Pub Date : 2021-09-20DOI: 10.22452/JUMMEC.VOL24NO2.10
Chui King Wong, Glen Chiang Hong Tan, M. J. Jaafar
Subcutaneous emphysema, a known complication of tracheobronchial injury (TBI), is usually a self-limiting condition, but occasionally, a massive one can become life-threatening. We present a patient with TBI who developed massive subcutaneous emphysema with bilateral pneumothorax causing hemodynamic instability. Upon arrival to the hospital, the patient required emergent intubation for impending respiratory collapse. Bilateral thoracostomy tubes were inserted, resulting in hemodynamic improvement. Emergent CT thorax showed a tracheal-oesophageal injury just distal to the cuff of the endotracheal tube (ETT) at the level of the third thoracic vertebra (T3). Despite surgical repair and intensive care, the patient succumbed after a week in ICU due to ventilatory failure. This case report highlights the importance of the initial management of TBI requiring rapid identification and airway management.
{"title":"MASSIVE LIFE-THREATENING SUBCUTANEOUS EMPHYSEMA: A MANIFESTATION OF TRACHEOBRONCHIAL INJURY","authors":"Chui King Wong, Glen Chiang Hong Tan, M. J. Jaafar","doi":"10.22452/JUMMEC.VOL24NO2.10","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.10","url":null,"abstract":"Subcutaneous emphysema, a known complication of tracheobronchial injury (TBI), is usually a self-limiting condition, but occasionally, a massive one can become life-threatening. We present a patient with TBI who developed massive subcutaneous emphysema with bilateral pneumothorax causing hemodynamic instability. Upon arrival to the hospital, the patient required emergent intubation for impending respiratory collapse. Bilateral thoracostomy tubes were inserted, resulting in hemodynamic improvement. Emergent CT thorax showed a tracheal-oesophageal injury just distal to the cuff of the endotracheal tube (ETT) at the level of the third thoracic vertebra (T3). Despite surgical repair and intensive care, the patient succumbed after a week in ICU due to ventilatory failure. This case report highlights the importance of the initial management of TBI requiring rapid identification and airway management.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46818728","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 : 2021-09-18DOI: 10.22452/JUMMEC.VOL24NO2.8
W. L. Cheng, John E. George, Zulkarnain Jaafar, Wai Kong Lim, K. Hussein
Type 1 and type 2 anterolateral ligament (ALL) or meniscocapsular tears are frequently treated conservatively. However, the initiation of the healing process of these tears could take up to six weeks, and about 70% of acute ALL injuries demonstrated poor healing at the 1-year follow-up. This case report describes the successful treatment of an MRI-confirmed ALL tears by direct injection of platelet-rich plasma (PRP) into the ALL and adjacent anterolateral meniscocapsular tears under ultrasound guidance. This treatment yielded excellent outcome with complete relief of pain six weeks after the injection, and repeated ultrasound examination showed 80% restoration of the torn tissues.
{"title":"SUCCESSFUL TREATMENT OF ANTEROLATERAL LIGAMENT TEAR OF THE KNEE WITH ULTRASOUND-GUIDED PLATELET-RICH PLASMA INJECTION: A CASE REPORT","authors":"W. L. Cheng, John E. George, Zulkarnain Jaafar, Wai Kong Lim, K. Hussein","doi":"10.22452/JUMMEC.VOL24NO2.8","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.8","url":null,"abstract":"Type 1 and type 2 anterolateral ligament (ALL) or meniscocapsular tears are frequently treated conservatively. However, the initiation of the healing process of these tears could take up to six weeks, and about 70% of acute ALL injuries demonstrated poor healing at the 1-year follow-up. This case report describes the successful treatment of an MRI-confirmed ALL tears by direct injection of platelet-rich plasma (PRP) into the ALL and adjacent anterolateral meniscocapsular tears under ultrasound guidance. This treatment yielded excellent outcome with complete relief of pain six weeks after the injection, and repeated ultrasound examination showed 80% restoration of the torn tissues.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45059790","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 : 2021-09-18DOI: 10.22452/JUMMEC.VOL24NO2.9
S. Loong, E. Wong, R. Govindaraju, Ahmad Nordin Bin Afandi, Yves Brand, Zulkiflee Abu Bakar, P. Narayanan
