Pub Date : 2023-10-01DOI: 10.31436/imjm.v22i4.2272
Sivasangari Nachamuthu, Noor Airini Ibrahim, Felicia Su Min Hu, Shahmini Ganesh
INTRODUCTION: Over the past 10 years, the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing dramatically with numerous hospital outbreaks reported. Bacteraemia caused by CRE have limited treatment options and have been associated with high mortality rates. As a result, preventing both CRE transmission and CRE bloodstream infections have become important objectives in managing intensive care unit (ICU) patients. The study aims to determine the incidence and risk factors of CRE bacteraemia in intensive care settings, and its’ clinical outcome. MATERIALS AND METHODS: A retrospective, descriptive study was conducted, where data of the patients admitted to general ICU of Hospital Pulau Pinang from January 2017 till December 2018 were collected and assessed for incidence, presence of predisposing factors and clinical outcome for CRE bloodstream infection. RESULTS: Out of 2,585 total ICU admissions, there were 37 cases of CRE bacteraemia with an incidence rate of 1.43%. An analysis of risk factors revealed that the use of indwelling catheter has the highest association with CRE bacteraemia in which 95% of the patients were exposed. The commonest organisms of CRE bacteraemia were Klebsiella pneumoniae (97.3%) and Escherichia coli (2.7%). The 30-day mortality rate after CRE bacteraemia was 78.4%. CONCLUSION: CRE bacteraemia among ICU patients showed a high mortality rate. Most of the patients were exposed to multiple risk factors. A high index of suspicion and rapid identification of patients at risk for CRE infection are important for effective therapy and initiation of infection control measures to prevent further spread.
{"title":"Carbapenem-Resistant Enterobacteriaceae Bacteraemia in Intensive Care Unit: A Descriptive Study on Risk Factors and Clinical Outcome","authors":"Sivasangari Nachamuthu, Noor Airini Ibrahim, Felicia Su Min Hu, Shahmini Ganesh","doi":"10.31436/imjm.v22i4.2272","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2272","url":null,"abstract":"INTRODUCTION: Over the past 10 years, the prevalence of carbapenem-resistant Enterobacteriaceae (CRE) has been increasing dramatically with numerous hospital outbreaks reported. Bacteraemia caused by CRE have limited treatment options and have been associated with high mortality rates. As a result, preventing both CRE transmission and CRE bloodstream infections have become important objectives in managing intensive care unit (ICU) patients. The study aims to determine the incidence and risk factors of CRE bacteraemia in intensive care settings, and its’ clinical outcome. MATERIALS AND METHODS: A retrospective, descriptive study was conducted, where data of the patients admitted to general ICU of Hospital Pulau Pinang from January 2017 till December 2018 were collected and assessed for incidence, presence of predisposing factors and clinical outcome for CRE bloodstream infection. RESULTS: Out of 2,585 total ICU admissions, there were 37 cases of CRE bacteraemia with an incidence rate of 1.43%. An analysis of risk factors revealed that the use of indwelling catheter has the highest association with CRE bacteraemia in which 95% of the patients were exposed. The commonest organisms of CRE bacteraemia were Klebsiella pneumoniae (97.3%) and Escherichia coli (2.7%). The 30-day mortality rate after CRE bacteraemia was 78.4%. CONCLUSION: CRE bacteraemia among ICU patients showed a high mortality rate. Most of the patients were exposed to multiple risk factors. A high index of suspicion and rapid identification of patients at risk for CRE infection are important for effective therapy and initiation of infection control measures to prevent further spread.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135407329","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 : 2023-10-01DOI: 10.31436/imjm.v22i4.2287
Faiz Daud, Perema Kumari Ponnampalam, Nur Fatin Nabila Mohd Nadzri
INTRODUCTION: Fee-for-service (FFS) has been the main payment method for clinical specialists around the world. However, until most recently, several payment methods for doctors, particularly clinical specialists, such as salary, pay for performance and blended remuneration of the above models have been researched. This mechanism is being used to increase the level of quality and value of healthcare services in the health sector. Despite increasing interest in these alternative payment methods, there is limited research about the payment method offered to clinical specialists in Malaysia. MATERIALS AND METHODS: Using qualitative interview with 15 private clinical specialists and 4 hospital administrators working in private hospitals in Malaysia, we explored the existing payment methods offered to private clinical specialists by private hospitals. RESULTS: Our study found that four payment methods were used which were FFS, salary-based, salary-based plus incentives and pool system. Majority of the clinical specialists interviewed were under the FFS payment method. New emerging payment methods which include salary-based and salary-based plus incentives were implemented in recent years, while the pool system was confined to certain specialities. CONCLUSION: The private hospitals in Malaysia provides different payment methods to the private clinical specialists which includes FFS, salary-based, salary-based plus incentives and pool system. These findings can help policymakers to explore the potential of various payment methods in the near future.
