gafor AH, Cader RA, Das S, Masir N, Wahid FA
    Am J Case Rep, 2013;14:1-3.
    PMID: 23569551 DOI: 10.12659/AJCR.883849
    BACKGROUND: Hypercalcemia is common in primary hyperparathyroidism malignancies and even in tuberculosis. Interestingly, systemic lupus erythematosus (SLE) rarely presents with hypercalcemia.
    CASE REPORT: We describe an interesting case of SLE in a patient who was otherwise thought to have either tuberculosis or a malignancy. The patient initially presented with feeling unwell, with generalized lymphadenopathy, bilateral pleural effusion, and bilateral corneal calcium deposits secondary to severe hypercalcemia. The diagnosis of SLE was made based on positivity of antinuclear antibodies (ANA) and anti-dsDNA, the presence of serositis, lymphadenopathy, autoimmune hemolytic anemia, and constitutional symptoms. She was treated with steroids, with tremendous improvement in her general well-being, resolution of lymphadenopathy and pleural effusion, and normalization of her hemoglobin and serum calcium. The atypical presentation of SLE with hypercalcemia with pleural effusion is discussed.
    CONCLUSIONS: SLE should be one of the differential diagnoses in patients presenting with severe hypercalcemia.
    KEYWORDS: atypical presentation; hypercalcemia; systemic lupus erythematosus
  20. An unexpected case of primary peritoneal carcinoma
    Nur-Syahrina R, Siti-Aishah MA, Swaminathan M, Ng PH, Ismail S, Syazarina SO, et al.
    Clin Ter, 2010;161(3):261-3.
    PMID: 20589359
    Primary peritoneal carcinoma (PPC) is a rare tumor that is histologically and immunohistochemically indistinguishable from epithelial ovarian carcinoma. The diagnosis is usually made after excluding gross ovarian involvement or the ovarian involvement is only confined to the surface. A 68-year-old lady presented with right iliac fossa pain and increasing CA125. The CT scan showed bilateral pelvic adnexal masses with peritoneal deposits within the right side of abdomen. She was initially diagnosed as carcinomatosis peritonei from the omental cake removed after exploratory surgery. She was managed as advanced ovarian tumor with peritoneal metastasis and was then administered six cycles of chemotherapy. Surgical intervention included debulking surgery consisting of total abdominal hysterectomy, bilateral salpingooophorectomy and omentectomy and also with right hemicolectomy. The histopathological findings were of primary peritoneal serous carcinoma with only minimal involvement of the serosal surface of the right ovarian capsule. No microscopic invasion into underlying ovarian cortex and stroma was observed. Multiple tumor deposits were also seen over the right paratubal and paraovarian tissue, both parametrium as well as serosal surface of the terminal ileum and periappendicular tissue. Immunohistochemically, the malignant cells were positive to CA125, focally positive to CK7 and negative to CD20 and Calretinin. PPC is one of important differential diagnosis which needs to be considered in cases of advanced ovarian tumor, although the former can only be ascertained after excluding the ovarian involvement microscopically.
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