IIUM Medical Journal Malaysia (IMJM)
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Preliminary Study on the Formulation of Syariah Compliant Generic Sustained Release Gliclazide Tablet Using Xanthan Gum
Get PDFGliclazide (1-(3,3a,4,5,6,6a-hexahydro-1H-cyclopenta[c]pyrrol-2-yl)-3-(4-methylphenyl)sulfonylurea) is a second-generation sulfonylurea which is orally administered in the treatment of non-insulin-dependent diabetes mellitus in adults. Sustain release drugs help to improve drugs bioavailability by controlling the time of drug release or prolonging it. We are reporting the preliminary formulation of sustain release gliclazide tablets with careful choice of all the ingredients and processes related to syariah compliance manufacturing of pharmaceutical products. In this work, xanthan gum, a natural gum was used to achieve the sustain release criteria. The tablets were produced by wet granulation and semi-automatic tableting process. Tablet characterisation was done following the British Pharmacopoeia (BP) criteria. We expect that the outcome of our study will result in a suitable formulation that could be useful for the formulation of such product that will be helpful for the Muslim patient especially during the fasting month
The Correlation between Oral Health Knowledge & Attitude towards Practice of Caretakers in Day-Care Centres
Get PDFModernization has made young children to spend most of their time in day-care centres as their mothers are working outside the home. Hence, the role of caretaker has become more important in the daily diet and oral health care of children. The objective of this study is to assess the oral health knowledge, attitude and practice among caretakers in day-care centres. A cross-sectional study among 54 caretakers aged 18 and above was conducted in Kuantan. The data was collected using a self-administered questionnaire addressing aspects of oral health knowledge, attitude and practice of caretakers. The results were analyzed by descriptive and Spearman correlation coefficient tests. The participants were mainly Malay ladies and 16.7% had university education. The knowledge of sugary food causing dental caries was found good for all caretakers; however, 48.1% of them do not know the important about filling the teeth of their children. Preliminary analysis was performed and followed by Spearman correlation coefficient analysis. Correlation between attitude and practice was weak (rho=0.29, p0.05). The caretakers had good oral health knowledge but it did not reflect in their attitude and practices. The action must be based on knowledge, and that knowledge must produce action. As Abu Bakr (R.A) said, “without knowledge action is useless and knowledge without action is futile.” The Arabic term ‘ilm translates to knowledge, but the word has a broader definition than its English counterpart. ‘Ilm encompasses theory, action, and education whereas in English, knowledge is defined as merely the awareness of facts, truths, and principles
The Ethical Significance of Antibiotic Resistance towards Aquaculture Practices
Get PDFIn recent decade, aquaculture species, including fish are under danger from bio-aggressors like viruses, bacteria, parasites and fungi. These organisms harm either spontaneously or through aquatic animal husbandry practices or both. The chemicals employed in aquaculture are drugs like antibiotics used to treat diseases, chemicals introduced through construction materials and hormones used to alter the reproductive viability, sex and growth rates. Drugs used to treat disease are the most dangerous to the fish. These persistent antibiotics tend to increase antibiotic-resistant free-living bacteria, thereby altering the composition of normal marine and freshwater bacterial flora. Evidence suggests that these antibioticresistant organisms in the marine environment will, in turn, pass their antibiotic resistance genes to other bacteria including human and animal pathogens. Antibiotic treatment in aquaculture is achieved by medicated baths and medicated food. In both cases, the probability exists for antibiotics to pass into the environment, affecting wildlife, remaining in the environment for extended periods of time and exerting their antibiotic effects to human. In this manner, potential alterations of the diversity of the marine microbiota produced by antibiotics may alter the homeostasis of the marine environment and affect complex forms of life including fish, shellfish, marine mammals, and human beings. The contamination of surface waters with antimicrobials has become an increasing public health concern because of the emergence of multi-resistant pathogens. Efforts to make progress on these issues require us to raise, confront and enact some difficult ethical decisions that will affect the living standard of human. Nevertheless, excessive antibiotic use in aquaculture should be of high concern to the aquaculture industry and its regulators, to public officials dealing with human and animal health and with the preservation of the environment, and to non-governmental organizations dealing with these issues
The Islamic Perspective of Lingual Dens Evaginatus in a Mandibular Left Second Premolar: A Case Report
