Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2425
Wong Khung Ying, Mizanur Rahman, Andrew Kiyu
INTRODUCTION: During adolescence, significant physical, emotional, and social changes influence growth. This phase exposes adolescents to risky situations. Understanding adolescent risk-taking is crucial. This study aims to determine the extent of risk-taking behaviour among Malaysian adolescents and identify associated factors. MATERIALS AND METHODS: In a community-based study, we surveyed 1,344 Malaysian adolescents aged 10-19 across 22 districts in Sarawak using multi-stage cluster sampling and face-to-face interviews. Data analysis was performed with IBM SPSS v28.0. RESULTS: Analysis found that 43.7% of adolescents engaged in risky behaviours, with a higher incidence in males (50.1%) compared to females (37.4%). Multinomial logistic regression analysis identified for low-medium risk behaviours were being aged 15-19 (AOR=1.52; CI:1.14-2.02), infrequent religious practice (AOR=1.70; CI:1.01-2.84), poor parent-child relations (AOR=2.02; CI:1.07-3.83) and having a history of mental abuse (AOR=3.02; CI:1.37-6.62). However, a larger family size appeared to be a protective factor (AOR=0.39; CI: 0.18-0.89). High-risk behaviours were more prevalent in older (AOR=2.65; CI:1.91, 3.68) male adolescents (AOR=2.75; CI: 2.02, 3.75) and low religious value (AOR=3.55; CI: 1.32-9.52), larger families (AOR=2.03; CI: 1.38-3.00), lower school grades (AOR=1.74; CI: 1.27-2.38), physical ailments (AOR=2.63; CI:1.60-4.32), and a history of mental abuse (AOR=3.85; CI:1.78-8.31). CONCLUSION: Adolescents aged 15-19 with weak family ties, low religious engagement, and a history of mental abuse tend to exhibit low to medium risk behaviours. Older male adolescents with health issues are more likely to engage in high-risk behaviours, whereas those from larger families show fewer such tendencies. These insights are crucial for shaping targeted interventions and policies.
{"title":"Prevalence and Factors Determining Adolescents Risk Taking Behaviours in Sarawak, Malaysia","authors":"Wong Khung Ying, Mizanur Rahman, Andrew Kiyu","doi":"10.31436/imjm.v23i01.2425","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2425","url":null,"abstract":"INTRODUCTION: During adolescence, significant physical, emotional, and social changes influence growth. This phase exposes adolescents to risky situations. Understanding adolescent risk-taking is crucial. This study aims to determine the extent of risk-taking behaviour among Malaysian adolescents and identify associated factors. MATERIALS AND METHODS: In a community-based study, we surveyed 1,344 Malaysian adolescents aged 10-19 across 22 districts in Sarawak using multi-stage cluster sampling and face-to-face interviews. Data analysis was performed with IBM SPSS v28.0. RESULTS: Analysis found that 43.7% of adolescents engaged in risky behaviours, with a higher incidence in males (50.1%) compared to females (37.4%). Multinomial logistic regression analysis identified for low-medium risk behaviours were being aged 15-19 (AOR=1.52; CI:1.14-2.02), infrequent religious practice (AOR=1.70; CI:1.01-2.84), poor parent-child relations (AOR=2.02; CI:1.07-3.83) and having a history of mental abuse (AOR=3.02; CI:1.37-6.62). However, a larger family size appeared to be a protective factor (AOR=0.39; CI: 0.18-0.89). High-risk behaviours were more prevalent in older (AOR=2.65; CI:1.91, 3.68) male adolescents (AOR=2.75; CI: 2.02, 3.75) and low religious value (AOR=3.55; CI: 1.32-9.52), larger families (AOR=2.03; CI: 1.38-3.00), lower school grades (AOR=1.74; CI: 1.27-2.38), physical ailments (AOR=2.63; CI:1.60-4.32), and a history of mental abuse (AOR=3.85; CI:1.78-8.31). CONCLUSION: Adolescents aged 15-19 with weak family ties, low religious engagement, and a history of mental abuse tend to exhibit low to medium risk behaviours. Older male adolescents with health issues are more likely to engage in high-risk behaviours, whereas those from larger families show fewer such tendencies. These insights are crucial for shaping targeted interventions and policies.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2249
Maizatul Akma Ibrahim, Nor Hazwani Mohd Hasali, N. Zakaria, F. A. Abdul Majid, Fatimah Hashim, Syed Ahmad Tajudin Tuan Johari
