IIUM Medical Journal Malaysia (IMJM)
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A Multidimensional Strategy: Ways to Combat Cyclic Vomiting Syndrome with Hiatus Hernia and Gastroesophageal Reflux Disease in A Young Adult Female
Get PDFCyclical vomiting syndrome (CVS) is a chronic idiopathic functional gastrointestinal disorder characterised by intermittent episodes of severe nausea and vomiting with symptoms-free intervals in between. CVS is seen in various age groups with a prevalence of 1.9%. Numerous psychosocial, physical and infectious stressors have been attributed as a trigger of CVS. Often, a co-existing organic and psychiatric comorbidities mask the disorder, and an absence of diagnostic investigation causes a delay in diagnosis and makes it challenging to treat
Systems Thinking Approach on Foetal Abnormalities Due to Alpha-Fetoprotein Level
No full textFoetal complications due to abnormal Alpha-Fetoprotein (AFP) levels are becoming a serious matter. The risk of adverse pregnancy outcomes (APOs) is substantially greater in the raised maternal serum-alpha fetoprotein (MS-AFP) group than in the normal MS-AFP groups. The top three APOs in terms of occurrence rate in the increased MS-AFP group were structural foetal abnormalities, spontaneous abortion, and premature delivery. Low levels of AFP in the maternal may indicate a risk of Down syndrome. This is a critical matter that needs to be investigated and dealt with seriously, based on the systems thinking approach. This research aims to investigate screening methods on AFP foetal based on system thinking approach. The main purpose of the study is to provide an analytical and integrated approach to deal with foetal complications due to AFP level. This integrated approach comprises various analytical aspects, including conceptual framework, data analysis, evaluation of the screening methods. How systems thinking can contribute to improve all these aspects of foetal complications will be investigated. The methodology will enable to conduct a detailed explanation to the major problems of AFP in the form of a causal loop diagram based on the holistic view of the systems thinking approach. It is expected that the application of a systems approach could provide an effective method of analysis for understanding and managing the foetal abnormalities by considering all aspects in a holistic manner and clearer methods of intervention to reduce the cases.
Knowledge of Ventilator Care Bundles among Registered Nurses in the Intensive Care Unit at Sarawak General Hospital, Malaysia
Get PDFINTRODUCTION: Ventilator Care Bundles (VCB) is a group of evidence-based highimpact interventions for mechanically ventilated patients. The study aims to identify the knowledge of VCB among Intensive Care Unit (ICU) nurses at the local hospital in Sarawak, Malaysia. MATERIALS AND METHODS: A quantitative cross-sectional survey was conducted among 30 nurses who worked in the ICU at Sarawak General Hospital, Malaysia. A modified questionnaire with 20 items was used to measure the level of knowledge. Data analysis was performed using the Statistical Package for the Social Sciences Statistics 26.0 for Windows with p< 0.05 was considered statistically significant. RESULTS: The results revealed that 86.7% (n=30) of respondents had a high-level knowledge of the VCB. There is a significant relationship between the level of knowledge of VCB and qualification as a Registered Nurse (p=0.03), ICU post-basic qualification (p=0.02), and level of nursing education (p<0.001). The level of knowledge was significantly related to the level of education (r=0.71; p<0.001), the number of years qualified as a registered nurse (r=0.38; p=0.03), and post-basic qualification (r=0.42; p=0.02). CONCLUSION: The good level of knowledge regarding VCB implementation among registered nurses indicates that they are well-equipped with the proper knowledge for caring for mechanically ventilated patients
Sleep Disturbances and Sensory Processing among Autism Spectrum Disorder Children
Get PDFINTRODUCTION: Research on sleep disturbances and sensory processing disorder (SPD) among children with autism spectrum disorder (ASD) has received little attention. Identification of sensory components that cause sleep disturbances among ASD children will guide the therapists to select the best intervention for the condition. This study aims to identify the pattern of sensory processing that is responsible for sleep disturbance among ASD children. MATERIALS AND METHODS: A cross-sectional study was conducted among 55 ASD children between three and 18 years old who participated in the study. SPD was analyzed using Short Sensory Profile (SSP) while sleep disturbances utilized the Sleep Disturbance Scale for Children (SDSC). RESULTS: The subscale of SPD showed a strong correlation with the score for overall sleep disturbances. The subscales SPD are movements sensitivity with a positive association and auditory filtering with a negative correlation association (p<0.05). However, no significant association between total SPD and sleep disturbances (p>0.05) were noted. CONCLUSION: This finding may therefore shed light that SPD and sleep disturbances need to be addressed reciprocally. Increasing the number of participants and battery of tests are required to accurately determine the relationship between SPD and sleep disturbances
The Reliability of SketchAndCalcTM Area Calculator Software in Evaluating The Obturated Surface Area of Mandibular Premolars and Molars
