Materials and Methods: Sixty-three diabetic foot patients admitted from June 15, 2019 to February 15, 2020. Methods included one-on-one interview for clinico-demographic data, physical examination to determine the classification. Patients were followed-up and outcomes were determined. Pearson Chi-square or Fisher's Exact determined association between clinico-demographic data, the classifications, and outcomes. The receiver operating characteristic (ROC) curve determined predictive abilities of classification systems and paired analysis compared the curves. Area Under the Receiver Operating Characteristic Curve (AUC) values used to compare the prediction accuracy. Analysis was set at 95% CI.
Results: Results showed hypertension, duration of diabetes, and ambulation status were significantly associated with major amputation. WIFi showed the highest AUC of 0.899 (p = 0.000). However, paired analysis showed AUC differences between WIFi, Wagner, and University of Texas classifications by grade were not significantly different from each other.
Conclusion: The WIFi, Wagner, and University of Texas classification systems are good predictors of major amputation with WIFi as the most predictive.
Material and methods: A 3-year-old intact male domestic shorthair cat weighing 3.7 kg was referred to the Universiti Malaysia Kelantan Veterinary Clinic with clinical signs of hematuria and dysuria. History revealed that it was managed outdoor, fed with kibbles and wet food, but with no vaccination and deworming. Upon physical examination, the cat had a dull appearance, pale mucous membrane, normal respiratory rate, hypothermia, and bradycardia. Upon the examination of the urogenital system, there were urine burns at the anal region, necrotized penile tip, and presence of bite wound observed at the perineal region. Turgid and enlarged urinary bladder was identified upon palpation.
Results: Diagnostic investigation revealed the hemotropic mycoplasmosis via microscopy, while urine culture was positive for Escherichia coli infection. The cat was successfully treated symptomatically.
Conclusion: However, the prognosis of this cat was guarded given that the anemia was unresolved at the point of discharge.
CASE REPORT: An 87-year-old male had a tumour nodule over the left parotid tail for about 20 years. Physical examinations revealed a 4.5 cm soft, non-tender and fixed mass. After the left parotidectomy, pathology confirmed the diagnosis of IDC arising within an intraparotid lymph node. The cystic component of the tumour was lined by single to multilayered ductal cells with micropapillary growth pattern. The solid part showed intraductal proliferation of neoplastic cells in solid, cribriform, micropapillary and Roman bridge-like structure. By immunohistochemistry (IHC), the tumour cells were positive for S-100, CK (AE1/AE3), mammaglobin, SOX10, and estrogen receptor (ER), with myoepithelial cell rimming highlighted by positive p63 and calponin IHC stains. The prognosis of this patient is excellent after complete excision.
DISCUSSION: The mechanism of salivary gland tumour arising in the intra-parotid gland LN was assumed to be related to salivary duct inclusion within the intraparotid gland LN which is a normal occurrence during embryology development. Although the terminology may raise some confusion about the relationship between IDC and conventional salivary duct carcinoma (SDA), they are different in immunophenotype and clinicopathologic features. IDC is characterised by S100 (+) ER (+) with predominant intraductal growth and excellent prognosis; while SDC features S100 (-) androgen receptor (+) with predominant invasive growth and aggressive behavior. Recent discovery of recurrent RET gene rearrangement in IDC but not SDC also supports that IDC is not precursor lesion of the SDC.
CASE PRESENTATION: We report a case of a middle-aged lady who presented with severe pain and morning stiffness over the small joints of the left hand for 3 months and painless deformity of the affected joints 1 year before. She was under treatment for pruritic rash over her ankles and knees for the past 1 year as well. Physical examination revealed a fixed flexion deformity, swelling and tenderness of the left ring and little fingers' distal interphalangeal (DIP) joints. Left hand radiograph showed sclerotic joint margin, narrowed joint space and marginal osteophytes of the affected DIP joints. Dermoscopic examination showed red- violaceous, flat-topped papules and plaques with minimal scales on both ankles; hyperpigmented scaly plaques over both knees and vertical fingernail ridges. Serum autoimmune screening and inflammatory markers were unremarkable. Left ankle skin biopsy showed features consistent of psoriasis. PsA was diagnosed. Weekly titrated oral methotrexate and topical steroid were started. The patient showed significant improvement after 1 month of treatment.
