IIUM Medical Journal Malaysia (IMJM)
Not a member yet
1450 research outputs found
Sort by
Depression, Anxiety and Stress among Dental Undergraduate Students: Prevalence, Stressors and Relieving Factors
Get PDFAim: To investigate the depression, anxiety and stress, stressors and relieving factors among dental students at Kulliyyah of Dentistry (KOD). Materials and methods: A cross-sectional study was conducted among 222 dental students. Their socio-demographic data, self-reported depression, anxiety and stress (DASS-21) scores, causes and relieving factors were collected using validated semi-structured pre-tested questionnaires. The data was analysed using percentages, chi-square test and Binary logistic regression tests with SPSS version 24. Results: The prevalence of depression, anxiety and stress was 41%, 68.9% and 34.2% respectively. Cross analysis showed that academic-related and laboratory or clinical related reasons were significantly associated with the depressive symptoms [(X2= 15.86, p<0.0001) and (X2= 10.45, p=0.001) respectively] and stress symptoms [(X2= 19.95, p<0.0001) and (X2= 6.11, p<0.05) respectively] among dental student. Furthermore, the item ‘examination’ being the highest factor chosen in academic-related stressors. The response for stress-relieving factors was high for Islamic ritual prayer/spiritual activities (94.6%), sleeping (86.5%) and doing exercise/playing sports (76.1%), while ‘seeking professional help’ (19.8%) was the least. Conclusion: This study shows that depressive, anxiety and stress symptoms are prevalent among dental students. Islamic ritual prayer and involvement in spiritual related activities was found to be the most preferred way for students to relief stress. Hence, it is vital that the university continually evaluates the psychological health of the students, tailor preventive measures and spiritual related programs to help students to cope with stress
Euthanasia from the Islamic Perspective: Ending Life of a Patient whose Recovery is Absolutely Impossible
Get PDFLife and death of men is in the discretion of Allah, SWT. No one can decide how long they should live, but Allah, SWT. However, in our society today, life is being terminated by someone such as doctor or family of terminally ill patients when their recovery is absolutely irretrievable according to medical expert opinions. In medical science, ending life for such a situation is called euthanasia i.e. an act or practice of painlessly putting to death persons suffering from painful and incurable disease or incapacitating physical disorder or allowing them to die by withholding treatment or withdrawing artificial life-support measures. Justification given by pro-euthanasia is that it is the right of the patient who should not suffer unbearable pain physically and who does want to be a burden to their family. They insisted mercy killing is absolutely appropriate if the patient’s body is in gradual decline, their organs are in continuous failure, their agonizing pain is unbearable, and the cost of their artificial support system is beyond their limit. This issue has been controversial to many Islamic as well as social organizations as it is against their doctrine and norms. Since life and death is in Allah’s hand, who is to decide that a life has to be ended at a specific time? Is it against predestination and fixation of life by Allah that when the time come no one can stop its arrival? This undesirable situation is confronted by many Muslims in our world too, hence is there any room in Shari’ah law that allows a physician to end the life of a patient? The objective of this paper is to explore any possibility in Shari’ah law that authenticates ending of a life
Legal Rulings on Medical Issues: A Comparative Study between the Malaysian and Islamic Law
Get PDFThe medical profession is amongst the professions that offer tremendous benefit to the entire humanity. Nevertheless, the responsibilities that they have to undertake in their daily practice are constantly increasing as they deal with two most precious commodities of mankind, which is life and health. The demands for accountability when ‘the consequences of an action are considered not to be at par with the expectations’ has become a common trend within the society recently. Law, being an instrument of social regulation, intervenes to establish the rights and responsibilities in medical practice to determine the boundaries of rightful conducts in areas where there exist conflicts of moral, ethical and religious issues. Therefore, it is pertinent for Muslim doctors to keep abreast with the developing law that is governing their practices and at the same time, to ensure that any deliberations flourish within the confines of Islamic law. By employing qualitative research method, namely, doctrinal analysis, this paper seeks to discuss the legal rulings from the Malaysian and Islamic law perspectives relating to significant and current medical issues such as negligence, confidentiality, assisted reproductive technologies, abortion, euthanasia, organ transplantation and sterilisation
Review on the Control of Waterborne Diseases – The Islamic Approach
