Background: With increasing number of dengue cases in Malaysia, it’s of utmost importance that immediate
action be taken to limit the epidemic. Since dengue control is a behavioral problem, the knowledge,
attitude and practice in population needs to be studied in order to control the disease. Hence, the aim of
this study is to assess knowledge, attitude and practice regarding dengue and its associated factors among
adult residents of Felda Sungai Panching Timur (SPT), Kuantan, Pahang, 2014.
Method: A cross sectional
study was carried out involving 265 adult respondents. A face to face interview questionnaire which was
divided into 2 parts (Part A: Sociodemoghraphic; Part B: Knowledge, Attitude and Practice) was used. Data
was analyzed using descriptive statistics, simple and multiple logistic regression.
Results: 53.2% of the
respondents had good knowledge about dengue and it was found that the main source of information from
mass media (76.6%). However, only 43.4% were found to have good attitude towards dengue. Multiple
Logistic Regression analysis showed there was no association between sociodemographic characteristics with
the level of knowledge and attitude towards dengue. There was also no association found between
knowledge of dengue and the attitude of the respondents towards dengue. Descriptive analysis on the
practice of dengue showed majority of the respondents who had possible breeding site for Aedes mosquitos
(water container, drains/gutter roof/flower pots/tires) in their compound practiced good habit in
preventing the Aedes mosquitoes from breed.
Conclusion: Although knowledge and practice towards dengue
is good, their attitude require improvement.
Introduction: Malocclusion is one of the most common dental problems observed. Limited data is currently
available regarding the demographics of malocclusion observed locally.
Materials And Methods: This is a
retrospective study where 770 patients were recruited from May 2009 till December 2014. 560 orthodontic
study models that met the inclusion criteria were examined and the malocclusions were classified according
to the British Standard Institute (BSI) incisor classification. Demographic pattern and their relationship were
analysed by structural equation modelling using SPSS (version 23.0).
Results: From 560 study models
analysed, 72% were female. The age of the patients ranges from 7-12 years old (17.1%), 13-17 years old
(55.9%) and >18 years old (27.0%). Majority of the patients were Malay followed by Chinese (5.7%), Indian
(1.8%) and other races (1.8%) Treatments received were fixed appliances (FA) (60.0%), removable appliances
(RA) (12.5%), functional appliances (FnA) (1.1%), combination of RA and FA (16.1%), combination of FnA and
FA (2.1%) and consultation (8.2%). Types of malocclusions observed were Class I (25.7%), Class II/1(32.7%),
Class II/2 (7.5%) and Class III (34.1%). There was significant association (p
Left ventricular non-compaction cardiomyopathy (LVNC) is a rare congenital cardiomyopathy, which is
characterized by hypertrabeculations and deep recesses of the left ventricle. A patient could be
asymptomatic or presented with common manifestations, including reduced systolic function, arrhythmia,
thromboembolic events and heart failure. The rarity of the condition as well as lack of proper assessment
has probably led to this condition to be largely underdiagnosed or unrecognized. A 23-year-old lady had
collapsed at home thirty one days after delivering her first child. She had a history of goitre diagnosed a
year ago and noted to be fairly well throughout the pregnancy. Post mortem findings showed increased
trabeculations of the left ventricle. Further history was obtained after the procedure, revealing symptoms
such as syncopal attacks and bilateral lower limb weakness dated back as far as five years prior to her
sudden demise. These features were in keeping with hypotension hypoperfusion effects resulted from
reduced systolic function and decreased ejection fraction, as a result of left ventricular dysfunction. While
LVNC remains a rare type of disease, we would like to highlight the importance of a good anamnesis. It may
help to uncover some uncommon pathology such as this heart disease, thus warranting an appropriate
cardiac imaging to be engaged to clinch the primary diagnosis.
The increasing awareness amongst the society on medico-legal issues as well as the growth of consumerist
attitude towards the provision of medical services has caused the medical profession to be subjected to
vociferous criticism if they do not meet rising expectations of the society. Substandard services have not
been well tolerated and paternalistic approaches in medical treatment are considered to be outmoded and
inappropriate. Any dissatisfaction on the part of the patient towards medical services provided nowadays
may easily trigger claims in the court of law. This changing trend has also fundamentally changed the
behaviour of the courts towards the medical profession. Judicial and legislative interventions in medical
practice have created more and more rights for the patients and consequently, corresponding legal duties
for the medical profession to uphold. In the present healthcare setting, the medical profession will not be
able to provide infallible services without knowledge of the legal standards which they have to adhere.
