This paper presents a conceptual approach to the integration of Islamic perspectives into a Medical Imaging Curriculum to the concept of Outcome-Based Education (OBE). This work is seen within the context of harmonising Islamic principles to a currently accepted concept in education. Although there have been discussions that question the concept of OBE, this paper contends that the integration can benefit from the practicality aspect of OBE. This can reduce the complexities and fatigue in addressing the integration using an educational approach that is different to that being applied to the human sciences. This paper features the main elements in OBE in the form of Islamic programme educational objectives, Islamic programme outcomes, and Islamic domain learning outcomes. The justification to use domain learning outcomes instead of course learning outcome is given. The teaching and learning strategies, as well as the assessment, are examined through a lens that serves to provide a desirable, practical and holistic model of Islamic integration. It is felt that the currently accepted teaching and assessment methodologies can be adapted for the integration exercise. This work also highlights two often overlooked elements of OBE; teacher and student characteristics. The various terminologies that describe the Islamic teacher characteristics and the differences in student learning styles and preferences are presented. Furthermore, suggestions are made to align the assessment of the integration to various taxonomies of learning, with the aim in evaluating the internalisation of the Islamic essences. This work contents that a holistic approach towards integration of Islamic perspectives into Medical Imaging curriculum can be realised.
Type 1 Neurofibromatosis (von Reckinghausen’s disease) has been associated with several gastrointestinal tumor complications, either benign or malignant. We report a case of a middle age man who had Type 1 Neurofibromatosis and presented with acute intestinal obstruction. Laparotomy revealed multiple nodular lesions along the small intestine with two larger nodules which were resected. Histopathological examination of the nodules confirmed it as gastrointestinal stromal tumors (GIST) with malignant potential. The association between neurofibromatosis and GIST is discussed.
Introduction: The Malay Version of EORTC-QLQ C30 was validated among Malaysian women who had undergone breast cancer surgery. Materials and Methods: Test-retest evaluation (i.e. three weeks and ten weeks following surgery) was carried out to examine the validity and reliability of the scale. The Cronbach’s alpha value was used to determine the internal consistency, meanwhile, test-retest Intraclass Correlation Coeffi cients (ICC) indicates the reliability of the scale. Effect Size Index and Mean Differences interpret the sensitivity of the scale. Discriminant validity was evaluated by comparing two groups i.e. women who had mastectomy and women who had lumpectomy. Results: Internal consistencies are acceptable for Global Health Status (0.91), Functional domains (ranging from 0.50-0.89) and Symptomatology domains (ranging from 0.75-0.99). Intraclass Correlation Coeffi cient (ICC) ranged from 0.05 to 0.99 for Global Health Status and Functional domains, and ranged from 0.13 to 1.00 for Symptomatology domains. Sensitivity of the scale was observed in nearly all of the domains. Conclusion: The Malay Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ C30) is a suitable tool to measure the quality of life of women with breast cancer.
