Pub Date : 2021-03-05DOI: 10.22452/JUMMEC.VOL24NO1.8
H. Lip, T. J. Huei, B. Kannan
Inferior vena cava agenesis (IVCA) is an uncommon congenital anomaly which was first described in the seventeenth century. The detection of such an anomaly is often incidental and patients are asymptomatic until the third to fourth decade of life. Due to the scarcity of these cases, there is no consensus on the subsequent treatment and surveillance of incidental asymptomatic IVC anomalies. Herein, we report on a young male with incidental findings of suprarenal IVC agenesis identified on contrast enhanced computed tomography (CT) scan of the abdomen in the course of treatment for acute appendicitis.
{"title":"ABSENT SUPRARENAL INFERIOR VENA CAVA REVEALED ON CT SCAN IN A PATIENT WITH ACUTE APPENDICITIS","authors":"H. Lip, T. J. Huei, B. Kannan","doi":"10.22452/JUMMEC.VOL24NO1.8","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO1.8","url":null,"abstract":"Inferior vena cava agenesis (IVCA) is an uncommon congenital anomaly which was first described in the seventeenth century. The detection of such an anomaly is often incidental and patients are asymptomatic until the third to fourth decade of life. Due to the scarcity of these cases, there is no consensus on the subsequent treatment and surveillance of incidental asymptomatic IVC anomalies. Herein, we report on a young male with incidental findings of suprarenal IVC agenesis identified on contrast enhanced computed tomography (CT) scan of the abdomen in the course of treatment for acute appendicitis.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42240300","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 : 2021-02-18DOI: 10.22452/JUMMEC.VOL24NO1.5
Reza Jouybar, G. Heidari, Reza Khajeh, Hojatollah Najafi, E. Asadpour, Z. Esmaeilinezhad
Introduction: Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) triggers an inflammatory reaction, leading to the development of myocardial damage and dysfunction. It is assumed that propofol, a general anesthetic agent, has a protective role against oxidative stress. The aim of this study was to evaluate the effect of propofol on myocardial protection when added to cardioplegic solution in patients undergoing CABG. Methods: In this prospective and double-blind RCT study, 120 patients undergoing CABG surgery were randomly assigned into two equal groups. In one group, we added 1200 µg/min (ultimate dose 4 µg/ml) propofol to cardioplegic solution and in the control group, an equal volume of normal saline was added to cardioplegic solution. Serum levels of CPK-MB and Troponin I were checked at four time points, including: just after induction (T1) as baseline, after chest closure (T2), 6 hours after arrival to ICU (T3) and 24 hours after ICU admission (T4). Results: Cardiac enzyme levels had significant increase over time in both groups (p-value <0.05). It was observed that the enzyme levels in the propofol group increased less compared with the control group; however, this difference was not significant. Both groups were also similar in incidence of post-operative arrhythmia and need for use of IABP. Conclusion: Adding a dose of 1200 µg/min (ultimate dose 4 µg/mL) propofol to cardioplegia solution does not have an effect on CPK-MB & troponin I level.
