IIUM Medical Journal Malaysia (IMJM)
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Parvovirus Infection and Congenital Leukemia: Is It a Causal or Casual?
Get PDFCongenital leukemia is an extremely rare disease but frequently fatal. We report a case of intrauterine death (IUD) secondary to congenital erythroid leukaemia associated with maternal Parvovirus B19 infection. Further research is needed to ascertain the association between maternal Parvovirus B19 infection and congenital leukemia
Re-Emergence of Tetanus in a District Referral Hospital
Get PDFTetanus is an acute, potentially fatal disease caused by Clostridium tetani. It is characterized by generalized, painful spasms and rigidity of skeletal muscles. We present two fatal cases and discuss the potential causes that lead to mortality in cases of tetanus infection
Renoprotective Role of Tualang Honey Against High Cholesterol Diet Induced Acute Kidney Diseases in an Animal Model
Get PDFIntroduction: Although there is a growing insight into the causes and mechanisms of kidney diseases, preventive and therapeutic measures are still few. The aim of this study was therefore to determine the renoprotective effect of tualang honey against high cholesterol diet induced acute kidney disease in an animal model. Materials and method: Ten female Sprague-Dawley rats were divided into two groups: high cholesterol diet (HCD) group, fed with 12% cholesterol diet with 0.3% cholic acid, and high cholesterol diet with tualang honey (HCD + TH) group, fed with HCD with oral daily dose of 1.4 g/kg/day of tualang honey by gavage. Biochemical analysis of lipid profile and renal function were performed at 48 hours, 7 days, and 6 weeks of the experiment. The animals were sacrificed at 6 weeks and the kidneys were harvested for histological examination. Results: There was no significant difference between the HCD and the HCD+TH groups in the level of TC. The mean serum LDL-c, TG and vLDL levels at completed 48 hours and 7 days for the HCD+TH group were lower as compared to the HCD group. The only significant difference in renal function test between HCD and HCD + TH groups reported were theserum creatinine at completed 48 hours. Histological examination of the kidney tissue of the HCD and HCD+TH groups at 6 weeks revealed segmental mesangial hypercellularity and mesangial matrix expansion of the glomeruli. Conclusion: Tualang honey supplementation has resulted in an improvement of the renal profile which is suggestive of its renoprotective effect. However, the histopathological examination of the kidneys revealed similar changesin both groups and this may be related to the dose of honey used in the study. Additionally, tualang honey showed improvement in LDL-c, triglyceride and vLDL levels indicating its lipid lowering activities
The Effects of Different Types of Stimulus and its Test-Retest Reliability on Cervical Evoked Myogenic Potential (Cvemp) Results
Get PDFIntroduction: The Cervical Vestibular Evoked Myogenic Potential (cVEMP) is used to evaluate the integrity of saccule and inferior vestibular nerve. There are a lot of factors affecting cVEMP results including stimulus types. This study was carried out to determine the effects of different stimuli on cVEMP results and its test-retest reliability. Materials and method: 25 normal hearing subjects were recruited. The cVEMP testing were performed in 2 sessions with 1 week gap between each sessions. The cVEMP waveforms were recorded in sitting upright position with electrodes placed at; i) upper one-third of sternocleidomastoid muscle for active electrode, ii) suprasternal notch for inactive electrode and, iii) middle of forehead for the ground electrode. The stimuli (500Hz tone burst, click, narrowband chirp and broadband chirp) were presented via insert phone at 95dBnHL. The cVEMP results (P13-N23 peak-to-peak amplitude, P13 latency and N23 latency) were recorded. Results: Result showed; i) 500Hz tone burst produced significantly largest amplitude; ii) narrowband chirp produced significantly shortest P13 latency; iii) broadband chirp produced significantly shortest N23 latency; iv) no significant difference of P13 and N23 latency were observed between two sessions; and v) significant difference of P13-N23 amplitude were observed between two sessions for all stimuli except for narrowband chirp. Conclusion: The 500Hz tone burst was observed to be the most ideal stimulus (produce highest amplitude). All stimuli produced good test-retest reliability in terms of latency. However, most of the stimuli produced poor test-retest reliability in terms of amplitude except for narrowband chirps
The Level of Depression, Anxiety, Stress and Coping Strategies in Parents with Congenital Talipes Equinovarus Children
