The huge population of persuadable, active, healthy and young students is the potential as blood donors to meet safe blood donation. This study focused on the existing level of knowledge regarding voluntary blood donation among medical (Faculty of Medicine and Health Science) and nonmedical students with science background (Faculty of Engineering) at the Universiti Malaysia Sabah. Four hundred and fifty-five students consisting of medical (231) and nonmedical (224) were selected through stratified random sampling to participate in the study. Data was collected using validated structured questionnaire. Statistical analysis was performed by structural equation modelling using SPSS AMOS Graphics version 22 and SPSS version16. The results showed a significant (pp
Medication errors (MEs) are preventable mistakes that occur when there is a failure in the treatment process of any disease that can cause potential harm to patients. Having an effect on patients, health outcomes and costs incurred, it does burden our economically-developing country. Database systems have been created worldwide for the reporting of MEs, but varying countries practise different classifications of MEs hence it poses a challenge to categorize them. This makes it next to impossible to fully curb this continual problem. There are a number of classifications of MEs, based on mistakes and errors based on skills, based on the mistakes itself, based on symptoms and based on the stages of drug delivery system. This review summarizes the pre-existing classifications of MEs.
Many factors contribute to the reluctance towards blood donation, but available studies done in Malaysia involving University students does not reflect the knowledge of the public in general. The objective of this study is to determine knowledge, attitude practice towards blood donation among the Sandakan population. A cross-sectional study was employed using an adapted 29-item structured validated questionnaire available in English and Bahasa, consisting of subject’s demography, questions regarding knowledge, attitude, and perception of blood donation. Convenient random sampling was done within the hospital compound, 79 healthy adults consented, and their data were used for the final data analysis, yielding an excellent internal consistency (Cronbach’s α coefficient = 0.816). Out of all, 74.7% of the respondents had a high level of knowledge, and independent t-tests showed that those who were not married, had tertiary education, donated blood in the past, had a statistically significant higher level of knowledge and 96.2% of respondents have a positive attitude. Some donors (40.6%) donated blood for moral satisfaction, and only a quarter (25%) experienced adverse events. Fear of pain, needle, fainting was the highest reason for reluctance in blood donation (36.2% of non-donors), followed by self-perception of being medically unfit to donate (31.9% of non-donors). Even though the sampled population in Sandakan showed an adequate level of knowledge as well as a positive attitude towards blood donation, blood product shortage is still present. This study may contribute by serving as an educational platform for awareness and education to improve the number of blood donors.
Since 1996, World Health Organisation (WHO) and member countries, through the World Health Assembly Resolution 49.25 acknowledged violence (including violence against women) (VAW) as a serious public health issue. The United Nations, at its Sixty-second General Assembly on 7 February 2008 not only reiterated the health impact of VAW but also the rights dimension of VAW and sees it “…as an offence against the dignity and integrity of the victim… and that all forms of violence against women seriously violate and impair or nullify the enjoyment of women of all human rights and fundamental freedoms and constitute a major impediment to the ability of women to make use of their capabilitiesâ€.
Posterior capsular rupture (PCR) is a common and serious complication of cataract surgery. It complicates the process of inserting posterior chamber intraocular lens and affects the visual outcome. This study is a review on visual acuity of patients that had PCR during cataract surgery in Hospital Melaka, risk factors of PCR, and factors that cause poor visual outcome. The record of all patients that had PCR during cataract surgery from 1 January 2014 till 31 March 2017 was traced using National Eye Database (NED) and the patients’ folders were reviewed retrospectively. Data collected was demographic data, type of cataract surgery, status of surgeon, underlying ocular diseases, risks factors for PCR, postoperative visual acuity, and factors that cause poor visual outcome. There were 238 eyes that had PCR during cataract surgery, from 126 (53%) female and 112 (47%) male patients. The mean age was 66.62 years old, ranging from 9 to 87 years old. Major risk factors identified were hard cataract, polar cataract, uncooperative patients, extended continuous capsulorhexis, subluxated lens, myopia, vitrectomised eyes, and poor pupil dilatation. From 153 cases that had no pre-existing ocular diseases, 119 (78%) cases had normal vision (best corrected visual acuity – BCVA) two months after surgery, 10 (7%) cases had moderate visual impairment, and four (2%) cases had severe visual impairment. Causes of BCVA poorer than 6/18 were high astigmatism, CMO, and prolonged inflammation. Cataract surgery, even complicated by PCR, is compatible with good visual outcome if the complications are managed promptly.
