Pub Date : 2020-06-12DOI: 10.22452/JUMMEC.VOL23NO2.1
A. S. Moni, Lai Ho Yeung Kelvin, You Mei Sin, W. Ip
Cubital tunnel syndrome (CuTS) is the second most common nerve compression neuropathy in the upper extremity. Intraneural ganglion cyst (IGC) within the ulnar nerve around the elbow, might present as CuTS. A 51-year-old Chinese man presented with paresthesia at the ulnar two digits of the left hand for one year. He was clinically diagnosed as severe CuTS. Nerve conduction study revealed marked axonal damage of the left ulnar nerve and ultrasonography showed a mass along the ulnar nerve, three centimetres proximal to the medial epicondyle, which was highly suggestive of Schwannoma. The mass was explored by a longitudinal incision. Intraoperatively, multiple cystic lesions were found within the epineurium of the ulnar nerve. Communication was seen between the elbow joint and the cyst. Swellings were partially excised under microscope. Decompression or partial excision of the cyst along with ligation of the articular branch should be the treatment of choice to prevent recurrence in case of IGC.
{"title":"THE CUBITAL TUNNEL SYNDROME CAUSED BY MULTIPLE GANGLION CYSTS-A CASE REPORT","authors":"A. S. Moni, Lai Ho Yeung Kelvin, You Mei Sin, W. Ip","doi":"10.22452/JUMMEC.VOL23NO2.1","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO2.1","url":null,"abstract":"Cubital tunnel syndrome (CuTS) is the second most common nerve compression neuropathy in the upper extremity. Intraneural ganglion cyst (IGC) within the ulnar nerve around the elbow, might present as CuTS. A 51-year-old Chinese man presented with paresthesia at the ulnar two digits of the left hand for one year. He was clinically diagnosed as severe CuTS. Nerve conduction study revealed marked axonal damage of the left ulnar nerve and ultrasonography showed a mass along the ulnar nerve, three centimetres proximal to the medial epicondyle, which was highly suggestive of Schwannoma. The mass was explored by a longitudinal incision. Intraoperatively, multiple cystic lesions were found within the epineurium of the ulnar nerve. Communication was seen between the elbow joint and the cyst. Swellings were partially excised under microscope. Decompression or partial excision of the cyst along with ligation of the articular branch should be the treatment of choice to prevent recurrence in case of IGC.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2020-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45784123","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 : 2020-04-20DOI: 10.22452/JUMMEC.VOL23NO1.10
Sai Wai Yan Myint Thu, A. Zaw, P. Kyaw
Background: Many studies have shown that exercise can effectively reduce the non-high density lipoprotein cholesterol (non-HDL-C) level, one of the major risk factors for cardiovascular diseases, in different sex and age groups. However, there are very few studies conducted in older women, who are in a group having a higher mortality rate due to cardiovascular diseases. Moreover, there has been no recent meta-analysis focusing on the effect of exercise on non-HDL-C level in older women. The purpose of this study was to investigate the effect of exercise on non-HDL-C level in older women (≥50 years old) by means of systematic review and meta-analysis of previous randomised controlled trials. Methods: Searches were conducted from 9 electronic databases by applying specific eligibility criteria of the review. Data regarding changes in non-HDL-C, high density lipoprotein cholesterol (HDL-C) and total cholesterol levels, were extracted as primary outcomes. Random-effect meta-analysis was used to calculate pooled effect sizes of primary and secondary outcomes. Results: Ten studies that met the inclusion criteria were selected for meta-analysis. Random-effect meta-analysis showed statistically significant reduction in non-HDL-C level (= -9.69 mg/dL; 95%CI= -17.09 to -2.29 mg/dL; p 0.05) in the exercise group compared to the control group. Subgroup analysis of data from different continents showed significant subgroup differences in the non-HDL-C level after exercise (Q= 12.39; p<0.005; I2= 83.9%). Conclusion: Exercise decreases non-HDL-C level and increases HDL-C level in older women and might be efficacious in preventing dyslipidemia and associated diseases in older women.
