IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
OrthoBoard: An Orthopaedic App for Medical Education
Get PDFIntroduction: Use of mobile apps as a pedagogical tool in the medical education has gained popularity as mobile apps have great potentials in perpetuating clinical knowledge and skills. To leverage mobile technology in medical education, we designed a hybrid mobile app based on our undergraduate orthopaedic curriculum. Materials and Methods: The frontend was created using hybrid mobile framework to target both iOS and Android platforms. The backend is powered by Firebase (Google Inc.) to manage authentication and social messaging. The content consisted of basic orthopaedic skills, trauma and resuscitation skills, Islamic input in orthopaedic and information cheatsheets. Results: OrthoBoard is being used by IIUM medical undergraduates as an ancillary source of learning, particularly useful as quick references and visual guides for enhancing orthopaedic knowledge and performing clinical procedures. The social messaging capability built into the app serves as a platform for discussion and exchange of information. This is the first medical app, to our knowledge, that integrates orthopaedic clinical knowledge and practice as well as Islamic input in orthopaedics into teaching and learning with the integration of social messaging as a platform for enhancement of knowledge and practice. Conclusion: Use of mobile apps as pedagogical tool in the medical education will undoubtedly increase in the future. As students and teachers embrace mobile technology in and outside the classroom, better user-centric and subject-specific apps will be required to fulfil the needs. For medical educators, developing mobile apps will possibly be one of the future armamentarium in the delivery of knowledge and skills
Phantom Pain in Major Lower Limb Amputation: Primary Ligation Cauterization vs Traction Neurectomy
Get PDFIntroduction: Phantom Limb Pain (PLP) is haunting amputees in silent. Neuroma hyperexcitability is one of the popular peripheral theories which can be addressed during primary amputation by orthopaedic surgeons. There was no study comparing type of neurectomy association with PLP. The objective was to compare the occurrence of PLP between conventional and alternative techniques of neurectomy in major lower limb amputations. Materials and Methods: A prospective, randomized, interventional study was conducted involving 98 patients in Hospital Kuala Lumpur requiring major lower limb amputation due to diabetic complication, tumor and trauma from October 2016 to June 2017. Patients were evenly randomized into two groups; Group A: conventional traction neurectomy (CTN) and Group B: ligation and cauterization neurectomy (LCN). End point of the study was the outcome of PLP which was assessed clinically at post-operative day 3, 14 and 6-month. Results were analyzed using univariate and multivariate simple logistic regression. Results: There were have 47 and 46 patients in Group A and B respectively. Of these, 70.2% in Group A (n=33) and 28.3% in Group B (n=13) end up with PLP (p<0.001). Sixty nine percent of patients who underwent amputation above knee level (n=20) suffered from PLP (p<0.05). Group B patients had higher mean PLP pain score (3.31 and 2.94) but it was not statistically significant. 69.6% of patients with pre-operative pain (n=32) and 43.5% with peripheral vascular disease (n=20) developed PLP (p<0.05). Conclusion: LCN has 0.1 chance to develop PLP compared to CTN. Other significant factors in those who developed PLP include levels of amputation, pre-operative pain and peripheral vascular disease. LCN should be considered in primary amputation
Recurent Ectopic Pregnancy Score As Predictor To Fertility Outcome Following Tubal Ectopic Pregnancy
Get PDFIntroduction: Ectopic pregnancy may occur in fallopian tube, ovary or abdominal cavity. This study focused on tubal pregnancy outcome. The return of fertility after operative removal of tubal ectopic pregnancy was examined in 237 women who were admitted to Hospital Sultanah Nur Zahirah (HSNZ) for ectopic pregnancy between 2012 and 2016. The follow-up period averaged six months to four years. Materials and Methods: This was a case control, retrospective non-comparative study. Data collected from HSNZ Human Resources Management Information System (HRMIS). Patient who has no pregnancy or delivery record after six months of ectopic event were contacted via phone. Multivariate analysis was done to identify score for patients who were at risk of recurrence, and who require fertility help. Results: One hundred forty eight women (64%) aged 20-35 years old able to conceive spontaneously after ectopic pregnancy, with the mean-time of 8 months if one tube is patent. Ninety three percents of those who conceived had intrauterine pregnancy, 5% had recurrent ectopic pregnancy. Conclusion: From a multivariate analysis, a scoring system, Recurrent Ectopic Pregnancy (REP) score was made to choose most suitable patient for laparoscopic intervention, preserve fertility or facilitate fertility. Significant REP score of 4/5 suggest laparoscopic salpingectomy with contralateral sterilization to prevent recurrence of ectopic. Patient with REP score 2-3 may have spontaneous conception and REP score less than 1/5 will require further fertility treatment
Retrospective Study on Upper Gastrointestinal Endoscopic Findings in Patients with Dyspepsia without Alarm Features in International Islamic University Malaysia Medical Centre