Since the past decades, the prevalence of microbial keratitis (MK) has risen notably among contact lens (CL) wearers. The main contributor to this infection is the use of an inefficient CL disinfecting solution. This paper highlights a systematic review of articles from journals on the multipurpose solution (MPS) of CL ingredients available currently in the market. This review emphasizes the compositions of MPS to evaluate their effectiveness and risks to lens wearers. A search for original articles published was conducted through Scopus, PubMed, and Google Scholar databases, focusing on the keywords contact lens ingredients and preservatives, MPS, polyquaternium, biguanides, and MK. A thorough review was conducted to extract the data on the subjects from the generated searches.The review revealed that hydrogen peroxide (H2O2), polyhexamethylene biguanide (PHMB), povidone-iodine (P-I), and polyquaternium-1 (PQ-1) are the preferred MPS formulations in the current industry of CLs. These chemical ingredients are effective against causative agents of keratitis for faster disinfection and lower risks of microbial infections in CL users. Thus, proper hygienic practices must follow the guidance from the respective product manufacturers to prevent harmful risks of ocular diseases.
过去几十年来，隐形眼镜（CL）佩戴者中微生物性角膜炎（MK）的发病率显著上升。造成这种感染的主要原因是使用了低效的隐形眼镜消毒液。本文重点对目前市场上销售的隐形眼镜多用途消毒液（MPS）成分的期刊文章进行了系统综述。该综述强调了多用途溶液的成分，以评估其对镜片佩戴者的有效性和风险。通过 Scopus、PubMed 和 Google Scholar 数据库，以隐形眼镜成分和防腐剂、MPS、聚季铵盐、双胍类和 MK 为关键词，对发表的原创文章进行了搜索。综述显示，过氧化氢（H2O2）、聚六亚甲基双胍（PHMB）、聚维酮碘（P-I）和聚季铵盐-1（PQ-1）是目前隐形眼镜行业首选的 MPS 配方。这些化学成分能有效抑制角膜炎的致病因子，加快消毒速度，降低角膜接触者受微生物感染的风险。因此，正确的卫生习惯必须遵循相关产品制造商的指导，以防止眼部疾病的有害风险。
{"title":"A Systematic Review on Multiple Purpose Solution of Contact Lens Ingredients: Benefits and Risks","authors":"Maizatul Akma Ibrahim, Nor Hazwani Mohd Hasali, N. Zakaria, F. A. Abdul Majid, Fatimah Hashim, Syed Ahmad Tajudin Tuan Johari","doi":"10.31436/imjm.v23i01.2249","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2249","url":null,"abstract":"Since the past decades, the prevalence of microbial keratitis (MK) has risen notably among contact lens (CL) wearers. The main contributor to this infection is the use of an inefficient CL disinfecting solution. This paper highlights a systematic review of articles from journals on the multipurpose solution (MPS) of CL ingredients available currently in the market. This review emphasizes the compositions of MPS to evaluate their effectiveness and risks to lens wearers. A search for original articles published was conducted through Scopus, PubMed, and Google Scholar databases, focusing on the keywords contact lens ingredients and preservatives, MPS, polyquaternium, biguanides, and MK. A thorough review was conducted to extract the data on the subjects from the generated searches.The review revealed that hydrogen peroxide (H2O2), polyhexamethylene biguanide (PHMB), povidone-iodine (P-I), and polyquaternium-1 (PQ-1) are the preferred MPS formulations in the current industry of CLs. These chemical ingredients are effective against causative agents of keratitis for faster disinfection and lower risks of microbial infections in CL users. Thus, proper hygienic practices must follow the guidance from the respective product manufacturers to prevent harmful risks of ocular diseases.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139126118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2372
Kumar Hari Rajah, Somanathan C. Menon
The management of complicated appendicitis has undergone a transformative shift in recent years, moving away from the traditional conservative approach followed by interval appendectomy towards early appendectomy. This review article explores the current landscape of complicated appendicitis management, investigating the roles of conservative treatment, interval appendectomy, and early appendectomy. With no definitive consensus in place, the choice of treatment largely depends on the individual surgeon. The emergence of laparoscopic appendectomy has played a pivotal role in this paradigm shift, further highlighting the need to reevaluate and understand the various management options available. A total of 43 articles, 24 from Asia, 12 from Europe, 5 from the USA and 1 from Africa were retrieved from PubMed, Google scholar and the Cochrane database of clinical reviews. This review synthesizes existing literature, shedding light on the advantages and considerations associated with each approach.
