IIUM Medical Journal Malaysia (IMJM)
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Effects of Shen Men Auricular Acupressure on Haemodynamics During Laryngoscopy and Intubation and Preoperative Anxiety
No full textINTRODUCTION: Laryngoscopy and endotracheal intubation is known to cause tachycardia and increase in blood pressure during general anaesthesia. This study was designed to assess if auricular acupressure has beneficial effects in attenuating the haemodynamic changes during laryngoscopy and intubation. Secondly, this study aimed to evaluate the effectiveness of auricular acupressure in reducing preoperative anxiety. MATERIALS AND METHODS: Eighty patients who were scheduled for surgery under general anaesthesia were randomised to receive either active auricular acupressure over bilateral Shen Men (Group A) or sham auricular acupressure (Group B). A total of three stimulations of auricular acupressure with ten minutes interval were performed before induction of anaesthesia. Haemodynamic parameters (heart rate and blood pressure) were recorded ten minutes after each stimulation, during laryngoscopy and intubation and every minute for ten minutes after intubation. Visual analogue scale for anxiety was documented before and at 30 minutes post first stimulation. RESULTS: The heart rate and mean arterial pressure were statistically higher in Group B comparing to Group A during intubation (p=0.043 and p=0.049 respectively). There was statistically significant reduction in blood pressure after intubation in both groups as compared to baseline (p<0.003 respectively). However, there was no significant difference when comparing both groups (p>0.05). There was no significant reduction of preoperative anxiety level in both groups after auricular acupressure (p=0.879). CONCLUSION: Auricular acupressure over bilateral Shen Men helped to attenuate the haemodynamic changes during intubation. However, it did not reduce preoperative anxiety
Oral Health and Cardiac Rehabilitation: A Scoping Review
Get PDFThis scoping review aimed to gain an insight into the oral health status, behaviour, knowledge, and risk among cardiovascular patients, as well as to explore challenges and to make a recommendation concerning oral health and cardiovascular patients. It focused on four key areas, namely oral health status, behaviour, knowledge, and associated risk factors. Relevant studies were searched using a combination of keywords and related search terms. Four available databases were used; EBSCOhost, Scopus, Proquest, and Pubmed to identify the relevant studies. A total of 789 papers were screened and duplicated papers were removed, 28 papers were retrieved for full-text review. It was found that most cardiovascular patients have poor oral health, while their oral health behaviour and knowledge were at a fair level. There are a limited number of studies assessing oral health conditions during cardiac rehabilitation. In general, protocol and guidelines about the importance of oral health care for cardiovascular patients are still lacking. Having good oral health has potential impacts in reducing the risk of CVD. Future research is warranted with potential intervention approaches to improve oral health conditions among cardiovascular patients, thus reducing the risk of CVD
Islam, Iman, and Ihsan: The Role of Religiosity on Quality of Life and Mental Health of Muslim Undergraduate Students in Islamic University
No full textINTRODUCTION: The current study examines the relationships between religiosity, quality of life, and positive mental health among Muslim students in an Islamic university in Malaysia. This study uses the operational definition of religiosity based on Hadith Jibril, which defined Islam into three elements: Islam, Iman, and Ihsan. Materials and Methods: One hundred and seventy-nine students participated in this cross-sectional study. Three measures were used to measure religiosity (IIUM Religiosity Scale), quality of life (WHO Quality of Life-BREF Scale), and positive mental health (Positive Mental Health Scale). Results: Significant relationships between religiosity, quality of life, and positive mental health were found. Further analysis found that i) Ihsan highly predicts the physical and psychological domains of quality of life and mental health; ii) Islam shows the highest prediction on social-based quality of life, and iii) Iman highly predicts the environmental-based quality of life. Conclusion: Religiosity plays a vital role in predicting an individual’s quality of life and mental health. These findings provide hope for future research and utilisation of Islamic elements as an intervention for psychological wellbeing among students.