Thus, educating future medical professionals with the fundamentals of law and ethics would ensure greater
accountability, knowledge and personal commitment in providing medical services to the society as the
ideals of professionalism not only require them to have the necessary expertise, dedication, respect,
compassion, empathy, honesty, altruism, responsibility, integrity, self-improvement and accountability but
also adherence to the demands of law and highest ethical standards.
The upper airway is a crucial structure. It becomes a grave problem should it be narrowed. Several methods
of treatment were rendered for patients with laryngotracheal stenosis. We share our experience with the
combination total intravenous anaesthesia and apneic pause technique with or without steroid injection.
Four cases of laryngotracheal stenosis were observed in Hospital Ampang: two adult and two paediatric
cases. Age, gender, causative factor, stenosis segment length, grade or severity were observed before and
after dilatation, number of dilatation were observed and compared. The outcome measures are
decannulation and avoidance of tracheostomy. All cases had improvement of symptoms. Half or 50% of the
patient required repeated balloon dilatations. The paediatric cases successfully avoided tracheostomy while
the adult cases successfully decannulated with no complication from the procedure. Balloon dilatation by
total intravenous anaesthesia coupled with apneic method is a safe and effective method of treatment for
the narrowed airway.
Introduction: Dyslipidaemia is one of the risk factors contributing to the pathogenesis of cardiovascular
diseases (CVDs). This study was conducted to investigate the effect of wet cupping on lipid profile.
Methods: This randomized controlled trial was conducted in 2012 at the School of Medical Sciences,
Universiti Sains Malaysia, Malaysia. Sixty-two healthy volunteers ranging from 30 to 60 years old were
randomized into control and intervention groups. Subjects in the intervention group were assigned to two
sessions of wet cupping at the beginning of the study and at the third month; individuals in the control group
did not undergo any cupping procedure. Venous blood sample was collected for serum lipid profile: Total
Cholesterol (TC), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C),
and triglycerides; measured at baseline, first, third and fourth month.
Results: Subjects in the cupping
group had significant improvements from baseline to third and fourth month for TC (MD=-0.56, P=0.004),
HDL-C (MD=-0.22, P
Thyroglossal duct cyst is the most common upper neck midline lesion in children. Approximately 1% of
thyroglossal duct cyst undergoes malignant transformation. Calcification which is a marker of malignancy
almost always points out to papillary thyroid carcinoma. Benign case of calcified thyroglossal cyst maybe
undiagnosed or under reported. We report a case of a 5 year old girl with a benign calcified thyroglossal
duct cyst, a fourth case in world literature. Here the differences between a benign and malignant
thyroglossal duct cyst are discussed.
Tonsillectomy is a very common procedure in Otolaryngology practice. Common complications include
bleeding, which can be primary or secondary due to infection of the tonsillar bed. Subcutaneous emphysema
after a tonsillectomy is very rare. We report a 19-year-old girl who developed cervicofacial subcutaneous
emphysema several hours after tonsillectomy with successful conservative treatment outcome.
Introduction: A survey in 2011 reported that the prevalence of diabetes in Malaysia is 20.8% (2.8 million people) and 88% have uncontrolled diabetes. Diabetic foot ulcer (DFU) is one of the common diabetes complications in Malaysia that leads to other devastated situation including infection, amputation and death. In Pahang, 95% of the patients have uncontrolled diabetes and 50% of them suffered from DFU. Self-wound management is an important element in reducing the risk of further complications of DFU. However, little is known on the patients' understanding of diabetes and their practice of self wound management. This study aimed to understand the knowledge, attitude and practice of self-wound management among patients with diabetic ulcer in Pahang.
Materials and method: A quantitative, cross-sectional study was conducted in a tertiary hospital in Pahang involving 100 participants. Participants were recruited using purposive sampling from April 2017 until May 2017. Participants' knowledge, attitude and practice of self-wound management were measured using self-administered questionnaires. Additionally, the data on socio-demographic was gathered. The data was computed into SPSS and analyzed using descriptive and inferential statistics.
