Introduction: Assessing radiation exposure is a vital step in determining the potential health risks associated with radiation and identifying the necessity for protective measures. The study assesses the occupational radiation dose encountered by undergraduate students specializing in diagnostic imaging and radiotherapy (DIR) during their clinical training in the radiology department. Materials and methods: An analysis was conducted to compare individual exposure doses with the dose limits established by the International Commission on Radiological Protection (ICRP), concurrently assessing the variations in mean effective doses among distinct student cohorts. Optically stimulated luminescence dosimeters (OSLD) were employed to monitor 143 students across five cohorts from 2017 to 2022. The electronic Secondary Standard Dosimetry Laboratory (e-SSDL) information security management system tracked the deep (Hp(10)) and shallow (Hp(0.07)) dose equivalents of DIR students. Results: The mean values for accumulated Hp(10) and Hp(0.07) were found to be 0.51 and 0.50 mSv, respectively, averaged over 800 hours of clinical training. The highest recorded exposure was 1.30 mSv, signifying that the radiation exposure experienced by DIR students was well below the threshold. The mean annual effective radiation dose per student amounted to 0.17 mSv. Small but significant difference (p < 0.001) in the radiation exposure between five cohorts was observed with increments over a 5-year period. Conclusion: The students' radiation dose was notably below the ICRP dose limit of 6 mSv/ year designated for trainees. These results indicate the efficacy of the existing radiation protection measures during clinical training, reducing the likelihood of overexposure

Introduction: The high prevalence of obesity in adults with type 2 diabetes (T2D) has become a major public health burden. This study explored the readiness to change for weight loss in adults with T2D with obesity, examining its association with sociodemographics, health status, dietary self-efficacy, and social support for physical activity and diet. Materials and methods: This cross-sectional study involved 381 adults with T2D with obesity in Kemaman, Terengganu. The stages of change were dichotomized into ‘not ready’ and ‘ready'. The self-efficacy was measured using the Weight Efficacy Lifestyle Questionnaire (WEL-Q), and the social support for physical activity was measured using the Social Support Scale for Diet and Physical Activity Questionnaire. Results: More than half of the participants (50.4%) were still not ready to change for weight loss. Multiple logistic regression showed patients who are not married (p = 0.011), obtained tertiary education (p = 0.018), have a higher score in self-efficacy for social pressure (p < 0.001) and received better family support for physical activity (p = 0.001) tend to be ready for weight loss efforts. Conclusion: This study identified marital status, academic background, self-efficacy for social pressure, and family support for physical activity as the determinants in influencing the readiness to change for weight loss in adults with T2D with obesity. The results highlight the importance of targeting the large proportion of adults with T2D who are not ready to lose weight, providing valuable insights to improve obesity interventions within this population.

“Rusty pipe syndrome” is a condition that needs to be considered in a primiparous woman who presents with bilateral bloody nipple discharge in the early postpartum period. Its prevalence is low and can occur due to physiological condition that arises primarily in primiparous women with increased alveolar and ductal vascularization associated with the onset of lactation. Here, we report a case of a 29-year-old primigravida who presented with bilateral painless bloody nipple discharge after delivery. Her breast examination showed no signs of infection or structural changes, and breast ultrasound did not reveal any significant observations except for a bilateral simple breast cyst. Six days after the onset of lactation, the bloody nipple discharge ceased and lactation continued on demand.

