IIUM Medical Journal Malaysia (IMJM)
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Prediction model for peak expiratory flow among children in Kocaeli, Turkey
Get PDFObjective: To evaluate Peak Expiratory Flow (PEF) values in Turkish children between the ages 6 and 14 years old according to height, gender and age. Methods: Data was obtained from public health screening days in primary care practice on 1439 children. Peak expiratory flow (PEF) was measured for each child with a Mini Wright Peak Flow Meter. The study was assessed to find a correlation between heights, age and PEF values in children. Results: In our study, PEF values increased significantly with age and height in both genders. According to our results, the equation for prediction of PEF was calculated for girls as (7.37 × age [years])+ (3.02 × height [cm]) – 222.1 (p < .001, r= 0.83) and for boys (7.92 × age [years])+ (3.13 × height [cm]) – 230.9 (p < .001, r =0.83). Conclusions: The PEF values are statistically significant associated with age and height for girls and boys. The prediction equations specifically developed for children in Kocaeli can be used in clinical practice and these equations may help clinicians to better characterize individual or population airway responsiveness
Hartman’s solution or normal saline in the treatment of hyperemesis gravidarum among South East Asian population: a randomised controlled trial”
Get PDFIntroduction: The aim of treatment for hyperemesis gravidarum is to stop vomiting, correction of dehydration, starvation and electrolytes imbalance. The common types of fluid used for fluid replacement are isotonic solutions like normal saline and hartman’s solutions. The absence of potassium in normal saline makes hartman’s solution superior but there is a possibility that the lactate component in hartman’s solution could worsen the starvation state of the patients. This study is to evaluate which of these two solutions is more effective for fluid replacement in hyperemesis gravidarum. The objectives are to compare which solution corrects dehydration, hypokalaemia and acetonuria faster and to evaluate whether the ketosis state is aggravated by lactate component in hartman’s solution. Materials and Methods: Patients with hyperemesis gravidarum were randomised to receive either Hartman;’s solution or normal saline at the rate of 125mls/ hour. Blood urea and serum electrolytes, haematocrit, lactate and urine acetone were taken during admission and repeated every 12 hours. The volume of fluid required to correct dehydration, hypokalaemia and acetonuria were compared. Comparison of the pre and post treatment level of serum lactate were also done. Results: Both hartman’s solution and normal saline are both effective in correcting dehydration (11.52±3.28 pints versus 11.94 ± 2.30pints respectively) and acetonuria (11.64 ± 2.75 pints versus 11.64 ± 2.54 pints respectively). A lower volume of hartman’s solution was needed to correct hypokalaemia (8.34 ± 2.44 pints versus 8.88 ± 2.63 pints) but was not statistically significant. Ketonaemia was not made worse after treatment with hartman’s solution. Conclusion: Normal saline and hartman’s solution are equally effective in treating complications of hyperemesis gravidarum
Hepatic hydrothorax without ascites
Get PDFHepatic hydrothorax (HH) in the absence of ascites is a rare complication of liver cirrhosis. A 58-year-old woman presented to our department with dyspnea because of massive right pleural effusion requiring chest tube drainage. Investigations confirmed chronic hepatitis C, She had no signs of hepatic failure or ascites but there was evidence of portal hypertension. After pleural drainage and standard treatment for ascites with restriction of salt intake and diuretic administration, the pleural effusion improved with minimal recurrence
Azygos continuation of the inferior vena cava in carcinoma of oesophagus
Get PDFThe azygos system enlarges in cases of obstruction to the superior vena cava or inferior vena cava and result in increase blood flow through the system. Azygos continuation of the inferior vena cava is usually congenital and asymptomatic. The azygos vein is the sole drainage of the blood from the lower half of the body to the heart. It is crucial to identify the anomaly as it might involve in the surgical planning of tumours in the thorax or abdomen. Computed Tomography is a non-invasive technique and provide important information about the tumour and the vascular anomaly
C–kit proto-oncogene expression in uterine leiomyosarcomas: case series
Get PDFIntroduction: The proto-oncogene c-kit is the cellular homologue of the oncogene v-kit of HZ4 feline sarcoma virus. It is located on chromosome 4 (4q11-12) in the human genome. Interaction between the c-kit receptor and its ligand, stem cell factor, is essential in the development of tissues. C-kit expression has been identified in a number of different neoplasms like seminoma/dysgerminoma, and gastrointestinal stromal tumors (GIST). Recently it has been reported that c-kit is also present in leiomyosarcomas. Tyrosine kinase inhibitors (TKIs) are a promising new therapy in the treatment of cancer. These agents target cellular proteins like kit and its related homologues decreasing cellular proliferation and survival. TKIs may be helpful in treating leiomyosarcomas expressing c-kit. Materials and Methods: In this study a total of 6 cases diagnosed as leiomyosarcomas at Department of Pathology, Universiti Sains Malaysia, Kubang Kerian, Malaysia, were investigated for reactivity for c-kit using immunohistochemical stain. Stain was considered positive if more than 10 percent of the cells showed membrane or cytoplasmic positivity. Results: Two leiomyosarcomas stained faintly with c-kit and in less than 10 percent of the cells. The other 4 cases showed no staining. The control showed good membrane and cytoplasmic positivity. Conclusion: Uterine leiomyosarcomas did not express c-kit. The reason for this could be that the tumors are inherently c-kit negative. More study using larger number of cases is required to validate these findings and further molecular characterization of these mesenchymal tumors is needed to identify the true nature of these sarcomas
A case report of pyomyoma: radiological diagnosis of a potentially fatal complication of uterine leiomyoma.
