IIUM Medical Journal Malaysia (IMJM)
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Knowledge, Attitude and Practice on Electronic Cigarette and their Associated Factors among Undergraduate Students in a Public University
Get PDFIntroduction: Smoking tobacco has been a longstanding issue worldwide, but the trend of smoking electronic cigarette (e-cigarette) is now on the rise. Many people have the view that smoking e-cigarette is safer and less harmful, and this is worrying. Adolescents and young adults are easily influenced by advertisements on e-cigarette. Thus, this study was conducted to determine the knowledge, attitude, and practice on e-cigarette among university students. Materials and methods: A cross-sectional study using self-administered questionnaire among 484 university students was carried out in a public university in Negeri Sembilan, Malaysia. Results: Respondents were 19 to 25 years old undergraduates, with the majority being female. In terms of smoking status, 32 (6.6%) of them were smokers, with only nine have ever tried e-cigarette, and only one being a regular user. Bivariate analysis showed knowledge, attitude and practices score on e-cigarette were correlated. Statistically significant associations were found between knowledge score and gender (p<0.001), while attitude and practice scores were associated with gender (p<0.001), household income (p = 0.013 and p = 0.001 respectively), as well as smoking status (p<0.001). Multivariate analysis revealed that being female and being a non-smoker were associated with higher attitude and practice scores. Conclusion: In conclusion, the awareness on e-cigarette needs to be improved among young adults and a more holistic intervention strategy should be implemented to prevent the rise of e-cigarette smoking
Cytomegalovirus (CMV) Infection in Infants: Two Case Reports and Review of Literature
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Cytomegalovirus (CMV) is a virus under the Herpesviridae family. We describe two case reports on different manifestations of infants with CMV infection presented with neonatal jaundice, small for gestational age (SGA) and congenital cataract. Congenital CMV (cCMV) was diagnosed in a neonate presented with jaundice and SGA. cCMV cannot be excluded in another case as no CMV PCR done within 3 weeks of life. Only one cCMV infection was treated with 6 weeks of ganciclovir anti-viral therapy, which presented with neonatal jaundice, SGA with a very high CMV viral load. All cases were under multidisciplinary follow[1]up, including pediatric for developmental assessments, audiologist for hearing assessment, and ophthalmology for vision assessment. These case reports describe the importance of thorough clinical examination and early screening of CMV infection in infants to rule out cCMV as CMV is the commonest congenital treatable viral infection in Malaysia. Early treatment and intervention can be planned for child wellbeing
Virulence-genes Rib and Bca in Serotypes of Group B Streptococcus (GBS) Isolated from Symptomatic Pregnant Women in East Coast Malaysia
Get PDFINTRODUCTION: Group B streptococcus (GBS) is a leading cause of maternally-acquired invasive infections in neonates. Nowadays maternal immunization is of utmost demand for prevention of these infections. We undertook capsular serotyping and virulence factor genes identification for local GBS isolates as a pilot study, to identify potential candidates to propagate vaccine development. MATERIALS AND METHODS: This is a descriptive lab -based study to determine GBS serotypes and presence of genes coding virulence factors bca and rib in isolates obtained from symptomatic pregnant women in Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia. Sixty-two GBS isolates from high vaginal swabs were collected. Latex agglutination test was performed to determine GBS serotypes. Real-time PCR was done to determine the presence of virulence genes. RESULTS: Of the 62 GBS isolates, 77.4% were serologically typeable, and 22.6% were non -typeable. Serotypes Ia and Ib (16.1% each) were the most common capsular types, followed by II, V, and VII (9.7% each), III (8.1%), VI (6.5%), and VIII (1.6 %). Furthermore, 67.7% of the isolates harboured the rib gene while 98.4% possessed the bca gene. CONCLUSION: The five known prevalent serotypes worldwide, do not match the CPS distribution in symptomatic pregnant women in Kuantan. However, the frequency of virulence genes rib and bca is high among our isolates, which if confirmed by further bigger and wider studies makes the proteinaceous vaccine, N-terminal domains of Rib and AlpC a suitable candidate for GBS prevention in this geographical area
Evaluating Frozen Strawberries as a Strategy for Thirst Management in Patients with Congestive Heart Failure (CHF)
