IIUM Medical Journal Malaysia (IMJM)
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An Unusual Cause of Progressive Chest Deformity in A Child
Get PDFInflammatory myofibroblastic tumour (IMT) is a rare tumour with intermediate malignant potential and unclear aetiology. In most cases, the clinical presentation is non-specific. The liver and lung are the most common location for IMT in children, and mediastinum is an uncommon place. Symptoms vary depending on the location of IMT, thus making a definitive diagnosis to be even more difficult. Until the histological investigation can rule out IMT, it should be considered in the differential diagnosis of individuals with localised masses. We report here a case of an 8-year-old boy with right-sided chest pain and deformity before the diagnosis of mediastinal IMT was made through tissue biopsy
Dual Method P6 Acupressure Therapy for Nausea and Vomiting during Early Pregnancy in Indonesia: A Mixed Method Study
Get PDFINTRODUCTION: Nausea and vomiting during pregnancy (NVP) are not only considered to be a sign of discomfort both culturally and clinically but also seen as potential safety risks for mothers and their unborn children. One of the non-pharmacological complementary therapies was the use of acupressure. The purpose of this study was to assess the effectiveness, safety, and satisfaction of the dual method of P6 acupressure as an intervention in affected pregnant women to reduce NVP and explore the method P6 acupressure perception as the intervention of choice in the treatment of nausea and vomiting in pregnancy. MATERIALS AND METHOD: A mixed-methods sequential explanatory study was conducted which consisted of two phases: quantitative followed by qualitative. The first phase involved the recruitment of 120 pregnant women with moderate to severe NVP symptoms. Six participants were in the intervention group qualitative phase. RESULTS: The Pregnancy-Unique Quantification of Emesis (PUQE) scores of participants in the intervention group were lower compared to that of the control group after the intervention period (p=<0.01). The PUQE score was found to be reduced in the intervention group of having severe into having mild symptoms. There were no adverse effects reported after the intervention. Majority of the participants were satisfied after using the dual P6 acupressure method (Z=1830, p<0.01).Meanwhile, during the qualitative phase, six themes emerged. CONCLUSION: A dual method of P6 acupressure therapy could be effective, safe, and satisfactory in relieving NVP. Therefore, maternity care providers may consider using this method as a therapeutic alternative for the management of NVP
Barriers Towards Healthcare Access and Services among People with Disabilities: A Scoping Review of Qualitative Studies
Get PDFHealthcare access and services is one of the challenges faced by people with physical disability (PWPD). PWPD also has at risk of early death and preventable chronic illness. Lack of access to healthcare services includes delay or failure to receive needed care, lack of continuity of care and financial burden will result in deterioration of health, wellbeing and functional status. The aim of this paper was to review barriers towards healthcare access and services among PWPD based on the existing qualitative studies. We conducted a scoping review of relevant qualitative articles from PubMed, Scopus and ProQuest. The article search was based on the available keyword in the title with the publication restricted within 10 years (between 2012 to 2021). The search strategy was conducted using MeSH terms of ‘barriers, healthcare access, healthcare services and physical disability’. In this review, people with different kinds of physical disabilities were included. There were 2004 articles obtained from the initial search. 27 articles met the inclusion criteria for the final review. In each study, PWPD noted various barriers to access healthcare services. Findings from this review revealed five themes: personal; financial; attitudinal and communication; health system; structural and physical barriers. The findings showed that PWPD faces various barriers when accessing healthcare services. Addressing these barriers could help create a healthcare system that is inclusive and accessible for all
Adrenal Cavernous Hemangioma: A Rare Incidental Finding from A Routine Ultrasound Assessment
Get PDFCavernous hemangioma of the adrenal gland is a very rare benign vascular tumour. Its rarity and non-specific presentation pose a challenge to the radiologists and surgeons in making the correct diagnosis. We report a case of adrenal cavernous hemangioma in a 76 years old gentleman, in which a large heterogeneous mass was incidentally found at his left hypochondriac region during a routine KUB and prostate ultrasound assessment for benign prostatic hyperplasia. A multiphasic CT study performed and revealed a large mass with a maximum diameter of 18 cm occupying the left suprarenal area. Considering the large size of the left suprarenal mass with mass effect to the surrounding structures, the patient undergone left adrenalectomy. His final histopathological diagnosis revealed a cavernous hemangioma. This case highlighted literature review and role of imaging in this extremely rare benign tumour as one of the differential diagnosis of an adrenal incidentaloma
Toxicity Effects of Clitoria Ternatea L. Extract in Liver and Kidney Histopathological Examination in Mus Musculus
