Cerebral aneurysm is an exceedingly rare aetiology of neonatal Subarachnoid Haemorrhage (SAH). Detailed history and pattern recognition of the SAH is crucial in suspecting aneurysm.
Since the COVID-19 pandemic, Taiwan reported a total of 776 cases of COVID-19 (Dong et al., 2020) in comparison with its neighbouring countries, Japan and the Philippines which reported 210,769 and 465,724 cases of COVID-19 respectively, until 24 December 2020. Looking at the curve of the COVID-19 pandemic among various countries, Taiwan had indeed distinguished herself and stood out considering her well-contained COVID-19 infection despite it being a widespread infection in other countries.
There is a strong need to reduce costs of hospital and advocating health economics in countries like the United States of America. The rising cost of healthcare globally especially in the United States of America has interestingly outraged the temper of many citizens about the Obamacare and Trumpcare. The issue about high cost in healthcare is the failure for people globally to recognize that healthcare facility is a 24-hour round-the-clock service. It therefore involves doubling of the utility bills, tripling the manpower due to shifts and rest, wear-and-tear of basic electrical devices is short-lived, breakdown period of huge machine is consistently due to overloaded usages in the government hospitals and poor knowledge of the maintenance programme. Low birth weights (LBW) is a public health concern because it has a well-known predisposition to increased risk for perinatal infections, respiratory distress and ultimately mortality. There is also a higher risk of poor health outcomes throughout the life course of the LBW newborns that includes Type 2 diabetes, high blood pressure, neurodevelopmental disabilities and cardiovascular diseases. The World Health Organization and United Nations Child’s Fund estimate the prevalence of low birth weights in the world ranges from 3% to 32%. Albania in the year 2000 recorded prevalence of low birth weight of 3% whereas Yemen recorded a low birth weight of 32% in 1997. In 2015, the US national vital statistics pointed out that 83.9% of preterm birth (PTB) are LBW. This indicates that prevention of PTB will lead to a decrease in the incidence of LBW.
Obesity has become a global health issue, not to mention Malaysia, which topped over the list of countries in Asia. On World Health Day in 2019, the World Health Organization (WHO) announced that 64% of the male population and 65% of the female population in Malaysia are either obese or overweight1. The ringing of alarm is tremendously loud in the silence. Depending on each of us, this can be an issue that we laugh over or a kind but severe urge for us to take a step backwards, observe, and self-reflect.
hildhood undernutrition while being a preventable condition remains a major public health issue because it contributes to the mortality and morbidity of children globally. Intervention to improve the nutritional status of children includes supplementary feeding, fortified foods, cash transfers and nutritional education.
Keywords:
Ocular trauma is a significant health problem in paediatric age group. This study is to evaluate the
demographics, etiology, management and visual outcome of paediatric ocular trauma in Sabah.
This is a retrospective review of all ocular trauma occurring in the paediatric age group from age
12 years old and below from January to December 2014 at Hospital Wanita Dan Kanak-Kanak,
Sabah. Medical records were reviewed and the data was examined based on Birmingham Eye
Trauma Terminology (BETT) system. Incomplete case notes were excluded from the study. A total
of 37 cases were accumulated during the study period. All the paediatric ocular trauma cases were
admitted and accounted for 13.4% of the total paediatric eye ward admission. However, 4 cases
were excluded from the study as the medical records were incomplete. There were 26(78.8%) males
while 7(21.2%) female children with a ratio male: female of 3.7: 1. There were 31(93.9%) unilateral
ocular injury cases while only 2(6.1%) bilateral injury caused by chemical injury. The most
common type of ocular trauma was closed globe injury totaling 24 (72.7%) cases. Trauma caused
by blunt object contributed to the highest mode of injury 15 (45.5%) of cases. Open globe injuries
which had poor visual outcome accounted for 9 (27.3%) cases. Most of patients required surgical
treatment 21(63.6%) while 12(36.4%) cases treated non-surgically. In conclusion, ocular trauma
was more common in male and pre-school age group. The main aetiology was blunt injury. Most
of the cases treated surgically. Poorer visual outcome was observed in open globe injury.
Community and nosocomial-associated methicillin-resistant Staphylococcus aureus (MRSA) infections in Malaysian healthcare setting are terrifically increasing in recent years. There is an urgent need for an effective antibacterial agent to cope with this important issue. Due to the development of new antibiotics is not parallel with the increase of cases of infections, researchers have initiated isolation of compounds from natural resources to develop new potent therapeutic agent. Meanwhile, Ganoderma boninense is an oil palm devastating pathogen, which has been known to contain many bioactive compounds that might be potential to be developed as a new source of therapeutic agent.
Schools provide an efficient and effective way to reach large numbers of people. In 2013, over 90% children of primary school age and over 80% children of lower secondary school age were enrolled in schools globally. Behaviours and habits are developed in early childhood. The effective way to prevent non-communicable disease (NCD) is from early education as primary prevention. This platform had been in the system since early millennium but the NCD risk factor is still increasing.
