IIUM Medical Journal Malaysia (IMJM)
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The Knowledge And Practice Of Copy Denture Technique Among Dentist And Dental Technologist
Get PDFIntroduction: Copy denture technique is a classic technique for construction of a new denture based on the favourable aspects of the original denture using a replica. This technique helps in adaptation of new denture in elderly population. The aim of this paper was to assess the knowledge and practice of copy denture technique among dentists and dental technologists. Materials and Methods: A pre-tested questionnaire was sent to all participants who attended the Copy Denture Workshop organized by USIM on 13th April 2017. Two sets of the same questionnaire were distributed to the participant before and after the seminar. Results: Out of 100 participants, only 77% (n=77) have given valid feedbacks. The results showed, even though 54.5% (n=42) participants had more than 5 years of clinical experience, 42.9% (n=33) of the participants have poor knowledge in this technique before the seminar begin. However 55.9% presented with positive attitude towards copy denture. Most of the participants did not know about copy denture technique (43.1%) and the advantages of the technique (32.9%). 74.1% (n=57) participants were uncertain to perform the technique and did not have the skills to perform the copy denture technique. However, after attending the workshop, their attitude towards copy denture increased (+15.6%) and the mean score value was statistically significance with p-value 0.049. Conclusion(s): Awareness and workshop on copy denture technique should be encouraged to improve knowledge and practice, so that the patient who requested for replacement denture will benefit from this technique
Functional Outcome 6 Months after Severe Traumatic Brain Injury Following Admission to Intensive Care Unit: A Follow-Up Study in Two Neuro-Center Hospitals
Get PDFIntroduction: Traumatic brain injury (TBI) is a major medical and socioeconomic problem. Patients with severe TBI shows physical and functional improvement but remain with cognitive and psycho-social problem throughout recovery. Despite all the issues, the impact of TBI on long-term survivors in Malaysia is unknown. The aim of this study is to measure the functional level of ICU survivors with severe TBI within 6 months post injury. Materials and method: A cohort study was employed for this study. 33 participants from Hospital Tengku Ampuan Afzan (HTAA) Kuantan, Pahang and Hospital Sultanah Nur Zahirah (HSNZ) Kuala Terengganu with severe TBI were included in this study. The functional assessment of Glasgow Outcome Scale Extended (GOSE) was measured in all samples within in a 6 month period. Results: The participants mean age was 31.79 with ranged from 16 to 73 years old. The result of this study showed that within 3 months after discharged from the hospital, all the participants still had poor recovery n=33 (100.0%). Meanwhile, at 6 months after discharge from the hospital, n= 16 (48.5%) participants were scored good recovery. In this case, the SOFA and SAPS II score contributed significantly to the prediction (SOFA score p=0.045, SAPS II score p= 0.028) of functional outcome. Conclusion: The functional outcome of severe TBI improved in six months post injury. The SOFA score and SAPS II score become significant predictors for functional outcome in this study. However, there were some limitations to this study, which are small sample size and short follow-up duration. This study emphasized the importance of SOFA and SAPS II score in predicting functional outcome; thus early care plan should be done if severe TBI have higher SOFA or SAPS II score
Knowledge of Osteoporosis among Men Attending Primary Care Clinic and the Associated Factors
Get PDFIntroduction: Osteoporosis has frequently been regards as a disease of women only. However, men are also at risk of developing osteoporosis. We aimed to evaluate the knowledge of osteoporosis among men and its associated factors. Materials and method: A cross-sectional study of 245 male patients aged 50 and above was conducted in the primary care clinic, University Kebangsaan Malaysia Medical Centre. The research instrument used in this study was a validated self-administered questionnaire which consists of socio-demographic data and 16 items of knowledge of osteoporosis among men. Results: The mean score for knowledge was 7.78± 3.32 out of 16 points. Most of the subjects (83 percent) knew the definition of osteoporosis but were not aware that osteoporosis was a silent disease. Only a quarter of subjects (38 percent) recognized family history as a risk factors for osteoporosis. Despite 78 percent of subjects answer correctly regarding importance of calcium intake in their diet however only 7 percent of them knew the recommended dosage of daily calcium intake. Knowledge of osteoporosis was found to be significantly associated with education and total monthly household income. Conclusion: Findings indicate limited knowledge of osteoporosis among the subjects. Public education of osteoporosis among men is important to increase their knowledge. Meanwhile, primary care doctors should also emphasize and educate men regarding osteoporosis to enhance their knowledge of the disease
Liver Sinusoidal Endothelial Cell (Lsec) Isolation Following a Liver Perfusion Technique
