IIUM Medical Journal Malaysia (IMJM)
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Prevalence and Factors Associated with Hypertension among Adolescents in Malaysia
Get PDFIntroduction: Evidence has shown an increase in paediatric hypertension globally and this could give rise to increase prevalence of adult hypertension. The purpose of this paper was to determine the prevalence of hypertension among adolescents in Malaysia as well as the association between hypertension and lifestyle factors selected based on published literature. Methods: Adolescents aged 13-17 years old were selected randomly from two secondary schools to have their blood pressure measured. Their lifestyle information was obtained through completed bilingual questionnaires based on validated instruments, as well as anthropometry measurements. The relationship between hypertension and lifestyle factors was determined through statistical analysis. Results: A total of 273 students were included in the study with 120 (44%) males and 153 (56%) females. The prevalence of hypertension was 24.5% among the respondents with the highest being recorded among Malays (28.7%). Generally, hypertension was associated with an increased Body Mass Index (BMI) (AOR=4.053, 95%CI=1.677-9.795, p=0.002) and waist circumference (WC) (AOR=2.918, 95%CI=1.171-7.269, p=0.021) in all respondents. Similar associations were noted in females (BMI: AOR=7.707, 95%CI=2.043-29.072, p=0.003; WC: AOR=3.690, 95%CI=1.011-13.464, p=0.048) but not in males. Conclusion: Hypertension recorded high prevalence among Malaysian adolescents in our study. The strong association between elevated body weight, BMI and WC with hypertension may require further study to evaluate the need for screenin
The Incidence of Thyroid Gland Invasion in Patients with Carcinoma of the Larynx who Underwent Total Laryngectomy
Get PDFIntroduction: Total thyroidectomy or at least hemithyroidectomy is routinely performed alongside total laryngectomy in patients with advanced carcinoma of the larynx. Life-threatening hypocalcaemia and hypothyroidism are common sequelae especially with adjuvant radiation. The study aims to determine the incidence of microscopic thyroid gland invasion and challenge the idea of routine thyroidectomy in advanced carcinoma of the larynx. Materials and Methods: This study was a retrospective observational study. It was done in two tertiary centres in Malaysia between 2003 and 2013 for a total duration of 11 years. A total of 72 patients were included in this study. Data from medical records, operative notes, and histopathological reports were collected and analysed. Results: Three patients (4.2%) had the presence of microscopic thyroid gland invasion. There were no significant associations between microscopic thyroid gland invasion and tumour subsites, histological types of a tumour nor T staging (p>0.05) Conclusion: The incidence of microscopic thyroid gland invasion in advance carcinoma of the larynx is low, disavowing routine thyroidectomy. Limitations: Some factors such as cartilage invasion on CT imaging and central lymph node treatment were not considered due to limitations in case documentation
Colonic Perforation in Percutaneous Nephrolithotomy: A Case Report
Get PDFWe aim to report a rare case of colonic perforation post percutaneous nephrolithotomy (PCNL) and its conservative management. We report a 63-year-old Malay, thalassemia carrier male who underwent an uncomplicated left PCNL for a left renal stone. On second postoperative day, clinically evidence of subcutaneous emphysema. Serial CXR imaging confirmed presence of air under diaphragm. Small colonic perforation was diagnosed which subsequently developed localized collection retroperitoenally. He was successfully treated with non-operative management including intravenous antibiotic, surgical drainage and good nutrional has successfully support healed the collection. Serial CT renal protocol showed a healed retroperitoneal collection and patient made a good clinical recovery. PCNL has promising stone clearance rate. However, it carries complications. A rare yet important complication; colonic perforation is a serious complication that if detected earlier, good clinical recovery can be achieved conservatively
Strangulated Meckel’s Diverticulum in a Littre’s Hernia: A Rare Complication
