Displaying publications 1 - 20 of 80 in total

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  1. Ismail AF, Daud A, Ismail Z, Abdullah B
    Oman Med J, 2013 Sep;28(5):331-6.
    PMID: 24044059 DOI: 10.5001/omj.2013.96
    Noise is known to be one of the environmental and occupational hazards listed in the Factory and Machinery Act 1967. Quarries with loud deafening sounds from trucks and machineries pose the risk of noise-induced hearing loss to workers. This study was designed to assess the knowledge, attitude and practice towards noise-induced hearing loss and to determine the prevalence of noise-induced hearing loss and its associated factors among quarry workers in a north-eastern state of Malaysia.
  2. Sulaiman W, Toib A, Chandrashekhar G, Arshad A
    Oman Med J, 2009 Oct;24(4):260-06.
    PMID: 22216379 DOI: 10.5001/omj.2009.53
    OBJECTIVES: To evaluate the trends of disease-modifying anti-rheumatic drugs (DMARDs) used in the treatment of rheumatoid arthritis (RA).
    METHODS: Patients who fulfilled the ACR criteria for RA from 1995 to 2006 and who attended the Rheumatology clinic at Ipoh Hospital were selected and their records were evaluated to determine the changing trends in the use of DMARDs.
    RESULTS: 128 patients with RA were identified. The most commonly prescribed DMARD as monotherapy was sulphasalazine (47.7%), followed by methotrexate (35.9%) and hydroxychloroquine. Methotrexate and sulphasalazine were the most frequently prescribed DMARDs, of which the use of methotrexate has increased 6 folds from 1997 to 2007 and the use of sulphasalazine remains around 30% to 50%. The combination of methotrexate with leflunomide has significantly increased in usage by 4 folds during the study period whilst methotrexate with sulphasalazine combination usage had slightly declined.
    CONCLUSION: DMARDs are still the cornerstone in the treatment of RA. Changes in the trend and aggressive use of DMARDs has been markedly influenced by the patient's awareness of early treatment, the incapacitating damage, availability of recently introduced leflunomide and the advancement of current recommended treatment protocol.
    Study site: Rheumatology clinic, Hospital Raja, Parmaisuri Bainum (HRBP), Ipoh, Perak, Malaysia
  3. Sulaiman W, Seung OP, Ismail R
    Oman Med J, 2012 Nov;27(6):505-8.
    PMID: 23226825 DOI: 10.5001/omj.2012.121
    OBJECTIVE: In Rheumatology, non-steroidal anti-inflammatory drugs (NSAIDs) has been widely prescribed and used. However, despite their clinical benefits in the management of inflammatory and degenerative joint disease, NSAIDs have considerable side effects, mostly affecting the upper gastrointestinal system, which therefore, limit their use. This study was conducted to determine the patients' knowledge and perception regarding the used of NSAIDS.
    METHODS: A total of 120 patients who attended the rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia, and received NSAIDs more than 3 months were interviewed irrespective of their rheumatological conditions. Patient's knowledge and perception on the side effects of NSAIDs were recorded.
    RESULT: Fifty-four percent of the patients obtained information regarding the side effect of NSAIDs either from the rheumatologist, rheumatology staff nurse or other medical staffs (75.4%). The remaining 45.8% were naive of such knowledge. Fifteen percent obtained the information by surfing the internet and 9.2% from printed media. Twenty-four (24.2%) patients, experienced indigestion and/or stomach discomfort attributed to NSAIDs used. Two patients (1.7%) had hematemesis and malena once.
    CONCLUSION: This study shows that half of the patients who attended the rheumatology clinic were unaware of the side effect of NSAIDs. Available data showed that most of the knowledgeable patients are more conscience and self-educated. This study also reveals the important roles of clinicians, trained staff nurses as well as the pharmacist in providing the guidance and knowledge of any medication taken by patients.
    KEYWORDS: Knowledge; NSAIDs; Rheumatology; Side effects

