Erotomania is a rare subtype of delusional disorder, whereby the affected person believes that another individual, usually someone with higher socio-economic status, is in love with them despite having little or no contact. To the best of our knowledge, this is the first published case of same gender erotomania, involving a 28-year-old single lady and a 42-year-old divorcee towards a female psychiatrist. We aimed to share the challenges experienced by the managing psychiatrist as she inopportunely became the theme of her patients' delusion. We also reviewed and discussed recent literature on erotomania to create awareness among psychiatrists towards this rare psychiatric condition.
Many new objective tests to assess the function of specific structures of the vestibular organ are currently adopted in vestibular clinics. One of the objective assessments include the video head impulse test (vHIT) where gain & velocity responses of eye relative to the head movements are recorded using an infrared camera. Methods: Thirty normal hearing subjects age between 18 to 25 years old participated in this study. At least ten Lateral, Left Anterior Right Posterior (LARP), and Right Anterior Left Posterior (RALP) responses were recorded for each participant by making small and rapid unpredictable head movements. Results: The average velocity gain for Lateral responses at 40 ms, 60 ms and 80 ms were 1.05 ± 0.003, 1.03 ± 0.002 and 1.01 ± 0.003 respectively. The LARP average velocity regression were 1.01 ± 0.24 for Left Anterior and 1.05 ± 0.25 for Right Posterior, with an average gain asymmetry of 5.13%. The RALP average velocity regression were 1.08 ± 0.31 for Right Anterior and 1.12 ± 0.30 for Left Posterior, with an average gain asymmetry of 5.87%. One sample T-test were conducted to compare Lateral responses to a previous study by Mossman et al. (2015) where significant differences in velocity gain at 60 ms and 80 ms between studies were found where, t (59) = 5.56, p
Motivation, especially on the relationship of remuneration of government doctors to it, has long been an issue of concern. This study sought to elucidate the demotivating factors in service and the perceived discrepancy in income. It was conducted amongst doctors serving in the Ministry of Health, Negeri Sembilan, using self-administered questionnaires. Factors considered demotivating were remuneration, workload and recognition given. Career development, promotion prospects, issues with superiors, resources and patient attitudes were other factors identified. On average, respondents expect an income of 1.63 times more than their current drawn salary and 87.2% cited rewards as a recommendation to improve their satisfaction in service. In-service training was desired by almost all. Though the medical profession has traditionally been viewed as altruistic in nature, doctors in service are voicing out their views and perception, and they should be heard.
A cross sectional study was carried out in Negeri Sembilan to identify factors associated with job satisfaction of doctors serving in Ministry of Health and their intentions to resign. All Ministry of Health doctors currently working in Negeri Sembilan were included in the study and data collection was done via a self-administered postal questionnaire. The response rate was 69.4%. Out of those who responded, only 31.3% had global job satisfaction, with the majority dissatisfied. Intention to resign was high among 32.7% of the respondents. Factors found to be significantly associated with job satisfaction were age, job designation, income, duration of service and intention to resign. Intention to resign was found to be significantly associated with ethnicity and income. From logistic regression, predictors of job satisfaction identified were age, place of first graduation, and satisfaction with status and autonomy, satisfaction with career development, satisfaction with workload and satisfaction with transfers. Predictors of intention to resign were race, income and global job satisfaction.
C-C motif Chemokine Ligand 3 Like 1 (CCL3L1) is characterized as a gene with copy number variable (CNV) and clustered at the segmental duplication on chromosome 17q12. CCL3L1 is responsible for the production of mac- rophage inflammatory protein (MIP) 1α that plays an important function in the immune system and host defense. Various copies range of CCL3L1 have been reported and associated with the diseases in different populations. Thus, this review aimed to summarise the distribution of CCL3L1 copy number from different populations according to the geographical region and highlighted the lacking of data from Malaysian population, which is one of the multi-ethnic countries due to the impacts of CCL3L1 copies on various diseases. Besides, we also outlined the methodologies available for the copy number typing. In overall, this review could provide significant information on the role of CCL3L1 copies in disease association and as well as providing evidence on the population diversity.
