IIUM Medical Journal Malaysia (IMJM)
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Effect of Trihoney (A Mixture of Trigona, Mellifera and Tualang) on Male Reproductive Hormones and Insulin Resistance in Hypercholesterolaemic Rabbits
Get PDFIntroduction: Hypercholesterolaemia affects Sertoli and Leydig cells secretory functions, impairs steroidhormone biosynthesis, and disrupts the hypothalamic-pituitary-gonadal axis. The use of honey in previousstudies resulted in an improvement of male reproductive hormonal disturbances. This study aimed toinvestigate the protective effects of Trihoney on hypercholesterolemia-induced male reproductive hormonalchanges in male rabbits and compare its effects with atorvastatin. Materials and methods: Forty-eight maleNew Zealand white rabbits were assigned into 6 groups as follows; Control: commercial pellet; CH:commercial pellet with 0.6 g/kg/day Trihoney; HCD: 1% cholesterol diet; DH1: 1% cholesterol diet with 0.3g/kg/day Trihoney; DH2: 1% cholesterol diet with 0.6 g/kg/day Trihoney and DAt: 1% cholesterol diet with2mg/kg/day atorvastatin. After 12 weeks, the rabbits were sacrificed and blood samples were collected foranalysis of hormones and pro-inflammatory cytokines and calculation of HOMA-IR. The testes werehomogenized for intra-testicular testosterone measurement. Results: Serum testosterone reducedsignificantly in HCD (p<0.05) and DAt (p<0.05) groups. Likewise, intra-testicular testosterone reducedsignificantly in HCD (p<0.01) and DAt (p<0.01) groups. Serum FSH increased significantly in HCD (p<0.001)and DAt (p<0.01). Trihoney particularly at the dose of 0.6 g/kg/day improved serum and intra-testiculartestosterone (p<0.05) and FSH (p<0.05). Trihoney and atorvastatin improved serum pro-inflammatorycytokines. Trihoney and atorvastatin did not affect HOMA-IR. Conclusion: Trihoney attenuated thedetrimental effects of hypercholesterolaemia on male reproductive hormones which probably through alocal effect on testicular tissue and Trihoney anti-inflammatory effect independent of insulin resistance.Atorvastatin did not counteract the impact of hypercholesterolaemia on the reproductive hormones
Male Infertility: Evaluation and Treatment
Get PDFGlobally, 48.5 million couples are suffering from infertility. One of six couples in United Kingdom is categorized as infertile. In developing countries, infertility affects one of four couples. Male infertility constitutes about 40-50% of the incidence. A minimum of 30 million men worldwide are infertile. Mortality rate is higher in men with impaired semen quality than those who have normal semen quality. The initial evaluation of a male partner of an infertile couple should be done if there is a delay in the pregnancy in the female partner for one year or more from unprotected sexual intercourse. It can be done earlier if there is a predisposing factor for infertility. Identification of the underlying aetiology of infertility is the guide for treatment course which could be medical, surgical or through assisted reproductive technology. The aim of this review is to highligh the main courses of evaluation and treatment of male infertility
Outcome of Core Out Fistulectomy and the Ligation of Anal Fistula Tract: A Single Center Experience in Malaysia
Get PDFIntroduction: Fistula-in-ano is a benign anorectal disease which always poses a big dilemma to the surgeons because of their significant recurrent rate following surgery. Materials and Methods: A cross-sectional study involving 42 patients undergoing core out fistulectomy in the Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia were included in this study. Demographic data of patients were assessed. Endoanal ultrasound (EAUS) was done prior to the surgery to determine types of fistula and classified using Park’s classification. Follow up was made post-operatively at 4th week, 2nd month, 3rd month, 4th month, 5th month and 6th month to look for the duration of healing or recurrence. Results: 5 out of 42 patients were lost to follow up leaving 37 patients available for the analysis. Mean age of the patient was 38.4 (13.8) years old. Transphincteric and intersphincteric type of fistula accounted for 54.5% and 40.1%, respectively. 62.2% (n=23) of patients achieved primary healing after the procedure. The mean for healing duration was 3.7 (3.1) months. Recurrence of the disease was seen only in 37.8% (n=14) of the patients. Conclusions: Even though we managed to achieve significant success rate cumulatively, recurrence of fistula still impose a significant challenge toward patient’s management. Therefore, further prospective study with a bigger sample size is recommended to look into this method to reduce recurrence of fistula
Assessment of Diabetic Patient Waiting Time in A Primary Healthcare Clinic