{"title":"Exploratory Study on the Compensation Practices in Private Hospitals for Clinical Specialists in Malaysia","authors":"Faiz Daud, Perema Kumari Ponnampalam, Nur Fatin Nabila Mohd Nadzri","doi":"10.31436/imjm.v22i4.2287","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2287","url":null,"abstract":"INTRODUCTION: Fee-for-service (FFS) has been the main payment method for clinical specialists around the world. However, until most recently, several payment methods for doctors, particularly clinical specialists, such as salary, pay for performance and blended remuneration of the above models have been researched. This mechanism is being used to increase the level of quality and value of healthcare services in the health sector. Despite increasing interest in these alternative payment methods, there is limited research about the payment method offered to clinical specialists in Malaysia. MATERIALS AND METHODS: Using qualitative interview with 15 private clinical specialists and 4 hospital administrators working in private hospitals in Malaysia, we explored the existing payment methods offered to private clinical specialists by private hospitals. RESULTS: Our study found that four payment methods were used which were FFS, salary-based, salary-based plus incentives and pool system. Majority of the clinical specialists interviewed were under the FFS payment method. New emerging payment methods which include salary-based and salary-based plus incentives were implemented in recent years, while the pool system was confined to certain specialities. CONCLUSION: The private hospitals in Malaysia provides different payment methods to the private clinical specialists which includes FFS, salary-based, salary-based plus incentives and pool system. These findings can help policymakers to explore the potential of various payment methods in the near future.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135407486","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 : 2023-10-01DOI: 10.31436/imjm.v22i4.2325
Maryam Riyadh Yaseen Al-Bayati, Ghasak Ghazi Faisal, Azliana Abd Fuaat, Khairunisa Ahmad Affandi, Batoul Alallam
INTRODUCTION: Collagen is the key component of the extracellular matrix that plays a critical role in the strength and quality of the healed wound. Eurycoma longifolia Jack root extract (TA) has been documented as an anti-inflammatory, antioxidant, and antimicrobial agent that may improve the quality of healed wounds. The objective of this study is to investigate the effect of topical application of TA hydrogel on the quality of the healed skin in rats. MATERIALS AND METHODS: Twenty male Sprague Dawley rats were grouped into 4 groups: Negative control, Hydrocyn® aqua gel positive control, vehicle (Xanthan) hydrogel, and Eurycoma longifolia Jack (TA) hydrogel. Treatments were applied twice daily starting on wounding day until day 21. An excisional wound was created on the back of 20 rats. Tissue samples of the healed skin were collected for histological examination by measuring the epidermal and dermal thicknesses and evaluating the collagen fibre quality by VVG stain. RESULTS: The TA hydrogel group had the thickest newly formed epidermis compared with the other experimental groups. For the dermal thickness, compared with the vehicle (xanthan) hydrogel group, TA hydrogel, and Hydrocyn aqua® gel positive control groups showed significantly increased thickness with p values 0.020 and 0.045, respectively. Histologically TA hydrogel group showed a significant increase in mixed-oriented collagen fibres, and fascicular collagen bundles and showed profound collagen density. CONCLUSION: TA hydrogel improved the quality of healed skin by increasing the epidermal/dermal thicknesses and enhancing the quality of newly produced collagen fibres. It can be considered a promising and effective wound-healing agent.
