1.Surgical Reconstruction in Chronic Posterior Cruciate Ligament Injuries of the Knee
The International Medical Journal Malaysia 2015;14(2):29-34
This is a cross-sectional study to evaluate the outcome of posterior cruciate ligament
reconstruction in chronic injuries using ipsilateral Bone-patella tendon-Bone graft in nine patients, between
January 2000 and January 2003 at our institution. Methods: Eight male and one female patient; their ages
ranged from 18 to 36 years old. The surgery was done at an average of 17.2 months (range from 3 and 40
months) post injury. All patients were followed up for a minimum of two years period. The assessment was
done at twelve and twenty-four months using Lysholm knee score, IKDC knee examination evaluation score and
arthrometric measurement with KT-2000. Results: The result showed only moderate success in restoration of
ligament stability with 73.4% satisfactory objective results. However, the functional improvement and patient
satisfaction is only 55%. The incidences of degenerative changes were 89% at the time of operation. Conclusion:
Surgical reconstruction of chronic Posterior Cruciate Ligament restored satisfactory stability of the knee but the
functional outcome was only moderate.
2.Non-syndromic young girl with epibulbar choristomas: the never end battle
Che Mahiran Che DAUD ; Retnasabapathy SHAMALA ; Liza-Sharmini Ahmad TAIUDIN
International Eye Science 2008;8(7):1304-1306
Choriostomas represent the most common epibulbar lesions in the pediatric age group. Generally, they are on the surface and do not involve the deeper layer of cornea or sclera. Epibulbar dermoids frequently cause amblyopia and cosmetic problems due to high astigmatism and the presence of the tumor. Surgery is the only option for epibulbar dermoids. Lamellar or penetrating keratoplasty has been advocated depending on the site and the depth of the epibulbar dermoids. However, the outcome is not always promising due to accompanying amblyopia and high incidence of vascularization of the grafts. In the present article we report a case of epibulbar choriostomas in the right eye of a 5-year-old, non-syndromic girl who underwent right limbal dermoid excision with lamellar keratoplasty.Postoperatively she was improved cosmetically, however the astigmatism and the vision remained the same. Therefore the amblyopic therapy should be emphasized postoperatively.
3.The Brain in Pain
Asma Hayati Ahmad ; Che Badariah Abdul Aziz
Malaysian Journal of Medical Sciences 2014;21(Special Issu):46-54
Pain, while salient, is highly subjective. A sensation perceived as painful by one person may be perceived as uncomfortable, not painful or even pleasant to others. Within the same person, pain may also be modulated according to its threat value and the context in which it is presented. Imaging techniques, such as functional magnetic resonance imaging and positron emission tomography, have identified a distributed network in the brain, the pain-relevant brain regions, that encode the sensory-discriminative aspect of pain, as well as its cognitive and affective/emotional factors. Current knowledge also implicates the prefrontal cortex as the modulatory area for pain, with its subdivisions forming the cortico-cortical pathway, an alternative pain modulatory pathway distinct from the descending modulatory pathway of pain. These findings from neuroimaging in human subjects have paved the way for the molecular mechanisms of pain modulation to be explored in animal studies.
4.Neonatal Clavicle Fracture: A Review of Fourteen Cases in East Coast Peninsular Malaysia
Awang MS ; Abdul Razak AH ; Che Ahmad A
The International Medical Journal Malaysia 2017;16(2):79-83
Introduction: The purpose of this study is to identify the incidence of clavicle fractures in newborn
associated with fetal, maternal and process of deliveries in Kuantan General Hospital from June 2012 until
January 2014. This study is to determine epidemiological data of clavicle fractures, maternal and baby risk
factors associated with clavicle fractures of newborn and its’ outcome. Methods: This is a prospective
study. 13 patients were identified to fulfill the inclusion criteria of the study. The data of
sociodemographic, associated fetal and maternal risk factors and the outcomes were recorded using
proforma. The statistical data analysis was done using SPSS 12.0. Results: Out of 20,257 live births at our
centre during the study period, 13 infants were diagnosed to have clavicle fractures, giving an incidence of
0.64 per 1000 live births. There were 5 (38.5%) left, 7 (53.8%) right and one (7.7%) bilateral fracture. All
fractures located at the mid shaft of the clavicle and none have associated brachial plexus injuries. All
infants were delivered through vaginal delivery (61.5%); five through assisted delivery (instrumental); 2
(15.4%) forcep and 3 (23.1%) vacuum. Two of the babies developed shoulder dystocia. The average birth
weight was 3371 grams (SD 0.269) and mean gestational age was 38.7 weeks (SD 1.16). Five of the mothers
(38.5%) were primigravida and eight (61.5%) were multigravida in which,7 (53.8%)were healthy without
other co-morbidty, 5 (38.5%) having gestational diabetis and one (7.7%) hypertension. The average maternal
weight was 62.0 kg and height 1.58 metres with average BMI of 24.16 (3.29SD). All eventually had a
complete recovery at 6 weeks with clinical and radiological evident of fracture union. Conclusions: In
conclusion, all patients with clavicle fractures were found following vaginal delivery. There were no
associations between neonatal clavicle fractures with maternal or baby risk factors. All fractures healed
without any complications.
