Snakebite has been categorised as a ‘neglected tropical disease’ by WHO
in 2009 and it affects mainly the poorer countries like Africa and Asia. The standard
treatment for snake envenomation is the anti-snake venom medication which can be
very expensive, not readily available and specific against a snake species. This study
was conducted to screen the phytochemical compounds of Tamarindus indica seed
extract (TSE) and its in-vitro effects on snake venom of three snake species; namely
Daboia russelli, Naja kaouthia and Ophiophagus hannah. (Copied from article).
Dural arteriovenous malformation (DAVM) is relatively rare and defined as abnormal connections or shunts between the arterial and the venous side of vascular tree located within the dura mater. Spontaneous closures of DAVM are rare and have been scarcely reported. This case report will describe the neuroimaging findings and classification of DAVM. A 50 year old lady presented with headache. Neuroimaging showed prominent serpinginous flow-void structures, cerebral angiogram confirmed the presence of DAVM at the occipital region. She had defaulted treatment and follow-up for 3 years. On second admission, she had a cerebral angiogram which showed normal findings with no evidence of fistulas or malformation. She was discharged well. Causes of spontaneous closure of DAVM are discussed.
Introduction: Abdominal obesity and inflammation are two independent risk factors for cardiovascular disease. However, the inter-relationship between these two factors among Malay population is fragmented. The purpose of this study is to determine the association between waist circumference as a measure of abdominal obesity and high-sensitivity C-reactive protein as an indicator of inflammation status among Malay obese adults in Kuantan, Pahang. Materials and Methods: Ninety-three apparently healthy obese adults (BMI between 27.5 and 39.9 kg/m2 ) aged between 20 to 62 years old were recruited in this study (68% men and 32% women). Circumference tape was used to measure the waist circumference and fasting venous blood was obtained to determine the high-sensitivity C-reactive protein level. Results: On average, the waist circumference of obese men and women was 103 cm (SD = 8.7) and 94 cm (SD = 7.0), respectively. The median (IQR) of the hs-CRP level of the study participant was 3.80 mg/L (1.5, 10.1). The Kendall’s Tau correlation reveals that there is a significant positive linear correlation between waist circumference and hs -CRP level in obese men (r (30) = 0.355, p = 0.006) and women (r (63) = 0.177, p = 0.043). Conclusion: There is a significant inter-relationship between waist circumference and hs-CRP level among apparently healthy obese adults in Kuantan, Pahang. This study suggests that assessment of hs-CRP level is beneficial to predict the risk for future cardiovascular disease event and facilitate the management of obesity in this population. A prospective clinical study is recommended to confirm the findings.
Introduction: Ambulatory blood pressure accurately reflects a patient's actual blood pressure than casual or office blood pressure. This study aims to describe the circadian blood pressure profile of hypertensive patients and to identify the associated cardiovascular risk factors in non-dippers.
Methods: A cross-sectional study was conducted from 1st January 2008 to 30th June 2008 among hypertensive patients attending Family Medicine Clinic HUSM. Schiller BR-102 plus was used to get 24 hours blood pressure (BP) reading. Mean of two offices BP were also taken. Non-dippers are defined as a systolic or diastolic nocturnal drop of less than 10%. Analysis was done using SPSS Version 12.
Results: 105 patients were recruited with mean (SD) age of 51.8 (9.34) year old. The mean (SD) 24-hour systolic and diastolic BP was 128.4 (12.7) mmHg and 79.7 (8.74) mmHg respectively. Mean (SD) daytime systolic and diastolic BP was 132.1 (11.72) mmHg and 82.4 (9.41) mmHg while for the night time were 123.3 (12.78) mmHg and 76.2 (9.01) mmHg. Mean (SD) systolic and diastolic office BP was 144.2(15.16) mmHg and 90.2(9.71) mmHg. Percentage of non dippers were 68.6% for systolic and 61.9% for diastolic.
Conclusion: Mean 24 hours and daytime ambulatory BP was normal but the mean night time diastolic and office BP was above-normal value. Majority of the patients were categorized as non dippers. Therefore, using ambulatory BP is clinically important to get a better understanding of blood pressure fluctuations over 24-hour periods compared to simple clinical measurements.
Study site: Family Medicine Clinic, Hospital Universiti Sains Malysia (HUSM), Kelantan, Malaysia
Copy number variation (CNV) caused by changes in DNA sequences of 1000
or more bases is implicated with susceptibility to common diseases. A study on CNV
esv27061 among hypertensive Australian adults reported association with high blood
pressure (BP). In Malaysia, no study on CNV among hypertensive young adults is
available. Thus, this investigation aimed to assess the CNV esv27061 of young Malaysian
adults with high blood pressure using optimized ddPCR. (Copied from article).