    Study site: rheumatology clinic Hospital, Raja Permaisuri Bainun, Malaysia,
  4. Adwin Z, Nur A, Suhaimi S, Rahman R
    Oman Med J, 2016 Jan;31(1):69-72.
    PMID: 26816570 DOI: 10.5001/omj.2016.13
    Follicular thyroid adenoma and carcinoma are very common. Benign and malignant lesions are usually indistinguishable from cytology alone and often require confirmatory resection. The spread of follicular carcinoma is usually hematogenous and is treated with surgery and adjuvant radioactive iodine. Very rarely, metastases occur in the mediastinum. Patients usually present with severe compressive symptoms. With proper treatment and follow-up, the prognosis for these type of thyroid malignancies is excellent. In the case presented here, our patient presented to the Universiti Kebangsaan Malaysia Medical Center with a progressively enlarging anterior neck swelling. The swelling had started 10 years before his presentation. We diagnosed him with an advanced thyroid malignancy with bulky mediastinal metastases. After extensive investigations and counseling, we chose to treat the patient with tumor excision and mediastinal metastases resection. Typically, mediastinal resection involves the removal of the sternum and use of an acrylic implant to recreate the sternum. In this case, the sternum and ribs were removed with subsequent myocutaneous flap coverage for the wound defect. Our experience represents an alternative treatment option in cases where implant use is unsuitable.
  5. Parsa P, Masoumi Z, Parsa N, Parsa B
    Oman Med J, 2015 May;30(3):187-92.
    PMID: 26171125 DOI: 10.5001/omj.2015.40
    To determine factors related to breastfeeding and its perceived health benefits among Iranian mothers.
  6. Yusoff SM, Bahar R, Hassan MN, Noor NHM, Ramli M, Shafii NF
    Oman Med J, 2020 Sep;35(5):e177.
    PMID: 33083035 DOI: 10.5001/omj.2020.95
    Objectives: Red blood cell (RBC) immunization is a common complication in blood transfusion recipients. Patients with chronic kidney disease (CKD) eventually develop anemia, which is multifactorial, and requires regular blood transfusions, which exposes patients to the development of RBC antibodies. We sought to determine the prevalence and specificity patterns of RBC immunization and its risk factors among transfused CKD patients.

    Methods: We conducted a cross-sectional study over one year from January to December 2018 in the Transfusion Medicine Unit, Hospital Universiti Sains Malaysia. A total of 249 samples were recruited from CKD patients who received a blood transfusion (at least one-pint), which only match for ABO and Rh(D) antigen. The serum was screened for the presence of the RBC antibody using the gel agglutination technique (Diamed gel cards). Samples with positive antibody screening were subjected to antibody identification.

    Results: Of the 249 transfused CKD patients, 31 (12.4%) developed RBC immunization. Thirty (12%) were alloimmunized, and one (0.4%) was autoimmunized. Anti-Mia was the most common antibody (n = 14, 46.7%) among alloantibodies, followed by anti-E (n = 7, 23.3%). There was a significant association between pregnancy history with the development of antibodies whereas, no significant association was found between sociodemographic background, stage of CKD, hemodialysis status, underlying medical illness, and number of packed cell transfusions with the development of RBC antibodies.

    Conclusions: One-eighth of our patient cohort had RBC alloimmunization, and the risk was increased in patients with a history of pregnancy. We propose Rhesus RBC phenotyping and to supply blood match Rhesus antigen in CKD patients, especially patients of reproductive age.

  7. Yusoff MSB
    Oman Med J, 2020 Nov;35(6):e199.
    PMID: 33214913 DOI: 10.5001/omj.2020.90
    Objectives: This study investigated the outcomes of multiple mini interviews and personal interview on personality traits, emotional intelligence, perceived educational environment, and stressors.

    Methods: This is a comparative cross-sectional study on two cohorts of pre-clinical medical students who were selected by multiple mini interviews and personal interview, respectively. Their personality traits, emotional intelligence, perceived educational environment, and perceived stressors were measured using different measurement tools.

    Results: Multiple mini interviews and personal interview demonstrated a similar ability to recruit medical students with a high level of emotional intelligence. The main advantage of personal interviews over multiple mini interviews in terms of personality traits is that it recruited candidates who had a higher level of conscientiousness trait. The main advantage of multiple mini interviews over personal interview on the educational environment is that medical students chosen by multiple mini interviews had a higher level of satisfaction with social aspects of medical training. Regardless of admission processes, the medical students were equally vulnerable to psychological distress due to various stressful events throughout medical training particularly related to academic loads.

    Conclusions: This study provided evidence to support the outcomes that multiple mini interviews and personal interview have on medical students' emotional intelligence, personality traits, perceived educational environment, and perceived stressors during the pre-clinical medical training. Interestingly, personal interview had a better outcome on conscientiousness while multiple mini interviews had a better outcome on the social aspect.

  8. Ramli M, Zulkafli Z, Chambers GK, Zilan RSAR, Edinur HA
    Oman Med J, 2020 Nov;35(6):e189.
    PMID: 33110633 DOI: 10.5001/omj.2020.86
    Objectives: Blood bank centers routinely screen for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) to ensure the safety of blood supply and thus prevent the dissemination of these viruses via blood transfusion. We sought to evaluate the detection of transfusion-transmitted infection (TTI) markers using standard serological methods and nucleic acid testing (NAT) among blood donors in Hospital Universiti Sains Malaysia.