{"title":"EFFECT OF PROPOFOL IN CARDIOPLEGIA SOLUTION ON BIOMARKERS OF MYOCARDIAL INJURY IN CORONARY ARTERY BYPASS GRAFTING SURGERY: A RANDOMIZED DOUBLE-BLIND CLINICAL TRIAL","authors":"Reza Jouybar, G. Heidari, Reza Khajeh, Hojatollah Najafi, E. Asadpour, Z. Esmaeilinezhad","doi":"10.22452/JUMMEC.VOL24NO1.5","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO1.5","url":null,"abstract":"Introduction: Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) triggers an inflammatory reaction, leading to the development of myocardial damage and dysfunction. It is assumed that propofol, a general anesthetic agent, has a protective role against oxidative stress. The aim of this study was to evaluate the effect of propofol on myocardial protection when added to cardioplegic solution in patients undergoing CABG. Methods: In this prospective and double-blind RCT study, 120 patients undergoing CABG surgery were randomly assigned into two equal groups. In one group, we added 1200 µg/min (ultimate dose 4 µg/ml) propofol to cardioplegic solution and in the control group, an equal volume of normal saline was added to cardioplegic solution. Serum levels of CPK-MB and Troponin I were checked at four time points, including: just after induction (T1) as baseline, after chest closure (T2), 6 hours after arrival to ICU (T3) and 24 hours after ICU admission (T4). Results: Cardiac enzyme levels had significant increase over time in both groups (p-value <0.05). It was observed that the enzyme levels in the propofol group increased less compared with the control group; however, this difference was not significant. Both groups were also similar in incidence of post-operative arrhythmia and need for use of IABP. Conclusion: Adding a dose of 1200 µg/min (ultimate dose 4 µg/mL) propofol to cardioplegia solution does not have an effect on CPK-MB & troponin I level.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46510719","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 : 2021-02-04DOI: 10.22452/JUMMEC.VOL24NO1.3
Hafizuddin Awang, Tengku Alina Tengku Ismail
Evidence-based recommendations on intrapartum care are important to ensure the safety of mothers and neonates. The objective of this study was to compare two established guidelines for intrapartum care to provide clinicians with more comprehensive recommendations on intrapartum management. We carried out a descriptive analysis of guidelines from the Integrated Management of Pregnancy and Childbirth (IMPAC) guidelines published by the World Health Organization, and the Perinatal Care Manual published by the Ministry of Health Malaysia, on intrapartum care to determine differences, if any, with regards to management. Latent, active and the second phase of labour are defined differently in both guidelines. Both guidelines showed high similarity in the steps of clinical management for all phases of labour but differed in foetal monitoring methods, indications for episiotomy, mood and behavior assessment, universal precautions, pain management, and placental disposal. Both guidelines had similar managements for most of the problems encountered during the intrapartum period except for preterm labour and multiple births which have substantial differences. Malaysian guidelines highlight additional systems such as the red alert system, and referral and retrieval system, which would enhance the quality of intrapartum management. The IMPAC guidelines emphasize supportive care, birth companionship, maternal care and monitoring up to one hour after placental delivery; and home birth management; these are inadequately explained or lacking in Malaysian guidelines. From the comparison, it was seen that substantial variation exists in intrapartum management between both guidelines that indicates the need for better evidences to synthesize a more comprehensive set of guidelines for the improvement in intrapartum care.
{"title":"COMPARISON OF INTRAPARTUM MANAGEMENT BETWEEN INTERNATIONAL STANDARDS WITH THE MALAYSIAN GUIDELINES","authors":"Hafizuddin Awang, Tengku Alina Tengku Ismail","doi":"10.22452/JUMMEC.VOL24NO1.3","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO1.3","url":null,"abstract":"Evidence-based recommendations on intrapartum care are important to ensure the safety of mothers and neonates. The objective of this study was to compare two established guidelines for intrapartum care to provide clinicians with more comprehensive recommendations on intrapartum management. We carried out a descriptive analysis of guidelines from the Integrated Management of Pregnancy and Childbirth (IMPAC) guidelines published by the World Health Organization, and the Perinatal Care Manual published by the Ministry of Health Malaysia, on intrapartum care to determine differences, if any, with regards to management. Latent, active and the second phase of labour are defined differently in both guidelines. Both guidelines showed high similarity in the steps of clinical management for all phases of labour but differed in foetal monitoring methods, indications for episiotomy, mood and behavior assessment, universal precautions, pain management, and placental disposal. Both guidelines had similar managements for most of the problems encountered during the intrapartum period except for preterm labour and multiple births which have substantial differences. Malaysian guidelines highlight additional systems such as the red alert system, and referral and retrieval system, which would enhance the quality of intrapartum management. The IMPAC guidelines emphasize supportive care, birth companionship, maternal care and monitoring up to one hour after placental delivery; and home birth management; these are inadequately explained or lacking in Malaysian guidelines. From the comparison, it was seen that substantial variation exists in intrapartum management between both guidelines that indicates the need for better evidences to synthesize a more comprehensive set of guidelines for the improvement in intrapartum care.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46411366","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 : 2021-01-29DOI: 10.22452/JUMMEC.VOL24NO1.2
H. Lip, T. J. Huei, P. Vellusamy
In Malaysia, incidence of Wilms’ Tumor (WT) is rare, with only 8 cases reported over four years according to the Malaysia Cancer Registry Report (2012-2016). Reports of spontaneous rupture of WT are scarce and the commonest presentation of this entity is a palpable mass in the abdomen. Herein, we report on the unusual presentation of an 11-year-old boy with typical symptoms of acute appendicitis. The child was subjected to an initial open appendicectomy and diagnosed intra-operatively with a right sided ruptured renal mass. Subsequent investigation leading to the diagnosis of a ruptured Wilms’ tumor and its treatment is discussed in this case presentation.
