IIUM Medical Journal Malaysia (IMJM)
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Effects of Xiang Sha Yang Wei Wan on Ethanol-Induced Gastric Ulcer in Sprague Dawley Rats: a Histological Study
Get PDFIntroduction: Xiang Sha Yang Wei Wan (XSYWW) is a Chinese traditional medicine that is used for gastrointestinal disorders, specifically gastric ulcer in many countries of South-East Asia. The aim of the study was to evaluate the potential effects of XSYWW on ethanol-induced gastric ulcer in rats by means of histological Study. On a similar basis of treatment, ranitidine, a conventional medication was used as gold standard. Methods: Fifty five male Sprague-Dawley rats (250-300 gm) were divided into four groups. Group I (ethanol treated group) was the control group and gastric ulcers were induced by administering 100% ethanol (1 ml/200 g). Group II (Pre-treatment group) was divided into two subgroups; they were orally fed with 1.0 gm/kg and 2.0 gm/kg respectively of XSYWW solution. Thirty minutes later they were administered with absolute ethanol as in group I. Group III, was given an oral dose of 2gm/kg of XSYWW solution after one hour of ethanol administration. Group IV was given an oral dose of 200mg/kg ranitidine solution after one hour of ethanol administration. Five rats from groups I, III and IV were sacrificed on day 1, 2 and 3 while the animals of group II were sacrificed one hour after ethanol administration. Results: Histological study of the stomachs from ethanol treated rats showed multiple ulcers of various depths that reached the muscularis and the serosa. Conclusion: Pre or post-treated rats with XSYWW showed that XSYWW has protective effect against ethanol-induced gastric mucosal lesion. However, there was a faster and more complete healing process in the ranitidine treated group when compared to the XSYWW treated subjects
Continuity Theory of Ageing and Leisure Participation among Elderly Attending Selected Health Clinics in Selangor
Get PDFIntroduction: Leisure participation in old age is often a continuation of their participation at younger age. This study aims to explore the association between current and former leisure participation of the elderly. Methods: A cross-sectional survey was conducted among 268 persons aged 60 years and above, purposively selected from eight health clinics in Selangor. Current leisure participation was measured using a validated Leisure Participation Questionnaire (LPQ), specific for Malaysian elderly. The LPQ consists of 25 activities, categorized into recreational (physical), cognitive, social and productive activity. Frequency of participation in each activity was measured on a 6-point scale. Leisure participation at younger age only involved their general participation in leisure. The most common daily leisure activities were having conversations while relaxing (78.7%) and watching television (74.6%), while the least were from playing golf (0.01±0.12) and performing musical instruments (0.04±0.36). More than half (64.9%) reported being actively involved in any leisure activity at younger age. Results: The study found there was a significant association between former and current leisure participation, especially for cognitive (t=-2.45, p=0.015), social (t=-2.68, p=0.008) and productive (t=-2.89, p=0.004) activities. However, only productive activity involvement was predicted by their leisure participation while younger (B=1.304, p=0.027). Conclusion: The findings suggest the importance of considering active intervention programmes at younger age to ensure better leisure participation of the elderly, especially in recreational physical activity
End of Life Decision: We are not Playing God?
Get PDFAdvances in neonatal care now enable more infants to be kept alive despite clear clinical evidence of inevitable or imminent death on a life-support system. It is therefore no longer acceptable to the society that a patient is left to die in the hospital, without any form of treatment or intervention. We report a case of severe birth asphyxia, hypoxic-ischemic encephalopathy, neonatal seizures and left cephalohematoma. In spite of initial successful resuscitation, the infant could not survive until all possible methods of treatment were exhausted. This case illustrates one of many examples of the process involved in dealing with ending of life decision in a condition considered as futile
Multiple Nail Gun Penetrating Head Injury: A Case Report
Get PDFIntracranial nail gun injury is a rare subset of penetrating head injury. Here we report a case of intracranial nail gun injury in a Vietnamese patient who attempted suicide with no neurological deficit. Three nails were launched. Because the nail head acted as a brake, the launched nail could make a hole into the skull but could not entirely pass it. A rational management strategy should permit these patients to be discharged with no additional injury. Some medical and surgical management in penetrating head injury are discussed. The use of antibiotics and antiepileptic drugs and the retraction of the nail aided by the performance of a craniotomy surrounding the entry point are recommended
Epidemiology of Fungal Infections at an Infectious Disease Reference Centre in Malaysia
Get PDFIntroduction: Epidemiology of fungal infections in an infectious disease reference centre is different from other institutions. This study aimed to look at the scenario of fungal infections at an infectious disease reference centre in Malaysia. Methods: All positive fungal cultures from an infectious disease reference centre were identified by routine mycology laboratory methods. Patient demographic, laboratory and clinical data were collected and analyzed. Duplicate data were excluded. Results: Middle-aged Malay males were the most common group. However, increased proportions of Chinese, Myanmar and Indonesians reduced the Malay predominance in HIV-positive group. In all patients, Candida species represented 64.1% isolates, followed by Cryptococcus neoformans (14.7%) and Penicillium marneffei (14.7%). Among HIV[1]positive individuals, C. neoformans (37.9%) was the most common species, followed by P. marneffei (35.6%) and all Candida species (17.2%). In contrast to other non-infectious disease reference centres, common causes of fungaemia included P. marneffei (43.5%), Candida species (25.8%), C. neoformans (24.2%) and H. capsulatum (6.5%). Conclusion: The prevalence of fungal infection at an infectious disease reference centre is different from other non-infectious disease reference centres. This may have an impact on current antifungal practice especially empiric antifungal therapy, patient morbidity and mortality