Results: Out of 100 participants, 95% of them had good knowledge on diabetes and DFU, 84% had a positive attitude towards self-wound management and 56% perceived good practices of self-wound management. However, a chi-square test between knowledge on diabetes and DFU and practice of self-wound management found no significant interaction (p > 0.05). Meanwhile, there was a significant interaction between attitude and practice of self-wound management (p < 0.05).
Conclusion: Good knowledge on diabetes and DFU do not determine the patients’ practice of self-wound management. However, positive attitude towards self-wound management would contribute to the practice and willingness of the patients to selfmanage their foot ulcer wound at home.
The dopamine hypothesis has earlier dominated the theories for the
development of schizophrenia based on the early pharmacologic evidence. The
antipsychotic drugs, among others, is thought to interfere with the function of the
dopamine D2 receptor (DRD2) resulting in clinical improvement. Accumulating evidence
suggest the role of epigenetic mechanisms in the pathophysiology of schizophrenia.
Despite this, specific evidence linking the DRD2 DNA methylation with schizophrenia is
insufficient mainly due to the poor accessibility and limited brain samples. Of late, new
data has suggested the global impact of DNA methylation in the development of
schizophrenia, thus methylation in the peripheral blood could infer changes in the brain.
The aim of this study was to assess the DRD2 DNA methylation in the peripheral blood of
Plasma Cystatin C (CysC) is as an early functional marker for acute kidney
injury. Estimates of glomerular filtration rate using CysC (eGFRCysC) has been used in
some clinical setting. We evaluated the utility of CysC and eGFRCysC in diagnosing acute
kidney injury (AKI) and predicting death in critically ill patients with sepsis. (Copied from article).
Cancer is one of the global health problems that has a detrimental effect
to a person's life. However, chemotherapeutic agents success are subject to the side
effects due to lack of specificity in the drug delivery system to cancer cells and an
increase risk of systemic toxicity to the normal cells. Polyamine transport system (PTS)
is one of the potential pathways for transporting anticancer agent into specific cancer
cells. This is due to the upregulation of PTS in cancer cells compared to normal cells for
the proliferation activity. The aim of this study was to investigate the cytotoxicity effect
of putrescine-sulphur analogues type 1 (PSA-1) and type 2 (PSA-2) on human lung
adenocarcinoma cells (A549), human colorectal adenocarcinoma cells (HCT-8) and
human breast adenocarcinoma cell (MCF-7).
Streptococcus pneumoniae (S. pneumoniae) is a gram-positive diplococci belonging to the genus Streptococcus and it is a well-studied pathogenic bacterium. Pneumococcal diseases such as otitis media, pneumonia, sepsis and meningitis caused by pathogenic strains of S. pneumoniae still brought significant mortality and morbidity worldwide. The pathogenicity of S. pneumoniae is exerted by various virulence factors and one of it is the enzyme hyaluronate lyase. Hyaluronate lyase plays a major role in
the invasive capability of S. pneumoniae. Its mechanism of action and crystallographic
structure have been determinedbut its regulatory mechanism is still poorly understood.
Drawing connections between the nutritional behaviour and invasive property of S.
pneumoniae, CodY regulator is hypothesized as a potential hyaluronate lyase regulator.
This work was aimed to construct CodY deficient mutant of S. pneumoniae to form
foundational work for the study of CodY regulatory effect on hyaluronate lyase.
Over accumulation of polyamines is one of the causes of cancer because
polyamines could promote the cancer cells growth. Due to the lack of specificity and
increased reports of side effects in the current cancer treatment, one of the strategies
to overcome the challenges is by utilizing polyamines as vectors of known cytotoxic
compounds to target the cancer cells. Therefore, this study was aimed to investigate
the cytotoxicity effect of Spermidine Sulphur Analogues Type 1 and Type 2 (SSA-1 and
SSA-2) against human lung adenocarcinoma cells (A549), human colorectal
adenocarcinoma cells (HCT-8) and human breast adenocarcinoma cell (MCF-7). (Copied from article).