Get PDFMeckel’s diverticulum occurs in 2-3% of general population and can presents as Littre’s hernia. We are reporting an 88-year-old female referred to our surgical unit with a painful right groin hernia 2 weeks, associated with vomiting, fever and diarrhoea. Physical examination showed an irreducible tender lump in the right groin with overlying erythematous skin. Plain radiograph showed dilated small bowel with a loop of bowel seen within the right groin region. A diagnosis of strangulated right femoral hernia was made preoperatively. Right inguinal incision initially employed, however, after a grossly inflamed Meckel's diverticulum with adjacent bowel perforation was found, a midline laparotomy ensues. Meckel's diverticulum was resected together with the perforated segment of small bowel. A primary anastomosis was then performed. In managing Meckel’s diverticulum the proposed treatment for is wedge resection and primary repair of the ileum. If there is oedema or inflammation at the base of the diverticulum, resection and anastomosis of a segment of the ileum may be necessary. Meckel’s diverticulum may be found in any type of abdominal hernia and thus an incarcerated hernia should not be attempted to manually reduce
Penetrating Rectal Wound in Domestic Injury
Get PDFAn 11-year-old boy tried to jump over a metal rod but landed on it presented with perianal pain and rectal bleeding. On examination, there is a 1.5cm perineal laceration. His blood results showed a normal TWC with a normal abdominal and chest radiographs. His vital signs were within normal limits. He was planned for bedside T&S by ED team but deferred as persistent blood oozing from rectal, thus referred to Paediatric Surgery. Upon review, there was 2x1cm perianal laceration at 7 o’clock, abrasion wound at 10 & 12 o’clock. Ultrasound showed no free fluid. He was taken to emergency OT for EUA, intraoperative findings were a perianal laceration, on table sigmoidoscopy showed posterior rectal wall irregularities with slow oozing blood from it, however, no obvious perforation seen. The patient developed fever with lower abdominal tenderness on the following day. Urgent CECT abdomen pelvis performed and showed features of extraperitoneal rectal perforation. He was treated conservatively with antibiotics and NBM with parenteral nutrition support. He made a good recovery and was discharged home on day 9. Pediatric perineal impalement injuries often caused by falls on an offending object. These children are prone to severe injuries as compared to adults and the lesions in the pediatric perineum may appear innocuous, but can be potentially life-threatening and surgically challenging. Perineal impalement injuries in children are classified as transanal or perineal and further subdivided as extraperitoneal or intraperitoneal. This classification method is used to predict potential injuries and develop treatment guidelines. Evaluation of perineal impalement injuries in children needs to be thorough even in the presence of minimal or no symptoms
Prevalence of Metabolic Syndrome (MetS) and Determinants Among Obese Teachers in Makassar, Indonesia
Get PDFMetabolic Syndrome (MetS) is related to the increased risk of non-communicable diseases (NCDs). Teacher profession is an adult group with various risks of NCDs. This study aims to assess the determinants of the MetS in teachers with central obesity. Material and Methods: The study was conducted in Makassar, South Sulawesi, Indonesia with cross- sectional study design on 12 secondary schools. The number of samples in this study was 129 teachers. The prevalence of the MetS was determined using criteria from the Joint Interim Statement, while physical activity and sitting time were measured using the International Physical Activity Questionnaire (IPAQ). Results: Respondents in our study were mostly women (78.3%) with an average age of 49.8 years. The prevalence of the MetS in our study population was 39.5%. The prevalence of the Mets was higher in Buginese ethnic (70.6%), respondents with more income (56.9%), bachelor degree (80.4%), married (98%), family history of diabetes mellitus, obesity, hypertension and heart diseases (52.9%), and moderate physical activity (37.3%). There was a significant relationship between sitting time 4 hours; p=0.004), parameters of Mets (p<0.001), LDL (p=0.026), and LDL/HDL ratio (p<0.001) with the Mets. Conclusions: The prevalence of the Mets is high among obese teachers in our study population. Sitting time was an important determinant for MetS among obese teachers
The Effect of Flaxseed Extract on Skin Elasticity of The Healing Wound In Rabbits
