MyMedR

Fulltext The effectiveness of a Malaysian House Officer (HO) preparatory course for medical graduates on self-perceived confidence and readiness: A quasi-experimental study

Rashid AA, Ghazali SS, Mohamad I, Mawardi M, Musa H, Roslan D

PLoS One, 2020;15(7):e0235685.

PMID: 32678838 DOI: 10.1371/journal.pone.0235685

INTRODUCTION: House Officer (HO) Preparatory Courses in Malaysia are designed to prepare medical graduates to work as a HO. The courses are designed to address the issues related to lack of confidence and readiness to work, which could lead to stress and HO dropping out of work. The modules focus on how to prepare medical graduates into the real-life working scenario. Hence, we determined the effectiveness of a HO Preparatory Course on the level of confidence and readiness to work among medical graduates.

METHODOLOGY: A quasi-experimental study was conducted at three time-points (pre-intervention, post-intervention and one-month after working as a HO) on the level of confidence and readiness of medical graduates. The intervention was the Medicorp module, which included information and training needed for the HO such as common clinical cases in the wards, case referrals, experience sharing and hands on clinical training. We recruited eligible participants undergoing the course between April-November 2018. The adapted IMU Student Competency Survey was used to measure the confidence and readiness levels, which were scored from a Likert scale of 1-5. The higher score indicated higher levels of confidence or readiness.

RESULTS: A total of 239 participants were recruited at baseline (90% response rate). They were mostly female (77.8%), Malays (79.1%), single (90.0%), graduated overseas (73.6%), in 2018 (65.3%). The mean (SE) confidence scores significantly increased from 2.18 (1.00) pre-course to 3.50 (0.75) immediately after course and 3.79 (0.92) after one-month of work (p <0.001, η2 = 0.710). The mean (SE) readiness scores at pre-course, immediately and one-month post work were 2.36 (1.03), 3.46(0.78) and 3.70(0.90), respectively (p< 0.001, η2 = 0.612).

CONCLUSION: The HO Preparatory Course module was effective in increasing levels of confidence and readiness for medical graduates, most of whom are overseas graduates; namely Egypt, Russia and Indonesia.

Mantle Cell Lymphoma: A Rare Vallecular Tumour

Lo R, Mohamad S, Krishnamoorthy M, Mohamad I, Zulkarnain S, Hussain FA

Medeni Med J, 2020;35(1):67-70.

PMID: 32733752 DOI: 10.5222/MMJ.2020.22208

Vallecular lymphoma is an extremely rare tumour of oropharynx. We report a case of 61-year-old gentleman presented with severe dysphagia and globus sensation for two months. Patient underwent endoscopic transoral tumour debulking for diagnostic and therapeutic purpose. Histopathologically, patient was diagnosed as mantle cell lymphoma (MCL). In this case report, atypical presentation of the disease, histopathological features and its current treatments are discussed.

Carcinosarcoma of the Mediastinum: A Rare Cause of Vocal Cord Palsy and Progressive Dysphagia

Kanesan N, Mohamad I, Mohamad Umbaik NA, Zawawi N

Medeni Med J, 2020;35(2):166-169.

PMID: 32733767 DOI: 10.5222/MMJ.2020.82956

Carcinosarcoma is a rare type of malignant tumour that possess both the elements of carcinoma and sarcoma. They may occur in various locations such as the uterus, breast, thyroid, lung and gastrointestinal system. However, very few primary mediastinal carcinosarcomas have been reported. We are presenting a case of a 75-year-old male who presented with progressive dysphagia and hoarseness for 3 weeks. Contrast-enhanced computed tomography of the neck showed features of enlarged mediastinal necrotic nodes and the biopsy of this mass showed morphology and immunohistochemical profile that are consistent with carcinosarcoma. However, the patient succumbed to his illness soon after diagnosis.

Ex Utero Intrapartum Treatment (Exit) of Gigantic Intrapartum Lymphangioma and Its Management Dilemma - A Case Report

Lo RH, Mohd NKN, Abdullah K, Aziz A, Mohamad I

Medeni Med J, 2020;35(2):161-165.

PMID: 32733766 DOI: 10.5222/MMJ.2020.06992

With the advancement of radiological investigation, intrapartum detection of fetal abnormalities is now precisely performed. Lymphangiomas are now diagnosed even before patient is born. The swelling may be gigantic and potentially life-threatening during the delivery. Nowadays, it is still a great challenge to doctors as how to deliver the baby together with the big neck mass. We present a case of huge intrapartum neck lymphangioma, for which we performed ex-utero intrapartum treatment (EXIT) procedure, followed by excision of the lesion later. The challenges on managing both mother and infant will be discussed.

