IIUM Medical Journal Malaysia (IMJM)
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Jinn and Mental Illness among Muslims - A Commentary
Get PDFIt is common for Muslims to associate mental illness with the work of jinn. Typically, an initial consultation with folk-healer is made within the local community by those who experience deviant symptoms. This behaviour results in several serious negative health implications. Misconception about the meaning of Islamic medicine, the use of ruqyah among the public, and the lack of culturally competent approach in handling mental illnesses are thought to perpetuate the problem. Despite the lack of evidence in the Qur'an and Sunnah to support jinn possession, the belief persists in the community. Thus, a multidisciplinary approach through engagement, advocacy, and research are much needed to manage the issue at hand
Predicting Falls Risk in Hospital; KPJ Seremban Experience
Get PDFIntroduction: Falls may result in injuries, prolonged hospitalization, increase in morbidity and mortality, incur cost to the individual and the healthcare system and increase potential litigation. Various hospital fall prevention programs such as Morse Fall Scale Assessment Tool have been implemented in the last decade; however most of the program had no sustained effects on falls reduction over extended period of time. Benchmarking from private hospitals showed patients fall increased by 27% in 2008 as compared to 2007 (MPC report, 2008). There were 25 cases of falls in 2008 at KPJ Seremban Specialist Hospital. The objective of this program is to comply with The Joint Commission’s National Patient Safety Goals 9, “reduce the risk of patient harm resulting from falls” and to formulate evidence based best clinical practice recommendations on assessment and prevention of falls in the hospital for all inpatients, outpatients, customers and staffs within hospital premises. Materials and Methods: Contributing factors were identified based on the retrospective analysis of falls from 1st.January 2008 to 30th September 2008. A fall risk assessment tool identified as KPJ FRAT (KPJ Fall Risk Assessment Tool) for inpatient was developed and various other strategies to reduce the risk of falls throughout the hospital premises were identified. Points of engagement for inpatient assessment using KPJ FRAT were on admission, transfer in or when there is a change in patients’ condition. A prospective descriptive study was done and data was collected from 1st January 2009 till 31st December 2009 through interview with patients, healthcare providers and review of adverse event reports and medical records. Results: No of inpatients during this study were 37058 and there were 13 falls. The post implementation data reflects for every 1000 inpatient days the fall rate decreased to 4.3 falls. Conclusion: The use of KPJ FRAT and Fall Prevention program implemented throughout KPJ SSH has reduced the incidence of falls significantly by 48%. This might be due to increase awareness among the staff, hospital wide policy to report all cases and the formation of patient safety committee to formulate policy and reinforce the implementation processes. Limitation of the study include under reporting and heavy workload
Forecasting Malaysia COVID-19 Incidence based on Movement Control Order using ARIMA and Expert Modeler
Get PDFINTRODUCTION: Coronavirus disease (COVID-19) is a novel pandemic that affects every other country in the world. Various countries have adopted control measures involving restriction of movement. Several studies have used mathematical modelling to predict the dynamic of this pandemic. Forecasting techniques can be used to predict the incidence cases for the short term. The study aims to forecast the COVID-19 incidence using the Auto Regressive Integrated Moving Average (ARIMA) method. MATERIALS AND METHODS: Using publicly available data, we performed a forecast of Malaysia COVID-19 new cases using Expert Modeler Method in SPSS and ARIMA model in R to predict COVID-19 cases in Malaysia. We compare 3 different time frames based on different Movement Control Order (MCO) period. We compare the model fit and prediction across models. RESULTS: All models show static cases for each MCO 7-day prediction. For prediction until 12 May, the third MCO time frame shows the best model fit for both techniques. Both software shows a stationary trend of cases of below 100. CONCLUSION: These MCO models have shown to stabilize the rate of new cases. Further sub analysis and quality of data is needed to improve the accuracy of the model
Oral Health Related Quality of Life Among Adult Patients Attending Periodontal Clinic in Kuliyyah of Dentistry IIUM Kuantan
