Levonorgestrel (LNG) is a well-known safe and efficacious emergency contraception (EC). However, ectopic pregnancy following the failure of LNG-only EC has been reported. The exact incidence of ectopic pregnancy has been hindered by lack of data due to the fact that LNG-only EC is accessible at pharmacies without a prescription. We describe a case of ectopic pregnancy in an 18 year-old single woman who took LNG-only EC within 48 hours of unprotected sexual intercourse. She presented to the emergency department at 8 weeks period of amenorrhoea with an acute abdomen and hypovolaemic shock. Laparotomy confirmed a ruptured right tubal pregnancy and salpingectomy was performed. The patient was discharged well after 2 days. We aim to highlight this potential adverse effect and to discuss the plausible causality of ectopic pregnancy following administration of LNG-only EC.
The purpose of this study was to determine the timing and sequence of emergence of the first 28 permanent teeth in a cross-section of Malay children in the district of Kota Bharu, in northeastern Peninsula Malaysia. The sample consists of 478 boys and 908 girls of Malay descent aged between 5-19 years. The criterion for tooth emergence was the appearance of the tooth through the gingivae. Descriptive statistics were calculated and probit regression analysis performed to determine the mean age of emergence of the permanent dentition. The mean age at emergence was found to conform to general trends, with emergence seen earlier in girls than in boys. Comparisons were made with the Chinese (Hong Kong) and the Punjabi (Chandigarh) profiles, which showed earlier emergence timings in those ethnic groups. The emergence timing in Malays, however, was earlier than in Thais (Central Thailand). The sequence of emergence was determined by referring to the mean age of tooth emergence of individual teeth and conforms to the general trend seen in other studies.
Hospital Information System (HIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. This study is to describe those aspects of the implementation of hospital information system in three tertiary hospitals in Klang Valley; Serdang Hospital, Selayang Hospital and University Kebangsaan Malaysia Medical Centre (UKMMC). A qualitative study was conducted to obtain views on information system development and implementation in the hospitals mentioned above. In-depth interviews with personnel representing both the system providers and the end-users were done guided by a questionnaire. The results of the interviews were categorized into few themes namely the system development, human resource, scope of implementation, support system, user-friendly, training, hardware and security. There were differences in hospital information system development and implementation in the three hospitals. Each system has its own strengths and weaknesses that make it unique. In developing HIS, its important to ensure the system can work effectively and efficiently. Quality human resource, good support system, user-friendly and adequate training of the end-user will determine the success of implementation of HIS. Upgrading of hardware and software as needed is the basis to keep up with the pace of technology advancement and increasing number of patients. It is hoped that HIS will be implemented in all other hospitals with effective integration and networking.
Diversified leisure involvement pose various health benefits to the elderly population. However, some elderly are too focus on doing a particular type of activity during their leisure time such as religious activity. This study aims to explore factors that could possibly contribute to the higher involvement in religious activity among the Malay ethnic elderly in Malaysia. In depth interviews were conducted, involving a total of 20 elderly aged 60 years and above with stratification by background characteristics. Each interview was conducted for an average of 15 to 30 minutes. They were purposively selected from two health clinics located in two different districts in the state of Selangor, representing an urban and a rural area. Majority of the elderly interviewed perceived that by engaging in religious activities such as prayer and reciting the Holy Quran or old Islamic scripture gives them serenity or calmness. Additionally, they also felt that involvement in such activities is very synonymous with being old and therefore one should be actively involved in religious activities with increasing age. In view of the lack of diversity of leisure involvement among the elderly and the passive and solitary nature of some of the religious activities, the elderly should be made aware of the importance of participating in other types of leisure activities especially physical activities. Although, they gain spiritual and social benefits from involving in religious activities, they also need to perform other form of activities that can improve the physical health status.
The trend of using nonprescription substances for weight-loss management is common. There are several factors associated with the use of nonprescription substances. This study aimed to determine prevalence and factors associated with the use of nonprescription substances for weight-loss management among university students. A cross sectional study was conducted from August until October 2013 among 358 postgraduate students aged 22 - 45 years in Universiti Kebangsaan Malaysia (UKM). A validated self-administered questionnaire was distributed by multistage sampling to the students. The prevalence of using nonprescription substances among university students was 27.9% (n=100). There were significant association between use of nonprescription substances with age (t=2.41, p=0.017), peer influence (t=7.06, p
Objective: To review the presentation and outcome of developmental dysplasia of the hip (DDH) cases in the last 6 years. Methodology:We retrospectively reviewed the presentation as well as short and mid-term outcome of 17children (18 hips) with DDH seen and treated from 2004 to 2010. Treatment was either splinting with Pavlik harness,closed or open reduction depending on age at presentation and the individual needs of each patient. Results:Theaverage age at presentation was 31.1 months, and the male to female ratio was 1:4.6. Six patients (35%) presented early(less than 6 months old) while 7 patients (41%) presented between 6 -24 months. In these 2 groups splinting or closed reduction under anaesthesia was initially utilized for treatment depending on age, and open reduction was use dafter failure of closed reduction and for those presented late.Average age at the time of closed reduction was 11 months,and 6 years for those underwent open reduction. The average period of follow up for all patients was 29.4 months. The final outcome was successful in 12 hips (66%) in 11 patients.Ten of these presented at less than 2 years old, in the other 6 hips in which there was failure, 50% presented after 3 years of age. Conclusion:Late presentation of DDH is still common in Malaysia, which necessitates more complex management and more frequent occurrences of unfavourable results.