Get PDFINTRODUCTION: The measurement consistency of an assessment tool in biomedical research is important for validation of data. This study aims to determine the reliability of SketchAndCalcTM Area Calculator software in evaluating the obturated surface area of single rooted mandibular premolars and mandibular first molars between two examiners and to compare with the previous studies. MATERIALS AND METHODS: 30 scanning electron microscopy (SEM) images of extracted single rooted mandibular premolars and 30 SEM images of mandibular first molars were obtained from the previous studies. The extracted teeth were previously obturated with GuttaFlow Bioseal. Calibration between two examiners was done prior to start of the study. SketchAndCalcTM Area Calculator software was used to evaluate the volumetric percentage of obturated surface area. Inter-examiner reliability was determined between two examiners and compared to the previous studies using Intraclass Correlation Coefficient (ICC) with the following categories; ICC<0.50: poor reliability, ICC 0.50-0.75: moderate reliability, ICC 0.75-0.90: good reliability, ICC>0.9: excellent reliability. The data was analysed with SPSS version 25.0. RESULTS: The ICC values between two examiners were 0.979 in mandibular premolars and 0.918 in mandibular molars. Meanwhile, the ICC values between two examiners and to the previous studies were 0.844 in mandibular premolars and 0.962 in mandibular molars. CONCLUSIONS: Excellent inter-examiner reliability was observed in premolars and molars, however when compared to the previous studies, good and excellent inter-examiner reliability were observed in premolars and molars respectively
Management of Deep Neck Infection with Descending Mediastinitis using Video-Assisted Thoracoscopic Surgery
Get PDFDescending mediastinitis is defined as the spread of oropharyngeal or odontogenic infection into the mediastinum. It occurs uncommonly and has a high mortality rate. Prompt commencement of broad-spectrum antibiotics combined with surgical drainage is crucial to limit further spread of infection. We report a case of extensive deep neck infection in a 66-year-old female which rapidly progressed to the contralateral neck complicated by descending anterior mediastinitis. She underwent a combined transcervical and video-assisted thoracoscopic surgery (VATS) for drainage of abscess and was put on 3 weeks of intravenous antibiotics coupled with another 3 weeks of oral antibiotics. Deep neck infection with descending mediastinitis can be successfully treated with antibiotics and early surgical drainage via a combined transcervical and VATS approach
Human Milk Expression Practices, Experiences and Perceptions among Mothers: A Systematic Literature Review
Get PDFHuman milk expression is commonly practiced among breastfeeding mothers. Their practices, experiences, and perceptions varies due to many underlying environments and issues. This review describes practices, experiences, and perceptions of mothers in expressing milk. Literature search was conducted for peer-reviewed articles on milk expression using Scopus, Krisalis Discovery, CINAHL, and PubMed from 2010 to 2020 for qualitative and mixed studies. This review and reporting was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Screening and selection of articles were conducted using Distiller Systematic Review (DSR). Twenty-two qualitative studies were identified focusing on the milk expression practices, experiences, and perceptions of mothers. Their practices indicated time, duration and method of milk expression. The experiences found were on the reasons, challenges, coping strategies and motivations. The perceptions on milk expression were found to influence the experience and practices of milk expression. Human milk expression practices, experiences and perceptions have been highlighted in many studies; however, there is no clear association between practices, experiences and perception
The Difference in Brain Processing Between Animate and Inanimate Beings in Moral Violation: An Electrophysiological Evidence
Get PDFINTRODUCTION: Moral violation is known to elicit negative moral emotions and is associated with the electroencephalography (EEG)-derived P300 wave. However, the neural basis of moral categorisation (immoral behaviors towards animate beings or inanimate beings) has yet to be explored in moral psychology, which may increase knowledge and further understanding of brain function for the rehabilitation process. Thus our study aims to investigate the difference in brain processes between animate and inanimate moral violations. MATERIALS AND METHODS: Twenty-six participants (mean age of 24 years old) were involved in the experimental observation that was held in the Neuroscience Laboratory. In the event-related potential (ERP) session, EEG-derived P300 data were recorded while participants viewed a random series of 200 trials of visual stimuli that were distributed according to the odd-ball paradigm. The trials consisted of three image categories (15% of immoral behaviour toward animate beings, 15% of immoral behaviour to non-animate beings, and 70% of neutral images). Participants also pressed the buttons numbered ‘1’ or ‘2’ while responding to animate beings and inanimate beings, respectively. RESULTS: When compared to neutral images and nonanimate objects, the brain regions that were activated with immoral behavior toward animate beings had the biggest P300 amplitude with stronger neural activation in the temporal and occipital regions. CONCLUSION: Immoral behaviour towards animate beings is associated with greater neural cognition, as reflected by the activation in most brain regions. This discovery contributes to a better understanding of the moral foundation. It could be applied in determining the abnormal pattern of brain function and as a baseline reference to be used in the medical rehabilitation field.
