MyMedR

Heterochromia iridis: More than beautiful eyes

Saniasiaya J

Postgrad Med J, 2020 11;96(1141):721.

PMID: 32144119 DOI: 10.1136/postgradmedj-2020-137621

Fulltext Diabetes and related variables among the five main racial groups in South Africa: comparisons from population studies

Jackson WP

Postgrad Med J, 1972 Jul;48(561):391-8.

PMID: 5069893 DOI: 10.1136/pgmj.48.561.391

We have investigated the total prevalence of diabetes and related factors among representative, randomly chosen samples of the five ethnic groups living in Cape Town, and (East) Indians in Durban. Comparisons are hindered by differences in age distribution of the populations, while small, isolated groups were found to be unrepresentative. The variability of a single individual's blood sugar levels led us to require at least three abnormal values on 2 different days for a positive diagnosis. The use of different criteria for the diagnosis of diabetes varying from ‘lax’ to ‘stringent’ alters the discovered prevalence in our groups by the factor of approximately 2.

Mean blood glucose levels rose with middle age but never between childhood and early adulthood. Afternoon screening tests appeared valid, despite the agreed diurnal difference in glucose tolerance figures.

Both high screening blood glucose levels and diabetes itself were most common among Indians and coloured people and least among Whites and Bantu, each of the latter having a total diabetes prevalence of approximately 3·5% over age 15. It is noted that the Cape Coloured have more diabetes than any of the constituent races from which they originated.

The reasons for such racial differences are unclear—obesity cannot be the explanation here, since, to take one example, the fattest group of all, the Bantu women, have the lowest prevalence of diabetes. We found mild diabetes not uncommon among young people under 20 in the Indian, Malay and coloured population but none among White or Bantu. There was little difference between the sexes, and if anything the poorer people had more diabetes than the better-off.

Sustained clinical knowledge improvements from simulation experiences with Simulation via Instant Messaging-Birmingham Advance

Zhou D, Davitadze M, Ooi E, Ng CY, Allison I, Thomas L, et al.

Postgrad Med J, 2023 Mar 22;99(1167):25-31.

PMID: 36947426 DOI: 10.1093/postmj/qgac008

BACKGROUND: Simulation via Instant Messaging-Birmingham Advance (SIMBA) delivers simulation-based learning through WhatsApp and Zoom, helping to sustain continuing medical education (CME) for postgraduate healthcare professionals otherwise disrupted by the coronavirus (COVID-19) pandemic. This study aimed to assess whether SIMBA helped to improve clinical knowledge and if this improvement in knowledge was sustained over time.

METHODS: Two SIMBA sessions-thyroid and pituitary-were conducted in July-August 2020. Each session included simulation of various real-life cases and interactive discussion. Participants' self-reported confidence, acceptance, and knowledge were measured using surveys and multiple-choice questions pre- and post-simulation and in a 6- to 12-week follow-up period. The evaluation surveys were designed using Moore's 7 Levels of CME Outcomes Framework.

RESULTS: A total of 116 participants were included in the analysis. Significant improvement was observed in participants' self-reported confidence in approach to simulated cases (thyroid, n = 37, P

NeuroVerse: neurosurgery in the era of Metaverse and other technological breakthroughs

Kundu M, Ng JC, Awuah WA, Huang H, Yarlagadda R, Mehta A, et al.

Postgrad Med J, 2023 May 22;99(1170):240-243.

PMID: 36892407 DOI: 10.1093/postmj/qgad002

The tremendous evolution in modern technology has led to a paradigm shift in neurosurgery. The latest advancements such as augmented reality, virtual reality, and mobile applications have been incorporated into neurosurgical practice. NeuroVerse, representing the application of the metaverse in neurosurgery, brings enormous potential to neurology and neurosurgery. Implementation of NeuroVerse could potentially elevate neurosurgical and interventional procedures, enhance medical visits and patient care, and reshape neurosurgical training. However, it is also vital to consider the challenges that may be associated with its implementation, such as privacy issues, cybersecurity breaches, ethical concerns, and widening of existing healthcare inequalities. NeuroVerse adds phenomenal dimensions to the neurosurgical environment for patients, doctors, and trainees, and represents an incomparable advancement in the delivery of medicine. Therefore, more research is needed to encourage widespread use of the metaverse in healthcare, particularly focusing on the areas of morality and credibility. Although the metaverse is expected to expand rapidly during and after the COVID-19 pandemic, it remains to be seen whether it represents an emerging technology that will revolutionize our society and healthcare or simply an immature condition of the future.