Introduction: Epilepsy remains a stigmatised disease across geographical and temporal boundaries. Very little is known about epileptic stigma (ES) in cross-cultural settings. The aim of this study was to assess the prevalence of perceived stigma and factors associated with it, among patients with epilepsy (PWE) at a tertiary care referral hospital in East Coast of Malaysia. Methods: A cross sectional survey among 132 consenting PWE using pre-tested, semi-structured questionnaire in Malay/English language to assess their knowledge, attitude and practices (KAPs). Results: Among 132 respondents, 51.5% were male and 48.5 % were female. Their age ranged from 14 to 70 years (mean=31.6±13.41). Majority (53.8%) of them were aged 30 years or younger. The median number of years they had epilepsy was 8.0 (IQR 4.0-18.8) years and average duration of seizure prior to seeking medical attention was 1.0 (IQR 0.3 - 4.5) year. Most of them (90.9%) did not know the cause of epilepsy; however nearly all (91.7%) believed that it was a disease of the
brain. Higher education level respondents possessed significantly higher KAP scores compared to lower education level respondents (p
Restrictive dietetic practices, rather than helping the patient, reduce his food intake and thereby impair recovery. This is a cruelty born-of erroneous notion passed on to us as a legacy from hakims and vaids (quakes), rather than having any scientific justification. Even if some doctors do not entertain such restrictions, the so called well-wishers of patients will definitely offer free advice and impose food restrictions upon their patients. Everybody has his own share of bitter experiences, horrific memories, and heart-rending stories of the past. The chain of death and destruction remains unbroken. The gloomy, dark sky is waiting for break of a new dawn gone into eclipse years before. The ongoing Indo- Pak peace process has already resulted in a number of confidence- building measures, but in spite of all that an average of five persons each day are being killed in terror-related incidents across the State. A tricky situation prevails in which militants and security forces are pitted against each other, converting the streets, the lanes and by-lanes, and human settlements in to a well-entrenched battle ground. Innocent Kashmir’s are dying, getting maimed, and suffering mental agony and the world is watching with a nonchalant indifference.
Due to globalizing trend of homogenisation of culture, changes in the health care delivery system and market economics infringing on the practice of medicine, there has been a gradual shift in the attitude of the medical community as well as the lay public towards greater acceptance of euthanasia as an option for terminally ill and dying patients. Physicians in developing countries come across situations where such issues are raised with increasing frequency. As the subject has gained worldwide prominence, we want to review this topic from Islamic perspective due to its significance in medical ethics and clinical practice.
Dentigerous cyst is the most common odontogenic cysts that are associated with the
crowns of permanent teeth. Treatment modalities normally include enucleation or marsupialization
of the cyst. However, currently there are no standard assessment criteria to dictate which kind of
treatment for certain cases. (Copied from article).
Intraoral periapical radiographic film is essential and aids in diagnosis, treatment
planning, monitoring treatment and monitoring lesion development. A poor image quality of
radiographic film and poor record keeping of these radiographs can affect the clinician's decision
making. This first audit was to evaluate the quality of radiographic images and the compliance in
following the standard of recording and labeling of radiographic films. The objectives of this audit
were; firstly to highlight any potential problems involving quality of radiographic films within the
department. Second, to assess the compliance of record keeping and labeling of intraoral
radiographs. Materials and Methods: The study was conducted in a retrospective manner in the
year 2017 with a sample of 100 intraoral periapical radiographic films from the year 2015 to 2016 in
Hospital Sultanah Bahiyah. Results: This first audit cycle demonstrated: Good quality of
radiographic films: 13% (n= 13/100), Good compliance of record keeping and labeling of radiograph: 32% (n= 32/100).
Comorbid adult attention-deficit hyperactivity disorder (ADHD) and stimulant dependence is widely recognized, but efficacy of pharmacotherapy in this patient population is not well established. We aimed to review whether pharmacotherapy is efficacious in reducing ADHD symptoms and stimulant use in comorbid adult ADHD and stimulant use disorder. English articles until June 2017 were systematically searched in electronic databases (MEDLINE and PsycINFO), an online clinical trials register (ClinicalTrial.gov), and through hand-search of article references. Randomized, double-blind, placebo-controlled trials that studied efficacy of pharmacotherapy in adults with comorbid ADHD and stimulant dependence were included. Two reviewers assessed studies for inclusion and extracted data; disagreements were resolved by consensus. Study outcomes included were changes in ADHD symptom severity, substance abstinence, treatment retention rates and safety. From the 1394 records identified, five trials (n=358) were included. Four studies involved methylphenidate; in another study extended-release mixed amphetamine were used. The comorbid stimulant was cocaine in three studies, and amphetamines in the rest. All were short-term studies involving predominantly young male adults conducted in outpatient settings. There is early promising but mixed evidence for therapeutic efficacy in improving ADHD symptoms. Stimulant medications did not worsen stimulant dependence or adverse effects of stimulant medications. Side effects were mild and tolerable. High attrition rates and small sample size limited the generalizability of findings. Current limited evidence suggests that stimulant treatment for comorbid adult ADHD and stimulant dependence is feasible. Welldesigned trials with adequate power are needed for more robust evidence on ADHD and stimulant use outcomes.