Kimura Disease with Parotid Swelling and Cervical Lymphadenopathy: A Case Report and Literature Review

Eh Dam VSK, Mohamad S, Mohamad I

Medeni Med J, 2020;35(2):170-174.

PMID: 32733768 DOI: 10.5222/MMJ.2020.84594

Kimura disease (KD) is a rare chronic benign inflammatory disorder of unknown etiology that is prevalent in Asian males. The head and neck region, especially the parotid glands and cervical lymph nodes, are most commonly affected. Diagnosis is based on clinicopathological features, while radiology findings are nonspecific. Although various treatment strategies have been proposed, there is a high recurrence rate. Combination therapy has been found to produce better results than monotherapy. We present a case of KD with huge parotid and cervical lymph node involvement that was treated with a combination of surgery and corticosteroids administered perioperatively.

Fulltext The Insights of Head and Neck Non-Hodgkin Lymphoma

Wan Abdul Rahman WF, Mohamad I

Medeni Med J, 2020;35(2):179-180.

PMID: 32733770 DOI: 10.5222/MMJ.2020.23682

Fulltext Purulent Discharge on the Pharyngeal Wall

Sefein M, Mohamad I, Hayati F, Ng CY

Oman Med J, 2021 Jan;36(1):e228.

PMID: 33628463 DOI: 10.5001/omj.2021.24

Real-time loop-mediated isothermal amplification assay for rapid detection of human papillomavirus 16 in oral squamous cell carcinoma

Hamzan NI, Ab Rahman N, Suraiya S, Mohamad I, George Kalarakkal T, Mohamad S

Arch Oral Biol, 2021 Apr;124:105051.

PMID: 33581498 DOI: 10.1016/j.archoralbio.2021.105051

OBJECTIVE: The present study established a real-time loop-mediated isothermal amplification (qLAMP) for rapid detection of human papillomavirus subtype 16 (HPV-16) in oral squamous cell carcinoma (OSCC).

METHODS: The qLAMP assay was optimized targeting the HPV-16 E7 gene. The analytical sensitivity and specificity of the assay were determined using HPV-18 (ATCC® 45152D™), HPV-35 (ATCC® 40330™), HPV-43 (ATCC® 40338™) and HPV-56 (ATCC® 40549™) viral strains and oral bacteria. HPV-16 standard curve was constructed for determination of HPV-16 viral load. The diagnostic performance of the assay was evaluated from 63 OSCC patients comprising 63 tissue, 13 saliva and 49 blood samples, in comparison with p16 immunohistochemistry (IHC), in-house PCR and nested PCR assays.

RESULTS: The detection limit of developed LAMP and PCR assays was 4.68 × 101 and 4.68 × 103 copies/μl, respectively. qLAMP assay enabled detection of positive results as early as 23 min at 67 °C. This assay can detect HPV-16 positivity in 23 % (3/13) saliva and 4.8 % (3/63) tissue samples with the viral load ranging from 4.68 × 101 to 4.68 × 104 copies/μl. HPV-16 positivity was not detected in all the blood samples. The sensitivity and specificity of qLAMP were 100 % in comparison with that of p16 IHC and nested PCR.

CONCLUSION: This study reports for the first time on the use of qLAMP assay for detection of HPV-16 in OSCC in both tissue and saliva as the sample matrix which holds promise in improving the diagnostic application owing to its rapidity, simplicity, high sensitivity and specificity.

Malignant Transformation of Juvenile Recurrent Respiratory Papillomatosis

Muhammad Fauzi HG, Mohan Singh AS, Abdul Rahim S, Chooi LL, Ramasamy V, Mohamad Pakarul Razy NH, et al.

Gulf J Oncolog, 2021 May;1(36):79-81.

PMID: 35017141

Malignant transformation of recurrent respiratory papillomatosis (RRP) is a rare entity occurring in only less than 5% of patients with RRP. The risk of transformation can arise even in the absence of risk factors such as smoking and radiation. We describe a patient with juvenile RRP diagnosed since childhood, who suffered malignant transformation into a squamous cell carcinoma after 29 years. Keywords: Recurrent respiratory papillomatosis; laryngeal neoplasms; squamous cell carcinoma; human papilloma-virus.