Get PDFIntroduction: Having children with congenital anomalies, particularly congenital talipes equinovarus (CTEV) may impact the psychological wellbeing of the parents. This study is to assess the psychological impact of CTEV, the related factors, and the coping strategies used by the parents in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang. Materials and method: A cross-sectional study involving 43 parents with CTEV child was conducted from 18 July till 27 August 2016 at Hospital Tengku Ampuan Afzan. Selfadministered Malay version of Depression Anxiety and Stress Scale 21 items (DASS-21)1 is used to measure the psychological wellbeing of the parents and the Malay version of Brief COPE is used to measure coping strategies. Data were analysed using frequencies, percentages and Chi-square χ2 test. Results: There were 43 respondents, majority were Malay (90.7%), female (86%), and married (97.7%). Average age was 30.3 years old. 70% of the respondents were having a positional CTEV child and 30% have structural CTEV. Overall, prevalence of depression, anxiety, and stress among parents were very low. Only 9.3% experience depression, 11.6% experience anxiety, and only 2.3% was reported to be stress. The psychological wellbeing of the parents was not related with the parental age, gender, marital status, education level, and monthly income. The most common coping strategy used is religion, acceptance and positive reinterpretation. Conclusion: Only a few parents with structural and positional CTEV reported symptoms of depression, anxiety, and stress and most of them use positive coping strategies such as religion, problem focused and dysfunctional focused
Neonatal Clavicle Fracture: A Review of Fourteen Cases in East Coast Peninsular Malaysia
Get PDFIntroduction: The purpose of this study is to identify the incidence of clavicle fractures in newborn associated with fetal, maternal and process of deliveries in Kuantan General Hospital from June 2012 until January 2014. This study is to determine epidemiological data of clavicle fractures, maternal and baby risk factors associated with clavicle fractures of newborn and its’ outcome. Methods: This is a prospective study. 13 patients were identified to fulfill the inclusion criteria of the study. The data of sociodemographic, associated fetal and maternal risk factors and the outcomes were recorded using proforma. The statistical data analysis was done using SPSS 12.0. Results: Out of 20,257 live births at our centre during the study period, 13 infants were diagnosed to have clavicle fractures, giving an incidence of 0.64 per 1000 live births. There were 5 (38.5%) left, 7 (53.8%) right and one (7.7%) bilateral fracture. All fractures located at the mid shaft of the clavicle and none have associated brachial plexus injuries. All infants were delivered through vaginal delivery (61.5%); five through assisted delivery (instrumental); 2 (15.4%) forcep and 3 (23.1%) vacuum. Two of the babies developed shoulder dystocia. The average birth weight was 3371 grams (SD 0.269) and mean gestational age was 38.7 weeks (SD 1.16). Five of the mothers (38.5%) were primigravida and eight (61.5%) were multigravida in which,7 (53.8%)were healthy without other co-morbidty, 5 (38.5%) having gestational diabetis and one (7.7%) hypertension. The average maternal weight was 62.0 kg and height 1.58 metres with average BMI of 24.16 (3.29SD). All eventually had a complete recovery at 6 weeks with clinical and radiological evident of fracture union. Conclusions: In conclusion, all patients with clavicle fractures were found following vaginal delivery. There were no associations between neonatal clavicle fractures with maternal or baby risk factors. All fractures healed without any complications
Demographics Characteristics and Analysis of Malocclusions of Orthodontic Patients Seen at IIUM Dental Specialist Clinic, Kuantan, Pahang
Get PDFIntroduction: Malocclusion is one of the most common dental problems observed. Limited data is currently available regarding the demographics of malocclusion observed locally. Materials And Methods: This is a retrospective study where 770 patients were recruited from May 2009 till December 2014. 560 orthodontic study models that met the inclusion criteria were examined and the malocclusions were classified according to the British Standard Institute (BSI) incisor classification. Demographic pattern and their relationship were analysed by structural equation modelling using SPSS (version 23.0). Results: From 560 study models analysed, 72% were female. The age of the patients ranges from 7-12 years old (17.1%), 13-17 years old (55.9%) and >18 years old (27.0%). Majority of the patients were Malay followed by Chinese (5.7%), Indian (1.8%) and other races (1.8%) Treatments received were fixed appliances (FA) (60.0%), removable appliances (RA) (12.5%), functional appliances (FnA) (1.1%), combination of RA and FA (16.1%), combination of FnA and FA (2.1%) and consultation (8.2%). Types of malocclusions observed were Class I (25.7%), Class II/1(32.7%), Class II/2 (7.5%) and Class III (34.1%). There was significant association (p<0.05) between age and gender towards the types of malocclusions and treatments received were observed. Conclusion: Age and gender play significant role in determining the types of treatment received by patients with malocclusion. Data obtained will be beneficial for departmental future management and clinical planning. 