Introduction: Non-communicable disease accounted for 73% of premature death in year 2015 Malaysian national survey. The orang asli population may be affected similarly. The prevention of non-communicable diseases should start as early as modifiable risk factors prevention, as proposed by STEPWISE approach of WHO. This study aims to identify the prevalence of hypertension, diabetes mellitus and dyslipidaemia among Jakun orang asli population and examine the association with risk factors. Methods: This is a cross-sectional study analysing 72 case reports of General health screening done in year 2015. The study population was adult Jakun orang asli Tasik Chini using cluster sampling followed by simple random sampling methods. Chi Square test was used for bivariate analysis of relationship each variable has with the diseases, and binary logistic regression was used to analyse association of covariates with each disease. Results: The prevalence was 41.7% for hypertension, 25% for Diabetes mellitus, 6.9% for dyslipidaemia. Education level was significantly related to hypertension, X2 = 11.565 (1), p =0.001; obesity was significantly related to diabetes, X 2 = 8.333 (1), p=0.004. After adjusted for covariates, low education level has 13.379 odds of getting hypertension. Obesity has 7.384 odds of getting diabetes mellitus; female gender has higher odds of getting dyslipidaemia while younger age, physically active and not smoking are protective factors. Conclusion: Higher prevalence of hypertension and diabetes mellitus was found among Tasik Chini orang asli population. Lower sociodemographic characteristics and unhealthy lifestyle factors are associated with the diseases.
Essential hypertension is a multifactorial disease. Many experimental studies have elucidated
the role of oxidative stress and atherosclerosis in the pathogenesis of essential hypertension. Apolipoprotein
E is a plasma protein that is found to have antioxidant properties, and it also protects against atherosclerosis.
Interestingly, the biological function of apolipoprotein E is strongly affected by polymorphisms in its gene.
Based on this evidence, our aim was to investigate the association of apolipoprotein E gene polymorphisms with
essential hypertension.
Enamel demineralization is associated with decrease in saliva pH due to fermentation of sugar by oral commensal. Thus, exploring the changing pattern of saliva pH is meaningful in dental caries prevention. The aim of this study was to compare the changing pattern of saliva pH after consuming different types of sweeteners (sucrose and maltitol). Methods: It was a case-control study involving 14 male patients attending IIUM dental clinic who were selected with the intention of getting seven patients with high caries risk ( DMFT ≥6) and seven patients with low caries risk (DMFT ≤3) with initial saliva pH interval of 6.5 to7.5. Patients were asked to consume snacks containing 8 gram sucrose and 8 gram maltitol as sweeteners. The changing pH values of the saliva were measured by Waterproof pHTestr 10BNC (Oakton, Vernon Hills, USA) seven times consecutively at 0 (before snack consumption), and at 5, 10, 15, 20, 30 and 60 minutes after snack consumption. The pH values of saliva of patients with low and high caries risk after consuming sucrose and maltitol were statistically analized by using Anova and Tukey-HSD tests at α = 0.05. Result: There were significant differences in saliva pH changes between low-risk group and high-risk group after consuming sucrose and maltitol. Conclusion: The changing patterns of saliva pH in high-risk patients were lower than those of low-risk patients after consuming two types of snacks containing sucrose and maltitol.
The effect of surgical removal of impacted third molars on the periodontal
parameters of adjacent second molar revealed inconsistent results. Some authors suggested
improvement of periodontal parameters distal to second molar, whilst others demonstrated loss of
attachment and reduction of alveolar bone height. This study was conducted to evaluate the
alveolar bone height (ABH) and periodontal status of second molar after the surgery. (Copied from article).