Get PDFIntroduction: Scarcity of fresh water is currently blighting the population of the least developed countries around the world. According to WHO, waterborne diseases accounts for 4.1% of total disability adjusted life years (DALYs) with a mortality rate of 1.8 million per year. Numerous pathogens and chemicals may be the potential sources of water contamination that leads to waterborne diseases in humans. Some pathogens are only active and express disease whilst within the host. The aim of this article is to identify the cause of water-borne diseases and how to control it from the Islamic perspective. Material and Methods: In this review we had compiled the latest scientific findings related to waterborne diseases and integrated them with Islamic approach of cleanliness. There are many Hadiths of the Prophet (peace be upon him) (PBUH) regarding methods of cleanliness with scientific background to control waterborne diseases. Water pollution may be a natural process, men made, intentional or accidental. More often than not, man are infected after accidently consuming or coming in contact with contaminated water Results: Scientific literature search reveals that individual hygiene and sanitation is the most prominent way to prevent waterborne diseases. In Islam, Prophet Muhammad (PBUH) puts a great emphasize on purification in terms of personal cleanliness and made it mandatory to follow rule to remain pure both physically and spiritually. Conclusions: Sunnatic approaches of cleanliness may hinder waterborne disease
The Use of Venom and Venom-Derived Products in Medicine and Cosmetics: the Ethical Issues From Islamic Perspective
Get PDFVenom is a mixture of biologically active toxins that affect normal physiological functions. With the advance in technology, the complexity and functions of venom and its toxins are slowly being revealed. It has become important source for therapeutic, diagnostic and cosmetic agents. However, there is concern among the Muslim community pertaining to halal and safety issues on the venom and venom-derived product usage. There are few studies that discuss the Islamic views in the usage of venom and venom-based product in medicine and cosmetic applications. There is a need for Muslim scientists and scholars to seriously identify the potential ethical and safety issues in the usage of venom and venom-derived products in view of the widespread application in medicine and cosmetic, which subsequently forming the basis for relevant and reliable shariah ruling. This is an attempt to review the relevant articles based on the following keywords: venom and Islamic ruling, venom-based product, venom and medicine, venom and cosmetic, antivenom, venom toxin, snake poison and venom diagnostics. It will also attempt to clarify and elaborate the implication of the “halal” status for venom-based product. Finaly the current available shariah rulings on the usage of venom and venom-based product both in medical and cosmetic area and the related principle of fiqh involved will be analyzed. The findings from this review, particularly the current available ruling will allow various parties to be well informed on the current ruling and related issues on the usage of this products
Clinical Dilemma-Management of Low Rectal Cancer in a Jehovah’s Witness
Get PDFJehovah’s Witness followers pose a clinical dilemma to the medical practitioners due to their religious belief of an absolute prohibition of blood transfusion under any circumstances. We present a case of Jehovah’s Witness follower who underwent an ultra-low anterior resection for rectal cancer after neo-adjuvant chemo-radiotherapy. The challenges in the perioperative management are highlighted and managed accordingly
Prevalence and Modifiable Risk Factors of NonCommunicable Diseases among Jakun Orang Asli at Tasik Chini, Pekan, Pahang
Get PDFIntroduction: Non-communicable disease accounted for 73% of premature death in year 2015 Malaysian national survey. The orang asli population may be affected similarly. The prevention of non-communicable diseases should start as early as modifiable risk factors prevention, as proposed by STEPWISE approach of WHO. This study aims to identify the prevalence of hypertension, diabetes mellitus and dyslipidaemia among Jakun orang asli population and examine the association with risk factors. Methods: This is a cross-sectional study analysing 72 case reports of General health screening done in year 2015. The study population was adult Jakun orang asli Tasik Chini using cluster sampling followed by simple random sampling methods. Chi Square test was used for bivariate analysis of relationship each variable has with the diseases, and binary logistic regression was used to analyse association of covariates with each disease. Results: The prevalence was 41.7% for hypertension, 25% for Diabetes mellitus, 6.9% for dyslipidaemia. Education level was significantly related to hypertension, X2 = 11.565 (1), p =0.001; obesity was significantly related to diabetes, X 2 = 8.333 (1), p=0.004. After adjusted for covariates, low education level has 13.379 odds of getting hypertension. Obesity has 7.384 odds of getting diabetes mellitus; female gender has higher odds of getting dyslipidaemia while younger age, physically active and not smoking are protective factors. Conclusion: Higher prevalence of hypertension and diabetes mellitus was found among Tasik Chini orang asli population. Lower sociodemographic characteristics and unhealthy lifestyle factors are associated with the diseases
