IIUM Medical Journal Malaysia (IMJM)
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A Huge Ovarian Cyst: Why is it Missed?
No full textA 15-year-old girl presented with progressive abdominal distention for four months duration. An initial assessment by primary care and gynaecological teams concluded that the ascites as the cause based on the clinical and initial ultra sonographic findings. However, an abdominal radiography revealed that a huge mature cystic teratoma as the actual cause of the presenting issue. Despite being a rare incidence, this case report highlighted why a high index of suspicion of ovarian pathology in large abdominal fluid accumulation in the paediatric population should be raised. The case report also highlighted the value of abdominal radiography, particularly in a primary care setting facility in differentiating intra-abdominal mass and ascites, especially when the massive volume of ovarian mass hampered the ultrasound findings. Though it is not specific, it may improve accuracy of initial diagnosis leading to an appropriate investigation with timely referral to the appropriate department. The unusual component of this case was the ‘pseudoascites' presentation and the literature on the detail of distinction between the two conditions from the primary aspect point.
Periodic Medical Examination: A Systematic Review
Get PDFA periodic medical examination is also referred to as a health screening, an annual health checkup, a preventive health check or a general health checkup. This study aimed to conduct a systematic review in order to identify the techniques, their origin, and conceptual foundation, as well as the instruments or items that were utilised in evaluating views about periodic medical examinations. Three databases were searched using the PRISMA checklist for publication searches from inception to April 2019. Some of the PICO (population, intervention, comparison, outcome) acronym selection criteria that were looked for included: focusing on general health check-ups and involving adults; and is published in peer-reviewed journals from inception to April 2019, with full-text papers available in English. Of the 2,445 articles identified, 340 were examined, and only 15 were finally included in this review. One study used a mixed method and another two qualitative methods, while the rest were quantitative in nature. The Mixed Method Appraisal Tool (MMAT) was used to evaluate the overall quality of each item that was kept. A multi-factorial impact on periodic medical examination is seen in the practice of periodic medical examination. Lack of awareness, self-practice, and compliance with suggestions from healthcare experts might be responsible. As a medical examination is the initial step of a healthcare intervention, action taken at this stage may help in management later, thus maximising the advantages of health check-ups. In order to get the full benefits of periodic health checks, a wide variety of techniques will be required
Is Cognitive Behaviour Therapy Effective for Borderline Personality Disorder : A Case Report and Review of Literature
Get PDFManaging people with borderline personality disorder (BPD) is an arduous task due to the complexity of the condition. This paper describes the role of Cognitive Behaviour Therapy (CBT) in a patient diagnosed with BPD who has undergone a modified DBT skill group training. Despite receiving multiple interventions in the past, this patient had her bouts of struggles living with this illness which required a new approach to facilitate her recovery. A trial of a short-term, 12 session-ed treatment of mindfulness-based CBT was commenced. In this case report we describe the challenges and modifications which surpass during this session and literature review on the role of CBT on BPD.
A Brief Review of the Safe Management of COVID-19 Related Death and Its Control Strategies
Get PDFCoronavirus disease 2019 (COVID-19) is a disease caused by a virus named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). With the increasing COVID-19 associated deaths, the infectivity and handling of the dead bodies associated with COVID-19 has become a worldwide concern in terms of spreading the infection further during handling of these bodies. As precaution, measures should be taken to contain the spread of infection while handling COVID-19 associated deaths. This review article aims to review the current management of COVID-19 associated deaths and control strategies in various countries which can guide medical examiners in handling the bodies including those with autopsy
Adult Moyamoya Syndrome as A Manifestation of Varicella-Associated Cerebral Vasculopathy: A Case Report
Get PDFMoyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive large intracranial artery narrowing and development of small vessel collaterals. Moyamoya syndrome (MMS) refers to the angiographic findings of MMD with predisposing medical conditions. Varicella-associated cerebral vasculopathy (VACV) is a severe complication of varicella zoster virus (VZV) infection and its association with MMS is rare in adult. We report on a case of a 55-year-old lady who presented with progressively worsening dysphasia and left lower limb weakness following a week of right herpes zoster ophthalmicus infection. The initial Magnetic Resonance Imaging (MRI) of brain demonstrated features of encephalitis with micro abscesses. Her serial repeated MRI brain imagings subsequently demonstrated worsening of cerebral infarctions with right internal carotid artery stenosis and basal ganglia collaterals suggestive of Moyamoya vasculopathy. This case highlights the rare association of VACV with MMS and should be considered as a potential serious complication in patients with VZV infection
Validity and Reliability of Malay Language Breast Cancer Awareness Scale for Male-to-Female Transgender
Get PDFIntroduction The breast cancer risk among female transgender for those using hormonal therapy is emerging. However, most of them also engaged in breast implant procedures resembling female sexual characteristics and satisfaction without realizing the risk of cancer development. Thus, breast cancer risk assessment of female transgender in Malaysia should be further evaluated. This study aims to develop and validate an assessment tool in the Malay version to measure breast cancer awareness among female transgender in Malaysia. Materials and Methods A cross-sectional study with a purposive sampling method was conducted among 300 respondents in Pahang, Kedah, and Kelantan. The minimum number of respondents required was 300 persons based on the Nunnally method, with an item ratio of 1:10. All the subjects were given questionnaires on sociodemographic data and breast cancer-related items, consisting of five domains; knowledge of symptoms and clinical features, breast cancer risk factors, breast screening programs, barriers in seeking medical help, and lastly, the confidence, skills and behaviour concerning breast self-examination. Each domain consists of five to seven items. All the responses are recorded as ‘Yes,’ ‘No,’ or ‘Not Sure’ responses. Reliability was determined using Cronbach’s alpha for internal consistency, while construct validity was assessed using exploratory factor analysis. Results The reliability of the 28 items for Malay Version of Breast Cancer Awareness scale by Cronbach Alpha is 0.864, suggesting that the constructs are reliable and acceptable. In addition, the construct validity was assessed using exploratory factor analysis highlights five meaningful domain. Conclusion This Malay language breast cancer awareness scale is a convenient self-assessment method, inexpensive and understandable which highlights common issues faced male-to-female transgender with targeted domains. In conclusion, this scale is valid and reliable by achievable internal consistency value of 0.864.