Introduction: Sniffin’ Stick test is a quantitative olfactory test first introduced in the 1990s and has since been used in several countries after cultural-based modifications. Objective: To develop a culturally adapted Sniffin’ Stick test suitable for a Malaysian population. Methods: The study was done in 3 phases. The first phase involved a questionnaire rating the familiarity of 70 odors based on a Likert scale. Sixteen items were then selected for the second phase where subjects were tested on the identification of the 16 odors. Odors recognized by less than 75% of the subjects or their distractors were replaced. These steps were repeated until all 16 odors were recognized by more than 75% of the subjects. In the final phase, the mean Odor Identification (OI) scores utilizing the newly selected 16 odors were collected among healthy individuals. Results: A total of 417 subjects participated in the study. In the first-phase, 5 odors from the original Sniffin’ Stick Test which were unfamiliar were replaced for the phase 2 of the study. In the second-phase, modifications were performed 3 times requiring change of 41 distractors and an additional odor. Finally, using the modified Sniffin Stick test version-4, preliminary results of the mean odor identification scoring for the age groups 16-35,36-55 and more than 55 years of age were obtained which showed age-related variations. Conclusion: Our study revealed cultural modifications to the original Sniffin’ Stick Test are required to validate its use in a Malaysian population.
{"title":"CULTURAL ADAPTATION OF SNIFFIN’ STICKS TEST FOR A MALAYSIAN POPULATION","authors":"S. Loong, E. Wong, R. Govindaraju, Ahmad Nordin Bin Afandi, Yves Brand, Zulkiflee Abu Bakar, P. Narayanan","doi":"10.22452/JUMMEC.VOL24NO2.9","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.9","url":null,"abstract":"Introduction: Sniffin’ Stick test is a quantitative olfactory test first introduced in the 1990s and has since been used in several countries after cultural-based modifications. Objective: To develop a culturally adapted Sniffin’ Stick test suitable for a Malaysian population. Methods: The study was done in 3 phases. The first phase involved a questionnaire rating the familiarity of 70 odors based on a Likert scale. Sixteen items were then selected for the second phase where subjects were tested on the identification of the 16 odors. Odors recognized by less than 75% of the subjects or their distractors were replaced. These steps were repeated until all 16 odors were recognized by more than 75% of the subjects. In the final phase, the mean Odor Identification (OI) scores utilizing the newly selected 16 odors were collected among healthy individuals. Results: A total of 417 subjects participated in the study. In the first-phase, 5 odors from the original Sniffin’ Stick Test which were unfamiliar were replaced for the phase 2 of the study. In the second-phase, modifications were performed 3 times requiring change of 41 distractors and an additional odor. Finally, using the modified Sniffin Stick test version-4, preliminary results of the mean odor identification scoring for the age groups 16-35,36-55 and more than 55 years of age were obtained which showed age-related variations. Conclusion: Our study revealed cultural modifications to the original Sniffin’ Stick Test are required to validate its use in a Malaysian population.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41962194","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 : 2021-09-17DOI: 10.22452/JUMMEC.VOL24NO2.7
Haerawati Idris, Misnaniarti, Iwan Stia Budi, A. Ainy, Dian Safriantini
Many countries are trying to achieve Universal Health Coverage. Indonesia wanted to do this by implementing National Health Insurance in 2014. The purpose of this study is to explore the demand for health services based on visits to service providers, for both outpatient and inpatient care. This study used secondary data from wave five of the Indonesia Family Life Survey (IFLS). The sample used in this study comprised 34,177 individuals who were aged >15 years old. In this study, the demand for health services was measured based on whether respondents had visited a healthcare facility and their number of visits to healthcare facilities. Data was analysed using bivariate analysis with chi-square and multivariate analysis using the negative binomial regression model and probit model. The proportion of respondents visiting healthcare facilities for outpatient care was 16%, while for inpatient visits it was 5%. Both models produced almost the same effect in indicating the probability of individuals visiting a healthcare facility and their number of visits. Age, gender, marital status, education level, economic level, having health insurance, region, health status, chronic disease, and the number of diseases were statistically significant (P < 0.001) in influencing outpatient service demand. Age, gender, marital status, education level, economic level, having health insurance, regional status, health status, and the number of diseases were statistically significant (P < 0.001) in influencing inpatient service demand. Individual characteristics, demographics, and health status were independent factors associated with demand for healthcare services. The government should consider these factors in expanding health service demand in Indonesia.
