IIUM Medical Journal Malaysia (IMJM)
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A Case of Acute Hepatitis E Complicated by Acute Pancreatitis in Eastern India
Get PDFViral hepatitis may be occasionally associated with acute pancreatitis. Usually the patient presents with abdominal pain in the second or third week of illness. Hepatitis A or E viruses are mostly implicated. HEV related acute pancreatitis was first reported only 12 years ago. We report a case of a young male presenting with acute Hepatitis E infection complicated by pancreatitis. He had an uneventful recovery. This is probably the first report of this association from Eastern India
Obesity and Habitual Physical Activity Level among Staffs Working in a Military Hospital in Malacca, Malaysia
Get PDFIntroduction: Obesity has been recognized as a major public health concern due to lack of physical activity and a sedentary lifestyle. Methods: This cross sectional study was carried out to determine the status of body mass index (BMI) and habitual physical activity level among staffs working in Military Hospital, Malacca using Habitual Physical Activity Questionnaire (HPAQ). Results: About 120 HPAQ were distributed and only 82 responded with 23(28%) of them males and 59 (72%) females, aged between 21 to 59 (40.52 ± 9.38) years old. Anthropometry analysis showed the mean weight of male respondents was 79.48 (± 16.33) and 70.95 (± 15.66) for the females. Body mass index (BMI) for males (33.61 ± 2.82) was almost similar to females ( 33.20± 2.95).The mean waist circumference of men was 93.26 (± 10.94)cm compared to 94.03 (± 11.98)cm in the females. Following categorization of BMI, 59% (n=48) are in the obese group, 24% (n=20) are overweight and only 17% (n=14) have an ideal body weight or normal BMI. Relationship between BMI and HPAQ demonstrated strong and significant correlation coefficient for habitual physical activity at work (r = 0.775, p < 0.001), sports (r = 0.735, p < 0.05) and leisure ( r = 0.713, p < 0.001). Conclusion: The staffs working in the Hospital demonstrated poor habitual physical activity which explains for the high incidence of obesity among the staffs. This requires measures to be taken to promote a healthier lifestyle among them
Saliva pH Changes in Patients with High and Low Caries Risk After Consuming Organic (Sucrose) and Non-Organic (Maltitol) Sugar
Get PDFIntroduction: Enamel demineralization is associated with decrease in saliva pH due to fermentation of sugar by oral commensal. Thus, exploring the changing pattern of saliva pH is meaningful in dental caries prevention. The aim of this study was to compare the changing pattern of saliva pH after consuming different types of sweeteners (sucrose and maltitol). Methods: It was a case-control study involving 14 male patients attending IIUM dental clinic who were selected with the intention of getting seven patients with high caries risk ( DMFT ≥6) and seven patients with low caries risk (DMFT ≤3) with initial saliva pH interval of 6.5 to7.5. Patients were asked to consume snacks containing 8 gram sucrose and 8 gram maltitol as sweeteners. The changing pH values of the saliva were measured by Waterproof pHTestr 10BNC (Oakton, Vernon Hills, USA) seven times consecutively at 0 (before snack consumption), and at 5, 10, 15, 20, 30 and 60 minutes after snack consumption. The pH values of saliva of patients with low and high caries risk after consuming sucrose and maltitol were statistically analized by using Anova and Tukey-HSD tests at α = 0.05. Result: There were significant differences in saliva pH changes between low-risk group and high-risk group after consuming sucrose and maltitol. Conclusion: The changing patterns of saliva pH in high-risk patients were lower than those of low-risk patients after consuming two types of snacks containing sucrose and maltitol
Circadian Blood Pressure Profile and Associated Cardiovascular Risk Factors in Non-Dippers