The Perception of Doctor Bullying by Patients and Relatives at Malaysian Emergency Departments in Regional Referral Hospitals
Get PDFINTRODUCTION: Bullying can occur in terms of physical, verbal, mental, sexual, and/or litigation. The main objective of this study was to determine the prevalence of Emergency Department (ED) doctors being bullied by patients and/or relatives, the types of bullying faced and the Post-Traumatic Stress Disorder (PTSD) it may have caused them. MATERIALS AND METHODS: This was a cross-sectional study conducted in all 14 Malaysian state-tertiary government EDs. EDs were chosen as they encountered the maximum number of patients in hospitals. Data was obtained electronically among doctors randomized in each hospital. A validated questionnaire (POPAS-NZ) was used to determine the act of bullying and the impact of the most distressing event (IES-R scale) to detect PTSD. RESULTS: In total, 316 doctors participated in this study and the majority (98.7%) experienced some kind of bullying (98.1% faced verbal abuse). Among those bullied, 83.7% of doctors reported verbal abuse to be the most distressing event. Most of the preparators of the distressing incident were by accompanying relatives of patients (62.1%). Sexual abuse caused PTSD of concern- high enough to suppress the immune system. The final factors that were deemed to be significant to the mental abuse were age (p=0.03) and gender (p ≤ 0.001). Ladies had 2.69 times the odds (AOR 95% CI:1.57;4.60) to be mentally abused compared to men. Ladies had 5.50 times the odds (AOR 95% CI:1.88;16.11) to be sexually abused compared to men. CONCLUSION: Most doctors who worked in the ED faced bullying- commonest being verbal abuse. Sexual abuse caused the most distressing PTS
Anticoagulant Activity in Medicinal Plants: A Systematic and Bibliometric Review Over 10 Years (2011-2021)
Get PDFAnticoagulants are helpful as treatment for coagulation disorders. Medicinal plants have been demonstrated to be part of history as a traditional treatment for this disorder, and these plants have anticoagulant properties. Hence, the goal of this study is to review the available publications on anticoagulant activity in medicinal plants from the year 2011 until 2021 using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and bibliometric analysis. This review was performed based on the PRISMA guidelines and VOSviewer as a bibliometric analysis tool, using three search databases which were PubMed, MyMedR, and ScienceDirect. The findings of this study revealed that 27 articles met the inclusion criteria and focused on anticoagulant activity in medicinal plants. In each study, anticoagulant properties in medicinal plants were addressed. Meanwhile, the results of the bibliometric analysis demonstrated that China has the most publication for anticoagulant activity in medicinal plants and had the mostcollaboration among institutes in their country. For the most used keywords used by the author, the word "anticoagulant activity" came on top of the results. To conclude, this study can contribute to the field of study as it helps combine the data related to anticoagulant activities in medicinal plants
Patterns of Breastfeeding Practices among Mothers in Two Urban Cities in Vietnam
Get PDFINTRODUCTION: Breastfeeding is associated with lower risk of child morbidity and mortality and foster overall child development. However, suboptimal breastfeeding practices have been reported in many countries. This study aims to describe patterns of breastfeeding from birth to 24 months in Vietnam and examine factors associated with the maintenance of breastfeeding at 12 months. MATERIALS AND METHODS: 573 mothers whose infants aged from 12 to 24 months in a multi-centre cross-sectional study were recruited. RESULTS: The prevalence of initiation of breastfeeding within the first hour post-partum was 52.9%, between 1 to 24 hours was 21.9%, after the 24 hours was 25.2% and none not initiated by the 7th day after birth. The prevalence of delayed initiation of breastfeeding was significantly higher in caesarean section than in vaginal births (p=0.0001). Prevalence of infants ever breastfed was 100%; exclusively breastfed at 6 months was 19.7%, continued breastfeeding at 12 months was 92.5%, and continued breastfeeding at 20-24 months was 43.5%. There were 16.4% of mothers had breastfeeding problems. Correctly describing the recommended duration of exclusive breastfeeding and not using a bottle to give expressed milk to the infants were factors associated with the higher prevalence of breastfeeding maintenance for 12 months. CONCLUSION: Early initiation of breastfeeding and exclusive breastfeeding prevalence at 6 months in our study earn rating of “good” and “fair” respectively according to World Health Organization (WHO) recommendation. Improving mothers’ knowledge of exclusive breastfeeding recommendations and educating about breast milk expression may improve the prevalence of breastfeeding maintenance at 12 months
