Displaying publications 1 - 20 of 27 in total

  1. Loong CW, Firdaus MAM, Said MRM, Abidin IZ
    Medeni Med J, 2020;35(3):266-270.
    PMID: 33110680 DOI: 10.5222/MMJ.2020.47374
    Takotsubo syndrome is a rare disease and remained ambiguous with its etiology. The disease manifests in various clinical characteristics and even mimicking acute coronary syndrome. We are reporting a case of an elderly lady who manifested by unsteady gaits and recurrent falls. Subacute infarct of the right corona radiata was observed on the brain CT. In addition, coronary angiography and ventriculogram were performed because of dynamic ECG changes and elevated troponin I levels. The angiogram was normal while ventriculogram showed apical ballooning. She was diagnosed and treated as Takotsubo syndrome.
  2. Baki AM, Ramli R, Noor RM, Mohamad I, Jais M
    Medeni Med J, 2020;35(3):276-280.
    PMID: 33110682 DOI: 10.5222/MMJ.2020.90093
    Nodular fasciitis (NF) is an uncommon and benign tumour-like fibroblastic proliferation that is difficult to distinguish from sarcoma both clinically and histologically. In addition, it is a type of lesion characterised by having a potential for spontaneous regression. NF is frequently misdiagnosed due to its rapid growth, rich cellularity, and mitotic figure. Although NF is only rarely diagnosed in children, the head and neck represent the most common locations for NF among this population. The cause of NF remains unknown, however trauma is believed to be an important triggering factor. We describe an unusual case of NF in the posterior ethmoid sinus in a six-year-old boy with no history of trauma. The NF was incidentally noted on a computed tomography scan after the patient complained of a squint. The diagnosis of NF was also supported by histopathology and specific immunohistological staining. A surgical biopsy was performed, and no recurrence was observed after one year.
  3. Hakim I, Yunus MRM
    Medeni Med J, 2020;35(3):271-275.
    PMID: 33110681 DOI: 10.5222/MMJ.2020.88120
    Histopathologically adult extracardiac rhabdomyoma is a benign tumour of mature striated muscle. It is a slow- growing tumour with predilection to occur in head and neck region. They appear mainly as a solitary lesion, and about 15% of them can be multicentric. A 56-year-old man presented to us with the floor of mouth swelling persisted for one year and the right neck swelling for three years mimicking a plunging ranula. Radiological imaging revealed enhancing mass at the floor of mouth and submandibular region. The mass represented a nonvascular benign tumour. Subsequently, the patient underwent excision of the mass via transcervical and transoral method. Histopathological examination revealed adult type of extracardiac rhabdomyoma. Adult type of extracardiac rhabdomyoma should be considered in the differential diagnosis for the head and neck masses. A complete excision will reduce the risk of recurrence.
  4. Salvaraji L, Jeffree MS, Avoi R, Akhir HM, Rahim SSSA, Lukman KA
    Medeni Med J, 2020;35(4):304-309.
    PMID: 33717622 DOI: 10.5222/MMJ.2020.82246
    Objective: Increasing amount of waste concurrently increases the risk of exposure to hazardous materials among waste collectors. Vigorous exertion in the field intensifies the abundance of contaminated inspirable droplets. If left undetected and untreated, it may provoke significant pernicious health effects and redundant burdens to employees and employers. The purpose of this study is to determine the prevalence of respiratory symptoms and their associated factors among domestic waste collectors.

    Method: A cross-sectional study was conducted in Kota Kinabalu, Sabah between January and April 2020. Data were collected using a validated questionnaire which encompasses details about sociodemographic, health status, environment, and employment characteristics.

    Results: A total of 290 waste collectors with a mean age of 40 (±9) years old were participated in the study. Most of them were from Kadazan-Dusun-Murut ethnic origin with educational background till secondary school. The average monthly income of the workers was USD 298.45 (±171.9) per month, and they had been in service for 11 (±9.04) years. Respiratory symptoms were seen in 21% of the workers. The identified significant risk factors were determined as underlying chronic diseases (OR=2.34; 95% CI=1.054, 5.219) and contact with pets (OR=1.87; 95% CI=1.004, 3.288).

    Conclusion: Respiratory symptoms are prevalent amidst domestic waste collectors and related to their health and field activities.

