Displaying publications 21 - 40 of 399 in total

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  1. Tan, T.L., Mohd Fazrul, M.
    Medicine & Health, 2018;13(1):237-242.
    MyJurnal
    Hemichorea-hemiballismus (HC-HB) is a movement disorder characterized by involuntary movements involving limbs on one side of the body. Many etiological factors were identified and these included stroke, infection, and neoplasm. However, acute hyperglycemia-induced HC-HB is less well known. We present two cases of non-ketotic hyperglycemia-induced HC-HB. The cases depicted here Illustrate that HC-HB can be the sole presentation from among a variety of neurological manifestations of poorly controlled diabetes which can be easily reversed when hyperglycemia is corrected.
  2. Rathna, R., Mushawiahti, M., Bastion, M.L.C., Masdar, A., Ropilah, A.R.
    Medicine & Health, 2018;13(1):243-250.
    MyJurnal
    Central retinal vein occlusion (CRVO) is uncommon among young patients. Among the young adults, CRVO tends to be more benign with good visual prognosis. Macular oedema secondary to retinal vein occlusion is a relatively common complication that is currently being treated with intravitreal anti vascular endothelial growth factor with good outcomes. Other complications include lamellar hole, vitreous hemorrhage and neovascular glaucoma. We report a case of central retinal vein occlusion in a young female who presented to us with the complaint of blurring of vision in the left eye for four months. Fundus examination showed hyperemic optic disc, dilated tortuous vein, extensive retinal hemorrhages with macular oedema and an inferior shallow exudative retinal detachment. One month later, intravitreal ranibizumab injection for her macular oedema, a full thickness macular hole developed with reduction of macular oedema. Four months later, the hole spontaneously closed but her macular oedema persisted. The possibility of rare complications like exudative retinal detachment and full thickness macular hole must be kept in mind to ensure early detection and effective management is provided to preserve vision.
  3. Khor CC, Tan TL
    Medicine & Health, 2018;13(1):227-231.
    MyJurnal
    Acupuncture is a form of complementary medicine that has been practiced in China for thousands of years. Adverse effect of acupuncture is rarely reported in local literature. This is a case of a patient who developed bilateral pneumothorax following an acupuncture session. A 63-year-old lady with no significant medical illness presented with sudden onset of shortness of breath half an hour following acupuncture and massage session by traditional medicine practitioner. On examination, she was tachypnoiec and there was reduced air entry bilaterally on lung auscultation. Urgent portable chest X-ray was done and it showed bilateral pneumothorax. Bilateral chest tubes were inserted. Patient was discharged well following five days of hospitalization. As acupuncture is gaining popularity among Malaysian population, medical practitioners need to increase their awareness and knowledge regarding the adverse effect of such alternative practice.
  4. Nurul Ain, S., Norshamsiah, M.D., Safinaz, M.K., Bastion, M.L.C.
    Medicine & Health, 2018;13(1):232-236.
    MyJurnal
    Spontaneous closure of idiopathic full thickness macular hole is a rare case as it occurs in only 3.5% while awaiting vitrectomy surgery. There are few pathologies associated with it such as vitreomacular traction (VMT) and posterior vitreous detachment. We report a case in a 74-year-old man who presented with right eye painless, progressive blurring of vision with idiopathic stage 4 full thickness macular hole which was confirmed on optical coherence tomography. It closed spontaneously after sometimes while waiting for surgery. It is important to monitor closely for the possibility of spontaneous closure based on the optical coherence tomography findings.
  5. Ng, V.H., Ahmad, K.I.
    Medicine & Health, 2018;13(1):264-271.