This study was carried out to determine the concentration of lead (Pb), anions, and cations at six primary schools located around Kuala Lumpur. Low volume sampler (MiniVol PM10) was used to collect the suspended particulates in indoor and outdoor air. Results showed that the concentration of Pb in indoor air was in the range of 5.18 ± 1.08 μg/g-7.01 ± 0.08 μg/g. All the concentrations of Pb in indoor air were higher than in outdoor air at all sampling stations. The concentrations of cations and anions were higher in outdoor air than in indoor air. The concentration of Ca(2+) (39.51 ± 5.01 mg/g-65.13 ± 9.42 mg/g) was the highest because the cation existed naturally in soil dusts, while the concentrations of NO3 (-) and SO4 (2-) were higher in outdoor air because there were more sources of exposure for anions in outdoor air, such as highly congested traffic and motor vehicles emissions. In comparison, the concentration of NO3 (-) (29.72 ± 0.31 μg/g-32.00 ± 0.75 μg/g) was slightly higher than SO4 (2-). The concentrations of most of the parameters in this study, such as Mg(2+), Ca(2+), NO3 (-), SO4 (2-), and Pb(2+), were higher in outdoor air than in indoor air at all sampling stations.
Selenium is a micronutrient mineral found mainly in soils. Studies on selenium have increased rapidly worldwide especially after it has been shown to reduce the risk of certain types of cancer in humans and animals. The exact mechanism of action on how selenium inhibits diseases, in particular cancer, is still unknown. To date, the use of selenium in preventing or treating diseases is limited. However, many aspects about the biochemistry of selenium have been identified. This article reviews a number of key clinical, experimental and epidemiological studies on selenium as an anti-carcinogenic agent for some types of cancers. Some nutritional information on selenium and its recommended intake are also included. More clinical and experimental studies are needed to confirm previous findings on the role of selenium as an anticarcinogenic agent.
Supracardiac total anomalous pulmonary venous drainage is commonly associated with a left-sided ascending vein draining into innominate vein. We present a case of a newborn with a right-sided ascending vein, draining into the right superior caval vein with stenosis at the SVC-ascending vein junction, posing a surgical dilemma in corrective surgery. Usage of three-dimensional computed tomographic scan was essential in delineating the anatomy and aiding surgery. The case demonstrates the rarity of this type of cardiac disease and the complications that develop.
We described the case of a 42-year-old man who presented with left index finger mass persisting for 6 months. The mass was small and, painless and had gradually increased in size with limited finger flexion. Physical examination showed a firm mass over the volar surface of the left index finger. There was no tenderness, redness, warmth or punctum. The overlying skin was normal, and the mass did not transilluminate. Further examination of the head and neck, chest, upper limbs and neurovascular system revealed normal findings. No similar masses were found elsewhere in the body. Bedside ultrasound with further investigation and management confirmed the suspected diagnosis.
Irritant contact dermatitis (ICD) is a common skin condition in primary care. The frequent cause of ICD includes hair dye, nail polish, paints, cleaners, soap, and detergent. We present a case of ICD caused by topical garlic medicament, successfully identified and managed in primary care. A 20-year-old woman presented with a sudden onset of multiple painful localized blisters on the right antecubital fossa. She reported applying raw garlic paste to the area one day before the clinic visit to treat mild itchiness. She had no known allergies or medical illnesses. Otherwise, there were no rashes elsewhere or oral and genital ulcers. She was not on any regular medication or taking traditional medication. Examination revealed multiple bullae on the antecubital fossa with perilesional erythema. The lesion was sharply bordered within the contact areas, was asymmetric, and did not spread elsewhere. The clinical history of immediate bullae formation after direct contact with garlic was consistent with ICD due to garlic medicament. The lesions were managed with regular dressings. At one week follow-up, the lesions had healed well. She was advised to avoid further application of topical garlic medicines. Although Allium sativum (garlic) has been used either topical or orally as a medicinal treatment worldwide for thousands of years to treat various conditions, it still has the potential to cause irritant dermatitis when applied to skin and mucosa. Patients and healthcare providers should be cautious of the potential side effects, such as ICD, when using garlic for medicinal purposes.