Exploring Problem-Based Learning (PBL) and Case-Based Learning (CBL) in Stimulating Cognitive Skills among Medical Students: Analysis of Verbal Interaction
Get PDFINTRODUCTION: Problem based learning (PBL) has many benefits; however, research on PBL indicates that students are not quite good at integrating knowledge in basic sciences and clinical aspects. Case-based learning (CBL) might be an alternative method to enhance the integration of this knowledge. No research explored the way these two methods stimulate cognitive skills. This study aimed to explore the differences between PBL and CBL in stimulating cognitive skill by analyzing verbal interaction. MATERIALS AND METHODS: This descriptive research was performed at the Faculty of Medicine, Universitas Islam Indonesia (FM UII). Twenty-one undergraduate students contributed voluntarily to this study. The students were then split up randomly into a PBL Group (n=10) and a CBL group (n=11). Each group performed twice discussion meetings facilitated by an experienced tutor. The discussion processes were video recorded and analyzed using a coding scheme categorizing the verbal interaction into five types: cumulative reasoning, exploratory questioning, procedural interaction, handling conflict about knowledge, off-task/ irrelevant interactions. RESULTS: Students in both PBL and CBL groups spent most of their time-sharing cumulative reasoning and then asking exploratory question. Students in the PBL group were more frequently asking exploratory questions. Students in both groups rarely handled conflict about knowledge since it was a high order thinking skill. Students in the CBL group were more frequent than the PBL group in performing procedural interaction. CONCLUSIONS: Students performed various cognitive skills in both PBL and CBL. Each method has its own strengths in stimulating reasoning skills of students
Oxidative Stress Induces Endothelial Dysfunction and Endothelial Cell Damage in Rapid Eye Movement (REM) Sleep Deprivation Animal Model
Get PDFINTRODUCTION: Rapid eye movement (REM) sleep deprivation causes oxidative stress, leading to endothelial dysfunction, a predictor of cardiovascular disease. It is still unclear what causes endothelial dysfunction in patients with sleep disorder. This study evaluates the effects of REM sleep deprivation on the endothelium in the rat model of REM sleep deprivation. MATERIALS AND METHODS: Sprague-Dawley male rats (N=28) were divided into four groups (n=7); (1) free-moving control (FMC), (2) REM sleep deprivation (REMsd), (3) tank control (TC), and (4) sleep recovery (SR). The inverted flowerpot technique was utilised to develop REM sleep deprivation. Bodyweight gain (BWg), food consumption (Fc), and systolic blood pressure (SBP) were evaluated. The descending thoracic aorta was isolated to assess oxidative stress markers, in vitro functional study, and histomorphological examination. RESULTS: REM sleep deprivation showed a decrease in BWg significantly despite a significant increase in Fc, increased SBP, increased oxidative stress markers, caused endothelial dysfunction and endothelial cell damage. In REM sleep-deprived rats, there was a significant reduction in antioxidant markers, including total antioxidant capacity (TAC), superoxide dismutase (SOD) activity, catalase (CAT), and glutathione (GSH), while the levels of malondialdehyde (MDA) were significantly increased. The REM sleep-deprived rats displayed altered vascular function, including impaired vasorelaxation and hypercontractility. Histomorphology of the endothelium in REM sleep-deprived rats revealed features of endothelial damage. CONCLUSION: REM sleep deprivation is suggested to be linked to endothelial dysfunction due to endothelial damage. These changes are proposed to result from increased oxidative stress. Sleep recovery reduced the harmful effects following REM sleep deprivation.
A Comparison of Wound Complications and Post-operative Factors Following the Use of Hydrodissection for Mastectomy in Breast Cancer Patients
Get PDFIntroduction: Mastectomy with axillary clearance remains the hallmark of breast cancer treatment. The conventional use of electrocautery has been associated with the risk of post-operative complications. Hydrodissection may reduce surgery time and produce fewer wound complications with less post-operative pain. The aim of this study was to compare these 2 modalities. Materials & Methods: This prospective randomised control trial was performed with breast cancer patients in Hospital Selayang, Malaysia, between 1 June 2019 to 1 September 2020. The patients were randomised into conventional and hydrodissection groups. The outcomes of interest were post-operative wound complications and other post-operative factors. A chi-square test and independent Student t-test were used to compare the 2 groups. Result: A total of 94 patients were recruited. There was a significant reduction in post-operative seroma in the hydrodissection group compared to the conventional group (40.4 vs 19.1, p<0.05). The surgery in the hydrodissection group was also shorter (114.09 vs 100.15, p<0.05), and there was less 24-hour post-operative pain (3.28 vs 2.13, p<0.05). However, no significant association was observed with other post-operative wound complications (i.e. flap necrosis, surgical site infection and hematoma) or other post-operative factors (i.e. estimated blood loss, mean volume of drain and duration of drain). It was also demonstrated that the hydrodissection technique lowers the risk of developing seroma 3-fold (odds ratio=0.349, p<0.05). Conclusion: The use of hydrodissection with liposuction cannula reduced the rate of post-operative seroma and provided a shorter operative duration and better post-operative pain control.