Gliosarcoma is a rare primary malignant tumour of the central nervous system. A 28-year-old radiographer without a history of neurological disorder, malignancy or trauma presented with unprovoked seizures. He was symptom-free for 3 years but developed relapsed. Computed tomography of the brain was consistent with anaplastic convexity meningioma which was identical via intraoperative findings. However, the final histology revealed gliosarcoma of the brain. He recovered well postoperatively without any neurological deficit and had completed adjuvant chemo-radiotherapy. He was asymptomatic during follow up with no tumour recurrence. Gliosarcoma with predominant sarcomatous component mimicking a meningioma has prolonged survival as compared to a case with predominant glioblastoma component. Hence, the discordance between clinical, radiological, intraoperative and histopathological findings is a challenge in establishing a diagnosis of gliosarcoma.
Colonic lipomatosis is relatively a rare tumour of mesenchymal origin, composed of welldifferentiated adipocytes interlaced by fibrous tissues. A 59-year-old lady presented with right iliac fossa pain with positive rebound tenderness, Rovsing’s and obturator signs. Investigation revealed marked leucocytosis suggestive of an acute appendicitis. Diagnostic laparoscopy revealed an inflamed appendix with concomitant caecal mass suspecting of a malignancy. Laparoscopic right hemicolectomy was proceeded following oncologic resection. However, final histopathologic examination was consistent with caecal colonic lipomatosis with concomitant acute appendicitis. Hereby, dual pathologies can be elicited in an acute abdomen.
Milk discharge from neonatal breast commonly occurs bilaterally. Majority of them are benign in nature. Those cases usually require conservative management and will resolve with time. It typically occurs within one month of age in which late-onset of galactorrhoea in toddlers is indeed a rare occasion. Thus, an abnormal cause needs to be ruled out. An 18-months-old child had persistent milky discharge from the left nipple for several days without underlying specific identified causes. This case highlights the occurrence of physiological milk discharge can still possibly occur at the age beyond one-year-old despite its absence in the initial months of life. The principle observation at primary care is still adequate in managing such cases unless high suspicion of alarming disease arises. This case proved a late onset of physiological galactorrhoea can still occur in the early toddler age group.
Globally, 998 million tonnes of agricultural waste is produced per year and in Malaysia, 1.2 million tonnes of agricultural waste is disposed of into landfills annually. Concurrently, increasing demands of concrete leads to vary of research conducted on improving cement production methods and formulating reduction or eliminate CO2 emissions.
Cerebral venous thrombosis (CVT) is a neurological condition occurring because of thrombosis involving the cerebral venous sinuses. This case report is an unusual clinical manifestation of cerebral venous thrombosis in a 76-year-old Chinese man who presented with restricted eye movement and double vision. Despite extensive investigation, there was no better explanation for his clinical symptom and sign apart from cerebral venous thrombosis which was confirmed by magnetic resonance venography (MRV) of the brain. Once cerebral venous thrombosis was diagnosed, he was initiated on anticoagulation and discharged with oral warfarin. This case emphasizes the need to consider cerebral venous thrombosis as one of the rare causes of complex ophthalmoplegia especially when typical cardiovascular risk factors are lacking in an individual.
Critical aortic stenosis (AS) is very severe narrowing at aortic valve in newborns, causing left ventricular outflow tract obstruction (LVOTO). It is lethal if not treated soon after birth.
