IIUM Medical Journal Malaysia (IMJM)
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Giant Pyogenic Granuloma Gravidarum of the Hand
Get PDFWe describe a case of a giant pyogenic granuloma affecting the left index finger of a 23-year-old pregnant lady requiring surgical excision. Pyogenic granuloma gravidarum is a benign hyperplastic lesion that commonly presents on oral mucosa, typically the gums, in approximately 5% of pregnant women. Skin lesions over the fingers are an unusual site during pregnancy with only a few cases reported in the literature. The lesion was excised and a diagnosis of lobular capillary haemangioma was made based on histopathological evaluation. We delayed surgery until after parturition since recurrence is likely to be lower due to lower levels of circulating oestrogen and progesterone. The prognosis is usually excellent following resection. However, recurrences have been reported regardless of the treatment method
Integration of Islamic Input in Medical Curriculum – Universiti Sains Islam Malaysia (USIM) Experience
Get PDFMuslim doctors are those qualified doctors who practise their professional knowledge and skills in line with Islam and upholds the highest standards of ethical and professional behaviour. The medical curriculum of the Faculty of Medicine and Health Sciences of Universiti Sains Islam Malaysia (USIM) was designed with the integration of Islamic input which aims at producing doctors who are able to practise medicine that is integrated with Islamic, moral and ethical values. Halaqah Studies and Fundamental Islamic Knowledge (FIK) courses such as History of Medicine in Islam, Science and Medicine in Quran and Sunnah, Akhlak and Tasawuf, Islamic Jurisprudence and Medical Ethics and Fiqh Issues are taught to students during the pre-clinical and clinical phases. Memorization of selected Quranic verses throughout the programme aim to get the students to apply the verses of the al-Quran into practice in everyday life and especially in their clinical practice. Islamic values are emphasised during doctor-patient interactions in all clinical postings. Islamic knowledge and values integrated in the curriculum are assessed in written and clinical examinations. The outcome of the integration of the Naqli component in the medical curriculum has been demonstrated positively by the students in the patient management problems and clinical consultations. Studies on the outcome of the integrated Islamic input in the medical curriculum among the clinical students and graduates are being carried out
Allergic Reaction Following Insertion of Vancomycin Loaded in Bone Cement
Get PDFVancomycin bead is an important ancillary treatment for osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA). However, red-man syndrome, which can be a life-threatening complication of vancomycin, may occur from the use of vancomycin beads albeit rarely. We report our first case of red-man syndrome caused by vancomycin bead's insertion for chronic osteomyelitis. Symptomatic treatment was not effective and removal of the vancomycin beads seems to be the best treatment for this condition
Acute Appendicitis in Pregnancy: a Diagnostic and Management Challenge
Get PDFAcute appendicitis is the most common extra-uterine surgical emergency encountered during pregnancy, but an accurate diagnosis is still an enigma. Anatomical shifting of the appendix by the enlarging uterus makes the clinical and sonographic diagnosis difficult. Prompt diagnosis and treatment are essential to prevent perforation, which increases the risk of fetal and maternal death. Surgical intervention, either by an open laparotomy or laparoscopy is the most appropriate treatment for appendicitis. This article reviews the epidemiology, clinical diagnosis, investigation, complications and treatment of acute appendicitis in pregnancy
Multiple Renal Arteries with an Ascending Upward Renal Vein of the Right Kidney: a Case Report
Get PDFAs it is known; the majority of the human subjects has two renal arteries arising from the abdominal aorta; each will supply one kidney but in 30% of individuals, certain variations can be found. Accessory renal arteries constitute the most common and clinically important of these variations. For our case report, we are presenting one of these different variations that can be found in the blood supply of the kidneys. During dissecting the abdomen of an approximately 65 years-old male cadaver, multiple variations were found. There were double right renal arteries with prehilar branching of the upper renal artery. We found also that the right renal vein ascended upwards obliquely before ending in the lateral aspect of the inferior vena cava. Variation in the renal vessels is relatively common, especially multiple renal arteries, and can go smoothly without any abnormalities with the function of the kidney, but in some situations like renal transplantations, vascular reconstructions, and various surgical and radiological diagnostic techniques, the study of the anatomy of these variations is of crucial importance to decrease the patient morbidity during surgical procedures
A Case of Eosinophilic Granulomatosis with Polyangiitis (Churg-Strauss, EGPA) Presenting With Relapsed Mononeuritis Multiplex
Get PDFWe report a case of eosinophilic granulomatosis with polyangiitis (EGPA), a rare multisystem disorder characterized by difficult-to-control asthma, hypereosinophilia and polyneuropathy. We also discuss the Five Factor Score (FFS) risk stratification strategy, which is used to quantitate the extent of the disease and guide treatment strategy
A Puzzling Case of Biliary Stricture with Calcified Liver Nodules
Get PDFTuberculous (TB) biliary stricture with calcified liver nodules rendering obstructive jaundice is a rare clinical phenomenon. Recently, we encountered a young patient with obstructive jaundice who was investigated in a general hospital. He was sent to our hospital for subsequent management after undergoing a series of investigations and biliary stenting. The radiological imagings performed revealed multiple calcified lesions in the liver with proximal bile duct strictures. Blood investigations, tumor markers and tuberculous work up were not remarkable. Subsequently, he underwent laparotomy and biliary reconstruction. Postoperatively, he was discharged well. Histopathological examination of the hepatoduodenal nodes showed chronic infections and granulomatous lymphadenitis, suspicious of a mycobacterium infection
Thoracic Aortic Aneurysm Presenting as Vocal Cord Paralysis
Get PDFWe present a case of 80-year-old man with two-year history of hoarseness of voice secondary to left vocal cord paralysis. CT scanning revealed a saccular thoracic aneurysm compressing the left recurrent laryngeal nerve. A review of literature on Ortner's or cardiovocal syndrome is presente
Pilot Study on the Effect of Yasiin Recitation on the Haemodynamics of Ventilated Patients
Get PDFIntroduction: Qur’anic verses recitations to ill patients are practiced by many Muslims as a form of healing and worship. The effectiveness has been observed in many medical institutions; however, it has never been objectively measured and documented. This pilot study was conducted to construct a methodological approach to evaluate the therapeutic effects of Yasiin recitation on the haemodynamics of critically ill patients. Methods: Ventilated Muslim patients in coronary care unit of a teaching hospital were evaluated. Yasiin was recited twice; by one of the researchers and then by the patients’ relatives. Mean arterial blood pressure, pulse rate, oxygen saturation level and electrocardiographic changes, were observed. The difference of the parameters before and during recitation was analysed. Results: Five patients fulfilling the selection criteria were selected; two acute myocardial infarctions, two congestive cardiac failures, and a third-degree atrioventricular block. Based on a non-parametric two-related-sample test, the haemodynamic parameters were not significantly affected by Yaasiin recitation. At the end of the study, two of the patients passed away, one patient was extubated and survived. Two patients were still on ventilators when the study had been completed. Limitations in the study were observed and highlighted in explaining the equivocal results. Conclusions: The effect of Yasiin recitation on heamodynamics of patients was not proven in this study. Further refinements might be needed based upon the observation on limitations encountered. It is hoped that this humble effort would pave the way for further studies to explore this field