“If you hear of an outbreak of plague in a land, do not enter it; if the plague breaks out in a place while you are in it, do not leave that place”, reported by Sahih Al-Bukhari. This was the phrase quoted by Prophet Muhammad 14 centuries ago concerning both in disease spread and prevention. The relevancy of this statement is now widely seen and surge by the social media in a hashtag of “stay home” on an international level due to pandemic of COVID-19 disease.
As in other parts of the world, the practice of traditional healing has been part of the local healthcare system for most of the indigenous ethnic groups, since time immemorial. Using descriptive research format, this study looked into the practice of a traditional medicine practitioner in one of the villages of Kota Marudu in Sabah, Malaysia. The practitioner comes from the Dusun Tagahas subethnic group which is one of the numerous ethnic groups in Sabah. The large number of ethnic group in Sabah has made the research of ethnomedicine rather challenging. The practitioner acquired knowledge of traditional healing and treatment which is mainly herbal medicines alluded with some spiritual aspects. He used many herbal preparations in various forms and applications. Similar to the other traditional medicine practitioners, his knowledge and skill regarding his practice are impressive but the practitioner is unable to explain on the mechanism of how the therapy works. Generally their philosophy rests on the notion that disease responds to right medicine but not explanation. There is an urgent need to capture all the knowledge and skill possessed by traditional medicine practitioners, who generally belong to an ageing and fading population, especially those live in remote and hard to reach areas. Scientific research should be conducted to help traditional medicine healers and herbalists to understand their practices before they suffer the consequences of inexorable extinction.
Over the last few years, Universiti Malaysia Sabah (UMS) as part of its global marketing initiative opened its doors to international students to take up elective as well full time programmes. In September 2017, 36 nursing students from a university in China completed a 12-week elective /mobility programme in UMS.
Melioidosis is a tropical infectious disease cause by gram-negative bacterium, Burkholderia pseudomallei. It is predominantly in tropical climate especially Southeast Asia and Northern Australia. This disease is associated with significant mortality due to early onset of sepsis.
New techniques based on digital analysis and more precise visualisation in monitoring of individual health status can improve the accessibility and reliability of healthcare services. An innovation in capturing human biofield energy level using Electrophotonic Imaging (EPI) is seen as a breakthrough approach to healthcare service. This non-invasive imaging approach produces an image, i.e. the Kirlian image in digital form to aid visualization and probe for disease identification. The diagnosis and treatment process are fast, reproducible and cost-effective. EPI technique works using computational models of human health state, commonly before and after a course of treatment or meditation. The reliability and efficacy of EPI are validated by the physician’s perceptions using biomedical measurements. At the same time, the algorithms developed by engineers embedded in the imaging system have advanced gradually with the help of clinical data from physicians. To close the gap between engineering and medicine, the field of research known as ‘Biomedical Engineering’ (BME) has been established to merge engineering principles with medicine in order to advance = diagnosis, treatment, and monitoring, which will in turn improves quality of life of mankind. Engineering approach is used to study on how the captured image indicates the energy level of human biofield. This elementary analysis introduces a pre-processing procedure to extract the effects texture. The image indicates the radiation energy level based on its most significant glow (digitallyimaged isolines) and is used for medical biometrics and health analysis.
Escherichia coli (E. coli) is one of the most frequent causes of many bacterial infections especially
gastroenteritis in developing countries. It is also used as an indicator for faecal pollution in the
surveillance of bacteriological quality of drinking water. This study was conducted to determine the
survival of E. coli in water at room temperature (27oC). E. coli which is cultured in Lactose Peptone Broth
was inoculated into 8 bottles each containing 10 millilitres of distilled water. They were kept at 27oC.
Starting from the day 1, ten-fold dilutions were made from each bottle number and E. coli count was
done from each dilutions by using pour plate method. The colony forming unit/ millilitre (CFU/ml) was
calculated. The same procedure was carried out from bottles number 2 to 8 from day 2 to day 8
consecutively. CFU/ml of E. coli in dilution 10-5was markedly decreased from 3.9 x 106
in day 1to 0 in
day 8. The findings suggest that if the water is contaminated with low number of E. coli, it can be
eliminated by keeping water at room temperature for only few days.
The success of cataract surgery is accessed by the improvement in visual acuity and accuracy of the post-operation refractive outcome against the pre-operation refractive target. Hence, the benchmark of 85% of patients achieving a final spherical equivalent within 1D of the desired target is used to monitor the refractive outcome. Meanwhile, the unaided visual acuity threshold of 6/12 after cataract operation is chosen as a yardstick because it allows patients to perform instrumental activities of daily living (IADL) independently without relying on spectacles.
