Displaying publications 41 - 60 of 393 in total

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  1. Amirah binti Azzeri, Nur Farhan Abdul Hakim, Mohd Hafiz Jaafar, Maznah Dahlui, Sajaratulnisah Othman, Tunku Kamarul Zaman Tunku Zainol Abidin
    JUMMEC, 2020;23(102):10-15.
    MyJurnal
    The sudden surge in the number of healthcare utilizations compels the hospital to plan for its future needs. Several time-series projections of Covid-19 were conducted to forecast the disease burden and resources utilization through simple predictive analytics. The projections revealed a rapid increase in the number of cases and patient in care at the hospital. It was estimated that the number of patients in care to range from 62 to 81 and 89 to 121 patients daily in the second and third phase of movement control order respectively. It was estimated that more than 100,000 plastic aprons, 80,000 sterile and non-sterile isolation gowns, 40,000 masks N95 and face shields, 30,000 gloves and nearly 17,000 bottles of hand sanitizers are needed until late May. Hence, a simple mathematical algorithm is a helpful tool to manage hospital resources during the pandemic.
  2. Yen, Yong Jo, Sinniah, Mangalam, Joash, Tan-Loh, Nor Akmal Mokhtar, Keong, Brian Cheong Mun
    JUMMEC, 2020;23(102):1-5.
    MyJurnal
    Reverse transcriptase polymerase chain reaction (RT-PCR) assays for coronavirus disease 2019 (COVID-19) should be interpreted with clinical, epidemiological history and exposure risk to avoid misdiagnosis. We report a cruise-ship worker with significant travelling history, presented with acute respiratory symptoms and radiographic evidence of viral pneumonia. Initial RNA-dependent RNA polymerase (RdRp) gene confirmatory assay was negative. Use of a more robust RT-PCR assay detected ORF1ab, N and S genes for COVID-19, and the diagnosis was supported by an IgM and IgG positive COVID-19 serology. Subsequent follow up samples which reported inconsistencies in detecting RdRp gene also raise the concern of reliability of RdRp gene as the confirmatory assay for diagnosis of COVID-19. Patient later had prolonged viral shedding beyond serological recovery, with a negative viral culture reflecting non-infectivity.
  3. Ping, Nicholas Pang Tze, Kamu, Assis, Mohd Amiruddin Mohd Kassim, Mun, Ho Chong
    JUMMEC, 2020;23(102):16-27.
    MyJurnal
    The COVID-19 pandemic resulted in 5 consecutive Movement Control Orders (MCOs) in Malaysia in an attempt to flatten the epidemiological curve, with a reduction of cases. This study aims to use statistical analysis to assess whether the decisive public health interventions in the MCO were efficacious. Three statistical tests were employed: Mann-Kendall trend analysis; one way between groups ANOVA; and Pearson correlation test. Results demonstrated significant differences between the second block, MCO 3-5, compared to MCO 1-2. Johor and Selangor states experienced significant increase in early MCO, whereas Sarawak and Selangor states experienced significant decrease by MCO 3-5. The northern border states of Kedah, Perlis and Kelantan, had caseloads stabilised to zero by MCO 4/MCO 5. This study demonstrates that the MCO was effective within the target of twice the two-week incubation period of COVID-19, with cases from community transmission and importation through the air and southern land borders. Selangor and Sarawak had higher cases in early MCO due to situational factors. In conclusion, MCO has been efficacious, with different states attaining different levels of case reduction due to individualised reasons.
  4. Hafizuddin Awang, Tengku Alina Tengku Ismail
    JUMMEC, 2021;24(1):15-22.
    MyJurnal
    Evidence-based recommendations on intrapartum care are important to ensure the safety of mothers and neonates. The objective of this study was to compare two established guidelines for intrapartum care to provide clinicians with more comprehensive recommendations on intrapartum management. We carried out a descriptive analysis of guidelines from the Integrated Management of Pregnancy and Childbirth (IMPAC) guidelines published by the World Health Organization, and the Perinatal Care Manual published by the Ministry of Health Malaysia, on intrapartum care to determine differences, if any, with regards to management. Latent, active and the second phase of labour are defined differently in both guidelines. Both guidelines showed high similarity in the steps of clinical management for all phases of labour but differed in foetal monitoring methods, indications for episiotomy, mood and behavior assessment, universal precautions, pain management, and placental disposal. Both guidelines had similar managements for most of the problems encountered during the intrapartum period except for preterm labour and multiple births which have substantial differences. Malaysian guidelines highlight additional systems such as the red alert system, and referral and retrieval system, which would enhance the quality of intrapartum management. The IMPAC guidelines emphasize supportive care, birth companionship, maternal care and monitoring up to one hour after placental delivery; and home birth management; these are inadequately explained or lacking in Malaysian guidelines. From the comparison, it was seen that substantial variation exists in intrapartum management between both guidelines that indicates the need for better evidences to synthesize a more comprehensive set of guidelines for the improvement in intrapartum care.
  5. Chan, Siaw Leng, Fonny, Dameaty Hutagalung, Lau, Poh Li
    JUMMEC, 2021;24(1):1-10.
    MyJurnal
    An alarming increase in the prevalence of depression has been found among Malaysian young adults which necessitates responsiveness. This study sought to better understand the subjective personal growth experience in terms of the processes among young adults recovering from major depressive disorder (MDD). A qualitative, transcendental phenomenological design was adopted by collecting data through in-depth, semi-structured interviews, audio recordings, interview transcripts and documents. Nine Malaysian young adults with MDD (Mean age=28) who reported being in recovery from MDD for at least one year were recruited from local mental health settings through purposive sampling. Data analysis involved Colaizzi’s eight-step method. The findings revealed eight personal growth processes themes: revealing the struggles, self-discovery and personal strength, personal responsibility, readiness for change, hope, redefining the meaning, forgiveness, and acceptance. Noticeably, each theme was interconnected to facilitate personal growth among major depressive young adults. The implications for mental health psychotherapy practice and future research were discussed.
  6. Seong, Lim Ghee, Buzayan, Muaiyed Mahmoud Ali, Elkezza, Aeman
    JUMMEC, 2021;24(1):23-29.
    MyJurnal
    Introduction: Flexible denture is an alternative treatment modality for removable partial denture (RPD) that aid the retention by ensuring seal around the entire border of the denture. It is also referred as hypoallergenic denture especially for those who are allergic towards conventional acrylic denture which is the poly-methylmethacrylate monomer (PMMA) and metal (cobalt chromium). The flexible material exhibits lower flexural modulus than conventional type of baseplate material denture that makes it nearly unbreakable. Nowadays, there are a handful of different flexible materials in the dental market for the general dental practitioners to choose but somehow the studies on the properties of these different types of flexible materials are sparse.

