1.Transorbital Sonographic Measurement of Normal Optic Sheath Nerve Diameter in Nigerian Adult Population
Malaysian Journal of Medical Sciences 2014;21(5):24-29
Background: The optic nerve covering is elastic enough to allow a detectable enlargement in response to changes in intracranial pressure. The objective of the present study was to determine the optic nerve sheath diameter (ONSD) in normal Nigerian adults.
Methods: This study was conducted on 400 healthy adults. The ONSD was measured at 3 mm posterior to the globe using a 7.5 MHz linear transducer.
Results: The study population consisted of 192 males and 208 females with mean age of 36.94 years (SD 16.63). The range of values for ONSD was 3.36 to 5.1 mm. The median right ONSD was 4.110 with a range of 3.36–4.86 mm (mean: 4.18 mm (SD 0.49)), while the median left ONSD was 4.35 mm with a range of 3.77−5.10 mm (mean: 4.17 + mm (SD 0.44)). No statistically significant variation in ONSD was found between the right and left sides (P = 0.12) and also between male and female participants (P = 0.296 and 0.745 for the respective right and left ONSD).
Conclusions: The normal reference values of ONSD measurements in adults were obtained. It showed no significant correlation with side (right and left), age, and sex. Furthermore, there is no significant correlation of ONSD with the body height and weight.
2.The Roles of NGOs in Promoting Mental Health for the PLHIV Community in Malaysia
Malaysian Journal of Public Health Medicine 2012;12(Supplement 1):21-21
The first support for HIV/AIDS intervention for the PLHIV community in Malaysia was initiated by non-governmental organisations (NGOs) particularly to sustain positive living and to reduce the mental health and psychosocial impact of HIV/AIDS. While there may be several studies pertaining to mental health and HIV/AIDS carried out in Malaysia, there are limited studies on the role of the Malaysian HIV/AIDS NGOs in promoting mental health. The mental health conditions of the PLHIV community cannot be easily summarised as the side effects of the infectivity as the contributory factors affecting the PLHIV‟s mental health are varied according to their needs and groups of community particularly due to the stigmatisation of the pandemic in Malaysia.
The HIV/AIDS NGOs which initially started as support groups are now challenged with more intensified and wide-ranging task particularly with the introduction of the Malaysian National Strategic Plan in 2006. However, the capability of the small number of HIV/AIDS NGOs to cater for the needs of over 90,000 cases of HIV/AIDS in Malaysia remains unrequited. These NGOs have played a crucial role in providing diverse services and have become the core intermediaries to the various groups of stakeholders. Yet, there is still a serious need to strengthen their effort in promoting mental health as a mission for the PLHIV community‟s well-being. Promoting mental health demands specific skills to enable the PLHIVs to accept cope and manage their condition: an expertise which HIV/AIDS NGO members need continuous training and guidance. With a majority of volunteers‟ involvement and limited professional workers, the NGOs face a great challenge in realising its aims of promoting mental health among the PLHIV community.
This paper looks into some of the ways for mental health programme inclusion in HIV/AIDS NGOs and concludes with some future directions in identifying a collaborative agenda with various stakeholders as well as policy adjustment that will enable to sustain mental health promotion for the PLHIV community in Malaysia.
3.The Effects of Aquilaria malaccensis Leaves Aqueous Extract on Sperm of Sprague Dawley Rats towards Early Embryogenesis
The International Medical Journal Malaysia 2019;18(2):59-68
Introduction: Oxidative stress induced by excessive and unopposed levels of reactive oxygen species in
male reproductive system results in impaired sperm quality, fertilization capacity and poor embryo
development. Our goal is to assess the potential effects of Aquilaria malaccensis (AM) leaves, a plant with
strong antioxidant property on early embryo development in vitro and embryo quality following fertilization
with cyclophosphamide (CP) exposed rat sperm. Materials and Methods: Twenty four male Sprague Dawley
rats were allocated into eight groups of three rats (n = 3): control, CP only (200 mg/kg), AM only (100 mg/kg,
300 mg/kg and 500 mg/kg) and CP + AM (100 mg/kg, 300 mg/kg and 500 mg/kg). Animals were sacrificed
after 63 days of treatment and sperm from caudal epididymis were taken for in vitro fertilization (IVF) with
oocytes from untreated female. Fertilization, embryo division and embryo morphology were examined at 8
and 48 hours post insemination and compared between groups. Statistical evaluations were performed using
Chi-Square test and Fisher’s exact test and p-value<0.05 was considered significant. Results: Administration
of AM leave extract at 100 mg/kg/day to normal rats and CP-exposed rats has significantly increased (p<0.05)
the fertilization rate, early cleavage rate and embryo quality when compared to CP only treated group.