Ambulance response time (ART) has an inseparable relationship with mortality rates and therefore is important to be reduced. However, an unprecedented increase in road traffic congestion has led to longer ART, especially during peak hours. To reduce ART despite congested traffic, a pre-dispatched ambulance is deployed at hotspot locations during peak hours. This study aims to determine if the hotspot strategy is able to reduce ART in an Urban Emergency Medical Services system.
The current COVID-19 pandemic has forced many clinical disciplines to evolve to function safely and still provide the necessary care. Otorhinolaryngology (ORL) is a field that has been greatly affected by this highly transmissible viral pathogen. Aerosolizing procedures, proximity examination and other common procedures must be revamped to suit current time. The usual norm ORL procedures need also be altered to incorporate safeguards to protect both patient and healthcare workers. This recommendation for current practices aims to give a practical approach to modify current practices to maintain safety during the pandemic. These recommendations are the consensus amongst ORL practitioners in Hospital Sungai Buloh which is the designated COVID-19 centre for Malaysia’s central region and is currently being practised.
Introduction: Oral cancer screening programmes have been promoted to be an integral part of national-control strategies. However, such programmes are often not endorsed due to lack of evidence of its cost-effectiveness. This study aims to systematically review studies on the cost-effectiveness of oral cancer screening programmes.
Reconstruction of hand injury is the challenge for the surgeon especially in rural settings. This case report is about a 10-year-old boy, who sustained large degloving wound of dorsum of right hand with extensor tendon injury following a road traffic accident. We performed a staged abdominal flap with tensor fascia lata graft for tendon reconstruction as microsurgery facilities was not available. Post-operatively he was subjected to physiotherapy and he has a functional right hand. This case report aimed to highlight abdominal flap as reconstructive option as compared to skin grafting which is reproducible with limited resources. Besides that, overall exposure to all surgical options is of paramount importance in the training of trainees to equip them with skills to serve in rural setting.
Many studies on postural photogrammetry had reported various intra-class correlation coefficients (ICC) across postural variable measurements, however no conclusive solution was given. This reliability and cross-sectional study was done in June 2016 at the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah. A total of 24 male adult subjects with mean age 28.5 years (± 4.8 years), body mass 24.97 kg (± 3.85 kg) and height 166.6 cm (± 6 cm) were evaluated for standing postural photogrammetry. Four sets of manually digitized posture image files (by 4 raters) were measured and statistically analyzed for interrater agreement as well as the influence of image resolution and camera height from the floor on various postural variable measurements. The ICC between 4 raters for all postural variables was excellent (the lowest ICC was 0.940 for Q Angle of the Right Knee measurements). Two-Way ANOVA showed that postural variable measurements were not affected by either image resolution or camera height from the floor. Scrupulous attempts done on standing postural photogrammetry amplified the potential for standing postural evaluation in clinical settings.
Abstracts of 4th Scientific Research Conference, organised by the Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah.
Background: Malaysia has been ranked the fattest country in Southeast Asia. Overweight and obesity are the fifth leading risk factor for death globally in 2008. It may lead to increase of risk of non-communicable diseases such as cardiovascular diseases, diabetes, cancer and hypertension.
Objectives: This research aimed to determine the prevalence of overweight and association of overweight with sociodemography, lifestyle as well as its health related conditions of adults in Kampung Tiga Papan.
Methods: Cross-sectional analytical study was used to achieve our specific objectives. A total of 199 adults aged 18 years and above in Kampung Tiga Papan had been recruited by non-probability sampling method. Sociodemographic data and lifestyle adopted were obtained via validated questionnaire, the BMI status of respondents were calculated, blood pressure was measured and DASS-21 score was used to assess mental health of the respondents.
Results: There are 118 (59.3%) respondents categorized into overweight group (BMI>23 kg/m2) and 130 (65.3%) respondents are having abdominal obesity (Waist-hip ratio: male>0.9 and female>0.8). There are significant association between gender, household-income, alcohol status and preference of food and BMI status. Besides, there are significant association between gender, household income, alcohol and smoking status and significant increased risk of hypertension in overweight group.