  5. Lum SG, Mahmud N, Isa N, Mat Baki M
    Medeni Med J, 2020;35(4):349-355.
    PMID: 33717629 DOI: 10.5222/MMJ.2020.83479
    Angiosarcoma is one of the rarest types of malignant vascular tumours that involved the head and neck region. It predominantly affects the scalp and superficial soft tissues. Angiosarcoma arising from the deep cervical soft tissue is extremely rare. There is a limited literature on neck angiosarcoma that occurred simultaneously with papillary thyroid carcinoma. We report a rare case of concurrent papillary thyroid carcinoma and cervical epithelioid angiosarcoma, and postoperative rapid progression of residual angiosarcoma that mimicked a neck haematoma. The diagnostic challenge and possible etiologies have been discussed here.
  6. Che Mat CMH, Mustapha F, Noor RM, Ramli R, Mohamad I
    Medeni Med J, 2020;35(4):344-348.
    PMID: 33717628 DOI: 10.5222/MMJ.2020.01057
    Mucocele is a mucous filled benign cystic lesion. It develops due to obstruction of any natural os-tium of the paranasal sinus. Even though being benign, it has capability to erode and cause thinning the adjacent bony structures. Isolated intraorbital mucocele without paranasal sinus disease is a rare condition. We present a 39-year-old female patient with right medial canthal swelling without any nasal symptoms, and normal nasoendoscopic finding. Imaging revealed the lesion as a right ethmoidal mucocele with normal paranasal sinuses. However intraoperatively, it was an isolated intraorbital lesion, lateral to lamina papyracea with thick-yellowish mucin discharge.
  7. 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.
  8. Nasir MSNM, Ishak MN, Abd Wahid FH, Asif JA, Mohamad I
    Medeni Med J, 2019;34(4):400-403.
    PMID: 32821468 DOI: 10.5222/MMJ.2019.44977
    Oral cyst is uncommon in the neonatal period. Depending on the size and site of occurrence, its symptoms may vary. If not diagnosed and managed expeditiously, these oral cysts may cause significant and potentially fatal morbidity and mortality. We report a successfully managed case of oral cyst in neonate that presented with huge tongue at birth and complaints of impending airway obstruction. She was referred for tracheostomy as intubation was impossible. We attempted needle aspiration and the airway successfully relieved without the need for tracheostomy.
  9. Yau A, Haque M
    Medeni Med J, 2019;34(4):387-395.
    PMID: 32821466 DOI: 10.5222/MMJ.2019.54775
    The round-the-clock demands of healthcare services, coupled with the shortage of healthcare providers in many parts of the world, have made shiftwork widespread among healthcare workers. Understanding how to mitigate unfavourable effects of shiftwork on well-being is essential to improve health promotion, to prevent disease prevention, and to increase quality of life. This comprehensive review aims to present evidence linking shiftwork with cardiovascular diseases and cancers among healthcare workers. Several studies have demonstrated evidence indicating the relationship between long-term exposure to shiftwork tempo and a higher risk of cardiovascular diseases. Health workers are increasingly witnesing unfavourable effects of shiftwork on their health state. Shiftwork disturbs circadian rhythm and cardiopulmonary processes, leading to adverse health outcomes. Increasing prevalence of shiftwork in healthcare industries due to population expansion and public health threat of cancers call for investigation towards a better understanding of the underlying mechanism of shiftwork-induced diseases. The shift work period has been considered in different studies using various criteria, resulting in inconsistent definition of measurement criteria leading to misclassification of the study population. There is a need for a more considerable and holistic effort towards standardization of shiftwork definition and conduct an assessment to establish a more conveniently appliacable framework for intervention strategies.
  10. Lazim NM, Abdullah AM, Abdullah B, Ismail ZIM
    Medeni Med J, 2019;34(4):333-339.
    PMID: 32821458 DOI: 10.5222/MMJ.2019.25986
    Objective: The aim of the study was to determine the association of angulation of nasal septum with the severity of rhinosinusitis as measured by symptom score and Visual Analog Score (VAS).

    Method: The study was performed as a cross sectional study conducted at two different centres in Malaysia. Ninety-eight patients who were diagnosed with rhinosinusitis and fulfilled the selection criteria were assessed as for the symptom score and VAS and the measurement of angulation of nasal septum was performed through a coronal view of CT paranasal sinuses in bone window setting at osteomeatal complex level.

    Results: The result obtained from one-way ANOVA test revealed a significant association between category of severity of septal angulation and the symptom score of rhinosinusitis (p=0.025). In addition, the result obtained from one-way ANOVA test also revealed a significant association between category of severity of septal angulation and the VAS of rhinosinusitis (p<0.05).

    Conclusion: Severity of nasal septum angulation may be significantly associated with severity of rhinosinusitis based on symptom score and VAS. These findings could be used in tailored management of patient with rhinosinusitis especially during functional endoscopic sinus surgery.