Get PDFDens evaginatus (DE) is a developmental anomaly. It is an extra cusp or tubercle that protrudes from the occlusal surface of posterior teeth, as well as the lingual surface of anterior teeth. Tubercles are susceptible to pulp exposure from wear or fracture because of malocclusion;leading to pulpal complications early after eruption.DE may also complicate the process of daily routine oral health care. A 13-year-old girl presented to our polyclinic with sinus track at the posterior lower left buccal gingiva forthe past1 year. All 35 teeth were sound. At the lingual side, there was an accessory tooth in close relation to tooth 35 covered with supra-gingival inflammation. Electric pulp test (EPT) showed that tooth 35 was already non-vital. Intraoral periapical (IOPA) radiograph and cone beam computed tomography (CBCT) scan showed an abnormalappearing root which shows DE with radiolucency at the periapical area. Root canal treatment was performed using crown down pressureless (CDP) technique and obturation was done using lateral condensation technique. The tooth was restored using composite restoration. DE is a rare condition. It is quite a challenge for dental practitioner since the diagnosis is difficult and the treatment options are limited. In the case of DE with necrotic pulp and periapical abscess, root canal treatment is a treatment of choice. We have to accept and appreciate any gift from Allah SWT whether it is good or bad, no equal divine creation except from Allah SWT.Therefore we need to take care of our oral hygiene to prevent diseases. In every disease, there is a cure; we thus need to try to do the best to find the cure and to not easily get rid of the tooth and replace it with a denture. Early diagnosis of DE can lead to proper treatment which can result in high success rate if it is followed by adequate restoration
Nutritional Knowledge, Attitude and Practice among Antenatal and Postnatal Mothers in Hospital Tengku Ampuan Afzan (Htaa), Kuantan, Pahang 2016
Get PDFBackground: Balanced and sufficient maternal nutritional intake ensures not only the wellbeing of pregnant mother, fetus, and newborn (protection of life) but also her future health and her three generations (protection of progeny). Nutritional inadequacies during pregnancy have been reported and several factors were attributed. The objectives were to measure nutritional knowledge, attitude, and practice (KAP) during pregnancy and the relationship with socio-demographic characteristics. Methods: A cross-sectional study was conducted among 320 antenatal and postnatal mothers in Hospital Tengku Ampuan Afzan (HTAA), Pahang, Malaysia from 18th July to 27th August 2016. A pre-tested self-constructed, interview-guided questionnaire was used. Independent variables were age, ethnicity, educational level, marital status, and monthly household income. Outcomes were nutritional KAP-level with median used for the categorization. The relationship between independent variables and outcomes was obtained by logistic regression with significance at p<0.05. Results: Sixty-five percent aged from 25 to 34, 84% Malays, 37% completed secondary education with SPM/O-level, 96% married, 48% from middle-income family, 52% had a good nutritional knowledge, 67% with a positive attitude and 55% with good practice. Age and educational level were significantly related to knowledge. The only educational level was significantly related to practice. Less than 70% of respondents have good nutritional KAP, reflected by educational level with more than half of them received up to secondary education. Hence, the rights of mothers in getting a necessary and adequate education should be fulfilled. Conclusion: Results emphasize the importance of empowering girls and women with adequate educations and to strengthen the nutritional and health education of our educational system. It is for them to be knowledgeable with good attitude and practicing healthy nutritional lifestyle as they entering reproductive life, maintaining and transferring at least optimum healthy life to their progenies
Technical Issues in Craniomaxillofacial Distraction Osteogenesis: A Case Series
Get PDFDistraction osteogenesis allows superior skeletal advancement compared to conventional surgical osteotomy. It can be considered as a reliable and predictable surgical procedure and is widely used to correct the craniomaxillofacial bone discrepancy. Nevertheless, the outcome is technically dependent and requires comprehensive peri-operative assessment, preparation, and precision in application. The objective of this study is to highlight some important technical issues in distraction osteogenesis when the technique is indicated in various craniomaxillofacial regions and at the same time to discuss the options of preventing and overcoming these technical complications based on our experience and relevant literature. Important technical issues on the application of distraction osteogenesis in 5 different craniomaxillofacial regions were selectively highlighted based on the completed cases in one centre. Potential complications and its prevention methods were documented and discussed. The 5 highlighted regions of craniomaxillofacial distraction osteogenesis were alveolar, mandibular, cleft maxilla, craniofacial and facial cleft. Technical issues and complications were mostly device related and associated with anatomical limitations and surgical technique. Nevertheless, these complications are preventable and can be appropriately managed. From the literature and our experience, the technical aspects vary according to its application in different craniomaxillofacial regions. Preventing the potential complications contribute to the success of its application. This article also discussed the concept of Ihsan application in the medical field, to achieve the best of treatment in terms of delivery and technical preparation for the patients