Conclusion: Overweight is associated to some sociodemographic and lifestyle factors. It helps to target high risk population and community intervention can be done to reduce the prevalence of overweight
Silicosis is a fibronodular lung disease secondary to the inhalation of crystalline silica dust. It had continued to cause significant morbidity and mortality worldwide. Here is a case of a 63-year-old woman, a lifelong non-smoker who complained of intermittent wheezing since retired 8 years ago. She had worked in the clay and piping industry for more than a decade. She wore only a simple 3-ply face mask at work without other protective devices. She had multiple hospital admissions for acute exacerbation of chronic lung disease for the past several years. Respiratory examinations revealed bilateral fine crepitations and occasional rhonchi on auscultation. Chest radiograph revealed ground glass changes. Pulmonary function testing showed an irreversible severe obstruction picture with an FEV1 of 45%. High resolution computed tomography thorax demonstrated hyperinflated lungs with emphysematous changes and multiple nodules over subpleural region, conglomerate mass with calcifications over bilateral lungs. Her imaging findings combined with a significant occupational history were suggestive of progressive massive fibrosis (PMF) due to silicosis. She is currently being treated with several inhalers and does not require home oxygen therapy. She is suffering from accelerated silicosis which may potentially progress to radiological deterioration, altered respiratory function and premature death. Therefore, it is essential to avoid any potential hazards that may predispose to silicosis.
The Diamond Dialogue has previously been used as a research tool, as a way of evaluating the effectiveness of development of interventions in changing quality of life in a variety of contexts. This paper aims to describe the development of the Diamond Dialogue as a community intervention tool to reduce alcohol-related harm. This was part of an action research study. Focus groups, using the Diamond Dialogue, were conducted during workshops to reduce alcohol-related harm in two different villages. The Diamond Dialogue was initially used as a tool to better understand how drinking was affecting their quality of life. The Diamond Dialogue was intentionally used as part of the intervention in one village, with the discussion on alcohol and quality of life leading into discussion on community level change to reduce alcohol-related harm. The discussion notes were analysed for themes related to quality of life and alcohol use. Alcohol was seen by community members to have both positive and negative effects on the community. Using the Diamond Dialogue as an intervention lead to greater levels of engagement, created a collective motivation to change and led to community level action planning. Exploring community ambivalence towards alcohol, acceptance of both the positive and negative effects and validation of the community’s views provided a platform for engagement. This then lead to “change talk” about adopting low-risk drinking and ownership of possible solutions for alcohol related problems.
Non-communicable diseases are the leading causes of mortality and morbidity worldwide. Non-communicable diseases (NCDs) kill 40 million people each year and accounts for 70% of all deaths globally. NCDs were previously considered to only affect high-income countries. However, they now account for a very large burden in terms of both death rates and disability in low- and middle-income countries. Also, age standardized mortality rates from NCDs are greater in these countries as compared to high-income countries. By 2020, it is predicted that these diseases will be causing 7 out of every 10 deaths in developing countries. NCDs also have potentially serious socioeconomic implications through increasing individual and household impoverishment thereby hindering social and economic development. This article is an effort to determine the magnitude and consequences of this expeditiously growing public health problem of NCDs through published literature.
Besides the common respiratory symptoms or viral pneumonia, COVID-19 is also presented with different neurological symptoms. Olfactory dysfunction (OD) or impairment of the sense of smell is one of the common neurological symptoms being reported in infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The severity varies from anosmia to microsmia or hyposmia. OD could have a potential early screening and diagnostic value besides other neurological and common respiratory symptoms. In our descriptive concise review, we aimed to elicit the manifestation of olfactory dysfunction as an early predictor of SARS-CoV-2 infection. We are also aiming to establish, OD as a quick and reliable assessment tool of COVID-19 risk, among the healthcare workers and contact tracers, which can justify self-quarantine of the person as well as recommendation for testing on a priority basis. We have also focused on, any effect to produce this symptom by the drug used for treatment in COVID-19, and if the old age of the patient showing any extra influence to develop OD in COVID-19.
Calcification of costal cartilage increases with age and it is rare before the age of thirty years. Early
onset of costochondral calcification can be associated several endocrine and metabolic diseases,
following a trauma, infections, malignancies or due to genetic factors and very rarely idiopathic. Our
case exemplifies premature calcification of costal cartilages. The patient was a 20-year-old lady,
referred to endocrine clinic in UMS polyclinic, Kingfisher, University Malaysia Sabah for evaluation
of metabolic and endocrine causes of premature costochondral calcification. Physical examination
findings were normal except mild tenderness over the left lower lateral part of the chest. Investigation
results were inconclusive to detect any underlying endocrine, metabolic or inflammatory conditions.
Chest X-Ray revealed bilateral calcification of the 10th, 11th and 12th costal cartilages and was diagnosed
as idiopathic calcification of costal cartilage. Only analgesics were given as treatment and the pain
subsided after few days.
The number of active smokers in Malaysia is increasing despite the availability of stop smoking clinics and smoking cessation medications. Other than smokers’ level of motivation to quit smoking, competency of the healthcare professionals involved in providing smoking cessation intervention using evidence based guidelines needs to be considered. Hence, knowledge, attitude and practice (KAP) of the healthcare providers in relation to existing clinical practice guidelines on smoking cessation should be assessed. In this review, we look at the factors contributing to the KAP of medical personnel on the guidelines and also the previously available assessment tool, mainly in the form of a validated questionnaire, for the purpose of applying it to the context of the Malaysian healthcare providers.