胶原蛋白是细胞外基质的关键成分，在愈合伤口的强度和质量中起着关键作用。长叶Eurycoma longifolia杰克根提取物(TA)已被证明是一种抗炎，抗氧化和抗菌剂，可以改善愈合伤口的质量。本研究旨在探讨TA水凝胶外用对大鼠皮肤愈合质量的影响。材料与方法:雄性Sprague Dawley大鼠20只，随机分为4组:阴性对照组、Hydrocyn®水凝胶阳性对照组、载体(黄原胶)水凝胶组和长叶Eurycoma longifolia Jack (TA)水凝胶组。从受伤日起至第21天，每日2次。在20只大鼠的背部留下了一个切除伤口。取愈合后皮肤组织标本进行组织学检查，测定表皮和真皮厚度，用VVG染色法评价胶原纤维质量。结果:与其他实验组相比，TA水凝胶组新生表皮厚度最大。真皮厚度方面，与载体(黄原胶)水凝胶组相比，TA水凝胶组和Hydrocyn aqua®凝胶阳性对照组的真皮厚度显著增加(p值分别为0.020和0.045)。组织学上，TA水凝胶组混合取向胶原纤维和束状胶原束明显增加，胶原密度较深。结论:TA水凝胶通过增加表皮/真皮厚度和提高新生成胶原纤维的质量来改善皮肤愈合质量。它可以被认为是一种有前途和有效的伤口愈合剂。
{"title":"Improved Quality of Healed Wounds with Topical Application of Eurycoma Longifolia Jack Root Extract Hydrogel","authors":"Maryam Riyadh Yaseen Al-Bayati, Ghasak Ghazi Faisal, Azliana Abd Fuaat, Khairunisa Ahmad Affandi, Batoul Alallam","doi":"10.31436/imjm.v22i4.2325","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2325","url":null,"abstract":"INTRODUCTION: Collagen is the key component of the extracellular matrix that plays a critical role in the strength and quality of the healed wound. Eurycoma longifolia Jack root extract (TA) has been documented as an anti-inflammatory, antioxidant, and antimicrobial agent that may improve the quality of healed wounds. The objective of this study is to investigate the effect of topical application of TA hydrogel on the quality of the healed skin in rats. MATERIALS AND METHODS: Twenty male Sprague Dawley rats were grouped into 4 groups: Negative control, Hydrocyn® aqua gel positive control, vehicle (Xanthan) hydrogel, and Eurycoma longifolia Jack (TA) hydrogel. Treatments were applied twice daily starting on wounding day until day 21. An excisional wound was created on the back of 20 rats. Tissue samples of the healed skin were collected for histological examination by measuring the epidermal and dermal thicknesses and evaluating the collagen fibre quality by VVG stain. RESULTS: The TA hydrogel group had the thickest newly formed epidermis compared with the other experimental groups. For the dermal thickness, compared with the vehicle (xanthan) hydrogel group, TA hydrogel, and Hydrocyn aqua® gel positive control groups showed significantly increased thickness with p values 0.020 and 0.045, respectively. Histologically TA hydrogel group showed a significant increase in mixed-oriented collagen fibres, and fascicular collagen bundles and showed profound collagen density. CONCLUSION: TA hydrogel improved the quality of healed skin by increasing the epidermal/dermal thicknesses and enhancing the quality of newly produced collagen fibres. It can be considered a promising and effective wound-healing agent.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135407470","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 : 2023-10-01DOI: 10.31436/imjm.v22i4.2329
Azriani Rahman, Nor Azila Rani, Wan Mohd Zahiruddin Wan Mohammad, Norzila Zakaria
INTRODUCTION: Adolescent depression is a substantial health concern nowadays, and perceived social support determines the outcome. Lack of research on depression amongst Malaysian younger group of adolescents, puts them at risk of being under diagnosed and under treated. Furthermore, the function of various social supports for depression in early adolescents is less explored. The primary objective of this study was to determine the level of support for adolescent depression from five different sources: i) parents, ii) teachers, iii) close friends, iv) classmates, and v) others in school. The secondary objective is to study the prevalence of depression amongst primary school adolescents and establish their association and the other factors that influence depression. MATERIALS AND METHODS: A cross-sectional study involving 576 adolescents between the ages of 10-11 year olds were conducted from August 2020 till September 2020 using the Malay Children Depression Inventory (M-CDI) and Malay Child and Adolescent Social Support Scale (M-CASSS). RESULTS: The respondents reported that teachers were the most supportive. Approximately 131 (22.7%) of them had depressive symptoms. Only parental support significantly reduced their risk of developing depression. Having a single parent household, being bullied, emotional abuse, and performing poorly in school increased the likelihood of developing depression. CONCLUSION: Findings from this study, demonstrated the necessity for early depression screening amongst primary school adolescents and the need for stakeholders to continue supporting parents in their efforts to deal with adolescent concerns.
