S. D., Razman Mr, Ramli M, M. Ma, M. S., Muhamad Shaiful Lizam Ma, Muhammad Salman Mh, Mohamad Faqihuddin H
Introduction: Lack of knowledge and negative attitude towards HIV/AIDS may be the risk factors for HIV infection among transsexuals. Research on knowledge and attitude towards HIV infection in transsexual communities is very limited at both local and international levels. This study aimed to assess the knowledge and attitude towards HIV infection among the male-to-female transsexual community in Kuantan, Pahang. Methods: A cross-sectional study was carried out from July to August 2014 among 33 male-to-female transsexuals in Kuantan, Pahang. Convenience sampling was used. Participants who gave consent answered a self-administered questionnaire. Data obtained was analyzed with descriptive statistics, χ2-test, and independent sample t test. Results: The majority of the subjects in this study were 29 years and below (48.5%), Muslims (93.9%), and had completed up to secondary education (60.6%). Most of them were sex workers (60.6%), and had relatively low income (no income to RM 3000, mean of RM1528). A total of 87.9% of the subjects demonstrated good knowledge and also positive attitude towards HIV/AIDS. Level of education was significantly associated with scores in knowledge (p=0.01). Conclusions: Despite the positive outcome from this study, misconceptions towards HIV/AIDS still exist among transsexuals. Education and interventions from multiple directions on HIV/AIDS are essential to deliver the correct information to this population, so as to emphasize prevention, early detection, and holistic medical care. Transsexuals also require attention from religious bodies and non-governmental organizations to help them in employment, financial, spiritual, and psycho-social issues.
{"title":"Knowledge and Attitude towards HIV/AIDS among transsexuals in Kuantan, Pahang","authors":"S. D., Razman Mr, Ramli M, M. Ma, M. S., Muhamad Shaiful Lizam Ma, Muhammad Salman Mh, Mohamad Faqihuddin H","doi":"10.31436/IMJM.V15I1.406","DOIUrl":"https://doi.org/10.31436/IMJM.V15I1.406","url":null,"abstract":"Introduction: Lack of knowledge and negative attitude towards HIV/AIDS may be the risk factors for HIV infection among transsexuals. Research on knowledge and attitude towards HIV infection in transsexual communities is very limited at both local and international levels. This study aimed to assess the knowledge and attitude towards HIV infection among the male-to-female transsexual community in Kuantan, Pahang. Methods: A cross-sectional study was carried out from July to August 2014 among 33 male-to-female transsexuals in Kuantan, Pahang. Convenience sampling was used. Participants who gave consent answered a self-administered questionnaire. Data obtained was analyzed with descriptive statistics, χ2-test, and independent sample t test. Results: The majority of the subjects in this study were 29 years and below (48.5%), Muslims (93.9%), and had completed up to secondary education (60.6%). Most of them were sex workers (60.6%), and had relatively low income (no income to RM 3000, mean of RM1528). A total of 87.9% of the subjects demonstrated good knowledge and also positive attitude towards HIV/AIDS. Level of education was significantly associated with scores in knowledge (p=0.01). Conclusions: Despite the positive outcome from this study, misconceptions towards HIV/AIDS still exist among transsexuals. Education and interventions from multiple directions on HIV/AIDS are essential to deliver the correct information to this population, so as to emphasize prevention, early detection, and holistic medical care. Transsexuals also require attention from religious bodies and non-governmental organizations to help them in employment, financial, spiritual, and psycho-social issues.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44376547","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}
D. Abdulwahab, I. Hamizah, N. Zalina, S. Yong, A. Mokhtar
Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25 women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9 years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%) women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus. Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various maternal morbidities, in this case series , which could have been prevented if they were diagnosed and terminated at early trimester. A new direction is needed in our local practice.
