IIUM Medical Journal Malaysia (IMJM)
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From Weight Loss to Bedroom Gains: A Case Report on Bariatric Surgery Resolving Erectile Dysfunction
Get PDFThis case involves a 59-year-old Malay man who struggled with erectile dysfunction (ED) due to his poorly controlled underlying health conditions for about two years. Despite long-term management for diabetes, hypertension, and dyslipidemia, his weight gain and worsening sugar control affected his ability to maintain an erection during sexual activity. He tried various medications and treatments, including traditional remedies and oral drugs like Kamagra, with little success. Eventually, he underwent bariatric surgery, which led to improvements in his ED, along with better control of other health issues. Psychological factors, like stress and desperation, also played a significant role in his journey, highlighting the importance of holistic care and proper management of both physical and mental health in addressing er ED ectile dysfunction. This case underscores the potential benefits of bariatric surgery in obese patients with ED and emphasizes the need for comprehensive healthcare approaches to manage these complex issues effectively
Prevalence of Premature Ejaculation and Its Associated Factors Among Men Attending Government Health Clinics in Kuantan, Pahang
Get PDFINTRODUCTION: Premature ejaculation (PE) is a common sexual dysfunction affecting men globally, often underdiagnosed and under-treated. Its prevalence varies across different sociocultural and geographical settings. The objective of this study is to determine the prevalence of PE and its associated factors among men attending government health clinics in Kuantan, Pahang, Malaysia. MATERIALS AND METHODS: A six-month cross-sectional study was conducted from April 2023 to September 2023 at twelve health clinics. The respondents who were selected were sexually active men over the age of 18 years. Those with psychiatric illness or illiteracy were excluded. Data were collected using the validated Malay version of the Premature Ejaculation Diagnostic Test (PEDT) and the Depression, Anxiety, and Stress Scale (DASS-21). PE was defined as a PEDT score above 9. Descriptive analysis and simple and multiple logistic regression were performed using SPSS. RESULTS: Out of 300 eligible men, 287 responded (95.7% response rate). The prevalence of PE was 32.4% (n=93), with 17.8% (n=5) classified as probable PE and 14.6% (n=42) as PE. Multiple logistic regression showed PE were significantly associated with stress [AOR (95% CI): 3.83 (1.33–11.00); p-value=0.013] and anxiety [AOR (95% CI): 2.60 (1.29–5.25); p value=0.008]. CONCLUSION: The study revealed a high prevalence of PE among men and potentially linked to stress and anxiety. Raising awareness among the public and healthcare providers can improve detection rates in primary care. Therefore, routine PE screening is recommended for men attending health clinics, and such measures would facilitate early diagnosis and treatment
A Retrospective Cohort Single-Centre Study of Prophylactic Vs. Preemptive Valganciclovir Therapy in Cytomegalovirus-At-Risk Kidney Transplant Recipients in Malaysia
Get PDFINTRODUCTION: Valganciclovir is commonly used for prophylaxis or preemptive therapy to prevent post-transplant cytomegalovirus (CMV) infection and disease in kidney transplant recipients. However, there are a limited data on the outcome and the association between valganciclovir and clinical characteristics of kidney transplant recipients, particularly those who are CMV seronegative (R-) receiving a transplant from CMV seropositive donors (D+), as well as in populations with high CMV seroprevalence. MATERIALS AND METHODS: This retrospective, single-center cohort study collected clinical data from kidney transplantation recipients at a tertiary referral hospital from January 2020 to June 2022. The data on the recipients' demographics, CMV risk categories, clinical characteristics, and types of valganciclovir therapy were obtained. Associations between clinical data, CMV risk categories, and therapies were determined. RESULTS: Among 110 kidney recipients, 9 were classified as high-risk and 101 as intermediate-risk. There were no significant differences found in the recipients' demographics and underlying factors between the risk categories. CMV infection occurred significantly less in the prophylaxis group than in the preemptive group (22.2% vs. 59.4%, p=0.04). There were no significant differences in one-year graft outcomes or patient survival observed between prophylaxis and preemptive therapies. Leukopenia incidence was higher in patients receiving prophylaxis. The incidence of co[1]infection with CMV viremia was similar between high-risk and intermediate-risk recipients. A significant association was found between CMV risk categories and prophylactic therapy in relation to post-transplant complications, CMV viremia clearance duration, and peak titer. CONCLUSION: Valganciclovir was the preferred therapy to prevent CMV infection and disease in kidney transplant recipients, with prophylactic therapy showing particular benefit in high-risk groups without increasing complications
