MyMedR

Fulltext Work related upper limb disorders in telecommunication workers in Malaysia

Premalatha GD, Noor Hassim I

Med J Malaysia, 1999 Jun;54(2):247-56.

PMID: 10972037

A total of 323 workers from 5 different occupational groups in the telecommunication industry were studied in this cross sectional study, which sought to determine the prevalence of Work Related Upper Limb Disorders (WRULD) in 5 occupational groups; operators using the Video Display Terminals, switchboard operators, clerks, data entry processors and the supervisors. WRULD was also studied with regard to factors such as sex, race, height, age, stress and the discomfort perceived due to the work station design. The possibility of WRULD was determined from a self-administered questionnaire and confirmed by history and physical examination. Psychological stress and the discomfort due to the workstation were measured from the questionnaire. The overall prevalence was found to be 31.2% and the prevalence among the various occupations differed with it being the highest in the switchboard operators and data processors and the lowest in the supervisors. The older workers and the female workers were found to have higher prevalences of WRULD. It was also found that a higher stress score and a higher score of discomfort perceived at the work station were associated with higher prevalences of WRULD.

Women's empowerment based on self-regulated learning as mother's ability to fulfill nutrition in stunted children

Hastuti AP, Sukartini T, Arief YS, Nursalam N, Roesardhyati R, Kurniawan AW, et al.

Med J Malaysia, 2024 Jan;79(1):28-33.

PMID: 38287754

INTRODUCTION: The role of providing nutrition to children aged 6-24 months who are stunted is related to the mother's ability to provide proper nutrition. Empowerment of mothers based on self-regulated learning is a nursing intervention that can be carried out by using the abilities, belief and individual capacities of mothers in completing tasks, managing and providing nutrition to children aged 6-24 months. Mother's characteristic are motivation, self-esteem, self-efficacy, knowledge, belief and ability to decisionmaking about providing nutrition to children, so it can be a learning process for the mother in using resources which improve the nutrition ability of the mother. This study aims to apply a women's empowerment model based on selfregulated learning in increasing the mother's ability to fulfill nutrition in stunted children aged 6-24 months.

MATERIALS AND METHODS: The research design used a quasiexperiment. The sampling technique used cluster sampling with 76 respondents in intervention group and 76 respondents in control group. The research was conducted in the working area in Public Health Center, Malang Regency. Data analysis in this study used the Wilcoxon Signed Rank Test and Mann-Whitney.

RESULTS: The results of the study found that there were differences in the ability of mothers to fulfill nutrition in stunted children between the intervention group and the control group (p = 0.000). There were mean differences in the ability of mothers to fulfill nutrition for stunted children before and after the intervention in the intervention group with indicators of breastfeeding, food preparation and processing, complementary- feeding and responsive feeding were increased (p = 0.000). However, in the control group, there were no differences in the ability of mothers to fulfill nutrition with indicator breastfeeding (p = 0.462), food preparation and processing (p = 0.721), complementary feeding (p = 0.721), complementary feeding (p = 0.462). (p = 0.054), responsive feeding (p = 0.465) and adherence to stunting therapy (p = 0.722).

CONCLUSION: The women's empowerment model based on self-regulated learning is formed by individual mother factors, family factors, health service system factors, and child factors so that it can increase the mother's ability to fulfill nutrition in children aged 6-24 months who are stunted. The women's empowerment is a learning process about breastfeeding, food hygiene, infant and young children feeding, and responsive feeding by mothers to fulfill nutrition in children with stunting, with a goal and plan to achieve an improvement in mother's ability and nutritional status in children.

Windscreen eye injuries in Singapore

Hong LC, Chong AB

Med J Malaysia, 1977 Dec;32(2):165-7.

PMID: 614486

Fulltext Wilson's disease--a review of cases at University Hospital, Kuala Lumpur

Mohamed R, Tan CT, Wong NW

Med J Malaysia, 1994 Mar;49(1):49-52.

PMID: 8057991

The clinical course of 18 patients with Wilson's disease is reported. There were 13 males and five females of whom one is Malay. The prevalence of Wilson's disease in Malaysia is probably the same as elsewhere. Being a genetic syndrome, the genetic carrier rate for Wilson's disease is probably lower amongst the Malays. At diagnosis, the clinical signs were predominantly hepatic in 10 patients, neurological in five patients with three asymptomatic cases. All patients were commenced on penicillamine but poor compliance was observed in many patients. Two patients defaulted follow-up and seven patients died. Out of the nine surviving patients, only four are well with no clinical symptoms.