{"title":"SPONTANEOUS RUPTURE OF WILMS’ TUMOR PRESENTING AS ACUTE APPENDICITIS: A RARE CASE PRESENTATION","authors":"H. Lip, T. J. Huei, P. Vellusamy","doi":"10.22452/JUMMEC.VOL24NO1.2","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL24NO1.2","url":null,"abstract":"In Malaysia, incidence of Wilms’ Tumor (WT) is rare, with only 8 cases reported over four years according to the Malaysia Cancer Registry Report (2012-2016). Reports of spontaneous rupture of WT are scarce and the commonest presentation of this entity is a palpable mass in the abdomen. Herein, we report on the unusual presentation of an 11-year-old boy with typical symptoms of acute appendicitis. The child was subjected to an initial open appendicectomy and diagnosed intra-operatively with a right sided ruptured renal mass. Subsequent investigation leading to the diagnosis of a ruptured Wilms’ tumor and its treatment is discussed in this case presentation.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45962814","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 : 2020-12-22DOI: 10.22452/JUMMEC.SP2020NO1.3
A. Azzeri, Nur Farhan Abdul Hakim, M. Jaafar, M. Dahlui, S. Othman, T. T. Z. Abidin
The sudden surge in the number of healthcare utilizations compels the hospital to plan for its future needs. Several time-series projections of Covid-19 were conducted to forecast the disease burden and resources utilization through simple predictive analytics. The projections revealed a rapid increase in the number of cases and patient in care at the hospital. It was estimated that the number of patients in care to range from 62 to 81 and 89 to 121 patients daily in the second and third phase of movement control order respectively. It was estimated that more than 100,000 plastic aprons, 80,000 sterile and non-sterile isolation gowns, 40,000 masks N95 and face shields, 30,000 gloves and nearly 17,000 bottles of hand sanitizers are needed until late May. Hence, a simple mathematical algorithm is a helpful tool to manage hospital resources during the pandemic.
{"title":"PREDICTION OF DISEASE BURDEN AND HEALTHCARE RESOURCE UTILIZATION THROUGH SIMPLE PREDICTIVE ANALYTICS USING MATHEMATICAL APPROACHES, AN EXPERIENCE FROM UNIVERSITY OF MALAYA MEDICAL CENTRE","authors":"A. Azzeri, Nur Farhan Abdul Hakim, M. Jaafar, M. Dahlui, S. Othman, T. T. Z. Abidin","doi":"10.22452/JUMMEC.SP2020NO1.3","DOIUrl":"https://doi.org/10.22452/JUMMEC.SP2020NO1.3","url":null,"abstract":"The sudden surge in the number of healthcare utilizations compels the hospital to plan for its future needs. Several time-series projections of Covid-19 were conducted to forecast the disease burden and resources utilization through simple predictive analytics. The projections revealed a rapid increase in the number of cases and patient in care at the hospital. It was estimated that the number of patients in care to range from 62 to 81 and 89 to 121 patients daily in the second and third phase of movement control order respectively. It was estimated that more than 100,000 plastic aprons, 80,000 sterile and non-sterile isolation gowns, 40,000 masks N95 and face shields, 30,000 gloves and nearly 17,000 bottles of hand sanitizers are needed until late May. Hence, a simple mathematical algorithm is a helpful tool to manage hospital resources during the pandemic.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47303539","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 : 2020-12-22DOI: 10.22452/JUMMEC.VOL23NO2.14
M. A. Karim, C. Kong, A. Yusoff, Alizan A. Khalil
Epidermal cyst is the most common type of cyst to occur in subcutaneous tissue. It is usually small, asymptomatic, and solitary in lesion. When the size is greater than 5 cm, it is classified as a giant epidermal cyst. If the size is big, it may sometimes mimic a soft tissue sarcoma, hence requiring further evaluation with imaging or histopathological studies. We report a case series of two patients whom presented with a huge swelling at different body regions, involving gluteal and chest. Both patients underwent different modes of imaging to delineate the anatomical extent of the lesion. Excision biopsy was done and the histopathological report confirmed epidermal cyst with no malignancy. The purpose of this case series is to describe the rare occurrence of giant epidermal cyst and to elaborate the methods of approach to arrive at the diagnosis.