Managing iatrogenic subclavian artery cannulation using a vascular closure device: a minimally invasive option

Raja Shariff RE, Ibrahim KS, Khir RN, Ismail JR, Undok AW

Postgrad Med J, 2021 Aug 09.

PMID: 34373342 DOI: 10.1136/postgradmedj-2021-140706

Paper-thin roof: submucosal cleft palate with rhinolalia aperta

Tuang GJ, Zainal Abidin ZA

Postgrad Med J, 2021 Jul 21.

PMID: 34290122 DOI: 10.1136/postgradmedj-2021-140077

Stevens-Johnson syndrome as a primary skin manifestation of COVID-19

Muhd Besari A, Lim JA, Vellaichamy PT, Hussain FA, Kamaludin Z, Nor M

Postgrad Med J, 2022 Mar 01;98(e2):e70.

PMID: 37066525 DOI: 10.1136/postgradmedj-2021-140778

Ectopic tooth within a maxillary odontogenic myxoma

Tan SH, Chong AW

Postgrad Med J, 2021 Apr 20.

PMID: 33879547 DOI: 10.1136/postgradmedj-2021-139837

Fulltext Schwartz rounds for healthcare personnel in coping with COVID-19 pandemic

Saniasiaya J, Ramasamy K

Postgrad Med J, 2020 Jul;96(1137):425.

PMID: 32345755 DOI: 10.1136/postgradmedj-2020-137806

Fulltext COVID-19 pandemic: stringent measures of Malaysia and implications for other countries

Umair S, Waqas U, Faheem M

Postgrad Med J, 2021 Feb;97(1144):130-132.

PMID: 32561598 DOI: 10.1136/postgradmedj-2020-138079

The African cancer burden: what is the potential role of modern oncology innovation in reducing the continent's rapidly rising mortality?

Awuah WA, Ng JC, Mehta A, Nansubuga EP, Abdul-Rahman T, Kundu M, et al.

Postgrad Med J, 2023 Aug 22;99(1175):941-945.

PMID: 37280156 DOI: 10.1093/postmj/qgad043

With increasing prevalence and an expected rise in disease burden, cancer is a cause of concern for African healthcare. The cancer burden in Africa is expected to rise to 2.1 million new cases per year and 1.4 million deaths annually by the year 2040. Even though efforts are being made to improve the standard of oncology service delivery in Africa, the current state of cancer care is not yet on par with the rise in the cancer burden. Cutting-edge technologies and innovations are being developed across the globe to augment the battle against cancer; however, many of them are beyond the reach of African countries. Modern oncology innovations targeted to ward Africa would be promising to address the high cancer mortality rates. The innovations should be cost-effective and widely accessible to tackle the rapidly rising mortality rate on the African continent. Though it may seem promising, a multidisciplinary approach is required to overcome the challenges associated with the development and implementation of modern oncology innovations in Africa.

Physical and psychosocial characteristics differ between individuals with knee pain and different knee osteoarthritis diagnostic criteria

Tan GJ, Kioh SH, Mat S, Chan SHL, Lee JMY, Tan YW, et al.

Postgrad Med J, 2023 Sep 21;99(1176):1104-1109.

PMID: 37392161 DOI: 10.1093/postmj/qgad049

PURPOSE: Knee pain and osteoarthritis (OA) are common and often lead to disability among older adults. Existing published evidence, however, utilizes differing criteria to define studies' knee OA populations. We, therefore, aimed to determine whether differences exist in the characteristics of individuals with the presence of knee pain and different diagnostic criteria for knee OA.