Fulltext Whole lung tomography in the early detection and follow-up of lung secondaries following hydatidiform mole

Sivanesaratnam V, Singh J

Med J Malaysia, 1985 Dec;40(4):317-20.

PMID: 3842732

22 patients with proven hydatidiform molar pregnancy were subjected to whole lung tomography. By this technique, lung metastases were detected in four patients when plain chest radiographs had shown no secondaries. In a fifth patient additional nodules not observed on the plain radiographs were seen. The usefulness of this procedure as an adjunct to existing methods of following up of patients with metastatic trophoblastic disease is discussed.

When polymyositis meets Graves' disease: A rare case report

Chai ST, Lim YS, Achok HN

Med J Malaysia, 2021 Nov;76(6):937-940.

PMID: 34806691

Polymyositis is rarely associated with Graves' disease. A 22- year-old woman was admitted for progressively worsening proximal muscle weakness of both upper and lower extremities. One month prior to admission, she was diagnosed with thyrotoxicosis and prescribed carbimazole 10mg twice daily. Neurological examination confirmed proximal myopathy and blood investigations revealed marked elevation of muscle enzymes, particularly creatine kinase. Electromyography demonstrated myopathic changes while right quadriceps muscle biopsy showed only traces of inflammatory myopathy. She was treated with pulsed intravenous methylprednisolone followed by tapering doses of oral prednisolone, which was eventually down-titrated to 5mg daily during subsequent clinic visits. The initial clinical improvement that she exhibited did not persist despite being rendered euthyroid. She was readmitted approximately one year later with the same complaint. A second course of intravenous methylprednisolone brought about clinical improvement as well as reduction of creatine kinase levels. A diagnosis of polymyositis was then made, for which she was managed with oral prednisolone 20mg daily in combination with gradual up-titration of azathioprine. She continued to show clinical and biochemical improvements during follow-ups. Polymyositis should be considered in the diagnostic workup of proximal myopathy in a patient with Graves' disease, especially in the setting of markedly raised muscle enzymes.

Fulltext What is obesity?

Shashikiran U, Sudha V, Jayaprakash B

Med J Malaysia, 2004 Mar;59(1):130-3; quiz 134.

PMID: 15535353

Fulltext What are the direct medical costs of managing type 2 diabetes mellitus in Malaysia?

Feisul IM, Azmi S, Mohd Rizal AM, Zanariah H, Nik Mahir NJ, Fatanah I, et al.

Med J Malaysia, 2017 10;72(5):271-277.

PMID: 29197881 MyJurnal

INTRODUCTION: An economic analysis was performed to estimate the annual cost of diabetes mellitus to Malaysia.

METHODS: We combined published data and clinical pathways to estimate cost of follow-up and complications, then calculated the overall national cost. Costs consisted of diabetes follow-up and complications costs.

RESULTS: Patient follow-up was estimated at RM459 per year. Complications cost were RM42,362 per patient per year for nephropathy, RM4,817 for myocardial infarction, RM5,345 for stroke, RM3,880 for heart failure, RM5,519 for foot amputation, RM479 for retinopathy and RM4,812 for cataract extraction.

CONCLUSION: Overall, we estimated the total cost of diabetes as RM2.04 billion per year for year 2011 (both public and private sector). Of this, RM1.40 billion per year was incurred by the government. Despite some limitations, we believe our study provides insight to the actual cost of diabetes to the country. The high cost to the nation highlights the importance of primary and secondary prevention.

Fulltext What are the clinical factors that affect quality of life in adult asthmatics?

Hooi LN

Med J Malaysia, 2003 Oct;58(4):506-15.

PMID: 15190625

A study was conducted to determine the clinical factors that affect the quality of life in adult asthmatics. As part of their routine follow-up visit, 399 patients completed the SF-36 quality of life questionnaire, had peak expiratory flow rate readings (PEFR) taken and were interviewed to determine current symptom severity. The grade of severity of asthma was verified by the consultant physician in-charge. The mean age of the patients was 41.8 years and 31.8% of the patients were men. Most of the patients were Malay (64.7%), 89% had at least secondary level education and the mean duration of asthma was 17.6 years. The majority of patients had moderate or severe disease (43.6% and 55.9% respectively). For asthmatics with moderate or severe symptoms of chest tightness and/or shortness of breath, all domains of SF-36 scored significantly lower than those with mild symptoms, with the exception of the domain bodily pain. Patients with moderate/severe cough recorded significantly lower scores than those with mild cough for all domains except for bodily pain and social functioning. Only the physical functioning, role physical, general health and role emotional scores were significantly worse in those with a consultant grade of severe asthma compared to those with mild/moderate asthma. Patients with PEFR < 80% predicted had lower scores for the domains physical functioning, role physical and general health than those with PEFR > or = 80% predicted, but the scores for the other domains were similar in both groups. Quality of life is significantly impaired in adult asthmatics with current respiratory symptoms. However, consultant grade of severity of asthma and PEFR readings do not affect quality of life scores as much.
Study site: Asthma clinics, hospitals, Malaysia

