IIUM Medical Journal Malaysia (IMJM)
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Spiritual Influence Towards Relapse in Opioid Addicts in Therapy
Get PDFIntroduction: Substance abuse is both a social and public health problem with a substantial burden to society. Opioid dependence results in unemployment, crimes, family disruption, and transmission of diseases. In Malaysia, methadone maintenance therapy (MMT) has been introduced as a harm reduction method. However, relapse during treatment remains an issue to be resolved that hinders successful outcome in the therapy. Spirituality in the treatment of substance abuse disorders has yet to be fully explored. This study aims to examine how MMT clients who relapsed perceive spiritual deficits as an influence and association of spiritual practice with relapse. Methods: This is a cross-sectional study done from June-July 2016. All MMT clients undergoing therapy at 3 treatment centers in Terengganu, Malaysia who fulfilled the inclusion and exclusion criteria and consented were included in the study. A semi-structured questionnaire was filled via face to face interview and spiritual practice was assessed using Hatta Islamic Religiosity Scale. 121 questionnaires were assessed and data was analyzed using SPSS version 22 for quantitative data. Results: All respondents were males of Malay race and Islamic religion. Current relapse, defined as any episode of intake of opioid for the past one month after a period of abstinence was 34%. Only three out of 42 clients who relapsed had some spirituality theme in their perceived cause of their relapse. However, a significant majority of those relapsed had a spiritual practice score of less than the mean practice score. Conclusion: Relapse in opioid addiction remains high in those receiving MMT in Terengganu, Malaysia. Spirituality may have a subconscious influence towards relapse in addiction in MMT clients. Further effort should be taken to inculcate spirituality intervention effective to prevent relapse which may contribute towards achieving a more successful therapy outcomes
Existence of Occult Hepatitis C virus Infection in Local Haemodialysis Setting
Get PDFIntroduction: Among chronic hepatitis C patients, the viral agent is well known to replicate in the hepatocytes and extrahepatic cells. Previous studies have demonstrated a new form of hepatitis C called 'Occult HCV Infection' (OCI). It is defined as the presence of HCV RNA in the hepatocytes but undetectable HCV RNA in the serum or plasma. The exact natural history, epidemiology, pathogenesis and clinical importance of OCI are unknown. Several studies have been carried out worldwide, but none from Malaysia. This study investigated OCI among local patients undergoing routine hemodialysis at a referral hospital in Pahang, Malaysia. Materials and Methods: Blood was collected from both anti-HCV positive (n=10) and anti-HCV negative (n=18) patients. Inclusion criteria for the seronegative patients included elevated liver enzymes. Results: 10 chronic hepatitis C patients were recruited in this study. All had viral RNA detected in both serum and peripheral blood mononuclear cells (PBMC). Viral quasispecies was common in this group of patients. Meanwhile, out of 18 seronegative patients, 3 patients (16%) showed active viral replication in PBMC. Conclusion: This study proved the existence of OCI in local haemodialysis setting. Further investigation is needed to get the actual prevalence of OCI
Predicting Sexual Intention to Engage In Premarital Sex among Late Adolescent in Kuantan Government Secondary Schools: An Application Of The Theory Of Planned Behavior
Get PDFIntroduction: The Theory of Planned Behavior (TPB) states that behaviour is determined by four main domains of social-cognitive factors; attitudes, social norms, self-efficacy and sexual intention. The aim of this study was to explore the correlation of the socio-cognitive factors predicting sexual intention to engage in premarital sex amongst late adolescent in Kuantan government secondary schools. Materials and Methods: This cross-sectional study was conducted among 466 single students aged 18 to 19 years in nine government secondary schools in Kuantan district. A self-administered validated Youth Sexual Intention Questionnaire (YSI-Q) that measured permissive attitude, perception of social norms, perceived selfefficacy and sexual intention towards premarital sex activity has been used. Statistical analyses were done using IBM SPSS version 22.0. Results: There was a significant difference of sexual intention between male (35.6%) and female (64.4%) students with a mean(SD) of 10.54(3.8) and 7.3(2.9) respectively. Permissive attitude, perception of social norms (peer pressure) and perceived self-efficacy have significant positive correlation on sexual intention towards premarital sex with the value of (r=0.579, p<0.001), (r=0.513, p<0.001) and (r=0.253, p<0.001) respectively. Thus, the higher permissive attitude, social norms and perceived self-efficacy led to higher sexual intention. In addition, a student with premarital sex experience (1.5%) has significant higher sexual intention than student without premarital sex experience given by mean(SD); 14.43(2.5) vs. 8.25(3.6). Conclusion: The Theory of Planned Behavior has a positive correlation towards premarital sex among late adolescent. It might successfully guide the development of sexual abstinence intervention-based theory to reduce unsafe sexual behavior among adolescents
The Role of Modern Medicine in Clarifying Definitions in Islamic Jurisprudence (Ta’rifaats fi al-Fiqh)
Get PDFTurner Syndrome with Ring X Chromosome: Do They Have a Distinct Phenotype?
