Tuberculosis or TB is a major issue in Malaysia as the dramatic emerge of infection. In Mac 2016 (Until 15 April 2016) 3049 cases were reported and total cases were reported 7717 cases which increasing 902 (13.0%) cases at same month 2015 (6815 cases). Meanwhile, prevention and diagnosis should be started from children. Educational planning with the collaboration from Ministry of Education (MOE) and Ministry of Health (MOH) should be intensive to ensure the prevention and mechanism control of this disease can be cure at the beginning. The focus of the study was given on the (1) transmission of tuberculosis (TB) in Malaysia (2) practice of prevention of TB (3) mechanism control in educational institutions and (4) promotion health programmes in schools. The conclusion of this study is drawn on the premise of providing plausible suggestion that will promote good governance for the Ministry of Education (MOE) and Ministry of Health (MOH) to strengthening the current policy for a better future implementation.

Mucoepidermoid carcinoma is a malignant epithelial tumour of glandular tissue, usually of the major salivary glands. However it can present in the minor salivary glands, especially in the soft palate. We report the case of a 72-year-old Malay female after presentation with sore throat, fever and odynophagia, was diagnosed with mucoepidermoid carcinoma of the soft palate.
Mucoepidermoid Tumor ; Salivary Gland Neoplasms ; Salivary Glands, Minor

Computer proficiency has become necessary in many areas of medicine, administration, clinical practices, research, as well as education. The need for greater competence in information and communication technologies (IST) by doctors and medical students is increasingly recognised. Objectives: This study was undertaken to determine the knowledge, attitude and practices on ICT in the medical students of a local university. Methods: A cross-sectional descriptive study was conducted among medical students (Years 1-5) from December 2005 to May 2006 in Universiti Putra Malaysia. A self-administered questionnaire was used to collect data. Descriptive statistics were used to obtain frequencies for allvariables studied. Results: There were 343 respondents aged 18-29 years old. The results showed 82.2% of the respondents (82.2%) were comfortable using computers after enteringmedical school and 89.2% believed that ICT and computers skills are important for doctors. About 81.3% of the respondents were aware of the role of ICT and computers in learning medicine, 90.4% had used presentation packages, and 83.4% used word processing and search engines as software tools. Conclusion: The findings of this study show that medical students are knowledgeable and do have skills in information technology (IT) and computers. They are also aware of the role of information technology (IT) and computers in medicine

Introduction: The objective of the study is to determine the level of agreement between measured total carbon dioxide (TCO2) and calculated bicarbonate (HCO3–) in our laboratory. Materials and Methods: TCO2 and HCO3– values of 1820 samples drawn at the same time from the patient were compared. TCO2 from venous samples was measured on Dimension RxL while HCO3 – was obtained from arterial blood gas samples analyzed on Radiometer ABL 700. Results: The TCO2 and HCO3– values correlated well (r = 0.977, p<0.001), with the correlation given by the equation, y = 0.986x – 0.5335. Using Bland-Altman analysis, the bias was 0.87 mmol/L (SD 1.42 mmol/L), and the limits of agreement (LOA) were -1.92 to 3.67 mmol/L. Story and Poustie’s criteria were applied to study the agreement between these two methods. Based on the fi rst criterion that the bias between TCO2 and HCO3– should be less than ±1 mmol/L, the results for the two methods appear to be in good agreement. The second criterion requires that the LOA between the two methods should range between a bias of ± 2 mmol/L or a total span of 4 mmol/L; the LOA was exceeded in our study. Using the total allowable error in the Bland Altman plot also showed that the two values cannot be used interchangeably especially at the lower values. Conclusions: TCO2 did not show good agreement with HCO3–. Clinicians should be aware of this discrepancy and hence should be cautious when using HCO3– for management of acid-base disorders.

Paraneoplastic neurological disorder (PND) is a condition due to immune cross-reactivity between the tumour cells and the normal tissue, whereby the “onconeural” antibodies attack the normal host nervous system. It can present within weeks to months before or after the diagnosis of malignancies. Nasopharyngeal carcinoma is associated with paraneoplastic syndrome, for example, dermatomyositis, and rarely with a neurological disorder. We report on a case of nasopharyngeal carcinoma with probable PND. Otolaryngologists, oncologists and neurologists need to be aware of this condition in order to make an accurate diagnosis and to provide prompt treatment.