However, other groups showed no significant differences. Conclusion: Overall, the present results indicate
the potential of AM leave extract supplementation to improve the fertility and early embryo development in
male rat exposed to CP by inhibiting the oxidative processes and scavenging free radicals.
4.International Comparisons of Economic Burden of EndStage Renal Disease to the National Healthcare Systems
The International Medical Journal Malaysia 2019;18(3):188-196
The global prevalence of chronic kidney disease (CKD) is between 11 to 13%. Renal replacement therapies
(RRT) – which include dialysis and renal transplantation – consume a significant portion of a country’s health
resources even though only 0.1% of all CKD patients are at stage 5, also known as end-stage renal disease
(ESRD). The aim of this review was to compare the magnitude of the economic burden of ESRD on national
healthcare systems of selected countries with high prevalence of ESRD including Malaysia. The quantity of
interest in this review were total ESRD expenditures and its proportions to the national health systems'
expenditure. It was identified that total ESRD expenditure contributes between 0.91% to 7.1% of national
health system expenditure in countries selected for this review. In Malaysia, the public sector - through its
various agencies at the federal and state levels, accounted for almost 70% of dialysis funding; the remaining
30% came from the private sector and out-of-pocket payments. The ESRD expenditures in Malaysia
constitutes 4.2% of total health expenditure by the public sector, relatively high compared to other
countries. This review will summarise findings of the currently available economic evaluations of RRT in
Malaysia. Based on available evidence, estimated weighted cost of treating ESRD patient in Malaysia is
MYR39,346 per patient per year (USD26,648, PPP 2016).
5.OBSTRUCTIVE SLEEP APNOEA HYPOPNEA SYNDROME – AN OVERVIEW
Malaysian Family Physician 2011;6(1):2-6
Obstructive sleep apnoea hypopnoea syndrome (OSAHS) is a common cause of breathing-related sleep disorder, causing
excessive daytime sleepiness. Common clinical features of OSAHS include snoring, fragmented sleep, daytime somnolence
and fatigue. This article aims to provide a comprehensive review of the condition, including its management.
6.Determination of Daidzein and Genistein Contents in Mangifera Fruit
Malaysian Journal of Nutrition 2008;14(2):189-198
The aim of this study was to determine the daidzein and genistein contents in Mangifera fruits. Three Mangifera species namely ‘bacang’ (Mangifera foetida), ‘kuini’
(M. odorata) and ‘bambangan’ (M. pajang) each from two different locations were selected. The extraction of isoflavones was carried out at 80oC for 30, 60 and 90
min. HPLC method was performed with a flow rate of 1.00 ml/min using three different separation columns to determine isoflavone contents. The Zorbax
Eclipse RP C18 reverse-phase column was found to give the best resolution for isoflavone separation in Mangifera fruits. Moreover, extraction time of 90 min
was found to increase the isoflavone aglycone contents. At optimised condition, ‘kuini’ had relatively high daidzein (9.4-10.5 mg/100 g) and genistein (1.6-1.7
mg/100 g) contents. Daidzein content of ‘bambangan’ (8.3-8.7 mg/100 g) was higher than ‘bacang’, but the genistein content of ‘bambangan’ (0.4-0.6 mg/100
g) was similar to that of ‘bacang’ (0.4-0.8 mg/100 g). However, there was a variation in daidzein and genistein contents in Mangifera fruits between two
geographical locations.