{"title":"Sources of Perceived Social Support and Associated Factors for Depression amongst Malay Primary School Adolescents in Kelantan, Malaysia","authors":"Azriani Rahman, Nor Azila Rani, Wan Mohd Zahiruddin Wan Mohammad, Norzila Zakaria","doi":"10.31436/imjm.v22i4.2329","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2329","url":null,"abstract":"INTRODUCTION: Adolescent depression is a substantial health concern nowadays, and perceived social support determines the outcome. Lack of research on depression amongst Malaysian younger group of adolescents, puts them at risk of being under diagnosed and under treated. Furthermore, the function of various social supports for depression in early adolescents is less explored. The primary objective of this study was to determine the level of support for adolescent depression from five different sources: i) parents, ii) teachers, iii) close friends, iv) classmates, and v) others in school. The secondary objective is to study the prevalence of depression amongst primary school adolescents and establish their association and the other factors that influence depression. MATERIALS AND METHODS: A cross-sectional study involving 576 adolescents between the ages of 10-11 year olds were conducted from August 2020 till September 2020 using the Malay Children Depression Inventory (M-CDI) and Malay Child and Adolescent Social Support Scale (M-CASSS). RESULTS: The respondents reported that teachers were the most supportive. Approximately 131 (22.7%) of them had depressive symptoms. Only parental support significantly reduced their risk of developing depression. Having a single parent household, being bullied, emotional abuse, and performing poorly in school increased the likelihood of developing depression. CONCLUSION: Findings from this study, demonstrated the necessity for early depression screening amongst primary school adolescents and the need for stakeholders to continue supporting parents in their efforts to deal with adolescent concerns.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135406720","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 : 2023-10-01DOI: 10.31436/imjm.v22i4.2443
Assoc. Prof. Dr. Nik Nur Fatnoon Nik Ahmad
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{"title":"Confronting Global Obesity Epidemic: Art of Simplicity, Puzzle of Complexity","authors":"Assoc. Prof. Dr. Nik Nur Fatnoon Nik Ahmad ","doi":"10.31436/imjm.v22i4.2443","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2443","url":null,"abstract":"-","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135406850","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 : 2023-10-01DOI: 10.31436/imjm.v22i4.2091
Wan Fatimah Suriyani Wan Mahmud, Mohammad Che Man, Muhammad Zubir Yusof, Islah Munjih Ab Rashid, Shahidah Che Alhadi, Iskandar Firzada Osman
INTRODUCTION: Erectile dysfunction (ED) is a significant issue that should not be ignored in the clinical setting and can negatively affect the quality of life of patients and their partners. This study aims to determine the prevalence of ED and its associated factors among men who visited 12 government health clinics in Kuantan, Pahang, Malaysia. MATERIALS AND METHODS: Between July and October 2021, 300 males aged 18 to 60 participated in this cross-sectional study at 12 government health clinics in Kuantan. Information on demographic data, medical history, and lifestyle of the participants was obtained through a self-administered questionnaire that included a validated Malay version of the 21 item Depression Anxiety Stress Scale (DASS 21) and the International Index of Erectile Function (IIEF-5). RESULTS: The overall prevalence of self-reported ED was 69.3%. In terms of severity, 45.7% had mild, 20.7% mild-to-moderate, 2.3% moderate, and 1% severe ED. Multivariate analysis showed that ED associated with diabetes (OR 2.97, 95% CI 1.13–7.79); anxiety (OR 2.85, 95% CI 1.06 – 7.67) and household income (OR 0.41, 95% CI 0.18–0.95). CONCLUSION: ED was high in our study population. Diabetes mellitus, anxiety and household income were significantly associated with ED.