{"title":"A Retrospective Review of 25 cases of Lethal Fetal Anomalies","authors":"D. Abdulwahab, I. Hamizah, N. Zalina, S. Yong, A. Mokhtar","doi":"10.31436/IMJM.V15I1.402","DOIUrl":"https://doi.org/10.31436/IMJM.V15I1.402","url":null,"abstract":"Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25 women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9 years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%) women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus. Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various maternal morbidities, in this case series , which could have been prevented if they were diagnosed and terminated at early trimester. A new direction is needed in our local practice.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44707306","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}
ABSTRACT Introduction: The proto-oncogene c-kit is the cellular homologue of the oncogene v-kit of HZ4 feline sarcoma virus. It is located on chromosome 4 (4q11-12) in the human genome. Interaction between the c-kit receptor and its ligand, stem cell factor, is essential in the development of tissues. C-kit expression has been identified in a number of different neoplasms like seminoma/dysgerminoma, and gastrointestinal stromal tumors (GIST). Recently it has been reported that c-kit is also present in leiomyosarcomas. Tyrosine kinase inhibitors (TKIs) are a promising new therapy in the treatment of cancer. These agents target cellular proteins like kit and its related homologues decreasing cellular proliferation and survival. TKIs may be helpful in treating leiomyosarcomas expressing c-kit. Materials and Methods: In this study a total of 6 cases diagnosed as leiomyosarcomas at Department of Pathology, Universiti Sains Malaysia, Kubang Kerian, Malaysia, were investigated for reactivity for c-kit using immunohistochemical stain. Stain was considered positive if more than 10 percent of the cells showed membrane or cytoplasmic positivity. Results: Two leiomyosarcomas stained faintly with c-kit and in less than 10 percent of the cells. The other 4 cases showed no staining. The control showed good membrane and cytoplasmic positivity. Conclusion: Uterine leiomyosarcomas did not express c-kit. The reason for this could be that the tumors are inherently c-kit negative. More study using larger number of cases is required to validate these findings and further molecular characterization of these mesenchymal tumors is needed to identify the true nature of these sarcomas. KEYWORDS: Leiomyosarcoma, Uterus, C-kit protein, Immunohistochemistry.
{"title":"C-kit proto-oncogene expression in uterine leiomyosarcomas: case series","authors":"V. Naik, J. Hasnan","doi":"10.31436/IMJM.V7I2.784","DOIUrl":"https://doi.org/10.31436/IMJM.V7I2.784","url":null,"abstract":"ABSTRACT Introduction: The proto-oncogene c-kit is the cellular homologue of the oncogene v-kit of HZ4 feline sarcoma virus. It is located on chromosome 4 (4q11-12) in the human genome. Interaction between the c-kit receptor and its ligand, stem cell factor, is essential in the development of tissues. C-kit expression has been identified in a number of different neoplasms like seminoma/dysgerminoma, and gastrointestinal stromal tumors (GIST). Recently it has been reported that c-kit is also present in leiomyosarcomas. Tyrosine kinase inhibitors (TKIs) are a promising new therapy in the treatment of cancer. These agents target cellular proteins like kit and its related homologues decreasing cellular proliferation and survival. TKIs may be helpful in treating leiomyosarcomas expressing c-kit. Materials and Methods: In this study a total of 6 cases diagnosed as leiomyosarcomas at Department of Pathology, Universiti Sains Malaysia, Kubang Kerian, Malaysia, were investigated for reactivity for c-kit using immunohistochemical stain. Stain was considered positive if more than 10 percent of the cells showed membrane or cytoplasmic positivity. Results: Two leiomyosarcomas stained faintly with c-kit and in less than 10 percent of the cells. The other 4 cases showed no staining. The control showed good membrane and cytoplasmic positivity. Conclusion: Uterine leiomyosarcomas did not express c-kit. The reason for this could be that the tumors are inherently c-kit negative. More study using larger number of cases is required to validate these findings and further molecular characterization of these mesenchymal tumors is needed to identify the true nature of these sarcomas. KEYWORDS: Leiomyosarcoma, Uterus, C-kit protein, Immunohistochemistry.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41684739","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}
Muziman Syah Mustafa, H. A. Mutalib, Sharanjeet Kaur Ms, Khairidzan Mk
Introduction : The purpose of this study was to evaluate inter-session repeatability, inter-examiner reproducibility and inter-device agreement of corneal power measurements from manual keratometer, autokeratometer, topographer, Pentacam high resolution and IOLMaster. Methods : Two sets of mean corneal power measurements ( n =40) were compared for inter-session repeatability and inter-examiner reproducibility in each instrument. Repeatability and reproducibility were evaluated by within-subject standard deviation (Sw), coefficient of variation (COV) and intraclass correlation coefficient (ICC). A one-way repeated measures analysis of variance was conducted to compare differences in the corneal power between each instrument pair. The Bland and Altman analysis and Pearson’s correlation were employed to assess agreement and determine strength of relationship between measurements. Results : There were no significant differences in mean corneal power measurements between 2 different visits ( p > 0.05). The Sw and COV values between 2 visits were lower than 0.09 D and 0.20 % respectively. The ICCs were stronger than 0.99 in all instruments. For reproducibility of each instrument, differences of the measurements between 2 different examiners were also insignificant ( p > 0.05). The Sw and COV values between 2 examiners were lower than 0.11 D and 0.23 % respectively. The ICCs were 0.99 and above in all instruments. The 95% limit of agreement between instruments ranged from -0.29 to 1.13 D and the r- values were stronger than 0.84. Conclusion : The corneal power measurements using these 5 instruments were repeatable and reproducible. These instruments can also be used interchangeably, however the topographer should be used with caution.