Get PDFIntroduction: Ambulatory blood pressure accurately reflects a patient's actual blood pressure than casual or office blood pressure. This study aims to describe the circadian blood pressure profile of hypertensive patients and to identify the associated cardiovascular risk factors in non-dippers. Methods: A cross-sectional study was conducted from 1st January 2008 to 30th June 2008 among hypertensive patients attending Family Medicine Clinic HUSM. Schiller BR-102 plus was used to get 24 hours blood pressure (BP) reading. Mean of two offices BP were also taken. Non-dippers are defined as a systolic or diastolic nocturnal drop of less than 10%. Analysis was done using SPSS Version 12. Results: 105 patients were recruited with mean (SD) age of 51.8 (9.34) year old. The mean (SD) 24-hour systolic and diastolic BP was 128.4 (12.7) mmHg and 79.7 (8.74) mmHg respectively. Mean (SD) daytime systolic and diastolic BP was 132.1 (11.72) mmHg and 82.4 (9.41) mmHg while for the night time were 123.3 (12.78) mmHg and 76.2 (9.01) mmHg. Mean (SD) systolic and diastolic office BP was 144.2(15.16) mmHg and 90.2(9.71) mmHg. Percentage of non dippers were 68.6% for systolic and 61.9% for diastolic. Conclusion: Mean 24 hours and daytime ambulatory BP was normal but the mean night time diastolic and office BP was above-normal value. Majority of the patients were categorized as non dippers. Therefore, using ambulatory BP is clinically important to get a better understanding of blood pressure fluctuations over 24-hour periods compared to simple clinical measurements
Arterial Stiffness and its Association with Dyslipidemia
Get PDFIntroduction: Cardiovascular diseases (CVD) are the leading cause of mortality in Malaysia as well as in other countries. It is associated with many risk factors, such as increasing age, hypertension, diabetes, dyslipidemia, oxidative stress and autonomic dysfunction and arterial stiffness. The objectives of this study were to measure the prevalence of arterial stiffness and to assess its association with dyslipidemia. Methods: A cross sectional study was conducted in a rural community in Malaysia involving 146 subjects. Data were collected using an interviewer administered questionnaire which included three sections – sociodemographic characteristics, personal profile, and past medical history. In addition, Seca Body Meter (Seca 220) was used to measure height and weight. Sphygmomanometer (OMRON Automatic Blood Pressure Monitor HEM 907) and SphygmoCor-AtCor MM3 SERIAL/RS-232 were used for blood pressure and augmentation index (AIx) measurement. Data were analysed using the SPSS for Windows, Version 18.0. Results: The mean age of respondents was 49.5 years, SD±15.6. The prevalence of arterial stiffness was 23.3% (95% Confidence Interval (CI): 16.44 – 30.16). The prevalence of dyslipidemia was 82.9% (95% CI: 76.79 – 89.01). Multivariate logistic regression revealed that total cholesterol was significantly associated with arterial stiffness (OR=4.56, CI 1.10-18.90). Conclusion: The prevalence of dyslipidemia was high. Despite an insignificant association between dyslipidemia and AIx, there is a significant association between TC level and AIx
Radiation-Induced Meningioma Following Radiotherapy for Pituitary Adenonoma: A Case Report
Get PDFIt is well known that ionizing radiation has an onco-genetic activity and has been implicated in the causation of brain tumors. However, when a new growth appears adjacent to the site of previous tumor, the diagnosis is more toward recurrence. In addition to that, the possible cause might be overlooked, when it occurs many years after radiation treatment. We report a case of radiation-induced meningioma developed 20 years after the patient received radiotherapy for pituitary adenoma
Combined Hysteroscopy and Laparoscopy in the Evaluation of Patients with Recurrent Pregnancy Loss