{"title":"CASE SERIES – GIANT EPIDERMAL INCLUSION CYST OF GLUTEAL REGION AND CHEST","authors":"M. A. Karim, C. Kong, A. Yusoff, Alizan A. Khalil","doi":"10.22452/JUMMEC.VOL23NO2.14","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO2.14","url":null,"abstract":"Epidermal cyst is the most common type of cyst to occur in subcutaneous tissue. It is usually small, asymptomatic, and solitary in lesion. When the size is greater than 5 cm, it is classified as a giant epidermal cyst. If the size is big, it may sometimes mimic a soft tissue sarcoma, hence requiring further evaluation with imaging or histopathological studies. We report a case series of two patients whom presented with a huge swelling at different body regions, involving gluteal and chest. Both patients underwent different modes of imaging to delineate the anatomical extent of the lesion. Excision biopsy was done and the histopathological report confirmed epidermal cyst with no malignancy. The purpose of this case series is to describe the rare occurrence of giant epidermal cyst and to elaborate the methods of approach to arrive at the diagnosis.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"99-102"},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45499894","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 : 2020-12-22DOI: 10.22452/JUMMEC.SP2020NO1.5
R. Z. M. Lim, E. Lee, H. C. Tan, J. Tan, Szekim Pang, Kuok Zhen Lee, Visagan Diya Das, T. Mat
Purpose: Numerous guidelines have been proposed in managing surgical emergencies during COVID-19 pandemic. Literature on the implications of these adjustments during this pandemic remained limited. This review aims to examine the implications of these critical adjustments with focus on appendicitis management. Method: This is a single-centre retrospective observational study in a Malaysian tertiary state surgical centre and review of recent guidelines and literature. Patients with appendicitis from March to May 2020 were included and medical records were reviewed and analysed. Results: Of the 173 appendicitis patients, 117 (67.6%) were operated and 56 (32.4%) were conservatively treated. Those screened for SARS-CoV-2 pre-operatively showed longer wait for operation (3.0 vs 2.0 days, p=0.001) and a longer hospital stay (4.5 vs 4.0 days, p=0.005). One-third of patients screened (36.6%) were expedited for surgery on clinical suspicion of complicated appendicitis and 42.1% progressed from acute to complicated appendicitis while waiting for screening result. All patients screened were COVID-19 negative. Delay due to SARS-CoV-2 screening did not result in worse outcome for appendicitis patients. Conclusion: With the increase in incidence and rise of COVID-19 cases, routine screening by questionnaire, physical examination and naso-oropharyngeal swab may be considered to detect asymptomatic carrier, especially in regions with high infection. Regular reassessment with low threshold to expedite the surgery is necessary, to ensure satisfactory surgical outcome.