    Methods: Donated blood units were assessed for the presence or absence of HBV, HCV, and HIV using two screening method: serology and NAT. Reactive blood samples were then subjected to serological confirmatory and NAT discriminatory assays.

    Results: A total of 9669 donors were recruited from September 2017 to June 2018. Among these, 36 donors were reactive either for HBV, HCV, or HIV by serological testing and eight by NAT screening. However, only 10 (three for HBV and seven for HCV) donors tested positive using serological testing and five (two for HBV and three for HCV) by NAT discriminatory assays. Note that all five NAT positive donors detected in the NAT discriminatory assays were confirmed to be serologically reactive. Therefore, the prevalence of HBV, HCV, and HIV was 0.03%, 0.1%, and 0.0%, respectively, in our donor pool.

    Conclusions: Both serological and NAT screening and confirmatory assays should be used routinely to reduce the risk of infection transmission via the transfusion of blood and blood components.

  9. Sulaiman W, Abdullah AC, Chung SF, Karim N, Tang JJ
    Oman Med J, 2019 Jul;34(4):345-349.
    PMID: 31360325 DOI: 10.5001/omj.2019.67
    Eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome) is a rare vasculitis in children. It commonly presents with respiratory symptoms, especially asthma, allergic rhinitis, and peripheral eosinophilia. Involvement of other systems, such as renal and cardiac, may carry a poor prognosis. Anti-neutrophil cytoplasmic antibodies have been found less frequently in children with this condition. We report a case of a 15-year-old male who presented with indurated and pruritic papules on both legs and peripheral eosinophilia without other system involvement. Histopathological findings from a skin biopsy were suggestive of eosinophilic granulomatosis with polyangiitis. Anti-neutrophil cytoplasmic antibodies were negative.
  10. Zulkafli Z, Janaveloo T, Wan Ab Rahman WS, Hassan MN, Abdullah WZ
    Oman Med J, 2019 Jul;34(4):336-340.
    PMID: 31360323 DOI: 10.5001/omj.2019.65
    Thrombocytosis in children as well as in adult is defined as platelet count ≥ 450 × 109/L, and it is usually a reactive feature to various medical disorders. However, extreme thrombocytosis (platelet count ≥ 1000 × 109/L) is an uncommon finding among pediatric and adult patients, which may indicate more than a reactive phenomenon. We describe a case of a five-year-old boy who was admitted due to recurrent epistaxis. He had no history of allergic tendency or trauma. Physical examination was unremarkable except for shotty neck nodes. Laboratory results at presentation showed normal hemoglobin and total leukocyte count with eosinophilia (0.92 × 109/L), and extreme thrombocytosis. Other relevant investigations including coagulation profile, serum ferritin, liver, and renal function tests were all within normal ranges. Stool samples for ova and cysts were negative. The peripheral blood smear and bone marrow aspirate confirmed thrombocytosis with increased megakaryocytic proliferation and no artefactual reasons for the high platelets such as red blood cell fragments. Different causes of thrombocytosis in childhood were investigated after considering the possible differential diagnoses for extreme thrombocytosis.
  11. Hassan MN, Fauzi HM, Husin A, Mustaffa R, Hassan R, Ibrahim MI, et al.
    Oman Med J, 2019 Jan;34(1):34-43.
    PMID: 30671182 DOI: 10.5001/omj.2019.06
    Objectives: Autologous peripheral blood stem cells transplantation (APBSCT) is a therapeutic option which can be used in various hematological, neoplastic disorders including lymphoproliferative disease (LPD). Differences in patient populations and treatment modalities in different transplant centers mean it is important to improve the knowledge of the different factors affecting engraftment after APBSCT for the success of this procedure. We sought to determine the factors influencing neutrophil and platelet engraftment after APBSCT in patients with LPD.

    Methods: We conducted a retrospective review of 70 patients with LPD (35 with lymphoma and 35 with multiple myeloma) who had undergone APBSCT between January 2008 and December 2016. Data obtained included disease type, treatment, and stem cell characteristics. Kaplan-Meier analysis was performed for probabilities of neutrophil and platelet engraftment occurred and was compared by the log-rank test. The multivariate Cox proportional hazards regression model was used for the analysis of potential independent factors influencing engraftment. A p-value < 0.050 was considered statistically significant.