{"title":"Complicated Appendicitis-Shifting towards Early Appendectomy-A Comprehensive Review","authors":"Kumar Hari Rajah, Somanathan C. Menon","doi":"10.31436/imjm.v23i01.2372","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2372","url":null,"abstract":"The management of complicated appendicitis has undergone a transformative shift in recent years, moving away from the traditional conservative approach followed by interval appendectomy towards early appendectomy. This review article explores the current landscape of complicated appendicitis management, investigating the roles of conservative treatment, interval appendectomy, and early appendectomy. With no definitive consensus in place, the choice of treatment largely depends on the individual surgeon. The emergence of laparoscopic appendectomy has played a pivotal role in this paradigm shift, further highlighting the need to reevaluate and understand the various management options available. A total of 43 articles, 24 from Asia, 12 from Europe, 5 from the USA and 1 from Africa were retrieved from PubMed, Google scholar and the Cochrane database of clinical reviews. This review synthesizes existing literature, shedding light on the advantages and considerations associated with each approach.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139126822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2237
Maisarah Abdul Mutalib, Noor Atiqah Aizan Abdul Kadir, Aida Soraya Shamsuddin, K. Khalid
Assessing nutritional status in older people is essential to screen for malnutrition and identify the individuals requiring nutritional intervention for a better quality of life and longer life expectancy. This review aimed to investigate malnutrition and the role of nutritional assessment tools among older people in Malaysia. We systematically reviewed the publications from 2000 to 2019 using PubMed/MEDLINE and Scopus databases, recovering 15 original articles published until January 2022. This systematic review was conducted from May to September 2022. Two reviewers were involved in the process of the selection of articles and data extraction. Only research papers on malnutrition among older people in institutionalized settings in Malaysia were included. Four articles related to malnutrition in older people in old folk homes in Malaysia were included in this review. The tools with the most significant evidence were Mini Nutritional Assessment (MNA) and Nutritional Health Checklist (NHC) in residential care for the elderly. It was found that the incidence of malnutrition among the elderly in old folk homes in Malaysia ranged from 12.3% to 17.4%. Meanwhile, 40.4% to 57.7% of the population are documented to be at risk of malnutrition. NA and DETERMINE NHC were found to be most suitable for use in residential care due to their high sensitivity and specificity. A subsequent study is proposed to build and implement a scoring system to rate screening tools based on the validity, suitability, and practicability of the tools to help with malnutrition screening research and clinical practice in Malaysia and internationally.