{"title":"THE DETERMINANTS OF HEALTH SERVICES DEMAND IN INDONESIA: AN ANALYSIS OF INDONESIA FAMILY LIFE SURVEY 5 (IFLS)","authors":"Haerawati Idris, Misnaniarti, Iwan Stia Budi, A. Ainy, Dian Safriantini","doi":"10.22452/JUMMEC.VOL24NO2.7","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.7","url":null,"abstract":"Many countries are trying to achieve Universal Health Coverage. Indonesia wanted to do this by implementing National Health Insurance in 2014. The purpose of this study is to explore the demand for health services based on visits to service providers, for both outpatient and inpatient care. This study used secondary data from wave five of the Indonesia Family Life Survey (IFLS). The sample used in this study comprised 34,177 individuals who were aged >15 years old. In this study, the demand for health services was measured based on whether respondents had visited a healthcare facility and their number of visits to healthcare facilities. Data was analysed using bivariate analysis with chi-square and multivariate analysis using the negative binomial regression model and probit model. The proportion of respondents visiting healthcare facilities for outpatient care was 16%, while for inpatient visits it was 5%. Both models produced almost the same effect in indicating the probability of individuals visiting a healthcare facility and their number of visits. Age, gender, marital status, education level, economic level, having health insurance, region, health status, chronic disease, and the number of diseases were statistically significant (P < 0.001) in influencing outpatient service demand. Age, gender, marital status, education level, economic level, having health insurance, regional status, health status, and the number of diseases were statistically significant (P < 0.001) in influencing inpatient service demand. Individual characteristics, demographics, and health status were independent factors associated with demand for healthcare services. The government should consider these factors in expanding health service demand in Indonesia.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47280836","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 : 2021-09-16DOI: 10.22452/JUMMEC.VOL24NO2.6
Jamilah Hanum Abdul Khaiyom, F. Mukhtar, T. Oei
Introduction: The current study aims to investigate the prevalence rates, associated factors, and predictors of anxiety disorders in Malaysia through a scoping review. Methods: PsycINFO and MEDLINE databases and a total of 28 local journals were used to search for published papers in this particular area. In this case, 37 out of 105 articles managed to meet the inclusion criteria and were subjected to review. A total of 17,673 respondents, which comprised university students, the general community, and numerous types of clinical patients, were included in the review. Results: The results showed that the prevalence rate of anxiety disorders was in the range between 1% and 67.6% for the mentioned populations. Moreover, various types of associated factors were found to be related to anxiety such as being divorced, widowed, or single; having a lower than tertiary level of education; being unemployed or retired; and having a low socioeconomic status. Meanwhile, there were also several predictors of anxiety such as having to deal with negative life events; domestic violence; family history of mental illness; severe psychological problems; and chronic physical illness. Conclusion: Generally, the prevalence of anxiety disorders is noticeable, and anxiety disorders may contribute to a decrease in the quality of life, an increase in social burden, reduced productivity, and increased utilization of health services. Therefore, awareness among community and health service providers regarding the prevalence rate of anxiety is believed to help in developing access to evidence-based psychological and pharmacological interventions.
