Introduction: Marital satisfaction is vital to the wellbeing and functioning of the individual and family. Marital dissatisfaction can lead to detrimental effects on mental, physical and family health. The study aimed to determine the proportion of marital dissatisfaction in outpatient setting and its association with sexual functioning and psychiatric morbidity in Kuala Lumpur, Malaysia.
Materials & Methods: A cross-sectional study was conducted in selected primary care using purposive sampling. Data collection was done using socio-demographic questionnaire and several validated Malay version of self-administered questionnaires. Marital satisfaction was measured by the Malay version of Golombok-Rust Inventory of Marital State (Mal-GRIMS).
Results: The prevalence of marriage dissatisfaction in sample population was about 37.3% with almost equal prevalence in both, 36.5% (male) and 37.8% (female). Using a regression analysis, the significant factors that affect marital dissatisfaction were respondent's age group between 31- 40 years old (Adjusted Odds Ratio, AOR. =11.4, 95% Confidence Interval, CI. =1.2-110.9), spouse's salary of RM1000-RM2000 (lower income category) (AOR=7.3, 95% CI= 1.9-28.1), anxiety case (AOR= 4.8, 95% CI=1.1- 21.5), depression case (AOR= 4.8, 95% CI=1.0-22.8), female sexual dysfunction in term of arousal function (AOR= 0.01, 95% CI=0.0-0.7), satisfaction dysfunction (AOR= 9.4, 95% CI= 1.5-58) and pain function (AOR=43.7, 95% CI=1.28 - 1489.2).
Conclusion: Marital dissatisfaction can be influenced by financial factor, sexual dysfunction and presence of psychiatric morbidity. Hence, in management of marital discord, thorough screening of these factors should be prioritized in clinical setting.
Introduction: Marital satisfaction is vital to the wellbeing and functioning of the individual and family. Marital dissatisfaction can lead to detrimental effects on mental, physical and family health. The study aimed to determine the proportion of marital dissatisfaction in outpatient setting and its association with sexual functioning and psychiatric morbidity in Kuala Lumpur, Malaysia.
Materials & Methods: A cross-sectional study was conducted in selected primary care using purposive sampling. Data collection was done using socio-demographic questionnaire and several validated Malay version of self-administered questionnaires. Marital satisfaction was measured by the Malay version of Golombok–Rust Inventory of Marital State (Mal-GRIMS).
Results: The prevalence of marriage dissatisfaction in sample population was about 37.3% with almost equal prevalence in both, 36.5% (male) and 37.8% (female). Using a regression analysis, the significant factors that affect marital dissatisfaction were respondent’s age group between 31-40 years old (Adjusted Odds Ratio, AOR. =11.4, 95% Confidence Interval, CI. =1.2-110.9), spouse’s salary of RM1000-RM2000 (lower income category) (AOR=7.3, 95% CI= 1.9-28.1), anxiety case (AOR= 4.8, 95% CI=1.1-21.5), depression case (AOR= 4.8, 95% CI=1.0-22.8), female sexual dysfunction in term of arousal function (AOR= 0.01, 95% CI=0.0-0.7), satisfaction dysfunction (AOR= 9.4, 95% CI= 1.5-58) and pain function (AOR=43.7, 95% CI=1.28 - 1489.2).
Conclusion: Marital dissatisfaction can be influenced by financial factor, sexual dysfunction and presence of psychiatric morbidity. Hence, in management of marital discord, thorough screening of these factors should be prioritized in clinical setting.
Adequate space is required in the interforaminal region for anterior mandibular
surgery, where the anterior loop is located within this region. The aim of this study is to evaluate
the prevalence of the anterior loop (AL) of the inferior alveolar nerve, and to measure its length
and position in patients attending Kulliyyah of Dentistry using cone beam computed tomography
(CBCT). (Copied from article).