Fulltext What Do Mothers know about Neonatal Jaundice? Knowledge, Attitude and Practice of Mothers in Malaysia

Ng SY, Chong SY

Med J Malaysia, 2014 Dec;69(6):252-6.

PMID: 25934954 MyJurnal

Study site: Hospital Teluk Intan, Perak, Malaysia

Fulltext Weights and blood pressures of women who attend family planning clinics in Sarawak

Wadsworth GR

Med J Malaysia, 1981 Sep;36(3):148-50.

PMID: 7329371

We're making it work! UKM'S Speech Sciences Programs' teleclinic experience in the time of COVID-19

Ahmad Rusli Y, Hassan FH, Haris SM, Mohd Azraai H, Md Almi SN

Med J Malaysia, 2021 08;76(Suppl 4):52-54.

PMID: 34558561

This paper highlights issues, challenges, and lessons learnt from implementing a speech-language therapy teleclinic service delivery model by the Speech Sciences Program, Universiti Kebangsaan Malaysia (UKM) during the wake of the recent COVID-19 pandemic. The teleclinic service provision was initially started to help our student cohorts attain and complete the required direct contact speechlanguage therapy clinical hours for graduation during the pandemic. It has since evolved to be an integral part of the clinical practicum curriculum and a service delivery model that is here to stay. Although far from perfect, the program hopes to systematically continue our endeavours in telerehabilitation as one of our niche areas, realising the wealth of benefits that this service delivery model has to offer.

Ways to overcome non-draining indwelling pleural catheter in malignant pleural effusion

Faisal AH, Ng BH

Med J Malaysia, 2019 12;74(6):555-557.

PMID: 31929490

The indwelling pleural catheter (IPC) is a 16-Fr-multifenestrated catheter. It has become an accepted practice in the management of malignant pleural effusion, especially in patients with non-expandable lung. However, IPC blockage or not draining is common. A 53-year-old female with malignant pleural effusion presented to us with blocked IPC and symptomatic pleural loculation one month after IPC insertion. After failing saline flushing and low-pressure wall suction, intrapleural alteplase was instituted through the IPC with a favourable outcome, and she continued to drain daily thereafter. The present case highlights the safety of intrapleural alteplase via IPC in the non-expandable lung.

Fulltext Warfarin--topical salicylate interactions: case reports

Ramanathan M

Med J Malaysia, 1995 Sep;50(3):278-9.

PMID: 8926909

This paper deals with two patients on warfarin in whom the use of topical methylsalicylate preparations led to clinically significant bleeding problems. The first patient required fresh frozen plasma to tide over the crisis while the second patient recovered spontaneously on stopping the warfarin temporarily. The possible mechanisms by which salicylates potentiate the anticoagulant effect of warfarin are briefly outlined.

Fulltext Wandering intrauterine contraceptive device: An unusual travel to the sigmoid colon

Kumarappan AL, Karthikeyan M, Gunaseelan D, Ros'aini P

Med J Malaysia, 2015 Oct;70(5):312-3.

PMID: 26556122 MyJurnal

Intrauterine contraceptive device (IUCD) is common choice for contraception. Migration of IUCD is one of the complications that are encountered. Here we report a case of IUCD migration to the sigmoid colon. A 39-year-old Malay lady carrying a copper T type of IUCD presented with missing thread then underwent examination under anaesthesia, proceeded to hysteroscopy but failed removal. Abdominal ultrasound detected it in the left lower quadrant of abdomen. She then underwent diagnostic laparoscopy where the device was found to be embedded in the sigmoid colon. Technical difficulty necessitated conversion to mini laparotomy and sigmoidotomy to remove the IUCD and the bowel closed primarily. IUCD is a relatively simple and safe contraceptive procedure but possible complications are bleeding and pain that usually co-exist, pelvic infection, expulsion and perforation. Investigations should be based on clinical suspicion and migrated IUCD in symptomatic patients should be surgically removed whereas, asymptomatic patients can be managed conservatively under certain circumstances. However in the presence of a concurrent pathology that requires exploration then retrieval of the migrated IUCD should be undertaken.

