Australasian Medical Journal
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Bilateral Parotid Involvement as the Solitary Metastatic Site from Squamous Cell Lung Cancer
Get PDFThe detection of metastatic disease has major therapeutic and prognostic implications on the management of cancer patients. We report an asymptomatic metastasis from the lung cancer to the intra-parotid lymph node which was detected by the FDG PET scan and subsequently confirmed by fine needle aspiration cytology. The case is unique as solitary metastatic involvement of the parotid from non-head and neck tumors are extremely rare and thus, may be missed during staging evaluation
Time trend and predictors of lab positivity among suspected cases in the post pandemic phase of H1N1
Get PDFBackgroundWHO declared Influenza A H1N1 to have entered the post pandemic phase on August 10, 2010. Continued surveillance activities are recommended in the post pandemic phase to watch over the trend, severity and impact of Influenza like illnesses (ILI).AimsThis study aimed to document the epidemiological profile of lab positive H1N1 cases in post pandemic period from August 2010-December 2014 in nodal H1N1 surveillance centre of Puducherry.MethodsThe study analysed secondary data collected during the period August 10, 2010 to Dec 2014 from ILI suspects attending a tertiary care hospital, for the Integrated Disease Surveillance Project (IDSP). Demographic details, lab positivity based on Real time –PCR technique for H1N1, clinical symptoms and outcomes were extracted. Data were analysed using STATA version 11.0. Independent predictors of lab positivity rate were identified using logistic regression analysis. Time trend of frequency of suspected cases and lab positivity rate were performed using time series plots.ResultsA total of 2065 suspected cases were reported, of whom 197 cases were positive for H1N1 (lab positivity rate 9.5%). Being an adult (OR: 1.6; 95% CI:1.1 - 2.3; p=0.02), management in in-patient settings (OR: 2.5; 95% CI:1.3-4.7; p=0.001), history of contact (OR: 2.7; 95% CI1.5 - 4.5; p=0.0001) and history of travel (OR: 2.3; 95% CI: 1.2 to 4.3; p=0.01) were the independent predictors for lab positivity. Death rate among lab confirmed cases was found to be 9.6 %. After 2012, the trend of laboratory confirmed H1N1 cases became a plateau. One needs to screen 35 suspected cases to capture one lab confirmed case of H1N1 in 2014.ConclusionLab positivity was seen among 9.5% of cases and the independent predictors were severe cases, adult patients, positive history of contact and travel. The number needed to screen to get one lab positive H1N1 case is 35 suspected cases
Characterization and lytic activity of methicillin-resistant Staphylococcus aureus(MRSA)
Get PDFBackgroundMethicillin-resistant Staphylococcus aureus (MRSA) is a well-known pathogen that causes serious diseases in humans. As part of the efforts to control this pathogen, an isolated bacteriophage, Siphoviridae, which specifically targets Methicillin-resistant Staphylococcus aureus (MRSA), was characterized.AimsThe objective of this study was to characterize of a virulent bacteriophage (Siphoviridae) isolated from a NICU bathroom sink.MethodsThe MRSA strain was isolated from patient blood. The isolated strain was confirmed as MRSA using conventional methods. Phages were isolated from a NICU bathroom sink and activity was lytic as determined by spot test. Titer phage lysate was measured by the Double Layer Agar (DLA) technique. The morphology was found with electron microscopy. The single-step growth curve was plotted.ResultsElectron microscopy showed the phage as a member of the family Siphoviridae, serogroup A and F. The isolated phage was capable of lytic activity against methicillin-resistant Staphylococcus aureus (MRSA) strain as shown by spot test. By DLA, the titre of the phages was determined to be 10×108PFU/ml. The single-step growth curve showed that the latent period of the isolated bacteriophage was 30 min and the total number of viable progeny per infected host, burst size, was 2600 PFU/infected host.ConclusionIn this study, two phages were isolated and characterized from a NICU bathroom sink, from the Siphoviridae family, which specifically targets methicillin-resistant Staphylococcus aureus (MRSA)
The influence of social support on cognitive impairment in the elderly
Get PDFBackgroundIn Malaysia, as a result of urbanization and due to the migration of the youth from rural to urban areas, more elderly are now living on their own leading to poor social support and reduced social interactions which may result in negative consequences to the cognitive function of the elderly.AimsTo determine the influence of social support on cognitive impairment among elderly Malaysians.Methods This cross sectional study was conducted using a representative sample for Penang, Malaysia. The Elderly Cognitive Assessment Questionnaire (ECAQ) was used to screen for cognitive impairment and Oslo-3 Social Support Scale (OSS-3) was used to measure social support.Results A total of 2005 elderly participated in the study, 10.8 per cent had borderline cognitive impairment whereas 4.8 per cent were cognitively impaired with borderline dementia. Most of the participants had moderate social support (63.6 per cent) and 16.3 per cent had poor social support. There is about a threefold higher odds of being cognitively impaired among those who have poor social support (OR 3.1 [2.0-4.8]. a OR 2.6 [1.2-5.4]). Attributable risk analysis showed that 65 per cent risk of cognitive impairment in the sample was due to poor social support whereas in the population it was 24.0 per cent.ConclusionThe rapid urbanization and the changes brought along with it are likely to affect social support and eventually the cognitive health of the elderly
