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  1. Periayah MH, Halim AS, Saad AZ, Yaacob NS, Karim FA
    Open Access Maced J Med Sci, 2016 Mar 15;4(1):112-7.
    PMID: 27275342 DOI: 10.3889/oamjms.2016.030
    BACKGROUND: Von Willebrand disease (vWD) is an inherited hemostatic disorder that affects the hemostasis pathway. The worldwide prevalence of vWD is estimated to be 1% of the general population but only 0.002% in Malaysia.

    AIM: Our present paper has been written to disclose the statistical counts on the number of vWD cases reported from 2011 to 2013.

    MATERIAL AND METHODS: This article is based on sociodemographic data, diagnoses and laboratory findings of vWD in Malaysia. A total of 92 patients were reported to have vWD in Malaysia from 2011 to 2013.

    RESULTS: Sociodemographic-analysis revealed that 60% were females, 63% were of the Malay ethnicity, 41.3% were in the 19-44 year old age group and 15.2% were from Sabah, with the East region having the highest registered number of vWD cases. In Malaysia, most patients are predominately affected by vWD type 1 (77.2%). Factor 8, von Willebrand factor: Antigen and vWF: Collagen-Binding was the strongest determinants in the laboratory profiles of vWD.

    CONCLUSION: This report has been done with great interest to provide an immense contribution from Malaysia, by revealing the statistical counts on vWD from 2011-2013.

  2. Bong WT, Tan CE
    Open Access Maced J Med Sci, 2018 Oct 25;6(10):1928-1933.
    PMID: 30455776 DOI: 10.3889/oamjms.2018.339
    BACKGROUND: Parental anxiety regarding fever may be unwarranted as most cases are owing to self-limiting causes.

    AIM: To assess the level of knowledge and concerns regarding childhood fever among parents with young children in a public health clinic in Kuching, East Malaysia.

    METHODS: This cross-sectional study was conducted among parents recruited from a maternal and child health clinic, with children aged 6 months to 6 years. The participants completed a self-administered questionnaire regarding their knowledge and concerns about childhood fever. Descriptive statistical analyses were performed, and associations between dependent and independent variables were determined.

    RESULTS: Only 26.1% of participants were found to have good knowledge. Knowledge regarding childhood fever was significantly associated with parent's ethnicity, education level, and household income. About 72% of parents were always worried about their child's illness. Three major reasons for their concerns were persistently rising temperature; discomfort caused by the fever, and feared complications of fever.

    CONCLUSION: Excessive parental anxiety due to poor knowledge and misconceptions about fever may lead to poor quality of life and inappropriate management of fever. Healthcare providers may help by educating parents about fever and serious signs that indicate the need to seek healthcare advice.

  3. Hanafy NA, Badr MS, Nasr GM
    Open Access Maced J Med Sci, 2018 Sep 25;6(9):1577-1580.
    PMID: 30337968 DOI: 10.3889/oamjms.2018.400
    BACKGROUND: Toxoplasma gondii is a common parasitic infection of humans. Infection is usually mild. Serious complications can occur in pregnant and immunocompromised patients.

    AIM: The present study aims to investigate the performance of 2 different PCR protocols; real-time quantitative molecular assays (qPCR) and conventional molecular assays (cPCR), using 2 different sets of primers and by using cloned purified Toxoplasma genomic substances to be evaluated as reference samples.

    METHODS: The target DNA was provided in 8 different quantities.

    RESULTS: Amplification failure was reported only with the cPCR in samples of low concentrations using both primer sets. Quantitative PCR detected the 8 different dilutions of the purified Toxoplasma gondii using the 2 sets of primers while cPCR was sensitive to detect only 6 different dilutions.

    CONCLUSION: Generally real-time quantitative molecular assays, is easy to use method compared to conventional PCR assay and produces more reliable results within only one hour time but still the possible application of qPCRs in routine diagnosis necessitates analysis of a large number of clinical samples in further studies to make the proper choice.

  4. Payus AO, Ibrahim A, Mustafa N
    Open Access Maced J Med Sci, 2018 Nov 25;6(11):2136-2138.
    PMID: 30559876 DOI: 10.3889/oamjms.2018.317
    BACKGROUND: Anaphylaxis often misdiagnosed and treated as acute asthma, especially when it has a predominant respiratory symptom, and there are no obvious precipitants or previous allergic history. This morbid outcome is preventable if the level of suspicion for anaphylaxis is high among healthcare provider when treating a patient who is not responding to the standard management of acute asthma. A proportion of anaphylactic patient shows a biphasic reaction which potentially fatal when it is under-anticipated and prematurely discharge without adequate observation period after the recovery of the initial episode.

