1.Rare Clinical Presentation of Tuberculous Meningitis: A Case Report
Jian Liang Tan ; Sudzilla Nordin ; Alwi Muhd Besari
Malaysian Journal of Medical Sciences 2017;24(5):119-123
Introduction: Tuberculosis is the second leading cause of death under the category of
infectious diseases, after the human immunodeficiency virus (HIV). Tuberculous meningitis
(TBM) constitutes about 5% of all extrapulmonary disease worldwide. This report describes a case
of Tuberculous meningitis with rare presentation in a 28-year-old woman, who was treated based
on a collection of her social background, clinical findings and Multiplex PCR of tuberculosis.
Case presentation: A 28-year-old Malay woman with no significant medical history
presented to HUSM with one month history of on and off fever, two weeks history of generalised
limbs weakness and one week history of dysphagia. She was reported to have experienced visual
hallucination and significant weight loss. Her laboratory result is significant for leukocytosis,
elevated ESR and hypernatremia. Non-enhanced and contrast CT scan of the brain showed
severe bilateral frontal cerebral atrophy. Cerebral spinal fluid (CSF) for multiplex PCR for
Mycobacterium tuberculosis complex was positive. She was promptly started on anti-TB regime
combined with dexamethasone. Subsequent follow-up showed significant improvement.
Conclusion: This is a rare clinical manifestation of Tuberculous meningitis that
demonstrates the importance of recognising and initiating the treatment early to reduce
disabilities and improve clinical outcome.
2.Usage of Traditional and Complementary Medicine among Dengue Fever Patients in the Northeast Region of Peninsular Malaysia
Ida Seriwati Ismail ; Suhaily Mohd Hairon ; Najib Majdi Yaacob ; Alwi Muhd Besari ; Sarimah Abdullah
Malaysian Journal of Medical Sciences 2019;26(3):90-101
Background: The recent epidemic of dengue fever (DF) in Malaysia was alarming. The
treatment of DF remains supportive as there is no anti-viral agent or vaccine available as yet.
Traditional and complementary medicine (T&CM) provides an alternative option for the treatment
of DF but there is limited evidence with regard to its usage. The aim of this study was to determine
the prevalence, types and predictor factors of T&CM usage among DF patients in the northeast
region of Peninsular Malaysia.
Methodology: This was a cross-sectional study of DF patients in the northeast region of
Peninsular Malaysia who had been admitted to a tertiary centre from January 2014 until December
2015. Serologically-confirmed DF patients aged 18 years and above were randomly selected.
Phone interviews were conducted to obtain information regarding the use of T&CM during
hospitalisation. Notes were made regarding the prevalence and type of T&CM used. Binary logistic
regressions were used to identify the predictor factors of T&CM usage.
Results: A total of 241 DF patients with a mean age of 36.62 (SD = 14.62) years were
included. The estimated prevalence of T&CM usage was 84.6% (95%CI: 80.1%, 89.2%). The most
common T&CM used were crab soup (85.3%), papaya leaf extract (64.2%) and isotonic drinks
(61.8%). The significant predictors for T&CM usage were age [adjusted odds ratio (AOR) 0.97;
95%CI: 0.94, 0.99], tertiary education (AOR 3.86; 95%CI: 1.21, 12.32) and unemployment (AOR
2.55; 95%CI: 1.02, 6.42).
Conclusion: The prevalence of T&CM usage in our population is high. Age, tertiary
education and unemployment influence the use of T&CM.
3.Effectiveness Of Community-Based Health Education On Preparedness For Flood-Related Communicable Diseases In Kelantan
Wan Mohd Zahiruddin Wan Mohammad ; Wan Nor Arifin Wan Mansor ; Noor Aman A Hamid ; Surianti Sukeri ; Habsah Hasan ; Lee Yeong Yeh ; Alwi Muhd Besari ; Nani Draman ; Rosnani Zakaria ; Zeehaida Mohamed
Malaysian Journal of Public Health Medicine 2020;20(3):117-124
The flood disaster in Kelantan in 2014 had resulted in substantial health implications including increased cases of communicable diseases. There was a lack of community preparedness including customized health educations in the prevention and control of flood-related communicable diseases in the affected areas. The research was aimed to evaluate the effectiveness of community-based health education modules on flood-related communicable diseases among communities in Kelantan. Health education modules focusing on major food-related diseases were developed. A non-randomized community-controlled trial using the modules were conducted. Outcomes were assessed on knowledge, attitude and preventive practice scores to flood-related communicable diseases using a pre-validated questionnaire. Independent t test was used to compare mean scores between the intervention community (Tumpat) and the control community (Bachok) at 1-month post intervention. One-way independent ANOVA test was done to compare score differences at baseline (pre), post 1-month and post 2-month from repeated surveys among random samples within the intervention community. There were significant improvements in all knowledge components from 9.4% to 52.6% with 10% increment in attitude scores toward preventing behaviours on flood-related communicable diseases. When compared against the control community at one-month post-intervention, there were significantly higher knowledge on types of diseases, symptoms and risk factors as well as practice scores of drinking safe water and protective habits. This research demonstrated that community-based health education is effective in improving relevant knowledge, attitude and preventive practices among affected communities as part of their preparedness toward communicable diseases related to flood.