A retrospective study was carried out to determine the distribution of intraocular pressure in normal patients who came for vision problems at the Optometry Clinic, Universiti Kebangsaan Malaysia (UKM) Kuala Lumpur Campus, and to determine the differences in intraocular pressure with respect to age, gender and race. The cohort consisted of 148 subjects divided into five groups with age ranged from 10 to 59 years. The inclusion criteria were, subjects had no sistemic or ocular disease, subjects were not taking any medication, visual acuity was 6/6 or better, refractive errors < ±6.00D, astigmatism < 2.00D, anisometropia <2.00D, and mean intraocular pressure measured using the X-PERT tonometer and taken between 9 am to 2 pm. Statistical analysis (ANOVA) showed the mean intraocular pressure without consideration for age, race or gender was 12.6 mmHg (SD ±2.5). There was no significant differences in intraocular pressure between right and left eyes, between different age groups and between different genders. However, the intraocular pressuse for the Chinese was found to be significantly higher than the Malays. It was found that the intraocular pressure of patients who came for vision problems at the Optometry Clinic UKM follows a normal distribution and there was no significant diference found between right and left eyes, between different age groups and genders. Race seemed to contribute to the differences in intraocular pressure. Keywords: Age; clinic population; genders; pressure; intraocular pressure; race
Study site: Optometry clinic, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
Human bocavirus (HBoV) is a newly discovered parvovirus associated with respiratory disease in children. There are many reports worldwide on the endemicity of this virus. Since it is relatively new, detection in clinical laboratories is not routinely performed. We describe the first detection of HBoV in Malaysia in a 13-month-old boy with pneumonia and underlying asthma. The infective agent was confirmed by molecular methods.
Neurofibromatosis type 1 (NF1) is a variable penetrance autosomal dominant condition predominantly involving the peripheral nervous system. NF1 exhibits a wide spectrum of clinical patterns involving the skin, eye, brain, spinal cord, and, to a lesser extent, long bones and arteries. Arterial stenosis or aneurysms have been variously studied, but the association with NF1 has not been firmly established. A 31-year-old gentleman with NF1 experienced progressive neck pain over a five-month period, associated with limited range of motion and dysphagia. Magnetic resonance imaging (MRI) of the cervical spine suggests paraspinal plexiform neurofibromas with excessive reverse cervical lordosis. Further workups revealed a large left vertebral artery fusiform aneurysm and a pseudoaneurysm. The patient made a full recovery following endovascular embolization. It is crucial to maintain a high index of suspicion for vascular malformations in patients with NF1. The pathogenesis of vascular manifestations in NF1 and options for therapeutic management were discussed.
BACKGROUND: Ramadan fasting for pregnant women with diabetes remains controversial and underreported. The objective of this study was to determine the glycemic control in pregnant diabetic women on insulin who fasted during Ramadan.
METHODS: This was a retrospective study carried out over a period of three years including pregnant diabetic women, who were on short-acting, intermediate-acting, or a combination of them, and opted to carry out Ramadan fasting. Glycemic control was assessed before, middle and after Ramadan fasting.
RESULTS: Thirty seven women opted to fast with 24 (64.9%) of them had type 2 diabetes mellitus and 83.8% of them required combined insulin (short- acting, intermediate-acting) therapy. The age of the participants was 32.13±4.68 years, and the age of their pregnancies was 25.60±7.12 weeks when the study was performed. The median number of days fasted was 25 days, and most of the women were able to fast for more than 15 days. There was no difference between glycemic control of type 2 diabetes mellitus and gestational diabetes mellitus women prior to fasting. In the middle of Ramadan, serum fructosamine decreased in both groups. However, only serum HbA1c reduced in gestational diabetes mellitus after Ramadan.
CONCLUSION: the findings indicate that pregnant diabetic women on insulin were able to fast during Ramadan and that their glycemic control was improved during fasting period. They may also suggest that instead of absolute ban on fasting for pregnant diabetic women more practical approach and close consultation with health care providers might be more helpful.
KEYWORDS: Fasting; diabetes; gestational diabetes; insulin; pregnancy
Pheochromocytoma during pregnancy is potentially disastrous to the mother and fetus. Its ambiguous presentation is often mistaken for pre-eclampsia, although it may imitate other problems during pregnancy. Early diagnosis and timely, appropriate management reduces possible maternal and fetal complications. We identified a case of pheochromocytoma during pregnancy; the condition was initially diagnosed as pre-eclampsia complicated with gestational diabetes. Surgical intervention via left adrenalectomy was successfully performed in the second trimester. After surgery, all of the patient's medical problems nearly subsided and she did not require further treatment. However, her fetus displayed restricted intrauterine growth, and the patient eventually had premature delivery via a caesarean section. A multidisciplinary team to identify and treat pheochromocytoma is mandatory to ensure optimal conditions for tumour removal and to anticipate any possible catastrophic events.