Get PDFIntroduction: Liver perfusion has been the standard method to digest and isolate liver cells including liver sinusoidal endothelial cells (LSEC). Poor cannulating skills through portal vein results in a waste of animal resource. Familiarization of both liver perfusion technique and adhering strictly to aseptic technique during cell handling ensure high cell yield, minimum morphology disruption and cell contamination. We aimed to present a method of liver perfusion procedure followed by the isolation of LSEC. Materials and method: The study was conducted with the approval of IACUC committee. Seven Sprague Dawley rats underwent these procedures under anaesthesia. Liver perfusion was done as previously described. Briefly, LSEC were isolated by liberase enzyme perfusion of the liver, isopycnic sedimentation in a two- step Percoll gradient and selective adherence. The purification and cultivation of LSEC was evaluated by light and electron microscopy. Results: Purity and viability of LSEC after selective adherence was 80.5 ± 3.5% and ≥ 95 %, respectively. The average concentration of the cells ranged from 32 - 75 x 106 per 400 gm rat. After 8 hours of culture, LSEC monolayers were contaminated with less than 5% of other cells. Conclusion: This method is reliable and reproducible for the isolation of LSEC to enable the study of structure and function of these cells in vitro. However, improvement on the perfusion skills and isolation technique are vital to ensure better cell purity
Outcome of Pseudoaneurysm Repair: A Single Tertiary Center Experience in Pahang, Malaysia
Get PDFIntroduction: Symptomatic arterial pseudoaneurysm is not an uncommon emergent vascular case presenting to a tertiary hospital. These are mainly associated with infection, iatrogenic puncture or trauma. The resultant morbidity, limb loss and mortality present a challenge to the surgeons managing these cases. Materials and method: We retrospectively reviewed all case notes of all pseudoaneurysm repair done at our centre from Jan 2015 to May 2017. Results: A total of 20 cases were treated surgically, with majority 16(80%) had ligation of the affected arteries. The rest were managed with reconstruction of the arteries with synthetic graft. In 7 patients (35%), the aetiology was identified as iatrogenic intravenous drug injection. Staphylococcus aureus remained the main causative organism with Treponema Pallidum and Burkholderia pseudomallei as the other organisms identified in the cultures. Our 3 patients with graft reconstruction had long term oral antibiotics upon discharge. Conclusion: Majority of pseudoaneurysms presented to our center results in ligation of the artery. Repair of mycotic aneurysm needs careful consideration as graft infection remains a lethal complication and no consensus is available regarding the duration of post-operative antibiotic cover
A Pilot Study of Enhance Recovery after Surgery (ERAS) for Liver Resection
Get PDFBackground: Morbidity post hepatectomy still remain persistent throughout decades compared to other surgery. Modern approach have been introduced to improve safety and reduce morbidity whilst at the same time enhance patient recovery. Thus, enhanced recovery after surgery or fast track recovery program for liver resection was initiated. Objective: The aim of this study was to achieve discharge by postoperative day 3 for minor resection and day 5 for major resection. Design and Setting: This is a prospective study conducted in Hospital Universiti Kebangsaan Malaysia (HUKM) from September 2014 till April 2015. Material and Methods: All patients undergoing open liver resection were included in the study. They were then managed post operatively according to ERAS protocol that was drawn up based on previous studies. Patient’s demographics data, intra operative parameters, postoperative complications and adherence to postoperative recovery protocol were recorded. Results: Seventeen patients (7 major and 10 minor resection) were recruited. The mean length of hospital stay for minor resection was 5.9 and major resection was 9.6 .With regards to the targets, 4 out of 10 (40%)patients in minor resection group and 4 out 7 (57.1%) in the major group were discharged on time. 9 patients had postoperative complications with no mortality recorded. In terms of the ERAS protocol targets, the PCA morphine discontinuation target was achieved in 15 patients (88.3%) ,nasogastric tube removal (13 patients -76.5%) , urinary cathether removal (6 patients - 35.3%), abdominal drains removal (9 patients-52.9%) and resumption of full diet was achieved by 82.4% (14 patients). Conclusion: From these overall achievement, most of our targets have been met and this shows that our ERAS protocol is safe to be applied to patient undergoing hepatectomy. Limitations: Some patients had achieved their target but not discharged for unknown reason
Pyrethroid Resistance Status of Aedes (Stegomyia) Aegypti (Linneaus) from Dengue Endemic Areas in Peninsular Malaysia
Get PDFVector control is still the principal method to control dengue and chemical insecticides, especially the pyrethroids such as permethrin are the forerunners of mosquito control agent. Intensive and extensive use of pyrethroids often result in resistance, thereby hampering control efforts. The present study was conducted to evaluate the susceptible status of Aedes aegypti, the primary vector of dengue against permethrin. A nationwide mosquito sampling via ovitrapping was conducted in 12 dengue hotspots across 5 states in Peninsular Malaysia. Field collected Aedes eggs were hatched and reared until L3 larval and further identified it species. Adult F0 Aedes aegypti were reared until F1 progeny and the female were used in adult assay, performed according to World Health Organization (WHO) protocol as to determine the resistance level. The laboratory strain maintained for more than 1000 generations that were susceptible to permethrin served as the control strain. Evaluation of resistance ratio was assessed by comparing the knockdown rate with laboratory susceptible strain. In this present study, 70% ofAe. aegypti population from dengue hotspots was highly resistance to permethrin. The study clearly demonstrated that widespread of permethrin resistant Ae. aegypti in Malaysian mosquito’s population, indicating the need of implementing an efficient pyrethroid resistance management
Do Patients with Type 2 Diabetes Mellitus Know about Specific Dietary Recommendations?