{"title":"EFFECT OF EXERCISE ON NON-HDL CHOLESTEROL LEVEL (NON-HDL-C) IN OLDER WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS","authors":"Sai Wai Yan Myint Thu, A. Zaw, P. Kyaw","doi":"10.22452/JUMMEC.VOL23NO1.10","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO1.10","url":null,"abstract":"Background: Many studies have shown that exercise can effectively reduce the non-high density lipoprotein cholesterol (non-HDL-C) level, one of the major risk factors for cardiovascular diseases, in different sex and age groups. However, there are very few studies conducted in older women, who are in a group having a higher mortality rate due to cardiovascular diseases. Moreover, there has been no recent meta-analysis focusing on the effect of exercise on non-HDL-C level in older women. The purpose of this study was to investigate the effect of exercise on non-HDL-C level in older women (≥50 years old) by means of systematic review and meta-analysis of previous randomised controlled trials. \u0000Methods: Searches were conducted from 9 electronic databases by applying specific eligibility criteria of the review. Data regarding changes in non-HDL-C, high density lipoprotein cholesterol (HDL-C) and total cholesterol levels, were extracted as primary outcomes. Random-effect meta-analysis was used to calculate pooled effect sizes of primary and secondary outcomes. \u0000Results: Ten studies that met the inclusion criteria were selected for meta-analysis. Random-effect meta-analysis showed statistically significant reduction in non-HDL-C level (= -9.69 mg/dL; 95%CI= -17.09 to -2.29 mg/dL; p 0.05) in the exercise group compared to the control group. Subgroup analysis of data from different continents showed significant subgroup differences in the non-HDL-C level after exercise (Q= 12.39; p<0.005; I2= 83.9%). \u0000Conclusion: Exercise decreases non-HDL-C level and increases HDL-C level in older women and might be efficacious in preventing dyslipidemia and associated diseases in older women.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"49-59"},"PeriodicalIF":0.0,"publicationDate":"2020-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42573010","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 : 2020-04-17DOI: 10.22452/JUMMEC.VOL23NO1.7
Gaik Kin Teoh, Haslee Sharil Lim Abdullah, P. L. Lau, M. Chong, M. Tan
Migration is a widespread phenomenon throughout the world and it has been under way since time immemorial. While studies have focused on the causes of migration and the impact of migrants, studies focusing on the emotional experience of the left-behind older persons’ adjustments in their twilight years after the departure of their adult children, are few and far between. Thus, the perspectives of these left-behind older parents/ persons are less understood. This paper aims to contribute to the literature by addressing the gap which will be filled through the experiences of left-behind Malaysian older persons. Drawing on in-depth interviews extracted from a qualitative study that focused on the strength of long-term marriages among Malaysian Chinese couples, this paper captures four older couples’ experiences that depict their feelings about their adult children’s migration. Analysis suggests that the children’s migration was induced by a lack of support and resources, followed by unequal educational opportunities. To deal with the gap left by their children, these older urban parents depend on kinship connection and community support in times of need. Government initiatives may also be able to empower the community in innovating and implementing plans which are tailored to the needs of the older parents left behind by children who have migrated. The living arrangements and recent bereavement experiences captured from the older couples can serve as cues for healthcare professionals and social support providers to assess the risks of social isolation and suicide among these left-behind older parents.
{"title":"LEFT BEHIND MALAYSIAN AGED PARENTS AND THEIR EXPERIENCES WITH ADULT CHILDREN’S MIGRATION","authors":"Gaik Kin Teoh, Haslee Sharil Lim Abdullah, P. L. Lau, M. Chong, M. Tan","doi":"10.22452/JUMMEC.VOL23NO1.7","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO1.7","url":null,"abstract":"Migration is a widespread phenomenon throughout the world and it has been under way since time immemorial. While studies have focused on the causes of migration and the impact of migrants, studies focusing on the emotional experience of the left-behind older persons’ adjustments in their twilight years after the departure of their adult children, are few and far between. Thus, the perspectives of these left-behind older parents/ persons are less understood. This paper aims to contribute to the literature by addressing the gap which will be filled through the experiences of left-behind Malaysian older persons. Drawing on in-depth interviews extracted from a qualitative study that focused on the strength of long-term marriages among Malaysian Chinese couples, this paper captures four older couples’ experiences that depict their feelings about their adult children’s migration. Analysis suggests that the children’s migration was induced by a lack of support and resources, followed by unequal educational opportunities. To deal with the gap left by their children, these older urban parents depend on kinship connection and community support in times of need. Government initiatives may also be able to empower the community in innovating and implementing plans which are tailored to the needs of the older parents left behind by children who have migrated. The living arrangements and recent bereavement experiences captured from the older couples can serve as cues for healthcare professionals and social support providers to assess the risks of social isolation and suicide among these left-behind older parents.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"29-38"},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47649732","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 : 2020-04-17DOI: 10.22452/JUMMEC.VOL23NO1.8
Hafizuddin Awang, H. Arif
Scrub typhus is an acute febrile illness caused by the bacteria Orientia tsutsugamushi, which can be transmitted to humans through the bite of infected trombiculid chigger mites. Besides the typical clinical features of fever and eschar formation, the central nervous system has been reported to be involved as evidenced of reported cases ranging from meningitis to meningoencephalitis. Here, we describe an atypical presentation of scrub typhus case that occurred in a 34-year-old Malay male who presented with quadriplegia following an insect bite at the back of his neck. Our case displayed unusual findings of this rare condition in a non-aboriginal Malaysian population. Based on previous literature, we emphasized the importance of prompt diagnosis of scrub typhus in order to reduce the mortality and morbidity and to improve the quality of life for patients with complications of this disease.