Madura Foot: A Rare Case of Eumycetoma and Proposed Classification and Treatment Guidelines
Get PDFMadura foot or mycetoma pedis is a chronic granulomatous disease of the foot caused by fungus or gram-positive aerobic bacteria. It is commonly encountered in tropical and subtropical countries but is rare in Malaysia. We reported a 40-year-old Rohingya refugee who has been resident in Malaysia for the past 11 years presented with a long-standing left foot mass that was proven to be a eumycetoma. A wide local excision of the mass and full-thickness skin graft were done, followed by a course of 6-month postoperative itraconazole. He subsequently recovered well without sequela. A high index of suspicion should be raised in a patient presenting with a chronic mass and discharging sinus in order to diagnose and treat mycetoma as early initiation of therapy leads to better outcomes. Based on literature review, we propose a new classification of eumycetoma and its treatment guideline
Islamic Perspective on Eye Protection from Occupational Radiation Exposures in Interventional Fluoroscopy Procedures: A Review Article
Get PDFThe healthcare staff in interventional fluoroscopy room are exposed to the scattered-radiation from the patient during the procedures. Excessive occupational radiation exposures to their eyes are associated with the formation of radiation-induced cataracts. Therefore, recommendations are set-up to reduce the occupation eye exposure but are often overlooked. Thus, there is a need to incorporate additional value into the recommendations. This review is conducted to incorporate the Islamic perspectives into the recommendations on the eye protection from occupational radiation exposures. Common themes were derived from the recommendations as stated in several guidelines and articles. The relevant Islamic perspective were then identified and linked. The main themes are the responsibilities of the staff in protecting their eyes and the responsibilities of the employers to ensure that their staff are protected. There were several subthemes identified for each main theme. The relevant Islamic perspectives which are related to the identified themes, eyes and concept of radiation protection were discussed in this review. The incorporation of Islamic perspective is an effort to motivate the Muslim staff and employers to see additional values and thus follow the recommendations on the eye lens protection
Risk Evaluation on Security Personnel Managing Illegal Detainees in a Makeshift Covid-19 Low Risk Quarantine and Treatment Centre
Get PDFBackground: The COVID-19 pandemic situation in Malaysia has resulted in a whole country approach where a newly built makeshift low risk Covid-19 treatment centre was chosen to house all COVID-19 positive illegal immigrants. In view of the desperate situation the detained illegal immigrants were in as the risks of them behaving aggressively, taking hostage, running away and escaping from the treatment centre were high this is the first time ever other governmental, non-governmental and security agencies worked alongside healthcare personnel in a biological hazard treatment centre while the clinical management was of no different than any other clinical setup in the country.
Methodology: This is a semi-quantitative and integrated type of hazard identification, risk assessment and risk control (HIRARC) approach where it incorporates risk rating and severity rating to cover four elements, which are people, property, environment, and reputation. Total scores range from 1 to 25 and was further categorized into low, medium and high risk in a color-coded representation. The assessment was done for two weeks from 27th May 2020 till 11th June 2020.
Result & Discussion: Four types of occupational and security hazards identified were physical, biological, psychological and ergonomics hazards. this evaluation serves as a good planning tool in optimizing the risk mitigation measures among security personnel working in a biological hazardous environment. Physical hazards with possible violence and riot scored the highest risk while ergonomic issues had the lowest rating.
Conclusion: The mapping combination of existing hazard, risk rating and control was able to facilitate organization to prioritise future planning. With the fluidity of the COVID-19 pandemic, periodical evaluation is recommended to meet dynamic changes such as demands for frontliner manpower strength, the number of existing detainee patients in ward and the evolution of the COVID-19 infection itself to maintain safety and security for all.