Diabetes mellitus is a chronic illness managed frequently by the family physician. Along with glycaemic control, consideration for other risk factor reduction for micro- and macrovascular complications of diabetes is important. With the introduction of newer pharmacological agents targeting the different pathophysiological aspects of diabetes, it is important for the family physician to make an informed decision, considering the risks and benefits, when choosing the most suitable therapeutic agent. A patient-centered approach is thus crucial in the management of diabetes. This review article focuses on the latest guidelines and new developments in diabetes management in the recent 1-2 years.

Computer Simulation ; Curriculum ; Education, Medical ; organization & administration ; trends ; Electronic Health Records ; Health Services Research ; Humans ; Interdisciplinary Communication ; Leadership ; Patient Care Team ; Public Health ; Schools, Medical ; Singapore

IMU is one of 17 institutions of higher learning conducting the Bachelor of Pharmacy course in Malaysia. The White paper on pharmacy student professionalism by the Task Force of the American Pharmaceutical Association Academy of Students of Pharmacy together with the American Association of Colleges of Pharmacy Council of Deans mentioned 10 essential traits of a professional, recommending their early development. Since the beginning of the IMU Bachelor of Pharmacy (BPharm) (Hons) course in July 2004 on Registration Day, IMU has adopted the concept of developing professionalism in the pharmacy student from the very first day of university, by having the White Coat Ceremony where the entire class takes the Pledge of Professionalism (adapted from the Task Force) against the “Code of Conduct for Pharmacists and Bodies Corporate” by the Pharmacy Board of Malaysia in the presence of the Senior Director of the Pharmaceutical Services Division of the Ministry of Health, Malaysia and the President of the Malaysian Pharmaceutical Society (MPS). Throughout their 4 years in IMU, the pharmacy students are exposed to various aspects of professionalism in different subjects in their curriculum. On 23rd April 2012, when the fifth cohort of BPharm students received their final examination results, “Pharmacy Professional Day” was launched. The graduating students took the Oath of a Pharmacist (adapted from the American Association of Colleges of Pharmacy’s Oath with slight amendment). Talks by alumni and speakers from MPS aimed to facilitate the transition of the new graduate to working life as a pharmacist.

Blood Pressure ; Cerebrovascular Circulation ; Circle of Willis ; Humans

The simple cutaneous flap and myocutaneous flap are presently being employed in skin defects since Daniel and Taylor first tried the free flap in 1973. But the simple cutaneous flap which is being employed at present has problem in the flap size, the variation and complexity of the anatomical structure and postoperative complication of the donor site. On the other hand, the myocutaneous flap has partially solved the problem of a simple cutaneous flap, but the myocutaneous flap remains inadequate when thin flap reconstruction only is required. The scapular flap was first suggested by Saijo in 1978 and Santos described the anatomical aspects of the scapular flap in 1980. Since Gilbert first clinically utilized the scapular flap, it was seen to be much more suitable for relatively thin cutaneous flaps, The authors present 10 cases of free scapular flap performed at the Department of Orthopedic Surgery of Severance Hospital during the period of one year and 2 months from April, 1983 until June, 1984. The results of the study are as follows: 1. The scapular flap was of medium size in 9 cases and large in one case. 2. The pedicles of the scapular flaps were constant in length and diameter. 3. The flap was uniform and relatively thin in thickness. 4. The reconstruction of a large soft tissue defect was possible with a combination of scapular flap and latissimus dorsi myocutaneous flap done in one stage. 5. The donor site of a scapular flap can be primarily closed. 6. The free scapular flap is an excellent choice when intermediate-sized or large-sized uninnervated flap coverage is necessary for soft tissue damage.
Clothing ; Free Tissue Flaps ; Hand ; Humans ; Myocutaneous Flap ; Orthopedics ; Postoperative Complications ; Skin ; Superficial Back Muscles ; Tissue Donors

We present the case of a 56-year old gentleman who presented with recalcitrant iliotibial band (ITB) friction syndrome which did not improve with various modalities of conservative treatment. Magnetic Resonance Imaging (MRI) of the affected knee did not show pathology typical of ITB friction syndrome. However, open exploration revealed a synovial cyst deep to the iliotibial band, abutting against the anterolateral capsule. The presence of distinctive clinical signs on physical examination should alert clinicians to consider knee synovial cyst as a differential diagnosis when dealing with recalcitrant ITB syndrome.
Iliotibial Band Syndrome

Animals ; Carotid Arteries ; physiology ; Cerebral Angiography ; Cerebral Arteries ; physiology ; Cerebrovascular Circulation ; Humans ; Rats ; Vertebral Artery ; physiology

No abstract available in English.
Clinical Study ; Dislocations

Introduction: Herpes zoster (HZ) is a common acute, cutaneous viral infection caused by reactivation of latent varicella zoster virus with devastating effects on quality of life. This study aims to describe the demographic and clinical characteristic and complications of HZ. Methodology: This was a retrospective study of 179 HZ patients from the Dermatology department of Penang Hospital between January 2010 and June 2013. Results: The 179 patients had a median age of 53 years. Chinese ethnicity was more affected. Majority of the patients came late to seek treatment with the median of disease duration of 4 days. The commonest presenting complaint was pain (98.9%), followed by itching (25.7%) and fever (9.5%). Single dermatome involvement was seen in 90.5% of the patients, of which the thoracic dermatome (54.9%) being the commonest. The incidence of complications such as secondary bacterial infection, post-herpertic neuralgia, eye complication(s) and scar were 36.3%, 4.5%, 5.6% and 2.8% respectively. The complications were not statistically different between the younger and the older patient. However, it was more common among male patients. Conclusion: Patients with HZ in Penang presented late and tend to have complications. Hence, public education and vaccination should be recommended.

Objective: This case report highlights folie a duex of a caregiver that complicate the management of a case of childhood onset schizophrenia. Methods: We report a case of a young Malay girl with symptoms of schizophrenia and her caregiver who share her delusion. Result: Folie a duex in the caregiver caused difficulty in the initiation and maintenance of treatment of a child with schizophrenia. Conclusion: Treating children with schizophrenia is not easy and could be complicated by the folie a duex in caregiver. Although Child Act 2001 can be applied in order to deliver appropriate treatment to this group of patients, one must be cautious about the implication in therapeutic alliance.