{"title":"Assessment Tools for Detecting Malnutrition among Elderly in Shelter Homes: A Systematic Review","authors":"Maisarah Abdul Mutalib, Noor Atiqah Aizan Abdul Kadir, Aida Soraya Shamsuddin, K. Khalid","doi":"10.31436/imjm.v23i01.2237","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2237","url":null,"abstract":"Assessing nutritional status in older people is essential to screen for malnutrition and identify the individuals requiring nutritional intervention for a better quality of life and longer life expectancy. This review aimed to investigate malnutrition and the role of nutritional assessment tools among older people in Malaysia. We systematically reviewed the publications from 2000 to 2019 using PubMed/MEDLINE and Scopus databases, recovering 15 original articles published until January 2022. This systematic review was conducted from May to September 2022. Two reviewers were involved in the process of the selection of articles and data extraction. Only research papers on malnutrition among older people in institutionalized settings in Malaysia were included. Four articles related to malnutrition in older people in old folk homes in Malaysia were included in this review. The tools with the most significant evidence were Mini Nutritional Assessment (MNA) and Nutritional Health Checklist (NHC) in residential care for the elderly. It was found that the incidence of malnutrition among the elderly in old folk homes in Malaysia ranged from 12.3% to 17.4%. Meanwhile, 40.4% to 57.7% of the population are documented to be at risk of malnutrition. NA and DETERMINE NHC were found to be most suitable for use in residential care due to their high sensitivity and specificity. A subsequent study is proposed to build and implement a scoring system to rate screening tools based on the validity, suitability, and practicability of the tools to help with malnutrition screening research and clinical practice in Malaysia and internationally.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2335
Mohamad Che' Man, Shahidah Che Alhadi, Muhammad Zubir Yusof, Siti Roshaidai Md. Ariffin, Mohd Zhafri Md. Razib, Salman Amiruddin
INTRODUCTION: Patient satisfaction is a key factor in determining any gaps or inadequacies in the healthcare provider's services. This study aimed to measure the level of patient satisfaction and its associated factors towards the healthcare service of outpatient clinics in Sultan Ahmad Shah Medical Centre (SASMEC), IIUM, Kuantan, Pahang. MATERIALS AND METHODS: A total of 1050 patients were recruited from internal medicine, paediatrics, surgery, obstetrics and gynaecology, orthopaedics, and psychiatry clinics between February 2021 and February 2022. A questionnaire was administered which consists of two parts: one that covers patients’ sociodemographic data and the other that assesses the patients’ level of satisfaction with the healthcare services using the Malay-validated Short-Form Patient Satisfaction Questionnaire (PSQ-18). RESULTS: The mean overall satisfaction level was 3.94 ± 0.46, with the highest mean scores in the interpersonal manners (4.2 ± 0.64) and communications (4.26 ± 0.56) domains. From the multivariate analysis, it was found that those patients in the lower income group (B40) were more satisfied with the quality of the healthcare services (B=0.172, 95% CI=0.08, 0.263) compared to the middle-income group. Being a student (B=- 0.202, 95% CI=- 0.296, -0.108) and having a follow-up treatment visit (B=-0.082, 95% CI=-0.156, -0.008), were significantly associated with lower satisfaction levels as compared to their counterparts. CONCLUSION: Overall, patients who attended SASMEC were satisfied with the service provided. Continuous service improvement aimed at patients’ household income, occupation and purpose of visit may help SASMEC enhance its service in the future
{"title":"Patient Satisfaction with the Quality of Healthcare Services at Selected Major Outpatient Clinics at Sultan Ahmad Shah Medical Centre Kuantan Pahang","authors":"Mohamad Che' Man, Shahidah Che Alhadi, Muhammad Zubir Yusof, Siti Roshaidai Md. Ariffin, Mohd Zhafri Md. Razib, Salman Amiruddin","doi":"10.31436/imjm.v23i01.2335","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2335","url":null,"abstract":"INTRODUCTION: Patient satisfaction is a key factor in determining any gaps or inadequacies in the healthcare provider's services. This study aimed to measure the level of patient satisfaction and its associated factors towards the healthcare service of outpatient clinics in Sultan Ahmad Shah Medical Centre (SASMEC), IIUM, Kuantan, Pahang. MATERIALS AND METHODS: A total of 1050 patients were recruited from internal medicine, paediatrics, surgery, obstetrics and gynaecology, orthopaedics, and psychiatry clinics between February 2021 and February 2022. A questionnaire was administered which consists of two parts: one that covers patients’ sociodemographic data and the other that assesses the patients’ level of satisfaction with the healthcare services using the Malay-validated Short-Form Patient Satisfaction Questionnaire (PSQ-18). RESULTS: The mean overall satisfaction level was 3.94 ± 0.46, with the highest mean scores in the interpersonal manners (4.2 ± 0.64) and communications (4.26 ± 0.56) domains. From the multivariate analysis, it was found that those patients in the lower income group (B40) were more satisfied with the quality of the healthcare services (B=0.172, 95% CI=0.08, 0.263) compared to the middle-income group. Being a student (B=- 0.202, 95% CI=- 0.296, -0.108) and having a follow-up treatment visit (B=-0.082, 95% CI=-0.156, -0.008), were significantly associated with lower satisfaction levels as compared to their counterparts. CONCLUSION: Overall, patients who attended SASMEC were satisfied with the service provided. Continuous service improvement aimed at patients’ household income, occupation and purpose of visit may help SASMEC enhance its service in the future","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2388