The Identifying the dynamic metabolome of the individual in response to a particular stimulus using a metabolomic approach is an emerging research area. Measuring the postprandial metabolite response utilising a meal-challenge test (MCT) provides information beyond the fasting state, which is especially important since human beings spend most of their time in the postprandial state. This is pertinent as an excessive rise in postprandial glycaemia is common in individuals with type 2 diabetes mellitus (T2DM), which puts them at a high risk of developing cardiovascular disease (CVD). While a low glycaemic index (GI) meal improves postprandial glycaemia and insulin levels in MCT studies among individuals with T2DM, its effect on metabolite changes in the postprandial state is unclear. This review summarises the perturbation in postprandial metabolites following a low GI meal in comparison to that following a usual or high GI meal and maps the metabolites in their metabolic pathways. We undertook a literature review using electronic databases, with the Medical Subject Headings (MeSH) terms, to retrieve relevant studies based on specific criteria. A total of seven related studies were documented. For the majority of metabolites studied, it was identified that metabolic regulation following an MCT extends beyond the glucose pathway. Altered metabolic pathways after the consumption of a low GI meal include: i) essential amino acid metabolism by altering the levels of plasma phenylalanine, tyrosine, lysine, leucine, isoleucine and valine; ii) glycolysis and tricarboxylic acid (TCA) metabolism by altering citrate and alanine, and iii) gut microbiota metabolism by altering betaine and acetate. The altered metabolites regulated the pancreatic insulin secretion and related to other dietary factors beyond GI modifications. These metabolomics data need to be interpreted cautiously because the metabolic changes analysed might not be due to the beneficial effects of a low GI meal. Validation of the putative metabolomic biomarkers following a dietary intervention MCT is suggested because researchers need to fully understand the kinetics and metabolism of individuals metabolite before reaching a solid conclusion. Further research characterising the metabotype based on habitual dietary patterns is warranted.
The climate, geomorphological changes, and hydrological elements that have occurred have all influenced future flood episodes by increasing the likelihood and intensity of extreme weather occurrences like extreme precipitation events. River bank erosion is a natural geomorphic process that occurs in all channels. As modifications of sizes and channel shapes are made to transport the discharge, sediment abounds from the stream catchment, and floods are triggered dramatically. The aim of this study is to analyze the flood-sensitive regions along the Pahang River Basin and determine how climate and river changes would have an impact on flooding based on hydrometeorological data and information on river characteristics. The study is divided into three stages, namely the upstream, middle stream, and downstream of the Pahang River. The main primary hydrometeorological data and river characteristics, such as Sinuosity Index, Dominant Slope Range and Entrenchment Ratio collected as important inputs in the statistical analysis process. The statistical analyses, namely HACA, PCA, and Linear Regression applied in river classification. The result showed that the middle stream and downstream areas demonstrated the worst flooding affected by anthropogenic and hydrological factors. Rainfall distribution is one of the factors that contributed to the flood disaster. There are strong correlations between the Sinuosity Index (SI) and water level, which indicates that changes occurred at both planform and stream classification. The best management practices towards sustainability are based on the application of the outcomes that have been obtained after the analysis of Pahang River planform changes, Pahang River geometry, and the local rainfall pattern in the Pahang River Basin.
Various factors contribute to suicidal attempt. This study aims to determine the relationship between suicidal attempt and its associated factors among school-going adolescents in Malaysia. Data from the National Health and Morbidity 2017 survey were analyzed. This survey was implemented as a nationwide school-based survey targeting adolescents 13 to 17 years old. Descriptive and multiple logistic regression analysis was done using SPSS version 20. A total of 27 399 adolescents participated in this survey. The prevalence of suicidal attempt was 6.9% (95% confidence interval = 6.2-7.7). Multivariate analysis found that the odds of suicidal attempt among adolescent with depression is 4.3 (adjusted odds ratio = 4.3; 95% confidence interval = 3.9-4.8). Other significant factors are young adolescent, non-Malay ethnicities especially Indian, adolescent with parents living apart, and those without peer support and parental connectedness. A holistic approach for the planning of preventative strategies and public health policies should be made according to these risk factors.
Study name: National Health and Morbidity Survey (NHMS-2017)