    Objectives: The present study is to study the development of the flexible materials, the different type of flexible materials and their physical properties.

    Methods: From the limited article journals available, the authors have summarized the history, development and constituents of different type of flexible materials used in fabricating denture. Besides that, the authors also discussed about the indications, contraindications, advantages and disadvantages of the materials in denture constructions based on all the published researches available on this topic using published materials available in the dental library, University of Malaya and the databases (Science Direct, PubMed).

    Conclusion: Each flexible material has its pros and cons. Therefore, careful selection of material and understanding of the flexible dentures’ indications and contraindications are utmost importance to make sure the best treatment outcome. Hence, patients’ best interest and quality of life can be upheld.
  7. Farahnaz Amini, Hou, Wong Fu, Chye, Edmond Ng Siah, Roslina Omar, Shafinaz Mohd Rejab, Izyan Wajiha Mohd Noor, et al.
    JUMMEC, 2021;24(1):37-44.
    MyJurnal
    Background: Breast cancer (BC) is the most common cancer in women globally. In low- and middle-income countries, the use of appropriate breast cancer genetics services for screening and personalized treatments is severely lacking. This review is aimed to assess and summarize the reported mutation profiles of Malaysian BC patients.

    Methods: A literature search was performed in PubMed and Google Scholar from 2002 to 2019 using a set of keywords and MESH terms.

    Results: Data from 14 eligible studies are presented here. A total of 28 genes were studied in Malaysian BC patients in which 445 genetic alterations (229 deleterious, 209 variants with unknown clinical significance (VUC), and seven protective variants) have been reported, with 73 being novel (16% novel). The frequency ranged from 0.2% to 76% for VUC and 2.1 to 15% for deleterious variations. Only BRCA1, BRCA2, PALB2, APOBEC3B, and P53 have been associated with BC risk in Malaysian patients. Nine of these studies were conducted using the overlapped source of patients, which may limit the generalizability of the findings to the whole population of Malaysia.