The existence of new entity called occult hepatitis C virus (HCV) has
become a raising and escalating concern among healthcare professionals worldwide. It
is defined by the presence of viral RNA in liver and/or peripheral blood mononuclear
cells (PBMCs) within non HCV-infected patients. Previous study had shown the occult
HCV is infectious and capable of transmitting the virus to another host. Till today, HCV
infection remains common among hemodialysis patients despite having the best
preventive plans. Because of this, there is a significant concern about the source of viral
transmission. The aim of the study was to identify and characterize occult HCV infection
in PBMC sample of hemodialysis patients. This was an observational and cross sectional
study. (Copied from article).
Evidence suggests that several genes; including MYO1H, play an important role in the
etiology of Class III malocclusion. Single nucleotide polymorphism (SNP) in marker rs10850110 (locus
12q24.11) within MYO1H gene has been associated with the incidence of mandibular prognathism
(MP). MYO is a class 1 myosin that is responsible for the synthesis of Matrilin-1; an important
protein involved in the formation of cartilage's extracellular matrix, hence is implicated in the
formation of mandibular condyle cartilage. This study aimed to detect the presence of MYO1H
(rs10850110) SNP and to determine its genotype and allele distribution in MP patient in the local
population. (Copied from article).
A Mondor’s disease is a rare, benign and self-limiting condition. It is due to thrombophlebitis of the superficial veins of the breast and chest wall. It usually occurs in middle-aged women who present with a palpable cordlike structure, often painful in the acute phase. The aetiology is unknown, and may be related to trauma, surgery, infection or tight clothing. The finding of a superficial vessel seen as a linear opacity on mammography and a tubular structure on ultrasound is typical. An intra-luminal thrombus may be seen on ultrasound, and there may be absent flow on Doppler imaging. Conservative treatment is usually instituted, although surgery may be indicated in certain circumstances.
Henoch-Schonlein purpura or anaphylactoid purpura is a systemic vasculitis of unknown cause that affects small vessels and mainly involves the skin, joints, gastrointestinal tract and kidneys. Gastrointestinal involvement occurs in more than half of patients and is thought to be related to edema and intramural haemorrhage. Radiologically the gastrointestinal findings are mainly those of bowel ischemia with thumbprinting and bowel wall oedema. Although this disease is usually treated conservatively, aggressive intervention is occasionally performed because of acute abdominal symptoms due to complications, such as perforation, intussusception and obstruction. This report illustrates a case of Henoch-Schonlein purpura with acute abdominal symptoms due to intussusception.
Orthodontic fixed appliance is now considered as fashion accessory and a symbol of
wealth. Due to overwhelming demand, 'fake' and 'real' braces services have been offered through
social media by unqualified personnel using poor quality orthodontic brackets and cases of metal
toxicity from using these type of braces has been reported. (Copied from article).
The growing demand for orthodontic braces among Malaysian community has led to
the development of "fake" and "real" braces. "Fake" braces refer to braces that are worn as costume
and are not bonded to teeth hence unable to produce movement of teeth. "Real" braces refer to
braces that are bonded to tooth structure and are able to produce tooth movement. The braces are
bonded by unqualified practitioners with no formal dental education and they provide braces
treatment in unlicensed premises such as hotel rooms or patients' own homes. (Copied from article).
Dental decays happened due to demineralization of dental minerals because of oral
acidic environment. The minerals that usually dissolved out from the enamel are calcium (Ca) and
phosphorus (P). To ensure more Ca and P absorbed via remineralization, high Ca and P content in
daily diet supply are required. In Malaysia, virgin coconut oil (VCO), coconut milk (CM) and coconut
water (CW) are a few of many major diet component of daily diet. The aim for this study is to
evaluate the Ca and P content of VCO, CM and CW. (Copied from article).
Intracranial nail gun injury is a rare subset of penetrating head injury. Here we report a case of intracranial nail gun injury in a Vietnamese patient who attempted suicide with no neurological deficit. Three nails were launched. Because the nail head acted as a brake, the launched nail could make a hole into the skull but could not entirely pass it. A rational management strategy should permit these patients to be discharged with no additional injury. Some medical and surgical management in penetrating head injury are discussed. The use of antibiotics and antiepileptic drugs and the retraction of the nail aided by the performance of a craniotomy surrounding the entry point are recommended.