    MyJurnal
    Fish bone is the commonest cause of foreign body disease in Asian population. Esophageal perforation following fish bone foreign body accounts for 1-4% of the total reported cases. A 60-year-old lady presented with progressively worsening dysphagia and odynophagia over five days period following a fish meal. She sought treatment at two general practitioner clinic and a private hospital before being referred to Ear, Nose and Throat specialist. Repeated neck X-ray revealed a significant increase in prevertebral soft tissue thickness with large air-pocket tracking, small opacity at the prevertebral C3 level and subcutaneous emphysema anterior to the neck suggestive of retropharyngeal hematoma or abscess. A CT neck and thorax showed a 2.1 cm linear dense structure at the level of C7/T1 that appeared to protrude outside the esophagus in between the tracheoesophageal space. Direct laryngoscopy and repeat emergency esophagoscopy revealed a perforation at the right side of esophagus distal to cricopharyngeus with pus discharge upon milking of posterior lateral wall and a fish bone measuring 3.0 x 0.5 cm was removed from posterior wall of esophagus 17 cm from incisor. Gastrograffin study on day 10 was normal and was discharged on day 11 with Ryle’s tube feeding and to complete oral antibiotic. Fiber optic endoscopic evaluations of swallowing at two weeks follow up was normal. Subsequent review in the clinic showed full recovery without sequelae. Migrating fish bone can lead to esophagus penetration with serious complications. Mortality and morbidity from fish bone foreign body can be minimized with early diagnosis, referral and removal.
  6. Yeoh, S.Y., Anhar, H.S., Chua, S.M., Raja, N.R.O., Nor, F.A.J., Azida, J.W.A.K.
    Medicine & Health, 2018;13(1):272-278.
    MyJurnal
    Diagnosis of ocular leptospirosis is challenging and requires a high index of suspicion of previous leptospiral infection and good laboratory support. This case series focuses on two young females with unilateral conjunctiva granuloma. To the best of our knowledge, these are the first two cases of ocular leptospirosis with conjunctiva granuloma. The definitive diagnosis of ocular leptospirosis was based on laboratory studies in which conjunctival biopsies in these two cases showed positive leptospira DNA. Retrospectively, the history was suggestive as both patients had exposure to leptospira organism. In conclusion, a diagnosis of ocular leptospirosis requires a high clinical suspicion index supported by mandatory laboratory investigations.
  7. Farah, N.A., Johar, M.J., Ismail, M.S.
    Medicine & Health, 2018;13(1):251-258.
    MyJurnal
    Damage control resuscitation, characterized by hemostatic resuscitation with blood products, rapid arrest of bleeding and when possible, permissive hypotension with restricted fluid load form a structured approach in managing a polytrauma patient. When complicated with traumatic rhabdomyolysis however, permissive hypotension strategy may cause more harm resulting in subsequent ischaemicreperfusion injury and acute kidney injury. We present a case involving a 20-yearold man who was rolled over by a lorry and sustained an open unstable pelvic fracture with vascular injury and left lower limb ischaemia. Permissive hypotension strategy was pursued for 4 hours prior to bleeding control in OT. This was followed by protracted surgery of 6 hours. Coagulopathy, acute kidney injury and rhabdomyolysis ensued in the post-operative period and patient succumbed to his injury on Day 3 post-trauma. Challenges and pitfalls in managing a complex polytrauma patient and recent evidences on damage control resuscitation is discussed.
  8. Loo, S.P.S., Siti Nidzwani, M.M.
    Medicine & Health, 2018;13(1):259-263.
    MyJurnal
    Superior vena cava syndrome is a medical emergency. The morbidity and mortality of superior vena cava syndrome can be decreased by early recognition, early establishment of primary cause, early supportive and definitive treatment. We illustrate a case of 53-year-old male with underlying advanced Parkinsonism and ischemic stroke who presented with superior vena cava syndrome over 4 days period. Diagnostic challenge in this patient lies in the fact that patient had aphasia and his daily living activity was dependent. Most of the information was based on caretaker’s observations. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment of superior vena cava syndrome.
  9. Hassan, S., Sutton, P.A., Smith, D.C., Kosai, N.R., Reynu, R., Shuhaili, M.A.
    Medicine & Health, 2018;13(1):291-295.
    MyJurnal
    Rectus sheath hematoma (RSH) is a rare clinical entity that has been associated with the use of injectable anticoagulant therapy. Although low molecular weight heparin (LMWH) was proven to have a better safety profile than its predecessor, it is not without its own risk of bleeding. The increase in use of self-injectable LMWH in both in-patient as well as out-patient basis warrants greater awareness among health care providers, patients and caregivers regarding the potential risks and identification of possible complications. We present a fatal case of rectus sheath hematoma in an elderly man that occurred following erroneous technique of Dalteparin injection.
  10. Norliyana, M., Mohd Yazid, B., Abdul Muhaimin, A.
    Medicine & Health, 2018;13(1):279-285.