Fulltext Challenges and Adaptation in Otorhinolaryngology Practice During Pandemic Lockdown: Experience from a Malaysian COVID-19 Hospital

Sultan Abdul Kader MI, Razak SS, Ramanna VR, Esa NK, Ahmad AR, Mohamad I

Malays J Med Sci, 2021 Jun;28(3):143-150.

PMID: 34285652 DOI: 10.21315/mjms2021.28.3.13

COVID-19 has taken the world by storm: since the first few cases appeared in Wuhan, China in December 2019 and by June 2020 there were more than 10 million cases of COVID-19 cases worldwide. Malaysia had its first case in January 2020 and acted promptly by implementing several drastic measures to contain the disease. Subsequently, the Ministry of Health Malaysia has implemented guidelines and recommendations on the management of COVID-19. The Department of Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) provides services for patients with ear, nose, throat, head and neck diseases and provides audiology, speech and language therapy, as well as undergraduate and postgraduate training. As the department's staff is heavily involved in examinations and interventions of upper aerodigestive tract problems, the challenges are distinctly different from other specialties. This article discusses how COVID-19 affected ORL-HNS services and what measures were taken in Hospital Melaka, Malaysia.

Fulltext The Role of Social Media in Making an Impact to Health Knowledge and Behaviour on COVID-19 in Malaysia

Rashid AA, Mohamad I, Mohd Haris AF

Malays J Med Sci, 2021 Jun;28(3):155-157.

PMID: 34285654 DOI: 10.21315/mjms2021.28.3.15

Fulltext The Influence of Reaction Time on Non-Covalent Functionalisation of P3HT/MWCNT Nanocomposites

Nurazzi NM, Abdullah N, Demon SZN, Halim NA, Mohamad IS

Polymers (Basel), 2021 Jun 09;13(12).

PMID: 34207577 DOI: 10.3390/polym13121916

Non-covalent functionalisation of the carbon nanotube (CNT) sidewall through polymer wrapping is the key strategy for improving well-dispersed CNTs without persistent alteration of their electronic properties. In this work, the effect of reaction time on regioregular poly (3-hexylthiophene-2,5-diyl) (P3HT)-wrapped hydroxylated multi-walled CNT (MWCNT-OH) nanocomposites was investigated. Five different reaction times (24, 48, 72, 96, and 120 h) were conducted at room temperature in order to clearly determine the factors that influenced the quality of wrapped MWCNT-OH. Morphological analysis using Field Emission Scanning Electron Microscopic (FESEM) and High-Resolution Transmission Electron Microscope (HRTEM) analysis showed that P3HT successfully wrapped the MWCNT-OH sidewall, evidenced by the changes in the mean diameter size of the nanocomposites. Results obtained from Raman spectroscopy, X-ray Photoelectron Spectroscopy (XPS) as well as Thermogravimetric Analysis (TGA) showed a significant effect of the wrapped polymer on the CNT sidewall as the reaction time increased. Overall, the method used during the preparation of P3HT-wrapped MWCNT-OH and the presented results significantly provided a bottom-up approach to determine the effect of different reaction times on polymer wrapping to further expand this material for novel applications, especially chemical sensors.

Fulltext Managing supraglottitis in the COVID-19 era

Sahril S, Narayanan MS, Mohamad I

Vis J Emerg Med, 2021 Jul;24:101092.

PMID: 34277997 DOI: 10.1016/j.visj.2021.101092

Challenges in conducting post graduate otorhinolarygology-head and neck surgery specialty examination in the time of pandemic

I Mohamad I, Hamizan A, Abdullah B

Med J Malaysia, 2021 08;76(Suppl 4):45-48.

PMID: 34558559

No abstract provided.

Fulltext Missed by RTK, caught by PCR, unimagined chest Radiograph

Mazlan MZ, Mohamad I, Deris ZZ

Vis J Emerg Med, 2021 Oct;25:101194.

PMID: 34642642 DOI: 10.1016/j.visj.2021.101194

Lichenoid uvula mass as a rare cause of hot potato voice and progressive dysphagia

Kandiah R, Aziz A, Nik Min NFA, Rahim MR, Zawawi N, Sayuti KA, et al.

Malays J Pathol, 2021 Dec;43(3):457-461.