    Conclusion: Information on the genetic basis of BC in the Malaysian population is scant. Multidisciplinary efforts with appropriate sample selection techniques and study design with multicenter collaboration are needed to address this issue. Out of thirteen high- and moderated-penetrance pathogenic mutations for BC, only five have been linked to Malaysians’ BC susceptibility. The findings from this review is valuable for decision-makers, researchers, and physicians, to enhance the research plans and utility of genetic services for screening and prevention.
  8. Awad H. Malik, Soha E.A. Al-Sayed, Mohamed Elfath, Hassan A .Musa, Amgad O. Abdelalim, Yasir Hassan, et al.
    JUMMEC, 2020;24(1):45-49.
    MyJurnal
    Bilharziasis is a tropical parasitic disease caused by different species of the genus Schistosoma. One species, S. haematobium, is widely spread in Sudan. There is a scarcity of information about S. haematobium infection among the fishermen in the country. Therefore, this study was designed to determine the prevalence of S. haematobium infection among fishermen, and the immune status among non-infected fishermen in two villages, El Hadib and Hawer-Ajowel at the White Nile state in Sudan. A cross-sectional survey was conducted among 119 fishermen in addition to 20 samples from non-endemic area which were included as a control group. Urine samples were examined by sedimentation method and faecal samples were examined by the Kato Katz method and formalin-ether concentration technique. Blood samples were examined for enumeration of IgE antibody and cytokines, interferon Gamma (IFN-γ), Tumor Necrosis Factor (TNF) and Interleukin10 (IL–10) levels using ELISA. The result of the study indicated that the overall prevalence of S. haematobium among the fishermen was 35 (29.41 %). Of the 35 positive participants, 23 (65.71 %) were infected for the first time, and 12 (34.29 %) for the second time (re-infection). Twenty-four candidates of the non-infected fishermen were included in the immunological study. The total IgE mean titer was 282.90 ±70.93 iu/ml, IFN-γ mean level was 9.62±4.60 pg/ml. TNF, 114.64±46.63 pg/ml and the IL–10 was 1.51±0.58 pg/ml. High prevalence of S. haematobium exists among fishermen and the non-infected fishermen from the endemic area showed high immune response similar to those exposed to the infection.
  9. Lip, Henry Tan Chor, Huei, Tan Jih, Vellusamy, V Muthualhagi
    JUMMEC, 2021;24(1):11-14.
    MyJurnal
    In Malaysia, incidence of Wilms’ Tumor (WT) is rare, with only 8 cases reported over four years according to the Malaysia Cancer Registry Report (2012-2016). Reports of spontaneous rupture of WT are scarce and the commonest presentation of this entity is a palpable mass in the abdomen. Herein, we report on the unusual presentation of an 11-year-old boy with typical symptoms of acute appendicitis. The child was subjected to an initial open appendicectomy and diagnosed intra-operatively with a right sided ruptured renal mass. Subsequent investigation leading to the diagnosis of a ruptured Wilms’ tumor and its treatment is discussed in this case presentation.
  10. Lip, Henry Tan Chor, Huei, Tan Jih, Kannan, Ballan
    JUMMEC, 2021;24(1):50-52.
    MyJurnal
    Inferior vena cava agenesis (IVCA) is an uncommon congenital anomaly which was first described in the seventeenth century. The detection of such an anomaly is often incidental and patients are asymptomatic until the third to fourth decade of life. Due to the scarcity of these cases, there is no consensus on the subsequent treatment and surveillance of incidental asymptomatic IVC anomalies. Herein, we report on a young male with incidental findings of suprarenal IVC agenesis identified on contrast enhanced computed tomography (CT) scan of the abdomen in the course of treatment for acute appendicitis.
  11. Sundus, Ahlam, Tan, Maw Pin, Sellappans, Renukha
    JUMMEC, 2021;24(1):63-69.
    MyJurnal
    Introduction: The population of Malaysia is ageing rapidly. Due to the relatively greater incidence of noncommunicable diseases among older adults, polypharmacy is highly prevalent in this population. This polypharmacy along with other age-related factors increases the risk of drug-related problems to several folds. Currently, no study in Malaysia or even Asia has determined the type and nature of drug-related problems among non-institutionalised older adults. Therefore, this study aims to highlight common drug-related problems among community-dwelling older persons (≥ 65 years) with polypharmacy.