Dengue fever and its fatal complications have made a comeback since its control in the 1990’s. The Flavivirus has evolved into 4 serotypes DEN 1,2,3,4 which can be passed on by the mosquitoes for 7 generations for each serotype. This communicable disease is predominantly confined to urban areas. Quick control of the spread of the disease will prevent it from becoming an epidemic. The two species mosquitoes involved have different behaviours. The Aedes aegypti is an indoor vector which breeds in clean, clear and calm freshwater. The Aedes albopictus is an outdoor breeding mosquito which breeds in stagnant waters. Surveillance of the areas prone to outbreaks is vital. One of the roles of the entomologist is to monitor the vector for resistance to the insecticides. Localities that have been subjected to recurrent outbreaks will have vector which develop resistance to the insecticides used.
As general population of obese patients in Malaysia rapidly increases, more obese patients are requiring anaesthesia for various operative procedures. Obesity is associated with anatomical and physiological differences and co-morbidities that influence on the choices of anaesthesia care. A surgical case with general anaesthesia is used as a basis of discussion. A 37-year-old female, history of untreated hypertension and gastrooesophageal reflux disease (GORD), BMI of 41 admitted for laparoscopic cholecystectomy for symptomatic cholelithiasis under general anaesthesia. She presented with pain at the upper right abdomen and associated with bloated abdomen, nausea and vomiting after intake of meals. General anaesthesia and right ultrasound-guided transversus abdominis plane (TAP) block for abdominal wall blocks via subcostal approach was performed. Operation was removal gallstones in the common bile duct via laparoscopic approach. Post-operation patient was extubated successfully. She was prescribed paracetamol 1g 4 hourly and started on fentanyl patient-controlled analgesia (PCA) for next 2 days. In this case report, there is the description of the application of TAP block which when used in obese abdominal surgical procedure, can provide excellent postoperative pain relief, early mobilization and recovery.
Palmaris longus (PL) tendon is regularly used in reconstructive surgeries as a donor tendon because it is observed as an accessory muscle and has little practical use to the human hands. It is only found in mammals. For example, the orangutan has PL but it is absent variable in the higher class of apes such as gorillas and chimpanzees. The absence of PL in humans appears to be hereditary, but the genetic transmission is unclear. The main objective of this study is to determine the prevalence of PL tendon absence in pre-clinical medical students of UMS and to compare the lack between gender and ethnic groups. By using standard Schaffer’s test, we examined the presence or absence of PL tendon among the first and second-year medical students of UMS. Four additional tests, Thompson’s test, Mishra’s test I, and II, Pushpakumar’s tests were used to determine whether PL present or not. A total of 134 volunteers were examined, and 91.8% were right-handed, and 8.2% were left-handed. The overall absence (bilateral and unilateral) of PL tendon was 23.9%, whereas unilateral absent was 17.9%, and bilateral absent was 6.0%. The high prevalence of absence of PL tendon among females 25.5% compared to males 20.0%. Chinese and Indian have a higher incidence of PL tendon absence followed by Kadazandusun and Malay. In this study, there were different figures for each ethnic group. The prevalence of absence of PL varies depending on the populations.
Dengue is one of the commonest viral diseases of Africa and tropical Asia. This disease is characterized by headache, fever, generalized body pain, severe malaise and back pain. The uncomplicated Dengue which is also named the classical dengue fever usually begins 3-8 days after biting of an infected mosquito. This is a cross sectional study on clinical presentation of Dengue in a general hospital in Bangladesh. The total number of patients was 198. The study period was 6 months (July 2004 to December 2004). All the patients who were admitted in the ‘Dengue ward’ and diagnosed as Dengue by serological test were included in this study. The aim of this study was to evaluate the common clinical presentations of Dengue in a General hospital in Bangladesh. The aim and objective was to compare the clinical presentations of Dengue in Bangladesh patients with those of other international studies. Most of the patients were male (3.7 :1) in sex and young adult(s) in age (80.3%). Fever and severe backache were the commonest clinical features. Nearly two-third (74%) patients presented with hemorrhagic features. Gum bleeding (20.2%) was the commonest bleeding feature. The result of this study showed a similarity with that of other international studies.