Introduction: The study was done at the aim to assess the functionality and viability of the β cells of the streptozotocin-induced diabetic rats model following repetitive dosage of administration of ethanolic extracts of Andrographis paniculata. Materials and Methods: The diabetic rats were treated with the extracts for fourteen days and at the dose given was 500 mg/kg twice daily. The assessments were made on fasting blood glucose, insulin, and immunohistochemical aspect of β cells before and after treatment. Results: The results showed that there was a signifi cant reduction on fasting blood glucose levels in metformin, 95% and 50% ethanolic plant extracts-treated groups but on insulin level only 95% and 50% ethanolic extracts-treated groups gave a signifi cant reduction(p
Introduction: According to the Youth Behaviour Risk Factor Surveillance (YBRFSS, 2011) in Malaysia, the prevalence of smokers nationally among Form 1, 2 and 4 students government secondary school students was 9.1% (ever smokers) and 8.7% (current smokers). However, there is limited information on the prevalence of smoking among religious secondary school students and self-esteem as risk factor. Thus, this study was conducted to determine the prevalence and factors associated with smoking among the religious secondary school students in Petaling district, Selangor.
Methods: A cross-sectional study was conducted among 899 students. The schools were selected using cluster sampling and self-administered questionnaire was used. Data was analyzed using chi-square test and multivariate logistic regression to identify the independent factors for smoking.
Results: The response rate was 94%. The prevalence of ever smoking was 10.1%; 3.9% among female and 18.6% among male. The median age (interquartile range) of smoking initiation was 12.00 (4.01) years. The results showed that independent factors for smoking were: males (OR= 5.47); age group 14-15 years (OR=2.82) and 16-17 years (OR=3.63) and having low self -esteem (OR=6.24).
Conclusion: prevalence of ever smokers is higher when compared to YBRFSS, (2011) and it was revealed that most of the smokers started smoking even before secondary school. The results also revealed the importance of promoting self-esteem. Efforts in smoking prevention should therefore be focused on curbing the initiation of the acts and improving students’ self-worth.
Introduction: Astrocytic gliomas are the most common and lethal intracranial brain tumours and rely on angiogenesis for the tumour development. Endothelial progenitor cells (EPCs) contribute to the angiogenesis of glioma tumour. Objectives: The study aimed to investigate the matured circulating endothelial cells population in the peripheral blood mononuclear cells (PBMCs) and its associations with tissue resident angiogenic cells in astrocytic glioma patients. Methods: A total of 22 astrocytic glioma patients were recruited from Hospital Universiti Sains Malaysia. Tumour were sliced and stained with CD133+ and VEGFA+ for angiogenic cells (n=22). The circulating (CD133-/VEGFR2+) matured endothelial cells in PBMCs (n=22) were quantified using FACS. The paired t-test and Pearson correlation test were used for the data analysis. Results: The angiogenic cells in brain tumour tissue were significantly higher compared to adjacent normal brain tissue (median 1.07±0.96% vs. median 0.69±0.68%; Wilcoxon signed rank test Z=-3.100; p=0.002). Positive correlation was found between the angiogenic cells of brain tumour tissue and adjacent normal brain tissue (Spearman’s rho correlation test, r=0.56; p=0.007). Significant positive correlation was found between matured endothelial cells in peripheral circulating systems and angiogenic cells in tumour of astrocytic glioma patients (Pearson correlation test, r=0.60, p=0.003).Conclusion:The findings of the study give support to the possible roles of EPCs in astrocytic glioma patients. Thus targeting tissue resident angiogenic cells and matured circulating endothelial cells by antiangiogenic treatment might be useful to prevent the tumour growth.
Introduction: Various initiatives and medications have been introduced to achieve better control of bronchial asthma. However total control according to Global Initiative for Asthma (GINA) remains elusive even at tertiary referral hospitals. Our study is to determine the level of asthma control (according to GINA 2009), Asthma Control Test (ACT) scores and the types of medications used among patients with bronchial asthma in a large tertiary hospital.
Methods: A cross-sectional study of all patients with bronchial asthma who attended the Chest Clinic at Hospital Tengku Ampuan Afzan (HTAA) from 2009 to 2011. Patient demographics, self-administered ACT scores, GINA-defined level of asthma control and medications were documented.
Results: 208 patients were recruited. There were 23.2%, 46.3% and 30.5% of patients with controlled, partly controlled and uncontrolled asthma respectively. The median ACT scores was 19 [inter quartile range (IQR) 6]. The most frequently used preventer therapy was inhaled long-acting β-agonist/corticosteroids (LABA/ICS) fixed-dose combination (61.7%), and 9.6% were not on preventer therapy. 75% of patients with controlled asthma were on LABA/ICS compared to 58.5% of the partly controlled and uncontrolled groups (p=0.039).
Conclusion: The majority of the asthmatic patients attending the Chest Clinic at HTAA did not have GINA-defined controlled asthma. Patients with higher ACT scores had better control of asthma. There were more patients with controlled asthma who were on LABA/ICS combination.