    MyJurnal
    Brachymetatarsia is a conditioned which has been described as abnormal short metatarsal bone due to premature closure of the epiphyseal growth plate. It usually involves a single metatarsal bone with the fourth metatarsal being the most common. It may be congenital or acquired. We here report a case in a 53-yearold lady who presented with foot pain and shoe wearing problem. Examination revealed shortening of the bilateral fourth toe and the toes were tilted dorsally. She was diagnosed with bilateral brachymetatarsia and operation was done mainly for cosmetic reasons. Gradual lengthening with distraction osteogenesis was performed using a MiniRail external fixator (Orthofix) and K-wiring of the right fourth metatarsophalangeal joint. Adequate length of fourth metatarsal and good bony union were achieved at the end of treatment.
  11. Muhammad Hafiz, A.S., Mohd Yazid, B., Norliyana, M., Rasyidah, R.
    Medicine & Health, 2018;13(1):286-290.
    MyJurnal
    Osteomyelitis refers to an infection of the bone characterized by progressive inflammatory destruction caused by infecting microorganism. Open fracture carries the risk of developing osteomyelitis from 3 to 50% with a high amputation rate. Salvage of the limb is always a challenge and needs perseverance. We report the case of a 44-year-old male with chronic osteomyelitis with successful multiple limb salvage surgeries. The curative approach to chronic osteomyelitis has the following goals including arrest of infection, pain reduction and salvage of limb and function. With regard to survival and function, the result obtained in this case is more promising compared to above knee amputation.
  12. Ling,S.l., Hatta, S., Azlin, B.
    Medicine & Health, 2019;14(1):1-22.
    MyJurnal
    Transgender adalah satu keadaan biopsikososial yang kompleks dan merupakan sebahagian daripada dimensi seksualiti manusia. Ia merangkumi komponen kognitif-emosi dan tingkah-laku yang membuatkan seseorang insan itu unik di dalam ekspresi seksualitinya. Kaum transgender cenderung untuk menggunakan hormon-silang-seks untuk mengubah keadaan dirinya menyerupai gender bertentangan yang diingini dengan cara menutupi ciri sekunder seksnya. Seks hormon yang biasa digunakan ialah: ““Female to Male Treatment Options (FMTO)” iaitu testosterone and hormon wanita pada “Male to Female Treatment Options (MFTO)”, di mana kombinasi estrogen dan anti-androgen digunakan. Hormonsilang-seks iaitu FMTO, atau MFTO mempengaruhi sifat biologi dan psikologi individu transgender. Namun begitu, hormon-silang-seks mempunyai profil kesan sampingan tertentu yang juga memberi impak biologi dan psikologi. Impak psikologi menjurus kepada masalah kesihatan mental dan bunuh-diri. Pelbagai tahap pengaruh biopsikososial kesan hormon-silang-seks diterangkan dan ulasan ini memberi ruang membincangkan kepelbagaian pilihan rawatan. Di dalam psikiatri, perubahan biologi memberi pengaruh yang besar ke atas individu transgender, terutamnaya dari aspek psikososial dan budaya.
  13. Azizam, N.A., Saperi, S., Aniza, I., Norazirah, M.N., Azura, M.A., Zafar, A., et al.
    Medicine & Health, 2019;14(1):23-33.
    MyJurnal
    Psoriasis imposes a great economic burden as a result of higher expenditures for different interventions, diagnostic procedures, pharmaceuticals and loss of productivity. Less is known about the economic impact of psoriasis treatment in Asean region. The aim of this research was to calculate the costs associated with four psoriasis treatment modalities. A prospective cohort study was conducted in five hospitals involving 91 moderate to severe psoriasis patients. Costs were calculated from the societal perspective using the principle of Step Down and Activity Based Costing (ABC) within a six (6) months follow-up duration. The components of the costs borne by the provider were inpatient cost, cost of medication, laboratory investigation and radiology. Patient’s cost included out of pocket expenses, travelling cost and loss of productivity. Cost per patient per day was RM1,105.24 (inpatient) (US$315.94) and RM298.02 (outpatient) (US$85.19). Medication accounted for almost 90% (RM457,014.00) (US$130 638.45) of the total provider cost. Meanwhile, loss of productivity represented 84% (RM167,439.00) (US$47,862.80) of the total patient’s cost. Biologic treatment exhibited the highest cost which was RM342,377.00 (US$97,869.21), followed by systemic treatment (RM105,607.00) (US$30,187.99), topical treatment (RM38,280.00) (US$10,942.42) and topical phototherapy treatment (RM21,824.00) (US$6,238.44). Understanding the relationship between direct and indirect costs from both perspectives is important to accurately identify and evaluate effective treatment for psoriasis.