5.Estimation of Energy Expenditure among Malaysian Young Adults: A Pilot Study Comparing Heart Rate Monitoring (HRM) Method and Activity Diary (AD) Method
Wong Jyh Eiin ; Ahmad Munir Che Muhamed ; Poh Been Koon
Malaysian Journal of Medicine and Health Sciences 2010;6(2):93-100
Introduction: Accurate yet inexpensive methods for measuring free-living energy expenditure (EE) are much needed. The aim of this study was to determine the feasibility of heart-rate monitoring method (HRM) in measuring EE as compared to the established activity diary (AD) were used simultaneously in 34 young adults (18 females, 16 males, mean age 21.5 ± 1.5 years). Estimates of the EE from HRM were based on individually measured and published energy cost of various activities. Total daily energy expenditure (TDEE) and its components (EE during sleep, during rest and during physical activity) were compared using Student paired-t tests. Results: TDEE from HRM method averaged 8.17 ± 2.00 MJ/day compared to 8.50 ± 1.28 MJ/day from AD method. Although large intra-individual differences were found (ranging from -36.9% to 47.4%), there was no significant difference between the two methods (mean difference -3.6 ± 19.4%). The limits of agreement (mean ± 2SD) were -3.77 and 3.11 MJ/day. There were no significant differences for any of the TDEE components between the two methods, except for EE during sleep (p<0.05). Conclusion: HRM method was found to be a feasible method for assessment of EE, and was comparable to AD for group assessment of TDEE and its components
6.The Development And Feasibility Evaluation Of A Module In Improving Functioning Of Children With Autism Spectrum Disorder (Asd)
Wong Ging Ging ; Normah Che Din ; Mahadir Ahmad
Malaysian Journal of Public Health Medicine 2018;18(Special Volume (1)):146-155
Children with Autism Spectrum Disorder (ASD) have significant challenges in their daily life including social communication and interaction, emotional awareness and management, as well as behavioural issues. Many interventions are conducted based on theoretical backgrounds and past literature. There is lack of research study that interview and explore the real psychological needs of children with ASD in Malaysia. It is a significant component as their needs may vary depending on the cultural background, lifestyle, and social norms. Besides, there is a need to develop standardised intervention module to enhance intervention fidelity and replication of future study. The current study aims to scrutinise the psychological needs of children with ASD in Malaysia, develop a standardised group intervention module based on the identified needs, and then examine the feasibility of the developed module. Nine children with moderate to high functioning of ASD (7 to 12 years old) and their parents from Kuala Lumpur and Sarawak participated in the study. Result from the focus group interview suggests that children with ASD have three major psychological needs which are sociocommunication, awareness of danger, and emotions. The group intervention module was designed to fulfil these needs. The feasibility result shows that the designed module is practical, useful, and understandable for the participants. In view of this, future study may explore the effectiveness of the module. Once the module is proven effective, it can be patented and utilised to improve the psychological functioning of children with ASD in Malaysia.
Autism Spectrum Disorder
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group intervention
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feasibility
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psychological needs.
7.Anatomy of Musculoskeletal System in the Light of the Qur’an and Hadith.
Nurul Asyiqin YUSOF ; Che Anuar Che Mohamad ; Ahmad Nizam HASSAN
The International Medical Journal Malaysia 2018;17(2):97-103
The integration of human knowledge between the medical and health care sciences with revealedknowledge was established since the era of Al-Razi (Rhazes), Ibn Sina (Avicenna), Ibn Rushd (Averroes), Al-Zahrawi (Albucasis) and others. However, the glorious period of Islamic medicine gradually declined afterthe period of 'Abbasiyyah and 'Uthmaniyyah. At present, many scholars tend to separate the modernmedicine and the revealed knowledge, resulting in the disconnection between these two fields. There islittle to suggest the presence of reference collections that integrate the Qur’an and Hadith with medicine.This review aimed to fill that gap. Relevant Qur’anic verses and authentic Hadith of the Prophet Muhammad(peace be upon him; henceforth PBUH) in relation to a specific field in medicine i.e. the anatomy of humanmusculoskeletal system was extracted. The musculoskeletal system is unique in which it forms the‘backbone’ of normal human posture. The system plays a vital role in maintaining human daily activities.From this review, it is noted that many Qur’anic verses and Hadith relate to the musculoskeletal system. Afew examples include the number human joints and its relationship with the daily prayers (Salah), the dailycharitable act recommended to all Muslim, the coccyx bone that is indestructible and shall be the source forhuman resurrection during the hereafter, and others. These examples necessitate for a more in-depthanalysis to enlighten the revealed knowledge from the medical perspective.