METHODS: The Promoting Independence in Seniors with Arthritis (PISA) study is a longitudinal observational study of individuals with and without knee pain and knee OA recruited from the orthopaedics clinic of the Universiti Malaya Medical Centre and the local hospital catchment. Patients were diagnosed with OA based on the American College of Rheumatology (ACR) criteria, the presence of knee pain, and a history of physician-diagnosed knee OA. Psychosocial parameters were measured using validated measures for social participation, independence, and ability to perform activities of daily living, and life satisfaction.

RESULTS: Of the 230 included participants, mean age was 66.9 years (standard deviation: 7.2) and 166 (72.2%) were women. Kappa agreement between ACR criteria and knee pain was 0.525 and for ACR and physician-diagnosed OA it was 0.325. Binomial logistic regression analysis showed that weight, anxiety, and handgrip strength (HGS) were predictive of ACR OA. Knee pain was only predicted by HGS but not weight and anxiety. Physician-diagnosed OA was predicted by weight and HGS but not anxiety. HGS was predictive of ACR OA, knee pain, and physician-diagnosed OA.

CONCLUSION: Our study showed that the characteristics of patients with OA are different, physically and psychosocially, depending on the criteria used. Poor agreement was observed between radiological diagnosis and the other diagnostic criteria. Our findings have important implications for the interpretation and comparison of published studies using different OA criteria.

Comprehensive management of Jehovah's Witness in pregnancy

Pang FS, Liaw EYF, De S

Postgrad Med J, 2023 Sep 21;99(1176):1068-1075.

PMID: 37334974 DOI: 10.1093/postmj/qgad047

Jehovah's Witness (JW) is a denomination of Christianity which has many-fold higher morbidity and mortality compared to the general population as they refuse blood transfusion. Information is scanty regarding guidelines on the optimal approach to pregnant ladies of JW faith. In this review we have attempted to analyse the ways and techniques available which can be used to reduce the morbidity and mortality of these women. In antenatal care, haematological status can be optimised to reduce modifiable risk factors, namely anaemia by parenteral iron therapy from the second trimester onwards especially in patients who do not respond to oral iron therapy. In severe cases, erythropoietin serves as an effective alternative to blood transfusion. During the intrapartum period, using antifibrinolytics, cell salvage, bloodless surgical techniques, and uterine cooling for patients undergoing caesarean delivery have been proven effective. To conclude, complications of pregnant JW patients may be reduced if they comply with the preventives and targeted monitoring during the various phases of pregnancy. Further studies are warranted as this population exists as a minor group but is growing worldwide.

3D printing in surgery: revolutionizing trauma and fracture care in low and middle-income countries

Awuah WA, Tenkorang PO, Adebusoye FT, Ng JC, Wellington J, Abdul-Rahman T, et al.

Postgrad Med J, 2023 Dec 21;100(1179):1-3.

PMID: 37857514 DOI: 10.1093/postmj/qgad100

Crosstalk between COVID-19 and the gut-brain axis: a gut feeling

Kalam N, Balasubramaniam VRMT

Postgrad Med J, 2024 Jul 18;100(1186):539-554.

PMID: 38493312 DOI: 10.1093/postmj/qgae030

The microbes in the gut are crucial for maintaining the body's immune system and overall gut health. However, it is not fully understood how an unstable gut environment can lead to more severe cases of SARS-CoV-2 infection. The gut microbiota also plays a role in the gut-brain axis and interacts with the central nervous system through metabolic and neuroendocrine pathways. The interaction between the microbiota and the host's body involves hormonal, immune, and neural pathways, and any disruption in the balance of gut bacteria can lead to dysbiosis, which contributes to pathogen growth. In this context, we discuss how dysbiosis could contribute to comorbidities that increase susceptibility to SARS-CoV-2. Probiotics and fecal microbiota transplantation have successfully treated infectious and non-infectious inflammatory-related diseases, the most common comorbidities. These treatments could be adjuvant therapies for COVID-19 infection by restoring gut homeostasis and balancing the gut microbiota.

Displaying publications 41 - 55 of 55 in total