K. Zulkiflee, Yusoff Sharizal Yusoff Azmi Merican, Maizura Mohd Zainudin, H. R. Ismawi, Fadhilah Zainal Abidin, Azliana Abd Fuaat
INTRODUCTION: Cardiovascular diseases (CVDs) are two to four times more likely to affect women with a history of hypertensive disorders of pregnancy (HDPs). One of the etiologies of CVDs is endothelial dysfunction, which results from an imbalance in the production of endothelin-1 (ET-1) and nitric oxide (NO). Although blood pressure (BP) is normalized postpartum, we hypothesize that a transient increase in BP during HDPs may cause ongoing endothelial dysfunction. We aimed to discover the impact of HDPs in the development of cardiovascular diseases after long-term postpartum changes in endothelin-A receptor (ETAR) and endothelin-B receptor (ETBR) expression and the concentration of ET-1 and NO. MATERIALS AND METHOD: Twenty-four female Sprague-Dawley (SD) rats were assigned into four groups (n = 6), including two treatment and two control groups. All rats were sacrificed on Day 30 postpartum. The NO and ET-1 concentrations were determined by ELISA and the ETAR and ETBR expression of the mesenteric arteries were measured by immunohistochemistry studies. RESULTS: The mean concentrations of ET-1 and NO were not significantly different in all groups. There was no significant difference in the mean immunoreactivity of ETAR and ETBR percentages area in the tunica intima and media in all groups. CONCLUSION: No evidence demonstrates significant changes in the endothelin system of the resistance arteries at the proteomic level in the long-term duration following HDP. Further investigation of its potential chronic effect warrants a deeper analysis at the molecular and ultrastructural levels.
{"title":"Unaltered Long-Term Maternal Endothelin System in a Gestational Hypertensive Rat Model","authors":"K. Zulkiflee, Yusoff Sharizal Yusoff Azmi Merican, Maizura Mohd Zainudin, H. R. Ismawi, Fadhilah Zainal Abidin, Azliana Abd Fuaat","doi":"10.31436/imjm.v23i01.2388","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2388","url":null,"abstract":"INTRODUCTION: Cardiovascular diseases (CVDs) are two to four times more likely to affect women with a history of hypertensive disorders of pregnancy (HDPs). One of the etiologies of CVDs is endothelial dysfunction, which results from an imbalance in the production of endothelin-1 (ET-1) and nitric oxide (NO). Although blood pressure (BP) is normalized postpartum, we hypothesize that a transient increase in BP during HDPs may cause ongoing endothelial dysfunction. We aimed to discover the impact of HDPs in the development of cardiovascular diseases after long-term postpartum changes in endothelin-A receptor (ETAR) and endothelin-B receptor (ETBR) expression and the concentration of ET-1 and NO. MATERIALS AND METHOD: Twenty-four female Sprague-Dawley (SD) rats were assigned into four groups (n = 6), including two treatment and two control groups. All rats were sacrificed on Day 30 postpartum. The NO and ET-1 concentrations were determined by ELISA and the ETAR and ETBR expression of the mesenteric arteries were measured by immunohistochemistry studies. RESULTS: The mean concentrations of ET-1 and NO were not significantly different in all groups. There was no significant difference in the mean immunoreactivity of ETAR and ETBR percentages area in the tunica intima and media in all groups. CONCLUSION: No evidence demonstrates significant changes in the endothelin system of the resistance arteries at the proteomic level in the long-term duration following HDP. Further investigation of its potential chronic effect warrants a deeper analysis at the molecular and ultrastructural levels.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2117
Aisyah Khaulah Muslim, Radhiana Hassan, Nasser Mohammad Amjad, Azliana Abd Fuaat
Cavernous hemangioma of the adrenal gland is a very rare benign vascular tumour. Its rarity and non-specific presentation pose a challenge to the radiologists and surgeons in making the correct diagnosis. We report a case of adrenal cavernous hemangioma in a 76 years old gentleman, in which a large heterogeneous mass was incidentally found at his left hypochondriac region during a routine KUB and prostate ultrasound assessment for benign prostatic hyperplasia. A multiphasic CT study performed and revealed a large mass with a maximum diameter of 18 cm occupying the left suprarenal area. Considering the large size of the left suprarenal mass with mass effect to the surrounding structures, the patient undergone left adrenalectomy. His final histopathological diagnosis revealed a cavernous hemangioma. This case highlighted literature review and role of imaging in this extremely rare benign tumour as one of the differential diagnosis of an adrenal incidentaloma.