Get PDFINTRODUCTION: Clitoria ternatea L. or butterfly pea is more increasingly being consumed as traditional medicine though it contains secondary metabolites, which can be non-beneficial to its consumer. LD50 and histopathological examination are used frequently in toxicity studies. Thus we aimed to determine the toxicity level of Clitoria ternatea L. flower extract and its effects on the liver and kidney in mice. MATERIALS AND METHOD: We carried out this analytical experimental study with from August 2021 to June 2022. Mice were categorised into five dose groups. They were treated with aquades, paracetamol-induced, and flower extract at 500, 1000, and 2000 mg/kg BW orally for 14 consecutive days. RESULTS: C.ternatea flower was classified as having very low toxicity (LD50>2000 mg/kg BW). We detected toxicity signs in mice such as lethargy and tremor in the group treated with more than 1000 mg/kg BW. Histopathological examinations showed leucocytes, vacuolation, and necrosis in the liver and kidneys of mice. There were significant differences in liver and kidney histopathological scores between the five study groups (p<0.05). CONCLUSION: C.ternatea flowers are safe to consume at a dosage of 500 and 1000 mg/kg BW since no mice died after being treated for 14 days. Liver and kidney damage appeared at 2000 mg/kg BW dosage in histopathological examination. Hence, its consumption at this dosage should be limited
Implementation of Video Modeling Animation on Toilet Training Ability in Autism Spectrum Disorders
Get PDFINTRODUCTION: Toilet training is critical for the quality of life of individuals with autism spectrum disorders (ASD) and other developmental disabilities. This is essential because an individual with ASD is often late to acquire these skills or fails to do so. This study aims to identify and analyze the implementation of animation video modeling (AVM) to improve toilet training abilities in children with autism spectrum disorders. MATERIALS AND METHODS: The research uses a quantitative descriptive approach with an experimental research design using One Group Pretest Posttest Design. The pretest was carried out before the intervention, and the posttest was carried out after the AVM gave toilet training intervention. The sampling technique was in the form of total sampling, namely 50 children(43 boys and 7 girls) with autism. The research instrument was a checklist of statements. Data analysis using the Wilcoxon Sign Rank Test. RESULTS: The results showed that almost half of the ability levels of children with autism before being given AVM toilet training were in a suitable category, nearly half of the children with autism after being given treatment were in a good type with a p-value 0.011; there was a significant difference in the level of ability before and after given an AVM. CONCLUSION: AVM is one of the effective interventions to improve toilet training abilities in children with ASD. AVM can help children in the elimination process that can be done independently in improving the quality of life in children with autism
Unaltered Long-Term Maternal Endothelin System in a Gestational Hypertensive Rat Model
Get PDFINTRODUCTION: Cardiovascular diseases (CVDs) are two to four times more likely to affect women with a history of hypertensive disorders of pregnancy (HDPs). One of the etiologies of CVDs is endothelial dysfunction, which results from an imbalance in the production of endothelin-1 (ET-1) and nitric oxide (NO). Although blood pressure (BP) is normalized postpartum, we hypothesize that a transient increase in BP during HDPs may cause ongoing endothelial dysfunction. We aimed to discover the impact of HDPs in the development of cardiovascular diseases after long-term postpartum changes in endothelin-A receptor (ETAR) and endothelin-B receptor (ETBR) expression and the concentration of ET-1 and NO. MATERIALS AND METHOD: Twenty-four female Sprague-Dawley (SD) rats were assigned into four groups (n = 6), including two treatment and two control groups. All rats were sacrificed on Day 30 postpartum. The NO and ET-1 concentrations were determined by ELISA and the ETAR and ETBR expression of the mesenteric arteries were measured by immunohistochemistry studies. RESULTS: The mean concentrations of ET-1 and NO were not significantly different in all groups. There was no significant difference in the mean immunoreactivity of ETAR and ETBR percentages area in the tunica intima and media in all groups. CONCLUSION: No evidence demonstrates significant changes in the endothelin system of the resistance arteries at the proteomic level in the long-term duration following HDP. Further investigation of its potential chronic effect warrants a deeper analysis at the molecular and ultrastructural levels
ECG Risk Score Model to Predict SCD in HFrEF: Retrospective Review in a Tertiary Centre
Get PDFINTRODUCTION: Heart failure with reduced ejection fraction (HFrEF) patients need to be risk stratify as guidelines have shown that patients with left ventricularejection fraction (LVEF) <35% could be prevented from sudden cardiac death (SCD) by insertion of prophylactic implantable cardioverter-defibrillator (ICD). Thus we conducted a retrospective single tertiary centre study to evaluate the used of electrocardiogram (ECG) risk score model in identifying the individuals who at higher risk of SCD. MATERIALS AND METHODS: A total of 356 heart failure with reduced ejection fraction (HFrEF) patients treated at University Malaya Medical Centre between January 2017 and December 2021 were enrolled into this study. The patients’ demographics, types of heart failure, medications, and ECG parameters data were collected. The study outcomes were survivor or death in and the cause of death were subdivided into SCD or non-sudden cardiac death (non-SCD). RESULTS: A total of 156 study patients were survivor whereas another 120 had SCD and 70 had non-SCD. There were six ECG parameters that remained significant in the final model, namely the bundle branch block (BBB), abnormal P waves, QRS duration, QTc duration, TpTe interval and PR interval. The significant ECG parameters were combined into a risk score to enumerate prediction ability towards SCD. From our ECG risk score model, subject with ≥2 ECG abnormalities had more than 3-fold increased risk for SCD (HR 3.739, 95% CI 1.703-8.211, P 0.001) and the risk proportionately increased with increasing ECG abnormalities. CONCLUSION: Our findings suggested that the cumulative ECG risk score model was independently associated with SCD and particularly effective for LVEF <40% where risk stratification model remained scarce. So, we would like to propose for a prospective study to further evaluate our study outcome