Objectives Diabetic retinopathy (DR) is a major cause of blindness and its prevalence is increasing. Fibrate, specifically fenofibrate, has been shown to be efficacious in reducing the progression of DR. This study aims to determine the five-year trend of and factors associated with the prescription of fibrate among patients with DR in Perak. Methods Data on all patients with DR in 76 government health clinics in Perak who were audited between 2018 and 2022 were extracted from the National Diabetes Registry (NDR), excluding those who were lost to follow-up. Multivariable logistic regression was used to identify factors associated with the prescription of fibrates. Results Data from 4028 patients were analysed. Commonly prescribed medications were statins (n = 3466, 86.0%), metformin (n = 3212, 79.7%), and angiotensin-converting enzyme inhibitors (n = 2318, 57.5%). Only 63 (1.6%) patients were prescribed fibrate. Factors associated with the prescription of fibrates were patients from the clinics in northern (adjusted odds ratio (aOR) = 0.33, 95% CI: 0.12-0.65) and southern clusters (aOR = 0.23, 95% CI: 0.08-0.655), triglycerides > 1.7 mmol/L (aOR = 4.85, 95% CI: 1.85-12.70), and prescription of insulin (aOR = 2.77, 95% CI: 1.07-7.18) and statin (aOR = 0.10, 95% CI: 0.04-0.27). Conclusion The prescription of fibrate among patients with DR was low, highlighting a missed opportunity for early treatment and improved outcomes in primary care. The prescription of fibrates to reduce the progression of DR should be expanded to primary care. Clinicians should consider the factors associated with the non-prescription of fibrate identified when prescribing to these patients. Policies, including those at the ministry level, to enhance the availability of these medicines, including financial resources for procurement, are necessary to guarantee easy access for patients in different areas. It is crucial for healthcare providers to be knowledgeable about and follow guidelines. Moreover, improving the overall management of DR in patients with multiple comorbidities can be achieved by addressing worries about the side effects of combination therapies through educational campaigns and providing clear directives. Nevertheless, the study's findings should be interpreted in light of the limitations discussed.
Perkhidmatan penghantaran makanan adalah satu perniagaan yang semakin popular
di Malaysia. Permintaan terhadap perkhidmatan ini bukan sahaja daripada kalangan
pekerja pejabat, tetapi juga daripada kalangan mahasiswa di universiti. Oleh itu,
tujuan utama kajian ini adalah untuk mengenal pasti sosioekonomi mahasiswa yang
menggunakan perkhidmatan ini, dan juga menganalisis atribut dan persepsi
penggunaan perkhidmatan penghantaran makanan dalam kalangan mahasiswa di
Universiti Putra Malaysia (UPM). Kajian ini terdiri daripada 200 orang mahasiswa
UPM yang dipilih secara persampelan rawak sistematik. Persempelan Rawak
sistematik dijalankan bagi mendapatkan responden di empat kolej kediaman yang
terpilih. Soal selidik yang digunakan berasaskan Kurtz model. Ia bertujuan untuk
mengetahui atribut perkhidmatan yang ada di pasaran kini, dan persepsi penggunaan
perkhidmatan penghantaran makanan dalam kalangan mahasiswa. Hasil kajian
menunjukkan responden wanita dan responden dari bandar lebih ramai
menggunakan perkhidmatan penghantaran makanan. Atribut perkhidmatan yang
paling tinggi peratusnya ialah atribut perkhidmatan ini memudahkan. Perkhidmatan
penghantaran makanan memudahkan mahasiswa mendapat makanan dan
memenuhi keperluan fisiologi. Responden dalam kajian ini berpuas hati
menggunakan perkhidmatan penghantaran makanan ini. Hasil kajian ini
menyumbang data kepada pengusaha restoran yang menjual makanan secara atas
talian apatah lagi pada era Covid-19. Data ini dapat digunakan oleh pengusaha
restoran dalam memahami pengguna atas talian serta mengatasi permasalahan
pengguna, terutama golongan mahasiswa.
Objective: Delusional infestation is a psychiatric condition in which a patient
belief that they are infested with living organisms in the absence of any objective
evidence. The objective of this case report is to highlight a rare case of delusional
infestations in a patient with schizophrenia who misusing polysubstance abuse.
Methods: We report a case of 36-year-old Malay gentlemen, unemployed,
married with three children, known case of schizophrenia since 2013, with
history of polysubstance abuse presented to the emergency department with
symptoms of itching followed by a sensation of insects crawling, biting and
burrowing under the skin on his head causing an ulcerated wound. Results: He
was diagnosed to be suffering from schizophrenia and was successfully treated
with monthly antipsychotic depot injection in view of his poor adherence to
medication On examination, ulcerated scalp wound measuring 4 x 4 cm was
noted at the parieto-occipital region of the scalp. Skull X-ray and computerized
tomography (CT) scan of the brain were normal. Electroconvulsive therapy
(ECT) was introduced in view of slow treatment response and self-inflicted
injury. The symptoms were successfully controlled after eight months, and no
extrapyramidal side effect was observed. Conclusion: Patients with delusional
infestation often poorly adhered to his treatment medication and the usage of
depot injection of antipsychotic may benefited some patients to control the
psychotic symptoms.