    CASE REPORT: Here, we present a case of a young man who has childhood asthma with the last attack more than 10 years ago presented with symptoms suggestive of acute exacerbation of bronchial asthma. As the symptoms failed to improve after standard asthma management, anaphylaxis was suspected, and he was given intramuscular adrenaline 0.5 mg which leads to symptom improvement. However, he developed another attack shortly after improvement while under observation.

    CONCLUSION: The objective of this case report is to emphasise the importance of keeping anaphylaxis in mind whenever a patient has treatment-refractory asthma, and also the anticipation of biphasic reaction that warrants adequate observation period especially those who are likely to have developed it.

  5. Al-Makramani BMA, Razak AAA, Abu-Hassan MI, Al-Sanabani FA, Albakri FM
    Open Access Maced J Med Sci, 2018 Mar 15;6(3):548-553.
    PMID: 29610618 DOI: 10.3889/oamjms.2018.111
    BACKGROUND: The selection of the appropriate luting cement is a key factor for achieving a strong bond between prepared teeth and dental restorations.

    AIM: To evaluate the shear bond strength of Zinc phosphate cement Elite, glass ionomer cement Fuji I, resin-modified glass ionomer cement Fuji Plus and resin luting cement Panavia-F to Turkom-Cera all-ceramic material.

    MATERIALS AND METHODS: Turkom-Cera was used to form discs 10mm in diameter and 3 mm in thickness (n = 40). The ceramic discs were wet ground, air - particle abraded with 50 - μm aluminium oxide particles and randomly divided into four groups (n = 10). The luting cement was bonded to Turkom-Cera discs as per manufacturer instructions. The shear bond strengths were determined using the universal testing machine at a crosshead speed of 0.5 mm/min. The data were analysed using the tests One Way ANOVA, the nonparametric Kruskal - Wallis test and Mann - Whitney Post hoc test.

    RESULTS: The shear bond strength of the Elite, Fuji I, Fuji Plus and Panavia F groups were: 0.92 ± 0.42, 2.04 ± 0.78, 4.37 ± 1.18, and 16.42 ± 3.38 MPa, respectively. There was the statistically significant difference between the four luting cement tested (p < 0.05).

    CONCLUSION: the phosphate-containing resin cement Panavia-F exhibited shear bond strength value significantly higher than all materials tested.

  6. Tualeka AR, Jalaludin J, Salesman F, Wahyu A, Tukiran T, Setiawan S, et al.
    Open Access Maced J Med Sci, 2018 Dec 20;6(12):2381-2385.
    PMID: 30607197 DOI: 10.3889/oamjms.2018.488
    BACKGROUND: Research on risk assessment at industrial sites has experienced growth during the end of this year. But in Indonesia, there is still limited research on risk assessment, especially regarding the importance of measuring non-carcinogenic risk assessment in the workplace. Benzene exposure is believed to reduce levels of immunoglobulin A (IgA) in workers.

    AIM: The purpose of this study was to analyse the relationship between risk quotient (RQ) of non-carcinogenic risk assessment of benzene and demographic factors on IgA levels.

    MATERIAL AND METHODS: The subjects of the study were shoe craftsmen who were at risk of benzene exposure. The study design was cross-sectional with a total population of 20 workers. Measurement of IgA levels by Immunoturbidimetric Assay with a normal standard of 2-3 mg/ml. Calculation of non-carcinogenic (RQ) risk characteristics with a comparison between risk agent non-carcinogenic intake with RfD or RfC benzene.

    RESULTS: The majority of the study subjects aged over 45 years and had a working period of ≥ 25 years. There were 2 location points that had a threshold value exceeding the benzene standard (> 0.05 ppm), and 40% of the subjects had decreased IgA levels. Age and working periods had a significant relationship to IgA levels (p = 0.027; p = 0.047), while benzene and RQ levels did not have a significant relationship with IgA levels (p = 0.179; p = 0.436).

    CONCLUSION: Increasing age and working period can reduce IgA levels in the body. Further research is needed on risk assessment, especially on the safe limits of benzene concentration in the workplace to find out how long benzene exposure forms a non-carcinogenic or carcinogenic risk in workers' bodies exposed to benzene.

  7. Mesaik AM, Poh HW, Bin OY, Elawad I, Alsayed B
    Open Access Maced J Med Sci, 2018 May 20;6(5):757-766.
    PMID: 29875842 DOI: 10.3889/oamjms.2018.168
    BACKGROUND: Ziziphus jujuba belongs to family Rhamnaceae widely distributed in subtropical and tropical countries. It is used traditionally for several pharmacological purposes including anti-inflammation, antidiarrhoeal and antibacterial, as well as tonic and sometimes as hypnotic (sedative).