Get PDFIntroduction: The purpose of this study was to review the significance of oesophago-gastroduodenoscopy (OGD) findings in patients with dyspepsia but without alarm features. Materials and Methods: OGD data from January 2017 to December 2017 were collected from ipesakit. The demographic details, indications and findings were reviewed. Results: OGDs were performed. Among these 56 (49%) were performed on dyspeptic patients with no alarm features. This subgroup was further analysed. Thirty two (57%) patients in this subgroup were female and 24 (43%) were male. 33 (59%) were 50 years and younger. Twenty (36%) patients were between 51 and 70 years old, while 3 (5%) patients were above 70 years of age. The commonest finding was gastritis (70%, n=39), followed by F3 gastric ulcer (3.5%, n=2), F3 duodenal ulcer (3.5%, n=2), gastric fundic polyp (1.8%, n=1), and hiatus hernia (1.8%, n=1). 11 (20%) patients had normal finding. No malignancy or pre malignancy lesion were found in this cohort. Two patients had positive CLO test. Conclusion: OGD in patients with dyspepsia but without alarm features has low yield of significant findings. This procedure may unnecessarily expose patients to the associated potential risks and may not be cost effective. This can be addressed by introducing a hospital guideline for OGD referral. Low positivity of CLO test may also need further evaluation with regards to its sensitivity and specificity. Alternative tests for H Pylori detection such as stool antigen test or urea breath test may need to be adopted
Factors Affecting Treatment Seeking Patterns amongst Public in Three Selected Areas in Kuantan: Discovery of perceptions (dzan) among community as thought in Islam
Get PDFSeeking treatment is a vital when an individual falls sick. However, some may not do so perhaps they are ashamed to admitting having shameful diseases or unable to seek and reach help. Negative perception of the community on sensitive diseases like AIDS or sexual transmitted disease (STD) may drive the patients away from seeking treatment and suffer alone. In Islam we are thought to always have positive perceptions (husnu dzan) towards any issues in daily life especially when dealing with human interaction by avoiding bad perceptions (su’u dzan). Thus, this study aims to identify the factors affecting treatment seeking patterns among public in three selected areas in Kuantan, and to explore factors affecting people not able or avoid seeking treatment, also to determine the relationship between treatment seeking patterns and the influential factors ie distance, accessibility and behaviour; attitude to health, healthcare and selfperception. A cross sectional survey was carried out at Taman Gelora, Teluk Cempedak and Terminal Makmur, Kuantan, Pahang. Convenient sampling method was used in this study. 201 respondents participated and answered a semi-structured questionnaire modified from Adamson. Results showed that the data was normally distributed, 50.2% respondents were male and 58.7% the total respondents were between 16-26 years old. Majority of the respondents had neutral attitude to health and healthcare, and to self-perception; 94.03% and 73.63% respectively. From the results, there were significant association between distance and accessibility, and monthly income, plus between self-perception and demographic data (p<0.05). Self-perception was the most influencing factor as to why people were not able to seek treatment This can be used to educate the community regarding perceptions (khusnu or su’u dzan) and to the policy makers to ensure equal distribution of healthcare services throughout the country
Islamic perspective on end of life issues in persistent vegetative state patients - a case report
Get PDFPersistent vegetative state (PVS) is a clinical condition of unawareness of self and environment with preserved sleep-wake cycles. Its clinical diagnosis can be a difficult unless a physician has adequate experience and expertise in evaluating neurological syndromes. Outcome is based on aetiology and age. Decisions on limiting life-sustaining treatment (LST) for these patients are emotionally and morally challenging. We present a case of a young boy who went into PVS following traumatic brain injury (TBI) with the aim to review some of the ethical issues regarding its management from Islamic perspective
Learning Style Preferences among Pre-clinical Medical Students in a Public University in Pahang
Get PDFEducational experts affirm that students prefer various type of learning preference. It is known that the learning style preferences vary among medical students worldwide. Knowing the types will help medical educators to improve their way of conveying lectures and teaching in a more effective learning environment. This study aims to describe the learning style preferences of pre-clinical medical students and the association with their socio-demography. This is a cross sectional study done among Year 1 and Year 2 pre-clinical year medical students in a public university in Kuantan Pahang. Medical students who fulfilled the inclusion and exclusion criteria were recruited using systematic random sampling. A validated learning style questionnaire (VARK) was used to assess their learning style. Descriptive statistics and bivariable analysis was used using SPSS version 23. A total of 166 pre-clinical year medical students participated in this study. The mean age was 21.3 (0.84). Majority of them were Malays (98.2%) and females (69.9%). Most of the students preferred unimodal learning style (80.0%) with the most preferred learning style preferences being kinaesthetic (39.1%). Bivariable analysis showed female students preferred kinesthetic learning style compared to male students (p=0.03). In this study, majority of the pre-clinical year medical students preferred ‘life-like’ learning experience in their study. Hence, we recommend that medical educators to be more aware of the varieties of learning style preferences in order to improve the quality of teaching and learning experiences