A faster method for sample preparation and qualitative analysis of phytohormones, i.e. abscisic acid (ABA), indole-3-acetic acid (IAA) and 1Â-aminocyclopropane-l-carboxylic acid (ACC) is reported. Solid phase extracÂtion of Umbellifereae sp. plant extract was performed using C18 catridge ana the effluent collected was reacted to form the pentafluorobenzyl derivatives of ABA, IAA and ACC mixture. The derivatives mixture was separated and negative ion chemical ionization was carried out by using methane in a gas chromatograph-mass spectrometric instrument (GC-MS). Mass spectra of the three phytohormones are quite simple and therefore suitable for selective ion monitoring (S/M) at high sensitivity, together with their respective internal standards labeled with deuterium. However, only IAA can be determined quantitatively by GC-MS technique through the peak area ratio of SIM chromatograms for m/z 179 with m/z 174. This method allows the correction for the loss of IAA endogen during extraction when compared to the internal standard without the need for precise sampling, except during addition of the internal standard. The detection limit of IAA by this method is 5 femtomole/g wet weight of the plant.
Satu kaedah penyediaan sampel dan analisis kualitatif yang pantas bagi fitohormon iaitu asid absisik (ABA), asid indol-3-asetik (IAA) dan asid 1Â-aminosiklopropana-l-karboksilik (ACC) dilaporkan. Ekstrak daripada tumbuhan Umbellifereae sp. dilakukan pengekstrakan fasa pepejal dengan menggunakan katrij C18 dan efluen yang dipungut ditindakbalaskan bagi membentuk terbitan pentafluorobenzil bagi campuran ABA, IAA dan ACC. Campuran terbitan tersebut dipisahkan dan dilakukan pengionan kimia ion negatif dengan menggunakan metana di dalam instrumen kromatografi gas-spektrometri jisim (GC-MS). Spektrum jisim tiga hormon tersebut agak mudah dan oleh itu adalah sesuai bagi pemonitoran ion terpilih (S/M) pada kepekaan tinggi bersama dengan piawai dalaman masing-masing yang berlabel deuterium. Walau bagaimanapun, penentuan kuantitatif hanya dapat dilakukan untuk IAA menggunakan kaedah GC-MS melalui penisbahan luas puncak kromatogram S/M bagi m/z 179 dengan m/z 174. Ini membolehkan pembetulan kehilangan IAA endogen semasa pengekstrakan berbanding piawai dalaman tanpa perlu pensampelan yang teliti, kecuali semasa penambahan piawai dalaman. Had pengesanan bagi IAA melalui kaedah ini ialah 5 femtomol/g berat basah tumbuhan.
Sensor optik pH berasaskan reagen kurkumin terpegun dalam matriks hibrid sol-gel/kitosan melamin telah dibangunkan dalam kajian ini. Sensor optik pH ini memberikan rangsangan linear pada julat pH 9-13 (R2 = 0.9846). Seterusnya, nilai RSD kebolehulangan adalah 7.38% - 9.65%, manakala nilai RSD kebolehasilan pula adalah 2.18% - 4.72%. Kestabilanfoto yang baik bagi reagen kurkumin terpegun diperolehi apabila filem disimpan dalam persekitaran gelap dengan nilai RSD 3.69% untuk tempoh kajian 3 minggu. Tiada kesan histerisis diperhatikan apabila sensor digunakan untuk mengukur pH dalam kitaran pH 2-12-2. Masa rangsangan sensor adalah 10-20 saat. Penentuan nilai pH bagi beberapa sampel sebenar menggunakan sensor pH yang dihasilkan dalam kajian ini menunjukkan tiada perbezaan secara signifikan pada nilai pH yang diperolehi apabila dibandingkan dengan keputusan yang diperolehi menggunakan meter pH.
Potensi larutan reagen fenilfluoron untuk digunakan sebagai bahan reagen bagi pembangunan sensor optik pH dibincangkan dalam kajian ini. Reagen ini dipilih kerana ia belum pernah dilaporkan sebelum ini untuk digunakan sebagai bahan reagen bagi pembangunan sensor optik pH. Berdasarkan kajian larutan yang telah dijalankan, julat rangsangan linear pH bagi reagen fenilfluoron ialah antara pH 4–11. Perubahan warna dapat diperhatikan, iaitu warna kuning dalam asid kuat, warna oren dalam asid lemah serta bes lemah dan warna ungu dalam bes kuat. Perubahan warna yang berlaku adalah lebih kurang 5 saat. Reagen fenilfluoron mempunyai kestabilan foto yang baik dengan nilai RSD 0.33% untuk tempoh kajian selama 95 hari. Nilai RSD bagi kebolehulangan pada pH 2, pH 7 dan pH 12 adalah masing-masingnya sebanyak 2.6%, 0.9% dan 1.4%. Pemerhatian ini menunjukkan fenilfluoron mempunyai potensi yang baik untuk digunakan sebagai bahan reagen bagi pembangunan sensor optik pH.