{"title":"A PARALYZING BITE: AN UNORTHODOX CASE OF SCRUB TYPHUS IN A NON-ABORIGINAL MALAYSIAN PATIENT","authors":"Hafizuddin Awang, H. Arif","doi":"10.22452/JUMMEC.VOL23NO1.8","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO1.8","url":null,"abstract":"Scrub typhus is an acute febrile illness caused by the bacteria Orientia tsutsugamushi, which can be transmitted to humans through the bite of infected trombiculid chigger mites. Besides the typical clinical features of fever and eschar formation, the central nervous system has been reported to be involved as evidenced of reported cases ranging from meningitis to meningoencephalitis. Here, we describe an atypical presentation of scrub typhus case that occurred in a 34-year-old Malay male who presented with quadriplegia following an insect bite at the back of his neck. Our case displayed unusual findings of this rare condition in a non-aboriginal Malaysian population. Based on previous literature, we emphasized the importance of prompt diagnosis of scrub typhus in order to reduce the mortality and morbidity and to improve the quality of life for patients with complications of this disease.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46220999","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 : 2020-04-17DOI: 10.22452/JUMMEC.VOL23NO1.11
Chin Wen Cong, W. Ling
Introduction: Optimal humidity, temperature, improper handling and storage of rice will increase the likeliness of aflatoxin growth in the air. The most common and carcinogenic aflatoxin is Aflatoxin B1 (AFB1) that may cause lung cancer if inhaled. This study aims to associate the exposure of AFB1 in inhalable dust and its respiratory effects among rice millers. Materials and Methods: This cross-sectional study utilised the purposive sampling method and recruited 76 rice millers as exposed subjects and 48 office workers as the control group. The total inhalable dust was collected using the filter-loaded air samplers for an eight working hours’ exposure. The subjects’ hands were swabbed with cotton pads wetted with 0.5 ml Phosphate buffered Saline Tween-20 solution post shift. The collected samples were analysed for AFB1 by using the ELISA kits. The questionnaire gathering information on sociodemographic, work data and respiratory symptoms were completed. The lung function test was performed for the pre- and post-shifts. Results: The mean airborne AFB1 at the rice mill area and personal exposure were 2.22 ng/m3 ± 0.07 and 0.25 ng/m3 ± 0.24, respectively. The mean contamination level of AFB1 on hands was 0.25 ng/ml detected on two rice millers (2.3%) while non-detectable in non-exposed workers. The most complained symptoms among rice millers were wheezing and breathlessness (n = 6, 9.2%). There was a significant difference in the mean forced expiration volume (FEV1) for pre- and post-shifts between rice millers and the non-exposed workers, but no significant correlation between the mean AFB1 concentration and lung function. Age and work factors were confounders in lung function. Conclusion: Despite no association being established in this study, the promotion of wearing suitable personal protective equipment (PPE) is highly recommended to prevent cumulative exposure among the rice millers.
