IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
Stress and Its Association with the Academic Performance of Undergraduate Fourth Year Medical Students at Universiti Kebangsaan Malaysia
Get PDFIntroduction: Student can be stressed due to different stressors such as academic, financial, health related or loss of close family member or friend, etc. Stress is the bodies’ reaction both neurologically and physiologically to adapt to the new condition. Stress has a negative effect on the academic performance of the students. This study was aimed to explore the stress and stressors and also to determine the association between stress levels and the academic performances in terms of cumulative grade point average (CGPA) of undergraduate medical students. Methods: It was a cross-sectional study conducted among all 234 year-4 medical students of Universiti Kebangsaan Malaysia (UKM), session 2011-2012. Sample size comprised of 179 students after fulfilling all inclusion and exclusion criteria. A validated Medical Students’ Stressor Questionnaire (MSSQ) was used to collect the data. Stress level and its association with CGPA of semester-1 examination were analysed. Results: Response rate was 76.49%, where 72% were female and 69% resided in the hostel. Academic Related and Social-related Stressors caused for severe and high stress in 84% and 49% respondents respectively, with insignificant differences between gender and residency. Respondents with a high and severe stress level were observed to have higher CGPA. Conclusion: UKM medical students are highly resourceful to manage their stress well and thus denying the negative effect of stress towards their academic performance. Medical schools should train students exposing various personal and professional developmental activities that able to face the everyday challenges and manage stress well and thereby achieve better academic performance
Hemorrhagic Thoracic Spinal Epidural Angiolipoma: A Case Report
Get PDFSpinal epidural angiolipomas are rare benign tumors. The tumors contain both vascular and mature adipose components. Typically, they present with a progressive clinical course. Acute presentation is rare. We present a case of a fifteen-year-old girl who presented with a sudden onset of backpain followed by paraparesis with bladder and bowel incontinence. Neurological examination showed sensory loss below T10 with Grade 2 motor power. Spinal MRI showed long segment extradural lesion at T6-T9 level. Multiple laminectomy and excision of the tumor containing areas of hemorrhage was performed. Histopathology report revealed angiolipoma
Sociodemographic Profile, Contraceptive Practice and Awareness of HIV Infection among Unmarried Postpartum Women in a Tertiary Centre in Malaysia
Get PDFIntroduction: To describe the sociodemographic profile, contraceptive practice, and awareness of HIV infection among unmarried post partum women in the biggest government hospital in Pahang. Methods: A cross sectional questionnaire-proforma-based study was conducted for one year duration from August 2010 until July 2011 by identifying and recruiting all the unmarried women upon admission for delivery. Basic information were obtained from the use of patients’ case notes, and further related and necessary information were obtained from a direct face-to-face interview based on a proforma. Results: A total of 121 unmarried women were identified and recruited. The age ranged from 13 to 36 years with a mean age of 21.6 years. 31.4% were teenagers. Only 16% of patients have tertiary education, and 2.5% never had any formal education. About one third of the women were smokers or ex-smokers, 7.5% had consumed alcohol, but none denied ever use of any recreational drugs. Almost 9% has prior history of being sexually assaulted. About three quarter of the women never used any contraceptive method. Majority of the patients (85.1%) were aware of HIV transmission risk; 75% never had any antenatal checkup or booked at late gestation (> 20 weeks); and 45.8% were not aware of any support groups for single mothers. Conclusion: Single unmarried women are associated with disadvantaged sociodemographic profile. Contraceptive practice was also very low despite significant awareness towards risk of HIV infection. Further follow up, support and care should be offered to these women
New Coumarinic Azo-Derivatives of Metoclopramide and Diphenhydramine: Synthesis and In Vitro Testing for Cholinesterase Inhibitory Effect and Protection Ability Against Chlorpyrifos
Get PDFIntroduction: This study aims to synthesize new coumarin azo compounds of metoclopramide and diphenhydramine and to evaluate their in vitro cholinesterase inhibitory effects and protection abilities against chlorpyrifos. Methods: Two series of azo coumarin compounds were synthesized. Series I compound resulted from the diazotization of metoclopramide and then coupling with coumarin and 4-methyl coumarin to give compounds 1 and 2 respectively. Series II compound resulted from the diazotization of 7-aminocoumarin and 7-amino 4-methyl coumarin and then coupling with diphenhydramine to give compounds 3 and 4 respectively. The new compounds were tested for their in vitro cholinesterase inhibitory effect and protection ability against chlorpyrifos using the modified Elman electrometric method. Results: Metoclopramide derivatives with coumarin show selectivity protection for ChE against chlorpyriphos inhibitory effect as protect BChE and increase the inhibition of the AChE, or the opposite. Conclusion: Diphenhydramine derivatives with coumarin show more protective ability for both BChE and AChE as one of them shows the maximum protection for all concentration. However, the other derivative shows different manner as the low concentrations act as metoclopramide derivatives while the high concentration act as first diphenhydramine derivative (protect both AChE and BChE)