{"title":"Adrenal Cavernous Hemangioma: A Rare Incidental Finding from A Routine Ultrasound Assessment","authors":"Aisyah Khaulah Muslim, Radhiana Hassan, Nasser Mohammad Amjad, Azliana Abd Fuaat","doi":"10.31436/imjm.v23i01.2117","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2117","url":null,"abstract":"Cavernous hemangioma of the adrenal gland is a very rare benign vascular tumour. Its rarity and non-specific presentation pose a challenge to the radiologists and surgeons in making the correct diagnosis. We report a case of adrenal cavernous hemangioma in a 76 years old gentleman, in which a large heterogeneous mass was incidentally found at his left hypochondriac region during a routine KUB and prostate ultrasound assessment for benign prostatic hyperplasia. A multiphasic CT study performed and revealed a large mass with a maximum diameter of 18 cm occupying the left suprarenal area. Considering the large size of the left suprarenal mass with mass effect to the surrounding structures, the patient undergone left adrenalectomy. His final histopathological diagnosis revealed a cavernous hemangioma. This case highlighted literature review and role of imaging in this extremely rare benign tumour as one of the differential diagnosis of an adrenal incidentaloma.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139126599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2195
Prince Saha, Bhavini Bhushan Shah, Subha Jose Vazhakalayil, Aishwarya Thakur
INTRODUCTION: Activation of sympathetic nervous system, increase of catabolic hormone release and pituitary gland suppression are responses to surgical stress. Neural blockade via epidural or spinal anesthesia, intravenous administration of high-dose of strong opioid analgesics, and infusion of anabolic hormones such as insulin are three main methods for balancing stress responses to surgery. However, there are conflicting reports about the extent of autonomic disturbances occurring after inducing spinal anesthesia in diabetic patients due to underlying autonomic neuropathy. METHODOLOGY: An observational cohort study was conducted in an operative room of a tertiary health care center involving 25 diabetic patients and 25 non-diabetic patients to evaluate the tolerance to stress. The diabetic patients undergone an exercise tolerance test to evaluate for postural hypotension which would indicate presence of autonomic neuropathy. Stress parameters such as heart rate, mean blood pressure, blood glucose level, and temperature were measured at regular intervals pre, peri- and post-operatively. RESULTS: Intraoperative heart rate, mean blood pressure, and blood glucose level were high in diabetic patients with autonomic neuropathy (p≤0.05). Temperature was higher in diabetic patients with autonomic neuropathy initially (p≤0.05) and had a higher fall peri-and post-operatively (T=15 minutes, T=20 minutes, and T=after surgery). A significant differences in the parameters of stress response were observed in diabetic patients with autonomic neuropathy. CONCLUSION: By understanding the correlation between stress-response in diabetic patients with autonomic neuropathy peri-operatively will help the anesthetist to provide customized services to every patient
{"title":"A Comparative Study of the Tolerance to Stress Response Under Spinal Anaesthesia in Diabetic Versus Non-Diabetic Patients","authors":"Prince Saha, Bhavini Bhushan Shah, Subha Jose Vazhakalayil, Aishwarya Thakur","doi":"10.31436/imjm.v23i01.2195","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2195","url":null,"abstract":"INTRODUCTION: Activation of sympathetic nervous system, increase of catabolic hormone release and pituitary gland suppression are responses to surgical stress. Neural blockade via epidural or spinal anesthesia, intravenous administration of high-dose of strong opioid analgesics, and infusion of anabolic hormones such as insulin are three main methods for balancing stress responses to surgery. However, there are conflicting reports about the extent of autonomic disturbances occurring after inducing spinal anesthesia in diabetic patients due to underlying autonomic neuropathy. METHODOLOGY: An observational cohort study was conducted in an operative room of a tertiary health care center involving 25 diabetic patients and 25 non-diabetic patients to evaluate the tolerance to stress. The diabetic patients undergone an exercise tolerance test to evaluate for postural hypotension which would indicate presence of autonomic neuropathy. Stress parameters such as heart rate, mean blood pressure, blood glucose level, and temperature were measured at regular intervals pre, peri- and post-operatively. RESULTS: Intraoperative heart rate, mean blood pressure, and blood glucose level were high in diabetic patients with autonomic neuropathy (p≤0.05). Temperature was higher in diabetic patients with autonomic neuropathy initially (p≤0.05) and had a higher fall peri-and post-operatively (T=15 minutes, T=20 minutes, and T=after surgery). A significant differences in the parameters of stress response were observed in diabetic patients with autonomic neuropathy. CONCLUSION: By understanding the correlation between stress-response in diabetic patients with autonomic neuropathy peri-operatively will help the anesthetist to provide customized services to every patient","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139128794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2313
