IIUM Medical Journal Malaysia (IMJM)
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Enucleation of Extraconal Frontomucocele: A Tripple-Window Approach
Get PDFMucoceles are expansile masses originating in the sinuses. They are relatively unusual, occurring most frequently at fronto-ethmoidal region. They are locally destructive. This expansile lesion caused bony erosion and displaces the adjacent structures. We report a case of a patient who presented to our clinic with bulging of his left eye and worsening of the left vision. This was preceded by history of sport injury to his left supraorbital ridge. CT scan revealed that there was an extraconal lesion at the superolateral part of the left orbital cavity which pushed the orbit inferomedially, which consistent with left frontomucocele. He underwent enucleation of the lesion via 3 windows created namely at the left supraorbital ridge, anterior table of left frontal sinus and through the septum separating the frontal sinuses
Gastrointestinal Involvement in Henoch Schonlein Purpura : A Case Report
Get PDFHenoch-Schonlein purpura or anaphylactoid purpura is a systemic vasculitis of unknown cause that affects small vessels and mainly involves the skin, joints, gastrointestinal tract and kidneys. Gastrointestinal involvement occurs in more than half of patients and is thought to be related to edema and intramural haemorrhage. Radiologically the gastrointestinal findings are mainly those of bowel ischemia with “thumbprinting” and bowel wall oedema. Although this disease is usually treated conservatively, aggressive intervention is occasionally performed because of acute abdominal symptoms due to complications, such as perforation, intussusception and obstruction. This report illustrates a case of Henoch-Schonlein purpura with acute abdominal symptoms due to intussusception
Syringomyelia in Pregnancy- Is Caesarean Section The Best Option For Delivery? - A Case Report
Get PDFSyringomyelia is a rare neurological disease, which is characterized by the formation of a cyst in the spinal cord. The aetiology of the disease still remains controversial. The damage to the spinal cord results in headache, weakness, stiffness and numbness on both lower and upper limbs. Only few a cases of syringomyelia in pregnancy have been reported thus far. As such, there is no standard management of intrapartum care.1 We present a case of symptomatic syringomyelia in pregnancy, its management and literature review. The mode of delivery with risks for vaginal route is discussed
Glycaemic Control, Lipid Profile, Blood Pressure and Body Weight Status Among Diabetics in Rural Malaysia
Get PDFIntroduction: Diabetes is associated with a high risk of cardiovascular disease. The management of blood glucose, dyslipidaemia and other modifiable risk factor, is a key element in the multifactorial approach to prevent complications of type 2 diabetes. Materials and Methods: A cross sectional study was conducted to determine the level of glycaemic control, lipid profile, blood pressure and body weight status among type 2 diabetics in rural Malaysia. A total of 237 diabetic subjects participated in this study. Physical examination was carried out, including measurements of height, weight, waist and hip circumferences, and systolic and diastolic blood pressure. Fasting venous blood samples were collected to determine the glucose level and lipid profile. Results: About 70% of the subjects had a high body mass index (BMI), equal to or above 25 kg/ m2. More than 60% of the subjects had systolic blood pressure ≥ 140 mmHg and/or diastolic ≥ 90 mmHg. Mean fasting blood glucose was 9.84±4.54 mmol/L. Mean total cholesterol was 5.18±1.35 mmol/L. High density lipoprotein cholesterol (HDLC) and triglyceride (TG) and glucose levels were higher in male than in female, but not statistically significant (p>0.05). However, low density lipoprotein cholesterol (LDLC) was higher in females than males (p<0.05). Mean HDLC was below 1.0 mmol/L in all subjects. Conclusion: Glycaemic control, lipid profile, blood pressure and body weight status were not satisfactory and may increase the risk of microvascular and macrovascular complications among these subjects. Appropriate intervention programs should be implemented for better diabetes control among rural subjects
Discrepancies in the diagnosis of methicillin resistant Staphylococcus aureus among different hospitals in Lahore, Pakistan