Surgical Management of Large Occipital Encephalocoele: A Case Report
Get PDFCranium dysraphism occur less commonly than spinal dysraphism. Overall, occipital encephalocoeles are more frequent than anterior encephalocoes. A large occipital encephalocoele possess difficulty in surgical intervention, not only the sac contains large amount of herniated brain tissue, but the appropriate positioning for successful intubation as well as the higher rate of surgical complications such as cerebrospinal fluid leakage and skin necrosis. In this case report, surgical management of large occipital encephalocoele is discussed. The use of antibiotics in ruptured encephalocoele is recommended
Use of Thoracoscopic Splanchnicectomy for the Relief of Chronic Pancreatic Pain: a Case Series
Get PDFChronic pancreatitis may cause disabling pain not responding to oral analgesics and/or drainage procedures. Although pancreatectomy is a definitive treatment, it carries a significant morbidity and mortality. Celiac plexus ablation is beneficial, although it is a temporary method for pain relief. While bilateral splanchnicectomy provides a more permanent pain relief, it is a difficult procedure requiring thoracotomy and results in significant morbidity. Thoracoscopy is an attractive alternative to perform splanchnicectomy. The results of a case series on video assisted thoracoscopic sympathectomies performed at the university surgical unit, Peradeniya, Sri Lanka from January 2011 to June 2013 was analyzed to evaluate the surgical technique and to quantify the efficacy of pain relief. Operating time, blood loss, intraoperative complications, conversion to open surgery, pre-operative and post-operative pain assessment using visual analogue scale score (VAS) were recorded. Seven patients who underwent video assisted thoracoscopic splachnicectomy were analyzed. All had an acceptable operating time (6omin), no measurable blood loss, no conversions to open surgery, no intercostal drainage, early mobilization and feeding. All had an average VAS of 8-10 pre-operatively. This reduced to a VAS of 1 or no pain in all, on post-operative day one, at one and six months. The few who experienced mild pain needed occasional use of paracetamol or diclofenac sodium. Non required narcotic analgesics. Bilateral thoracoscopic splanchnicectomy is a safe, effective and more attractive alternative as it carries a minimum morbidity, mortality and provides an excellent relief of chronic agonizing pancreatic pain
Pilomatrixoma: A Diagnostic Pitfall on Fine-Needle Aspiration Cytology of Benign ‘Neck Metastases’
Get PDFPilomatrixoma is a benign tumour that originates from the matrix of the hair root. This rare tumour is usually managed by the dermatologists. The commonest location of this tumour is in the head and neck region; hence, it can be encountered by any doctors with interest in this area. When presented in the neck, this hard tumour may pose a diagnostic challenge. A case report of pilomatrixoma misdiagnosed as a metastatic neck disease from fine-needle aspiration cytology is presented. The mistake in the diagnosis has led to a more aggressive and high morbidity surgery than necessary. It is important that head and neck doctors be aware of this condition and includes it in the differential diagnosis of hard masses presenting in the neck
Effects of Eurycoma Longifolia Extract on the Isolated Rat Heart
Get PDFIntroduction: Eurycoma longifolia (E. longifolia) which is better known locally as Tongkat Ali is an indigenous plant in Malaysia. It belongs to the family of Simaroubaceae and is popular as a traditional medicine for its aphrodisiac properties. Throughout the years, several studies have been conducted to prove its effect on aphrodisiac action, antimalarial, antibacterial and anxiolytic properties but its effect to the cardiovascular system had not been fully explored. This study was aimed to demonstrate the changes that take place in the isolated heart following the injection of the extract. Methods: Three parameters that were measured included the coronary perfusion pressure (CPP), the left ventricular developed pressure (LVDP) and the heart rate (HR). Eighteen isolated rat hearts were used and were divided equally into three groups. The first group was to observe the effect of Isoprenaline, a β agonist while the second group was to see the effect of sodium nitroprusside (SNP), a nitric oxide (NO) donor. The dose which gave the maximum effect for these two positive controls was used to compare with the effect of E. longifolia water extract in the third group of rats. Isolated heart was mounted using the Langendorff apparatus and perfused with modified Krebs-Henseleit buffer. Doses of controls and the extract were instilled through an injection port, and the effect of each dose was monitored. Results: E. longifolia extract was found to reduce the CPP in normotensive rat at two of the highest doses. A dose of 1.0 mg of the extract reduced the CPP significantly from 34.52 ± 4.99 mmHg of the baseline value to 31.99 ± 4.93 mmHg while the dose of 10.0 mg of the extract reduced the CPP significantly to 32.67 ± 3.89 mmHg. However, there were no significant changes of effect of the extract on the LVDP and HR as compared to control. Conclusion: These early findings suggest that E. longifolia extract may have vasodilatory property, which supports its traditional usage with minimum cardiovascular side effects