Ovarian cancer is the fourth most common cancer among women in Peninsular Malaysia. Epithelial ovarian cancer accounts for 90% of all ovarian tumours. Herein, we present a rapidly growing ovarian tumour in a young female patient, following an uneventful vaginal delivery at home. We discuss on the challenges of making said diagnosis in a post-partum patient who presented with abdomen distension. A 19-yearold lady presented to the Emergency Department three days after spontaneous vaginal delivery at home. Her chief complaint was that of a rapidly progressive abdominal distension. Diagnostic and therapeutic emergency laparotomy were done, revealing a huge cystic ovarian mass. Histopathology reported a high grade, serous ovarian carcinoma. There are multiple causes for abdominal distension in post-partum women, however priority should be given into looking for gynaecological origin, given the changes in hormone. Sudden abdominal distension during post-partum period is rare and a systemic approach in its management is vital. There is, inarguably, a role of diagnostic and therapeutic laparotomy in this.
Swallowing involves 55 muscles, five cranial nerves and two cervical nerve roots. When the coordination of this reflex is disturbed, dysphagia occurs. Dysphagia refers either to the difficulty someone may have with the initial phases of a swallow or to the sensation that the foods or the liquids are being obstructed in their passage from the mouth to the stomach. The objective of the study was to identify the diagnosis of patients attending Speech Therapy clinic, in Queen Elizabeth Hospital, Kota Kinabalu, Sabah, and to identify the demography of dysphagic patients. From the 406 patients that came during the study period, 139 patients (34.2%) were diagnosed with dysphagia, followed by developmental language disorders (33.3%). Of the 139 patients diagnosed with dysphagia, most of them are within the 41 to 60 (43.2%) and above 60 (42.2%) age groups. The majority were males (66.2%). A total of 81 (58.3%) patients with dysphagia had a history of cerebrovascular accident. Dysphagia is a common disorder among patients attending Speech Therapy Clinics at Queen Elizabeth Hospital, Kota Kinabalu. Training of Speech Therapists and early dysphagia intervention leads to a better outcome.
Anaphylactic reaction towards antibiotics is common during anaesthesia. It may present as bronchospasm, hypotension, desaturation, or urticarial. However it is uncommon for anaphylaxis reaction to present only as supraventricular tachycardia (SVT). This is a rare interesting case report on a 23-year-old healthy man whose anaesthetic categorization is American Society of Anaesthesiologist (ASA) 1, developed supraventricular tachycardia (SVT) towards intravenous cefuroxime, peri operatively. His condition resolved with carotid sinus massage. No pharmacological interventions were used. His skin prick intradermal tests showed allergies towards cefuroxime, cefazoline and cefoperazone. The patient subsequently underwent.
In Malaysia nasopharyngeal carcinoma (NPC) is ranked as number fourth (5.2%) from all cancer and third (8.4%) most common cancer among male population. Nasopharyngeal carcinoma in Malaysia mostly occurs among Chinese (49%), followed by natives of Sabah and Sarawak (28%) and Malay (22%). There were multiple researches done to determine the risk factors for nasopharyngeal carcinoma and most of them from western pacific region. Prevalence of nasopharyngeal carcinoma in Sabah in 2013 is about 106 cases while in 2012 is 75 cases. It shows almost 30% increment from previous year. A total of 53 patients were diagnosed NPC in 2013 from Kota Kinabalu locality and it contributes more than 50% from total prevalence NPC in 2013. NPC is common in local Sabahan, especially in Kadazan and Dusun ethnicity. In 2013, the youngest are 11 years old and the eldest are 84 years old. The upward trend of NPC cases in younger age group is worrisome for us. Thus it is very important to determine the risk factors associated with NPC and this would help the health provider and other stakeholders to do planning in prevention of NPC such as awareness programme or cancer screening for the target high risk group especially for Sabah population.
Galactorrhoea is non-lactational milk production and it may or may not be associated with prolactinemia1. It causes embarrassment and distress to a schizophrenic patient, especially, if the patient is male. One study in Germany reported that incidence and prevalence of galactorrhoea in schizophrenia are 14% and 19%, respectively2. Although galactorrhoea is not rare in schizophrenic patients, managing and understanding the a etiology can be problematic. In psychiatric patients, antipsychotics can be a cause but other causes need to be ruled out. Galactorrhoea also needs to be differentiated from pathologic nipple discharge which can be due to breast tumours. Usually, galactorrhoea is bilateral, multiductal, and milky, but discharge can be yellow, green or brown3. This case report describes a 32-year old patient with schizophrenia who visited a government psychiatric hospital in Kota Kinabalu, Sabah, Malaysia. This report highlights the clinical challenges to determine the aetiology of galactorrhoea and to manage it in schizophrenics. It raises the following clinical questions: Why a psychiatric patient develops galactorrhoea? How a schizophrenic patient presents with galactorrhoea? What hormonal imbalances are associated with this psychiatric disorder? How should a doctor handle a schizophrenic patient complaining of galactorrhoea? What is the danger of having galactorrhoea in a male?
The theory-practice gap is arguably the most important issue in nursing today, given that it challenges the concept of research-based practice, which is the basis of nursing as a profession. Majority of the student nurses shared their views that some of the practical procedures that they learned during their theory sessions were different from what was practised in the wards which caused some worries among the students that it may affect their performance during their Obstructive Structured Clinical Examination.