{"title":"EVALUATION OF APPENDICITIS MANAGEMENT DURING EARLY COVID-19 PANDEMIC AND LITERATURE REVIEW","authors":"R. Z. M. Lim, E. Lee, H. C. Tan, J. Tan, Szekim Pang, Kuok Zhen Lee, Visagan Diya Das, T. Mat","doi":"10.22452/JUMMEC.SP2020NO1.5","DOIUrl":"https://doi.org/10.22452/JUMMEC.SP2020NO1.5","url":null,"abstract":"Purpose: Numerous guidelines have been proposed in managing surgical emergencies during COVID-19 pandemic. Literature on the implications of these adjustments during this pandemic remained limited. This review aims to examine the implications of these critical adjustments with focus on appendicitis management. Method: This is a single-centre retrospective observational study in a Malaysian tertiary state surgical centre and review of recent guidelines and literature. Patients with appendicitis from March to May 2020 were included and medical records were reviewed and analysed. Results: Of the 173 appendicitis patients, 117 (67.6%) were operated and 56 (32.4%) were conservatively treated. Those screened for SARS-CoV-2 pre-operatively showed longer wait for operation (3.0 vs 2.0 days, p=0.001) and a longer hospital stay (4.5 vs 4.0 days, p=0.005). One-third of patients screened (36.6%) were expedited for surgery on clinical suspicion of complicated appendicitis and 42.1% progressed from acute to complicated appendicitis while waiting for screening result. All patients screened were COVID-19 negative. Delay due to SARS-CoV-2 screening did not result in worse outcome for appendicitis patients. Conclusion: With the increase in incidence and rise of COVID-19 cases, routine screening by questionnaire, physical examination and naso-oropharyngeal swab may be considered to detect asymptomatic carrier, especially in regions with high infection. Regular reassessment with low threshold to expedite the surgery is necessary, to ensure satisfactory surgical outcome.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47871158","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 : 2020-12-21DOI: 10.22452/JUMMEC.VOL23NO2.13
T. Y. C. Tan, Nor Liyana Mohamed Yusoff, R. Shah, N. David, Bee Ping Teh
Wound management is important as it helps to promote healing without microbial infection. Euphorbia hirta, a species of Euphorbiaceae family, also known as Ara tanah among Malaysians, is traditionally used to promote wound healing where its poultice is applied to the sores on the legs, bruises and wounds. Several reported pharmacological properties including antioxidant, antimicrobial, antidiabetic, anti-anaphylactic activities have been reported on this plant. The aim of this review was to evaluate the wound healing effects of E. hirta. Information involving only in vivo studies on wound healing effect of E. hirta was searched using electronic databases. The electronic databases include PubMed, Google Scholar, Ovid, CENTRAL, LILACS, and ClinicalTrials.gov from year 1962 to 2020. A total of five out of 70 studies were included and assessment was made. All included articles studied different wound models in rats. All showed significant wound healing activity with different mechanism of action for incision, excision and dead space wound. Quality assessment of the included studies suggested that experimental animal study design can be improved. It can be concluded that E. hirta displayed potential as a wound healing agent in vivo studies although further research on structureactivity relationship of compounds responsible for the wound healing effect and toxicological studies before it can proceed to clinical studies.
{"title":"SCOPING REVIEW: POTENTIAL WOUND HEALING EFFECT OF EUPHORBIA HIRTA (ARA TANAH) BASED ON IN VIVO MODELS","authors":"T. Y. C. Tan, Nor Liyana Mohamed Yusoff, R. Shah, N. David, Bee Ping Teh","doi":"10.22452/JUMMEC.VOL23NO2.13","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO2.13","url":null,"abstract":"Wound management is important as it helps to promote healing without microbial infection. Euphorbia hirta, a species of Euphorbiaceae family, also known as Ara tanah among Malaysians, is traditionally used to promote wound healing where its poultice is applied to the sores on the legs, bruises and wounds. Several reported pharmacological properties including antioxidant, antimicrobial, antidiabetic, anti-anaphylactic activities have been reported on this plant. The aim of this review was to evaluate the wound healing effects of E. hirta. Information involving only in vivo studies on wound healing effect of E. hirta was searched using electronic databases. The electronic databases include PubMed, Google Scholar, Ovid, CENTRAL, LILACS, and ClinicalTrials.gov from year 1962 to 2020. A total of five out of 70 studies were included and assessment was made. All included articles studied different wound models in rats. All showed significant wound healing activity with different mechanism of action for incision, excision and dead space wound. Quality assessment of the included studies suggested that experimental animal study design can be improved. It can be concluded that E. hirta displayed potential as a wound healing agent in vivo studies although further research on structureactivity relationship of compounds responsible for the wound healing effect and toxicological studies before it can proceed to clinical studies.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"92-98"},"PeriodicalIF":0.0,"publicationDate":"2020-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44549602","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 : 2020-12-14DOI: 10.22452/JUMMEC.VOL23NO2.12
Faizah Abdul Karim, Z. Yusof, N. Nor
Information regarding water fluoridation (WF) in Malaysia has been substantially documented, but is scattered in various government publications and may be lost to the stakeholders. This paper is a review of water fluoridation in Malaysia and its effect on oral health: a history of WF in Malaysia, the current policy, the evidence of its effectiveness, the challenges and the future directions. A search for relevant physical and electronic documents of WF in Malaysia resulted in the identification of 70 documents for review. WF was gazetted as national policy with an optimal fluoride level of 0.7 parts-per-million (ppm) in 1972, with a reduction of the level to 0.5 ppm in 2005. Evidence showed that WF effectively reduced population dental caries while fluorosis was not a prevalent public health concern. Strong collaboration between stakeholders and the extensive network of piped water supplies resulted in 80% of the population receiving WF in 2013. However, the coverage was reduced to 74.1% in 2018, largely due to the cessation of WF in Pahang. The key challenges in WF included a lack of funding, weak legislation, use of reverse osmosis water filtration system, difficulty to maintaining an optimal level of fluoride in the water, and lack of local data on the impact of WF cessation on oral health, and its cost-effectiveness. This review will provide dental health professionals with scientific evidence on WF and oral health in Malaysia and assist them in answering relevant questions about WF raised by the public.