{"title":"ANXIETY DISORDERS IN MALAYSIA FROM 2005 TO 2015: A SCOPING REVIEW OF THEIR PREVALENCE RATES, ASSOCIATED FACTORS, AND PREDICTORS","authors":"Jamilah Hanum Abdul Khaiyom, F. Mukhtar, T. Oei","doi":"10.22452/JUMMEC.VOL24NO2.6","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.6","url":null,"abstract":"Introduction: The current study aims to investigate the prevalence rates, associated factors, and predictors of anxiety disorders in Malaysia through a scoping review. Methods: PsycINFO and MEDLINE databases and a total of 28 local journals were used to search for published papers in this particular area. In this case, 37 out of 105 articles managed to meet the inclusion criteria and were subjected to review. A total of 17,673 respondents, which comprised university students, the general community, and numerous types of clinical patients, were included in the review. Results: The results showed that the prevalence rate of anxiety disorders was in the range between 1% and 67.6% for the mentioned populations. Moreover, various types of associated factors were found to be related to anxiety such as being divorced, widowed, or single; having a lower than tertiary level of education; being unemployed or retired; and having a low socioeconomic status. Meanwhile, there were also several predictors of anxiety such as having to deal with negative life events; domestic violence; family history of mental illness; severe psychological problems; and chronic physical illness. Conclusion: Generally, the prevalence of anxiety disorders is noticeable, and anxiety disorders may contribute to a decrease in the quality of life, an increase in social burden, reduced productivity, and increased utilization of health services. Therefore, awareness among community and health service providers regarding the prevalence rate of anxiety is believed to help in developing access to evidence-based psychological and pharmacological interventions.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45840714","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 : 2021-09-15DOI: 10.22452/JUMMEC.VOL24NO2.5
Azlin Muhammad, Mekadina Bernadus, Rozliana Hanim Mat Hasan, W. Wahid
Gastrointestinal microsporidiosis is a major cause of chronic diarrhea in people with acquired immune deficienc syndrome. However, it can also affect individuals with inherited or congenital immunodeficiency. We reported a case of intestinal microsporidiosis and salmonellosis in a young boy with Hyper IgM syndrome. He presented with severe diarrhea and fever for 5 days. Stool examination showed heavy infection of Microsporidia spp. PCR confirmed the species as Enterocytozoon bieneusi. He was treated with albendazole for 25 days which abated the symptoms. To our knowledge, this is the first reported case of intestinal microsporidiosis in inherited immunodeficiency, X-linked Hyper IgM (XHIGM).
{"title":"A MIXED INFECTION OF INTESTINAL MICROSPORIDIOSIS AND SALMONELLOSIS IN A 2-YEAR-OLD BOY WITH INHERITED IMMUNODEFICIENCY SYNDROME","authors":"Azlin Muhammad, Mekadina Bernadus, Rozliana Hanim Mat Hasan, W. Wahid","doi":"10.22452/JUMMEC.VOL24NO2.5","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.5","url":null,"abstract":"Gastrointestinal microsporidiosis is a major cause of chronic diarrhea in people with acquired immune deficienc syndrome. However, it can also affect individuals with inherited or congenital immunodeficiency. We reported a case of intestinal microsporidiosis and salmonellosis in a young boy with Hyper IgM syndrome. He presented with severe diarrhea and fever for 5 days. Stool examination showed heavy infection of Microsporidia spp. PCR confirmed the species as Enterocytozoon bieneusi. He was treated with albendazole for 25 days which abated the symptoms. To our knowledge, this is the first reported case of intestinal microsporidiosis in inherited immunodeficiency, X-linked Hyper IgM (XHIGM).","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42681196","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 : 2021-09-15DOI: 10.22452/JUMMEC.VOL24NO2.4
M. Jaafar, N. Alias, A. Yusof, M. Isa
This paper proposes a conceptual model for establishing a new approach to improvise anti-smoking strategies. The Tobacco Control programme under the World Health Organization (WHO) has established MPOWER measures to be applied globally. Although numerous approaches have been implemented, there is a knowledge gap pertaining to the positive impact of these strategies. Therefore, analyzing current approaches and establishing new strategies will be beneficial for the tobacco control movement. The proposed model has been adapted from the Medical Research Council (MRC), United Kingdom framework for complex interventions which can be used as reference for researchers to develop a new initiative or strategy for tobacco control. This proposed model incorporates three phases, which are (i) Phase 1: To identify factors influencing stop smoking desires and their successfulness among “specific location” population, (ii) Phase 2: To analyse available smoking cessation strategies globally using systematic review, and (iii) Phase 3: To develop new potential tools/products/guidelines for anti-smoking promotions based on Phase 1 and 2. The novelty of this concept in developing anti-smoking strategies is the incorporation of local needs in Phase 1. This research may contribute significantly to stop or quit smoking behavior among Malaysians. At the end of this study, researchers will be able to recommend new and/or adapted tools/products/guidelines based on the framework discussed. Also, government regulations regarding cigarettes should be properly reviewed in order to achieve more significant results whilst minimizing expenses for anti-smoking campaigns.