Inflammatory myopathies (IM) is a rare inflammatory muscle disorder, which can be broadly divided into 5 subgroups. The accurate diagnosis of subtype of IM can be challenging due to a diverse presentation of the disease. On the other hand, skeletal muscle complication is common in patients with systemic lupus erythematosus (SLE) in the form of myalgia or myopathy. Inflammatory myopathy is a rare association of SLE and the diagnosis and treatment can be quite challenging. A 43-year-old lady with underlying systemic lupus erythematosus (SLE), presented with subacute onset progressively worsening muscle weakness involving upper limbs and lower limbs. Neurological examination showed findings consistent with proximal myopathy, with proximal power of 3/5 and distal power of 4/5. She has elevated creatinine kinase, ALT and AST level. Her myositis-specific autoantibodies were positive for anti-Ku antibodies. Her electromyography showed evidence of active myopathy of the upper and lower limb. Here, we would like to report a case of polymyositis in a patient with SLE.
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.
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.
Introduction: Medication error is a global issue. Despite, the various impacts on health and non-health, continuous monitoring, assessment and intervention are required to reduce the number of medication error. Precise information on the root cause of medication error in Hospital Queen Elizabeth II, Kota Kinabalu will aid in the preventative measures to reduce medication error among nurses. Thus, this study aims to describe the incident of medication errors among nurses.
Methods: A retrospective cross-sectional study was conducted to review medication error incidents Reports between 2015 to 2018. Data were analysed according to the type of error, day and shift of medication error occurred, causes and month of services. The collected data were analysed using descriptive statistics in SPSS 22.
Results: A total of 54 reports was reviewed. The mean (SD) month of services among nurses involved in the medication error is 41.3 (24.9) months. The most common type of medication error is the wrong frequency with 23 (42.6%) cases. Majority cases of medication error occurred in weekdays with 41 (75.9%) cases and 24 (44.4%) cases happen during the night shift. Poor communication among healthcare workers was the most commonly reported human error with 42 (77.8%) reports, followed by36 (66.7%) reports of failure to comply standard of procedure in medication administration.
Conclusion: Though this study found team factor is the recurrent causes, poorly designed work systems and individual factor should be imperious as well. A qualitative study is required to understand more on nurse behaviour practice towards medication administration. The high authority plays an important role to monitor this matter to improve medication safety practice.
It is important to prepare the nursing students to be confident and able to interact with the patients,
colleagues, doctors and other staff because the nature of nursing work included a high degree of personal
and group interaction. Continuous communication and interaction in nursing work are some of the
important factors for self-esteem among nurses. Self-esteem affects the relationship between job roles and
job satisfaction as well as the link between work performance and work roles conflict. The objective of this
study is to examine the effects of low self-esteem on clinical performance among first year nursing students
at private nursing college in Kota Kinabalu, Sabah. A descriptive qualitative study was conducted among
10 first year nursing students in one of the private nursing college. Data was collected through one to one
interviews using semi-structured questions. The interview question was structured based on observation
and literature review. The design is ideal because it facilitate the collection of data from a small number of
participants through personal interview. The collected data was transcribed into verbatim and analysed by
identifying the themes via coding and categorization. The results showed there are two main themes
emerged from the study: Defensive behavior and poor communication as the effects of low self-esteem on
the students’ clinical performance. As conclusion from this study, defensive behavior and poor
communication and are the obvious effects of low self-esteem among the first year nursing students in a
private nursing college. This study revealed the needs to equip the students with more conducive learning
environment facilitate suitable motivational and mentoring approaches and practice good communication
skills. Future research suggested, extends the study to the public nursing college for outcomes comparison
and evaluation.
Hepatitis B is a well-recognized occupational risk for healthcare workers. This self-administered questionnaire study was designed to assess awareness and knowledge towards hepatitis B virus infection among 140 nurses at Serdang Hospital, Selangor, Malaysia from the period of 1st April to 30th September 2017. The response rate was 97.2% (n = 140/144). A total of 71.4% of participants showed adequate awareness of hepatitis B. Most participants had heard hepatitis B with the predominant sources receiving from friends, media and education. Majority of them did serology blood test of hepatitis B before. A total of 84.3% of participants were aware of vaccine available for hepatitis B, although 78.6% got vaccinated in the past. Antiviral treatment of hepatitis B was not well noticed by most of them. Education qualification determines the awareness of hepatitis B. Regarding the knowledge, 73.6% of participants showed poor knowledge of hepatitis B. Most participants understood that hepatitis B was caused by a virus infection and the organ most affected was the liver. Surprisingly, 77.9% of them failed to recognize that cancer could be caused by hepatitis B. Majority of participants were aware that transmission of hepatitis B could be mediated via sexual intercourse, as well as childbirth. Nevertheless, 14.3% of them believed that hepatitis B was able to spread by cough and sneeze. Older age, Chinese ethnicity, and having high educational qualification were factors leading to adequate knowledge of hepatitis B. Additional attention should be emphasized to strengthen knowledge towards hepatitis B among nurses and perhaps other healthcare workers in Malaysia.