KEYWORDS: Bronchial asthma, level of control, Asthma Control Test
Study site: Chest Clinic, Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
Device, Questionnaire & Scale: Asthma Control Test (ACT)
We present a case of a 45-year-old female who presented with blurring of right vision associated with constitutional symptoms. Examinations revealed right optic disc swelling with inferior exudative retinal detachment and hepatomegaly. Gynaecological examination showed a fungating cervical mass. Histopathological reports of cone biopsy confirmed the presence of large B cell non-Hodgkin lymphoma. HIV screening was positive. A diagnosis of HIV related lymphoma was made. Chemotherapy and antiretroviral treatment were instituted. The ocular signs resolved. However, the patient could not tolerate the side effects of medical therapy and opted for palliative treatment.
Pelvic inflammatory disease (PID) is a common cause of morbidity and accounts for 1 in 60 GP consultations by women under the age of 45 in the UK. Pelvic inflammatory disease encompases a broad category of disease including endometritis, salphingitis, salphingo-oopheritis, tuboovarian abscess and pelvic peritonitis. It most commonly occurs as a result of Chlamydia trachomatis or Nesseria gonorrhea 1,2 infection of the endocervix that eventually spread into the upper genital tract. Direct spread from a nearby infection such as appendicitis and diverticulitis is not that common. Hematogenous spread is rare except in cases of tuberculous pelvic inflammatory disease. This case illustrates atypical presentation of pelvic inflammatory disease in a previously healthy single unmarried lady. The presence of ascites, bilateral ovarian mass and constitutional symptoms closely mimics that of malignant ovarian tumour. This was preceded by empyema which grew E coli.
Augmented renal clearance (ARC) is a phenomenon where there is elevated
renal clearance and defined by creatinine clearance more than 130ml/min. ARC results
in changes of the pharmacokinetic and pharmacodynamic of antimicrobial therapy being
administered, which may result in its subtherapeutic dose. We evaluated the
prevalence, risk factors and outcome of ARC in critically ill patients with sepsis. (Copied from article).
The azygos system enlarges in cases of obstruction to the superior vena cava or inferior vena cava and result in increase blood flow through the system. Azygos continuation of the inferior vena cava is usually congenital and asymptomatic. The azygos vein is the sole drainage of the blood from the lower half of the body to the heart. It is crucial to identify the anomaly as it might involve in the surgical planning of tumours in the thorax or abdomen. Computed Tomography is a non-invasive technique and provide important information about the tumour and the vascular anomaly.
The upper airway is a crucial structure. It becomes a grave problem should it be narrowed. Several methods
of treatment were rendered for patients with laryngotracheal stenosis. We share our experience with the
combination total intravenous anaesthesia and apneic pause technique with or without steroid injection.
Four cases of laryngotracheal stenosis were observed in Hospital Ampang: two adult and two paediatric
cases. Age, gender, causative factor, stenosis segment length, grade or severity were observed before and
after dilatation, number of dilatation were observed and compared. The outcome measures are
decannulation and avoidance of tracheostomy. All cases had improvement of symptoms. Half or 50% of the
patient required repeated balloon dilatations. The paediatric cases successfully avoided tracheostomy while
the adult cases successfully decannulated with no complication from the procedure. Balloon dilatation by
total intravenous anaesthesia coupled with apneic method is a safe and effective method of treatment for
the narrowed airway.
Introduction: During pregnancy, increased acidity in the mouth increases the risk of antenatal mother to get dental caries. It is worsen if antenatal mother has morning sickness like vomiting during pregnancy. It can aggravate the problem by exposing the teeth to more gastric acid. In addition, antenatal mothers have hormonal changes that they are more susceptible to periodontal problems. Therefore, it is important for antenatal mother to get dental treatment and use oral health service. This study aim is to describe barriers to utilisation of oral health care services among antenatal mothers attending the Klinik Kesihatan Ibu dan Anak around Kuantan. Materials and Methods: A cross sectional study which was conducted among purposely selected 296 antenatal mothers aged 18-45 years from Kuantan, Pahang in 18 months duration. Study used validated self-administered questionnaire to obtain information on the variables of interest. Results: Common barriers to utilization of services among antenatal mothers are fear to dental pain (45.6%), time constraints- busy at workplace (36.5%) and feeling of not having any dental problems (36.1%). Meanwhile the least barrier to oral health care services among antenatal mothers is attitude of the dentist (0.7%), followed by attitude of the staff (1.4%) and condition of treatment room (1.7%) Conclusion(s): Fear of dental pain is the main barrier to utilization of service among antenatal mothers and dissatisfaction of the service provided is the least barrier among other factors.