    Materials and Methods: A cross-sectional exploratory study was carried out where in-depth home medication reviews were carried out by two pharmacists. Participants were recruited from geriatric and fall clinics of the University of Malaya Medical Centre located in the urban area of the Federal Territory of Malaysia. The total numbers of drug-related problems were classified using the Pharmaceutical Care Network Europe (PCNE) classification V9.0. Recommendations and referral letters were provided based on the pharmaceutical care issues identified.

    Results: Thirty participants were recruited, among whom 178 drug-related problems were identified with a median value of six [range 1-11] drug-related problems per participant. The majority of problems were related to the effectiveness of prescribed treatment (69.1 %), followed by the possibility of adverse effects (28.7 %).

    Conclusion: Home medication review identifies numerous medication-related issues and allows for patient education and detailed counselling in an informal and patient-friendly manner. Future studies to determine the longitudinal effect of home medication review on patient outcome, cost implications, and overall healthcare utilization are now indicated.
  12. Bouzaboul, Mounir, Abidli, Zakaria, Amri, Abdeslam, Rabea, Ziri, Ahami, Ahmed Omar Touhami
    JUMMEC, 2021;24(1):76-82.
    MyJurnal
    Introduction: Attention is one of many cognitive functions; it plays a central role in the learning process. For this reason, our study aims to determine the impact of attentional abilities on academic performance among middle school learners in Middle Atlas of Morocco.

    Methods: Data were collected from a sample of 137 middle school learners. For the assessment of attentional abilities, we performed the Trail Making Test (TMT) to estimate mental flexibility. Evaluation of selective attention was done through the Stroop Test and the measurement of sustained attention was achieved via the d2-R test.

    Results: Our results revealed that the attentional abilities of learners in our samples are positively correlated with their academic performance and vice versa.

    Conclusion: At the end of this study, it is important to establish a thorough diagnosis of attentional disorders to identify learners with attention problems in order to implement a remedial program so as to avoid the detrimental effects of these disorders on the academic performance of learners.
  13. Nik Nadirah Nik Azis, Samihah Abdul Karim, Mariam Mohamad, Nadia Mohd Mustafah
    JUMMEC, 2021;24(1):70-75.
    MyJurnal
    Objective: The aim of this study was to investigate scuba diving induced exercise response in novice divers as required in open water scuba diving certification.

    Methods: Maximal cardiopulmonary exercise test (CPET) was performed in 30 novice divers before and within 24 hours after a standard scuba diving open water certification diving protocol of four open water dives.

    Results: A significant increase in maximal oxygen consumption (VO2max) in mL·kg-1·min-1 after scuba diving training [25.84 (6.0) vs. 27.04 (7.0)] (p
  14. Tan, Jin Rong, Dayang Azzyati Awang Dahlan
    JUMMEC, 2021;24(1):91-97.
    MyJurnal
    Introduction: Ureteric obstruction commonly presents as a urological emergency requiring urgent intervention with urinary diversion. Double J stenting (DJS) is the preferred option to relieve ureteric tract obstruction in our centre.

    Objective: Our study aims to determine the feasibility and outcomes of DJS by general surgeons and medical officers in a hospital without a resident urologist and to identify the possible predictive factors for successful DJS.

    Methods: This is a clinical audit of all patients scheduled for DJS in Hospital Bintulu, Sarawak, from January 2017 to March 2020. A total of 57 patients were included. Socio-demographic data and factors predicting success rate, i.e., level of ureteric obstruction and its causes (intrinsic or extrinsic), diagnosis, size and nature of stone(s), degree of hydronephrosis and pre-operative renal profile, were collected. Success rate and postoperative outcomes for all successful cases were evaluated. Bivariate statistical analyses were used to investigate the association of predictive factors with the success rate of DJS.