  14. Leong, J.F., Levin, K.B., Rajkumar V., Abdullah, S., Jamari, S.
    Medicine & Health, 2019;14(2):261-265.
    MyJurnal
    Cavernous lymphangioma is a congenital malformation of lymphatic system causing dilated lymphatic sinuses that involve the skin and subcutaneous tissues. This was an interesting case of dystrophic macrodactyly of the left ring and little finger in a 18-month-old girl who presented with swollen and sausage like fingers deformity which turned out to be an isolated cavernous lymphangioma. This tumor, although rare to occur in the extremeties, must be differentiated from other congenital vascular lesions of the hand that include arteriovenous malformations and hemangiomas. Diagnosis should be solely based on histopathological analysis of the excised tissue mass. Surgical excision is usually necessary for satisfactory functional and cosmetic outcome
  15. Wong, S.K., Rangiah T., Bakri, N.S.A., Ismail, W.N.A, Bojeng, E.E.F., Abd Rahiman, M.A., et al.
    Medicine & Health, 2019;14(2):132-141.
    MyJurnal
    Delayed wound healing is one of the major complications of diabetes mellitus where it often leads to amputation. Virgin coconut oil (VCO) is a natural oil widely used to treat wounds and burns traditionally. It possesses potent antioxidant and antibacterial activities. This study aimed to determine the effect of VCO on the fibroblast population in diabetic wound healing. Full thickness cutaneous wound tissues were collected from non-treated, VCO-treated, and silver sulfadiazine (SS)- treated diabetic rats. The tissues were then subjected to Verhoeff eosin staining and immunohistology of fibroblast and myofibroblast. Histological analysis showed increased collagen deposition with intact epidermis in the VCO treated group compared to decreased collagen deposition with damaged epidermis in both non-treated and SS-treated groups. Interestingly, more fibroblasts and myofibroblasts were observed in the non-treated group compared to the VCO- and SS-treated groups. VCO significantly promoted wound healing process in diabetic rats via promoting re-epithelialization, and increasing collagen fibres deposition and wound contraction. The results suggested VCO can be used to treat diabetic wounds.

  16. Mohd Faiz, A.L., Marhanis-Salihah, O.
    Medicine & Health, 2019;14(2):0-0.
    MyJurnal
    An increase in the number of residents in nursing homes has become a significant concern due to the rise in medication demand and subsequently medication-related issues, especially in frail elderly. Community pharmacists are the closest healthcare professionals available that can contribute to this population to allow optimal utilization of the prescribed drugs and to prevent drug-related problems. The present study aimed to investigate the awareness of community pharmacists on issues regarding frail elderly and to determine their willingness in collaborative care of frail elderly in nursing homes and the services they are willing to offer. This was a cross-sectional study utilising a set of questionnaire that was delivered to practicing community pharmacists in Peninsular Malaysia from June 2018 until December 2018. Majority of the participants agreed to the fact that aging is the primary cause of frailty (n=98, 88.3%), and that chronic disease is also a cause of frailty (n=96, 86.5%). Most of the community pharmacists were also keen to participate in the collaborative care of frail elderly, and were willing to provide their pharmacy service to the frail elderly. There was a positive correlation between the awareness of community pharmacists on issues regarding frail elderly and their willingness on collaborative care of frail elderly in nursing homes (r=0.374, n=111, p=0.01). Majority of the pharmacists were aware of the issues regarding the frail elderly, and were willing to participate in the collaborative care of frail elderly in nursing home.

  17. Zainah, M., Muhammad Nur Akmal, A., Nor Syazwani, A.A., Sim, T.S., Nur Erietika, A., Wan Norshafika, W.M.Z.
    Medicine & Health, 2019;14(2):154-167.