  11. Tuang GJ, Lee JPH, Velayutham P, Git KA, Ariffin NAA, Abidin ZAZ
    Medeni Med J, 2019;34(3):324-328.
    PMID: 32821456 DOI: 10.5222/MMJ.2019.88886
    Glial heterotopia of oropharynx is a congenital anomaly, whereby ectopic mature glial tissue is found around oropharynx isolated from the brain and spinal cord. Herein we report a rare presentation of a mass at the base of tongue in a neonate. In addition, to underscore the rarity of oropharygeal glial heterotopia, we discuss the dilemma in approaching its diagnosis and management in a neonate.
  12. 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.
  13. Abdullah A, Dahari KASA, Tamil AM, Rohana J, Razif MYM, Shareena I
    Medeni Med J, 2020;35(2):116-120.
    PMID: 32733760 DOI: 10.5222/MMJ.2020.68466
    Objective: To study the prevalence of hearing loss (HL) and to identify the possible risk factors causing HL.

    Methods: This retrospective study was conducted from January 2014-December 2016 at a tertiary hospital in Malaysia. All neonates admitted to the neonatal intensive care unit (NICU), Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were screened with a two-step protocol using an automated auditory brain response (AABR) and/or Otoacoustic Emission and auditory brain response (ABR). Descriptive analysis was used for the prevalence of HL, degree of HL and number of risk factors per infant.

    Results: A total of 2713 babies underwent hearing screening in NICU was enrolled in this study. Two thousand six hundred eight (96%) babies passed the screening test and 214 (4%) babies required further diagnostic test. Only 105 (49%) babies completed diagnostic tests. Out of 105 babies, 40 (38.1%) babies had HL. Mild HL was the commonest HL with 22 (55%), moderate HL was in seven babies (17.5%), severe HL in two babies (5%), and profound HL in nine babies (22.5%). The presence of craniofacial anomalies was the only significant independent risk factor for HL with p<0.05 with an odds ratio of 0.105 CI 95% [0.028-0.389]. Of Babies with the presence of three or more risk factors, 100% of them had HL.There was an increased risk of hearing loss in those with craniofacial anomalies up to 11 times higher compared to those without such anomalies.

    Conclusion: The prevalence of HL among the NICU babies was 1.5% and mild HL was the commonest degree of HL (55%).

  14. Shakri NM, Husain S, Zahedi FD, Tan GC
    Medeni Med J, 2020;35(1):71-74.
    PMID: 32733753 DOI: 10.5222/MMJ.2020.45389
    Plasmablastic lymphoma (PBL) is a rare and aggressive variant of diffuse large B-cell lymphoma predominantly in oral cavities of human immunodeficiency virus (HIV)-positive male patients or immunosuppressive hosts. Limited number of reports on HIV-negative PBL in immunocompetent patients are available in the literature. We reported an unusual case of sinonasal PBL which occurred in an HIV-negative and immunocompetent female patient. She underwent endoscopic removal of the tumor and completed 6 cycles of chemotherapy (hyperfractionated-CVAD). Any finding in favour of tumour recurrence was not observed in positron-emission tomography scan (PET-scan) performed 18 months after the treatment.
  15. 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.
  16. 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.
  17. 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.
  18. 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.
  19. Bondi ME, Rahim SSSA, Avoi R, Hayati F, Ahmedy F, Omar A, et al.
    Medeni Med J, 2020;35(3):188-194.
    PMID: 33110670 DOI: 10.5222/MMJ.2020.02929
    Objective: Healthcare professionals with an advanced level of knowledge and skills on diabetic wound care management are needed to effectively manage complex wounds. This study aimed to determine the effects of an educational intervention to enhance the management of wound care among healthcare professionals.

    Method: This study was part of a quasi-experimental pre-post research design where 82 healthcare professionals were recruited and assigned to intervention and control groups. The participants in the intervention group attended two days of educational intervention training on diabetic wound care management, while there was no intervention in the control group. A questionnaire on knowledge, attitude, and practice was applied before and one-month post-intervention to both groups.

    Results: Pre-test resulted in a low level of knowledge 72.1% and 74.4%, negative level of attitude 67.4% and 66.7%, and a moderate level of practice 79.1% and 76.9% in both intervention and control groups respectively. Post-test resulted in increasing levels of knowledge (76.7%), positive attitude (100%), and practice (76.7%) in the intervention group. At the same time, there was no significant change in the control group. Repeated Measure ANOVA for within-subject and between-subject effects resulted in a statistically significant p-value of 0.001 for knowledge, attitude, and practice after the educational intervention.

    Conclusion: Health professionals have only a moderate level of knowledge on diabetic wound care management. It is important to improve this level by specific trainings and by using a good training module.
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