{"title":"THE CONCEPTUAL FRAMEWORK IN IMPROVING ANTI-SMOKING STRATEGIES IN MALAYSIA","authors":"M. Jaafar, N. Alias, A. Yusof, M. Isa","doi":"10.22452/JUMMEC.VOL24NO2.4","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.4","url":null,"abstract":"This paper proposes a conceptual model for establishing a new approach to improvise anti-smoking strategies. The Tobacco Control programme under the World Health Organization (WHO) has established MPOWER measures to be applied globally. Although numerous approaches have been implemented, there is a knowledge gap pertaining to the positive impact of these strategies. Therefore, analyzing current approaches and establishing new strategies will be beneficial for the tobacco control movement. The proposed model has been adapted from the Medical Research Council (MRC), United Kingdom framework for complex interventions which can be used as reference for researchers to develop a new initiative or strategy for tobacco control. This proposed model incorporates three phases, which are (i) Phase 1: To identify factors influencing stop smoking desires and their successfulness among “specific location” population, (ii) Phase 2: To analyse available smoking cessation strategies globally using systematic review, and (iii) Phase 3: To develop new potential tools/products/guidelines for anti-smoking promotions based on Phase 1 and 2. The novelty of this concept in developing anti-smoking strategies is the incorporation of local needs in Phase 1. This research may contribute significantly to stop or quit smoking behavior among Malaysians. At the end of this study, researchers will be able to recommend new and/or adapted tools/products/guidelines based on the framework discussed. Also, government regulations regarding cigarettes should be properly reviewed in order to achieve more significant results whilst minimizing expenses for anti-smoking campaigns.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41616260","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 : 2021-09-10DOI: 10.22452/JUMMEC.VOL24NO2.3
S. Tien, Ng Chen Yit, M. Mazlan
It is common to have vision problems after neurological insults such as traumatic brain injury, stroke or brain tumours. While these neurological insults can affect patients’ daily functioning to different extents, vision problems can be the main obstacle to the dysfunction. A 19-year-old boy with pontine cavernoma presented to the clinic with multiple visual problems at ten months after surgical removal of the tumour. He has left 6th cranial nerve palsy with persistent diplopia and nystagmus. These were associated with giddiness, imbalance, cerebellar impairments, right hemiparesis and hemisensory loss. This case illustrates the importance of adding the neuro-optometric vision rehabilitation, which include visual information processing therapy and other substitutive interventions, into the existing multidisciplinary rehabilitation program to achieve the greatest functional benefit.
{"title":"NEURO-OPTOMETRIC VISION REHABILITATION AFTER PONTINE CAVERNOMA: A CASE REPORT","authors":"S. Tien, Ng Chen Yit, M. Mazlan","doi":"10.22452/JUMMEC.VOL24NO2.3","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.3","url":null,"abstract":"It is common to have vision problems after neurological insults such as traumatic brain injury, stroke or brain tumours. While these neurological insults can affect patients’ daily functioning to different extents, vision problems can be the main obstacle to the dysfunction. A 19-year-old boy with pontine cavernoma presented to the clinic with multiple visual problems at ten months after surgical removal of the tumour. He has left 6th cranial nerve palsy with persistent diplopia and nystagmus. These were associated with giddiness, imbalance, cerebellar impairments, right hemiparesis and hemisensory loss. This case illustrates the importance of adding the neuro-optometric vision rehabilitation, which include visual information processing therapy and other substitutive interventions, into the existing multidisciplinary rehabilitation program to achieve the greatest functional benefit.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42797936","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 : 2021-07-15DOI: 10.22452/JUMMEC.VOL24NO2.1
N. Hamzah, Norazlina Muhamad, F. Hariri, M. Mazlan, N. Ramli, Vairavan Narayanan
This is a short-term longitudinal study of physical, cognitive, psychological and functional outcomes following mild traumatic brain injury (mTBI) in adults, caused by road traffic accident (RTA). Outcome measures were the Montreal Cognitive Assessment (MoCA), the Neuropsychological Assessment Battery Screening Module (S-NAB), the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7 (GAD-7) scale. Functional outcomes included returning to working/academia and driving, lifestyle changes, financial claims and litigation status. A total of 285 individuals were diagnosed with mTBI, involving young male motorcyclists (90%): uncomplicated mTBI, n=201; complicated mTBI, n=84. Ethnic distribution consisted of 204 Malays, 58 Indians and 23 Chinese. MoCA detected cognitive deficits (mean=23.11, SD=3.41) within 72 hours of injury. At two weeks, somatic manifestations, physical injuries, cognitive deficits and psychological symptoms were detected. At three months of injury, the language domain was persistently impaired, with a lower score on most cognitive domains in the complicated mTBI category than the uncomplicated mTBI. Psychological and somatic symptoms had improved. Almost 50% of patients had returned to a functional baseline within two weeks of injury and a further 24% within three months. A small proportion of patients made active lifestyle changes (<25%), financial injury claims (38%) and were involved in litigation (11%). In conclusion, mTBI in multi-ethnic Malaysia has multifaceted deficits and outcomes. Early management of symptoms may promote maximum recovery.