Cranium dysraphism occur less commonly than spinal dysraphism. Overall, occipital encephalocoeles are more frequent than anterior encephalocoes. A large occipital encephalocoele possess difficulty in surgical intervention, not only the sac contains large amount of herniated brain tissue, but the appropriate positioning for successful intubation as well as the higher rate of surgical complications such as cerebrospinal fluid leakage and skin necrosis. In this case report, surgical management of large occipital encephalocoele is discussed. The use of antibiotics in ruptured encephalocoele is recommended.
Introduction: With an increase in national nursing shortage, organizational commitment is extremely
important for retention of nurses. This predictive study determines the level of organizational commitment and the predictive ability of perceived organizational support, components of job satisfaction, including pay, task requirement, organizational policies, autonomy, interaction and professional status as well as years of experience on organizational commitment. Method: Data were collected from 416 nurses in four state hospitals in Malaysia, using self-administered questionnaires. The hospitals were selected from each region in Peninsular Malaysia and samples were selected by a random sampling method. Questionnaires, including demographic data, Organizational Commitment Questionnaires, Survey of Perceived Organizational Support,and Index Work Satisfaction were distributed by researcher and research assistants. Stepwise multiple regression technique was used to analyze the data. Results: The results discovered that (1) nearly half of the subjects (48.07%) reported high level of organizational commitment. (2) Professional status, autonomy, interaction, task requirement and years of experience could predict the organizational commitment (ß = 0.52, 0.17, p < 0.01); ß= 0.13, 0.11, 0.09, p < 0.05 respectively). Overall, all predictors explained 33% of variability
in the organizational commitment among nurses in state hospitals. Conclusions: This study found that nurses in state hospitals were highly committed to their organizations. Results of this study provide information for nurse administrators to consider and maintain these factors in nursing practice to foster a high level of organizational commitment among Malaysian nurses.
Hip fractures cases are common in elderly population. After a hip fracture, around 80% of patients were unable to carry out at least one independent activity of daily living (ADL). This review attempted to provide an evidence-based literature on ADL of elderly hip fracture patients. A computerised literature search using Medline (OVID) and Scopus databases were conducted to identify relevant studies on ADL of elderly hip fracture patients that was assessed with Katz ADL score. Only articles that fulfilled the inclusion criteria were included in this review. Initial search identified 314 potentially relevant articles but after careful screening, only 5 full-text articles were selected for the present review. Three studies showed an increase dependent level of the patients’ ADL after hip fractures. Two studies showed not more than half of the patients were unable to regain their pre-fracture ADL level after one year of hip fracture incidence. Feeding/eating showed the highest independent activity while bathing was the lowest independent activity among patients. In conclusion, elderly hip fracture patients have declined ADL with the risk that they may never regain their pre-fracture ADL level.
Lactiferous or milk fistula is a tract between the skin and lactiferous duct. Chronic lactiferous duct is uncommon and generally formed during lactating period. It commonly result from complication of the surgical intervention, such as excision biopsy of breast mass or incision and drainage (I&D) for breast abscess. We reported a case of chronic lactiferous fistula secondary to previous I&D for breast abscess in 31 year old lactating woman.
Solid papillary breast carcinoma is a rare type of breast carcinoma. We present four cases which highlight the radiological and histological findings of solid papillary carcinoma. Mammogram supplemented with ultrasound played an important role in detecting solid papillary carcinomas which usually presents as intraductal lesions or intracystic mass with Doppler signal. Excision biopsy is a better option than core biopsy as the latter modality may not be representative and the diagnosis of solid papillary breast carcinoma may be missed.
The aim of this study was to determine the incidence of torus palatinus and torus
mandibularis in Malaysians. The objectives are to evaluate the incidence of tori according to
ethnicity, to assess the incidence of tori according to gender and to determine the incidence of
torus palatinus vs torus mandibularis. (Copied from article).
Introduction: The purpose of this study was to determine the prevalence of defaulters of immunization, and their associated risk factors among children age 12 to 24 months. Materials and Methods: A cross-sectional study was conducted in all government's maternal child health clinics in District of Kota Kinabalu, Sabah. Data was collected using a standardised questionnaire from July to November 2006. Results: The prevalence rate for defaulting immunization was 16.8% from the 315 respondents. Bivariable analysis showed various significant factors associated with defaulters such as mother’s employment status, family mobility, transportation and cost. Nonetheless, multivariable analysis showed only mother’s age, mother employment status and family size were the significant predictors for defaulting immunization. Immunization that had the highest rate of defaulters was DPT–OPV booster dose (56.6%), followed by MMR immunization (43.4 %) and
DPT-Hib/OPV and Hep B third dose (37.7%).Conclusion: Employed mothers with bigger family size should be more closely monitored and advised to reduce the chance of defaulting on the immunization. Health promotion activities also should focus to these groups of mothers.