Get PDFIntroduction: There was lack of local study assessing the oral health related quality of life (OHRQOL) of patients with periodontal diseases. Hence, this study aims to assess the OHRQOL and its associated factors in adult patients who were diagnosed with gingivitis and periodontitis. Material and method: This was a cross sectional study conducted from May to December 2018 among 100 participants attended Periodontal Clinic, Kulliyyah of Dentistry of International Islamic University of Malaysia (IIUM) using purposive sampling methods. Clinical parameters of participants were recorded by a single examiner then followed by a selfadministered questionnaire using the validated short version of Oral Health Impact Profile(S-OHIP) (Malay) to assess the OHRQOL and its associated factors. The OHRQOL of participants were reported using mean and standard deviation. The factors associated with OHRQOL were determined using independent t-test and Spearman correlation test. Results: The mean score for S-OHIP was 14.73 ± 9.24. Participants with periodontitis have higher S-OHIP score compared to those with gingivitis. There were significant association between OHRQOL and underlying diabetes mellitus, self-perceived oral health status and self-perceived oral health satisfaction with p value < 0.05. This shows that those with underlying diabetes mellitus have higher S-OHIP score indicated poorer OHRQOL. Meanwhile, those who perceived they have either good or very good oral hygiene and satisfied with their oral health have lower S-OHIP score indicated better OHRQOL. Conclusion: This study found that periodontal diseases have significant association with the OHRQOL. Therefore, reinforcement of oral health education by the dentists is crucial
The Prevalence of Depression among Secondary School Students of Kuantan, Pahang, Malaysia
Get PDFIntroduction: Depression is a curable debilitating illness that becomes a leading cause of morbidity and mortality globally. The prevalence of depression is underrecognized among adolescents. The study is conducted to determine the prevalence of depression among secondary school students of Kuantan Malaysia. Materials and method: We conduct a quantitative cross-sectional study. A population of 414 students from two urban schools, two rural schools, and one international school will participate in the study. The assessment tool used is the Malaysian version of Depression, Anxiety and Stress Scale 21 (DASS 21). Data will be analyzed using SPSS version 21 (SPSS IBM, New York, USA). Factors associated with depressive symptoms will be analyzed using multi Variate logistic regression analysis. Results: Prevalence of depression in Kuantan, Malaysia will be compared to the same international trends. Conclusion: Our study can determine and compare the prevalence of depression in different categories. Education and early interventions of depressed adolescents will add extra value of the project
Morphometric Study of Changes in GAD 65 Expressing Beta Cell Mass In The Islets Of Langerhans In Pregnant Mice
Get PDFINTRODUCTION: This study explored the adaptive changes in pancreatic islets by assessing the maternal pancreatic β-cell mass (PβCM), islets size, number, shape, distribution and vascularity using the anti-GAD65 Ab as a marker in pregnant mice. MATERIALS AND METHODS: Fourty female Swiss-Webster mice were randomly divided into two age matched groups of 20 animals each, pregnant and control (non-pregnant) groups. The pregnant mice were sacrificed at Day 19 of gestation and the control group was sacrificed 19 days after observation in the same environmental conditions. Specimens of pancreata were fixed in 10% formal-saline, and processed for light microscopy. Paraffin sections were stained with chromogen DAB. Image scope (APERIO) with Image J software was used for morphometric study. RESULTS: Islets cells showed specific reaction with GAD65 Ab. There was an increase in the cellularity and vascularity of the PβCM. A significant increase in the islets area of the pregnant group ranging between 32-723 µm2 in comparison with the control group that ranged between 5–210 µm2 , the islet size and numbers also increased; there were numerous newly formed islets and coalescence of adjacent islets, positive reactivity of β-cells toward antiGAD65 during pregnancy, the mean of positive granulation in PβCM in pregnant group was 8273.5±SE 831.35 while in control group was 34±SE 0.2. CONCLUSION: The changes for alteration in PβCM such as increase in cells number, size, positive anti-GAD65 reactivity and their vascularity during pregnancy is related to the adaptation for hormonal and nutritional demands of both foetus and mother
Association of Angiogenic Cells in the Tumour Microenvironment and the Circulating Matured Endothelial Cells in Astrocytic Glioma
Get PDFIntroduction: Astrocytic gliomas are the most common and lethal intracranial brain tumours and rely on angiogenesis for the tumour development. Endothelial progenitor cells (EPCs) contribute to the angiogenesis of glioma tumour. Objectives: The study aimed to investigate the matured circulating endothelial cells population in the peripheral blood mononuclear cells (PBMCs) and its associations with tissue resident angiogenic cells in astrocytic glioma patients. Methods: A total of 22 astrocytic glioma patients were recruited from Hospital Universiti Sains Malaysia. Tumour were sliced and stained with CD133+ and VEGFA+ for angiogenic cells (n=22). The circulating (CD133-/VEGFR2+) matured endothelial cells in PBMCs (n=22) were quantified using FACS. The paired t-test and Pearson correlation test were used for the data analysis. Results: The angiogenic cells in brain tumour tissue were significantly higher compared to adjacent normal brain tissue (median 1.07±0.96% vs. median 0.69±0.68%; Wilcoxon signed rank test Z=-3.100; p=0.002). Positive correlation was found between the angiogenic cells of brain tumour tissue and adjacent normal brain tissue (Spearman’s rho correlation test, r=0.56; p=0.007). Significant positive correlation was found between matured endothelial cells in peripheral circulating systems and angiogenic cells in tumour of astrocytic glioma patients (Pearson correlation test, r=0.60, p=0.003).Conclusion:The findings of the study give support to the possible roles of EPCs in astrocytic glioma patients. Thus targeting tissue resident angiogenic cells and matured circulating endothelial cells by antiangiogenic treatment might be useful to prevent the tumour growth