    Results: Most patients were ethnic Malay, the median age at transplantation was 49.5 years. Neutrophil and platelet engraftment occurred in a median time of 18 (range 4-65) and 17 (range 6-66) days, respectively. The majority of patients showed engraftment with 65 (92.9%) and 63 (90.0%) showing neutrophil and platelet engraftment, respectively. We observed significant differences between neutrophil engraftment and patient's weight (< 60/≥ 60 kg), stage of disease at diagnosis, number of previous chemotherapy cycles (< 8/≥ 8), and pre-transplant radiotherapy. While for platelet engraftment, we found significant differences with gender, patient's weight (< 60/≥ 60 kg), pre-transplant radiotherapy, and CD34+ dosage (< 5.0/≥ 5.0 × 106/kg and < 7.0/≥ 7.0 × 106/kg). The stage of disease at diagnosis (p = 0.012) and pre-transplant radiotherapy (p = 0.025) were found to be independent factors for neutrophil engraftment whereas patient's weight (< 60/≥ 60 kg, p = 0.017), age at transplantation (< 50/≥ 50 years, p = 0.038), and CD34+ dosage (< 7.0/≥ 7.0 × 106/kg, p = 0.002) were found to be independent factors for platelet engraftment.

    Conclusions: Patients with LPD who presented at an early stage and with no history of radiotherapy had faster neutrophil engraftment after APBSCT, while a younger age at transplantation with a higher dose of CD34+ cells may predict faster platelet engraftment. However, additional studies are necessary for better understanding of engraftment kinetics to improve the success of APBSCT.

  12. Sundram ER, Norsa'adah B, Mohamad H, Moy FM, Husain NRN, Shafei MN
    Oman Med J, 2019 Jan;34(1):49-55.
    PMID: 30671184 DOI: 10.5001/omj.2019.08
    Objectives: We sought to determine the effectiveness of a voice care program among primary school teachers in a northeastern district in Malaysia.
    Methods: We conducted a randomized community trial in eight primary schools in a northeastern district in Malaysia. The self-administered and validated Malay-Voice Handicap Index-10 (M-VHI-10) questionnaire was used to assess overall voice handicap scores pre-intervention and eight weeks post-intervention. Teachers with a score of five or more (n = 86) were randomized into intervention (n = 41) and control groups (n = 45). The intervention group received portable voice amplifiers and vocal hygiene instruction, which was delivered by lectures and a booklet. The control group was not prescribed any intervention.
    Results: The sociodemographic, lifestyle, and occupational characteristics of the teachers (except maximum number of students per class) were similar between both groups. The baseline M-VHI-10 scores between both groups were also comparable. After the intervention phase, there was a significant effect observed in the total M-VHI-10 scores (p = 0.021, F-stat (df): 5.33 (1,79)) between both groups after controlling for the maximum number of students per class.
    Conclusions: Our results support the use of voice amplification in adjunct with vocal hygiene instruction as a prevention and treatment modality to reduce voice handicap among teachers. Our study demonstrated encouraging evidence on the low-cost voice care program as well as the success of group and workplace-based approaches in the school setting.
  13. Zakaria R, Harif N, Al-Rahbi B, Aziz CBA, Ahmad AH
    Oman Med J, 2019 Jan;34(1):44-48.
    PMID: 30671183 DOI: 10.5001/omj.2019.07
    Objectives: Overweight and obesity are known to cause various patterns of alteration to the pulmonary function test (PFT) parameters. We sought to investigate gender differences in PFT parameters and examine the relationship between body mass index (BMI) and PFT parameters.
    Methods: We conducted a retrospective study of 126 patients referred for a PFT by various medical specialties between January and December 2015. PFT was measured using spirometry, and BMI was calculated using Quetelet's index.
    Results: Female patients exhibited lower mean values for all PFT parameters compared to male patients. The forced vital capacity (FVC)% predicted was less than 80% for all patients while the ratio of forced expiratory volume in 1 second (FEV1)/FVC was higher with increased BMI. BMI was positively correlated with peak expiratory flow in all patients, and with FEV1/FVC ratio in males but not in females.
    Conclusions: In our studied population, males exhibited higher mean values of PFT parameters than females. Increased BMI may be associated with a restrictive pattern on spirometry.
  14. Paul M, Asmi NH, Omar EK, Abdullah S, Mohamad I
    Oman Med J, 2019 Jan;34(1):74-77.
    PMID: 30671189 DOI: 10.5001/omj.2019.13
    Mantle cell lymphoma (MCL) is a rare, aggressive subtype of non-Hodgkin lymphoma with a poor prognosis and high recurrence rate. It seldom affects the Waldeyer's ring let alone the nasopharynx. Patients usually present at late stages of the disease leading to poor failure-free and overall survival rates. Intensive chemotherapy regimes and autologous stem cell transplantation have reported increased survival rates. We report a relapsed case of nasopharyngeal MCL, which previously occurred in the gastrointestinal tract. The patient had undergone a hemicolectomy for colon intussusception secondary to the intraluminal lymphoma mass. He was unable to complete the treatment regime for MCL due to the adverse side effects. Oropharyngeal mass was discovered during routine outpatient follow-up, which was confirmed as nasopharyngeal MCL. We discuss the prognosis, disease progression, and possible treatments.
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