Get PDFIntroduction: Long waiting time is a common issue complained by diabetic patients that came for an early morning appointment in a health clinic. Therefore, an audit was conducted among diabetic patients in a primary care clinic with the aim to assess the patients’ waiting time and to formulate strategies for improvement. Methods: This audit was conducted for four weeks using a universal sampling method in November 2017. All diabetic patients who attended the clinic during this period were included except those who required longer period such as critically ill patients or those who came for repeat medication or procedures. The arrival and departure time for each station was captured using the modified waiting time slip, which is manually filled at every station. The waiting and consultation time for registration, screening, laboratory investigation, diabetic educator, doctor and pharmacy were recorded. The data were entered into the statistical software SPSS version 17 for analysis. Results: Results showed that all patients were registered within 11.0 minutes (SD=2.52min). Average total waiting time to see a diabetic educator and a doctor was 20.9 minutes (SD=15.53min) and 33.23 minutes (SD=27.85min), respectively. Average waiting time for other stations was less than 10 minutes. Average total time spend in the clinic for a diabetic patient was 107.58 minutes, which is comparable to a non-diabetic patient. The identified problems were due to the poor tracing and filing system. Conclusion: Improvement strategies recommended include enforcing early file tracing prior to appointment and providing a checklist for consultation by doctors and diabetic educators
Does Dietary Adequacy Reflect the Cognitive Performance of Children? A Study among the Homeless Children in Klang Valley, Malaysia
Get PDFIntroduction: Homeless children are prone to inadequate energy and nutrient intake which may highly influence their cognitive performance. However, few studies have been done in assessing diet adequacy and cognitive performance among homeless children in Malaysia. Materials and Methods: This cross-sectional study aims to assess the dietary adequacy and cognitive performance of 120 homeless children age 7-12 years living in Klang Valley. The dietary adequacy of these homeless children was assessed through two days of 24 hours of dietary recall. Dietary adequacy achievement was determined by fulfilling at least 50% of Recommended Nutrients Intake (RNI). Raven’s Coloured Progressive Matrices (RCPM) test was used to assess their cognitive performance. Results: The homeless children had an adequate intake of energy, iron, zinc, and vitamin B12. Seventy percent of homeless children had a poor cognitive performance. This study shows that there was no association between energy, iron, and vitamin B12 adequacy with cognitive performance, whereas there was a significant (p=0.028) association between zinc adequacy and children’s cognitive performance. Conclusion: These findings provide solid evidence-based for dietary adequacy and cognitive performance of the homeless children in Klang Valley. It is clear from the findings that both dietary intake and cognitive of these children require improvement for a better quality of life in the future. This study suggests that dietary adequacy does not relatively reflect the cognitive performance of these homeless children in Malaysia
Impact Factors in a Curriculum Vitae for Scholarship Application
Get PDFIntroduction: Scholarship applicants often receive different advice on what should be included in their Curriculum Vitae (CV). This study aims to investigate what the essential components of a CV being prepared for scholarships are, how to present them, and what their level of impact is. Materials and Methods: The authors sent an online structured questionnaire to 7512 corresponding authors of recent published papers in Scopus; 124 completed questionnaires were returned. Recommended elements for a CV were chosen according to the Delphi consensus technique with a threshold of 50%. Results: This survey revealed that headings, bullet points and careful error checking were essential parts of the layout. For the content of the CV, besides publications, education and training background, research experience and research interest were also necessary. Moreover, almost all respondents ranked publications as the most important qualification of an academic scholarship candidate. Publications also came first as the most impressive factor, followed by awards and honours. The number of publications, quality of journal, impact factor and total citation should be presented in publication section. The importance of publications in getting academic scholarships is significantly emphasized in this recent study. Conclusions: Having research experience and papers in peer review journals, are highly recommended for students seeking academic scholarships
The Comparative Effects of Listening to Prayer Recitation and Music Therapy Intraoperatively on Postoperative Pain
Get PDFIntroduction: Non-pharmacological interventions are considered as successful adjuncts to manage pain. We are studying the comparative effects of listening to prayer recitation and music therapy intraoperatively as non-pharmacological interventions on postoperative pain and intraoperative haemodynamics. Materials and Methods: Seventy two muslim patients with acute appendicitis requiring open, emergency appendicectomies under general anaesthesia were recruited and randomised into three groups: Group A: patients who listened to prayer recitation, Group B: patients who listened to music, Group C: control group - patients who did not listen to any prayer or music. Intraoperative blood pressure, heart rate and postoperative pain scores were monitored. Results: The demographic data, pre- and post-headphones application haemodynamics were compared. There were significantly lower heart rates at 10, 20, 30, 40, 50, 60 minutes for Group A and at 50 and 60 minutes for Group B patients when compared to Group C. Significant reduction in postoperative pain scores were seen in Group A patients at 30 minutes and 8 hours as compared to Group C patients. No significant differences in pain scores were seen between Group B and C patients. No significant differences in additional analgesic requirements postoperatively were seen in all three groups. Conclusion: Listening to prayer recitation or music intraoperatively significantly lowered intraoperative heart rates, however only prayer recitation significantly reduced postoperative pain scores as compared to the control group
