Cancers of the breast and cervix made up 30.4% and 12% of all cancer cases in Malaysia. Thus screening for reproductive organ cancers as women approached menopause becomes exceedingly important. The study reports the baseline assessment tests of 495 disease free urban Malaysian women aged 45 years and above who volunteered in a healthy lifestyle intervention study. The sample comprised of 58.0% premenopaused and 42.0% postmenopaused women with an average age of 51.27±5.35 years old. Over two thirds were Chinese followed by Malays and Indians. Overall, abnormal Pap smears were seen in 7.6% comprising of 1.3% cervical intraepithelial neoplasia (CIN), 6.1% human papilloma virus (HPV) infection and 0.2% atypical squmous cells of undetermined significances (ASCUS). Yeast and other infections were found in 6.9% and 1.9% respectively. Comparatively, postmenopausal women had a 2.8 fold higher cancerous changes whereas premenopausal women had a higher infection rate, 11.8% vs. 4.7% respectively (p=0.024) with comparable HPV infection rates in both. This study found 1.3% had breast cancer (BC) with 3.6% requiring a biopsy while 3.4% needed regular follow up. Postmenopaused women had more abnormal mammograms (p
Turner syndrome is one of the most common chromosomal abnormalities affecting newborn females. More than half of patients with Turner syndrome have a 45X karyotype The rest of the patients may have structurally abnormal sex chromosomes or are mosaics with normal or abnormal sex chromosomes. Mosaicism with a second X sex chromosome is not usually of clinical significance. However, Turner syndrome patients having a second Y chromosome or Y chromosomal material are at risk of developing gonadoblastoma later in life. The aim of this study is to compare the results of conventional (karyotyping) and molecular cytogenetics (FISH), and discuss the advantages and limitations in the diagnosis of Turner syndrome. We also aim to compare the degree of mosaicism identified using conventional cytogenetics and FISH techniques. Conventional cytogenetics and FISH analyses were performed on eight peripheral blood samples of patients with Turner syndrome collected between 2004 and 2006. From this study, two out of eight patients with Turner syndrome were found to have the sex determining region on the Y chromosome (SRY) gene by FISH analysis. Our results showed that the rate of detection of mosaic cases in Turner syndrome was also increased to 88% after using the FISH technique. We concluded that FISH is more superior to conventional cytogenetics in the detection of the Y chromosomal material. FISH is also a quick and cost effective method in diagnosing Turner syndrome and assessing the degree of mosaicism.
Patients’ satisfaction is of critical interest to all healthcare providers. Satisfied patients are more likely to seek health care and to comply with prescribed treatment regimes. The objective of the study was to identify factors that influence patient satisfaction with Emergency Department HUKM (ED HUKM). This study was conducted at ED HUKM from January 2007 till March 2007. A convenience sample of 100 participants was recruited from triage 4. The Davis Consumer Emergency Care Satisfaction Scale (CECSS) was adopted and modified. It consists of 19 questions; used a 5 point, Likert type scale of 1 to 5 (1= completely disagree and 5= completely agree) to measure patient satisfaction with triage, health care providers caring behaviours and health teaching. Results showed that 75 participants (75%) were satisfied. There were no significant difference found between male and female patients with total CESCC scores (t=0.308, p values >0.05). Pearson product moment correlation coefficients showed a positive relationship between total and subscale patient satisfaction scores, caring scores (r=0.905, p value
Orogastric lavage has been performed since 200 years ago for intoxicated patients. Due to the risk that outweighs benefits it has fallen out of favour for the last decade. A teenage girl presented to Emergency Department with history of ingestion of a bottle of pesticide within the time frame before gastric emptying. The girl was resuscitated, intubated and orogastric lavage was performed. Fifty cc of the toxic substance was siphoned and antidote of the toxin was administered. She was admitted to the Intensive Care Unit, subsequently recovered and discharge five days later. Definitive airway management, proper technique, correct selection of patients and adequate monitoring are paramount to the success of orogastric lavage.