Delayed tooth eruption (DTE) is the emergence of a tooth into oral cavity that
deviates from norms established for different races, ethnics and sexes, which commonly caused
either by local or systemic conditions. (Copied from article).
: Reconstruction of the primary defect following resection of primary tumour is part of
the surgical treatment of head and neck cancer.The present paper reports a case of reconstruction
of medium size through and through defect of the cheek with the transverse platysma
myocutaneous flap combined with the temporalis flap. (Copied from article).
Wan Khairunnisa Wan Juhari, Khairul Bariah Ahmad Amin Noordin, Wan Faiziah Wan Abdul Rahman, Andee Dzulkarnaen Zakaria, Ahmad Shanwani Mohd Sidek, Muhammad Radzi Abu Hassan, et al.
Background: Hereditary nonpolyposis colorectal cancer (HNPCC) also known as Lynch syndrome is commonly caused by genetic alterations in any of the four mismatch repair (MMR) genes; MLH1, MSH2, MSH6 and PMS2. This is the first study aimed to investigate genetic variants in Malay HNPCC families. Methods: Six Malay HNPCC families who fulfilled any of the Bethesda criteria were recruited into this study. A total of 3 ml of blood was withdrawn from each patient in the families. The samples were further analyzed using polymerase chain reaction and direct sequencing of the selected exons of MLH1 and MSH2 genes. Results: Two missense mutations and four single nucleotide polymorphisms (SNPs) were identified in six patients. These variants in the MLH1 and MSH2 genes were identified in four families who met the revised Bethesda guidelines. In two families, no mutation and polymorphism was identified in both the exon and intron of the respective genes. Of the mutations and polymorphisms identified, five have never been reported in Malay HNPCC families before. A missense mutation was detected in exon 5 of the MLH1 gene, c.394G>C (p.Asp132His) and four mutations and polymorphisms were detected in the MSH2 gene; heterozygous c.211+98T>C and c.211+9C>G and homozygous c.211+98T>C and c.211+9C>G, c.367-86A>C and c.382C>G. Conclusion: The results represented a new spectrum of mutations and polymorphisms in the Malay HNPCC families. However, a larger study involving additional families and analysis is required to determine the impact and nature of the identified mutations and polymorphisms.
Advances in neonatal care now enable more infants to be kept alive despite clear clinical evidence of inevitable or imminent death on a life-support system. It is therefore no longer acceptable to the society that a patient is left to die in the hospital, without any form of treatment or intervention. We report a case of severe birth asphyxia, hypoxic-ischemic encephalopathy, neonatal seizures and left cephalohematoma. In spite of initial successful resuscitation, the infant could not survive until all possible methods of treatment were exhausted. This case illustrates one of many examples of the process involved in dealing with ending of life decision in a condition considered as futile.
Introduction: Multiply transfused patients are frequently subjected to platelet alloimmunization. These platelet alloantibodies produced can result in refractoriness to platelet transfusion. Material and Methods: Ninety five thrombocytopenic (platelet count
Currently, it is almost impossible to diagnose a patient at the onset of
sepsis due to the lack of real-time metrics with high sensitivity and specificity. The
purpose of the present study is to determine the diagnostic value of model-based insulin
sensitivity (SI) as a new sepsis biomarker in critically ill patients, and compare its
performance to classical inflammatory parameters. (Copied from article).
Clinical scoring methods such as the Sequential Organ Failure Assessment
(SOFA) score are frequently used to predict outcome in sepsis, with limited capacity.
Further tools for risk assessment of septic critically ill patients would thus be useful.
Our purpose was to derive a scoring method i.e. Sepsis Mortality Score using multimarker
approach for the prediction of 30-day mortality in septic critically ill patients,
and compare its performance to the SOFA score (Copied from article).