Ling Tiong Michelle Hui, W. N. Wan Azman, A. A. Mat Zin, Zamzuri Idris, M. Maulidiani, Wan Nur Syuhaila Mat Desa
An inflammatory biomarker is an indicating substance that facilitates the process of cell injury and promotes the development of cancer cells. The brain structure naturally protects the extracellular matrix (ECM), which consists of microglia, astrocytes, and neurons, by separating them from harm with the blood–brain barrier (BBB). Yet, the inflammation process damages the brain cells, thus releasing inflammatory markers into the plasma. Chronic inflammation results from persistent inflammation, and any failure of control mechanisms within the brain tissues will promote the development of cancer cells. Previous studies showed that several proinflammatory biomarkers, which included interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), and C-reactive protein (CRP), were observably higher in patients with glioblastoma compared to those with healthy brain tissues. However, the relationship between proinflammatory factors and glioma development remains unclear. Against such background, this review discusses the potential association between inflammatory markers and a brain tumour, along with the importance of these parameters.
{"title":"Brain Tumours and Inflammatory Markers: Mini-Review","authors":"Ling Tiong Michelle Hui, W. N. Wan Azman, A. A. Mat Zin, Zamzuri Idris, M. Maulidiani, Wan Nur Syuhaila Mat Desa","doi":"10.31436/imjm.v23i01.2313","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2313","url":null,"abstract":"An inflammatory biomarker is an indicating substance that facilitates the process of cell injury and promotes the development of cancer cells. The brain structure naturally protects the extracellular matrix (ECM), which consists of microglia, astrocytes, and neurons, by separating them from harm with the blood–brain barrier (BBB). Yet, the inflammation process damages the brain cells, thus releasing inflammatory markers into the plasma. Chronic inflammation results from persistent inflammation, and any failure of control mechanisms within the brain tissues will promote the development of cancer cells. Previous studies showed that several proinflammatory biomarkers, which included interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), and C-reactive protein (CRP), were observably higher in patients with glioblastoma compared to those with healthy brain tissues. However, the relationship between proinflammatory factors and glioma development remains unclear. Against such background, this review discusses the potential association between inflammatory markers and a brain tumour, along with the importance of these parameters.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139128370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.31436/imjm.v23i01.2371
Norbaiyah Mohamed Bakrim, Wan Fatein Nabeila Wan Omar, Aszrin Abdullah, Nurul Nadiah Hamidon, Suhaila Abdul Muid, Aisyah Badrulhisham
INTRODUCTION: Uncontrolled hypertension is one of the recognized risk factors for coronary artery disease (CAD) in young adults, commonly underestimated owing to the young age. A novel biomarker to improve CAD risk assessment and hypertension management should be identified for this cohort. Thus, we had conducted a study to investigate plasma concentration and the role of haptoglobin in young hypertensive adults in the establishment of premature acute myocardial infarction (AMI). MATERIALS AND METHODS: A total of 120 male adults aged between 18 to 45 years enrolled into this cross-sectional study, divided into control, hypertensive, and acute myocardial infarction (AMI) groups. Blood samples were collected from all subjects, plasma concentrations of haptoglobin measured using enzyme-linked immunosorbent assays, and other CAD risk factors including high sensitivity C-reactive protein (hs-CRP) levels were analyzed. RESULTS: Plasma concentration of haptoglobin in the AMI group was the highest compared to hypertensive and control group (290.63±99.90 vs. 208.47±112.93 vs. 170.02±108.11 ng/ml, p<0.006). There was a significant association between AMI and plasma haptoglobin concentration in hypertensive subjects independent of other known CAD risk factors (OR: 0.985, 95% CI 0.973-0.997, p=0.017). There was positive correlation between plasma haptoglobin and hs-CRP (r=0.0370, p<0.001). CONCLUSION: Plasma haptoglobin is a potential biomarker to identify young hypertensive adults who are at risk of developing CAD.