PMID: 34958068

Lichenoid uvula mass is an unusual entity and the clinicopathologic entities are important for the diagnosis. In this case report, we report an elderly lady presented with dysphagia and "hot potato voice" due to a lichenoid uvula mass. Apart from muffled voice, the other associated symptoms are dysphagia, sore throat, globus pharyngeus and snoring. She was a non-smoker, and not on any medications except for hypertension and dyslipidaemia. Apart from the enlarged uvula, other parts of the oral cavity, oropharynx and larynx were normal. She has no other signs such as cutaneous lesions. The mass was excised under general anaesthesia followed by resolution of symptoms. Awareness of this entity, the clinical and histopathological features should be highlighted to differentiate it from other diagnosis.

Traumatic Neck Injury: An Accidental Impalement by a Needlefish

Ali AA, Gurung R, Hayati F, Zakaria AD, Mohamad I, Ching FF

Wilderness Environ Med, 2021 Dec;32(4):517-521.

PMID: 34479771 DOI: 10.1016/j.wem.2021.07.006

Encounters between marine animals and humans can result in critical injury and fatal complications. We highlight a 20-y-old male who sustained a penetrating injury to the neck as a result of impalement by needlefish (Tylosurus sp) while snorkeling. He sustained a penetrating injury in the posterior triangle of the neck. On presentation, he was stabilized and received empirical antibiotics, analgesia, and antitetanus toxoid injection before being transferred to a tertiary center. On presentation to the tertiary hospital, the patient was hemodynamically stable with no clinical evidence of injury to surrounding neck structures, and this was confirmed using computed tomography. The patient underwent local wound exploration and retrieval of the needlefish beak under general anesthesia. The wound was left open to heal by secondary intention. The patient was discharged with oral antibiotics and went on to make a complete recovery.

Fulltext Acute Retropharyngeal Calcific Tendonitis as a Rare Cause of Odynophagia and Neck Pain

Singh PKM, Noor MIM, Jaafar R, Ahmad A, Mohamad I

Medeni Med J, 2021;36(1):75-79.

PMID: 33828894 DOI: 10.5222/MMJ.2021.37539

Retropharyngeal calcific tendonitis (RCT) is an aseptic inflammatory process of the superior oblique tendons of the longus colli muscle caused by the deposition of calcium hydroxyapatite crystals. We reported a 23-year-old woman who presented with a sudden onset of neck pain with odynophagia after waking up from sleep. Physical examination showed paracervical point tenderness with limited neck movement in all directions. Prior to surgery, further imaging was requested to aid in diagnosis, which in turn revealed RCT. It is important to be aware that RCT presentation may mimic other severe conditions such as retropharyngeal space abscess or meningitis.

Primary Eustachian Tube Tuberculosis

Hamzah MH, Mohamad I, Mutalib NSA

Medeni Med J, 2021;36(2):172-175.

PMID: 34234985 DOI: 10.5222/MMJ.2021.52460

Nasopharyngeal tuberculosis is a rare occurrence, and primarily involves the proximal part of the Eustachian tube. Mechanical obstruction of the Eustachian tube will affect the pressure discrepancy between the middle ear and the external atmosphere, leading to aural fullness, unilateral hearing disturbance, and otitis media. These conditions can be overlooked or mistakenly diagnosed as ear pathology. We report a case of unilateral hearing loss and tinnitus in a 31-year-old healthy woman that was later confirmed to be tuberculosis of the Eustachian tube. In cases with indicators suggesting a high index of suspicion, a thorough examination of the head and neck regions is especially very important. Once it has been diagnosed, Eustachian tuberculosis can be successfully treated with anti-tuberculosis medications.

Fulltext Submandibular Gland Basal Cell Adenoma

Salleh MN, Ahmad Kailani AAA, Nik Min NFA, Mohamad I, Hussain FA, Mat Zin AA

Iran J Otorhinolaryngol, 2022 Mar;34(121):131-134.

PMID: 35655769 DOI: 10.22038/IJORL.2021.58329.3007

INTRODUCTION: Basal cell adenoma (BCA) is a rare benign epithelial tumour of the salivary gland majorly involving the parotid gland, and rarely the submandibular gland.

CASE REPORT: We describe a rare case of BCA of the submandibular gland diagnosed preoperatively using fine needle aspiration cytology in a 60-year-old woman presenting with painless submandibular swelling. The surgery went uneventfully, and the histopathological examination confirmed the diagnosis.

CONCLUSIONS: BCA can be accurately diagnosed only through histological observations due to its resemblance to various benign and malignant salivary and non-salivary gland tumours, which are difficult to biopsy.

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