{"title":"A Comparative Study on the Inter-Session and Inter-Examiner Reliability of Corneal Power Measurement Using Various Keratometry Instruments","authors":"Muziman Syah Mustafa, H. A. Mutalib, Sharanjeet Kaur Ms, Khairidzan Mk","doi":"10.31436/IMJM.V15I1.409","DOIUrl":"https://doi.org/10.31436/IMJM.V15I1.409","url":null,"abstract":"Introduction : The purpose of this study was to evaluate inter-session repeatability, inter-examiner reproducibility and inter-device agreement of corneal power measurements from manual keratometer, autokeratometer, topographer, Pentacam high resolution and IOLMaster. Methods : Two sets of mean corneal power measurements ( n =40) were compared for inter-session repeatability and inter-examiner reproducibility in each instrument. Repeatability and reproducibility were evaluated by within-subject standard deviation (Sw), coefficient of variation (COV) and intraclass correlation coefficient (ICC). A one-way repeated measures analysis of variance was conducted to compare differences in the corneal power between each instrument pair. The Bland and Altman analysis and Pearson’s correlation were employed to assess agreement and determine strength of relationship between measurements. Results : There were no significant differences in mean corneal power measurements between 2 different visits ( p > 0.05). The Sw and COV values between 2 visits were lower than 0.09 D and 0.20 % respectively. The ICCs were stronger than 0.99 in all instruments. For reproducibility of each instrument, differences of the measurements between 2 different examiners were also insignificant ( p > 0.05). The Sw and COV values between 2 examiners were lower than 0.11 D and 0.23 % respectively. The ICCs were 0.99 and above in all instruments. The 95% limit of agreement between instruments ranged from -0.29 to 1.13 D and the r- values were stronger than 0.84. Conclusion : The corneal power measurements using these 5 instruments were repeatable and reproducible. These instruments can also be used interchangeably, however the topographer should be used with caution.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49578533","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}
A. Ralib, N. Hamzah, Majdiah Syahirah Nasir, M. Nor
Introduction: There has been increasing evidence of detrimental effects of cumulative positive fluid balance in critically ill patients. The postulated mechanism of harm is the development of interstitial oedema, with resultant increase morbidity and mortality. We aim to assess the impact of positive fluid balance within the first 48 hours on mortality in our local ICU population. Methods: This was a secondary analysis of a single centre, prospective observational study. All ICU patients more than 18 years were screened for inclusion in the study. Admission of less than 48 hours, post-elective surgery and ICU readmission were excluded. Cumulative fluid balance either as volume or percentage of body weight from admission was calculated over 6, 24 and 48 hour period from ICU admission. Results: A total of 143 patients were recruited, of these 33 died. There were higher cumulative fluid balances at 6, 24 and 48 hours in non-survivors compared to survivors. However, after adjusted for severity of illness, APACHE II Score, they were not predictive of mortality. Sensitivity analysis on sub-cohort of patients with acute kidney injury (AKI) showed only an actual 48-hour cumulative fluid balance was independently predictive of mortality (1.21 (1.03 to 1.42)). Conclusions: Cumulative fluid balance was not independently predictive of mortality in a heterogenous group of critically ill patients. However, in subcohort of patients with AKI, a 48-hour cumulative fluid balance was independently predictive of mortality. An additional tile is thus added to the mosaic of findings on the impact of fluid balance in a hetergenous group of critically ill patients, and in sub-cohort of AKI patients.