Some call it climate change and some global warming, regardless of the term used, it has been deemed the biggest global health threat of the 21st century. It is the 13th goal of United Nations Sustainable Developmental Goals (SDG). Multiple factors contribute to this global phenomenon including the anthropogenic causes which are man-made. The repercussions of this crisis are vast and bring effect environmentally and socioeconomically. These then ultimately lead towards an effect on individual as well as population health.
Frontonasal dysplasia (FND) is an uncommon congenital anomaly affecting the eyes, nose and forehead. In this case report, a baby of a 22-year-old mother was diagnosed with a midline facial cleft, bifid nose and hypertelorism during an ultrasound scan at 29th week of gestation. Besides a history of miscarriage on first pregnancy, no other abnormalities findings were found in laboratory or radiological examination of the newborn. Counselling about abnormality and psychological support were given by both obstetrician and neonatologist during the antenatal period. The patient delivered vaginally at 36th week with spontaneous labour and no complication was observed. Further interventions including corrective treatment have been planned as they often interfere with important functions such as breathing and feeding. Thus, the paediatric surgical team decided to do the operation when the baby reaches one year old as then tissues have been developed to 90% of their eventual form to give optimal treatment results. Further life expectancy depends on the severity of the malformation and whether or not surgical intervention can improve the associated health problems. This case report raises the importance of awareness on the nutritional value of pregnant mothers especially carotene and folic acid intake which may be associated with the organ maldevelopment. Overall, this report outlined the management of this rare condition experienced by the patient, particularly in a resource-limited setting like Yangon in Myanmar and also reviewed the literature about the presentation and classification of this condition.
Emergence of multidrug resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB) is one of the reasons why tuberculosis (TB) continues to cause great mortality and morbidity in less-developed countries. The development of rapid diagnostic methods targeting genetic mutations associated with resistance to the anti-tuberculous drugs is essential to fight this deadly pathogen. Isoniazid (INH) has been included in the multidrug regimens for the treatment of drug-susceptible TB for the decades. In the worldwide setting, isoniazid resistance was highly prevalent and was observed in one of every seven TB cases. Since katG315 mutation is highly prevalent, the common mutation in the enzyme essential for the activation of the INH concerned with the mechanism of drug resistance and associated with high level resistance to INH, katG315 mutation was necessary to be identified by molecular method as a molecular determinant of INH resistant Mycobacterium tuberculosis. The prevalence of katG315 mutation in various countries was discussed in this report and a new molecular method for the detection of the mutation was proposed.
Toxigenic strains of Vibrio cholerae serogroup O1 and O139 are causative agents of deadly
diarrheal disease named cholera. Vibrio cholerae O1 is traditionally divided into two
biotypes, classical and El Tor, which are different in phenotypic as well as genotypic traits.
Since 1961, classical strains of Vibrio cholerae O1 serogroup has become obsolete as the
cause of epidemic and pandemic cholera and replaced by El Tor strains. Since 2002, atypical
O1 El Tor strains possessing the traits of classical strains have been increasingly recognized
as the cause of cholera in many countries across the world. This article focuses on the genetic
traits of O1 classical and El Tor strains. Furthermore, an overview of emergence of atypical
O1 El Tor strains and their genetic traits is presented.
Assessment method of medical students by conducting examination is to identify the quality and quantity of their academic performance. Essay paper is one of the most common assessment tools in the Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah. Double marking is a means by which academic staff attempts to produce fair results for the students. Eighty eight medical students sat for three sets of Essay Papers of Professional I examination in March 2012. The double marking on the essay papers was done by two lecturers of each clinical department concerned for each discipline. Inter-examiner agreement and its effect on the reliability of the final score for the students were calculated by using Kappa statistics and Intra-class Correlation Coefficient (ICC). Reliability coefficient of the scores were also calculated for the different disciplines. In Part A essay paper, Cohan’s Kappa was 0.48 (p