7.Factors Associated with the Recurrence of Complicated Diverticular Disease
Azlanudin Azman ; Ismail Sagap
Journal of Surgical Academia 2011;1(1):6-14
Colonic diverticula is observed in over 60% of the western population aged over 80 where up to 30% will eventually be symptomatic and may develop complications. The natural history and etiology of colonic diverticula have been well described. However, predictive indicators of complicated diverticular disease are not known thus preventing the prophylactic treatment of this subset of patients,. The aim of this study was to observe patients with complicated diverticular disease in order to identify common factors associated with recurrent complications. All hospital admissions from January 2005 to December 2008 for complications of diverticular disease were recruited. Using logistic regression, demographic data and factors such as clinical presentation, nature of complication, lifestyle, concomitant medical illness and medications that may be associated with recurrent episodes of complications were analyzed. A total of 121 patients were diagnosed with complicated diverticular disease during the study period with 24 patients having recurrent complications. Logistic regression analysis performed after controlling for confounders found active smoking (p=0.006) and alcohol consumption (p=0.036) along with underlying diabetes (p=0.031) and dyslipidemia (p=0.039) significantly associated with an increased risk of recurrent complications. We therefore concluded that smoking, alcohol consumption, diabetes mellitus and dyslipidemia are associated with recurrent complicated colonic diverticular disease. As these are modifiable risk factors, they should be sought for during the presentation of the first attack. Aggressive control of these factors will help in reducing the risk of recurrent complications.
8.Malignant melanoma of the ear canal presenting as wart
Rafiqahmed Vasiwala ; Ismail Burud
International e-Journal of Science, Medicine and Education 2016;10(1):47-48
Abstract: Malignant melanoma is a rare malignancy of
the external auditory canal. The vast majority of them
occur in the areas of the body that are exposed to the sun.
Early histological examination may possibly favor better
prognosis. We report a case of a 38-year-old female who
presented with a small mass in right ear canal, earache
and minimum discharge since 4 months. Initially
scraping was done in the ENT clinic. Subsequently she
had a wide excision done by the end aural approach at
a different hospital. A year later the patient presented
with a swelling involving the ear canal which extended
to the helix and supratemporal region with the histology
report as malignant melanoma. A literature review of
the disease, radiological findings, immunohistochemical
features and treatment options are discussed.
Melanoma
9.HIV Associated Opportunistic Pneumonias
The Medical Journal of Malaysia 2011;66(1):76-82
Opportunistic pneumonias are major causes of morbidity
and mortality in HIV infected individuals. The majority of
new HIV infections in Malaysia are adults aged 20 to 39
years old and many are unaware of their HIV status until
they present with an opportunistic infection. HIV associated opportunistic pneumonias can progress rapidly without appropriate therapy. Therefore a proper diagnostic
evaluation is vital and prompt empiric treatment of the
suspected diagnosis should be commenced while waiting
for the results of the diagnostic studies. Tuberculosis,
Pneumocystis pneumonia (PCP) and recurrent bacterial
pneumonias are common causes of AIDS-defining diseases
and are discussed in this article.
10.Effectiveness of Team-Based Learning in teaching Medical Genetics to Medical Undergraduates
Malaysian Journal of Medical Sciences 2016;23(2):73-77
This study explores the experience of both learners and a teacher during a team-based learning (TBL) session. TBL involves active learning that allows medical students to utilise their visual, auditory, writing and kinetic learning styles in order to strengthen their knowledge and retain it for longer, which is important with regard to applying basic sciences in clinical settings. This pilot study explored the effectiveness of TBL in learning medical genetics, and its potential to replace conventional lectures. First-year medical students (n = 194) studying at Universiti Kebangsaan, Malaysia, during 2014/2015 were selected to participate in this study. The topic of ‘Mutation and Mutation Analysis’ was selected, and the principles of TBL were adhered to during the study. It was found that the students' performance in a group readiness test was better than in individual readiness tests. The effectiveness of TBL was further shown in the examination, during which the marks obtained were tremendously improved. Collective commentaries from both the learners and the teacher recommended TBL as another useful tool in learning medical genetics. Implementation strategies should be advanced for the benefit of future learners and teachers.