{"title":"The Impact of Fluid Balances in the First 48 Hours on Mortality in the Critically Ill Patients","authors":"A. Ralib, N. Hamzah, Majdiah Syahirah Nasir, M. Nor","doi":"10.31436/IMJM.V15I1.401","DOIUrl":"https://doi.org/10.31436/IMJM.V15I1.401","url":null,"abstract":"Introduction: There has been increasing evidence of detrimental effects of cumulative positive fluid balance in critically ill patients. The postulated mechanism of harm is the development of interstitial oedema, with resultant increase morbidity and mortality. We aim to assess the impact of positive fluid balance within the first 48 hours on mortality in our local ICU population. Methods: This was a secondary analysis of a single centre, prospective observational study. All ICU patients more than 18 years were screened for inclusion in the study. Admission of less than 48 hours, post-elective surgery and ICU readmission were excluded. Cumulative fluid balance either as volume or percentage of body weight from admission was calculated over 6, 24 and 48 hour period from ICU admission. Results: A total of 143 patients were recruited, of these 33 died. There were higher cumulative fluid balances at 6, 24 and 48 hours in non-survivors compared to survivors. However, after adjusted for severity of illness, APACHE II Score, they were not predictive of mortality. Sensitivity analysis on sub-cohort of patients with acute kidney injury (AKI) showed only an actual 48-hour cumulative fluid balance was independently predictive of mortality (1.21 (1.03 to 1.42)). Conclusions: Cumulative fluid balance was not independently predictive of mortality in a heterogenous group of critically ill patients. However, in subcohort of patients with AKI, a 48-hour cumulative fluid balance was independently predictive of mortality. An additional tile is thus added to the mosaic of findings on the impact of fluid balance in a hetergenous group of critically ill patients, and in sub-cohort of AKI patients.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41724809","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}
Mohamed Saufi B. Awanga, K. Chan, Z. Zamzuri, Ar Ralib, A. Azlina
Spinal epidural angiolipomas are rare benign tumors. The tumors contain both vascular and mature adipose components. Typically, they present with a progressive clinical course. Acute presentation is rare. We present a case of a fifteen-year-old girl who presented with a sudden onset of backpain followed by paraparesis with bladder and bowel incontinence. Neurological examination showed sensory loss below T10 with Grade 2 motor power. Spinal MRI showed long segment extradural lesion at T6-T9 level. Multiple laminectomy and excision of the tumor containing areas of hemorrhage was performed. Histopathology report revealed angiolipoma.
{"title":"Hemorrhagic Thoracic Spinal Epidural Angiolipoma: A Case Report","authors":"Mohamed Saufi B. Awanga, K. Chan, Z. Zamzuri, Ar Ralib, A. Azlina","doi":"10.31436/IMJM.V13I1.497","DOIUrl":"https://doi.org/10.31436/IMJM.V13I1.497","url":null,"abstract":"Spinal epidural angiolipomas are rare benign tumors. The tumors contain both vascular and mature adipose components. Typically, they present with a progressive clinical course. Acute presentation is rare. We present a case of a fifteen-year-old girl who presented with a sudden onset of backpain followed by paraparesis with bladder and bowel incontinence. Neurological examination showed sensory loss below T10 with Grade 2 motor power. Spinal MRI showed long segment extradural lesion at T6-T9 level. Multiple laminectomy and excision of the tumor containing areas of hemorrhage was performed. Histopathology report revealed angiolipoma.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43954460","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}
Kulliyyah of Medicine, International Islamic University Malaysia (IIUM) was created with the intake of its first batch of students in 1997. It is one of the youngest public medical schools in Malaysia and was initially housed temporarily in the building constructed adjacent to Hospital Tengku Ampuan Afzan (HTAA), Kuantan. The Kulliyyah from inception has had an excellent relationship with the hospital and this has benefitted the public having access to high quality health care services. Subspecialties were established in 2002 with the support of IIUM in the fields of Respiratory Medicine (Internal Medicine), Intensive care (Anesthesia) and arthroplasty (Orthopedics). The subspecialty training in medical and surgical based specialties are a continuous commitment by IIUM.