Background: Cesarean delivery is linked with lower rates of early breastfeeding initiation. This study aimed to determine the prevalence and associated factors of early initiation of breastfeeding among women admitted for elective cesarean delivery in Kelantan, Malaysia. Methods: A total of 171 women admitted for elective cesarean delivery at two tertiary hospitals in Kelantan, Malaysia, participated in this study. On day two after cesarean delivery, face-to-face interviews were conducted with the mothers to get information on feeding practice. Descriptive statistics, including simple and multiple logistic regressions, were used for data analysis. Results: Seventy-three percent of mothers initiated breastfeeding within 1 hour of birth. Approximately 15.8% and 10.5% of mothers initiated breastfeeding within 24 hours and ≥24 hours, respectively. Skin-to-skin contact between mothers and their infants occurred in 77.8% of cases after cesarean delivery. Breastfeeding initiation was significantly associated with skin-to-skin contact (odds ratio [OR], 14.42; 95% confidence interval [CI], 3.58–58.06), mothers who exclusively breastfed during hospitalization (OR, 36.37; 95% CI, 5.60–236.24), and infants who were not sleepy during attempts at breastfeeding (OR, 5.17; 95% CI, 1.32–20.21). Conclusion Based on our results, it is possible to increase the proportion of mothers initiating breastfeeding within 1 hour among women who undergo elective cesarean delivery. Therefore, it is important that health practitioners educate women beginning in the antenatal period who plan to undergo cesarean delivery by emphasizing the importance of early initiation of breastfeeding.

“Rusty pipe syndrome” is a condition that needs to be considered in a primiparous woman who presents with bilateral bloody nipple discharge in the early postpartum period. Its prevalence is low and can occur due to physiological condition that arises primarily in primiparous women with increased alveolar and ductal vascularization associated with the onset of lactation. Here, we report a case of a 29-year-old primigravida who presented with bilateral painless bloody nipple discharge after delivery. Her breast examination showed no signs of infection or structural changes, and breast ultrasound did not reveal any significant observations except for a bilateral simple breast cyst. Six days after the onset of lactation, the bloody nipple discharge ceased and lactation continued on demand.

Background: Cesarean delivery is linked with lower rates of early breastfeeding initiation. This study aimed to determine the prevalence and associated factors of early initiation of breastfeeding among women admitted for elective cesarean delivery in Kelantan, Malaysia. Methods: A total of 171 women admitted for elective cesarean delivery at two tertiary hospitals in Kelantan, Malaysia, participated in this study. On day two after cesarean delivery, face-to-face interviews were conducted with the mothers to get information on feeding practice. Descriptive statistics, including simple and multiple logistic regressions, were used for data analysis. Results: Seventy-three percent of mothers initiated breastfeeding within 1 hour of birth. Approximately 15.8% and 10.5% of mothers initiated breastfeeding within 24 hours and ≥24 hours, respectively. Skin-to-skin contact between mothers and their infants occurred in 77.8% of cases after cesarean delivery. Breastfeeding initiation was significantly associated with skin-to-skin contact (odds ratio [OR], 14.42; 95% confidence interval [CI], 3.58–58.06), mothers who exclusively breastfed during hospitalization (OR, 36.37; 95% CI, 5.60–236.24), and infants who were not sleepy during attempts at breastfeeding (OR, 5.17; 95% CI, 1.32–20.21). Conclusion Based on our results, it is possible to increase the proportion of mothers initiating breastfeeding within 1 hour among women who undergo elective cesarean delivery. Therefore, it is important that health practitioners educate women beginning in the antenatal period who plan to undergo cesarean delivery by emphasizing the importance of early initiation of breastfeeding.

Introduction: The intention of a woman to breastfeed is one of the predictors of breastfeeding initiation and duration. Objective: The aim of this study is to determine exclusive breastfeeding (EBF) intention among women admitted for elective cesarean delivery in Kelantan and their postnatal EBF practices. Methods: A total of 171 women, mostly Malays, admitted for elective cesarean delivery at two tertiary hospitals in Kelantan participated in this prospective cohort study. The Malay version of Infant Feeding Intentions (IFI) scale was administered one day before the surgery to determine the EBF intention, and follow-up phone calls were made at one month, three months, and six months after delivery to determine the actual EBF practices. Results: Before delivery, 86.5%, 82.5% and 77.2% of the women somewhat agreed or very much agreed to practice EBF for 1, 3 and 6 months respectively and the actual EBF practices after delivery were 80.1%, 59.6%, and 42.1%. Women who had the intention to practice EBF for 6 months were about 2 times more likely to practice EBF for 6 months than those who did not have the intention to EBF (OR 2.19, 95% CI: 1.01-4.76). No significant association was found between EBF intention and the actual EBF practices at 1 month and 3 months postnatal. Conclusions: The number of women who practiced EBF after cesarean delivery was lower than those who had the intention prior to delivery. The number further declined as the child grew older. Prenatal EBF intention was associated with actual postnatal EBF practices at 6 months.