B Cell Lymphoma of Thoracic Vertebrae: A Great Mimicker
Get PDFIntroduction: Non Hodgkin lymphoma (NHL) is a malignant neoplasm affecting multiple systems in which extranodal NHL represents 10-20% of all NHL. Case report: This is a case of 45-year-old female with no known medical illness who presented with progressive numbness of bilateral lower limbs since March 2016 which subsequently progress to loss of motor power since November 2016. She initially was diagnosed as tuberculous (TB) spondylitis which then turned out to be B cell lymphoma of the thoracic vertebra. The diagnosis was confirmed on histopatological examination (HPE) after patient underwent laminectomy of T3-T7 vertebra bodies and excision biopsy with removal of the casseous material. Due to a lack of specific findings, the diagnosis of vertebral NHL is often missed or delayed. It warrants attention that NHL of thoracic vertebra may be misdiagnosed as TB spondylitis due to their similarities and sometimes the imaging features may simulate and overlap each other. The main treatment for vertebral NHL is chemotherapy, radiotherapy or both. Surgery maybe necessary if patient has story of neurological deficits. However patient was treated conservatively as she refused chemotherapy
Effects of Chronic Organic Arsenic Exposure on Rats Kidney - Light Microscopy and Electron Microscopy Study
Get PDFIntroduction: Monosodium methylarsonate (MSMA) is an organic arsenical pesticide widely used in agriculture. Humans are exposed to arsenic through drinking water and anthropogenic activities. Exposure to inorganic arsenic has been linked with multiple health problems. However, studies focusing on chronic organic arsenic exposure and its adverse effects on kidney were limited. The purpose of current study was to determine the effects of chronic organic arsenic exposure in rats kidney by light and electron microscopy. Materials and Method: Thirty-six male SpragueDawley rats were divided into six groups (n=6); three control and three treatment group respectively. All the control group was given distilled water via oral gavage. The treatment group was given oral gavage of MSMA at 42.10 mg/kg body weight (BW) which is equivalent 1/30 LD50 of MSMA. The control and treatment groups were sacrificed at two month, four month and six months interval. Both kidneys harvested for light microscopy and electron microscopy study. Results: Showed progressive changes. The changes initially focal and became diffused involving glomerular; such as glomerular hypercellularity, glomerular shrinkage and dilated Bowman's space. Meanwhile, in proximal tubules, showed diminished brush borders, detachment of nucleus and basement membrane thickening. Electron microscopy showed flattened cell bodies of podocytes, effacement and fusion of podocytes foot processes, thickening of glomerular basement membrane, and discontinuity of brush border. The control and two-months treated group appeared to be normal. Conclusion: Chronic organic arsenic (MSMA) exposure induced chronic kidney injury
Association between Social-Cognitive Factors and Sexual Intention towards Pre-Marital Sex Activity among School-Going Late Adolescents in Kuantan, Pahang
Get PDFIntroduction: The Theory of Planned Behavior (TPB) is determined by four main domains of social-cognitive factors; attitudes, social-norms, self-efficacy and sexual intention. This study aim to identify the socio-demographic and socio-cognitive factors associated with sexual intention towards premarital sex among school-going late adolescent. Materials and method: Cross-sectional study was conducted in nine government secondary schools in Kuantan district between January-July 2018. A total of 466 self-administered validated Youth Sexual Intention Questionnaires(YSIQ) data are collected among unmarried students aged 18-19-year-old. Statistical analyses were done using IBM SPSS version 22.0. Results: Out of 466 participants, 67.4%, 68.2%, 64.4% are Malays, Females and Muslims. Simple logistic regression showed for every one unit increase in permissive attitude, social-norms and selfefficacy scores, there were 1.424, 1.303 and 1.215 times increase risk of having sexual intention, with p -value of 0.001 each and 95% CI of odds ratio(OR) 1.2681.600, 1.191-1.425 and 1.066-1.386 respectively. Multivariate logistic regression showed that female had lower risk of having sexual intention( p=0.001, OR=0.163, CI=0.058-0.462). Non-Malays and ever-smoker students had higher risk compared to Malay and non-smoker towards having sexual intention with p=0.001 (OR=5.110,CI=1.881-13.886) and p =0.019 (OR=3.288, CI=1.218-8.875) respectively. For every unit increase in permissive attitude score, there was 1.236 times increase risk of having sexual intention with p=0.002 (95%CI, OR=1.084-1.410). Conclusion: The study showed the risk of having sexual intention was higher among males, nonMalay, ever-smoker students; and those with higher permissive attitude scores. Peer education intervention programs are necessity for school-going students to improve the permissive attitude in averting risk behavior that may lead to sexual intention towards pre-marital sex activity. The study should be expanded to adolescent who are no longer in school or in suburban areas