Get PDFIn contrast to classic Turner syndrome, Turner patients with ring X chromosome are associated with distinct dysmorphism and are likely to be mentally impaired. Four Turner patients with ring X chromosome were examined for phenotypic features of Turner syndrome and additional dysmorphism. Both patients 1 and 2 are twins with normal intelligence whereas patients 3 and 4 have mental impairment. With the exception of patient 4, the other three patients only have few Turner characteristics. None of the patients have the distinctive dysmorphism previously reported in Turner syndrome with ring X chromosome. Both twins developed spontaneous puberty. Patients 3 and 4 however had no spontaneous puberty. We postulate that this variation may be related to the ring size, the proportion of 45,X and ring X chromosome in cell lines of various body tissues as well as the ability of these rings to be inactivated as a result of lyonisation
Microbiological Study of Etiological Pathogen in Early Infection of Open Fracture in Orthopedics
Get PDFIntroduction: Infection is a dreaded complication of open fracture in the field of orthopaedics. This study was conducted to evaluate the susceptibility of microorganism involved in early infection of open fractures to current prophylactic antibiotics practice and determine the association of various characteristics to the resistance of such microorganisms. Materials and Methods: This cross sectional study was conducted from January 2015 to December 2017 in Hospital Tengku Ampuan Afzan, Kuantan, Malaysia. A total of 179 cases were collected from the operating record with 110 cases fulfilling the inclusion and exclusion criteria. The patients underwent routine debridement where culture and sensitivity were followed up. Previous notes were traced to identify the various risk factors involved and evaluated against resistance of microorganism. Statistical analysis was done with SPSS version 23 applying Pearson chi-square tests and Fisher's exact test. Results: Admission to intensive care unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of admission were all significantly associated with resistance of microorganism (p < 0.0001). This study also demonstrated 65.9% predominance of Gram-negative microorganisms. These gram-negative microorganisms were seen more in higher fracture grades, injury severity score, and longer duration of admission or antibiotics prescribed. The overall resistance to cefuroxime and gentamicin were 68.6% and 36.9% respectively. Conclusion: The shift of microorganism species to gram-negative and the high rate of resistance suggested that current antibiotic guidelines and regime needed to be fine-tuned to achieve optimal results in managing open fracture
Mortality Following Hip Fractures in the Elderly: Relation with Timing of Fixation, Length of Hospital Stay and Comorbidities
Get PDFIntroduction: The incidence of hip fractures in Malaysia was 218 per 100,000 for females and 88 per 100,000 for men and they are associated with mortality rate up to 33 % at 1 year as shown by international studies. There are no local studies available in regards to mortality rate and associated factors. We aimed to determine mortality rate in elderly patient following hip fractures within 1 year. In addition, we evaluated the association of timing of fixation, length of hospital stay and number of comorbidities with mortality in these patients. Materials And Methods: This was a cross sectional study conducted in Hospital Melaka. All patients aged 65 and older who were admitted and underwent surgery for hip fractures from January 2014 to January 2017 were included. Patients or relatives were contacted via phone calls to determine their status of living. From the records, timing of fixation, length of hospital stay and number of comorbidities were recorded. Results: Mortality rate at 1 year was 10.55%. From Simple Logistic Regression analysis, all three factors of timing of fixation, length of hospital stay and number of comorbidities were found to have significant value less than 0.25. From Multiple Logistic Regression, only length of stay was found to be significant (p<0.0001). The significant variable can be interpreted as follows: a person with one day longer in hospital stay has 1.89 times the chance to be deceased at 1 year. Conclusion: This study shows 10.55% mortality rate at 1 year following hip fractures in the elderly. There were an association between mortality and timing of fixation, length of hospital stay and patients’ comorbidities