{"title":"THE PREDICTING EFFECTS OF DEPRESSION AND SELFESTEEM ON SUICIDAL IDEATION AMONG ADOLESCENTS IN KUALA LUMPUR, MALAYSIA","authors":"Chin Wen Cong, W. Ling","doi":"10.22452/JUMMEC.VOL23NO1.11","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO1.11","url":null,"abstract":"Introduction: Optimal humidity, temperature, improper handling and storage of rice will increase the likeliness of aflatoxin growth in the air. The most common and carcinogenic aflatoxin is Aflatoxin B1 (AFB1) that may cause lung cancer if inhaled. This study aims to associate the exposure of AFB1 in inhalable dust and its respiratory effects among rice millers. \u0000Materials and Methods: This cross-sectional study utilised the purposive sampling method and recruited 76 rice millers as exposed subjects and 48 office workers as the control group. The total inhalable dust was collected using the filter-loaded air samplers for an eight working hours’ exposure. The subjects’ hands were swabbed with cotton pads wetted with 0.5 ml Phosphate buffered Saline Tween-20 solution post shift. The collected samples were analysed for AFB1 by using the ELISA kits. The questionnaire gathering information on sociodemographic, work data and respiratory symptoms were completed. The lung function test was performed for the pre- and post-shifts. \u0000Results: The mean airborne AFB1 at the rice mill area and personal exposure were 2.22 ng/m3 ± 0.07 and 0.25 ng/m3 ± 0.24, respectively. The mean contamination level of AFB1 on hands was 0.25 ng/ml detected on two rice millers (2.3%) while non-detectable in non-exposed workers. The most complained symptoms among rice millers were wheezing and breathlessness (n = 6, 9.2%). There was a significant difference in the mean forced expiration volume (FEV1) for pre- and post-shifts between rice millers and the non-exposed workers, but no significant correlation between the mean AFB1 concentration and lung function. Age and work factors were confounders in lung function. \u0000Conclusion: Despite no association being established in this study, the promotion of wearing suitable personal protective equipment (PPE) is highly recommended to prevent cumulative exposure among the rice millers.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"60-66"},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43272517","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 : 2020-03-16DOI: 10.22452/JUMMEC.VOL23NO1.6
Lenny Suryani Safri, Krishna Kumar, J. Tan, H. Lip, R. Zakaria, M. Idris, H. Harunarashid
Venous malformations (VM) of vulva, perineum and pelvis are uncommon condition which may present with cutaneous varices or aesthetically disabling swelling of external genitalia. Herein, we report a young woman who presented with a large left vulva bluish tinged swelling, progressively increasing in size since birth. Computed tomography of the pelvis and lower limbs confirmed the diagnosis of extensive VM of pelvis and perineum. She underwent selective angiogram which revealed venous malformations of left vulva and gluteal region with no arterial supply to the lesion. Surgical excision was performed but complicated with bleeding which necessitate multimodal hemostatic procedures and blood transfusion. There is no recurrent swelling after 5 years follow up. Surgical excision of vulvar venous malformation offer good cosmetic outcome. However, appropriate planning with axial scan, angiogram and operative technique including multimodal hemostatic measure are important steps to achieve good result with no recurrence. We discussed on challenges on management of this case in relation to the currently available literature.
{"title":"MANAGEMENT OF AN AESTHETICALLY DISABLING COMPLEX VULVAR VENOUS MALFORMATION IN A YOUNG WOMAN","authors":"Lenny Suryani Safri, Krishna Kumar, J. Tan, H. Lip, R. Zakaria, M. Idris, H. Harunarashid","doi":"10.22452/JUMMEC.VOL23NO1.6","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO1.6","url":null,"abstract":"Venous malformations (VM) of vulva, perineum and pelvis are uncommon condition which may present with cutaneous varices or aesthetically disabling swelling of external genitalia. Herein, we report a young woman who presented with a large left vulva bluish tinged swelling, progressively increasing in size since birth. Computed tomography of the pelvis and lower limbs confirmed the diagnosis of extensive VM of pelvis and perineum. She underwent selective angiogram which revealed venous malformations of left vulva and gluteal region with no arterial supply to the lesion. Surgical excision was performed but complicated with bleeding which necessitate multimodal hemostatic procedures and blood transfusion. There is no recurrent swelling after 5 years follow up. Surgical excision of vulvar venous malformation offer good cosmetic outcome. However, appropriate planning with axial scan, angiogram and operative technique including multimodal hemostatic measure are important steps to achieve good result with no recurrence. We discussed on challenges on management of this case in relation to the currently available literature.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"26-28"},"PeriodicalIF":0.0,"publicationDate":"2020-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48183321","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 : 2020-03-06DOI: 10.22452/JUMMEC.VOL23NO1.5
S. P. Gan, S. Yap, S. Ch’ng, H. Baharuddin
A 71-year-old lady with rheumatoid arthritis developed painful peripheral vasculitic neuropathy of the lower limbs and was treated with high dose steroid and cyclophosphamide. Eight months later, she presented with left hip and back pain for a week, with minimal relief from regular analgesia. Although the initial pelvic radiograph was normal, a repeat film performed two weeks later showed a destructive lytic lesion in the left pubic bone, confirmed as osteomyelitis with intramuscular collection by MRI. Cloxacillin was started empirically, and when the blood culture isolated methicillin-sensitive Staphylococcus aureus (MSSA), it was planned to be given for six weeks via a peripherally inserted central catheter. Despite an initial response, she became febrile on the fifth week of antibiotic therapy. Subsequent blood culture isolated Trichosporon asahii. Her condition deteriorated, and she succumbed on the fourth day of antifungal therapy. In conclusion, the diagnosis of osteomyelitis pubis, a rare complication of MSSA bacteremia, could be delayed in an atypical presentation.