The Effects of Vasectomy on Testicular Tissue of Mice: Histological Changes and DNA Fragmentation Study
Get PDFIntroduction: We aim to investigate the effect of vasectomy on the histology of the testis as well as to evaluate DNA fragmentation in testicular tissue of male mice. Methods: Bilateral vasectomy was performed on 20 mature male mice; 10 control mice underwent sham-operation. After 6 weeks, the testes were evaluated for histological changes and DNA fragmentation by single cell gel electrophoresis (comet assay). Results: Marked alterations were observed in the testes of vasectomized mice, including degeneration of spermatids, thickened basement membrane, dilatation of the seminiferous tubules, exfoliation of germ cells, reduction in the seminiferous cell population, vacuolated appearance of the epithelium in the tubules and marked interstitial fibrosis. Single cell gel electrophoresis showed a highly significant (P<0.0001) increase in DNA damage among vasectomized mice (46.02%) compared with control group (%27.17) after six weeks of operation. Conclusion: Vasectomy induced deterioration in the seminiferous tubules associated with increased testicular cell’s DNA fragmentation
Impact of Previous Abdominal Surgery on Laparoscopic Cystectomy/Oophorectomy Results: A Comparative Clinical Study
Get PDFIntroduction: In the past, patients with previous abdominal surgery were discouraged from laparoscopic surgery because of perceived increased risk of bowel injury caused by needle and trocar insertion. However, data on the feasibility and safety of surgery of this nature is increasing. We aim to evaluate the surgical outcome of laparoscopic ovarian cystectomy/oophorectomy in previous abdominal surgery. Methods: This is a cross-sectional study with descriptive analysis of retrospective data collection from the electronic medical records of women with laparoscopic ovarian cystectomy/ oophorectomy from January 2000 until Dec 2008. Results from patients with previous abdominal surgery were compared with those of women without prior abdominal surgery. Results: Three hundred and seventeen (317) laparoscopic cystectomies/ oophorectomies were performed during the study period. 71 patients (22.5%) had previous history of abdominal surgery. Adhesions were found in 72% of patients versus 40% (p=0.001) who had previous abdominal surgery but the conversion to open surgery rate was similar (3%, p < 0.05). There was no significant difference in blood loss (134.1 ml ±18.6 vs 119.0 ml ± 9.5), operating time (107 min ± 42.0 versus 102.6 min ± 42.6) and postoperative hospital stay (1.92 days ± 1.0 vs 1.91 days ± 0.7 ). The incidence of peri-operative and post-operative complication showed no significant difference in those who had undergone previous abdominal surgery than those without prior abdominal surgery (p=0.7). The overall complication rate in this series was 0.32 %. Conclusion: Laparoscopic cystectomy/ oophorectomy in the previous abdominal surgery is safe with no increase in morbidity
Undiagnosed Bicuspid Aortic Valve: A Silent Danger
Get PDFThe normal aortic valve has three leaflets, which are almost equal in size. A bicuspid aortic valve developed as a result of abnormal aortic cusp formation during early embryogenesis. Complications such as valvular stenosis or incompetence are well known. Delayed in identifying the congenital abnormality or the complications may cause morbidity and mortality. We report two cases of congestive cardiac failure as the results of undiagnosed bicuspid aortic valve with severe aortic incompetence. Both young men in their productive age without cardiac risk factors, were unfortunate to present too late. Although one of them was lucky to survive the ordeal, most late presentation ends up gravely. Aortic valve replacement can be offered if early detection is made. Those with severe disease at diagnosis may require a heart transplant
Biodynamics of Hepatitis C Virus in Haemodialysis Patients in Pahang
Get PDFIntroduction: HCV infection is frequent in patients undergoing maintenance haemodialysis, with prevalence between 8 and 10%. Hepatitis C has an adverse effect on both patient and graft survival in those who get renal transplants. There are relatively scarce reports on the natural fluctuation in viral load level in patients on chronic haemodialysis. Materials and Methods: This is a longitudinal short-term three months study, where 27 chronic haemodialysis patients infected with known HCV genotypes were recruited from seven haemodialysis centres in Pahang. Serum samples were collected monthly, both pre- and post-haemodialysis sessions, over a period of three months. Viral RNA was extracted from serum using QIAamp Viral RNA Extraction kit (Qiagen). The HCV viral load was measured using one-step reverse transcriptase qPCR (Applied Biosystems) targeting the 5`HCV non-coding region (5’UTR). The serum α-IFN level was measured using commercial ELISA kit (Amersham, UK). Six biochemical liver function tests (AST, ALP, TP, albumin, ALT and TB) were also done for all pre-haemodialysis samples. Results: All patients showed persistent low level viral load that varied significantly over the study period (p = 0.001). HCV genotype 1 viral load was significantly higher than that of genotype 3. Conclusion: No apparent correlation could be recognized between the viral loads and the corresponding interferon-alpha levels which were detectable in only a few patients during the period of study