简介:勃起功能障碍(ED)是一个重要的问题，不应忽视在临床设置，可以负面影响生活质量的患者和他们的伴侣。本研究旨在确定在马来西亚彭亨州关丹市12个政府卫生诊所就诊的男性中ED的患病率及其相关因素。材料和方法:2021年7月至10月期间，300名年龄在18至60岁的男性在关丹的12个政府卫生诊所参加了这项横断面研究。参与者的人口统计数据、病史和生活方式信息是通过自我管理的问卷获得的，该问卷包括21项抑郁焦虑压力量表(DASS 21)和国际勃起功能指数(IIEF-5)的马来文版。结果:自我报告ED的总体患病率为69.3%。在严重程度方面，45.7%为轻度ED, 20.7%为轻度至中度ED, 2.3%为中度ED, 1%为重度ED。多因素分析显示，ED与糖尿病相关(OR 2.97, 95% CI 1.13-7.79);焦虑(OR 2.85, 95% CI 1.06 - 7.67)和家庭收入(OR 0.41, 95% CI 0.18-0.95)。结论:本研究人群ED发生率高。糖尿病、焦虑和家庭收入与ED显著相关。
{"title":"Prevalence of Erectile Dysfunction and its Associated Factors among Men in Government Health Clinics in Kuantan, Pahang","authors":"Wan Fatimah Suriyani Wan Mahmud, Mohammad Che Man, Muhammad Zubir Yusof, Islah Munjih Ab Rashid, Shahidah Che Alhadi, Iskandar Firzada Osman","doi":"10.31436/imjm.v22i4.2091","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2091","url":null,"abstract":"INTRODUCTION: Erectile dysfunction (ED) is a significant issue that should not be ignored in the clinical setting and can negatively affect the quality of life of patients and their partners. This study aims to determine the prevalence of ED and its associated factors among men who visited 12 government health clinics in Kuantan, Pahang, Malaysia. MATERIALS AND METHODS: Between July and October 2021, 300 males aged 18 to 60 participated in this cross-sectional study at 12 government health clinics in Kuantan. Information on demographic data, medical history, and lifestyle of the participants was obtained through a self-administered questionnaire that included a validated Malay version of the 21 item Depression Anxiety Stress Scale (DASS 21) and the International Index of Erectile Function (IIEF-5). RESULTS: The overall prevalence of self-reported ED was 69.3%. In terms of severity, 45.7% had mild, 20.7% mild-to-moderate, 2.3% moderate, and 1% severe ED. Multivariate analysis showed that ED associated with diabetes (OR 2.97, 95% CI 1.13–7.79); anxiety (OR 2.85, 95% CI 1.06 – 7.67) and household income (OR 0.41, 95% CI 0.18–0.95). CONCLUSION: ED was high in our study population. Diabetes mellitus, anxiety and household income were significantly associated with ED.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135407299","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 : 2023-10-01DOI: 10.31436/imjm.v22i4.2352
Nik Nairan Abdullah, Mohammad Syafiq Hassan, Khalid Ibrahim
INTRODUCTION: Rabies is a neglected disease. Before the epidemic of rabies in Sarawak in July 2017, surveillance of mammal bites was not well implemented throughout the state. Our objective was to determine the prevalence of mammal bites in the Mukah Division and the factors that are associated with the risk of exposure to human rabies. MATERIALS AND METHODS: This is a cross-sectional study that used data from reported cases of mammal bites in Mukah Division, Sarawak, from 2018–2019. A universal sampling method was used, and 457 cases of mammal bites were included in the analysis. Data was analysed using single logistic regression and multiple logistic regression. RESULTS: The prevalence of mammal bites in Mukah Division was 0.35% with a cumulative incidence of 354 per 100 000 population. Age group 0-14 years old (AOR 6.49, 95%CI 1.26-33.53), free-roaming pet (AOR 2.93, 95% 1.36-6.28) and stray mammals (AOR 10.88, 95% CI 5.05-23.48) were found to be significantly associated with risk exposure to human rabies in Mukah Division in the final model. CONCLUSION: Health awareness and education should be emphasized to the community and medical personnel on the identified risk factors so that rabies infection can be prevented.