{"title":"METHICILLIN-SENSITIVE STAPHYLOCOCCUS AUREUS (MSSA) INFECTION RESULTING IN A RARE CASE OF OSTEOMYELITIS PUBIS IN AN ELDERLY FEMALE: A CASE REPORT","authors":"S. P. Gan, S. Yap, S. Ch’ng, H. Baharuddin","doi":"10.22452/JUMMEC.VOL23NO1.5","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO1.5","url":null,"abstract":"A 71-year-old lady with rheumatoid arthritis developed painful peripheral vasculitic neuropathy of the lower limbs and was treated with high dose steroid and cyclophosphamide. Eight months later, she presented with left hip and back pain for a week, with minimal relief from regular analgesia. Although the initial pelvic radiograph was normal, a repeat film performed two weeks later showed a destructive lytic lesion in the left pubic bone, confirmed as osteomyelitis with intramuscular collection by MRI. Cloxacillin was started empirically, and when the blood culture isolated methicillin-sensitive Staphylococcus aureus (MSSA), it was planned to be given for six weeks via a peripherally inserted central catheter. Despite an initial response, she became febrile on the fifth week of antibiotic therapy. Subsequent blood culture isolated Trichosporon asahii. Her condition deteriorated, and she succumbed on the fourth day of antifungal therapy. In conclusion, the diagnosis of osteomyelitis pubis, a rare complication of MSSA bacteremia, could be delayed in an atypical presentation.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"23-25"},"PeriodicalIF":0.0,"publicationDate":"2020-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42455516","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 : 2020-03-04DOI: 10.22452/JUMMEC.VOL23NO1.9
J. Hana, R. Pinzon
Background: Subarachnoid hemorrhage is a devastating type of stroke with high mortality rate. The understanding of factors that contribute to mortality in patient with subarachnoid hemorrhage can help clinicians in further management of the patients.Aim: The aim of this study is to identify mortality risk factors in patients with subarachnoid hemorrhage (SH).Methods: This study is a retrospective cohort study. Data were obtained from the stroke registry and medical records of patients at Bethesda Hospital Yogyakarta. Data were analyzed using univariate, bivariate and multivariate logistic regression analysis.Results: Data were obtained from 80 subarachnoid hemorrhage patients consisting of 40 males (50%) and 40 females (50%). Result of multivariate analysis show that there are significant associations between mortality in SAH patient with loss of consciousness (OR: 19.722, 95% CI: 1.788- 217.521, p: 0.015), elevated systolic blood pressure (OR: 157.4, 95%CI: 2.068- 11990.9, p: 0.022), high random blood glucose (OR: 12.457, 95%CI: 2.305- 67.322, p: 0.03) and presence of medical complication (OR: 30.539, CI95%: 2.685- 347.377, p: 0.006).Conclusion: This study demonstrated that loss of consciousness, elevated systolic blood pressure, high blood glucose, and presence of medical complication has significant association with mortality of SAH patient.