Factors Associated with Quality of Life in Huntington’s Disease
Get PDFIntroduction: Huntington's disease (HD) is an inherited progressive neurodegenerative disorder which affects motor function, cognition and the psychological state of HD patients. Its triad of unique symptoms compared to other neurodegenerative disorders might give rise to a higher level of burden for their carers. The aim of this study was to explore factors associated with the quality of life in patients with HD. Materials and Method: Eighty-one HD patients and their carers participated in this study. Cognitive impairment was assessed with the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG), motor disturbances was scored using the Unified Huntington's Disease Rating Scale (UHDRS) motor scale, psychological status of both patient and carer were assessed using the Depression Anxiety Stress scale (DASS21), behavior of the patient was assessed using Revised Cambridge Behavioural Inventory (CBI-r) and patient's quality of life was assessed with WHOQOL-BREF questionnaire. Results: Patients' psychological conditions, motor disturbances and behavior of the patient are correlated with low QOL in HD patient. Conclusion: Other than regular motor symptoms, psychological and behaviour of HD assessment should be assessed regularly to ensure the patients having good quality of life
Psoriasis - A Report of Disease Mimicry
Get PDFIntroduction: Psoriasis is a chronic, noncontagious, multifactorial inflammatory skin condition that has several subtypes. Therefore, prior to actual diagnosis, it may mimics other similar illnesses. In acute condition, it typically presents with erythroderma macules associated with pain and itchiness rather than hypopigmented and numbness lesions that supposedly occurs in post-treatment or post-acute phase, rather than as initial presentation. Case report: We report a case of 18-year-old girl, who presented with nonspecific localized hypopigmented rash over her forehead and scalp associated with numbness for three weeks duration. She had no itchiness or rashes elsewhere. She had no history of atopy or recent exposure to new cosmetics. She had no joint pain or hair loss. She had no recent contact with anyone with similar lesion. No significant similar history among family members. Clinically, there is reduced in both soft touch and pin-prick sensation over affected areas. We refer this case to dermatologist with possibility of leprosy in view of her reduced sensation over the lesion. To our surprise, the skin biopsy revealed supportive points towards psoriasis. She responds well towards coal tar and topical corticosteroids-the first line treatment of psoriasis. Her numbness has also resolved. This case highlights that psoriasis do presents with localized numbness in which its diagnosis should be take into consideration before confining the disease towards leprosy only
Prevalence and Predictors of Pediculosis Capitis among Female Primary School Children in Kuantan, Pahang
Get PDFIntroduction: Pediculosis capitis has been a worldwide concern among the vulnerable population of primary school children due to the physical, economical and psychological consequences that it brings to both the children and their caretakers. It is observed that there were only limited studies conducted in Malaysia and no previous study was done in Kuantan despite the health concern that it bears. Since both local and worldwide studies show that Pediculosis capitis is more prevalent among female as compared to male school children, thus, this study aims to investigate the prevalence and predictors of Pediculosis capitis among female primary school children in Kuantan. Materials and method: An analytical crosssectional study using cluster random sampling was carried out in Kuantan, Pahang, Malaysia. A self-administered validated questionnaire was used to collect the data among female primary school children from standard one to six. Hair and scalp examination was performed to identify presence of Pediculosis capitis infestation. Multivariate logistic regression was used to control for potential confounding and determine the predictors Results: 10 schools participated in the study with total number of 636 female students as respondents. The overall prevalence of Pediculosis capitis among female primary school children was 17.6% (n=112). Multivariate logistic regression analysis showed that Indian (OR=5.634, 95% CI= 3.157-10.055), history of contact with infested person (OR=2.822, 95% CI=1.6193.691) and those who had number of family members more than four (OR=0.065, 95% CI=0.008-0.550) were predictors for Pediculosis capitis Conclusion: The prevalence of Pediculosis capitis among female primary school children in Kuantan, Pahang is endemic (17.6%) and predictors are Indian, history of contact with infested person and having family members of more than 4. Hence, there is a need for health intervention to reduce the burden of Pediculosis capitis infestation