    MyJurnal
    Each human being exhibits their own personality traits and each aspect of stress and coping is essential and related. The relationship between the big five personality traits, coping mechanisms and stress level among final year medical students of Universiti Kebangsaan Malaysia (UKM) was investigated in this study. In this cross-sectional study, 152 final year medical students batch 2017/2018, were randomly selected, excluding those who had chronic diseases, married and repeated final year. The questionnaires used were Big Five Personality Inventory and 12-Item General Health Questionnaire. An open-ended question was used to determine how the respondents cope with their stress. Data was analyzed using SPSS 20.0. Agreeableness was the most common personality trait portrayed among the students, whereas Openness to Experience appeared to be the least. The relationship between the Big Five Personality Traits and coping mechanisms (p=0.016; p
  18. M.H., Omer, K.M., Ahmed, I.H., Mohammed, Hatta, S., Najmi, S.
    Medicine & Health, 2019;14(2):242-252.
    MyJurnal
    Lack of knowledge and inappropriate attitude towards electroconvulsive therapy (ECT) treatment may affect the outcome of psychiatric’s morbidity and mortality. However, less systematic studies have been done on this area. This study aimed to assess the patients’ and relatives’ perspectives, i.e. knowledge, attitude and compliance on ECT in Khartoum State, Sudan. This was an observational hospital-based study conducted among 103 psychiatric patients and their relatives respectively who visited the Taha Basher and Eltigani Elmahi psychiatric hospitals during 2016. Both the patients and their relative inquired about different criteria of knowledge and attitude towards ECT. The percentage of score was calculated based on their positive answers by selecting the most appropriate answer or by calculating the mean of many positive answers. All the data were collected through a pre-designed questionnaire, and further analyzed statistically. Male was represented 61 (59.2%) and the commonest age group of patients was 16-30 years. The overall score of knowledge towards ECT among patients and their relative was 54.9% and 59.4%, respectively. Acceptance on the use of ECT were agreed by 43.7% of patients and more than 70% of patients and their relatives believed giving ECT for emergency psychiatric cases. Psychiatrist was the most frequent source of information reported by both patients (73.8%) and relatives (67%). Male relatives showed significantly higher attitude of recommending ECT treatment (p=0.004) for other patients. Patients and their relatives were reported to have moderate and better knowledge and attitude towards the use of ECT, respectively.
  19. Aaina Iryani, M., Ahmad Khaldun, I.
    Medicine & Health, 2019;14(2):253-260.
    MyJurnal
    Foreign body (FB) ingestion among children is one of the most common presenting complaint to Emergency Department. Oropharyngeal foreign body are the least common, 5-10% in all FB ingestion. However, it carries significant mortality and morbidity following complications which may arise from it. Airway obstruction is one of the complications which may present after FB ingestion. Due to the significant differences in airway anatomy and physiology of children, management of an obstructed pediatric airway is challenging. It requires proper skill and experience to prevent further fatal complications. Proper assessment and airway evaluation are crucial before proceeding with endotracheal intubation. Surgical airway is only reserved in ‘Cannot Ventilate Cannot Intubate’ situation where it should be done by a skilled person, as it carries risk of injury to underlying vital structures.
  20. Anjo, Sharlene, Ida Zarina, Z.
    Medicine & Health, 2019;14(2):212-218.
    MyJurnal
    Acute aortic dissection (AAD) is rare in the paediatric and young adult population. We present a fatal case of acute aortic dissection Stanford B in a young male diagnosed with hypertension. He presented with severe acute abdominal pain with malignant hypertension. He did not have any trauma to the chest or did not have history of an illicit drug abuse. He had no features suggestive of connective tissue disease as well as other typical signs of aortic dissection. The complain of acute, severe abdominal pain which was out of proportion and required multiple doses of intravenous opioid, raised the suspicion of aortic dissection in this case. Point of care sonography (POC) was done in Emergency Department (ED). However, due to its highly operator dependability, the intimal flap was missed. Computed tomography (CT) scan of abdomen was done and confirmed the diagnosis of AAD. Unfortunately, his clinical condition rapidly deteriorated few hours later with no response to surgical intervention and succumbed within 36 hours of admission. We highlighted the importance of the early recognition of this disease as well as the point of care sonography in ED as a diagnostic tool to tackle this time-sensitive disease.
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