{"title":"STUDY OF MORTALITY RISK FACTORS IN PATIENTS WITH SUBARACHNOID HEMORRHAGE WITHIN INDONESIAN POPULATION","authors":"J. Hana, R. Pinzon","doi":"10.22452/JUMMEC.VOL23NO1.9","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO1.9","url":null,"abstract":"Background: Subarachnoid hemorrhage is a devastating type of stroke with high mortality rate. The understanding of factors that contribute to mortality in patient with subarachnoid hemorrhage can help clinicians in further management of the patients.Aim: The aim of this study is to identify mortality risk factors in patients with subarachnoid hemorrhage (SH).Methods: This study is a retrospective cohort study. Data were obtained from the stroke registry and medical records of patients at Bethesda Hospital Yogyakarta. Data were analyzed using univariate, bivariate and multivariate logistic regression analysis.Results: Data were obtained from 80 subarachnoid hemorrhage patients consisting of 40 males (50%) and 40 females (50%). Result of multivariate analysis show that there are significant associations between mortality in SAH patient with loss of consciousness (OR: 19.722, 95% CI: 1.788- 217.521, p: 0.015), elevated systolic blood pressure (OR: 157.4, 95%CI: 2.068- 11990.9, p: 0.022), high random blood glucose (OR: 12.457, 95%CI: 2.305- 67.322, p: 0.03) and presence of medical complication (OR: 30.539, CI95%: 2.685- 347.377, p: 0.006).Conclusion: This study demonstrated that loss of consciousness, elevated systolic blood pressure, high blood glucose, and presence of medical complication has significant association with mortality of SAH patient.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"44-48"},"PeriodicalIF":0.0,"publicationDate":"2020-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44716387","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 : 2020-01-30DOI: 10.22452/JUMMEC.VOL23NO1.3
Uma Devi Yookarajah, Lydia Abdul Latiff
Depression is a frequent companion of stroke. It is associated with a degree of functional impairment thatmight adversely affect rehabilitation. A study was carried out to determine the rate of self-reported depressionat admission and after six months, and the associated factors, in patients with stroke who were referred forrehabilitation. A multiple binary logistic regression was used to determine the associated factors at six months.Depression was recorded in 45% of patients at admission and in 39% at six months after the stroke. Patientswho were employed, those who were depressed at admission, those who did not return to work and thosewho did not return to driving six months after stroke, were significantly associated with depression.
{"title":"POST-STROKE DEPRESSION IN REHABILITATION","authors":"Uma Devi Yookarajah, Lydia Abdul Latiff","doi":"10.22452/JUMMEC.VOL23NO1.3","DOIUrl":"https://doi.org/10.22452/JUMMEC.VOL23NO1.3","url":null,"abstract":"Depression is a frequent companion of stroke. It is associated with a degree of functional impairment thatmight adversely affect rehabilitation. A study was carried out to determine the rate of self-reported depressionat admission and after six months, and the associated factors, in patients with stroke who were referred forrehabilitation. A multiple binary logistic regression was used to determine the associated factors at six months.Depression was recorded in 45% of patients at admission and in 39% at six months after the stroke. Patientswho were employed, those who were depressed at admission, those who did not return to work and thosewho did not return to driving six months after stroke, were significantly associated with depression.","PeriodicalId":39135,"journal":{"name":"Journal of the University of Malaya Medical Centre","volume":"23 1","pages":"11-17"},"PeriodicalIF":0.0,"publicationDate":"2020-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41342021","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 : 2020-01-29DOI: 10.22452/JUMMEC.VOL23NO1.2
W. Z. Chew, W. L. Jong, Z. Jamaluddin, Haiza Fasha Zakaraiah, A. Kadri, Mohamad Afandi Azman, Jasmin Loh, G. Ho
Background: Set-up errors are errors which are inevitable in radiotherapy. However, they should be kept to a minimum to achieve the maximum radiation dose to a tumour as to maximise treatment efficacy. This study aims to quantify those errors and assess if they remain within the tolerance limit of 5 mm in all directions. This study will also determine the adequacy of the margins for set up error for 3DCRT of rectal cancers at University of Malaya Medical Centre (UMMC).Methods: A total of 20 rectal cancer patients (July 2018 to May 2019) who were treated with radiotherapy amounting to a total of 119 CBCT images were included in the study. Population systematic errors and random setup errors were calculated.Results: Population systematic errors and random setup errors in the vertical, longitudinal and lateral direction were tabulated in Table 1. There is a large deviation (>5 mm) noted in some patients’ setup between the first 3 days and the next successive day of imaging. Clinical target volume (CTV) to planning target volume (PTV) margin were calculated using Van Herk’s margin recipe (M=2.5Σ+0.7σ). The margins were 5.0 mm, 6.2 mm, and 4.0 mm for vertical, longitudinal and lateral directions, respectively. The systematic error for the population was 1.1 mm, 0.9 mm, 0.9 mm in the vertical, longitudinal and lateral directions respectively, while the random error is 3.2 mm, 5.7 mm and 2.5 mm in the vertical, longitudinal and lateral directions respectively.Conclusion: All of the patients involved in the study were within tolerance limits at some point in their treatment. The results demonstrated that a larger margin is needed in the longitudinal direction. Weekly CBCT is also necessary after the initial 3-day imaging to ensure that patients are kept within the tolerance limits.
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