Fulltext Wandering humeral head mimicking a breast mass

Tan GJS, Tan AGS, Peh WCG

Med J Malaysia, 2008 Jun;63(2):164-5.

PMID: 18942311

A 74-year-old woman was incidentally found to have a left breast mass. The mass could not be adequately compressed to be visualized on mammography. Ultrasonography showed a heavily-calcified rounded mass in the left axillary tail of the left breast. Chest radiograph confirmed that the mass was a migrated humeral head. Remotely-displaced fracture-dislocations of the humeral head are very rare and to our knowledge, displacement into the breast, clinically mimicking a breast mass, has not been previously described.

Walking further. How surgery can help the cerebral palsy child

Syed A, Htwe O, Naicker MS, Rashid AHA, Yuliawiratman BS, Naicker AS

Med J Malaysia, 2023 Sep;78(5):566-569.

PMID: 37775480

INTRODUCTION: The prevalence of cerebral palsy (CP) in Malaysia is estimated at 2.6 per 1000 live births which is comparable to that of Australian and European data with ranges of 2.3- 4.21,2. Surgical intervention for the improvement of gait function and mobility in CP is a common practice, however scarce literature of its outcomes is available in Southeast Asia. This paper aims to address and compare outcomes of surgical interventions in our centre with other countries.

MATERIAL AND METHODS: Patients with Spastic CP with Gross Motor Function Classification System (GMFCS) I-III that underwent lower limb surgical intervention in our centre from 2008-2018 were retrospectively reviewed for The Spinal Alignment and Range of Motion Measure ROM subscale (SAROMM) scores and Functional Mobility Scale (FMS) 18 months after surgery. Changes in SAROMM, FMS scores and minimal clinically important difference (MCID) were determined.

RESULTS: 19 patients were included in the study with mean age of 12.58. All patients underwent muscle tendon procedures. Box plot analysis of SAROMM showed reduction of median scores at 6(26.3%) and 12(47.4%) months which plateaus at 18 months post-surgery. Repeated measure ANOVA analysis showed there was a statistically significant effect of time on SAROMM scores (p <0.001) with MCID of 13.4. Improvement of FMS scores was the most at 50m with 13 children (p < 0.05), one at 5m and five at 500m. None reported worsening of FMS scores at 18 months. There were no changes of GMFCS levels by the end of 18 months.

CONCLUSION: Surgeries performed on GMFCS I-III patients with the aim of gait improvement translates into improved mobility with results comparable to other countries.

Fulltext Waldenstrom's macroglobulinaemia--a case report

Chin NS, Teh A, Lee MK

Med J Malaysia, 1989 Jun;44(2):167-70.

PMID: 2516603

A case of Waldenstrom's macroglobulinemia with classical findings of IgM paraproteinaemia and a typical lymphoplasmacytic marrow infiltrate is reported and the treatment of this patient outlined.

Fulltext Waldenstrom's Macroglobulinaemia Presenting as Demyelinating Polyradiculoneuropathy

Fadilah SAW, Raymond AA, Najihah I, Cheong SK

Med J Malaysia, 2002 Jun;57(2):211-4.

PMID: 24326654

Patients (particularly elderly) undergoing evaluation for peripheral neuropathy of unknown cause should be screened for the presence of a monoclonal protein (M protein). The association of a neuropathy and a paraproteinaemia such as Waldenstrom's Macroglobulinaemia (WM) is not uncommon with the former antedating the haematologic symptoms by several years. Response to treatment has varied from good to very poor. We describe a case of WM presenting as a subacute demyelinating peripheral neuropathy. There was prompt resolution of the neuropathy with intravenous immunoglobulin therapy. Subsequent treatment with cyclophosphamide and plasmapheresis resulted in complete clinical remission with no further neurological relapses.

Fulltext Vulnerability of the lower limb in non-fatal motorcycle injuries

Pang TY, Radin Umar RS, Harwant S

Med J Malaysia, 2001 Dec;56 Suppl D:9-11.

PMID: 14569759 MyJurnal

Motorcyclists form the highest group of fatalities on Malaysian roads. This is a prospective study conducted at 3 major hospitals for a period of 12 months to determine the type of motorcyclist injuries that usually required hospitalization. Four hundred and twelve consecutively injured motorcyclists were available for study. One hundred and eighty six (45.15%) were fatally injured and 226 (54.85%) were seriously injured and surviving. The main cause of fatalities was head injury, while lower limb injuries accounted for majority of hospitalizations. This study highlights the vulnerability of the motorcyclist to lower limb injuries.

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