    Results: Double J stenting was successful in 63.2% (36 cases) of our total samples of 57 cases. Out of 36 successful cases, 82.1% of the cases were able to return to baseline renal profile within 14 days and 83.3% did not develop fever within 3 days post-operative. The post-operative mean length of stay was 3.16 days and post-operative day 1 mean pain score was 0.72. Causes of obstruction by intrinsic factors, urolithiasis, pre-operative normal serum creatinine (
  15. Pal, Bikramjit, Chong, Sook Vui, Thein, Aung Win, Tay, Ava Gwak Mui, Soe, Htoo Htoo Kyaw, Pal, Sudipta
    JUMMEC, 2021;24(1):83-90.
    MyJurnal
    Introduction: Medical simulation is a technique that allows interactive and immersive activity by recreating all or part of a clinical experience without exposing the patients to the antecedent risks. High-fidelity patient simulation-based teaching is an innovative and efficient method to address increasing student enrolment, faculty shortages and restricted clinical sites.

    Objective: To assess the effectiveness of high-fidelity patient simulation (HFPS) as compared to video-assisted lecture-based teaching method (VALB) among undergraduate medical students.

    Methods: The study was a Randomized Controlled Trial which involved 56 final year undergraduate medical students. The effectiveness of teaching based on HFPS (intervention group) and VALB (control group), on acquisition of knowledge, was assessed by multiple choice questions (MCQs) in the first and fourth week. Similarly, the skills competency was assessed by objective structured clinical examination (OSCE) in the second and fourth week. Mean and standard deviation (SD) for total score of knowledge and skills assessments were used as outcome measures. P value < 0.05 was considered to be statistically significant.

    Results: In both groups, students had significant higher mean MCQ scores at Post-tests. The intervention group had higher mean change score of MCQ marks than the control group but the difference was not statistically significant. In both the first and second skills assessments, mean OSCE scores for intervention group were higher than control group but this difference was not statistically significant.