Get PDFINTRODUCTION: Thirst sensation in Congestive Heart Failure (CHF) patients is caused by diuretic administration and fluid consumption limitation. Unhandled thirst sensation leads to a disobedient patient in fluid consumption limitation that causes the patient condition to worsen. This research aimed to analyse the frozen strawberries administration's effects on the thirst sensation in a patient with CHF . MATERIAL AND METHOD: The method used was a quasi-experiment with a pre-test and post-test control group design. The number of respondents was 34 patients divided into two groups: 17 respondents in the intervention group and 17 respondents in the control group. The sampling technique was stratified random sampling based on NYHA classification in the respondents. Frozen strawberries were given to the intervention group, while ice cubes were given to the control group. All the data were analyzed using a t-test.RESULT:The results showed that the mean score of the thirst intensity of the intervention and control group was 4.44 and 2.35, respectively. The independent t-test of the mean difference of thirst intensity pre and post-test between the intervention and control groups was p=0.001. According to the paired t-test analysis, the thirst intensity score between pre-test and post-test was p<0.001, from moderate to low thirst intensity. CONCLUSION:Frozen strawberries were statistically effective in reducing the thirst intensity in a patient with CHF
Heart Rate Variability and Muscle Strength in Young Adults with Sedentary Behaviour
No full textIntroduction: Sedentary behaviour or physical inactivity has been relatively prevalent among young adults globally. Multiple studies pointed out that Malaysia has been listed as one of the Asian countries with high prevalence of inactivity. Objective: This study aimed to examine the heart rate variability (HRV) and muscle strength among young adults in order to identify the early impact of this behaviour on their physiological and physical health. Method: This cross-sectional study involved 185 healthy male adults aged 18-25 years old. Participants’ height and body compositions were measured and their level of physical activities were obtained using Short Questionnaire to Assess Health (SQuASH). Those with less than 150 minutes per week of physical activity engagement were classified as sedentary. Their HRV was analysed as a determinant for early physiological change that was influenced by the sedentary behaviour. Muscle strength of upper and lower body was assessed via handheld dynamometer to identify the physical fitness associated to the behaviour. Results: Among the participants that volunteered in this study, approximately 44% were classified as sedentary. Analyses revealed that those with sedentary behaviour had lower variability of their HRV and lower muscle strength as compared to those who engaged with at least 150 minutes per week of physical activities. Conclusion: The highlighted evidence of the difference on parameters of HRV and muscle strength with this behaviour suggested that these parameters were suitable parameters to be utilised in determining subclinical improvement on health with any intervention to curb sedentary behaviour
Evaluating Effect of Prophylactic Intravenous Dexamethasone in Post Spinal Shivering: A Single Centre Randomised Controlled Study
Get PDFIntroduction: Shivering is a common side effect of central neuraxial anaesthesia. Intravenous pethidine is commonly used in reducing shivering but has been associated with significant opioid side effects. Dexamethasone as a powerful anti-inflammatory and analgesia agent is postulated to inhibit inflammatory mediators’ release thus inhibiting central thermoregulatory centre, potentially attenuating post spinal shivering. This double-blinded randomised controlled study was to determine the ability of intravenous dexamethasone in decreasing the incidence, severity and the need for treatment for post spinal shivering.
Methods: We recruited 72 patients requiring spinal anaesthesia and randomised them to receive either dexamethasone 0.1 mg/kg (up to 8 mg) or normal saline (placebo). We observed their tympanic membrane temperatures, mean arterial pressures and shivering scores at regular intervals up to 2 hours post-spinal or till end of surgery (minimum 30 minutes post spinal).
Results: Both groups showed consistent and comparable drop in tympanic membrane temperatures and mean arterial pressures after spinal anaesthesia, except at 15 minutes in which patients of dexamethasone group demonstrated significantly higher temperatures than saline group (p=0.04). There were also significantly less patients in the dexamethasone group reporting incidence of visible shivering as compared to the placebo group (p=0.003). No significant difference was seen in severity of shivering or usage of pethidine.