{"title":"A SHORT-TERM LONGITUDINAL STUDY ON MULTIDIMENSIONAL OUTCOMES FOLLOWING MILD TRAUMATIC BRAIN INJURY IN MULTI-ETHNIC MALAYSIA","authors":"N. Hamzah, Norazlina Muhamad, F. Hariri, M. Mazlan, N. Ramli, Vairavan Narayanan","doi":"10.22452/JUMMEC.VOL24NO2.1","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.1","url":null,"abstract":"This is a short-term longitudinal study of physical, cognitive, psychological and functional outcomes following mild traumatic brain injury (mTBI) in adults, caused by road traffic accident (RTA). Outcome measures were the Montreal Cognitive Assessment (MoCA), the Neuropsychological Assessment Battery Screening Module (S-NAB), the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder 7 (GAD-7) scale. Functional outcomes included returning to working/academia and driving, lifestyle changes, financial claims and litigation status. A total of 285 individuals were diagnosed with mTBI, involving young male motorcyclists (90%): uncomplicated mTBI, n=201; complicated mTBI, n=84. Ethnic distribution consisted of 204 Malays, 58 Indians and 23 Chinese. MoCA detected cognitive deficits (mean=23.11, SD=3.41) within 72 hours of injury. At two weeks, somatic manifestations, physical injuries, cognitive deficits and psychological symptoms were detected. At three months of injury, the language domain was persistently impaired, with a lower score on most cognitive domains in the complicated mTBI category than the uncomplicated mTBI. Psychological and somatic symptoms had improved. Almost 50% of patients had returned to a functional baseline within two weeks of injury and a further 24% within three months. A small proportion of patients made active lifestyle changes (<25%), financial injury claims (38%) and were involved in litigation (11%). In conclusion, mTBI in multi-ethnic Malaysia has multifaceted deficits and outcomes. Early management of symptoms may promote maximum recovery.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48267057","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 : 2021-07-15DOI: 10.22452/JUMMEC.VOL24NO2.2
Jegdiswary Krishinan, N. Karim, I. Shuaib, C. King, N. Sapiai
Omohyoid muscle syndrome (OMS) is one of the rare causes of lateral neck swelling during swallowing and it is often a worrisome observation due to the concern of malignancy and cosmetic deformity. Anatomical variation, congenital weakness, or trauma may cause incompetence of the fascial-retaining mechanism and subsequently OMS. Its prevalence is unknown as only a few cases were reported in the past and none in Malaysia. Diagnosing OMS is very challenging. Hence, imaging techniques like real time ultrasound or dynamic computed tomography can be useful in assessing the affected muscles.
{"title":"OMOHYOID MUSCLE SYNDROME: A CASE REPORT","authors":"Jegdiswary Krishinan, N. Karim, I. Shuaib, C. King, N. Sapiai","doi":"10.22452/JUMMEC.VOL24NO2.2","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO2.2","url":null,"abstract":"Omohyoid muscle syndrome (OMS) is one of the rare causes of lateral neck swelling during swallowing and it is often a worrisome observation due to the concern of malignancy and cosmetic deformity. Anatomical variation, congenital weakness, or trauma may cause incompetence of the fascial-retaining mechanism and subsequently OMS. Its prevalence is unknown as only a few cases were reported in the past and none in Malaysia. Diagnosing OMS is very challenging. Hence, imaging techniques like real time ultrasound or dynamic computed tomography can be useful in assessing the affected muscles.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43022140","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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