Patients’ Knowledge and Perception on Anaesthesiologist And Anaesthesia
Get PDFIntroduction: Anaesthesiologists play vital roles in perioperative patients’ care and chronic pain management. However, not many patients are aware of the role of anaesthesiologists. We aimed to measure the level of patients’ knowledge regarding the role of anaesthesiologist and anaesthesia. Materials and Methods: This was a single-centred, questionnaire-based cross sectional study. The self administered questionnaire was divided into three parts that includes, i) sociodemographic characteristics, ii) knowledge regarding role of anaesthesiologist, iii) knowledge of anaesthesia. Respondents were selected among patients attending several specialist clinics at the International Islamic University Malaysia Medical Centre (IIUM MC). Results: Almost 64% of the selected patients had previous experience of anaesthesia. Majority of the patients (78%) knew that anaesthesiologist is a medical qualified doctor, but only 52.5% of them knew the role of anaesthesiologist in operation theatre. Fifty eight percents of patients realized the fact that anaesthesiologist is primarily responsible to ensures the well-being during operation, 45.1% knew the involvement of anaesthesiologist in case of emergency and in the intensive care unit, 46.7% in managing obstetrics pain, 39.3% in long-standing pain, 52.5% on the issue of pre-operative visits and post-operative recovery. Besides that, 72.1% were well-informed regarding fasting before operation, 59.8% realized that smoking may affect the anaesthesia and surgery, 86.1% knew where anaesthesia will be administered, 66.4% and 62.3% of respondents knew regarding the general and regional types of anaesthesia respectively. Seventy three percents of patients realize how general anaesthesia will be administered. Lastly, only 54.9% of patients had some knowledge regarding complications of anaesthesia. There were also not much impacts of previous exposure of anaesthesia on the level of their knowledge. Conclusion: Patients’ knowledge regarding the role of anaesthesiologist and anaesthesia were average and variable
Predictive Factors of Major Lower Extremity Amputations in Diabetic Foot Infection: A Cross-sectional Study in Three District Hospitals
Get PDFIntroduction: Limb amputation in diabetic patients is associated with severe economic, social and psychological effects on patients and their families. This study aimed to evaluate the predictive factors of major lower limb amputation among patients with diabetes mellitus. Materials and Methods: This cross sectional study involved patients from a cluster of three district hospitals in Pahang, Malaysia (Hospital Kuala Lipis, Hospital Raub, and Hospital Bentong) from the 1 st September 2014 to the 31st December 2015. Age, sex, ethiniticy, facilities, presence of hypertension, duration of illness, fever, haemoglobin level, white blood cell level, urea, creatinine, history of more than three limb salvaging surgeries, diagnosis and tissue culture were assessed to determine the predictive factors of major lower limb amputation. Results: History of more than three times limb salvaging surgeries, white blood cell count more than 15x109 /L and longer duration of disease were significant predictive factors of major lower limb amputations in patients with diabetic foot infections. Conclusion: This study highlights the importance of initial limb salvaging surgeries as history of more than three times limb salvaging surgeries is a predictive factors of major amputation in diabetic foot infection
Isolated Unilateral Vocal Fold Palsy following Skull Base Fracture: A Case Report
Get PDFIsolated lower cranial nerve (CN) palsy affecting the CN X resulting from a skull base fracture is very rare. The clinical manifestation and natural history is related closely to the complex anatomy of this region and mechanism of injury. Here, we report a case of a 54 year-old man who presented with a delayed onset of dysphonia and dysphagia with aspiration following a closed head injury sustained from a motor vehicle accident. Injection laryngoplasty was implemented to alleviate symptoms of his CN X palsy, which eventually almost completely resolved. High index of suspicion should be maintained when investigating possible skull base fractures, especially with a suggestive clinical presentation of lower CN palsies affecting one or all the lower CNs. Delayed onset of these CN palsies are likely to have more favourable outcomes