A Study of Fasting Type 2 Diabetes Mellitus Patients With Acute Complications During Ramadan in Hospital Tengku Ampuan Afzan, Kuantan, Pahang
Get PDFIntroduction: A large number of Muslims fast during the holy month of Ramadan worldwide. A specific approach is needed to manage diabetic patients who intend to fast during Ramadan because of potential harm. Thus, the study aimed to describe the sociodemography and the characteristic of fasting diabetic patients admitted due to acute diabetic complications during Ramadan. Materials and Methods: A cross-sectional study was conducted among fasting diabetic patients in Hospital Tengku Ampuan Afzan (HTAA) who were admitted due to severe hypoglycemia, diabetic ketoacidosis, hyperglycemic hyperosmolar syndrome and uncontrolled diabetes mellitus during the month of Ramadan 2017/1438H. Subjects were interviewed and blood investigation results were obtained from medical records and recorded in patients' case report. Results: Thirteen patients who were admitted due to acute complications of diabetics during Ramadan were included in this study. Of these, 38.5% had severe hypoglycemia, 23.1% diabetic ketoacidosis, 15.4% hyperglycemia hyperosmolar syndrome and 23.1% uncontrolled diabetes mellitus. All of the patients had a long standing diabetes mellitus (median duration of 10 years). HbA1C was high (11.5%) among hyperglycemic subjects. Types of treatment and previous history of severe hypoglycemia prior to Ramadan were the only independent factors identified to be related with acute complications of diabetes during fasting month (p=0.030 and p=0.032 respectively). Insulin, either alone or in combination with oral hypoglycemic agent, was associated with higher number of hypoglycemic event. Conclusion: The significant risk factors found were consistent with other studies. A thorough, individualized and holistic approach is needed in managing patients with diabetes who intend to fast
Augmented Renal Clearance in Critically Ill Patients in Malaysian Intensive Care Unit: Assessment of Prevalence, Risk Factors and Outcomes
Get PDFIntroduction: Augmented renal clearance (ARC) is a phenomenon where there is elevated renal clearance and defined by creatinine clearance >130ml/min. ARC results in changes of the pharmacokinetic and pharmacodynamic of antimicrobial therapy being administered resulting in its subtherapeutic dose. We evaluated the prevalence, risk factors and outcome of ARC in critically ill patients in two Intensive Care Units (ICU) in Kuantan. Materials and Methods: This was a two centre, prospective observational study of critically ill patients. Inclusion criteria were patients older than 15 years old with plasma creatinine <130µmol/l, with arterial line and urinary catheter inserted. The creatinine clearance (CrCl) were measured using plasma creatinine, urinary creatinine and urinary flow rate. ARC is defined as CrCl of more 130ml/min. Results: Among 102 patients recruited, 57 (55.9%) had ARC. Those with younger age (39.9±19 years old, p=0.013) and lower SOFA score (2.8±2.6, p=0.012) had increased risk of developing ARC. No significant difference in other risk factors such as male and trauma were found. There was no difference in the ICU and hospital mortality (p=0.652 and p=0.128). There was also no difference in the duration of ICU admission amongst survivors with or without ARC (100.6±142.3). Measured CrCl correlated well with the estimated glomerular filtration rate (eGFR) using all four different eGFR equations (r=0.436 to 0.552, p<0.0001). Conclusion: ARC occurs in almost half of critically ill patients and more common in younger age and lower SOFA score. However, there was no difference in the outcome. eGFR may be used as surrogate in detecting ARC
Early Experience with Local Custom Made Synthetic Bone Construct for the Treatment of Bone Defect
Get PDFIntroduction: Segmental bone defect can be treated with autologous bone graft and bone transport. Synthetic bone graft has successfully been used for the treatment of metaphyseal fracture or bone cyst. However, their use for the treatment of segmental bone defect has not been establish. Recently, a local company has produced a biodegradable custom made synthetic bone construct phosphate-based materials that is used to treat fractures and bone defect. Materials and Methods: After getting approval from Medical Device Agency, we used SBC to treat segmental bone defect in our patients. A case series review was conducted in these cases. Results: Three patients underwent surgery using SBC as a spacer to fill the defect at the docking site to prevent soft tissue collapse in one patient and as a replacement for bone autologous bone grafting in two patients. In our observation granules resorbtion ranged from 40-80% by 6 months with no radiological evidence of new bone formation. SBC mixed with bone marrow aspirate failed to harden into a palette. Although no new bone formation was seen at the docking site, insertion of SBC prevents soft tissue invagination and reduced the need of a second surgery to remove other conventional spacers. Conclusion: SBC may be used as a spacer to prevent soft tissue interposition and skin invagination in bone transport. However mixing it with bone marrow aspirate resulted in failure to form beads and does not form bone