Sedation in Dentistry
Get PDFBackground Sedation in dentistry is a controversial topic given the variety of opinions regarding its safe practice. Aims This article evaluates the various techniques used to administer sedation in dentistry and specific methods practiced to form a recommendation for clinicians. Methods An extensive literature search was performed using PubMed, Medline, Google Scholar, Google, and local library resources. Results Most of the literature revealed a consensus that light sedation on low-risk American Society of Anesthesiologists (ASA) groups, that is ASA I, and possibly II, is the safest method for sedation in a dental outpatient setting. Conclusion Formal training is essential to achieve the safe practice of sedation in dentistry or medicine. The appropriate setting for sedation should be determined as there is an increased risk outside the hospital setting. Patients should be adequately assessed and medication titrated appropriately, based on individual requirements
Use of contraception among college students
Get PDFBackgroundYoung people’s vulnerability to risky or unwanted sex and other unhealthy behaviors is tied to a host of individual, family, and community factors that influence young people’s behavior and that are closely related to economic and educational opportunities.AimsThis study aims to identify factors determining the sexual activity, knowledge and use of contraception among college students in Malaysia.MethodsA cross-sectional study was conducted among students of aged 17-24 years in 4 colleges in Malaysia in 2010. Data was collected via a self-administered multiple response questionnaire. Data analyses were performed on 552 completed questionnaires.ResultsThe mean knowledge score for this study was 2.86/6 (± standard deviation=1.29), 47.7%. Place of education and living arrangement were significant associated with the mean knowledge score. More than one third of the total respondents have engaged in sexual intercourse. There were significantly higher proportion of respondents who engaged in sexual activity among those from age group 23-24 years, whom were male, and those who study in college with rural exposure. Among those who have engaged in sexual intercourse, more than half did not use any contraception. A significantly higher proportion of respondents who did not use contraception were found among those in the age group of 19-20 years old, whom were female and those who study in colleges with rural exposure. Students studying in colleges with urban exposure were more likely to have better contraceptive knowledge and use of contraception. Male students were more likely to engage in sexual activity and use contraception compared to females.ConclusionThere is a need to impart reproductive health knowledge during the adolescent period so that young people can make informed decisions when it comes to reproductive health matters
Perceptions of thalassemia and its treatment
Get PDFBackgroundThalassaemia is a common public health in Malaysia and one of the most common chronic and genetic disorders.AimsThe present qualitative study explores with respects to thalassaemia knowledge, perceptions of conventional therapies and the factors contribute to medication adherence in Malaysian populations.MethodsThis study used a qualitative was adopted a better understanding of the current perceptions and knowledge held by thalassaemia patients. Twenty-one thalassaemia patients were recruited from Thalassaemia Society, Kedah, Malaysia from May to July 2015 and interviewed. The semi-structured interviews were audiotaped, transcribe verbatim and translate into English for thematic content analysis.ResultsThe majority of patients’ fear of side effects was main reasons given for delay and seeking treatment but the participant perceived to change after receiving treatment with the success of the treatment. Participants also reported that there were fears with the complication of blood transfusion after receiving blood because transfusion related to iron overload. Complications of iron overload related to mortality and morbidity of thalassaemia patients.ConclusionThis study provides basic information about thalassaemia patients’ perceptions towards Thalassemia and its treatment. The findings can help in the design of educational programs to enhance awareness and acceptance of Thalassaemia screening at an earlier stage. Priorities for future research should focus on who refused the conventional therapies