Oral Condition Between Assisted Reproductive Technology Children And Natural Conceived Children
Get PDFIntroduction: Assisted Reproductive Technology (ART) children were shown to have higher neurological and musculoskeletal disorder. However, limited number of studies found concerning oral condition of ART children. This research aimed to determine oral condition between ART children and Natural Conceived (NC) children. Materials and Methods: This cross-sectional study consisted of 34 subjects, 17 ART children and 17 NC children. Intraoral examination and orthopantomogram (OPG) radiograph were done in these subjects. Any abnormalities of tooth development such as number and tooth structure was recorded. Caries experience of both groups were recorded using decayed, missing, filled tooth (dmft) index. Descriptive analysis and Mann-Whitney’s Test were used. Results: Most of the participants were female (58.8%) and majority aged 7 to 8 years old (47.1%). Of the patients, 70.6% of ART group were from intra-uterine insemination (IUI) technique while 29.4% were from in-vitro fertilization (IVF). One hypodontia case were found in each group. Caries experience in primary teeth were significantly lower in the ART group compared the NC group, with p value of 0.003. Conclusion: Children in ART group experience less dental caries in the primary teeth compared with NC children. However, there was a comparable case of tooth developmental defect in both groups
Pedobarography Study Among Malay Population In The District Of Kuantan, Pahang: A Preliminary Report
Get PDFIntroduction: Plantar foot pressure has been widely used in managing foot-related disease in developed countries for the past 2 decades. However, in Malaysia, it is still at its infancy. Studies showed that the normal values are not affected by gender and body mass index (BMI), but vary between one race to another. Currently, to the best of author’s review, there is no standard value available for Malaysian or Southeast Asia population. This study is designed to measure pressure values observed in the normal foot of Malay population in Kuantan and its difference between different gender and BMI. Materials and Methods: Measurements were taken from 184 healthy subjects, 79 males and 105 females. Age and BMI were identified. Plantar pressures were measured using Emed-q100 pedobarography platform device with its emed/E (Expert) software Results: The median plantar pressure was 480kPa (IQR 205). There was no significant difference between genders (p=0.483) and BMI (p=0.076) Conclusion: This result is not meant to represent the whole Malay population but rather to be used as an early reference for plantar pressure studies among Malay population. More studies are needed to more accurately describe the value of the population
Red Cell Antibody Screening: A Single Centre Experience
Get PDFIntroduction: The Transfusion Unit of International Islamic University Medical Centre (IIUM MC) performs screening for red cell antibodies for all patients who are to be or might be transfused with red cell components. There are two types of red cell antibodies, the alloantibodies and autoantibodies. While the red cell autoantibodies are produced against self-antigen, the alloantibodies are the results of sensitization through transfusion or pregnancies. These antibodies are implicated in haemolytic transfusion reactions. This retrospective study examines the prevalence of red cell antibodies among patients of IIUM MC. Materials and Methods: All group cross matching and group screen and hold testing performed in IIUM MC from January 2017 to June 2018 were reviewed. Results: In total, samples of 3,712 patients were subjected to antibody screening using gel card. Twelve patients (0.32%) had positive antibody screening tests. The age ranged from 17 to 77 years. Nine (75%) patients were females. Four patients had positivity with Screening Cell I, one patient with Screening Cell II and III respectively. In the remaining patients (6/12) the antibody screening was positive for both Screening Cell I and II. In nine patients (0.24%) alloantibodies were identified, with six exhibiting multiple antibodies. The alloantibodies identified include anti-Le(a), anti-Le(b), anti-Kp(a), anti-C, anti-c, anti-E and anti-e. In three patients autoantibodies with no specificities were detected. Conclusion: Although the prevalence of red cell antibodies, specifically the alloantibodies is lower compared to other studies, the finding further reiterates the need to screen for unexpected red cell antibodies prior to red cell transfusion