{"title":"IIUM Teaching Hospital: The Way Forward?","authors":"A. H. Zulkifly","doi":"10.31436/IMJM.V13I1.485","DOIUrl":"https://doi.org/10.31436/IMJM.V13I1.485","url":null,"abstract":"Kulliyyah of Medicine, International Islamic University Malaysia (IIUM) was created with the intake of its first batch of students in 1997. It is one of the youngest public medical schools in Malaysia and was initially housed temporarily in the building constructed adjacent to Hospital Tengku Ampuan Afzan (HTAA), Kuantan. The Kulliyyah from inception has had an excellent relationship with the hospital and this has benefitted the public having access to high quality health care services. Subspecialties were established in 2002 with the support of IIUM in the fields of Respiratory Medicine (Internal Medicine), Intensive care (Anesthesia) and arthroplasty (Orthopedics). The subspecialty training in medical and surgical based specialties are a continuous commitment by IIUM.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44103221","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}
M. Bujang, J. Joehaimey, Kamilov Mk, Sp Jaya Purany, I. Saadon, P. CheeHuan
Introduction: The aim of this study is to determine the most common organisms isolated in diabetic foot infection and the most utilised antibiotic regimes as the first line of treatment. Methods: This is a retrospective record review of the National Orthopaedic Registry Malaysia among diabetes mellitus type 2 patients who had foot infections. All identified cases admitted to 18 government hospitals in Malaysia from the 1st January 2008 until the 31st December, 2009 were included in the study. Results: A total of 416 patients were included in the study. The most common organisms cultured were Proteus species (17.5%), Klebsiella species (17.1%) and Staphylococcus aureus (17.9%), while the most commonly used antibiotic was ampicillin/sulbactam (67.5%). None of the patients was appropriately treated with metronidazole, cefoperazone or fucidic acid. All patients were given appropriate antibiotics to treat Serratia infection. Conclusion: Significant number of patients with diabetic foot infections were not treated using appropriate antibiotics as the first line treatment.
{"title":"Pattern of Organisms and Antibiotics Used in Treating Diabetes Foot Infection","authors":"M. Bujang, J. Joehaimey, Kamilov Mk, Sp Jaya Purany, I. Saadon, P. CheeHuan","doi":"10.31436/IMJM.V15I1.403","DOIUrl":"https://doi.org/10.31436/IMJM.V15I1.403","url":null,"abstract":"Introduction: The aim of this study is to determine the most common organisms isolated in diabetic foot infection and the most utilised antibiotic regimes as the first line of treatment. Methods: This is a retrospective record review of the National Orthopaedic Registry Malaysia among diabetes mellitus type 2 patients who had foot infections. All identified cases admitted to 18 government hospitals in Malaysia from the 1st January 2008 until the 31st December, 2009 were included in the study. Results: A total of 416 patients were included in the study. The most common organisms cultured were Proteus species (17.5%), Klebsiella species (17.1%) and Staphylococcus aureus (17.9%), while the most commonly used antibiotic was ampicillin/sulbactam (67.5%). None of the patients was appropriately treated with metronidazole, cefoperazone or fucidic acid. All patients were given appropriate antibiotics to treat Serratia infection. Conclusion: Significant number of patients with diabetic foot infections were not treated using appropriate antibiotics as the first line treatment.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41345278","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: Solute carrier family 2, member 9 (SLC2A9) is thought to be an important urate transporter that influences the excretion and reabsorption of serum uric acid, thus has a strong effect on serum urate and risk of gout. SLC2A9 polymorphisms have been extensively studied in various populations in association with gout development. Our aim was to test for association of SLC2A9 SNPs with gout in Malay males. Methods: 78 gouty patients and 82 normal subjects were recruited and genotyped for rs3733591, rs5028843 and rs11942223 using PCR-RFLP technique. Single association and haplotype association analyses were conducted using SHEsis online software. Results: rs3733591 and rs5028843 showed association with gout with p value of 0.020 and 0.036, respectively, whilst rs11942223 yielded no association with p value of 0.08 with trend towards susceptibility projecting by OR=3.547, 3.667 and 2.732, respectively. It is noteworthy that haplotype 1/1/1 conferred protection in gout with p value 0.004 (OR=0.324 [0.147-0.716]). Conclusion: This study might suggest an evidence of association of SLC2A9 SNPs with gout among Malay males.