The purpose of the present study was to determine the periodontal profile, toothbrushing habits and oral hygiene status of patients referred to a teaching institution for periodontal treatment, based on patients' treatment records. A total of 207 consecutive patients diagnosed with periodontitis who had been interviewed and clinically examined over a period of approximately one year were included in this study. The assessments of plaque levels, bleeding on probing (BOP) scores, probing pocket depth (PPD) and degree of bone loss from radiographs were made. The average age of this study group was 45 ± 12.8 years old with an age range of 20 to 76 years. The subjects comprised of 40% Malays, 34% Chinese and 26% Indians. The male to female ratio was almost 1.5: 1. These patients presented with high plaque and BOP scores. These findings do not concur with the high frequency of toothbrushing reported (86.5 % of subjects brushing twice or more times per day). This may reflect on the ineffectiveness of brushing as evident from their high plaque scores. Periodontal pockets were detected in 69 % of the teeth in these patients with an average of 17 teeth per patient being involved. Probing pocket depths of >6mm was found on the average in 3 teeth per patient. Alveolar bone loss as assessed from radiographs was detected in 52 % of the teeth in this study group of which 12 teeth per patient on the average exhibited this. Advanced bone loss involving about 2/3 and more of the root length was detected on the average on 1 tooth per patient. Early onset periodontitis accounted for about 5% of the total cases seen. About 21 % of subjects suffered from advanced adult periodontitis. Hence about a-quarter of the patients referred already had marked periodontal destruction.
This is a retrospective study to determine the distribution site, associated fracture and causes of mandibular fractures at HUSM, over a 5 year period, from 1st January 2002 - 31st December 2006. Records of patients who had mandibular fracture were reviewed. Data of age, sex, site of fracture, causes and associated fracture were recorded and analyzed using SPSS version 15.0. There were 113 (84.3%) males and 21 (15.7%) females. The mean age for male was 84.3% and female was 15.7%. The fracture occurs mostly at the age of 11-20 years (45.5%), followed by 21-30 years (30.6%). Motor vehicle accidents (MVA) were the commonest causes of mandibular fracture (92.5%), followed by fight and assault (3.7%), industrial accidents (3.0%), fall (0.7%). There were no cases recorded due to sport injury. The commonest site of mandibular fracture occurs at angle and para-symphysis (23%), followed by body (20.1%), symphysis (16.7%), condyle (15.5%) and ramus (1.7%). The most common associated fractures were head injury (23.5%), followed by clavicle fracture (17.2%) and fracture of radius (10.7%). Mandibular fracture was common in males with the mean age 24.63 years and mostly due to MVA. Angle and para-symphysis is the commonest site of mandibular fracture with most of the patient suffered from concomitant head injury.
The aim of this study was to identify the position of impacted mandibular third molars based on the classifications of Pell & Gregory and Winter, the indications for extraction, and the relation of post-operative complications and position. Records of patients who attended Hospital Universiti Sains Malaysia between January and December 2007 for surgical removal of mandibular third molars were reviewed. The angulation type, width and depth of impaction were determined by reviewing the orthopantomograms. The indications of extraction and occurrence of any post- operative complications were recorded. A total of 238 impacted teeth were surgically extracted from 194 patients (97 males, 97 females). The reasons for extraction include recurrent pericoronitis (43.1%) followed by prophylactic purposes (33.5%). Mesioangular impactions accounted for 52.3% and Class IIA position of impaction accounted for 45.7% of extractions. The most common post-operative complication was persistent pain and swelling (14.7%) followed by trismus (4.1%) and dry socket (3.0%). There was no significant relationship between the angulation, width and depth of impaction and the occurrence of complication. Mesioangular type and Class IIA position of impaction were the most common impaction. Although the association was not significant, high frequency of post-operative complications was observed in mesioangular, horizontal, IIA and IIC positions.
Mental health is an integral component to the formation of human capital performance. Human capital with high productivity is the key factor to the growth of a country. Thus, this study aims to investigate the relationship between the level of mental health of undergraduate students in Universiti Utara Malaysia (UUM) with their performance. Mental health was measured using the General Health Questionnaire 12-item (GHQ-12) and the performance was based on the Cumulative Grade Point Average (CGPA). A total of 316 undergraduate students at UUM had answered questionnaires that were distributed. The data were analysed descriptively and the effect of the level of mental health on performance was tested using probit model. Based on GHQ-12, 48% respondents were found to have a good mental health status. A total of 67.21% of the students who obtain CGPA 3.67 and above have a good level of health compared with only 36.08% for those with CGPA under 3.67. Based on the probit model, the level of mental health was found to be significant at 1% level in influencing the CGPA. These findings provide indication to policy makers of the importance of mental health in influencing the students’ performance. Mental health education programs should be implemented or enhanced to raise awareness of the importance of good mental health state among students in higher education institution.
Keywords: CGPA; GHQ-12; mental health; productivity; Kedah; Malaysia
Morbidly adherent placenta with spontaneous rupture of membrane at extreme prematurity poses poor pregnancy outcome. Various issues on different management modalities still remain perplexed and individual consideration is vital. Two cases of morbidly adherent placenta with symptomatic per vaginal bleeding and spontaneous rupture of membrane at severe prematurity were reviewed and discussed. We found that, active intervention by termination of pregnancy and methotrexate therapy at early gestation can prevent the need of hysterectomy following major obstetrics haemorrhage.