IIUM Medical Journal Malaysia (IMJM)
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Metastatic Adenocarcinoma of the Lung Mimicking Spinal Tuberculosis
Get PDFClinically, it is sometimes difficult to distinguish an infection of the spine from a metastasis. Spinal tuberculosis is common according to its endemic region and adenocarcinoma of the lung is also rising in the incidence worldwide. Similar presentations, with unknown primary, clinical findings and hematological investigations rarely conclude a true diagnosis. Radiologically, the hallmark of spinal infection is erosion of adjacent vertebral endplates and narrowing of the disc space with or without a paravertebral shadow. Metastasis typically does not involve the disc space with erosion of the adjacent vertebral endplates. It usually presents as a lytic/sclerotic lesion in the vertebral body or “winkle owl” sign. These distinguishing features of infection versus metastasis are not certainties. Biopsy is mandatory whenever in doubt or patient is not responded with provisional treatment. The author presents a case with so-called radiological features of spinal tuberculosis infection, which turns out to be a metastatic adenocarcinoma of the lung
Breast cancer screening: How knowledgeable are female staff of a public university?
Get PDFIntroduction: Breast cancer is the most common cancer among women worldwide and in Malaysia. It has better cure rate if detected early. However, the practice of breast cancer screening in Malaysia is still low. The objective of this study is to determine the knowledge and its associated factors as well as sources of information on breast cancer and breast cancer screening among female staff in a public university in Malaysia. Materials and Methods: This was a cross sectional study conducted in 2005 involving 394 female staff including academic and non-academic staff, which was selected by cluster sampling. A self-administered questionnaire on socioeconomic characteristics and family history of breast cancer was used for data collection. Chi-square Test and Fisher’s Exact Test was used for testing an association using SPSS 12.0. Results: The response rate was 84.3%. Only 50.9% had high knowledge on breast cancer and breast cancer screening and this was significantly associated with occupational status, monthly family income and educational level (p<0.05). The usual source of information was mass media (92.2%) while the most preferred source is the health team (71.4%). Conclusion: As mass media was a major source of information, all types of mass media could efficiently be utilized to disseminate knowledge by presenting specific programmes associated with breast cancer and breast cancer screening
Lipid Peroxidation in Chronic Cerebral HypoperfusionInduced Neurodegeneration in Rats
Get PDFIntroduction: Reduced cerebral blood fl ow is associated with neurodegenerative disorders and dementia, in particular. Experimental evidence has demonstrated the initiating role of chronic cerebral hypoperfusion in neuronal damage to the hippocampus, the cerebral cortex, the white matter areas and the visual system. Permanent, bilateral occlusion of the common carotid arteries of rats (two vessel occlusion - 2VO) has been introduced for the reproduction of chronic cerebral hypoperfusion as it occurs in Alzheimer’s disease and human aging. Increased generation of free radicals through lipid peroxidation can damage neuronal cell membrane. Markers of lipid peroxidation have been found to be elevated in brain tissues and body fl uids in neurodegenerative diseases, including Alzheimer’s disease, Parkinson disease and amyotrophic lateral sclerosis. Materials and Methods: Malondialdehyde (MDA), final product of lipid peroxidation, was estimated by thiobarbituric acid-reactive substances (TBARS) assay kit at eight weeks after induction of 2VO in the rats and control group. Results: Our study revealed a highly signifi cant (p<0.001) increase in the mean MDA concentration (12.296 ± 1.113 μM) in 2VO rats as compared to the control group (5.286 ± 0.363 μM) rats. Conclusion: Therapeutic strategies to modulate lipid peroxidation early throughout the course of the disease may be promising in slowing or possibly preventing neurodegenerative disorders
Factors Predicting Organizational Commitment among Nurses in State Hospitals, Malaysia
Get PDFIntroduction: With an increase in national nursing shortage, organizational commitment is extremely important for retention of nurses. This predictive study determines the level of organizational commitment and the predictive ability of perceived organizational support, components of job satisfaction, including pay, task requirement, organizational policies, autonomy, interaction and professional status as well as years of experience on organizational commitment. Method: Data were collected from 416 nurses in four state hospitals in Malaysia, using self-administered questionnaires. The hospitals were selected from each region in Peninsular Malaysia and samples were selected by a random sampling method. Questionnaires, including demographic data, Organizational Commitment Questionnaires, Survey of Perceived Organizational Support, and Index Work Satisfaction were distributed by researcher and research assistants. Stepwise multiple regression technique was used to analyze the data. Results: The results discovered that (1) nearly half of the subjects (48.07%) reported high level of organizational commitment. (2) Professional status, autonomy, interaction, task requirement and years of experience could predict the organizational commitment (ß = 0.52, 0.17, p < 0.01); ß= 0.13, 0.11, 0.09, p < 0.05 respectively). Overall, all predictors explained 33% of variability in the organizational commitment among nurses in state hospitals. Conclusions: This study found that nurses in state hospitals were highly committed to their organizations. Results of this study provide information for nurse administrators to consider and maintain these factors in nursing practice to foster a high level of organizational commitment among Malaysian nurses