Get PDFINTRODUCTION: Diabetic patients generally have a good idea about healthy diet however their awareness regarding specific dietary recommendations is questionable. Thus, this paper aims to examine the awareness regarding specific dietary components among diabetic patients at a primary care clinic and its influence on self-reported dietary practice. MATERIALS AND METHODS: The Summary of Diabetes Self-Care Activities (SDSCA) questionnaire (English-Malay version) was used. It was adapted with additional questions to assess respondents’ awareness on: (1) healthful eating plan, (2) the quantity of one serving of fruits and vegetables, (3) choices and the allowed quantity of high fat food intake, (4) meaning of carbohydrate, and (5) carbohydrate spacing per day. RESULTS: From the 360 respondents, 85.0% knew about healthful eating plan. However, those who were unaware of the meaning of carbohydrate, carbohydrate spacing, the allowed high fat food intake, and the quantity of one serving of fruits and vegetables were 34.1%, 47.5%, 40.0%, and 30.8% respectively. Generally, the dietary practice reported by those who knew ‘one serving of fruits and vegetables’ (p<0.001), ‘allowed quantity of high fat food intake’ (p=0.001), ‘meaning of carbohydrate’ (p<0.001), or ‘carbohydrate spacing’ (p<0.001) was significantly different than those who were unaware of these terms. CONCLUSION: Although most respondents knew about healthful eating plan, majority of them were unaware of the specific dietary components, suggesting superficial dietary knowledge. Unfortunately, poor dietary awareness significantly influenced their self-reported dietary practice which could be considered as inaccurate. Thus, strategies to improve their dietary knowledge is necessary at the primary care setting. 
Maternal Death and Isolated Left Ventricular NonCompaction Cardiomyopathy
Get PDFLeft ventricular non-compaction cardiomyopathy (LVNC) is a rare congenital cardiomyopathy, which is characterized by hypertrabeculations and deep recesses of the left ventricle. A patient could be asymptomatic or presented with common manifestations, including reduced systolic function, arrhythmia, thromboembolic events and heart failure. The rarity of the condition as well as lack of proper assessment has probably led to this condition to be largely underdiagnosed or unrecognized. A 23-year-old lady had collapsed at home thirty one days after delivering her first child. She had a history of goitre diagnosed a year ago and noted to be fairly well throughout the pregnancy. Post mortem findings showed increased trabeculations of the left ventricle. Further history was obtained after the procedure, revealing symptoms such as syncopal attacks and bilateral lower limb weakness dated back as far as five years prior to her sudden demise. These features were in keeping with hypotension hypoperfusion effects resulted from reduced systolic function and decreased ejection fraction, as a result of left ventricular dysfunction. While LVNC remains a rare type of disease, we would like to highlight the importance of a good anamnesis. It may help to uncover some uncommon pathology such as this heart disease, thus warranting an appropriate cardiac imaging to be engaged to clinch the primary diagnosis
Integration of Naqli and Aqli in Microbiology Teaching: Sharing the Experience
Get PDFBackground: In line with Universiti Sains Islam Malaysia’s (USIM) tagline ‘Exploring Islamic Science, Spearheading Knowledge’, we embarked on a new paradigm of teaching by integrating naqli components into the microbiology and immunology curriculum. The main objective of this integration was to enhance students’ appreciation towards Islam and Science, so that they would become good Muslim doctors. The naqli components were delivered through various teaching and learning techniques such as lectures, seminars, and online assignments. Methods: A total of eighty year 3 students from Faculty of Medicine and Health Sciences, USIM were involved in this study. They were exposed to the new method of teaching for the whole academic year, session 2014/ 2015. The effectiveness of this program was evaluated through questionnaires, given at the end of academic session. Outcome: More than 90% students agreed that the integration were clearly delivered, relevant to the topics at hand and enhanced their knowledge. Most students (>90%) preferred interactive lectures rather than students’ initiated method such as seminar and speaker’s corner. About two third of the students did not prefer online method. Moreover, 15.9% of them said the allotted time was insufficient and 46% agreed that there was inadequate resources in the library. Conclusions: The integration of naqli components into microbiology subject was favoured by students. However, it should be improved with allocation of more slots, upgrading of online system and increment of relevant library resources. Looking forward, we are convinced this is the way to go in producing holistic doctors equipped with necessary knowledge, both in aqli and naqli to further advance Medicine and Islam