导言：未控制的高血压是公认的青壮年冠状动脉疾病（CAD）风险因素之一，由于年龄较小，通常被低估。应该为这一人群找到一种新的生物标志物，以改善 CAD 风险评估和高血压管理。因此，我们开展了一项研究，以调查血红蛋白在年轻高血压成人中的血浆浓度及其在早发急性心肌梗死（AMI）中的作用。材料和方法：共有 120 名年龄在 18 至 45 岁之间的男性成年人参加了这项横断面研究，分为对照组、高血压组和急性心肌梗死（AMI）组。研究人员采集了所有受试者的血样，使用酶联免疫吸附测定法测量了血红蛋白的血浆浓度，并分析了包括高敏C反应蛋白（hs-CRP）水平在内的其他CAD风险因素。结果：与高血压组和对照组相比，AMI 组血浆中的高铁血红蛋白浓度最高（290.63±99.90 vs. 208.47±112.93 vs. 170.02±108.11 ng/ml，P<0.006）。高血压受试者的急性心肌梗死与血浆高铁血红蛋白浓度之间存在明显关联，与其他已知的冠状动脉粥样硬化风险因素无关（OR：0.985，95% CI 0.973-0.997，P=0.017）。血浆血红蛋白与 hs-CRP 呈正相关（r=0.0370，p<0.001）。结论：血浆高铁血红蛋白是一种潜在的生物标志物，可用于识别有患 CAD 风险的年轻高血压成人。
{"title":"Plasma Haptoglobin as A Potential Biomarker for Coronary Artery Disease in Young Hypertensive Adults","authors":"Norbaiyah Mohamed Bakrim, Wan Fatein Nabeila Wan Omar, Aszrin Abdullah, Nurul Nadiah Hamidon, Suhaila Abdul Muid, Aisyah Badrulhisham","doi":"10.31436/imjm.v23i01.2371","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2371","url":null,"abstract":"INTRODUCTION: Uncontrolled hypertension is one of the recognized risk factors for coronary artery disease (CAD) in young adults, commonly underestimated owing to the young age. A novel biomarker to improve CAD risk assessment and hypertension management should be identified for this cohort. Thus, we had conducted a study to investigate plasma concentration and the role of haptoglobin in young hypertensive adults in the establishment of premature acute myocardial infarction (AMI). MATERIALS AND METHODS: A total of 120 male adults aged between 18 to 45 years enrolled into this cross-sectional study, divided into control, hypertensive, and acute myocardial infarction (AMI) groups. Blood samples were collected from all subjects, plasma concentrations of haptoglobin measured using enzyme-linked immunosorbent assays, and other CAD risk factors including high sensitivity C-reactive protein (hs-CRP) levels were analyzed. RESULTS: Plasma concentration of haptoglobin in the AMI group was the highest compared to hypertensive and control group (290.63±99.90 vs. 208.47±112.93 vs. 170.02±108.11 ng/ml, p<0.006). There was a significant association between AMI and plasma haptoglobin concentration in hypertensive subjects independent of other known CAD risk factors (OR: 0.985, 95% CI 0.973-0.997, p=0.017). There was positive correlation between plasma haptoglobin and hs-CRP (r=0.0370, p<0.001). CONCLUSION: Plasma haptoglobin is a potential biomarker to identify young hypertensive adults who are at risk of developing CAD.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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