The objectives of this study were to determine the prevalence of the urban poor and its health related factors in Selangor. This cross-sectional study was conducted in the community of Selangor. Data was collected from January 2006 to June 2006. Three out of nine districts were selected to be involved in the study, which were Klang, Kuala Langat and Petaling. A Multistage Stratified Proportionate Systematic Random Sampling was used for this study. The sampling was carried out by the Statistics Department of Malaysia. The survey frame was based on the information gathered from the Population and Housing Census in year 2000. The respondents were interviewed by trained research assistants using a structured pre-tested standardized questionnaire prepared in Malay and English languages. A monthly income of RM706 and less was used to define urban poor based on the guidelines given by the Economy Planning Unit of Malaysia (2004). SPSS 16.0 version was used to analyze the data. Out of 2535 respondents interviewed in this study, 2491 respondents answered the questionnaire completely (response rate 98.3%). Out of 2491 respondents, 202 (8.1%) had a monthly income of RM706 and less. Analysis of the urban poor respondents found that majority were aged between 18 to 40 years old (55.9%), and 29.7% had diagnosed medical illnesses, where hypertension, diabetes and asthma were the most common illnesses at 12.4%, 10.9% and 5.0% respectively. About 10% of the urban poor respondents had physical disabilities such as blurring of vision (7.9%), hearing problems (1.0%) and other disabilities (1.0%).

Bilateral vocal fold immobility (BVFI) is commonly caused by injury to the recurrent laryngeal nerve (RLN) and leads to stridor and dyspnea of varying onsets. A retrospective study was done at the Department of Otorhinolaryngology of Universiti Kebangsaan Malaysia Medical Centre on laser microsurgical posterior cordectomy for BVFI. The objectives were to identify the average duration of onset of stridor from the time of insult and to evaluate the outcome of laser posterior cordectomy as a surgical option. From 1997 to 2007, a total of 31 patients with BVFI were referred for surgery. Twelve patients had tracheostomy done prior to the procedure, whereas 19 patients were without tracheostomy. Ten patients were successfully decannulated, and only 4 patients had complications related to the procedure. The minimum onset of stridor was 7 months, maximum onset of stridor was 28 years, and the mean onset of stridor was 8.7 years. The commonest complication observed was posterior glottic adhesion following bilateral posterior cordectomy. Laser endolaryngeal posterior cordectomy is an excellent surgical option as it enables successful decannulation or avoidance of tracheostomy in patients with BVFI. The onset of stridor took years after the insult to the recurrent laryngeal nerves.

Necrotizing fasciitis of the head and neck is a rare, rapidly progressive infection involving the skin, subcutaneous tissue and fascia. We report three cases of necrotizing fasciitis that differ in their presentation and outcome. The first case involves a patient who presented with progressively enlarging anterior neck swelling that was later complicated by dehydration and reduced consciousness. The second case is a patient with neck swelling and ipsilateral otorrhea. The third case concerns a patient with a buccal ulcer complicated by ipsilateral facial swelling. All of them underwent a fasciotomy with wound debridement with the addition of a cortical mastoidectomy in the second case. Two of these patients recovered well. Unfortunately, the third case succumbed to death due to airway compromise and septicaemia. We advocate the importance of eradicating the source of infection followed by frequent, meticulous wound dressing and strict blood sugar control to obtain better outcomes in managing necrotizing fasciitis of the head and neck. However, involvement of the airway carries a grave prognosis despite aggressive treatment.

Isolated optic neuritis as a presenting sign of tuberculosis in children is uncommon. We report a case of an immunocompetent child who displayed features of bilateral optic neuritis secondary to presumed tuberculosis. It is essential to highlight this alarming presentation in a child, as the presence of tuberculosis has re-emerged as a serious public health problem especially in developing countries.

p style=text-align: justify;strongOBJECTIVE:/strong To describe our experience in performing the lower cheek flap for access to the infratemporal fossa combined with the neurosurgical approach. br /br /strongMETHODS:/strongbr /strongDesign:/strong Case report br /strongSetting:/strong Tertiary Referral Center br /strongPatients:/strong Two br /br /strongRESULTS:/strong Two unusual tumours involving the infratemporal and middle cranial fossa were excised using this combined appoach. The infratemporal fossa tumour was accessed via the lower cheek flap while the intracranial portion was resected from above via craniotomy.br /br /strongCONCLUSION:/strong The lower cheek flap in combination with the neurosurgical approach allows optimal exposure to tumours involving the infratemporal and middle cranial fossae. It has less complications and better aesthetic outcome compared to other approaches./p
Human ; Male ; Female ; Surgical Flaps ; Surgically-Created Structures ; Cheek ; Neoplasms ; Neurosurgical Procedures ; Cranial Fossa, Middle ; Infratentorial Neoplasms