KEYWORDS: barriers, antenatal, pregnant mothers, dental caries, periodontal
Thyroglossal duct cyst is the most common upper neck midline lesion in children. Approximately 1% of
thyroglossal duct cyst undergoes malignant transformation. Calcification which is a marker of malignancy
almost always points out to papillary thyroid carcinoma. Benign case of calcified thyroglossal cyst maybe
undiagnosed or under reported. We report a case of a 5 year old girl with a benign calcified thyroglossal
duct cyst, a fourth case in world literature. Here the differences between a benign and malignant
thyroglossal duct cyst are discussed.
Radicular cyst is the most common cyst in the mandible. It usually presents in the later age of life because the formation of the cyst is the last step in a progression of inflammatory events following a periapical inflammatory lesion. The cyst usually goes unnoticed because of the size that is rarely palpable, and it is often painless. In this paper, we present a 12 year-old girl who developed a relatively large cyst for the age. The outline of management is discussed.
Paragangliomas are slow growing hypervascular tumour arising from neural crest cell derivatives throughout the body. In the head and neck region, the major paraganglial cells are located at the carotid bifurcation (carotid body), along the ganglia of the vagus nerve and along the nerves supplying the middle ear and jugular bulb. Less common locations include the larynx, orbit, nose and the aortic arch. Carotid body tumours are very rare neoplasms constituting less than 0.5% of all tumours. The true nature of the tumour is established at the time of attempted biopsy or surgical resection, sometimes with disastrous consequences. Only a few of the more than 500 cases reported in the literature have been studied and diagnosed preoperatively. These tumours must be considered in the evaluation of any lateral neck mass, even one located far from the carotid bifurcation. We report a case of bilateral carotid body tumours detected using 16-slice MDHCT in a patient who presented with pulsatile neck swelling for two years. This tumour is rarely malignant; however it produces serious problems by its progressive enlargement and impairment of adjacent structures in the neck. The treatment of choice is surgical resection; preferably to excise this lesion when it is small, because large, very vascular tumours are intimately attached to the carotid vessels and make surgical resection more hazardous. Pre-operative embolization can be performed in large tumours, as to facilitates surgery and reduce complication. In most of the cases, there is strong attachment of the tumour to the carotid arteries. When this is the situation, removal of the tumour means complete excision of both great arteries as well, and the mortality rate is 40 to 45 %. When surgical removal is not feasible, radiotherapy may help to control the tumour growth, although the results have not been encouraging. As it is very slow growing tumour with the growth rate of less than 5 mm per year tumours in old patients with significant risk factors for surgical intervention can be managed by observation alone.
We report a case of a 14-year-old Malay male who fell at school and sustained bilateral olecranon fractures. He had undergone an open reduction and tension band wiring to stabilize the fracture. Three months after the surgery, the movement of both his elbows was satisfactory.
Glaucoma is a major cause of permanent visual loss in patients with sarcoid uveitis.In this case glaucoma occurred early in the course of the disease and IOP started to rise up after one month from the initial presentation. Uveitic glaucoma can be extremely difficult to treat; pilocarpine is not normally used in eyes with active inflammation. Patients with uveitis respond poorly to laser trabeculoplasty, and filtering procedures usually fail. Success of modified goniotomy, trabeculectomy and Molteno valve implantation were reported. More drastic therapy, such as cyclodestructive procedures, may be required in the most severe cases. In this case the challenge in preserving the vision. by keeping the balance between the need to control the inflammation and the necessity to avoid the treatment related complications.
Renal arteriovenous malformation (AVM) is a rare congenital anomaly of the urinary system. We present a patient with bilateral renal AVMs who presented with back pain and microscopic hematuria. This case highlights the importance of careful diagnostic work-up in the evaluation of upper tract hematuria. Renal AVM was found to be the cause of mild back pain and persistent microscopic hematuria in a 45-year-old lady. This case highlights the importance of complete diagnostic work-up in the evaluation of microscopic hematuria in arriving at the correct diagnosis of an uncommon clinical entity.