Conclusion: Dexamethasone has the potential to mitigate the reduction in core body temperature, especially at 15 minutes post spinal. It can reduce the incidence of clinically significant visible grade of shivering post spinal
Manipulation of p53 Protein in Bladder Cancer Treatment
Get PDFChemotherapy and radiotherapy are gold standard treatment for bladder cancer (BC) for over 50 years. The efficacy on early stage BC patients is virtuous. However, patients with aggressive cancer growth benefited less from the therapy. Aberrant p53 was found in more than 50% of high-grade BC patients. Therefore, targeting p53 in a subset of high-grade BC patients expressing aberrant p53 is a promising strategy. In this paper, p53 role in BC carcinogenesis is discussed. Followed by p53-targeting strategies in current BC treatment. Besides, p53-targeting strategies that have been implemented in other types of cancer and their potential to be adapted in BC will be deliberated. Although targeting p53 is promising, none of the strategies studied were successfully implemented in healthcare settings. Restoration of p53 as the guardian of the genome is an exciting area for translational research. It has potential to replace the genotoxic chemotherapy and radiotherapy, thus, eliminating the notorious painful sideeffects on a subset of high-grade BC patients. Searches were performed on PubMed and Google Scholar web using the keywords “bladder cancer” or “urothelial cancer” or “urothelial cell carcinoma” and “p53”. Only full papers of research articles and review papers were included for analysis. Papers were categorized as either p53 function, current treatment using p53 and future potential treatment using p53 for details analysis
The Application of Maqasid-Oriented Approach in Islamic Bioethics: A Case Study on Fatwa Related to Cosmetic, Plastic and Reconstructive Surgery
Get PDFINTRODUCTION: Cosmetic surgery, which is a type of elective surgery designed to alter the physical features of the human body, is currently in high demand due to a combination of several main factors; namely low self-esteem, the desire to achieve beauty standards set by society, and the ubiquity of mass media and social media influencers. As a Muslim, cosmetic surgery must be evaluated from a jurisprudential lens to determine the level of necessity of the procedure, whether it reached the stage of essential (darurah), or necessity (hajah), or complimetary (tahsinah), along with close inspection of the maslahah dan mafsadah involved with the aspect of maslahah dan mafsadah in need of further clarification. A close inspection of medical fatwas relating to cosmetic surgery reveals that procedures that are intended solely for physical beautification with no medical justification whatsoever are forbidden. MATERIALS AND METHODS: This study collect data from fatwas issued by seven fatwa institutions worldwide, will look into the application of maqasid al-shariʿa in determining the legal status of cosmetic surgery in Islam. The data was analysed thematically. RESULT: The findings from this study suggest that all fatwas pertaining to cosmetic surgery were decided based on the considerations of maqasid al-shariʿa, which will greatly aid doctors and patients in evaluating the need, or the lack thereof, to proceed with cosmetic surgery. CONCLUSION: The discussion of Islamic law or fatwa related to medicine requires synergy between sharia experts and medical doctors
Relationship of Psychosocial Factors towards Medication Adherence among Hypertension Patients in A Tertiary Hospital
Get PDFINTRODUCTION: Hypertension is one of the invisible diseases causing heart failure and stroke, and responsible for death. This study aimed to determine the level of medication adherence and psychosocial factors among patients with hypertension, relationship between socio demographic and medication adherence, and relationship between psychosocial factors and medication adherence among patients with hypertension. MATERIALS AND METHODS: A cross-sectional descriptive study was performed at the Primary Health Clinic and Medical Clinic in one of the tertiary hospitals. There were 123 patients with hypertension who volunteered to participate using a validated adapted and modified questionnaire to assess the compliance and psychosocial factors. The data collected was analysed using IBM SPSS Statistics version 23. RESULTS: A hundred and twenty respondents were adherents to medication (97.6%) while respondents with non-adherence to medication were 3 (2.4%) with a mean adherence score of 42.2764 with SD ± 2.67134. Some of the psychosocial variables had good understanding, good emotional state, positive attitude, higher motivation, higher perception of severity, lower perception of susceptibility and less barrier to compliance. Emotional state was the only thing reported for the psychosocial factors as being statistically significant. The level of emotional state was found statistically significant differences with scores p=0.008 (p< 0.05). CONCLUSION: The level of medication adherence was good which reflected the patients’ compliance towards medication taking. This study showed a good medication adherence and compliance among hypertension patients