{"title":"WATER FLUORIDATION AND ORAL HEALTH IN MALAYSIA: A REVIEW OF LITERATURE","authors":"Faizah Abdul Karim, Z. Yusof, N. Nor","doi":"10.22452/JUMMEC.VOL23NO2.12","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO2.12","url":null,"abstract":"Information regarding water fluoridation (WF) in Malaysia has been substantially documented, but is scattered in various government publications and may be lost to the stakeholders. This paper is a review of water fluoridation in Malaysia and its effect on oral health: a history of WF in Malaysia, the current policy, the evidence of its effectiveness, the challenges and the future directions. A search for relevant physical and electronic documents of WF in Malaysia resulted in the identification of 70 documents for review. WF was gazetted as national policy with an optimal fluoride level of 0.7 parts-per-million (ppm) in 1972, with a reduction of the level to 0.5 ppm in 2005. Evidence showed that WF effectively reduced population dental caries while fluorosis was not a prevalent public health concern. Strong collaboration between stakeholders and the extensive network of piped water supplies resulted in 80% of the population receiving WF in 2013. However, the coverage was reduced to 74.1% in 2018, largely due to the cessation of WF in Pahang. The key challenges in WF included a lack of funding, weak legislation, use of reverse osmosis water filtration system, difficulty to maintaining an optimal level of fluoride in the water, and lack of local data on the impact of WF cessation on oral health, and its cost-effectiveness. This review will provide dental health professionals with scientific evidence on WF and oral health in Malaysia and assist them in answering relevant questions about WF raised by the public.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"76-91"},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47892081","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 : 2020-12-10DOI: 10.22452/JUMMEC.SP2020NO1.1
Summy Hastry Purwanti, C. Pramana
The pandemic outbreak caused by COVID-19 has been spreading throughout the world including Indonesia. The high number of infection cases and deaths due to Covid-19 and the lack of experience in managing corpses (post mortem) caused by COVID-19 disease creates defiance for forensic practitioners and the general public. Indonesia has extra challenges because there are still people who refuse to bury corpses known to be COVID-19 victims in their areas. This paper reviews and summarizes the experience of how to deal with a corpse case with COVID-19 including how to bury such a corpse hence providing a perspective view for the future.
{"title":"MANAGEMENT OF CORPSES WITH COVID-19: PERSPECTIVE ON CASES IN INDONESIA","authors":"Summy Hastry Purwanti, C. Pramana","doi":"10.22452/JUMMEC.SP2020NO1.1","DOIUrl":"https://doi.org/10.22452/JUMMEC.SP2020NO1.1","url":null,"abstract":"The pandemic outbreak caused by COVID-19 has been spreading throughout the world including Indonesia. The high number of infection cases and deaths due to Covid-19 and the lack of experience in managing corpses (post mortem) caused by COVID-19 disease creates defiance for forensic practitioners and the general public. Indonesia has extra challenges because there are still people who refuse to bury corpses known to be COVID-19 victims in their areas. This paper reviews and summarizes the experience of how to deal with a corpse case with COVID-19 including how to bury such a corpse hence providing a perspective view for the future.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46034715","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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