CONCLUSION: PsA is a great mimicker. Dermoscopy is an accessible and valuable tool to assess skin lesions in greater detail. Clinicians should be aware of coexisting diseases or misdiagnosis when patients do not respond to treatment.
METHODS: A nationwide population-based survey involving 3977 community-dwelling older persons aged ≥60 years was conducted via face-to-face interview, of whom 3466 older persons were eligible for screening using a locally validated tool. Elder abuse was defined as any one occurrence of neglect, financial, psychological, physical or sexual abuse perpetrated by someone in a position of trust that was experienced in the past 12 months.
RESULTS: About 9.0% of older persons in Malaysia have experienced elder abuse in the past 12 months, with neglect being the commonest type experienced (7.5%; 95% confidence interval [CI]: 5.54, 10.07). There is no significant difference by age group and geographical location. Males (adjusted odds ratio [aOR] 1.7; 95% CI: 1.06, 2.60), poorer social support (aOR 5.0; 95% CI: 2.25, 11.22), dependency in activities of daily living (aOR 2.1; 95% CI: 1.23, 3.44) and a previous history of abuse (aOR 10.1; 95% CI: 4.50, 22.86) show higher odds of experiencing elder abuse. Almost 5% of abused older persons reported experiencing multiple types of abuse. Reporting is low at 19.3% with none reporting to healthcare personnel.
CONCLUSIONS: The prevalence of elder abuse in this study is lower than global estimates, but similar to local studies. Preventive measures and programs are crucial to overcoming elder abuse and need to be carried out at multiple levels - the individual, community, healthcare and other stakeholders. Geriatr Gerontol Int 2020; 20: 85-91.
Methods: It was a cross-sectional study using online questionnaire, carried out in a public university in Sarawak, Malaysia. All medical and nursing students were invited to participate in this study. Data was entered and analysed using IBM SPSS version 22.
Result: A total of 304 respondents participated in the study, with 81.6% female and 69.4% medical students. Majority of the respondents were most willing to take a medical history, do a physical examination, throat swabbing, draw blood and perform IV drip insertion. There was a high commitment among respondents to treat COVID-19 patients regardless of personal risks. Majority of the respondents also agreed that medical staff who are involved in treating COVID-19 patients should be receiving a salary increase and compensation should be given to affected healthcare families, and all non-medical staff should be involved in treating COVID-19 patients. About 71% agreed about a law mandating medical staffs to treat patient.
Conclusion: The willingness and commitment of medical and nursing students to treat COVID-19 patients was high, indicating their potential work force as healthcare providers.
METHODS: A total of 416 parents with children aged between two months old and 17 years old were participated in this cross-sectional survey. The responses of parents' observation on signs and symptoms of eye problems were compared between one open-ended question and ten close-ended questions. We also examined the demographic contributing factors that could influence parental responses.
RESULTS: The total count of reported signs and symptoms through open-ended and close-ended question was 164 and 529 reports, respectively. Parents reported more diverse (70% higher) categories of signs and symptoms in open-ended compared to close-ended questions. Parent's ability to report eye problems using open-ended question was associated with their gender (p<0.05), but no similar significant association was found in close-ended questions.
CONCLUSION: Parents reported more signs and symptoms of eye problems among their children through close-ended questions (regardless of gender) and more diversified categories through open-ended question in this study suggested that different communication approaches might be needed in clinical practice between those who requested specific appointment and those attending screening or routine assessment. The discrepancy might imply the importance to enhance the parent's role in preventive eye care. Effective communication between eyecare providers and parents has the potential to improve paediatric eyecare delivery.