The brain is the most complex organ in the human body. Robust and vigorous daily activities may cause changes to the brain structure. Huffaz, individuals who memorise the Quran undergo intensive memorization training which may lead to structural changes in specific regions of the brain.
Introduction: Febuxostat is a non-purine-selective oral xanthine oxidase inhibitor drug, and is an alternative to Allopurinol to lower serum uric acid in gout patients. It is probably more effective than Allopurinol, however, its use is limited because of its cost and availability. Allopurinol has been the mainstay treatment for gout for about 50 years. However, its use has been associated with allergic reactions especially in patients with renal impairment.The objective of this study was to describe HTAA Rheumatology Unit experiences with Febuxostat in the management of gout.
Materials and method: Case records belonging to 6 patients who had been started on Febuxostat between January 2012 and January 2017 were analysed.
Results: The majority of patients on Febuxostat were males (83.3%) as well as Malays (83.3%). About 66.7% of patients had already developed mild to moderate chronic kidney disease (GFR between 30-89 mL/min) due to multifactorial causes by the time they were started on Febuxostat. Also 33% of patients had mild liver impairment (ALT & AST < 1.5 ULN) due to fatty liver prior to Febuxostat. All patients had been started on Febuxostat due to allergic reactions to Allopurinol. All patients were on Febuxostat 40 mg once a day. Following Febuxostat, a significant decrease in the uric acid levels much closer to the target level i.e. less than 360 µmol/L were achieved in all patients. Only 1 patient (16.7%) developed a side effect i.e. ALT > 1.5 ULN while the rest tolerated the drug very well.
Conclusion: Although the number of patients analysed was small, Febuxostat was shown to be very effective and safe for use in patients with gout even with concomitant mild to moderate renal impairment. Serum uric acid levels reduced significantly while on the lowest dose of 40 mg once a day.
Introduction: There was no previous study to assess relationship between dry eye symptoms and signs in the local population. The purpose of this study is to evaluate the relationship of symptomatic assessment and clinical signs of dryness in dry eye subjects.
Materials and method: A Cross-sectional study with convenient sampling involving 321 subjects with 642 eyes was done. Subjects were divided into non-dry eye (NDE) and dry eye (DE) groups. The division of NDE and DE groups were done using two types of classification. In Classification 1(symptoms-based), DE was defined if the score of Ocular Surface Disease Index (OSDI) score was more than 33. The value of tear film break-up time (TFBUT) less than 5 seconds and Schirmer test with anaesthesia (STA) less than 5mm/5 minutes were considered as DE for Classification 2 (signs based).
Results: There were poor correlations between OSDI and clinical signs of dryness in all subjects involved (p > 0.05). Similar findings were also noted within NDE subjects in Classification 1 and Classification 2. OSDI score was also not significantly correlated with the signs of dryness within DE subjects except with ocular protection index (OPI) (r = - 0.14, p = 0.047) in Classification 1 and with conjunctival lissamine green staining (CLGS) (r = 0.23, p = 0.040) in Classification 2.
Conclusion: There were no significant correlation between the symptoms of dry eye and the clinical signs of dry eye. Therefore, the clinical diagnosis of dry eye can be made based on either just on the symptoms or the signs.
Kinetic estimate of GFR (keGFR) is a more accurate estimate of GFR in the
acute settings with rapidly changing kidney functions. It takes into account the changes
of creatinine over time, creatinine production rate, and the volume of distribution,
however needs serial measurement of creatinine. We evaluated which methods of the
conventional eGFR measurement best correlates with keGFR. This could assist clinicians
in using a simpler method of calculation and is useful in the absence of serial plasma
creatinine. (Copied from article).
Radiological manifestation of pulmonary tuberculosis in HIV positive
patients is different with HIV negative patients. We aim to determine the differences in
chest radiological findings of Pulmonary Tuberculosis among HIV and non-HIV infected
patients in HTAA. (Copied from article).
Traumatic brain injury (TBI) is a major medical and socioeconomic
problem. Patients with severe TBI shows physical and functional improvement but
remain with cognitive and psycho-social problem throughout recovery. Despite all the
issues, the impact of TBI on long-term survivors in Malaysia is unknown. The aim of this
study is to measure the functional level of ICU survivors with severe TBI within 6 months
post injury. (Copied from article).