8.Mimics and diagnostic pitfalls of intracranial lesions in conventional MRI: Clues on advanced MRI
Alan Basil Peter ; Norlisah Ramli ; Kartini Rahmat ; Faizatul Izza Rozalli ; Che Ahmad Mazlan
Neurology Asia 2015;20(2):161-165
Objective: To delineate and differentiate between late subacute hemorrhage and intracranial lipomas
in clinically available conventional and advanced MR sequences. Methods: Two cases of late subacute
hemorrhage and two cases of intracranial lipoma were reviewed with CT scans and 3.0T scanner MRI.
The sequences evaluated in MRI were T1-weighted (T1W) fast spin echo (FSE), T2-weighted (T2W)
FSE, gradient echo T2*-weighted (GRE T2*W) images, diffusion weighted (DWI), apparent diffusion
coefficient (ADC) and multivoxel spectroscopy. Results: Late subacute hemorrhage and intracranial
lipoma have similar imaging features on T1W, T2W FSE with blooming artefact at the margins on
GRE T2*W. However on GRE T2*W sequence, the central area of lipoma demonstrates low signal;
while hemorrhage demonstrates high signal. In DWI, late subacute hemorrhage shows hyperintensity;
while in lipoma there is loss of signal.
Conclusion: Awareness of the potential pitfalls in standard sequence are important, as these entities
appear to have similar T1W/ T2W characteristic with blooming artefact on T2*W. Knowing the
distinctive central signal intensity pattern on GRE T2W* and DWI is therefore essential to differentiate
between these lesions as there are differences to their clinical management.
Magnetic Resonance Imaging
9.Nutritional Status of Malaysian Primary School Children Aged 8-10 Years: Findings from the 2008 National IDD Survey
Ahmad Ali Zainuddin ; Rusidah Selamat ; Azli Baharudin ; Suhaila Abdul Ghaffar ; Norsyamline Che Abdul Rahim ; Tahir Aris
Malaysian Journal of Nutrition 2013;19(2):149-161
Introduction: Child malnutrition continues to be a major public health problem
in developing countries. This study aims to determine the current nutritional
status of Malaysian school children using the anthropometric indicators of weight
for age (WAZ), height for age (HAZ), and body mass index for age (BAZ).
Methods: A nationwide school-based survey was undertaken in all Malaysian
states and territories, which included 18,078 children aged 8-10 years attending
445 primary schools. The software WHO AnthroPlus was used to calculate zscores
for the nutritional status (WAZ, HAZ and BAZ) of the target population
relative to the World Health Organization (WHO) 2007 reference. Results: The
national prevalence of underweight among school children was 13.6% and in
rural areas, this rate was nearly double that of urban areas. The national prevalence
rate for stunting was 10.9%, double among rural school children compared to
their urban counterparts. As for thinness, the national prevalence was 6.5%.
Using the WAZ indicator, we found that the national prevalence of overweight
children was 7.6%. Additionally, we found that urban areas showed a higher
prevalence of overweight children (8.8%) than rural areas (5.9%). Conclusion:
The findings of this study indicate that Malaysian school children face the burden
of malnutrition, suffering from both undernourishment and overweight.
Malaysia must make a concerted effort to overcome the problems of malnutrition
among children.
10.Sensitivity & Specificity Of Screening Tools For Postpartum Depression: A Systematic Review
Azreena Che Abdullah ; Nor Afiah Mohd Zulkefli ; Halimatus Sakdiah Minhat ; Anisah Baharom ; Norliza Ahmad
Malaysian Journal of Public Health Medicine 2019;19(2):160-169
Postpartum depression is a depressive episode that can start at any point during the first year after childbirth. There are several tools that can be used for PPD screening. The need to define a predictive tool that is clinically useful and has acceptable sensitivity and sensitivity is important especially to be used in the primary care setting. This systematic review investigates the evidence of the sensitivity and specificity of screening tools used for PPD screening. The Standard for Reporting of Diagnostic Accuracies (STARD) guidelines were used to conduct the review as a basis for our methodology. PubMed, ScienceDirect and Springerlink databases between 2007 until 2017 were comprehensively searched EPDS and BDI instrument has sensitivity of more than 80% but findings for specificity was inconclusive. The heterogeneity across studies could be the result of methodological differences in validation of the instruments. In addition, these studies were conducted across continents and settings with different cultures, languages and resources. We have identified 5 different instruments used to screen for postpartum depression. The EPDS was the most validated instrument in the review and we found that EPDS and BDI have higher accuracy to screen postpartum depression because the sensitivity reported were more than 80%.