    Conclusion: There was significant gain in knowledge in both methods of teaching but did not reach statistical difference in terms of skills enhancement in the intervention group as compared to the control group.
  16. Hoe VCW
    JUMMEC, 2006;9(1):35-38.
    MyJurnal
    A cross-sectional survey of commercial vehicle drivers who were renewing their own licences was conducted at the Selangor Road Transport Department office in Padang Jawa between 1 February 2002 and 28 February 2002, using questionnaire and medical examination. The objective was to determine the prevalence of myopia, colour vision deficiency and visual field defect among the commercial vehicle drivers. The respondents that reported visual defect at the time of interview was compared with those detected by the author through medical examination. Out of the 223 respondents, 21 (9.4%) reported to have myopia by the questionnaire survey. Through the visual examination there were 63 (28.3%) with myopia (visual acuity worse than 6/12),six (2.6%) had a visual field defect and 14 (6.3%) had red-green colour deficiency. The visual defect detected during the study among the commercial vehicle drivers, which were missed at the time of the routine medical examination were significant. The process of the statutory medical examination should be reviewed.
  17. Ramli A
    JUMMEC, 2007;10(1):29-33.
    MyJurnal
    Little is known of Malaysian older people’s participation in physical activities, and the purpose of this pilot study is to explore their participation and the barriers. A self-administered questionnaire was given to 80 eligible respondents at the Kuala Lumpur Health Clinic of which 70 responded. Thirty-six (51.4%) were males and 34 (48.6%) were females. There were 26 (37.1%) Malays, 20 (28.6%) Chinese, 18 (25.7%) Indians and 6 (8.6%) of other ethnic groups. Forty (57.1%) took part in some form of physical activities and the remaining 30 (42.9%) reported no participation at all. The Chinese participated actively in physical activities (90%), followed by Indians (66.7%) and Malays (30.8%). The five common activities were walking (60%), tai chi (20%), gardening (12.5%), stretching (2.5%) and cycling (5.0%). Identified barriers to physical activities were lack of time (26.7%), having health problems (26.7%), was already fit (26.7%), no companion to exercise with (13.3%) and no exercise knowledge (6.7%). These findings indicated that emphasis should be given to the females and the Malay ethnic group when planning physical activity education for the older people as they were identified to be the least active groups.
    Study site: Klinik Kesihatan Kuala Lumpur, Wilayah Persekutuan, Malaysia
  18. Lim, S.S., Shireene, V., Vijay, A., Tan, T.B.A., Rokiah, P., Chan, S.P.
    JUMMEC, 2007;10(1):34-38.
    MyJurnal
    We report a 33-year-old Malay lady who presented with fever, tonsillitis and pharyngitis a month after initiation of antithyroid therapy (carbimazole 15 mg tds) for thyrotoxicosis by her general practitioner. She was still clinically and biochemically thyrotoxic but not in thyroid storm. At that time, she was also confirmed to be four weeks pregnant. Her full blood count revealed neutropaenia with an absolute neutrophil count of 0.036 × 109/L. Bone marrow aspirate and trephine were compatible with carbimazole-related agranulocytosis. Carbimazole was discontinued and she was given broad spectrum antibiotics and Granulocyte Colony Stimulating Factor (GCSF), to which she responded. Verapamil was used for symptomatic heart rate control instead of beta-blockers as she had a history of bronchial asthma. The patient subsequently opted for termination of pregnancy after which she was given radioactive iodine I131 (10 mCi) for definitive therapy of her thyrotoxicosis. In conclusion, carbimazole-related agranulocytosis is an important entity to recognise and treat early to prevent morbidity and mortality. Termination of pregnancy was carried out as the treatment given during the episode of agranulocytosis may have negative effects on foetal viability and growth.
  19. Arumugam, K., Majeed, N.A.
    JUMMEC, 2011;14(1):6-9.
    MyJurnal
    We investigated the association between polycystic ovarian syndrome, dyslipidemia and glucose intolerance in a cross sectional analysis comparing 50 patients with polycystic ovary syndrome and 50 patients without the disease (control group) who were attending the Infertility clinic. Variables of interest were their body-mass index (Kg/m2), fasting and blood glucose levels after a 75 gram oral glucose tolerance test and their total cholesterol (mmol/L), total triglycerides (mmol/L), high density cholesterol lipoprotein (HDL) cholesterol (mmol/L) and, low density lipoprotein cholesterol (mmol/L) levels. Except for HDL where significantly lower values were observed, significantly higher levels were detected in patients with PCOS than that of the control group. The difference persisted even when the obesity index were adjusted and matched. We conclude that both glucose intolerance and dyslipidemia were significantly associated with PCOS irrespective of the obesity index.
  20. Nusee, Z., Naidu, A., Ranjudham, S.N., Ismail, H.
    JUMMEC, 2011;14(1):10-20.
    MyJurnal
    The use of transobturator tape (TOT) for the treatment of stress urinary incontinence (SUI) has gained popularity since it was introduced in 2001. Only few studies have reported that TOT is superior in safety and efficacy when compared to tension free vaginal tape (TVT). This case-series study was conducted to investigate the safety and efficacy of the TOT procedure in patients at Ipoh Hospital. A cross sectional study on patients who underwent TOT procedures from Jan 2006 to Jun 2008 was conducted. Patients were followed-up 1 month, 3 month, 12 month and annually thereafter. Data were retrieved from patients‟ records based on the standard pre-operative assessment sheet and follow up record. Interviews were then made via telecommunication to assess the patients‟ progression and satisfaction using a validated questionnaire. Fifty-two subjects (n=52) were recruited. The mean age was 54.2 ± 10.6 years with the median follow up time of 19 months. Majority of cases (n=46; 88.5%) had concomitant pelvic organ prolapse (POP), while only 2 (3.8%) had an isolated stress urinary incontinence (SUI). Pre-operatively, only 16 patients (30.8%) were diagnosed with mixed urinary incontinence (MUI) and 24 patients (46.2%) had over active bladder symptoms (OAB) which include increased frequency and urgency. The objective cure rate for SUI was 42 (80.7%), 3 (5.8%) failed while 7 (13.5%) improved. Complications were limited to minor conditions and was only observed in four patients: one case (1.9%) of acute urinary retention, three (5.7%) had prolonged indwelling catheter more than 3 days and one (1.9%) each for mesh erosion, hematoma, urinary tract infection (UTI) and wound infection. Cure rate for MUI, frequency and urgency were 37.4%, 70.8% and 54.2% respectively. De novo urgency was noted in three (n=3: 5.7%) cases while (n=3: 5.7%) required revision of the tape. Forty-nine women (n=49: 94.2%) were satisfied with the procedure. TOT procedures significantly improve OAB symptoms with high patient‟s acceptance rate and no serious operative complication.
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