Effect of Antipsychotic on the Dimension of Auditory Hallucination Among Patients with Schizophrenia
Get PDFINTRODUCTION: Auditory hallucination (AH) is the most common type of hallucinations in individuals with schizophrenia. Assessing the multidimensional aspects of AH provides more precise insights, particularly regarding associated psychological sequelae. This study aimed to examine the short-term effects of antipsychotics treatment on the emotional, cognitive and physical dimension of AH. MATERIALS AND METHODS: A total of 74 patients with schizophrenia with relapsing episodes were recruited. The Psychotic Symptoms Rating Scale subscale Auditory Hallucination.(PSYRATS-AH) was administered at baseline, and after 2 weeks and 4 weeks of treatment. Patients were treated with atypical, typical, or a combination of both types of antipsychotics. The emotional, cognitive and physical components of PSYRATS-AH were analysed. RESULTS: Most participants were Malay (89.2%), single (63.5%), unemployed (70%), and on atypical antipsychotic treatment (71.6%). At 4 weeks, there was a significant reduction in overall AH scores compared to baseline. Both atypical and combination antipsychotic regimen showed a significant difference in all three components, namely emotional (χ2=43.9, p<0.05 and χ2=27.8, p<0.05), cognitive (χ2=34.1, p<0.05 and χ2=19.0, p<0.05), and physical (χ2=39.5, p<0.05 and χ2=30.5, p<0.05). However, those on typical antipsychotic showed a poorer response in the physical component (χ2=5.4, p>0.05). CONCLUSION: Atypical and combination antipsychotic regimen demonstrated greater effectiveness in improving the emotional, cognitive, and physical dimension of AH. Typical antipsychotics alone were less effective, particularly in addressing physical symptoms. These findings support the preferential use of atypical antipsychotics managing the multidimensional aspects of AH in schizophrenia.
Halimatussaadia Mother’s Milk Centre (HMMC): A Unique Shariah Compliant Human Milk Bank with Single Donor Pools, Satiety Based Distribution
Get PDFKnowledge and Confidence Level among Emergency Healthcare Workers in Airway Management and Resuscitation of Suspected Covid-19 Patients: A Cross-Sectional Study in Penang and Kelantan
Get PDFINTRODUCTION: COVID-19 cases in Malaysia have followed a never-ending course of spike and fall since it was first detected. Though the prominent role of infection control standard precautions were strictly applied, cases among emergency healthcare workers (EHCW) contracting the disease continue to rise. Our study aims to evaluate the knowledge and confidence level and the factors that may influence the knowledge and confidence level among EHCW in airway management and resuscitation of suspected COVID-19 patients. MATERIALS AND METHODS: This was a cross-sectional study conducted in tertiary hospitals in Penang and Kelantan using a validated questionnaire. The territories evaluated include the possible method of transmission, proper steps during resuscitation, airway management and intubation, intensive care management, and etiquette of personal protective equipment. RESULTS: Out of 543 EHCW eligible for the study, only 300 participants responded to the questionnaire. Our study showed only 15.3% of respondents had good knowledge and 62.3% had high confidence in airway management and resuscitation of suspected COVID-19 patients. Significant associations were seen in knowledge and confidence level among respondents with previous experience attending continuing medical education (F=7.041, P=0.008 and F=19.398, P<0.001 respectively). Significant associations were also demonstrated in confidence level among respondents with previous simulation training experience (F=13.905, P<0.001). CONCLUSION: Our study revealed that most EHCW had poor knowledge and moderately adequate confidence in the airway management and resuscitation of suspected COVID-19 patients. A more comprehensive and strategized training program needs to be conducted to help in improvement of the knowledge and confidence level among EHCW
Protective Mechanism Pathway of Cinnamomum zeylanicum at High Dosage against Liver and Renal Damage in STZ-Induced Diabetic Rats