Get PDFIntroduction: To determine the relative frequency of gynecological pathologies in patients with recurrent pregnancy loss using combined hysteroscopy and laparoscopy, and to evaluate the potential of this combined strategy in the diagnosis of coexisting pathologies. Methods: Over 6 years, in a large referral infertility clinic and research centre in Tehran, 80 women with the diagnosis of recurrent pregnancy loss underwent hysteroscopy and laparoscopy. Results: Forty nine (61.3%) women had 3 episodes of miscarriage, 9 (11.3%) had 4 occurrence of pregnancy loss and 14 (17.5%) patients had experienced 5 abortions. Also, there were 4 (5%), 2 (2.5%) and 2 (2.5%) participants with 6, 7 and 8 miscarriages, respectively. Thirteen women (16.2%) had normal hysteroscopy, and in 52 (65%) participant's laparoscopy did not reveal abnormal findings. Septate uterus and submucous myomas together, comprised 62 (77.5%) of the recognized pathologies in hysteroscopy. Of the 28 abnormalities found in laparoscopy, 12 (43%) was endometriosis (15% overall) and the others were, pelvic and abdominal adhesions. Conclusion: Combined laparoscopy and hysteroscopy yields more satisfactory diagnostic results compared with hysteroscopy alone. Septate uterus, submucous myomas and endometriosis were common findings in patients with recurrent miscarriage. Especially, patients with recurrent pregnancy loss should be examined for the coexistence of endometriosi
Alcohol Consumption and Its Effect on Testicular Structure and on Sperm Count and Motility in Parent Mice and Their Offspring
Get PDFIntroduction: The goal of the present study was to examine the effect of alcohol consumption on sperm count and motility and the morphological changes in the seminiferous tubules of parent mice and their offspring. Methods: Animals were divided into two groups, Group 1 (alcohol group) of twelve male and twelve female mice, were given a daily dose of (3 g/kg body weight as 25%, v/v) ethanol by gastric gavage for four and eight weeks. Group 2 (control group) also of twelve male and twelve female mice; received normal access of food and water. After four weeks of treatment, the males and females in each group were allowed to mate, and ethanol treatment continued for up to another four weeks. Twelve male offspring from group 1 and twelve male offspring from group 2 were selected randomly and allowed to become mature. Male parent mice were killed at the 4th and 8th weeks of treatment, and their male offsprings were killed when they reached maturity age. Results: Physiological examination of the sperm solution showed that there was a significant decrease in sperm count and motility after 4 and 8 weeks of ethanol treatment in parent male mice, but this decrease was not significant in their adult offspring. Furthermore, histological investigations indicated testicular lesions in the parent male mice and their adult male offspring. Conclusion: Alcohol abuse has deleterious effects on the testes structure and on the sperm count and motility of the epididymal spermatozoa of both parent mice and their offspring
Assessment of Urinary Tract Infection and Cytokine (IL-2, IL-4 and IL-17A) Serum Levels in Iraqi Samples of Systemic Autoimmune Diseases (Rheumatoid Arthritis, Ankylosing Spondylitis and Systemic Lupus Erythematosus) Patients
Get PDFIntroduction: Aetiopathogenetic mechanisms that lead to autoimmune diseases are complex, but Urinary tract infection (UTI) and cytokines have been suggested to mediate important effects. Methods: UTI and serum levels of three cytokines (IL-2, IL-4 and IL-17A) were assessed in 98 rheumatoid arthritis (RA), 33 ankylosing spondylitis (AS) and 20 systemic lupus erythematosus (SLE) Iraqi patients, as well as 45 controls. Results: Out of 151 systemic autoimmunity patients, 23.8% were observed to have UTI, and such frequency was approximated in RA, AS and SLE (23.5, 27.3 and 20.0%, respectively), while in controls, it was 11.1%. Two pathogens were identified as a cause of UTI; E. coli and Proteus spp. In total patients, E. coli was present as a single causative pathogen in 10.6%, while for Proteus spp. it was 8.6%, in addition to 4.6% of mixed infection. The corresponding frequencies were 10.2, 8.2 and 5.1% in RA, 15.2, 6.1 and 6.1% in AS, 5.0, 15.0 and 0.0 in SLE and 8.9, 0.0 and 2.2% in controls, respectively. IL-2 was significantly increased in total patients (21.68 vs. 9.66 pg/ml), as well as RA, AS and SLE (25.10, 24.06 and 14.16 pg/ml, respectively) compared to controls. A similar increase was observed in UTI+ve versus UTI-ve cases in total patients, AS and SLE, but not RA or controls. Such differences were less clear in IL-4, while IL-17A showed no significant variations. Conclusion: UTI represents an important clinical complication in systemic autoimmunity and IL-2 also has its role in the pathogenesis