Get PDFIntroduction: Staphylococcus aureus is a pathogen causing a wide range of infections. It changes its genome under the selection pressure of antibiotics. Methicillin resistance is commonly determined by Kirby-Bauer disc diffusion method which has low sensitivity and specificity. Thus, anti PBP-2a latex agglutination test was used to confirm the identity of those labeled as MRSA. Materials and Methods: One hundred bacterial samples characterized as MRSA according to Kirby-Bauer diffusion method were collected from different hospitals in Lahore. Results: Biochemical characterization of these MRSA isolates revealed that only 64 (64%) were actually S. aureus while the other 36 isolates (36%) were coagulase negative staphylococci. Further serological characterization revealed that among the 64 isolates of S. aureus, 50 (78%) were MRSA while 14 (22%) were MSSA. Conclusion: Therefore, overall, 50% of the bacterial strains were misidentified as MRSA. Misdiagnosis of antibiotic resistance may lead to an inappropriate prescription of medicines to these patients
Bilateral facial nerve palsy secondary to an atypical presentation of Gullain-Barré syndrome
Get PDFBilateral simultaneous facial nerve palsy is an extremely rare clinical entity and may occur in association with a variety of neurological, infectious, neoplastic or degenerative disorders. We describe a patient, who presented with facial diplegia and normal reflexes on examination. During the entire hospitalization, he developed no motor weakness and remained ambulatory. Whether treatment is warranted for this and other milder variants of Gullain-Barré syndrome is also discussed. Atypical presentations with preserved or brisk reflexes, can be a diagnostic dilemma
Bilateral congenital renal arteriovenous malformation: A rare entity with uncommon presentation
Get PDFRenal arteriovenous malformation (AVM) is a rare congenital anomaly of the urinary system. We present a patient with bilateral renal AVMs who presented with back pain and microscopic hematuria. This case highlights the importance of careful diagnostic work-up in the evaluation of upper tract hematuria
Stress and Coping Strategies among Management and Science University Students: A Qualitative Study
Get PDFIntroduction: This study aimed to explore the associated factors related to causes of stress and coping strategies among university students. Materials and Methods: As a focus group discussion, it was universal sampling, conducted among 39 of Medical Science and Biomedicine students on their second semester from Management and Science University (MSU), Shah Alam, Malaysia. Three issues were discussed: firstly, how they define the stress; secondly, what the most important causes of stress in their life are; and thirdly, how they cope with stress. Verbal consent was obtained from all participants. Due to the small sample size, the data was analyzed manually. Results: Total of participants were 39 students, their age ranged from 21 to 26 years. Seventeen (43.6%) of the students were 21 years old and the majority were female 31 (79.5%). The most important causes of stress reported by the students were financial, lack of sleep, and family problems. In terms of coping with stress, the students were able to describe a variety of strategies to cope with their stressful situations. These included counseling services, doing meditation, sharing of problems, getting adequate sleep, and going out with friends. Conclusion: Most of the students defined stress as “a mental condition”. Lack of sleep, financial, and family problems were the most causes of stress among students. The students were able to identify some strategies to cope with stress
Osteoporosis-related life habits and knowledge about osteoporosis among women in Tabriz, Iran
Get PDFIntroduction: The objectives of this study were to investigate the calcium intake, physical activity level and knowledge about osteoporosis in women who attended health centers in Tabriz, Iran. Materials and Methods: Three hundred ninety-nine women of childbearing age were studied. Information was collected through face to face interviews with subjects. Results: The mean daily calcium intake was 689.08±393.15 mg. Majority of subjects had low or moderate physical activity levels. Only 8% of women reported high physical activity level. Knowledge about osteoporosis in majority of subjects (63.2%) was at moderate level. Educational status of subjects was positively correlated with calcium intake. There were no significant statistics relationship between calcium intake and physical activity with other studied variables. Conclusion: Public health programs are suggested to improve calcium intake of women and elevating healthy life styles. Establishment of educational workshops to health care providers and encourage and obligate them to proper consultation with women is suggested as a suitable approach for prevention of osteoporosis