{"title":"Factors Associated with Risk Exposure to Human Rabies among Mammal Bite Cases in Mukah Division, Sarawak, East Malaysia","authors":"Nik Nairan Abdullah, Mohammad Syafiq Hassan, Khalid Ibrahim","doi":"10.31436/imjm.v22i4.2352","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2352","url":null,"abstract":"INTRODUCTION: Rabies is a neglected disease. Before the epidemic of rabies in Sarawak in July 2017, surveillance of mammal bites was not well implemented throughout the state. Our objective was to determine the prevalence of mammal bites in the Mukah Division and the factors that are associated with the risk of exposure to human rabies. MATERIALS AND METHODS: This is a cross-sectional study that used data from reported cases of mammal bites in Mukah Division, Sarawak, from 2018–2019. A universal sampling method was used, and 457 cases of mammal bites were included in the analysis. Data was analysed using single logistic regression and multiple logistic regression. RESULTS: The prevalence of mammal bites in Mukah Division was 0.35% with a cumulative incidence of 354 per 100 000 population. Age group 0-14 years old (AOR 6.49, 95%CI 1.26-33.53), free-roaming pet (AOR 2.93, 95% 1.36-6.28) and stray mammals (AOR 10.88, 95% CI 5.05-23.48) were found to be significantly associated with risk exposure to human rabies in Mukah Division in the final model. CONCLUSION: Health awareness and education should be emphasized to the community and medical personnel on the identified risk factors so that rabies infection can be prevented.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135407187","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 : 2023-10-01DOI: 10.31436/imjm.v22i4.2152
Mukarramah Zainal, Nur Sabrina Md Asri, Nur Sabrina Mohamed Faizal, Hasnah Begum Said Gulam Khan, Wan Nurhazirah Wan Ahmad Kamil, Nurul ‘Izzah Mohd Sarmin, Noor Kaslina Mohd Kornain, Mohd Hafiz Arzmi
Cancer which synonymously known as neoplasia is a genetic disorder of cell growth that is triggered by acquired or less commonly inherited mutations affecting a single cell and its clonal progeny. The aims of this scoping review was to investigate the role of sugar and sugar substitutes in breast, lung, and oral cancers with a hypothesis that sugar promoted carcinogenesis. Three databases (EBSCO, PubMed, and Scopus) were searched from January 2010 to December 2021 to identify the preclinical studies eligible for this scoping review. The review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. A total of 361 articles were reviewed and the qualitative synthesis used 12 of these articles. Based on the qualitative synthesis, four studies reported dietary sugar (glucose- and/or sucrose) induced cancer progression, one study revealed sugar substitute (aspartame) induced cancer proliferation, seven studies reported that sugar substitutes inhibit cancer proliferation, and one study reported that sucrose promotes cancer while xylitol inhibits cancer. In addition., it was reported that D-allose and cisplatin have a synergistic effect in treating cancer. In conclusion, simple sugar intake is associated with an increased risk of carcinogenesis. In contrast, sugar substitutes inhibit cancer cell line progression, subsequently acting as a potential cancer therapy, thus supporting the study's hypothesis.
{"title":"The Association of Sugar and Sugar Substitutes to Breast, Lung, and Oral Cancer Cell Lines: A Scoping Review","authors":"Mukarramah Zainal, Nur Sabrina Md Asri, Nur Sabrina Mohamed Faizal, Hasnah Begum Said Gulam Khan, Wan Nurhazirah Wan Ahmad Kamil, Nurul ‘Izzah Mohd Sarmin, Noor Kaslina Mohd Kornain, Mohd Hafiz Arzmi","doi":"10.31436/imjm.v22i4.2152","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2152","url":null,"abstract":"Cancer which synonymously known as neoplasia is a genetic disorder of cell growth that is triggered by acquired or less commonly inherited mutations affecting a single cell and its clonal progeny. The aims of this scoping review was to investigate the role of sugar and sugar substitutes in breast, lung, and oral cancers with a hypothesis that sugar promoted carcinogenesis. Three databases (EBSCO, PubMed, and Scopus) were searched from January 2010 to December 2021 to identify the preclinical studies eligible for this scoping review. The review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. A total of 361 articles were reviewed and the qualitative synthesis used 12 of these articles. Based on the qualitative synthesis, four studies reported dietary sugar (glucose- and/or sucrose) induced cancer progression, one study revealed sugar substitute (aspartame) induced cancer proliferation, seven studies reported that sugar substitutes inhibit cancer proliferation, and one study reported that sucrose promotes cancer while xylitol inhibits cancer. In addition., it was reported that D-allose and cisplatin have a synergistic effect in treating cancer. In conclusion, simple sugar intake is associated with an increased risk of carcinogenesis. In contrast, sugar substitutes inhibit cancer cell line progression, subsequently acting as a potential cancer therapy, thus supporting the study's hypothesis.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135407496","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}
INTRODUCTION: Severe acute respiratory syndrome coronavirus (SARS-CoV) has mutated over time, affecting its virulence, pathogenicity and disease severity. In December 2019, a new coronavirus (SARS-CoV-2) has emerged causing a disease known as coronavirus disease (COVID-19). The COVID-19 has a broad spectrum of severity ranging from an asymptomatic to a severe acute respiratory syndrome requiring mechanical ventilation. COVID-19 is often more severe in people aged 60 years or more, or those with health conditions like lung or heart disease, diabetes, or conditions that affect the immune system including kidney transplant recipients. In this case series, we presented our experience with 17 kidney transplant recipients who had COVID-19 infection. In India, COVID-19 peaked twice: once between August and November 2020, and again between March and June 2021. Thus, there was paucity of COVID-19 data in kidney transplant recipients in India during these times. MATERIAL AND METHODS: Our case series constituted a retrospective observational study involving 17 kidney transplant recipients who experienced COVID-19 infection from November 2020 to September 2021 at a solitary tertiary care center in Pune. Within our institution, the nephrology team assessed kidney transplant recipients with COVID-19 for appropriate immunosuppression dosing, renal drug clearance when deemed necessary, and overall well-being. Treatment for COVID-19 adhered to institutional protocols. RESULTS: In our case series, majority of the patients (n=13) had COVID-19 in March 2021 to July 2021 and the commonest presenting symptoms were fever and cough. Out of 17 kidney transplant recipients included in this case series, 13 patients survived while 4 patients succumbed to infection. CONCLUSION: An individualized, case-based approach to managing transplant recipients with COVID-19 is crucial for achieving favorable clinical outcomes.