Mondor’s Disease
Get PDFA Mondor’s disease is a rare, benign and self-limiting condition. It is due to thrombophlebitis of the superficial veins of the breast and chest wall. It usually occurs in middle-aged women who present with a palpable cordlike structure, often painful in the acute phase. The aetiology is unknown, and may be related to trauma, surgery, infection or tight clothing. The finding of a superficial vessel seen as a linear opacity on mammography and a tubular structure on ultrasound is typical. An intra-luminal thrombus may be seen on ultrasound, and there may be absent flow on Doppler imaging. Conservative treatment is usually instituted, although surgery may be indicated in certain circumstances
The effect of lead exposure of mice during pregnancy on the concentration and motility of epididymal and testicular spermatozoa in offspring mature male mice
Get PDFIntroduction: The objective of this study was to investigate the effects of lead on concentration and motility of spermatozoa recovered from epididymis and testes in mature male offspring whose mothers were exposed to different doses and concentrations of lead acetate during gestation period. Materials and Methods: Seventy two healthy mature female mice were divided into three major groups according to the number of injections involving 1, 2 and 3 injections. Each major group was subdivided into four minor groups according to the concentration dose of (0, 25, 50 and 100) mg/Kg of lead acetate. Sperm concentration, percentage of motility and grade of activity were microscopically examined and statistically analyzed. Results: A significant reduction in the sperm functions were seen in relation to an increased in the number of injections and/or concentration of lead acetate dose as compared with the control groups. Conclusion: The toxic effects of lead acetate may interfere with spermatogenesis and metabolism of spermatozoa
Histological Observation Related to the Use of Laser and Ultrasound on Bone Fracture Healing
Get PDFObjective: To study the effect of both laser and ultrasound radiation on bone fracture healing process. Materials and Methods: Nd:YAG laser (1064 nm wavelength, 135 mW power, 16 joules energy) and ultrasound (1 MHz frequency, 50 mW/cm2 power intensity) were used in this work. Fifteen mature, male, albino rats, were divided into three groups and subjected to a partial fracture on the lateral aspect of femur by a sharp blade. The fi rst group of these animals served as control group. The second group was illuminated by the Nd:YAG laser for two minutes; the fi rst dose was given immediately after surgical fracture induction; the other doses were given on days two, three, six and then one dose weekly for the next three weeks while the third group were treated by the addition of the CW ultrasound perpendicular to the laser treatment in the second group. Results: The present study showed that ultrasound increases the penetration of laser power through the tissue. The histological assessments at day 28 after the fracture of fi rst group showed incomplete healing of the bone with disfi guration and disarrangement of Haversian system and the periosteum was not yet well developed. Treatment with laser showed irregularity and lack of Haversian system formation in bone healing of the second group. The laser and ultrasound treated group (third group) expressed a complete healing at the site of fracture with a complete layer of periosteum and a well arranged Haversian system. Conclusion: Combination of laser and ultrasound in therapy can enhance healing process of a fractured bone more than laser therapy alone, as ultrasound increases the depth of laser penetration in tissue
Psychological Insulin Resistance (PIR) Among Type 2 Diabetes Patients at Public Health Clinics in Federal Territory of Malaysia
Get PDFIntroduction: Insulin has been viewed as a treatment option of last resort in type 2 diabetes management. The decision to start insulin therapy is often diffi cult. Patients are usually reluctant to begin insulin and many cases delay the initiation of insulin therapy. The aim of this study is to determine the magnitude of insulin refusal or recognize as psychological insulin resistance (PIR) and to identify its predictors. Materials and Methods: This is a cross-sectional study and data was collected from two primary public health clinics in Kuala Lumpur and Putrajaya. The study sample consisted of 404 insulin naive patients with type 2 diabetes. A self-administered questionnaire was used to obtain demographic and clinical information. Results: Fifty-one percent of patients with type 2 diabetes were found to be unwilling to take insulin. Regression analysis revealed that females were 2.7 times more likely to resist insulin treatment compared to males and those with uncontrolled diabetes were 1.8 times more likely to resist insulin treatment compared to controlled diabetics. Patients will refuse insulin if they perceived their diabetes worsen with insulin use. After controlling for other attitudinal belief factors in the model, an increase in one unit of perceived disease severity will increase the likelihood of PIR around 2 times. Conclusion: Several misconceptions regarding insulin therapy were identifi ed and specifi c education intervention is recommended for successful transition to insulin therapy
Congenital Insensitivity to Pain with Recurrent Septic Arthritis of the Left Knee
Get PDFA 15-year –old Malay male with congenital insensitivity to pain presented with recurrent septic arthritis of the left knee complicated by osteomylitis. Repeated arthrotomy and wound debridement was done, however, the condition was not resolved. Amputation was suggested as the best method of treatment to eradicate the infection