The Role of Psychiatrists and Muslim Faith Healers in Mental Health Issues
Get PDFFollowing the announcement of Traditional and Complementary Medicine Act 2013, Muslim faith healers are slowly gaining grounds to make their practice mainstream. One of the major characteristics of Muslim faith healers is the strong inclination to attribute mental illnesses to Jinn possession (demonic possession). Unlike other traditional healers, Muslim faith healers’ primary mode of treatment is Ruqyah, an incantation or generally considered as ‘Du’a or prayers. This article is a sharing by a psychiatrist who has been actively engaging with faith healers in order to understand the world of faith healing including the attitude and knowledge of both the healers and clients while attempting to educate them on modern psychiatry based on bio-psycho-socio-spiritual paradigm. The methodology: 1) Involvement in symposium, seminar and focused group discussion, either as participant or as speaker. 2) Collaborating with local spiritual leader to conduct workshop on mental illness in mosques. 3) Writing articles in scientific and popular publications with and without faith healers as the collaborators. 4) Appearing in radio advocating and discussing about the dilemma of mental illness issue from the religious perspectives, and 5) Participate in workshop conducted by Muslim faith healers. As a result, several issues come to the author’s attention. The divisions of Muslim faith healers are rather complicated, for example Malay traditional healers or bomoh should not be categorized in the same group as Muslim faith healers. The oft-quoted ‘Islamic Medicine’ is problematic in view that it is laced with elements of local cultural value and practice which are not necessarily authentically Islamic. Since Malays make up the biggest community in Malaysia, one has to differentiate between Islam and Muslim. Majority of Muslims misunderstood the term Ruqyah as a form of healing exclusively done by the Muslim faith healers. In conclusion, psychiatrists should engage more proactively with faith and spiritual healers in order to curb stigmatization and delay in seeking psychiatric care and treatment
Appendiceal Hypoplasia - An Extremely Rare Appendiceal Anomaly
Get PDFAppendiceal anomalies are extremely rare malformations that are usually found incidentally. Agenesis and duplication of the appendix has been well documented, however the reported cases of appendiceal hypoplasia are very limited, as only few cases have been reported so far. Here, we report a 31-year-old male who underwent appendicectomy after clinical presentation and diagnosis of appendicitis. The appendicular specimen showed all histomorphological features of appendiceal hypoplasia. Appendiceal hypoplasia is often missed and usually difficult to be diagnosed in the preoperative workup. The chief concern in this case is to focus on the classical histo-morphological features of appendiceal hypoplasia, especially in view of its clinical course
Caring for Moderate to Severe Dementia Patients - Malaysian Family Caregivers Experience
Get PDFIntroduction: Caring for those with dementia affects the quality of life for both the caregivers and the patients themselves, particularly in the informal care system here in Malaysia. To date, only a few studies have explored from the family caregivers’ perspectives in the communities of different cultural background. The purpose of this study is to describe the Malaysian family caregivers’ perspectives of their experiences in providing care to for their family members suffering from moderate to severe dementia in Kuala Lumpur, Malaysia. Methods: This qualitative study involved in-depth individual interviews with twelve caregivers to patients with moderate to severe dementia. Participants were recruited via purposive sampling from the outpatient psycho-geriatric clinic at UKM Medical Centre, Kuala Lumpur. All interviews were audio-recorded and transcribed verbatim. Transcribed data was later analysed using a thematic approach. Results: Four themes identified in this study were; i) the feeling that ‘it is like caring for a baby’, ii) the caregivers’ perception of inadequate knowledge and skills, iii) the need for caregivers’ support system and iv) the importance of spirituality in enhancing care giving experiences. Conclusions: The framework of care shared by the caregivers in this study demonstrated strong cultural and spirituality influences in addition to the common issues of the challenges in managing the behavioural and psychological symptoms in people with dementia. Hence, culture and spirituality aspects should be addressed in the development of appropriate intervention to manage the needs of informal caregivers in this community