    AIM: To determine the in vivo antidiarrhoeal, antibacterial and anti-inflammatory activities of Z. jujuba fruit ethanolic extract.

    METHOD: The fruit was macerated and extracted by 95% (v/v) ethanol. The antidiarrhoeal activity was evaluated using castor oil and Escherichia coli induced diarrhoea mouse model. The antidiarrhoeal and antibacterial activity was investigated at graded doses (400-1200 mg/kg). The anti-inflammatory effects were tested using the carrageenan-induced paw oedema in female Wistar rats. Rat's treatment groups received tragacanth, 100 mg/kg diclofenac sodium, 800 mg/kg, 1200 mg/kg or 1600 mg/kg of an ethanolic extract of Z. jujuba (EEZJ). All treatment groups were fed with the compounds one hour before carrageenan injection at of rat's paw. Also, the EEZJ was further analysed by HPLC-PDA system for identification of the presence of betulinic acid and quercetin.

    RESULTS: EEZJ different doses did not show inhibitory activity against castor oil induced diarrhoea except for the higher (1200 mg/kg) dose. However, the frequency of defecation of stools and watery stool were reduced significantly when compared to control group (P ≤ 0.05 and P ≤ 0.01 respectively), resulted in overall 67% inhibition of diarrhoea. Our anti-inflammatory results demonstrated that EEZJ was able to inhibit the carrageenan-induced paw oedema in rats to a significant degree (p ≤ 0.05) and the paw volume and thickness of both left and right paw were affected compared to the negative control group.

    CONCLUSION: EEZJ possesses antidiarrhoeal and antibacterial activity in a dose depending manner and may provide a pharmacological basis for its clinical use in diarrheal diseases. The activity may partially be due to the presence of betulinic acid and quercetin.

  8. Payus AO, Rajah R, Febriany DC, Mustafa N
    Open Access Maced J Med Sci, 2019 Feb 15;7(3):396-399.
    PMID: 30834009 DOI: 10.3889/oamjms.2019.114
    BACKGROUND: De novo pulmonary embolism (DNPE) is a term used when pulmonary embolism (PE) occur in the absence of deep vein thrombosis (DVT). Most DNPE cases occur in a patient who had a recent injury to the chest.

    CASE PRESENTATION: However, here we report a case of DNPE with a slightly different presentation where there is no preceding trauma and has symptoms that mimic severe pneumonia. He presented with high fever, dyspnoea and pleuritic chest pain. Despite on 10 L of oxygen supplementation via high flow mask and already given bolus intravenous antibiotic, the patient still tachypnoeic and was persistently in type I respiratory failure. His chest X-ray showed consolidative changes. Upon further investigation revealed no evidence of DVT on Doppler ultrasound and normal D-dimer level. Due to the high index of suspicion by the attending physician, PE was suspected and later confirmed with computed tomography pulmonary angiography scan. He was successfully treated with anticoagulation therapy. The objective of this case report is to share the difficult experience of diagnosing PE when the presentation highly atypical and mimics severe pneumonia.

    CONCLUSION: And with such a masquerading presentation, one can easily miss the diagnosis. To the best of our knowledge, there are very few similar cases reported.

  9. Yusuf SYM, Ismail IA, Hamid RA, Jamil NA, Yasin MM
    Open Access Maced J Med Sci, 2019 Jun 15;7(11):1815-1817.
    PMID: 31316665 DOI: 10.3889/oamjms.2019.481
    BACKGROUND: Leprosy or Hansen disease is a chronic infectious disease that causes social stigma due to its deforming bodily appearance and physical disability. It has a wide spectrum of presentation affecting diagnosis.

    CASE REPORT: A 21-year-old man who presented with chronic isolated bilateral pinna swelling as a result of leprosy is reported. The bilateral pinna swelling started as multiple shiny papules with an erythematous background and progressively became hyperpigmented and lobular over two years. This rare presentation of leprosy poses initial diagnostic difficulties, leading to misdiagnoses by various health care professionals. Diagnoses ascribed include eczema, insect bite and perichondritis. A suspicion of leprosy was raised when hyperaesthetic hypopigmentation of skin started to appear on the body after two years, with worsening of the pinna swellings. This was confirmed by identification of Mycobacterium leprae in slit skin smear test and skin biopsy.