Detection rate of Pneumococcal Pneumonia using the Urine Antigen Kit BinaxNow Streptococcus Pneumoniae Test: a Prospective Cohort Study in a Tertiary Hospital in Malaysia
Get PDFBackground: Pneumococcal pneumonia is the commonest type of bacterial pneumonia worldwide. In Malaysia, the reported incidence of pneumococcal pneumonia is low. This may be due to poor sensitivity of conventional methods. The use of BinaxNOW, a urinary antigen test for Streptococcus pneumoniae can aid in the diagnosis of pneumococcal pneumonia. Objective: To determine the detection rate of pneumococcal pneumonia using BinaxNOW kit and to compare this with the conventional culture method for blood and sputum. Methods: This was a prospective cohort study involving patients 18 year-old and above admitted for community-acquired pneumonia (CAP) or health-care associated pneumonia (HCAP) to UKMMC between December 2011 and June 2012. BinaxNOW test, serology for Mycoplasma, Legionella and Chlamydia and cultures from blood/sputum/other respiratory tract samples and other routine investigations were performed. Results: A total of 102 patients were recruited; 89 (87.3%) with CAP, 13 (12.7%) with HCAP. 57 (55.9%) had pneumonia of unknown aetiology, 11 patients (10.8%) had positive blood cultures, 8 patients (7.8%) had a positive urine BinaxNOW test and 6 patients (5.9%) had positive sputum cultures. Streptococcus pneumoniae was the commonest isolate accounting for 9 cases (8.8%) followed by Klebsiella pneumoniae in 7 cases (6.9%). 8 out of 9 patients with positive urine BinaxNOW test had negative cultures for Streptococcus pneumoniae. One patient grew Streptococcus pneumoniae from the tracheal aspirate however the urine BinaxNOW test was negative. Conclusion: The use of urine BinaxNOW kit in UKMMC increased the detection rate of pneumococcal pneumonia in hospitalized patients
The Antimalarial Properties Of Essential Oils Of The Leaves Of Malaysian Plectranthus Amboinicus (Lour) Spreng In Mice Infected With Plasmodium Berghei
Get PDFThis study was conducted to evaluate the phytochemical contents and antimalarial properties of the oils extracted from the leaves of Malaysian Plectranthus amboinicus in mice infected with Plasmodium berghei. The essential oils were extracted and prepared by using steam distillation technique and subjected to phytochemical screening by using GC-MS. Antimalarial activity of different extract doses of the essential oil was tested in vivo in ICR mice infected with Plasmodium berghei (PZZ1/100) during early, established and residual infections. In all, 5 compounds made up 88.34% of total oil and the major chemical compounds were carvacrol (85.14%), thymoquinone (1.65%), terpinen-4-ol (0.70%), octenol (0.62%) and thymol (0.23%). Antimalarial assay showed this essential oil as a potential prophylactic agent with the percentage chemosuppression of 45.23%, 18.28%, 45.38% and 58.26% while treated with 50, 200, 400 and 1000 µL/kg respectively of essential oil and curative agent with percentage of chemo suppression of 54.10%, 47.35%, 56.75% and 65.38% while treated with the above dose of essential oil. Statistically no reduction of parasitemia was calculated for suppressive test. The extract has prophylactic and curative effects on P.berghei in mice
Prevalence of Hypertension and Glycaemic Control in Adult Type-2 Diabetes Patients: A Preliminary Retrospective Cohort Study in Kuantan, Pahang, Malaysia
Get PDFIntroduction: Hypertension (HPT) is the most common co-morbidity among type-2 diabetes mellitus (T2DM) patients which ominously increased their morbidity and mortality from cardiovascular diseases (CVD). We aimed to determine the prevalence and control status of HPT, and also the glycemic control among T2DM patients in a primary care clinic in Kuantan, Pahang. Methods: It was a retrospective study of 154 T2DM patients’ records, aged ≥18 years selected by random sampling. The statistical analysis is done by using Chisquare test, paired sample “t” test and ANOVA “F” test. Results: Among T2DM patients; 47% were Malay, 45% Chinese and 9% Indian. The prevalence of HPT was 72.1% and majority of T2DM patients were women (60%). Out of 82 T2DM aged >60 years, 80.5% were hypertensive. 67.2% of T2DM patients between the age of 40-60 years and 25% age <40 years were also hypertensive (p= 0.003). BP-controlled status were classified into controlled, uncontrolled, systolic and diastolic HPT. All patients were compared between the last visit and one year before, which reported 55.8% versus 33.1%, 14.9% versus 51.9%, 20.1% versus 10.4% and 9.1% versus 4.5% respectively. There were significant rises in percentage of systolic BP (by 9.7%) and diastolic HPT (by 4.6%) p<0.0001, from the first visit. BP controlled status for aged group >60 years showed increments in systolic HPT and diastolic HPT which were significant (p<0.0001). Regarding glycemic parameters, 71.4% T2DM patients had poor controlled level of Hb1Ac (≥6.5) and only 20.1% remained controlled after one year (p<0.0001). Conclusions: This pilot study found high prevalence of HPT, increasing prevalence of systolic HPT and diastolic HPT in older age group as well as poor glycemic control among T2DM patients