Get PDFPyomyoma (suppurative leiomyoma) is a rare complication of uterine leiomyoma. It results from infarction and infection of a leiomyoma. It may lead to diagnostic and therapeutic difficulties with potential complications such as bacteraemia, uterine rupture, compressive effect to adjacent structures and even death. We report a case of pyomyoma based on the Ultrasound (US) and Computed Tomography (CT) findings and literature review on the subject
Operative internal fixation of isolated femoral diaphyseal fractures – is interlocking nail the best option?
Get PDFFemoral fractures are one of the commonest fractures encountered in orthopaedic practice. Over the years, treatment of this injury has evolved tremendously. The initial non-operative methods of reduction and stabilization have largely been replaced by operative fixation. There are currently three basic modes of internal fixation of femoral diaphyseal fractures in the adult age group: plate and screws, intramedullary Kuntscher nailing, and interlocking nailing. The objective of this study is to determine whether the socalled more ‘technologically advanced’ interlocking nailing results in better outcome compared to the more ‘traditional’ plate and screws, and Kuntscher nailing. It is found that, in terms of time to union and final function after an average of just under 2 years post-operative period, the group of patients who had interlocking nailing fared poorer. A review of relevant literature will then be presented
A pilot study of the primary care management of knee osteoarthritis in the Northern States of Malaysia
Get PDFIntroduction: Primary care management of knee osteoarthritis OA has received little attention in the scientific literature and the main reason of this survey is to study and explore the variations and patterns of primary care management and assess both conventional and complementary therapy usage in knee OA in the primary care setting. Materials and Methods: A cross sectional survey of 100 randomly selected general practitioners (GPs) in the northern states of Malaysia (Kedah, Perlis, Pulau Pinang) was undertaken using questionnaires. The GPs involved were asked about basic knowledge of OA in terms of diagnosis, investigation, and treatment of OA. They were also asked their usage of conventional and complementary medication. Results: 80 (80%) GPs responded to the questionnaires sent. 85% of GPs were in solo practice and 15% in group practice. Most of the GPs surveyed (69%) were in practice for more than 10 years, 21% in 5- 10 years and 10% were in practice for less than 5 years. 65% GPs surveyed see an average of more than 20 patients per week, 25% see about 10- 20 patients and 10% see less than 10 patients per week. 75% of GPs surveyed would arrange an X-ray. 65% of GPs surveyed will arrange a blood test, mostly serum uric acid, rheumatoid factor and ESR. Pharmacological management consists of first line treatment with analgesics (32%), NSAIDs (59%) or a combination of the two (4%). Non-pharmacological management consist of advise an exercise (37%), weight reduction (23%) and referral to physiotherapy (8%). 89% of GPs surveyed prescribed some form of complementary medications. 68% prescribed glucosamine sulphate, 29% chondroitin sulphate, 18% cod liver oil, 12% evening primrose oil. Only 5% of GPs surveyed perform intra- articular injection. Conclusion: The data suggest that in the primary care, majority of GP over investigate the diagnosis of OA. Pharmacological interventions largely concentrate on analgesic and NSAIDs. The use of physiotherapy and non drug approach were enormously under-utilized. There is a need to further educate GPs in the management of OA
Male Contraceptive Behavior in Rajshahi District of Bangladesh
Get PDFThis article examines the actual scenario of male involvement either as a user of contraceptive methods or supportive reproductive partners of women on contraceptive use in Rajshahi district of Bangladesh. The analysis shows that, knowledge and use of contraception are low in our study area. Comparative figures of contraceptive practice between men and women found a large disparity. Findings reveal that the user rate of all male contraceptive methods (e.g., condom at 17 percent) is still low compared to that of female methods (pill at 33.8 percent), which shows that men like to impose contra ceptive responsibility on women. Identification of socio-economic and demographic differentials affecting contraceptive behavior of men is performed through the technique of logistic regression. This paper elucidates that education, residence, fertility preference, mass media facility and knowledge about AIDS are the significant factors to influence contraceptive practices among men. Regarding the factors shunning the contraceptive practice we found that men’s opposition to use contraceptive methods is as most significant. The next reason for not using is related to contraceptive method
Effect of atorvastatin on oxidative stress parameters and lipid profile in type 2 diabetic patients
Get PDFIntroduction: Evidence has long existed regarding the relationship between oxidative stress and diabetes. The present study was conducted to assess the effect of atorvastatin on selected oxidative stress parameters in the form of reduced glutathione (GSH), lipid peroxidation byproduct malondialdehyde (MDA) levels, glutathione –S- transferase (GST) activity and catalase (CAT) activity) and its effect on lipid profile (total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and very low density lipoprotein (VLDL) in dyslipidaemic type 2 diabetic patients . Materials and Methods: Fifty nine dyslipidaemic type 2 diabetic patients were included in this study. Full history was taken and general examination of patients was performed. Patients studied were taking glibenclamide (an oral hypoglycaemic drug) during the study as a treatment for their disease. These patients were followed up for 60 days and divided randomly into 2 groups. Group I (n = 31): no drug was given and served as dyslipidaemic diabetic control. Group II (n = 28): received atorvastatin tablets 20 mg once daily at night. Of the 59 Fifty patients, 46 completed the study while 13 patients withdrew. This is due to non compliance of the patients. Blood samples were drawn from the patients at the beginning and after 60 days of follow up between 8:30 & 10:30 am after at least 12-14 hours fast. Fasting blood glucose, lipid profile, selected oxidative stress parameters (GSH, MDA levels, GST and CAT activities) were measured. Renal and hepatic functions were also assessed. Results: This study revealed that: atorvastatin treatment increased serum GSH; reduced MDA levels significantly while did not significantly affect CAT and GST activity. In atorvastatin treatment, TC, TG, LDL and VLDL decreased significantly while HDL increased significantly. Conclusion: There was insignificant correlations between atorvastatin induced changes in the oxidation markers and the observed changes of the lipid profile