    CONCLUSION: Isolated involvement of pinna in a patient without lesions in other body parts is an unusual initial presentation of leprosy. However, leprosy should be kept as a rare differential diagnosis of isolated lesions on the ear in patients not responding to conventional treatment.

  10. Darlan DM, Tala ZZ, Amanta C, Warli SM, Arrasyid NK
    Open Access Maced J Med Sci, 2017 Apr 15;5(2):142-146.
    PMID: 28507618 DOI: 10.3889/oamjms.2017.014
    BACKGROUND: Soil Transmitted Helminth infection is one of most prevalent health problems worldwide, especially in environments with poor sanitation. Based on World Health Organisation (WHO) data, more than 2 billion people, or 24% of the world's population, are infected with intestinal parasite. The highest prevalence is located in areas of poor sanitation and unsafe water supplies. In Indonesia, the prevalence of parasite infections is 15% of the entire population.

    AIM: The purpose of this study was to determine the relationship between Soil Transmitted Helminth infection on levels of eosinophils among primary school children. In addition, this study also aimed to determine the prevalence of different types of worm infections and the levels of eosinophils in children infected with worms.

    MATERIAL AND METHODS: This study was analytic observational using a cross-sectional method. The sampling technique was consecutive and in total 132 samples was obtained. The study involved primary school children in Amplas Medan and Hamparan Perak, Deli Serdang through May to October 2016. Univariate analysis was performed to determine STH infection prevalence and bivariate analysis was used to find the correlation between STH infection and eosinophil levels through a Chi square (χ2) test.

    RESULTS: The results showed that the prevalence of Soil Transmitted Helminth was 7.6%. The most common types of STH infection were 3.8% with Trichuris trichiura and 3% with Ascaris lumbricoides. A significant correlation was found between Parasite infection and eosinophil levels (Contingency Coefficient (C) = 0.2, χ2 = 5.3, p = 0.021) and the risk of STH infection that caused eosinophilia or increased eosinophil levels in the children with a Prevalence Ratio (PR) of 1.56 (Confidence Interval (CI) 95%: 1.10-2.22).

    CONCLUSION: It is recommended that schools at similar risk improve and maintain hygiene and healthy behaviour in the school environment and that parents and teachers pay greater attention to the cleanliness of their children.

  11. Arrasyid NK, Sinambela MN, Tala ZZ, Darlan DM, Warli SM
    Open Access Maced J Med Sci, 2017 Apr 15;5(2):117-120.
    PMID: 28507613 DOI: 10.3889/oamjms.2017.016
    BACKGROUND: The latest estimates indicate that more than 2 billion people worldwide are infected by Soil-Transmitted Helminths (STH). The burden of STH infection is mainly attributed to the chronic effect on health and quality of life of those infected. It is also contributed to micronutrient deficiencies such as iron-deficiency anaemia. The prevalence of worm infection in Public Primary School students in Medan was quite high (40.3%), and 33.3% was anaemic in the latest study.

    AIM: To determine the correlation between STH infection with serum iron (SI) level on primary school children, as well as to determine the prevalence of SI level and worm infection, and the type of worm that infects the most of them.

    METHODS: This study was conducted in the cross-sectional method. Consecutive sampling technique was used and a total of 132 students age 8-12 years old were included. The study took places in Public Primary School 060925 Amplas, Medan and 101747 Hamparan Perak, Deli Serdang throughout May-October 2016. Fisher Exact test was used to analyse the correlation between STH infection and SI level.

    RESULTS: The prevalence of STH infection was 7.6%, and low SI was 11.4%.

    CONCLUSION: There was no significant correlation between STH infection and SI level (P = 0.317). The prevalence of low SI level was not significantly dependent on STH infection (RP = 1.877, 95% CI = 0.481-7.181).

  12. Thong HK, Athar PPSH, Mustaffa WMW
    Open Access Maced J Med Sci, 2019 Jul 15;7(13):2142-2145.
    PMID: 31456841 DOI: 10.3889/oamjms.2019.577
    BACKGROUND: Lymphoepithelial cysts, which are benign and slow-growing tumours, usually involve the head and neck regions. Benign lymphoepithelial cysts (BLECs) are the most common cause of parotid swelling in human immunodeficiency virus (HIV)-positive patients and are less common in immunocompetent patients.

    CASE PRESENTATION: Here, we present two cases of immunocompetent patients with long-standing, progressively enlarging parotid swelling. Postoperative histopathological examination of these patients revealed features of BLEC.

    CONCLUSION: Wide surgical excision is the gold standard for treatment and recurrences is rare. These cases are of particular interest because of the rarity of BLEC in HIV-negative patients and highlight an important differential diagnosis of parotid swelling.

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