Get PDFINTRODUCTION: Cinnamon zeylanicum (CZ) bark is widely used as supplement for diabetic management, there are concerns about its safety and potential toxicity at high doses, and limited evidence to support its efficacy. To investigate this further, this study examines the effects of Cinnamon zeylanicum aqueous extract (CZAE) on various factors in diabetic rats, including body weight, blood glucose level, biochemical parameters, histological changes, and gene expression. MATERIALS AND METHODS: In the study, 30 male Sprague Dawley rats were divided into five groups of six animals each. Type 2 diabetes mellitus (T2DM) was induced in all groups except the negative control by a single intraperitoneal injection of streptozotocin (STZ). The rats in the intervention groups (Groups C, D, and E) were given CZAE at 1000, 1500, and 2000 mg/kg, dose respectively, for 28 days. The body weight and fasting blood glucose were monitored weekly, and their liver and renal profiles were analyzed. Histology was assessed with hematoxylin and eosin stain, and apoptotic gene expression was examined in liver and renal tissues. RESULTS: The body weight of rats in intervention groups increased compared to the control group. There was a significant decrease (P<0.001) in blood glucose levels. The extract significantly reduced (P<0.05) liver biochemical markers in the intervention groups compared to the control group. The histology of the liver & kidney improved (p<0.001) with upregulated Bcl-2 and down-regulated BAX genes in preventing apoptosis in the intervention groups. CONCLUSIONS: High doses of CZAE are safe and effective for T2DM
Design and Usability Testing of a Web-Based Intervention Module for Obesity: CoPT Nutri Trail
Get PDFINTRODUCTION: Online interventions have emerged as innovative solutions to address health issues, notably obesity, while minimizing the necessity for in-person interactions during the recent COVID-19 pandemic. There is urgency in designing and developing an appropriate online intervention module within a web-based application. This study aims to describe the design process and usability of the online Canteen Operators, Parents, and Teachers (CoPT Nutri Trail) module for an upcoming school-based obesity intervention. MATERIALS AND METHODS: The design methodology consists of four phases: content development, design, web app development, and usability testing. The web application was designed to personalize usage for teachers, parents, and canteen operators to foster healthy environments for children. Thirteen experts, including teachers, nutritionists, and IT professionals, participated in the usability testing. RESULTS: All experts agreed that the design of the web application met the requirements of target users, requiring slight improvements in graphic design, language, and information elements. The web application tool was found acceptable, as the usability of alpha scores for all interface elements ranged from 68.2% to 86.6%, falling between good and very good scores. The content validation indices indicate good levels of validity (ranging from 0.83 to 1.00). CONCLUSION: The CoPT Nutri Trail web application is ready to be launched as a school-based intervention for obesity
Unraveling the Complex Role of Zinc, Boron, Chromium, and Selenium in the Pathogenesis of Diabetes Mellitus: A Review
Get PDFTrace elements are micronutrient components that are only required in small amounts but are critical for the biological functions of many human body tissues. Studies in multiple settings found significant connections between diabetic mellitus (DM) and trace elements caused by disturbances of overlapping cellular metabolic systems. Zinc, boron, chromium, and selenium at either extremely high or low levels could elicit some alteration in cellular metabolism. These lead to the development of DM. The changes include 1) the disturbance in the efficient release of insulin secretory granules, 2) the production of proinflammatory cytokines and oxidative stress state, 3) the failure of insulin signalling pathway, and 4) the reduction of glucose tissue uptake secondary to the downregulation of glucose transporters. Both significantly high and low concentrations have been linked to the development of insulin resistance. Nevertheless, conflicting evidence makes their optimum nutritional levels difficult to establish. For example, lead at a trace concentration may accelerate the development of insulin resistance. The purpose of this review is to emphasise the metabolic role of the 4 trace elements and their influence on the pathogenesis of diabetes when body levels are below optimal. Understanding the consequences of these elements could pave the way for therapeutic possibilities and breakthroughs in personalised DM management