Psychological Status among the Young Muslim Community in Yogyakarta Province, Indonesia, during the COVID-19 Pandemic
Get PDFINTRODUCTION: Since the COVID-19 pandemic, psychological well-being has become a growing concern. Coping strategies, including religious activities, are needed to deal with psychological distress. This study aimed to evaluate the prevalence of psychological status and its relationship with religious activities among young Muslims in Yogyakarta province, Indonesia, during the COVID-19 pandemic. MATERIALS AND METHODS: Our cross-sectional study was conducted during the second and third waves of the COVID-19 pandemic in Indonesia. A total of 268 young Muslim from Islamic boarding schools in Yogyakarta province, Indonesia, were included in the study. A selfreported questionnaire containing sociodemographic information, religious activity, and Depression, Anxiety, and Stress Scales-21 (DASS-21) was filled up by the study participants. A descriptive and bivariate analysis was performed accordingly. RESULTS: Out of 312 people screened, a total of 268 participants were included in this study. The majority of participants were male (64.6%), aged between 14 to 18 years (55.2%), studying in high school (53.0%), memorised 1 to 10 juz (section) (79.1%), recited the Al-Quran 1 to 3 hours/day (59.3%), and fasted every Monday and Thursday (47.4%). The prevalence of depression, anxiety, and stress were 24.6%, 46.6%, and 29.1%, respectively. Young Muslims with high religious activities were noted to be less suffering from depression, anxiety, and stress, but it was not statistically significant (p=0.57). CONCLUSIONS: This study reported a high prevalence of depression, anxiety, and stress (from mild to extremely severe) among the young Muslim community in Yogyakarta, Indonesia. Our findings should raise awareness of the educational institutions, government, and public and trigger them to prepare appropriate preventive strategies for psychological distress in the young population
Improved Quality of Healed Wounds with Topical Application of Eurycoma Longifolia Jack Root Extract Hydrogel
Get PDFINTRODUCTION: Collagen is the key component of the extracellular matrix that plays a critical role in the strength and quality of the healed wound. Eurycoma longifolia Jack root extract (TA) has been documented as an anti-inflammatory, antioxidant, and antimicrobial agent that may improve the quality of healed wounds. The objective of this study is to investigate the effect of topical application of TA hydrogel on the quality of the healed skin in rats. MATERIALS AND METHODS: Twenty male Sprague Dawley rats were grouped into 4 groups: Negative control, Hydrocyn® aqua gel positive control, vehicle (Xanthan) hydrogel, and Eurycoma longifolia Jack (TA) hydrogel. Treatments were applied twice daily starting on wounding day until day 21. An excisional wound was created on the back of 20 rats. Tissue samples of the healed skin were collected for histological examination by measuring the epidermal and dermal thicknesses and evaluating the collagen fibre quality by VVG stain. RESULTS: The TA hydrogel group had the thickest newly formed epidermis compared with the other experimental groups. For the dermal thickness, compared with the vehicle (xanthan) hydrogel group, TA hydrogel, and Hydrocyn aqua® gel positive control groups showed significantly increased thickness with p values 0.020 and 0.045, respectively. Histologically TA hydrogel group showed a significant increase in mixed-oriented collagen fibres, and fascicular collagen bundles and showed profound collagen density. CONCLUSION: TA hydrogel improved the quality of healed skin by increasing the epidermal/dermal thicknesses and enhancing the quality of newly produced collagen fibres. It can be considered a promising and effective wound-healing agent