{"title":"Suggestive Evidence of Slc2a9 Polymorphisms Association in Gouty Malay Males","authors":"W. Taib","doi":"10.31436/IMJM.V14I2.432","DOIUrl":"https://doi.org/10.31436/IMJM.V14I2.432","url":null,"abstract":"Introduction: Solute carrier family 2, member 9 (SLC2A9) is thought to be an important urate transporter that influences the excretion and reabsorption of serum uric acid, thus has a strong effect on serum urate and risk of gout. SLC2A9 polymorphisms have been extensively studied in various populations in association with gout development. Our aim was to test for association of SLC2A9 SNPs with gout in Malay males. Methods: 78 gouty patients and 82 normal subjects were recruited and genotyped for rs3733591, rs5028843 and rs11942223 using PCR-RFLP technique. Single association and haplotype association analyses were conducted using SHEsis online software. Results: rs3733591 and rs5028843 showed association with gout with p value of 0.020 and 0.036, respectively, whilst rs11942223 yielded no association with p value of 0.08 with trend towards susceptibility projecting by OR=3.547, 3.667 and 2.732, respectively. It is noteworthy that haplotype 1/1/1 conferred protection in gout with p value 0.004 (OR=0.324 [0.147-0.716]). Conclusion: This study might suggest an evidence of association of SLC2A9 SNPs with gout among Malay males.","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46227204","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}
ABSTRACT Introduction: Knowledge, attitude as well as adoption of pharmacogenomics in clinical practice among the pharmacists and physicians in Malaysia have not been reported. This cross-sectional study explores various facets of the two professions as related to pharmacogenomics to determine the need and preferred method to improve education among them. This study also aims to identify the current state of pharmacogenomics practice in Malaysia to help identify barrier and solution to reap advantages from pharmacogenomics practices. Methods: A questionnaire consisting of 38 questions in five parts was adopted and validated. It explores the respondents’ characteristics, attitude, knowledge, adoption and education. It was distributed online to 1500 pharmacists and physicians over five months. Results: Pharmacists differed from the physicians in terms of attitude, knowledge, adoption and education. Overall, adoption rate of pharmacogenomics was found to be low but its anticipation for future adoption is high, and benefits were reported by healthcare professionals who have used the test in a clinical setting. Majority of respondents had poor to fair knowledge and nearly half have had no prior formal teaching on pharmacogenomics. Interest in the education is very high, and most of them preferred to learn pharmacogenomics via continuous professional education programs. Conclusion: Pharmacogenomics is a field that promises many benefits, but to reap these benefits require its implementation in clinical setting. Pharmacists and physicians need to be equipped with adequate knowledge and positive attitude towards pharmacogenomics. KEYWORDS: Pharmacogenomics, education, attitude, health practitioners
{"title":"Pharmacogenomics Based Practice in Malaysia: The Attitude, Knowledge and Adoption by the Healthcare Professionals","authors":"Salleh MZa, Teh LKa","doi":"10.31436/IMJM.V13I1.491","DOIUrl":"https://doi.org/10.31436/IMJM.V13I1.491","url":null,"abstract":"ABSTRACT Introduction: Knowledge, attitude as well as adoption of pharmacogenomics in clinical practice among the pharmacists and physicians in Malaysia have not been reported. This cross-sectional study explores various facets of the two professions as related to pharmacogenomics to determine the need and preferred method to improve education among them. This study also aims to identify the current state of pharmacogenomics practice in Malaysia to help identify barrier and solution to reap advantages from pharmacogenomics practices. Methods: A questionnaire consisting of 38 questions in five parts was adopted and validated. It explores the respondents’ characteristics, attitude, knowledge, adoption and education. It was distributed online to 1500 pharmacists and physicians over five months. Results: Pharmacists differed from the physicians in terms of attitude, knowledge, adoption and education. Overall, adoption rate of pharmacogenomics was found to be low but its anticipation for future adoption is high, and benefits were reported by healthcare professionals who have used the test in a clinical setting. Majority of respondents had poor to fair knowledge and nearly half have had no prior formal teaching on pharmacogenomics. Interest in the education is very high, and most of them preferred to learn pharmacogenomics via continuous professional education programs. Conclusion: Pharmacogenomics is a field that promises many benefits, but to reap these benefits require its implementation in clinical setting. Pharmacists and physicians need to be equipped with adequate knowledge and positive attitude towards pharmacogenomics. KEYWORDS: Pharmacogenomics, education, attitude, health practitioners","PeriodicalId":53575,"journal":{"name":"International Medical Journal Malaysia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44279595","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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