Get PDFIntroduction: Management of disturbed wounds, large skin defects and the areas where skin tension precludes wound closure is of high clinical importance. Healing in wounds occurs through epithelization and contraction processes (second-intentions healing) that may result in certain undesirable complications including keloid and formation of a fragile epithelial layer. Materials and methods: 27 white New Zealand rabbit included in this study divided into 3 groups; one group of 9 rabbits received Flaxseed gel topically for three time intervals (1, 7, and 14 days); a second group received Fucidin cream as positive control, while a third group has not received any treatment as negative control, Skin elasticity measurements were performed using the DermaLab system. Results: Throughout the study, skin elasticity was significantly greater in Flaxseed group than in others. Flaxseed decrease elasticity value from (3.46 ± 2.05). Hence, Young's modulus of skin elasticity in flaxseed group was (2.46 ± 1.02) after 14 days (p = 0.003), while no significant differences were evident in both Fucidin group (1.16 ± 0.77) and non-treated group (1.86 ± 1.40) (p = 0.019), accordingly flaxseed extract more reproducible than other groups demonstrating comparable efficacy in skin elasticity and distensibility. Conclusions: This study showed the therapeutic effect of flaxseed on biologic tissue. Elasticity evaluation demonstrated increased density and firmness in the network of collagen fibers in the dermis and subcutis during wound healing process promise in generating therapeutic gel to be used in wound healing process
Posterior Restoration Selection Among General Dental Practices in Malaysia: A Preliminary Study
Get PDFIntroduction: Tooth restoration is a common, routine procedure among dentists but still has its own difficulties especially for posterior teeth. As it is a straightforward procedure, some dentists are not aware of the difficulties that may contribute in reducing the longevity of the filling. The aim of the study is to determine the difficulties encountered during and after placement of restorative materials in deep cavities. Materials and methods: Standardized questionnaires were divided randomly among general private dental practitioners in Kuala Lumpur. Chi-square test was used to determine any significant factors associated with difficulties of material placement. Results: This study showed that the most frequent difficulties encountered among practitioners were to obtain good moisture control (39.0%). No significant association was found between obtaining good moisture control and year of clinical experience (p= 0.286) and also place of graduation with the manipulation of the materials (p= 0.542). Conclusion: Dental practitioners claimed that it was difficult to obtain good moisture control in placement of posterior restoration. Thus, it is an obligation of dental practitioners to practice proper isolation and good manipulation of materials on posterior restoration
Protective Effects of Orlistat on Lipid Profile, Cardiac Oxidative Stress Biomarkers and Histology in High-fat Diet-induced Obese Rats
Get PDFIntroduction: Orlistat is a widely used drug in treating obesity as it promotes weight reduction. The aim of this study was to determine the protective effects of orlistat (10 mg/kg/day) on cardiovascular parameters and oxidative stress biomarkers in high-fat diet (HFD)-induced obese rats. Methods: Twenty-four male rats Sprague Dawley rats were divided into three groups and fed with normal diet (N), HFD and HFD with orlistat (HFD+O). Orlistat was administered daily by oral gavage and after six weeks, all rats were sacrificed. Results: Administration of orlistat along with HFD (HFD+O) has brought significant decreases in Lee obesity index and LDL level compared to HFD group. Activities of cardiac superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) were significantly higher, whereas level of oxidised LDL was significantly lower in HFD+O group compared to HFD group. HFD group had significantly higher necrotic patch area in myocardium while minimal histological changes were seen in HFD+O group. Conclusion: This study may suggest that administration of orlistat at 10 mg/kg/day for 6 weeks may have protective effects against the changes on Lee obesity index, lipid profiles, cardiac oxidative stress biomarkers and histology of myocardium in HFD-induced obese rats possibly through its hypolipidaemic and antioxidant actions