Background: Direct oral anticoagulants (DOACs) especially dabigatran, have gain popularity for their efficacy, fixed dosing and favourable safety profile. A dabigatran prescribing checklist has been prepared by the Ministry of Health, Malaysia (MOH) to ensure rational and safe prescribing of dabigatran. This study therefore aimed to audit the utilization and documentation of this checklist and use of dabigatran in the government healthcare facilities. Methods: This is a nationwide retrospective audit on the documentation of Dabigatran Prescribing and Dispensing Checklist for a period of two years from January 2013 till December 2014. Data from these Dabigatran Checklists (indication, dose, duration, renal function and adverse drug reactions encountered) were extracted by the pharmacist at MOH healthcare facilities. Results: A total of 52 out of 56 (92.9%) of MOH facilities complied to usage of checklist at their centres involving a total of 582 patients of which 569 (97.7%) patients were initiated on dabigatran for the approved indications. The recommended dose of dabigatran was used correctly in 501 (99.6%) of patients. Reason for switching to DOACs use was only documented in 76.7% (131/171) of patients. The most common reason for switching from warfarin was poor INR control (n=39), history of bleeding/overwarfarinisation (n=22) and unable to attend regular INR clinic (n=21). There were 75 cases of adverse events reported. The most common adverse event reported were abdominal discomfort (n=10) followed by gum bleeding (n=9) and dizziness (n=5). Conclusions: Compliance to the dabigatran check list was high with 70% of patients prescribed the appropriate dosing.

BACKGROUND: Breastmilk is the best nourishment for an infant for the first 6 months of life. Health professionals like medical doctors and dentists can help promote and support exclusive breastfeeding. We aimed to assess knowledge, attitudes, exposure, and future intentions toward exclusive breastfeeding among final year medical and dental students at Universiti Sains Malaysia, Kelantan, Malaysia. METHODS: A total of 162 students participated in this cross-sectional study that was conducted between May and September of 2015. Self-administered questionnaires were used to collect the variables of interest. RESULTS: Most students knew exclusive breastfeeding is recommended for the first 6 months of life (98.1%). However, some students incorrectly thought formula milk can be given if the infant appears hungry after having been breastfed (61.7%). Additionally, some incorrectly thought expressed breastmilk can be warmed on direct heat (47.5%) and left-over expressed milk can be re-stored (60.5%). Most students agreed that exclusive breastfeeding is easier to practice than formula feeding and that it is the best choice for working mothers. Most students (93.2%) intend to breastfeed their children, and this intention was significantly associated with their experience being breastfed as infants and attitudes toward exclusive breastfeeding. CONCLUSION: Generally, final year medical and dental students have favorable attitudes and future intentions toward exclusive breastfeeding, although some of them lacked knowledge about certain important aspects of the practice. Past experience of being exclusively breastfed and a more positive attitude toward the practice were associated with their future intentions to practice exclusive breastfeeding.
Breast Feeding ; Child ; Cross-Sectional Studies ; Dentists ; Health Occupations ; Hot Temperature ; Humans ; Infant ; Intention ; Malaysia ; Milk ; Mothers ; Students, Dental

Fixed cutaneous sporotrichosis is a differential diagnosis that can be considered in diabetic patients who present with a poorly healing ulcer. Although its prevalence is low, it can occur in patients with immunocompromised status. Here we report a case of a 70-year-old man with diabetes mellitus who presented with a 1-month history of an unhealed ulcer over the tip of his left middle finger. He experienced a cat bite over his left middle finger 1 month prior to the appearance of the lesion. A skin biopsy revealed the presence of Sporothrix schenckii. Oral itraconazole 200 mg twice daily was started empirically and the patient showed marked improvement in the skin lesion after 2 months of therapy.
Aged* ; Animals ; Biopsy ; Cats ; Diabetes Mellitus ; Diagnosis, Differential ; Fingers* ; Humans ; Itraconazole ; Prevalence ; Skin ; Sporothrix ; Sporotrichosis ; Ulcer*