{"title":"A Single Centre Case-Series of Covid-19 Infection in Kidney Transplant Recipients","authors":"Tushar Dighe, Purva Bavikar, Nilesh Shinde, Pavan Wakhare, Charan Bale, Atul Sajgure","doi":"10.31436/imjm.v22i4.2048","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2048","url":null,"abstract":"INTRODUCTION: Severe acute respiratory syndrome coronavirus (SARS-CoV) has mutated over time, affecting its virulence, pathogenicity and disease severity. In December 2019, a new coronavirus (SARS-CoV-2) has emerged causing a disease known as coronavirus disease (COVID-19). The COVID-19 has a broad spectrum of severity ranging from an asymptomatic to a severe acute respiratory syndrome requiring mechanical ventilation. COVID-19 is often more severe in people aged 60 years or more, or those with health conditions like lung or heart disease, diabetes, or conditions that affect the immune system including kidney transplant recipients. In this case series, we presented our experience with 17 kidney transplant recipients who had COVID-19 infection. In India, COVID-19 peaked twice: once between August and November 2020, and again between March and June 2021. Thus, there was paucity of COVID-19 data in kidney transplant recipients in India during these times. MATERIAL AND METHODS: Our case series constituted a retrospective observational study involving 17 kidney transplant recipients who experienced COVID-19 infection from November 2020 to September 2021 at a solitary tertiary care center in Pune. Within our institution, the nephrology team assessed kidney transplant recipients with COVID-19 for appropriate immunosuppression dosing, renal drug clearance when deemed necessary, and overall well-being. Treatment for COVID-19 adhered to institutional protocols. RESULTS: In our case series, majority of the patients (n=13) had COVID-19 in March 2021 to July 2021 and the commonest presenting symptoms were fever and cough. Out of 17 kidney transplant recipients included in this case series, 13 patients survived while 4 patients succumbed to infection. CONCLUSION: An individualized, case-based approach to managing transplant recipients with COVID-19 is crucial for achieving favorable clinical outcomes.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135407608","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}
Hypoglycaemia is a common complication seen in diabetic patients receiving insulin. However, insulin is not the risk factor for hypoglycaemia attack as patient with underlying liver problem is also at risk. Thus, as an attending physician, a high index of suspicion is required in dealing with hypoglycaemia patient. We report a 60-year-old woman with underlying diabetes mellitus who presented with recurrent hypoglycaemic episodes and noted to have multiple benign liver cysts that progressed into hepatic failure secondary to hepatocellular carcinoma.
{"title":"Recurrent Hypoglycaemia in A Diabetic Patient: The Unexpected Diagnosis","authors":"Poh Siang Ooi, Nani Draman, Nazri Mustaffa, Nurjasmine Aida Jamani","doi":"10.31436/imjm.v22i4.2151","DOIUrl":"https://doi.org/10.31436/imjm.v22i4.2151","url":null,"abstract":"Hypoglycaemia is a common complication seen in diabetic patients receiving insulin. However, insulin is not the risk factor for hypoglycaemia attack as patient with underlying liver problem is also at risk. Thus, as an attending physician, a high index of suspicion is required in dealing with hypoglycaemia patient. We report a 60-year-old woman with underlying diabetes mellitus who presented with recurrent hypoglycaemic episodes and noted to have multiple benign liver cysts that progressed into hepatic failure secondary to hepatocellular carcinoma.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135407605","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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